Body Memory and Sensations

1. Body Memory and Sensations Maryann Williams, MEd Ft. Bragg Schools Body memory and the discharging of sensations are the third tier of the TLC training. This is of great interest to me, I think it�s an untapped area that we are just starting to learn more about in the arena of children. During this phase of the training I was with many massage therapist and crainiosacrol therapist. They are in the business of releasing trauma � through body energy discharge � a very different approach than we take in our �talk type settings.� I think we really need to be aware of the work being done in this arena of trauma therapy and see how we could possibly use it in our setting. Body memory and the discharging of sensations are the third tier of the TLC training. This is of great interest to me, I think it�s an untapped area that we are just starting to learn more about in the arena of children. During this phase of the training I was with many massage therapist and crainiosacrol therapist. They are in the business of releasing trauma � through body energy discharge � a very different approach than we take in our �talk type settings.� I think we really need to be aware of the work being done in this arena of trauma therapy and see how we could possibly use it in our setting.

2. Bessel van der Kolk If it is true that at the core of our traumatized and neglected patients� disorganization is the problem that they cannot analyze what is going on when they re-experience the physical sensations of past trauma, but that these sensations just produce intense emotions without being able to modulate them, then our therapy needs to consist of helping people to stay in their bodies and to understand these bodily sensations. And that is certainly not something that any of the traditional psychotherapies, which we have all been taught, help people very well. We heard this name earlier - ReadWe heard this name earlier - Read

3. The Body Remembers(Babette Rothchild) Trauma � a psychophysical experience Effects body and mind PTSD first appeared in DSM III, 1980 For children 1994 Somatic disturbance is at the core of PTSD Many suggest that dissociation during the traumatic event predicts development of PTSD Reference: THE BODY REMEMBERS BY BABETTE ROTHCHILD Trauma is psychophysical, even when the body is not harmed. Trauma effects the body and the mind. Again as we said yesterday, PTSD first appeared in DSMIII in 1980 � before that it was called battle fatigue, shell shock � it was referred to mostly in military terms It was once believed that children didn�t suffer from PTSD � that they would just forget about what happened to them � or that they really couldn�t internalize what took place � little did the mental health profession understand, that that was exactly what kids did � internalize in their bodies what took place, which in turn changed their core belief system and outlook on life. Now it is the #1 diagnoses for children in most residential mental health settings People who suffer from PSTDare plagued with many of the same frightening body symptoms that are characteristics that they experienced during the event�accelerated heart rate, cold sweating, rapid breathing, heart palpitations, hypervigilance and hyperstartle response. When chronic, these lead to sleep disturbances, loss of appetite, sexual dysfunctions and difficulties concentrating and attending. Rothchild says somatic disturbances are the core of PTSD. It is suggested that dissociation during the traumatic event predicts the development of PTSDReference: THE BODY REMEMBERS BY BABETTE ROTHCHILD Trauma is psychophysical, even when the body is not harmed. Trauma effects the body and the mind. Again as we said yesterday, PTSD first appeared in DSMIII in 1980 � before that it was called battle fatigue, shell shock � it was referred to mostly in military terms It was once believed that children didn�t suffer from PTSD � that they would just forget about what happened to them � or that they really couldn�t internalize what took place � little did the mental health profession understand, that that was exactly what kids did � internalize in their bodies what took place, which in turn changed their core belief system and outlook on life. Now it is the #1 diagnoses for children in most residential mental health settings People who suffer from PSTDare plagued with many of the same frightening body symptoms that are characteristics that they experienced during the event�accelerated heart rate, cold sweating, rapid breathing, heart palpitations, hypervigilance and hyperstartle response. When chronic, these lead to sleep disturbances, loss of appetite, sexual dysfunctions and difficulties concentrating and attending. Rothchild says somatic disturbances are the core of PTSD. It is suggested that dissociation during the traumatic event predicts the development of PTSD

4. Consequences of Trauma and PTSD Vary greatly Reduced quality of life Body signals misread Vicious cycles take place Can lead to phobias Panic attacks Illness The consequences of trauma and PTSD vary greatly depending on the age of the victim the nature of the trauma and the response and support of others. Those afflicted with PTSD suffer reduced quality of life due to intrusive symptoms. They may alternate from periods of overactivity with periods of exhaustion. Reminders of the trauma may appear suddenly causing instant panic and anxiety � leaving the victim confused and overwhelmed. Body signals that once provided essential information, now become dangerous. The ability to orient danger and safety becomes decreased. It can become a vicious cycle for people suffering from PTSD.The consequences of trauma and PTSD vary greatly depending on the age of the victim the nature of the trauma and the response and support of others. Those afflicted with PTSD suffer reduced quality of life due to intrusive symptoms. They may alternate from periods of overactivity with periods of exhaustion. Reminders of the trauma may appear suddenly causing instant panic and anxiety � leaving the victim confused and overwhelmed. Body signals that once provided essential information, now become dangerous. The ability to orient danger and safety becomes decreased. It can become a vicious cycle for people suffering from PTSD.

5. Developing Brain Healthy attachment between infant and caretaker = infant can self-regulate Early experiences are crucial to optimal organization and development of the brain It is suggested that some people are more predisposed to PTSD than others, based on their early life � and their needs being unmet � leading to faulty brain development If a child is raised in a safe, nurturing environment and has a healthy attachment to his caretaker the child will learn to self=regulate. As we saw in trauma and its effects of learning, at first the caretaker helps the child regulate its responses to stimuli, including being uncomfortable from hunger, thirst, wetness, cold, pain, etc. Gradually, the caretaker does less and then the child in regulating his emotional responses: frustration, anger, loneliness, fear and excitement. It is suggested that some people are more prone to PTSD based on their early life situation and their needs going unmet. If a child is raised in a safe, nurturing environment and has a healthy attachment to his caretaker the child will learn to self=regulate. As we saw in trauma and its effects of learning, at first the caretaker helps the child regulate its responses to stimuli, including being uncomfortable from hunger, thirst, wetness, cold, pain, etc. Gradually, the caretaker does less and then the child in regulating his emotional responses: frustration, anger, loneliness, fear and excitement. It is suggested that some people are more prone to PTSD based on their early life situation and their needs going unmet.

