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News
We have accomplished a great deal since the last newsletter: many trainings, fundraising, course development, writing and research. We have gratitude for the many excellent clinicians we have trained who have compassion and passion in their work with very traumatized individuals. Those trainings would not have taken place if not for the generous donation of time and energy by the many training assistants we have had around the world. We are also very grateful for the support for our fundraising efforts: art auctions, Usana product sales, and generous financial contributions by many individuals.
At the beginning of the new year we received many salutations wishing us peace and joy. It has caused me to reflect on the neural connections required for peace and joy. A dysregulated being cannot experience joy, gratitude, empathy, or peace because those states require the capacity to reduce neural firings and to switch to and increase the tone in a part of the parasympathetic system called the ventral vagal complex. If inner peace isn’t established by yelling “serenity now”, there are a few things in daily life that you can incorporate to at least create the optimal conditions for change.
- Slow down. In everything you do, try pacing yourself. Leave yourself more time to get from place to place. Take frequent breaks to rest, not just to catch up with other work. Spend time every day in quite reflection—even ten minutes makes a difference. Practice slowing down every day. It will require effort because it is a new neural pathway for most of us.
- Stop watching TV at night. You orient approximately every 15 seconds while watching TV, which puts you into high sympathetic arousal or dorsal vagal response (dissociation). This is not exactly the right kind of stimulation and contact we need for brain growth.
- Ward off depression by encouraging neurogenesis, which requires an enriched learning environment: learn a language, play an instrument, do crosswords, learn how to dance.
- Avoid meanness and rudeness in yourself and others. It is a habitual way of relating to others and facilitates a catharsis into high sympathetic arousal and reinforces those stress pathways. There is a difference between being angry and being mean. Anger is a sign that a boundary is being threatened or has been crossed. It is not a permanent state of being. When we are aggressive and angry, we decrease our longevity, damage our brain from the bath of stress hormones and become less attractive—decreased ventral vagal tone and changes in the neuroendocrine system cause wrinkles and weight gain—so if world peace doesn’t move you, at least be concerned about your physical well being and aesthetics. Bearing a grudge is much more harmful to oneself than to the begrudged. Forgiveness is a letting go of resentments that can be measured physiologically. Heart rate, muscle tone, sympathetic arousal, pain levels all improve when we really let go.
- The biggest lie we are told is that we can’t make a difference, we are too small, too insignificant. World peace starts within and between. Like John Lennon wrote so many years ago, we need to be able to imagine it for it to become reality—starting with our personal and professional lives. Start imagining how your life will be different with more joy and peace. The experience of joy requires a reduction of neural firings in the sympathetic system and increased ventral vagal tone. To get there, one has to be in the moment and be really connected to this moment in one’s whole body, emotion, sensation, and thought. It requires a quieting and a movement down from interest and excitement. Most of us do not make the time for the joy. I hope your year becomes more and more joyful and peaceful. I am imagining it right now.
Upcoming Events and Trainings
For more information about all of the events listed below please call 604-693-0090, toll free 866-387-3863, web: www.cftre.com, email: info@cftre.com.
Self Regulation Therapy® Practitioner Training
Significant overwhelming events at anytime in one's life such as motor vehicle accidents, surgeries, or exposure to violence, can result in changes in the nervous system that negatively impact the way a person feels and relates to others. Self Regulation Therapy® (SRT) is a psychophysiological approach aimed at diminishing dysregulation in the nervous system resulting from traumatic events, while increasing neural pathways connected to contentment and joy. SRT facilitates an integration of overwhelming events and returns balance to the nervous system.
This nine-day training occurs over three weekends during which basic psychophysiological treatment skills are taught that include:
- Research on the psychophysiology of trauma and neurobiological development
- Understanding and treatment of traumatic symptoms from the perspective of the autonomic nervous system
- Somatic skills of containment, grounding, centering, resourcing, boundaries, attunement
- Assessment and treatment of developmental derailments that impede self-regulation
- Tracking and titration skills to renegotiate unresolved fight, flight, and freeze
- Integration of psychophysiological work into your current therapeutic approach
Foundation Level SRT Trainings 2008
Vancouver
Mar 28-30, 2008
Apr 18-20, 2008
May 23-25, 2008
Belfast, Northern Ireland
Apr 29-May 1, 2008
Jun 16-18, 2008
Sept 30-Oct 2, 2008
Winnipeg
Spet 20-22, 2008
Oct 18-20, 2008
Nov 8-10, 2008
View SRT brochure for North America on the CFTRE website.
View SRT brochure for the United Kingdom on the CFTRE website.
Advanced Level SRT Trainings 2008
Winnipeg
Apr 11-13, 2008
Jun 6-8, 2008
Sept 5-7, 2008
Oct 24-26, 2008
Vancouver
Nov 14-16, 2008
Jan 16-18, 2009
Mar 20-22, 2009
May 1-3, 2009
View SRT brochure on the CFTRE website.
