The Brain & Trauma

1. The Brain & Trauma October 4, 2013 – Colorado School Social Workers Association Presented By: Aaron Wiemeier M.S. LPC Online Power Point & Documents: www.allabouttrauma.com

2. Trauma What is Trauma?

3. Trauma Definition: Medical • Injury or insult to body/shock • Experience that is emotionally painful or distressing Psychiatric Both can be Acute or Long Term

4. Trauma Definition: Psychiatric/Emotional Subtypes: • Developmental (1) • Environmental • Secondary

5. Trauma Important Notes: • Trauma is relative • Body/Brain organized to heal trauma naturally • Developmental trauma as harmful as single acute episode (1) • Be aware  Perception of Trauma  What one feels is traumatic another may not

6. Trauma Posttraumatic Stress Disorder Criteria: A) Both 1) experience/witness/confronted  death/serious injury/threat of 2) Response  fear/helplessness/horror

7. Trauma Posttraumatic Stress Disorder Criteria: B) Recurrent thoughts/dreams/feelings  can happen anytime/anywhere similar to day dream – how many of your students “zone out” C) Avoidance of things associated with event  what if the trauma was verbal abuse for “not working hard enough” or doing something to expectation D) Persistent symptoms of increased arousal  sometimes less environmental stimulation is better E) Duration F) Causes clinically significant impairment in academic, social, occupational or other areas of functioning

8. Trauma Trauma Memory Non-Declarative Memory

9. Trauma Trauma Memory • Stored as early as 6 months In-Utero • Stored in Limbic System (Amygdala & Hippocampus) • Much more permanent • Unconscious • Similar to procedural memory

10. Trauma Trauma’s Effect on the Brain

11. Trauma Trauma’s Effect on the Brain • Smaller Hippocampus (long term memory) (3) • Short term memory deficits • Dysfunctional Stress-Response System (Cortisol) (1)

12. Trauma Trauma’s Effect on the Brain Behavioral Because the trauma has affected the structures our brain uses to deal with stress/hurt/pain emotional or otherwise We resort to other less natural and more dysfunctional patterns of dealing such as:

13. Trauma Trauma, the Brain & Behavior: Coping • Anger  The “safest” feeling to express - emotional dysregulation • PTSD/ADHD/SPD/ASD/RAD/ODD/DMDD Comorbidity •  This new diagnostic category includes children exhibiting persistent irritability and severe behavioral outbursts 3 or more times per week for more than 1 year • Emotional Withdrawal/Numbing • Enuresis/Encopresis  primal soothing mechanism • Distraction: creating conflict/cutting etc. • Delayed/Impaired Ability to recognize feelings  categorical “fight or Flight”/all or nothing response

14. Trauma Hierarchy of Self-Protective Brain Responses

15. Trauma & Assessment • Starting Point: Everyone has experienced some form of trauma! What is yours and how might it interact with the students? (Anger Clue) • Become Familiar with Trauma Symptom Checklist (www.allabouttrauma.com) • Know basic differences between common diagnosis (Bipolar/RAD/ADHD comparison) (www.allaboutrauma.com) • Add to assessment measures questions that incorporate secondary/developmental trauma (i.e. what shows/video games do they or their families frequently watch/play – CSI/Call of Duty/Reality Shows/Springer Shows) • Community based secondary trauma  assessments/interventions/protocols that assist staff/students in dealing with these experiences in a way that’s consistent with PTSD integration protocol and current PTSD research ** What is the first and most important step in coping with a trauma initially regardless of its type?

16. Taken From An MTSS Presentation out of Kansas by Dr. Alexa Posny October 9,2009 “I’ve come to the frightening conclusion that I am the decisive element in the classroom. It’s my daily mood that makes the weather. As a teacher, I possess tremendous power to make a child’s life miserable or joyous. I can be a tool of torture or an instrument of inspiration. I can humiliate or humor, hurt or heal. In all situations, it is my response that decides whether a crisis will be escalated and a child humanized or dehumanized.” ~Dr. Haim Ginott “I’ve come to the frightening conclusion that I am the decisive element in the school. It’s my daily mood that makes the weather. As a principal, I possess tremendous power to make a teachers life miserable or joyous. I can be a tool of torture or an instrument of inspiration. I can humiliate or humor, hurt or heal. In all situations, it is my response that decides whether a crisis will be escalated and a teacher or staff member is humanized or dehumanized.” ~Dr. Haim Ginott – Edited by Aaron Wiemeier LPC

17. The Road Block To Healing Trauma Negative Cognitive Message – I am powerless, I deserve bad things, I am not worthy, I am not loveable etc.

18. The Aversive State Trauma Outside does not equal inside • Creates a state of stress that must be reduced eventually • We reduce the stress on one side or the other (inside traditionally is harder to “reduce” and because its tied to trauma and is more permanent. Our environment and thoughts are not nearly as permanent. • Explains Self-Sabotage, Messy Rooms etc.

19. Practical Applications – General Overview The Brain & Trauma

20. The Brain & Trauma Practical Applications for Adults • Our own negative cognitive message = largest trigger • Taking Care of Yourself • Separate the action from the person – right & wrong choice • Time is your “ally” Adult Emotional Regulation 4-7-8

21. The Brain & Trauma Practical Applications for Adults “It’s not how you feel but where you feel” Non-Verbal Body Awareness • 75% of all communication • Eye Contact • Facial Expression • Voice Tone • Posture • Gesture • Timing & Intensity of response (1)

22. The Brain & Trauma Practical Applications for Children & Families Reframing Behavior as Fear-Based • for self as well as child (www.postinstitute.com) • not focusing on surface behavior but what is underneath (Attachment Disorder) • Repetition • Eliminate/Reduce systemic fear-SocietyAdminStaffChild

23. Practical Applications – Children The Brain & Trauma Coping Skill Development & Emotional Awareness • Healing Hand • Method of Loci (memory strategy) • Need to be different types (at least one internal)

24. The Brain & Trauma Practical Applications for Adults Structure & Discipline • Discipline = “to teach” • Consistency/Follow Through • 3 Levels of Choice: Open/You Choose (weighted?) /”I action – base on emotional needs of child at current time Love/Nurturing • Attachment Considerations – hypodermic/good coach approach - how much can they tolerate/grounding statements • Chemistry of Connection/The Connected Child

25. The Brain & Trauma: Resources The Brain Gym Challenge Software: www.cpschallenge.com My Sensory Book: Lauren Kerstein www.laurenkerstein.com

26. The Brain & Trauma: Resources www.myfeelingsworkbook.com

27. Brain, Trauma & MTSS/RTI

28. The Brain & Trauma Family-School-Community = Healthy Resilient Children Thank You For All You Do!

29. The Brain & Trauma References: www.traumaresources.org (Trauma, Brain & Relationship DVD 2000) (1) www.brainconnection.com (2) www.leadershipcouncil.org (3) www.growingchild.com (4) http://library.thinkquest.org (5) Perry, B.D. (1997) Incubator of Terror: Neurodevelopmental Factors in the Cycle of Violence (6) Other Helpful Websites: www.postinstitute.com www.attachment.org