6. Conditioned Memory Classical Conditioning Pavlov�s dog � responds to bell Underlying phenomenon of traumatic triggers Same triggers can later produce similar body responses Example � Raped woman Classical conditioning should be a term you are familiar with. We all remember Pavlov�s dog � in his experiment Pavlov rang and bell, then presented food to a hungry dog. He repeatedly rang the bell just before serving the food. The dog would salivate each time. Eventually Pavlov removed the food and only rung the bell, the dog still salivated. It was now a conditioned response. During a traumatic event, many cues can become associated or conditioned with trauma and therefore the response is conditioned. Let me give you an example: Jane is raped by a man in a red shirt and she is very afraid. She later becomes fearful of anything the color red. If enough information was recorded explicitly in her brain � then she might be able to make the connection herself � red reminds me of the time I was raped. However, even if she doesn�t remember in her explicit brain � the implicit brain remembers and she is full of body sensations that she can�t make sense of � heart beats faster, sweats, difficulty breathing, etc. She might think something is wrong with her � which adds to the discomfort � what is wrong with me? Maybe later she walks down the street and there is a display of red shirts in a store window. Again her body reacts � heart beat, dizziness, she doesn�t know what is wrong and she goes into a full blown panic attack. If she still doesn�t make a conscious connection with the original event, she might conclude that this street is dangerous, and therefore she stops walking down this street and then later determines that any street could be dangerous, so she becomes acrophobic. This is distressful � the color red is a trigger to this woman. - Perhaps through a drawing activity, this could be discovered � or perhaps it will never be connected, but this woman still has body memory to deal with. (Tell Carolyn story � June 7th � panic attacks) � anniversaries � same weather, perhaps doing the same type of chores, etc. (School Christmas Sing � Marshal story) (Tell Patrick story � rain/sadness) Classical conditioning should be a term you are familiar with. We all remember Pavlov�s dog � in his experiment Pavlov rang and bell, then presented food to a hungry dog. He repeatedly rang the bell just before serving the food. The dog would salivate each time. Eventually Pavlov removed the food and only rung the bell, the dog still salivated. It was now a conditioned response. During a traumatic event, many cues can become associated or conditioned with trauma and therefore the response is conditioned. Let me give you an example: Jane is raped by a man in a red shirt and she is very afraid. She later becomes fearful of anything the color red. If enough information was recorded explicitly in her brain � then she might be able to make the connection herself � red reminds me of the time I was raped. However, even if she doesn�t remember in her explicit brain � the implicit brain remembers and she is full of body sensations that she can�t make sense of � heart beats faster, sweats, difficulty breathing, etc. She might think something is wrong with her � which adds to the discomfort � what is wrong with me? Maybe later she walks down the street and there is a display of red shirts in a store window. Again her body reacts � heart beat, dizziness, she doesn�t know what is wrong and she goes into a full blown panic attack. If she still doesn�t make a conscious connection with the original event, she might conclude that this street is dangerous, and therefore she stops walking down this street and then later determines that any street could be dangerous, so she becomes acrophobic. This is distressful � the color red is a trigger to this woman. - Perhaps through a drawing activity, this could be discovered � or perhaps it will never be connected, but this woman still has body memory to deal with. (Tell Carolyn story � June 7th � panic attacks) � anniversaries � same weather, perhaps doing the same type of chores, etc. (School Christmas Sing � Marshal story) (Tell Patrick story � rain/sadness)

7. Somatic Memory Implicit Memory � core of somatic memory Somatic memory relies on network of nervous system One perceives the world through their senses Body exercise Memory can be recalled Individuals with PTSD suffer inundation of images, sensations, and behavioral impulses (implicit memory) disconnected from context, concepts and understanding (explicit memory). Somatic memory, part of the implicit memory, relies on the communication network of the body�s nervous system. It is through the nervous system, via synapses, that information is transmitted between the brain and all the points of the body. We perceive the world through our senses. We are going to do a little body exercise to make us more aware of our sensations: Do Body exercise pg 39 Memory of an event stored in the implicit memory as sensations can sometimes be elicited if similar sensory input is replicated. Just about everyone has at one time or another experienced sensory based memory recalled by a trigger: a song, a smell, a taste, a time of year: �Oh my gosh, I hadn�t thought about that in year!� It could be positive or negative � but it happens all the time. And you may not ever know what caused the memory to trigger. You may be asking yourself, �Why did I think about that now?� Baby powder - THOSE ARE GOOD MEMORIES AND I STAY WITH THEM AWHILE, WHAT DO SMELLS DO TO YOUR BODY WHEN IT�S A BAD MEMORYIndividuals with PTSD suffer inundation of images, sensations, and behavioral impulses (implicit memory) disconnected from context, concepts and understanding (explicit memory). Somatic memory, part of the implicit memory, relies on the communication network of the body�s nervous system. It is through the nervous system, via synapses, that information is transmitted between the brain and all the points of the body. We perceive the world through our senses. We are going to do a little body exercise to make us more aware of our sensations: Do Body exercise pg 39 Memory of an event stored in the implicit memory as sensations can sometimes be elicited if similar sensory input is replicated. Just about everyone has at one time or another experienced sensory based memory recalled by a trigger: a song, a smell, a taste, a time of year: �Oh my gosh, I hadn�t thought about that in year!� It could be positive or negative � but it happens all the time. And you may not ever know what caused the memory to trigger. You may be asking yourself, �Why did I think about that now?� Baby powder - THOSE ARE GOOD MEMORIES AND I STAY WITH THEM AWHILE, WHAT DO SMELLS DO TO YOUR BODY WHEN IT�S A BAD MEMORY