Balancing Mind and Body To Resolve Trauma: Winnipeg April 7-8, 2008
This two day training in Winnipeg is an introduction to Self Regulation Therapy. SRT is a targeted mind/body approach that helps to resolve the psychological and physiological impact of trauma. Trauma is broadly defined as any event that is overwhelming to an individual. Traumatic experiences range from abandonment, all forms of abuse, and developmental derailments to natural disasters and motor vehicle accidents. In threatening or highly stressful situations, we are hard-wired to react the same as animals with an instinctive, survival-oriented response (fight, flight, or freeze). When this response is not successfully completed, trauma can develop. This excess activation builds up in the nervous system and impairs the person's ability to respond adaptively to life's challenges, both emotionally and behaviorally to self-regulate. Dysregulation, manifests in many disorders including post-traumatic stress disorder, anxiety and mood disorders, phobias, and personality disorders. Physical symptoms of dysregulation include insomnia, asthma, allergies, migraines, tinnitis (ringing in the ears), hyperacusis (sensitivity to sound), photophobia (sensitivity to light), chronic pain, fibromyalgia, chronic fatigue, autoimmune diseases, gastrointestinal difficulties, headaches, pain in neck and back, temporomandibular joint (TMJ) dysfunction, alcohol and drug abuse. SRT is designed to diminish excess activation and enable an individual to complete the thwarted responses of fight, flight, and/or freeze. Once the nervous system is balanced, symptoms begin to resolve. The person experiences an enhanced capacity for joy and for closeness in relationships, as well as increased vitality and resilience in the body. This workshop will introduce participants to the neuroscience theory and research that underpins the SRT model, help practitioners better observe and identify behavioral indicators of past traumatic events and demonstrate how SRT can resolve trauma.
Register with payment before March 1 2008 and cost is $185. Register with payment after March 1 2008 and cost is $205. Students who register with payment before March 1 2008 pay $150.00, after March 1 $205.00. For more information please contact Professional Initiatives at SRTworkshop@mts.net or 204-254-7148.
UK Pediatric Psychology Conference
June 20-22, 2008 Belfast, NI
Psychological Anatomy
Kelowna September 9-14, 2008
In this exciting six-day course we will explore stages of development starting in utero and extending to the teen years. The concomitant conflicts that may arise within the therapy as a result of derailments at any given stage will be discussed. The psychological function of the neuromusculature initiated within each stage will be explicated. In addition, utilizing the most recent psychophysiological research, attachment and the cognitive, and emotional aspects of stage-specific brain development, will be explored. Affective development and its centrality in the capacity to self regulate will be discussed. Therapeutic progress may be slowed or stalled as a result of unresolved developmental challenges that are often misinterpreted as resistance, attention seeking and help-rejecting behaviour, interpersonal conflict, malingering, or character disorders. These misinterpretations lead to frustration, re-wounding of the client, and ultimately premature termination. Strategies for helping clients work through developmental derailments will be presented through experiential and didactic modalities allowing individuals to integrate what they have learned directly into their work on Monday morning. This seminar integrates the work of Daniel Siegel, Allan Schore, Joseph Ledoux, Bruce Perry, and other developmental neuroscientists with clinical and practical applications for professionals.
Post Advanced High Impact Trauma
Saskatoon July 11-13, 2008
Vancouver October 31-November 2, 2008
Post Advanced Medical/Dental Trauma
Vancouver Thursday May 29 to Saturday May 31
Advanced Psychological Anatomy I
Jan 26-31, 2009 Ixtapa Mexico
Advanced Psychological Anatomy II
Feb 9-14, 2009 Ixtapa Mexico
Featured Article
A great many of the questions asked in supervision suggest a strong developmental component. The following article is not meant to discuss in any depth the etiology or treatment of early forming psychopathologies. For a fairly comprehensive review of the literature on developmental dysregulation, I recommend Allan Schore’s two volume set: Affect Regulation and the Repair of the Self and Affect Dysregulation and Disorders of the Self (2003). For an introduction to working with clients who have suffered early dysregulation, I strongly recommend our course Advanced Psychological Anatomy. The purpose of this article is to discuss some basic points relevant to the development of psychopathology and to reassert the importance and necessity of therapist self-care in working with clients who have developmental dysregulation.
Developmentally, different types of unregulated experiences may result in different psychopathological presentations in later life. It is now known that the right hemisphere is in a growth cycle during the first year of life. The right hemisphere is chiefly involved with the perception of the emotional states of others and does so through perceiving nonverbal facial expressions and tone and pacing of speech. The right hemisphere is largely unconscious and communicates its state to other right hemispheres that are attuned to receive these communications. As Freud first noted in 1915, the unconscious of one human being can have an affect upon that of another without passing into consciousness. Freud also proposed that a therapist should “turn his own unconscious like a receptive organ towards the transmitting unconscious of the patient…so the doctor’s unconscious is able… to reconstruct (the patient’s) unconscious”. He called the state of receptive readiness “evenly suspended attention”.
