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Fast System

Fast System. Stress. Reset. Slow System. Action. Rest. Control. Trust. Realism. Hope. Autonomy. Affiliation. The Miracle of Small Babies (van der Kolk). “If babies were just the size we are, the world would be a terrifying place.”. Amygdala: The Survival Brain.

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Fast System

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  1. Fast System Stress Reset Slow System Action Rest Control Trust Realism Hope Autonomy Affiliation

  2. The Miracle of Small Babies(van der Kolk) “If babies were just the size we are, the world would be a terrifying place.”

  3. Amygdala: The Survival Brain

  4. Insular Cortex: The “Taste” Brain

  5. Hippocampus: The Wikipedia Brain

  6. Adrenaline Norepinephrine Dopamine Cortisol Endorphins Serotonin Acetylcholine GABA Oxytocin Fast System (Sympathetic) Slow System(Parasympathetic)

  7. Two memory systems • Emotional memory • Alarm system • Concrete, primitive • Unconscious, powerful • Narrative memory • Conscious, context • Fast and slow systems • Chemicals • Feedback loops • Balance

  8. Anterior Cingulate:The Social Brain

  9. Prefrontal Cortex

  10. Google Eyes

  11. 3 Core Assumptions(Janoff-Bulman, 1992) The world is benevolent The world is meaningful The self is worthy

  12. In real life…

  13. When children’s pain isn’t: • Validated • Comforted • Resolved

  14. Power ofSurvival  Sympathetic  Arousal  Parasympathetic  Dissociation  Immunity  Serotonin  Moods  Impulsivity  Attachment problems • Self-regulation  Alcohol/drugs  Reenactment • Self/safety/meaning

  15. Grounding

  16. Social-Emotional Development (Erikson) Basic Trust (1-2) Autonomy vs. Shame (2-4) Initiative vs. Guilt (3-6) Industry vs. Inferiority (6-13) Identity (13-20) Intimacy vs. Isolation (young adult) Generativity vs. Self-Absorption (adult) Integrity vs. Despair (mature adult)

  17. Maslow’s Hierarchy of Needs

  18. The Individual Age Generation Cultures Values Hopes/dreams Sophistication Functioning Understanding Living/working Exposure Resilience

  19. Culture World view Interpretation of events Suffering Expression Interpretation of disorders Psychological “Nervous” Somatic Spiritual Idioms of distress

  20. Strengths • Vulnerabilities • Relationship Gender

  21. genetics SERTPR, 5-HTTLPR, SLC6A4 (serotonin) FKBP5 (cortisol) SLC6A3 (dopamine) APOE (memory, reexperiencing) Epi

  22. Clinical Effects of Trauma

  23. This is your brain on trauma

  24. Acute Stress Disorder Embodied Stress PTSD Brain Injuries Anxiety Somatic Effects SUDs DESNOS Complex Trauma Developmental Trauma Depressive Disorders

  25. DSM-IV Diagnostic Criteria for PTSD

  26. Sympathetic Hyper-everything Anger, irritation Sleeplessness Kindling Parasympathetic Numbing Detachment Avoidance Shutting down Boredom Memory-related symptoms PTSD

  27. Even so… How might post-trauma symptoms be the body’s effort to heal?

  28. Temporary balance Pain relief Self-medication Dulled memories Risk/stimulation Complication

  29. Complex Trauma (a.k.a. Developmental Trauma, DESNOS, “the B-Word”) Assault by neglect Complexity, chronicity, repetition, multiple perps Intimacy (act, perps) Invalidation or punishment Failure of attachment Injury to trust, loss of self Lack of regulation Hypersexuality Dissociation  big trouble

  30. Helpful Distraction, self-soothing, positive stuff Harmful Yelling, cutting, risk taking, self-harm, violence, compulsivity Pleasure just to feel “less bad” Sexual abuse  TRBs and IDU Tension-Reduction Behaviors (TRB)

  31. Somatic Effects  immune function Infection, CFS, fibromyalgia Adrenal challenges Heart, high blood pressure, headaches Hypoadrenia Costs of compulsion Conversion disorder Effects of traumatic injuries

  32. What’s the big question?

  33. Core Issues for Kids

  34. Characteristics Core Issues Traits Roles

  35. Shame

  36. Abandonment

  37. Boundary Issues

  38. Lack of Trust

  39. Denial

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