8. Sensory Memory and Trauma Memories are encoded both explicitly and implicitly Typical PTSD � missing explicit memory necessary to make sense of their body sensations Understand body sensations Feel and identify Flashbacks Van der Kolk says in his article, �The body keeps score.� Memories of traumatic events are encoded just like other memories. Typically those with PTSD are missing the explicit component to their memory, so they have difficulty making sense of what is happening. One of the goals of helping those through trauma is to understand their body sensations. The must first feel and identify sensations on the body level. Then they must use language to name and describe them, narrating what meaning the sensations have for them in their current life. At times, it then can become possible to clarify the relationship to past trauma. A word about flashbacks � on a sensory level flashback feel like they are happening now They can be triggered by sensations - something seen, heard, tasted or smelled, anniversaries, weather. Or it could be a body position or a body action that is the source of triggers, especially in cases of rape, physical abuse and sexual abuse. Remember, nightmares can be forms of flashbacks. Just an aside � at times stimulants like coffee, tea, cola and even some medications can elicit triggers because of the accelerated heart rate. Babette Rothchild in her books tells about one client who periodically would have panic attacks � she had him keep a journal of what he would do each day, including what he ate, and they noticed together that on the days he drank more than one cup of coffee he would have a panic attack � the caffeine accelerated his heart rate, which triggered a body memory of a traumatic event and he panicked. His treatment was simple � don�t drink caffeinated beverages. Van der Kolk says in his article, �The body keeps score.� Memories of traumatic events are encoded just like other memories. Typically those with PTSD are missing the explicit component to their memory, so they have difficulty making sense of what is happening. One of the goals of helping those through trauma is to understand their body sensations. The must first feel and identify sensations on the body level. Then they must use language to name and describe them, narrating what meaning the sensations have for them in their current life. At times, it then can become possible to clarify the relationship to past trauma. A word about flashbacks � on a sensory level flashback feel like they are happening now They can be triggered by sensations - something seen, heard, tasted or smelled, anniversaries, weather. Or it could be a body position or a body action that is the source of triggers, especially in cases of rape, physical abuse and sexual abuse. Remember, nightmares can be forms of flashbacks. Just an aside � at times stimulants like coffee, tea, cola and even some medications can elicit triggers because of the accelerated heart rate. Babette Rothchild in her books tells about one client who periodically would have panic attacks � she had him keep a journal of what he would do each day, including what he ate, and they noticed together that on the days he drank more than one cup of coffee he would have a panic attack � the caffeine accelerated his heart rate, which triggered a body memory of a traumatic event and he panicked. His treatment was simple � don�t drink caffeinated beverages.

9. Emotions and the body Emotions are experienced by the body What emotion looks on the outside of the body � tells others What emotion feels on the inside of the body � tells ourselves FEEL Somatic Basis of emotion exercise Emotions are in integral experience of the body � they are connected to our nervous system. . There is an inside emotion and an outside emotion. Outwardly our emotions are telling others what we feel. But also each emotion feels different on the inside of the body � this is what we are telling ourselves, they don�t always match. The English language is a bit awkward when it comes to differentiating the conscious experience of emotions from body sensations. The word FEELING usually stands for both. I feel sad and I feel a lump in my throat. Emotions have a distinct link with the body �again our sayings prove it. He�s a pain in the neck. I�m all choked up. She makes me sick. I could burst. I can�t look you in the eye. He cracks me up. Emotions are expressed from the first moments outside of the womb � inside and outside our bodies � What does a babies crying mean � I�m cold, I�m hungry, I�m tired � outwardly it�s one thing, and we guess what is going on inwardly. Somatic Basis of Emotion - exercise Pg 60Emotions are in integral experience of the body � they are connected to our nervous system. . There is an inside emotion and an outside emotion. Outwardly our emotions are telling others what we feel. But also each emotion feels different on the inside of the body � this is what we are telling ourselves, they don�t always match. The English language is a bit awkward when it comes to differentiating the conscious experience of emotions from body sensations. The word FEELING usually stands for both. I feel sad and I feel a lump in my throat. Emotions have a distinct link with the body �again our sayings prove it. He�s a pain in the neck. I�m all choked up. She makes me sick. I could burst. I can�t look you in the eye. He cracks me up. Emotions are expressed from the first moments outside of the womb � inside and outside our bodies � What does a babies crying mean � I�m cold, I�m hungry, I�m tired � outwardly it�s one thing, and we guess what is going on inwardly. Somatic Basis of Emotion - exercise Pg 60

10. So what do we do? First do no harm � let the child do the leading � don�t assume you know Recognize it is not possible to resolve a trauma when a child lives in an unsafe environment Help the child feel safe Explore triggers and remove them if possible Help the child resource Safe place to live, extra locks on doors, making phone calls, staying away from certain people, finding safe family members, join a group How to access help Physical strength training Spiritual resources So what do we do now that we know the body and mind are connected or disconnected in trauma and for that matter every day life. First � do no harm � let the child do the leading � don�t assume you know what is going on inside that child � whenever I think I have someone figured out, they do something to let me know I don�t Recognize that it is not possible to resolve a trauma when a child lives in an unsafe environment � your job might just be to offer 30 minutes of respite and talk. Your job might be in helping the child feel safe. Your job might be helping the child explore triggers that puts his body in alert or in dissociation These children need coping mechanisms and safety. 3. We can do that through helping a child resource = are they in a safe place to live, do they know how to make phone calls, instruct them on staying away from certain people � dad when he�s drunk, mom when she�s mad, etc. Work with the gym teacher to help increase physical strength in these children � they will feel safer and more capable. Discuss spiritual resources if appropriate Often we see chronic stress, trauma and chaos in the lives of many of our children. Bill Steele says to work with the most recent event and go from there. Camille�s story � too activated to work within a school environment So what do we do now that we know the body and mind are connected or disconnected in trauma and for that matter every day life. First � do no harm � let the child do the leading � don�t assume you know what is going on inside that child � whenever I think I have someone figured out, they do something to let me know I don�t Recognize that it is not possible to resolve a trauma when a child lives in an unsafe environment � your job might just be to offer 30 minutes of respite and talk. Your job might be in helping the child feel safe. Your job might be helping the child explore triggers that puts his body in alert or in dissociation These children need coping mechanisms and safety. 3. We can do that through helping a child resource = are they in a safe place to live, do they know how to make phone calls, instruct them on staying away from certain people � dad when he�s drunk, mom when she�s mad, etc. Work with the gym teacher to help increase physical strength in these children � they will feel safer and more capable. Discuss spiritual resources if appropriate Often we see chronic stress, trauma and chaos in the lives of many of our children. Bill Steele says to work with the most recent event and go from there. Camille�s story � too activated to work within a school environment

