Transcript Slide 1
Stress Reset Fast System Action Control Realism Autonomy Slow System Rest Trust Hope 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 Insular Cortex: The “Taste” Brain Hippocampus: The Wikipedia Brain Fast System (Sympathetic) • Adrenaline • Norepinephrine • Dopamine Slow System (Parasympathetic) • • • • • • Cortisol Endorphins Serotonin Acetylcholine GABA Oxytocin • Two memory systems • Emotional memory – Alarm system – Concrete, primitive – Unconscious, powerful • Narrative memory – Conscious, context • Fast and slow systems – Chemicals – Feedback loops – Balance Anterior Cingulate: The Social Brain Prefrontal Cortex Google Eyes 3 Core Assumptions (Janoff-Bulman, 1992) • The world is benevolent • The world is meaningful • The self is worthy In real life… When children’s pain isn’t: • Validated • Comforted • Resolved Power of Survival Sympathetic Arousal Parasympathetic Dissociation Immunity Serotonin Moods Impulsivity Attachment problems Self-regulation Alcohol/drugs Reenactment Self/safety/meaning Grounding 1. Basic Trust (1-2) 2. Autonomy vs. Shame (2-4) 3. Initiative vs. Guilt (3-6) 4. Industry vs. Inferiority (6-13) 5. Identity (13-20) 6. Intimacy vs. Isolation (young adult) 7. Generativity vs. SelfAbsorption (adult) 8. Integrity vs. Despair (mature adult) Social-Emotional Development (Erikson) Maslow’s Hierarchy of Needs • • • • • • • • • • • Age Generation Cultures Values Hopes/dreams Sophistication Functioning Understanding Living/working Exposure Resilience The Individual • World view • Interpretation of events • Suffering • Expression • Interpretation of disorders – – – – Psychological “Nervous” Somatic Spiritual • Idioms of distress Culture • Strengths • Vulnerabilities • Relationship Gender • SERTPR, 5HTTLPR, SLC6A4 (serotonin) • FKBP5 (cortisol) • SLC6A3 (dopamine) • APOE (memory, reexperiencing) Epi genetics Clinical Effects of Trauma This is your brain on trauma Embodied Stress Acute Stress Disorder Brain Injuries PTSD Anxiety Somatic Effects DESNOS Complex Trauma Developmental Trauma SUDs Depressive Disorders DSM-IV Diagnostic Criteria for PTSD • Sympathetic – Hyper-everything – Anger, irritation – Sleeplessness – Kindling • Parasympathetic – Numbing – Detachment – Avoidance – Shutting down – Boredom • Memory-related symptoms PTSD Even so… How might post-trauma symptoms be the body’s effort to heal? • Temporary balance • Pain relief • Self-medication • Dulled memories • Risk/stimulation • Complication 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 • Helpful – Distraction, selfsoothing, 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) • immune function Somatic Effects – Infection, CFS, fibromyalgia • Adrenal challenges – Heart, high blood pressure, headaches – Hypoadrenia • Costs of compulsion • Conversion disorder • Effects of traumatic injuries What’s the big question? Core Issues for Kids Core Characteristics Issues Roles Traits Shame Abandonment Boundary Issues Lack of Trust Denial