When

THE PASTIs Always

PRESENT

EMOTIONAL TRAUMATIZATION

ORIGINS

CONSEQUENCES

AND CURES

FELITTI, V.J. (2002)The relationship between adverse childhood events and adult health: Turning Gold into Lead. The PermanenteJournal Volume 6 :1.

Havening has three components

• Recall and activation of an emotional core

• Distraction / other sensory input

• Havening touch

TOUCH• Touch modulates GABA release via serotonin

• Increase in Delta wave production

• Depotentiates activated glutamate receptors

THE EXTRASENSORY RESPONSE TO

Displacement of thought from working memory by distraction

• Humming a tune

• Counting

• Visualizing movement

Extrasensory Responses of Sensory Input Can Change

the brain

• Smell

• Touch

• Auditory

• Sight

• Taste

• Kinesthetic

THE PSYCHOSENSORY THERAPIES

• INVOLVE THE APPLICATION OF SENSORY INPUT TO ALTER BIOLOGICAL FUNCTIONING

• ARE SENSORY RECEPTOR DRIVEN• ARE ELECTROCHEMICAL IN NATURE• THE RESPONSE TO THE SENSORY INPUT CAN

BE LEARNED OR INNATE• THE EFFECT DUE TO AN EXTRASENSORY

RESPONSE

UFS

Awareness vigilance / salience

Flight or fight /Freeze response \ return to normal behavior

Ancient Emotions and Survival Reactive Emotions

Fear Defensive rage

-- most primitive

-- predator driven

Types of Fear

• Freeze, Salience and vigilance

• Flight or fight

• Panic

• Flaccidity / thanatosis

FLIGHT/FIGHT → PANIC

↓

THANATOSIS

Panic Prefrontal Cortex taken off line

Fear is stimulated by our senses

• Olfactory

• Auditory

• Kinesthetic

• Visual

• Gustatory

Fear Activates Physiologic Changesvia the Amygdala

-- increased heart rate

-- pupil dilation

-- heightened sensory awareness

-- increased oxygen availability

-- increased muscle strength

-- inhibition of all non survival activities

-- increases our ability to store and retrieve events

The Amygdala Activates our Emotions and Coordinates our Survival Responses

OUTFLOW FROM CENTRAL NUCLEUS

Emotional StimulusThalamusLA/BLA/AB AmygdalaCe AmygdalaPhysiological Response

RESPONSE BRAIN AREA

Prepare us for Flight or Fight Sympathetic Activation Aid in Danger Evaluation Prefrontal Cortex Motivate us to Action Nucleus Accumbens Increase Salience Ventral Tegmentum Increase Vigilance Locus Coeruleus Cause Freezing Central Grey Mediate Pain Perception Insula and Amygdala

Encoding a Trauma

EVENT

• Increases cortisol and norepinephrine, dopamine• Experienced personally or vicariously • Produces intense emotional response

MEANING

Is about ATTACHMENT

• PHYSICAL• PERSONAL• PUBLIC

LANDSCAPE

The neurochemical state of the brain at any given time.

INESCAPABILITY

A perceived inescapable threatening situation has the potential to traumatize. The perception need not last long, nor is it necessary for this perception to reach conscious awareness. The prefrontal cortex does not inhibit amygdala encoding.

mPFC also inhibits BLC

A TRAUMATIC ENCODING MOMENT

• Requires four conditions• Remains permanently biologically active• Stimulation activates a part or all of the original physiological response• Emotional component synaptically encoded in

the amygdala

Mechanism of Traumatization

Event sensed by thalamus as UFS Signal sent to LA

Activation of Ce Release of NE and Cortisol Inhibition of mPFC

Content and context enters amygdala via LA and hippocampus

Requirements met Glutamate receptors in amygdala potentiated

Binding of components of event Traumatization occurs

Traumatization at the neural level is the process that permanently encodes and synaptically consolidates linkages between the emotional,cognitive, autonomic, and somatosensory components present during the traumatizing event.

Any of the components recalled, either consciously or subconsciously, activates the amygdala and causes the release of stress hormones.

For each reactivation, we experience some or all of the components as if they were happening for the first time.