11. Oases, Anchors and Safe Places Oases � an activity that demands concentration and attention � knitting, computer games, solitaire, journaling, stamping, painting, reading, sports Reduces hyperarousal as well as quieting the internal dialogue Some tools of the trade include: oases, anchors and safe places An oases is an activity that demands your concentration and attention: like knitting, computer games, solitaire, journaling, stamping, painting, reading and sports. In Dr. Phil�s new book, Family First, he describes a boy who lives in a dysfunctional family system � the dad�s an alcoholic, and typically emotionally unavailable to the boy, they are very poor, the mother works 2 jobs to try to provide food for her family, life is emotionally barren, full of desperation and drama with one crisis after another. The 12 year old boy would wander around the streets at night � he made almost no connection with his family � climbing in and out of his window, rather than dealing with his family. But the one thing the boy has is sports � he calls it an �absolute godsend.� Through sports he found his self esteem and an acceptable outlet for his anger � that he doesn�t understand, but he knows is there. If you read his book, you will recognize that this is Dr. Phil. If you know the story of Oprah � you know her life was also very dysfunctional � abandoned by her mother and father for a time, raised by her grandparents, dirt poor � sexually abused by an uncle � later having to live with her father and so on, she also had an oases and it was books. Maybe both Dr. Phil and Oprah made it through the chaotic times because they had an oases to go to. My oases is reading for pleasure � I love to become part of a story � I feel like the characters are my friends and I often don�t want the book to end. - Share �The Summer I Dared� We need to talk to our children about developing methods for handling distress � help them to access an oases Some tools of the trade include: oases, anchors and safe places An oases is an activity that demands your concentration and attention: like knitting, computer games, solitaire, journaling, stamping, painting, reading and sports. In Dr. Phil�s new book, Family First, he describes a boy who lives in a dysfunctional family system � the dad�s an alcoholic, and typically emotionally unavailable to the boy, they are very poor, the mother works 2 jobs to try to provide food for her family, life is emotionally barren, full of desperation and drama with one crisis after another. The 12 year old boy would wander around the streets at night � he made almost no connection with his family � climbing in and out of his window, rather than dealing with his family. But the one thing the boy has is sports � he calls it an �absolute godsend.� Through sports he found his self esteem and an acceptable outlet for his anger � that he doesn�t understand, but he knows is there. If you read his book, you will recognize that this is Dr. Phil. If you know the story of Oprah � you know her life was also very dysfunctional � abandoned by her mother and father for a time, raised by her grandparents, dirt poor � sexually abused by an uncle � later having to live with her father and so on, she also had an oases and it was books. Maybe both Dr. Phil and Oprah made it through the chaotic times because they had an oases to go to. My oases is reading for pleasure � I love to become part of a story � I feel like the characters are my friends and I often don�t want the book to end. - Share �The Summer I Dared� We need to talk to our children about developing methods for handling distress � help them to access an oases

12. Anchors Concrete, observable resource Chosen from the child�s life A grandmother, a pet, a place, an activity Gives the child a feeling of relief and well being Establish to use as a braking tool Anchors are another tool that should be used in intervention � an anchor is just what it sounds like � a heavy weight that keeps a boat or person from floating away � it keeps a boat in its place � stable. Anchors need to be established early in intervention. It might sound something like this: Tell me something or someone that is important in your life � something or someone that makes you feel good. An anchor needs to be concrete and observable. They need to be chosen from the child�s life: a friend, a grandmother, an activity An anchor gives the child a feeling of relief and well being, it�s a good braking tool when working with traumatic intervention. When hyperarousal gets too high, the counselor changes the subject. �Let�s just stop talking about this for a moment and tell me more about your pet�does he wag his tail when he sees you? Does his fur feel soft when he lays next to you?� It is often difficult to insert an anchor because it disrupts the flow � but anchors make it possible to continue addressing difficult memories while lowering arousals. You can explain to the child why you are doing this before you start your interview � then educate the child on how to use anchors in his own life. Anchors are another tool that should be used in intervention � an anchor is just what it sounds like � a heavy weight that keeps a boat or person from floating away � it keeps a boat in its place � stable. Anchors need to be established early in intervention. It might sound something like this: Tell me something or someone that is important in your life � something or someone that makes you feel good. An anchor needs to be concrete and observable. They need to be chosen from the child�s life: a friend, a grandmother, an activity An anchor gives the child a feeling of relief and well being, it�s a good braking tool when working with traumatic intervention. When hyperarousal gets too high, the counselor changes the subject. �Let�s just stop talking about this for a moment and tell me more about your pet�does he wag his tail when he sees you? Does his fur feel soft when he lays next to you?� It is often difficult to insert an anchor because it disrupts the flow � but anchors make it possible to continue addressing difficult memories while lowering arousals. You can explain to the child why you are doing this before you start your interview � then educate the child on how to use anchors in his own life.

13. The Safe Place Should be actual On earth, the child knows it Somatic memory of it � smells, sights, sounds, Child can imagine safe place when needed And a specialized anchor, called the safe place � first used in hypnosis for reducing stress. You�ve probably practiced this in one of your psychology classes. It is preferable that it be a real place well remembered by the child. In Bill Steele�s process, the child would draw this out. Keep in mind also, the body just doesn�t remember uncomfortable sensations � it also remembers positive feelings and sensations. We want to keep a balance when dealing with children � there are good things that happen too.And a specialized anchor, called the safe place � first used in hypnosis for reducing stress. You�ve probably practiced this in one of your psychology classes. It is preferable that it be a real place well remembered by the child. In Bill Steele�s process, the child would draw this out. Keep in mind also, the body just doesn�t remember uncomfortable sensations � it also remembers positive feelings and sensations. We want to keep a balance when dealing with children � there are good things that happen too.

