Transcript Emotionally traumatic effects

14th ANNUAL TRAUMA SYMPOSIUM
Racing Pulse, Toxic Stress, Shock:
The Effect of Trauma on the Brain
Panelists:
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Margo DeMont, Ph.D.
Cynthia Lemp, M.S.W.
Kimberlie Warren, Ph.D.
The Effect of Trauma on the Brain
Presentation Objectives
The Learner will be able to:
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Describe the effect of stress on the brain
Explain how to alter emotions to minimize the “flight or
fight” stress response
Identify at least three symptoms of post-traumatic
stress disorder
Describe two physiological changes resulting from
using Acute Trauma Incident Processing with a patient
Bi-directional communication between
the brain and the body via
Autonomic nervous system (ANS)
ALLOSTATIC
LOAD
Amygdala Hijacking
The CEO is
out of
commission!
Emotionally traumatic effects
• “Multiple conflicts, wars…and personal
trauma from accidents, abuse, disaster,
bullying…large numbers of individual psyches
and family systems have been traumatized.
The emotional devastations come from the
same emotions that can be powerful
emotional catalysts for healing.”
(www.energeticinstitute.com.au)
Reptilian versus Thinking Brain
Reptilian and
limbic, sub-cortical
areas mediate
emotional life.
Healing and rewiring
emotional responses and defenses
occurs in older brain areas.
The heart – brain connection
EMOTIONS AS
ENERGY SOURCES
Energetic frequencies
Positive (high),
negative (low)
Emotions and Heart Rhythms
Institute of HeartMath
17
Heart Rhythms
Directly Impact
Physical and Mental
Performance
Incoherence
Inhibits Brain
Function
Institute of HeartMath
The heart signals especially
affect the brain centers
involved in social and
situational awareness, the
capacity to care, and the
ability to self-manage.
Coherence
Facilitates Brain
Function
Impact and outcomes of chronic/toxic stress
Brain cell death
Alzheimer's
Accelerated aging
Impaired memory or learning
Hypertension
Heart disease
Obesity
Cancer
Diabetes
Stress – cognitive
inhibition
Vitality – cognitive
facilitation
Synchronize the Autonomic Nervous System
http://assists.blogspot.com/
Emotional Landscape
Exhausted
Bored
Withdrawn
Apathetic
Shamed
Depressed
Despaired
Hopeless
Burned Out
Negative
Stress / ‘Belly Fat’ Hormone
Joyful
Happy
Energized
Excited
Creative
Productive
Appreciative
Caring
Emotions
Hormonal System
DHEA
Vitality /Anti Aging Hormone
Positive
Cortisol
Emotions
Angry
Hostile
Resentful
Judgmental
Frustrated
Worried
Anxious
Afraid
Tolerant
Calm
Centered
Reflective
Compassionate
Satisfied
Serene
Forgiving
Content
Low Arousal - Acetylcholine
ANS - Parasympathetic Pathway
Relaxation
Stress-Free Zone
Stress Zone
Autonomic Nervous System – Sympathetic Pathway
High Arousal - Adrenaline
EMOTION
REGULATION
Negative to neutral,
to positive.
Cortisol
DHEA
TRAUMA
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(photo collage)
Little t
- BIG T
Jeffrey Brenner, M.D.
Medical Director of the Urban Health Institute at
Cooper University Healthcare
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More than 15 years ago . . .
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Better care at lower cost in America
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The largest and most valuable health study
ever done.
Adverse Childhood Experiences:
A Chronic Public Health Disaster
Adverse Childhood Experiences Study the Largest Public Health Study You Never Heard Of
Adverse Childhood Events
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Kaiser Permanente (1997)
Center for Disease Control and Prevention (2009
publication; on-going)
St. Joseph County Community Health Needs
Assessment (2012)
What Are ACEs?
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Abuse
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Dysfunctional Family
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Neglect
Prevalence of Adverse
Childhood Experiences
Adverse Childhood Experiences Are Common
Household dysfunction:
Substance abuse
Parental sep/divorce
Mental illness
Battered mother
Criminal behavior
27%
23%
17%
13%
6%
Abuse:
Psychological
Physical
Sexual
11%
28%
21%
Neglect:
Emotional
Physical
15%
10%
ACEs Research: >37,000 Subjects
Death
Early
Death
Disease, Disability
& Social Problems
Adoption of Health-risk
Behaviors
Social, Emotional, &
Cognitive Impairment
Adverse Childhood Experience
Conception
Scientific
Gaps
Implications
Those with four categories of ACEs
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240% higher risk of hepatitis
390% higher risk of COPD (emphysema or chronic
bronchitis)
240% higher risk of STDs
Twice as likely to smoke
Twelve times as likely to have attempted suicide
Seven times higher risk to be an alcoholic
Ten times higher risk of injecting street drugs
Trauma, Toxic Stress and the Brain
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Orbitofrontal Cortex
 Pathological Aggression
Amygdala
 Fear
 Anxiety
Executive
Function
Reversing the Trajectory
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Post Traumatic Stress Disorder
Eye Movement Desensitization and
Reprocessing
Post-Traumatic Stress Syndrome
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Reliving
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Avoiding
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Increased Arousal
Eye Movement Desensitisation &
Reprocessing
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Introduction to EMDR
Acute-Trauma
Intervention and Processing
Crisis Management
Impact of Event Scale
53 subjects randomly assigned
Immediate/Wait-list
Self Reported Distress from Trauma was
statistically significant at p=< .001
Adult
Adversity
Elementary
Children
12% ≥ 3
ACEs
1. Health,
attendance,
behavior
2. Academic
failure
High
School
Youth
42% ≥ 3
ACEs
CourtInvolved
Youth
Higher ACE Scores
Among those with ≥4:
51% special ed. (vs. 33%
0-1)
74% below 2.0 GPA
(58%)
85% suspended by
2nd (71%)
33% re-offend in 2
years (13%)
Incarceration
Victim of
Intimate
Partner
Violence
Drug/Alcohol
Mental Illness
Work injuryDivorce
illness
Homelessness
Disability
Poverty
Health limits
activity
Unemployment
Parenting
Adults
with ≥5 ACE
14 TIMES
more likely to
have
two or more
conditions
that make
ACEs for kids
Community Partnerships to Build a Network
for ACEs Intervention and Prevention
We are committed to
Trauma-Informed Care:
Proving a safe environment that
promotes healing and recovery
EMDR in Practice
Demonstration
Cynthia Lemp, MSW, LCSW
Memorial Hospital of South Bend
Trauma Center Social Worker