Somatic Approaches Treating biopsychosocial Impacts of Trauma

SOMATIC APPROACHES TO TRAUMA TREATMENT - SECTION B

Somatic Approaches to Treating Biopsychosocial Impacts of Trauma

PACE Attitude – Quality of Contact Playfulness – A willingness to laugh, joke and play even in difficult

situations. Pulls an individual out of fight flight into frontal lobe and limbic connection.

Acceptance – Acceptance builds a context of safety and connection. Accepting is not agreeing or supporting but just recognizing reality when it is present.

Curiosity – Curiosity is the hallmark of social engagement. This pulls an individual out of fear or anger states and into the state where new possibilities can arise. It begins to support decreased stress reaction and increase parasympathetic tone.

Empathy – The experience of being understood develops the ability to care for one’s self. Creates a context of safety and understanding. This allows for an individuals guard to go down and the shift into more curiosity and possibility.

The Hidden Epidemic – ACEs

The Hidden Epidemic – ACEs

Finding Our Cultural Location

The Hidden Epidemic – ACEs

It is not all in your head…

Picard, M. et al. (2014) Mitochondrial allostatic load puts the ‘gluc’ back in glucocorticoidsNat. Rev. Endocrinol. doi:10.1038/nrendo.2014.22

Clinical Review – The Human Impact

Trauma exposer increases the incident of paradoxical and complex reactions to medications.

DM-II: Hypothalmic-pituitary-adrenal activity is enhanced in patients DM-II related complications and the degree of cortisol relates to presence and number of diabetes complications. Journal Diabetes Care - Cortisol Secretion in Patients With Type 2 Diabetes - doi: 10.2337/dc06-1267

Clinical Case – Discussion

HPA Axis is Triggered

in Extreme Stress• It is a hormone

triggered system and is not triggered by direct nerve stimulation.

• This sets a global activation state for the whole body.

• It is meant to be time limited. To turn off and to turn on.

Polyvagal TheoryThe way it works… V.V.C. Brake

Disengages

Sympathetic Nervous system

Engages V.V.C Brake Engaged at rest and Socially Engaged.

DMNX EngagesShutting Down Consciousness

Deer Orienting… https://www.youtube.com/watch?v=fUnX65RmPko

Coherence in Birdshttps://www.youtube.com/watch?v=DmO4Ellgmd0

Polar Bear Freeze State https://www.youtube.com/watch?v=eT4060GeodI

Opossum Freeze Statehttps://www.youtube.com/watch?v=sNNCBCqdHQs&index=3&list=PLKt47oQNSAs5AQSZtMt5Pv5oPXTkEJIl7

Gazelle Saved by Baboons: Comes out of Freezehttps://www.youtube.com/watch?v=xmF52x3EJso&index=6&list=PLKt47oQNSAs5AQSZtMt5Pv5oPXTkEJIl7

Pathways of Care - 3 Core Impacts +1

PTSD Treatment Addressing Impact of PTSD and Acute Stress Reactions

Trauma Informed Care Addressing sub-syndromal impacts of high stress and adverse events

Trauma Informed Disease ManagementImpact of Stress and Dysregulation on Health Conditions

+1 - Providers are People First Impact of Patient Trauma on Treatment Providers

Sensory Motor Therapy Notices the three levels (or four if using

Perry’s system) of functioning how these are effecting function.

Adapts the intervention to the area of function most likely to produce integration.

Speaks the language of the brain system most likely to lead to integration.

Somatic Experiencing Trauma is a Feedback Loop

High Arousal

Unsuccessful Escape

Experiencing

Fear and Hopelessn

essImmobiliza

tion

Trauma Based

Meaning/Cog

Somatic Experiencing Supporting the Innate Drive to Health

Payne, P., Levine, P. A., & Crane-Godreau, M. A. (2015). Somatic experiencing: using interoception and proprioception as core elements of trauma therapy. Frontiers in psychology, 6, 93. http://dx.doi.org/10.3389/fpsyg.2015.00093

Clinical Tools – Treatment Relationships

Bruce Perry’s “4 Steps” Regulate Self – When we are stressed we have

non-verbal cues that indicate to those we are around we are stressed. Individuals exposed to trauma have a heightened sensitivity to these cues (Facial Expression of Emotion Studies).

Regulate Other – Actively help your patient regulate. Use a stress reduction tool, distraction technique or simply become more interesting then their stress.

Attune – Engage the ‘Serve and Return’ style. When people feel seen, heard and understood they shift from stress to rest.

Reason – Once some one is regulated they are more available to reason. Signs of regulation are good eye contact, taking a deep breath, borboygmi, expression of curiosity (indicates frontal lobe is working again).

Exercise Tracking State Changes

Watch the video of Peter working with Ray. Observe the non-verbal conversation. Watch for changes in states or what Dr. Crane calls ‘Preparatory Set.’

1. Each member of the class take one state sign: Fight, Flight or Freeze.

2. Every time there is a change in state hold up the sign for the state change.

Payne, P., & Crane-Godreau, M. A. (2015). The preparatory set: a novel approach to understanding stress, trauma, and the bodymind therapies.Frontiers in human neuroscience, 9, 178.http://journal.frontiersin.org/article/10.3389/fnhum.2015.00178/full