14. Rothchild�s 10 Foundations for Safe Intervention Establish safety Develop rapport and good contact Be confident in applying the brakes Build on child�s internal and external resources Never get rid of coping strategies � instead create more View trauma system as a pressure cooker � always work to reduce the pressure Adapt to the child Have a broad knowledge of trauma theory Do not judge � interventions will not always work the same Be prepared at all times to put aside technique and talk to the child Safety with you and in the environment (Called Bill Steele � Stuart who lied) This could take months You must both know how and when to apply the brakes Build on Resources � �What did you do before when you were scared?� �Who else do you talk to about this?� Defenses are resources, denial is a resource � never get rid of them, just add more of them Throughout this process we are trying to reduce stress, not increase it � it�s like a pressure cooker � release a little at a time Don�t be so set on how you are going to do it�at times the child needs to do the leading. (Carl�s story � drew his brothers hitting him, rather than what happened in CA) Read up on trauma and stress. If you are not comfortable � don�t do it. Respect differences � don�t expect interventions to have the same results with each child Be prepared to put away your plans and just talk � it just might not be the right day to make it happen Safety with you and in the environment (Called Bill Steele � Stuart who lied) This could take months You must both know how and when to apply the brakes Build on Resources � �What did you do before when you were scared?� �Who else do you talk to about this?� Defenses are resources, denial is a resource � never get rid of them, just add more of them Throughout this process we are trying to reduce stress, not increase it � it�s like a pressure cooker � release a little at a time Don�t be so set on how you are going to do it�at times the child needs to do the leading. (Carl�s story � drew his brothers hitting him, rather than what happened in CA) Read up on trauma and stress. If you are not comfortable � don�t do it. Respect differences � don�t expect interventions to have the same results with each child Be prepared to put away your plans and just talk � it just might not be the right day to make it happen

15. Body AwarenessB. Rothchild First step toward interpreting somatic memory is to concentrate on body sensations Terms to help you identify sensations: Breathing, location, speed, depth, position, skin, hot, cold, tense, relaxed, big, small, restless, calm, movement, still, dizzy, shivers, prickles, pressure, pulling, rotation, twist, contraction, expansion, pulse rate, heartbeat, pain, burning, vibration, shaking, weak, strong, sleepy, awake, tears, light, heavy, soft, hard, tight, loose, crooked, straight, balanced, unsteady, uptight, upright, tilted, shaky, empty, full Do exercise on page 102 The first step toward interpreting somatic memory is to concentrate of body sensation � sensations are the language of body memory. If the child cannot distinguish the sensations they are feeling you can ask specific questions to help: What is the sensation in your stomach right now? What is the temperature of your hands? Can you notice your breathing � is it deep or shallow? Do exercise on page 102 The first step toward interpreting somatic memory is to concentrate of body sensation � sensations are the language of body memory. If the child cannot distinguish the sensations they are feeling you can ask specific questions to help: What is the sensation in your stomach right now? What is the temperature of your hands? Can you notice your breathing � is it deep or shallow?

16. Making Friends with The Body Start by identifying the sensations Learn to use the sensations as a gauge Body awareness � Anchor vs. Accelerator Awareness lessens the pressure Quick pace A link to the present Child = high arousal state Do a body awareness Discuss cues and their effects Use body anchor or safe place Emotions are identified by a combination of distinct body sensations, such as: SHALLOW BREATHING + ELEVATED HEART RATE + COLD SWEAT = AFRAID What might make up sad? Deep breathing + Slowed heart rate + heavy shoulders = Sad. You may want to spend some time putting sensations and feelings together. We start with identification of feelings�inside and outside You may want to start by asking how would you know a stove is too hot to touch? How do you know when to stop running? How do you know when to not walk down a dark deserted street? Show how we are already doing this in our minds without really thinking about it�and these sensations are gauges to us to keep us safe. As people bring awareness to parts of their bodies � it brings about relief � don�t linger too long on one area � it might stir up more memories and we do a little at a time. Once a person becomes adept at being aware of sensations � they stay in the present. (tell Sadie story) When children are in a high state of arousal � do body awareness with them, talk about the cues they get and what happens. Then anchor them before they leave. Samantha story � making friends with her sensations - naming it and talking to it � and then taking it to another place in their body that is not feeling that sensation. You may want to draw out what you talk about with body sensations. Jordan � sliding around in his chair � in the classroom he sits perfectly still and pays attention � but when he comes to visit me, he is on full alert because we are going to talk about a distressing situation. I want you to notice what your body is doing right now�describe it to me. And he stopped.Emotions are identified by a combination of distinct body sensations, such as: SHALLOW BREATHING + ELEVATED HEART RATE + COLD SWEAT = AFRAID What might make up sad? Deep breathing + Slowed heart rate + heavy shoulders = Sad. You may want to spend some time putting sensations and feelings together. We start with identification of feelings�inside and outside You may want to start by asking how would you know a stove is too hot to touch? How do you know when to stop running? How do you know when to not walk down a dark deserted street? Show how we are already doing this in our minds without really thinking about it�and these sensations are gauges to us to keep us safe. As people bring awareness to parts of their bodies � it brings about relief � don�t linger too long on one area � it might stir up more memories and we do a little at a time. Once a person becomes adept at being aware of sensations � they stay in the present. (tell Sadie story) When children are in a high state of arousal � do body awareness with them, talk about the cues they get and what happens. Then anchor them before they leave. Samantha story � making friends with her sensations - naming it and talking to it � and then taking it to another place in their body that is not feeling that sensation. You may want to draw out what you talk about with body sensations. Jordan � sliding around in his chair � in the classroom he sits perfectly still and pays attention � but when he comes to visit me, he is on full alert because we are going to talk about a distressing situation. I want you to notice what your body is doing right now�describe it to me. And he stopped.

