14 th annual trauma symposium racing pulse, toxic stress, shock: the effect of trauma on the brain...
TRANSCRIPT
14th ANNUAL TRAUMA SYMPOSIUM
Racing Pulse, Toxic Stress, Shock: The Effect of Trauma on the Brain
Panelists: 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:
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 BrainReptilian 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 RhythmsEmotions and Heart Rhythms
17Institute of HeartMath
CoherenceFacilitates Brain
Function
Heart Rhythms Directly Impact
Physical and Mental Performance
The heart signals especially affect the brain centers involved in social and situational awareness, the capacity to care, and the ability to self-manage.
IncoherenceInhibits Brain
Function
Institute of HeartMath
Brain cell death Accelerated aging
Impaired memory or learningAlzheimer's
Hypertension Heart disease
CancerObesity
Diabetes
Impact and outcomes of chronic/toxic stress
Stress – cognitive inhibition
Vitality – cognitive facilitation
http://assists.blogspot.com/
Synchronize the Autonomic Nervous System
Emotional LandscapeAutonomic Nervous System – Sympathetic Pathway
High Arousal - Adrenaline
Hormonal System
Low Arousal - AcetylcholineANS - Parasympathetic Pathway
Relaxation
Stre
ss Z
one
Stress-Free Zone
Cortisol DHEA
AngryHostile
ResentfulJudgmentalFrustratedWorriedAnxiousAfraid
JoyfulHappy
EnergizedExcitedCreative
ProductiveAppreciative
Caring
TolerantCalm
CenteredReflective
CompassionateSatisfiedSerene
ForgivingContent
ExhaustedBored
WithdrawnApatheticShamed
DepressedDespairedHopeless
Burned Out
Neg
ative
Emoti
ons
Posi
tive
E
moti
ons
Vitality /Anti Aging HormoneStress / ‘Belly Fat’ Hormone
Negative to neutral, to positive.
EMOTION REGULATION
Cortisol
DHEA
TRAUMA
(photo collage)Little t - BIG T
Jeffrey Brenner, M.D.Medical Director of the Urban Health
Institute at Cooper University Healthcare
More than 15 years ago . . .
Better care at lower cost in America
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
Kaiser Permanente (1997)
Center for Disease Control and Prevention (2009 publication; on-going)
St. Joseph County Community Health Needs Assessment (2012)
Abuse
Dysfunctional Family
Neglect
What Are ACEs?
Prevalence of Adverse Childhood Experiences
Substance abuse 27% Parental sep/divorce 23% Mental illness 17% Battered mother 13%
Adverse Childhood Experiences Are Com m on
Household dysfunction:
Criminal behavior 6%
Abuse: Psychological 11% Physical 28% Sexual 21%
Neglect: Emotional
15%
Physical 10%
ACEs Research: >37,000 Subjects
Adverse Childhood Experience
Social, Emotional, & Cognitive Impairment
Adoption of Health-risk Behaviors
Disease, Disability & Social Problems
Early Death
Scientific Gaps
Death
Conception
Implications
Those with four categories of ACEs 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
Orbitofrontal Cortex Pathological Aggression
Amygdala Fear Anxiety
Executive Function
Reversing the Trajectory
Post Traumatic Stress Disorder
Eye Movement Desensitization and Reprocessing
Post-Traumatic Stress Syndrome
Reliving
Avoiding
Increased Arousal
Eye Movement Desensitisation & Reprocessing
Introduction to EMDR
Acute-Trauma Intervention and Processing
Crisis ManagementImpact of Event Scale53 subjects randomly assignedImmediate/Wait-list
Self Reported Distress from Trauma was statistically significant at p=< .001
Elementary Children
12% ≥ 3 ACEs
1. Health, attendance,
behavior 2. Academic
failure
Court-Involved
YouthHigher ACE ScoresAmong 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%)
Adult AdversityIncarceration
Victim of Intimate Partner Violence
Drug/Alcohol Mental Illness
Divorce
Parenting Adults
with ≥5 ACE
14 TIMESmore likely to
have two or more conditions that make ACEs for
kids
Work injury- illness
HomelessnessDisabilityPoverty
Health limits activity
Unemployment
High School Youth42% ≥ 3 ACEs
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, LCSWMemorial Hospital of South
BendTrauma Center Social Worker