Traumatic Memory

Conscious activation or inadvertent reminders lead to the recalling of the event and its emotional content.

Components of a traumatic memory

• Emotional – the affective response to an event

• Autonomic – automatic brain functions that regulate body functions

• Cognitive – both conscious and subconscious

• Somatosensory – sensed throughout the body as in pain, tingling, numbness and other sensations

Dissociated Traumatic Memory

Thoughts, feelings and sensations that are experienced when activated by subconscious stimuli that arise from abnormal retrieval.

POTENTIATION OF AMPA GLUTAMATE RECEPTORS AND THEIR STABILIZATION THAT MAKES THEM PERMANENT THE ABSENCE OF FORGETTING

REQUIRES PHOSPHORYLATION OF RECEPTORS

PROTEIN KINASE Mζ –EXPRESSED ONLY IN NEURALTISSUE

PROTEIN KINASE Mζ CONTINUALLY PHOSPORALATESAMPA RECEPTORS BECAUSE IT LACKS A REGULATORY DOMAIN

DURING ELECTRICAL STIMULATION AT 100Hz THE TRANSLATIONOF THE PROTEIN KINASE Mζ FROM RNA TO PROTEIN IS ACTIVATED

PROTEIN KINASE Mζ STABLIZES AND MAKES PERMANENT POST-SYNAPTIC AMAPA RECPTORS.

Mechanism of Traumatization

Stimulus [ unimodal and UFS ] pass through thalamus Signal toAmygdala Fear / defensive rage generated increases NE andCortisol in amygdala Inhibition of mPFC Complex content andContext enter amygdala Four requirements met AMPA GlutamateReceptors in BLC amygdala potentiated BLC modulates binding ofthe components of event A traumatic memory is stored

Thalamo-Amygdala Pathway Generated During Traumatization

CORTEX

Complex Content and Context (directly and via hippocampus)

Thalamus Emotion Producing Stimulus

Electrochemical Transduction

Sensory Input Components

Emotional

Somato- sensory

Autonomic

Cognitive

Lateral Nucleus of Amygdala

AMPA ReceptorAMPA Receptor

Disrupting A Traumatization

Recalling and activating of a traumatic memory requires working memory

• Cognitive conscious / subconscious (feelings)

• Autonomic

• Somatosensory

• Emotional

Retrieval of cognitive and somatosensory component into working memory

• Limited storage focus on one thought

• Short term usage

• Part of the pre frontal cortex

• Controlled by central executive which modulates attention

• Phonological loop auditory and speech information i.e. Verbal commands

• Visual spatial sketchpad visual and spatial information i.e. Ride a bike, imagine doing a physical task

EFFECT OF STIMULATION OF VARIOUS AREAS

DELTA WAVE POWER GENERATED AS MULTIPLE OF RESTING STATE

CHEEK 90X SHOULDER 5-38XPALMS OF HANDS 5X BACK OF HANDS 1.1XKNEE 1XVIBRATING PADS ON PALMS 3-4XLATERAL EYE MOVEMENT 12-20XGAMUT POINT 1.1X MERIDIAN POINTS VS NON MERIDIAN POINTS 1X

Amygdala Pathway Is Disrupted During Depotentiation

STIMULUS AMPA

Receptor Internalized

AMPA

Receptor Internalized

Emotional

Somato- sensory

Autonomic

Cognitive

Lateral Nucleus of Amygdala

DE-POTENTIATION OF AMPA RECEPTORS BY LOW FREQUENCY WAVE

LOW FREQUENCY WAVE OPENS CALCIUM CHANNELS IN ACTIVATED NEURONS

THIS ACTIVATES CALCINEURIN FOR WHICH THE AMPARECEPTOR IS THE CRITICAL SUBSTRATE

PARTS OF AMPA RECEPTOR DEPHOSPHORYLATED

REMOVAL FROM SURFACE AND THUS NO LONGER ABLE TO TRANSMIT… RECEPTOR IS DE-POTETNTIATED

CALCINEURIN INHIBITORS BLOCK THIS EFFECT

THE TIME COURSE IS IN MINUTES, CONSISTENT WITH CLINICAL OBSERVATIONS

ACTIVATION OF POST-SYNATPTIC NEURON BY RECALL