17. Body Exercises Breathing Yawning Sound around (group activity) Pulsing (group activity) Trust Blind faith Mirror Game Character/Feeling improv These body exercises can be done to encourage children to become more in touch with their bodies � they can also be done for calming activities � or jump offs for further interventions with art and conversation The better you breath the better you have control over your voice and the more oxygen is in the body. Standing up straight, against a wall or not, put one hand on your chest and breathe slowly and deeply. Feel you hand rise and fall. Now put your other hand just below your rib cage. Breathe in again. This time, when you feel your chest rise � try to make your other hand rise also � this muscle is called the diaphragm � it should be the muscle you use in breathing. Pant like a dog � you should be feeling your diaphragm. Draw a slow, deep breath � the breathe out saying AAAHHH for as long as you can. Think about ways you could use this exercise � for calming when someone�s heart is racing, for someone who feels like they can�t catch their breath. How could you add art to this? Draw out your breaths � in each breath write something you need to get rid of. Yawning � Make a yawning face � put out different sounds through your yawn. - using all your breath You could practice this with words � all you want to say in one breath and get it out. Ask the children to close their eyes � make different sounds (like paper crumbly, scratching, hammering, etc.) ask the children what the sounds remind them of. What do they feel in their bodies when they hear the sounds. Pulsing � sit in a group � hold hands, send the pulse around � slowly, the quickly. What was that experience like for you? How could you get energy from someone else? How do you expend energy in response to someone else? How does your body feel now? Trust � 2 people of equal size stand one behind the other, then one leans in being supported by the other, one person could be moved back and forth if appropriate � describe the process and how it feels? How does that relate to your life? Could you trust? Are the sensations the same when you deal with your divorced parents? Blind faith � with blind folds, one person leads the other around � process body feelings and what it brings to mind. Mirror Game � two people face each other � trying to mirror each other�s moves. Swap being the leader. Process � how do we do this in real life? Process the feelings. Character/Feeling Improv � pass out feeling cards or character cards � mime out their cards � or ask the students to make up phrases that goes with their card. Or say a statement with that feeling � like �I HOPE YOU HAVE A GOOD DAY.� Process - These body exercises can be done to encourage children to become more in touch with their bodies � they can also be done for calming activities � or jump offs for further interventions with art and conversation The better you breath the better you have control over your voice and the more oxygen is in the body. Standing up straight, against a wall or not, put one hand on your chest and breathe slowly and deeply. Feel you hand rise and fall. Now put your other hand just below your rib cage. Breathe in again. This time, when you feel your chest rise � try to make your other hand rise also � this muscle is called the diaphragm � it should be the muscle you use in breathing. Pant like a dog � you should be feeling your diaphragm. Draw a slow, deep breath � the breathe out saying AAAHHH for as long as you can. Think about ways you could use this exercise � for calming when someone�s heart is racing, for someone who feels like they can�t catch their breath. How could you add art to this? Draw out your breaths � in each breath write something you need to get rid of. Yawning � Make a yawning face � put out different sounds through your yawn. - using all your breath You could practice this with words � all you want to say in one breath and get it out. Ask the children to close their eyes � make different sounds (like paper crumbly, scratching, hammering, etc.) ask the children what the sounds remind them of. What do they feel in their bodies when they hear the sounds. Pulsing � sit in a group � hold hands, send the pulse around � slowly, the quickly. What was that experience like for you? How could you get energy from someone else? How do you expend energy in response to someone else? How does your body feel now? Trust � 2 people of equal size stand one behind the other, then one leans in being supported by the other, one person could be moved back and forth if appropriate � describe the process and how it feels? How does that relate to your life? Could you trust? Are the sensations the same when you deal with your divorced parents? Blind faith � with blind folds, one person leads the other around � process body feelings and what it brings to mind. Mirror Game � two people face each other � trying to mirror each other�s moves. Swap being the leader. Process � how do we do this in real life? Process the feelings. Character/Feeling Improv � pass out feeling cards or character cards � mime out their cards � or ask the students to make up phrases that goes with their card. Or say a statement with that feeling � like �I HOPE YOU HAVE A GOOD DAY.� Process -

18. Rothchild�s Interview Form Three stages 1. Name the trauma 2. Outline the trauma by referring to main incidents 3. Fill in details of each incident one at a time This is Rothchild�s interview form: Three stages � Rothchild suggests that the greater the amount of details one gets into, the greater the risk of hyperarousal. But a controlled interview � monitoring body sensations, makes the process tolerable. First the trauma must be named. With Bill Steele�s interview � we do that. �We are here to talk about the car accident.� �We are here to talk about the death of Mrs. Smith.� Rothchild has the client name it. She contends that if there is a lot of hyperarousal at this point, you should just work with the body until it is stable. Safety is a priority. If the child can name the incident without arousal (or dissociation) then the next step is to outline the main topics of the trauma � again without details There was a car accident. The ambulance came. They thought I was dead. But I finally was able to move to show them I was a live. My mom got mad at me because I wasn�t supposed to be riding in that area. It will be hard for the child to not go into details, but keep them in the outline format. Again, check for body awareness � is there too much hyperarousal at this time, if so discharge with a body anchor, or safe place. Finally, fill in the details: There was a car accident, etc I was driving my dad�s car. I wasn�t supposed to be in that area of town. The road was pretty slippery and wet. I didn�t think I was going too fast. But some how the car went off the road and flipped over 3 times. I landed in a ditch. During this step you will be using body checks, possibly anchors to retell this story � this strategy should give them sense of control over there memories and should provide a safe avenue of expression.This is Rothchild�s interview form: Three stages � Rothchild suggests that the greater the amount of details one gets into, the greater the risk of hyperarousal. But a controlled interview � monitoring body sensations, makes the process tolerable. First the trauma must be named. With Bill Steele�s interview � we do that. �We are here to talk about the car accident.� �We are here to talk about the death of Mrs. Smith.� Rothchild has the client name it. She contends that if there is a lot of hyperarousal at this point, you should just work with the body until it is stable. Safety is a priority. If the child can name the incident without arousal (or dissociation) then the next step is to outline the main topics of the trauma � again without details There was a car accident. The ambulance came. They thought I was dead. But I finally was able to move to show them I was a live. My mom got mad at me because I wasn�t supposed to be riding in that area. It will be hard for the child to not go into details, but keep them in the outline format. Again, check for body awareness � is there too much hyperarousal at this time, if so discharge with a body anchor, or safe place. Finally, fill in the details: There was a car accident, etc I was driving my dad�s car. I wasn�t supposed to be in that area of town. The road was pretty slippery and wet. I didn�t think I was going too fast. But some how the car went off the road and flipped over 3 times. I landed in a ditch. During this step you will be using body checks, possibly anchors to retell this story � this strategy should give them sense of control over there memories and should provide a safe avenue of expression.