For the brain to learn (or develop), whether it is a set of cognitive skills, a pattern of behaviours or that which involves affect as in social learning of role identification, the brain must operate within a range that is regulated. When the brain is either over-stimulated or under-stimulated, new pathways involved in learning will not be initiated. A “growth-facilitating emotional environment” (Schore) is one in which a mother responds in an appropriate and timely manner to her child’s emotional expressions. In addition, she must also stimulate positive affect in her child without overwhelming him/her. In so doing, she is increasing the child’s ability to cope with stress and inocculating him against trauma-induced psychopathology.
In sub-optimal developmental scenarios, as seen in the case of abuse and neglect, the child is subjected to long periods of negative affect with little or no repair. The mother is less accessible and reacts to her infant’s emotional expressions of stress either inappropriately or rejectingly. As a result, the child is left for long periods in an intensely disruptive psychobiological state with which he cannot cope. When a child’s nervous system is dysregulated, he spends all of his energy attempting to get regulated or manage the dysregulation. Consequently, there is little or no additional energy for learning or development. Traumatized infants do not develop socioemotionally during critical periods of right brain development.
Thus, without emotional resonance from a regulated mother, a child is subject to chronic arousal or understimulation which produces immature, under-developed right orbitofrontal systems that cannot successfully regulate affect. The result is a system which cannot adapt his internal state or behaviour to stressful external demands. All psychiatric disorders may be viewed as an inability to adapt to stress and the continuous activation or inhibition of internal systems that is inappropriate to a particular environmental situation. There are substantial data and numerous researchers who argue that every type of early forming developmental disorders involves altered right orbitofrontal function.
When doing therapy with a client who has suboptimal right orbitofrontal function, or developmental trauma, it is important to realize that the unconscious right brain is the main avenue of communication. Our ability to maintain contact depends in large part on our ability to remain grounded in the felt sense. As our client’s dysregulated immature right brain connects with our regulated mature right brain, his brain is using ours as a template for containment. Helping a client find ways to ground are secondary to our own sense of feeling grounded. As a result we must tolerate or experience a great deal of dysregulation coming from our client’s nervous system. It is demanding work. For practice, the next time you are in an environment where a baby is crying (for me it’s usually on a plane), try remaining present and grounded. Imagine the baby getting just what she needs and let your own nervous system settle.
Holmes (2002) writes “just as a tropical disease expert needs to be immunized against the organism she is likely to encounter, so personal therapy for therapists can be seen as an immunization process, not just to protect them and their patients from themselves, but also to extend the range of experience that therapists can then draw on in working with clients”. Working with clients who have developmental dysregulation takes a lot of energy. Therapists who take care of their own needs for rest, relationships, movement, food and beauty are better able to provide a regulated nervous system for their clients. Strive towards valance in your life and your work with early dysregulated clients can be rewarding. Without your own self-regulation, working with these clients will feel overwhelming, frustrating and eventually lead to burnout.
Questions and Answers
Current themes in recent supervisions
(These questions are composites of many supervision questions and are not meant to shame or embarrass any student. Any similarities to questions you have asked individually are purely coincidental)
Question #1
I am working with a woman who has a lot of trauma in her history. Her mother was in an abusive relationship during her pregnancy and for the first few years of my client’s life. At two years of age she had several surgeries to correct a cleft palate and at one point was declared legally dead during a surgery. When she was five she was placed in a foster home where she experienced sexual and physical abuse. She also has had several car accidents and is currently experiencing anxiety, panic attacks and moderate agoraphobia. Our second session is next week and I wondering where I should begin using SRT?
Answer #1
You have already begun. You did not learn to take a “trauma history” from the SRT training. I suggest that you felt overwhelmed by the dysregulation in this client’s nervous system and as a result, grounded yourself by doing something that was “routine” for you like taking a trauma history. However, in so doing, you increased both her and your activation. While an understanding of a client’s history is relevant, it should unfold as you are forming a relationship. As she likely presented with activation, this would be the place to start. It is helpful (and containing for the client) to stop them from telling you about all the “trauma” that they have experienced as it will only overwhelm them. Stop her! Inform her that you want to hear her story but that you have a lot of time and what is important right now is getting to know each other better. Ask about symptoms rather than incidents. Track symptoms in the present moment. Work with activation: resource, titrate, discharge. Teach, in vivo, about the nervous system. Assure her that there will be lots of time over the next several sessions to hear her story, but that your job is to help her feel better now. When you do begin to work with content (which will also help contain activation) choose something relatively recent, relatively minor, with a good outcome.
Question #2
I have seen my client for three sessions during which we worked through his war experience and two car accidents, only one of which was significant. He is still experiencing difficulty with sleep, anxiety and headaches that are quite painful, yet he cannot remember any other traumas to work on. What should I do?
Answer #2
You will not have worked through the activation of a war experience (even in the absence of two car accidents) in three sessions. Likely he is dissociative and is reporting little at the time of the session, which you are confusing for no activation. In order to work with activation, you will need to slow down. I would suggest working with the most recent minor car accident. Review Advanced I manual. Work peripherally and slowly. Look for signs of dissociation and/or high activation. He obviously has activation as he reports anxiety, sleep problems and headaches.
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