19. During the Trauma Interview Observe and ask for feedback on the child�s body state Explain why you are doing this Encourage monitoring his/her own responses Remember the key to our trauma work is psycho-educational. We ultimately want our children to be able to deal with their sensations and emotions. We are teaching them how to. So as we are interviewing the child we ask for lots of sensation feedback � we also teach our children how to provide their sensation feedback. It might sound something like this: �When you tell me about a wet and dark road, how does your body respond? Answer � my heart goes faster, my head feels like its tightening, and I start to sweat. Ask the child to really visit those body sensations � what does he need to do to calm them and control them � sometimes just visiting those sensations work, but maybe the child needs to stop talking, shifting weight, squeeze a ball, think of their anchor until those sensations go away. David Grill � TLC instructor uses a technique he calls TITRATION � titration is a term used in chemistry. It�s a method that is used to determine the concentrate of something, by add another concentrate to get a known reaction � it is shown through color change and electrical measurement. Titration in the body is adding a known measured sense to an unmeasured sensation trying to balance out the body�s sensations. Basically it is something like this: Find an area in your body that feels good � it might be your feet, they are in comfortable in your shoes, you walked this morning so they have a warm, used feeling. They are on the floor, so they feel supported. You have some good feelings in them, because when you walked this morning the breeze was blowing and the sun was shining � this adds to your good feelings. Now take the area of your body where you feel an uncomfortable sensation � like your head is starting to tense up because you are talking about something you feel uncomfortable about. It feels like your bones are shrinking in and your jaw is getting tighter. Your head also is starting to get warmer � but not a good feeling of warmth � the kind of warmth that usually brings on a headache. David suggests that you simple move from one area of your body to the other until they have both balanced out. Now spend some time feeling your feet and then spend some time feeling your head. Move back and forth. Visualize the movement of these sensations. Take your tight jaw to the relaxed area of your feet.Remember the key to our trauma work is psycho-educational. We ultimately want our children to be able to deal with their sensations and emotions. We are teaching them how to. So as we are interviewing the child we ask for lots of sensation feedback � we also teach our children how to provide their sensation feedback. It might sound something like this: �When you tell me about a wet and dark road, how does your body respond? Answer � my heart goes faster, my head feels like its tightening, and I start to sweat. Ask the child to really visit those body sensations � what does he need to do to calm them and control them � sometimes just visiting those sensations work, but maybe the child needs to stop talking, shifting weight, squeeze a ball, think of their anchor until those sensations go away. David Grill � TLC instructor uses a technique he calls TITRATION � titration is a term used in chemistry. It�s a method that is used to determine the concentrate of something, by add another concentrate to get a known reaction � it is shown through color change and electrical measurement. Titration in the body is adding a known measured sense to an unmeasured sensation trying to balance out the body�s sensations. Basically it is something like this: Find an area in your body that feels good � it might be your feet, they are in comfortable in your shoes, you walked this morning so they have a warm, used feeling. They are on the floor, so they feel supported. You have some good feelings in them, because when you walked this morning the breeze was blowing and the sun was shining � this adds to your good feelings. Now take the area of your body where you feel an uncomfortable sensation � like your head is starting to tense up because you are talking about something you feel uncomfortable about. It feels like your bones are shrinking in and your jaw is getting tighter. Your head also is starting to get warmer � but not a good feeling of warmth � the kind of warmth that usually brings on a headache. David suggests that you simple move from one area of your body to the other until they have both balanced out. Now spend some time feeling your feet and then spend some time feeling your head. Move back and forth. Visualize the movement of these sensations. Take your tight jaw to the relaxed area of your feet.

20. Nightmare/Flashback Protocol(B. Rothchild) I am going to awaken in the night feeling ____ And will be sensing in my body _____ Because I will be remembering _____ At the same time, I will look around where I am now in ___ Here _____ And I will see ____ And so I will know ____ Is not happening to me now. Rothchild has a protocol for nightmares that is worth looking at � every child I�ve worked with who has been traumatized has had bad dreams. Insert name of anticipated emotions � usually fear Describe your anticipated bodily sensations � at least 3 of them Name the trauma by title only � no details Current year or month Name the place where you are Describe some of the things that you will see right now in this place Name the trauma by title only again With elementary aged children I might draw this scenario out. I usually suggest to my students to think about a good thing before they go to bed and be ready to think about that same thing when they wake up. I try to make the �thing� very sensory based. Like being hugged by your grandma � where it is, what she smells like, what it feels like, etc.Rothchild has a protocol for nightmares that is worth looking at � every child I�ve worked with who has been traumatized has had bad dreams. Insert name of anticipated emotions � usually fear Describe your anticipated bodily sensations � at least 3 of them Name the trauma by title only � no details Current year or month Name the place where you are Describe some of the things that you will see right now in this place Name the trauma by title only again With elementary aged children I might draw this scenario out. I usually suggest to my students to think about a good thing before they go to bed and be ready to think about that same thing when they wake up. I try to make the �thing� very sensory based. Like being hugged by your grandma � where it is, what she smells like, what it feels like, etc.

21. The PTSD WorkbookAn excellent resource for working with teens and adults Mary Beth Williams, PhD Soili Poijula, PhD New Harbinger Publications, 2002 This workbook is the best I�ve seen and It is an excellent resource for teens and adults � I think I got mine at Borders. I�m going to present a few activities they have that are relevant to adolescents. This workbook is the best I�ve seen and It is an excellent resource for teens and adults � I think I got mine at Borders. I�m going to present a few activities they have that are relevant to adolescents.

22. Self Harm/Self Mutilation(Williams, Poijula) Feel a deep loss that leads to feelings of tenseness, anxiety, anger or fear, and you express those feelings by harming your body in a controlled way Self-cutting is most common Gain control over your body Challenging those around you to care enough to do something Substitute for anger Reconnect your body and mind Feel real and alive Self harm and self mutilation can come from feelings of deep loss. Self harm is a way to gain control over your body, when you feel you have no control. Self harm is a way to challenge those around you to care enough to do something. It is a substitute for anger. Hurting yourself reconnects your body and mind, it makes someone feel real and alive. It�s also: A way to manage painful emotions you cannot express A way to stop feeling feelings and control them A way to reenact the trauma or abuse An addictive action that can become compulsive An expressions of self blame Self hate A way to resist taking care of yourself in a positive way A way to divert the pain of rejection A way to have physical evidence of emotional injury A way to stop dissociation A way to release endorphins A way to self-punish Self harm and self mutilation can come from feelings of deep loss. Self harm is a way to gain control over your body, when you feel you have no control. Self harm is a way to challenge those around you to care enough to do something. It is a substitute for anger. Hurting yourself reconnects your body and mind, it makes someone feel real and alive. It�s also: A way to manage painful emotions you cannot express A way to stop feeling feelings and control them A way to reenact the trauma or abuse An addictive action that can become compulsive An expressions of self blame Self hate A way to resist taking care of yourself in a positive way A way to divert the pain of rejection A way to have physical evidence of emotional injury A way to stop dissociation A way to release endorphins A way to self-punish

23. Looking for reasons List self-injurious behaviors How do they help me survivor? How does the behavior give meaning to my trauma? How does the behavior give me a sense of master and control? How does the behavior make me feel better? How does the behavior give me revenge? How does the behavior reinforce my feelings of guilt, shame and self-blame? How does the behavior punish me? How does the behavior reenact what I learned earlier in life? How does the behavior bring me affection and care? Cutting, burning, not eating, over eating, extreme sports, head banging, car speeding, drugs, smoking, risky sexual behaviors are all forms of self harming. After you list or discuss the self harming behavior that the child is presenting go over these questions: How do they help me survive? How does the behavior give meaning to my trauma? How does the behavior give me a sense of master and control? How does the behavior make me feel better? How does the behavior give me revenge?How does the behavior reinforce my feelings of guilt, shame and self-blame? How does the behavior reenact what I learned earlier in life? How does the behavior bring me affection and care?Cutting, burning, not eating, over eating, extreme sports, head banging, car speeding, drugs, smoking, risky sexual behaviors are all forms of self harming. After you list or discuss the self harming behavior that the child is presenting go over these questions: How do they help me survive? How does the behavior give meaning to my trauma? How does the behavior give me a sense of master and control? How does the behavior make me feel better? How does the behavior give me revenge?How does the behavior reinforce my feelings of guilt, shame and self-blame? How does the behavior reenact what I learned earlier in life? How does the behavior bring me affection and care?

24. Checklist I want to show that I own my body. I want to express my rage at myself. I hate myself. I want to distract myself from other pain. I want to numb out my feelings. I have a message to give that I can�t say directly. I am asking for help. I want to be rescued. I want to cleanse myself. I want to express my shame. I am taking over where my abuser left off. I am retaliating against myself for telling secrets. I am trying to bring my emotions under control. The work book then goes into a check list � here�s a sample of what they ask the person to check off if it pertains to them. This check list leads to discussion and self discovery. I want to show that I own my body. I want to express my rage at myself. I hate myself. I want to distract myself from other pain. I want to numb out my feelings. I have a message to give that I can�t say directly. I am asking for help. I want to be rescued. I want to cleanse myself. I want to express my shame. I am taking over where my abuser left off. I am retaliating against myself for telling secrets. I am trying to bring my emotions under control. I want to show that I own my body. I want to express my rage at myself. I hate myself. I want to distract myself from other pain. I want to numb out my feelings. I have a message to give that I can�t say directly. I am asking for help. I want to be rescued. I want to cleanse myself. I want to express my shame. I am taking over where my abuser left off. I am retaliating against myself for telling secrets. I am trying to bring my emotions under control. The work book then goes into a check list � here�s a sample of what they ask the person to check off if it pertains to them. This check list leads to discussion and self discovery. I want to show that I own my body. I want to express my rage at myself. I hate myself. I want to distract myself from other pain. I want to numb out my feelings. I have a message to give that I can�t say directly. I am asking for help. I want to be rescued. I want to cleanse myself. I want to express my shame. I am taking over where my abuser left off. I am retaliating against myself for telling secrets. I am trying to bring my emotions under control. I want to show that I own my body. I want to express my rage at myself. I hate myself. I want to distract myself from other pain. I want to numb out my feelings. I have a message to give that I can�t say directly. I am asking for help. I want to be rescued. I want to cleanse myself. I want to express my shame. I am taking over where my abuser left off. I am retaliating against myself for telling secrets. I am trying to bring my emotions under control.

25. Selecting alternatives After exploring reasons for self-mutilating, explore other things you could do to express that emotion or action. An example: I want to numb out my feelings. Get lost in a book Watch a movie Soak in a tub Help your grandmother or someone in need Run After looking over the check list and discussing different discoveries talk about what other things a person could do to express those emotions or actions. For example: I want to numb out my feelings: Get lost in a book, watch a movie, soak in a tub, help someone in need, exercise The workbook goes into further exploration of sexual involvement and self harming � which would be good for those of you working with teens to explore. We are also not going to cover suicide today, which would be a 2 day workshop in itself. After looking over the check list and discussing different discoveries talk about what other things a person could do to express those emotions or actions. For example: I want to numb out my feelings: Get lost in a book, watch a movie, soak in a tub, help someone in need, exercise The workbook goes into further exploration of sexual involvement and self harming � which would be good for those of you working with teens to explore. We are also not going to cover suicide today, which would be a 2 day workshop in itself.

26. Peter Levine is also a trauma specialist who focuses on the body. He believes we do not have to unlock memories to unlock body sensations that are stuck. He believes in working with the sensations. He states: We all have the innate capacity to heal trauma. And when we are unable to flow through the trauma and complete our instinctive responses, then these incomplete actions undermine our lives. That trauma gets trapped in our bodies. The healing process of trauma is a natural process that can be accessed through an inner awareness of the body. He further believes that Post traumatic stress symptoms are incomplete physiological responses suspended in fear. And humans suffer when we are unable to discharge the energy that is locked in the freeze response. We need support from friends and family, as well as nature to begin to trust and honor the natural process that will bring us to completion and wholeness and eventually peace. Peter Levine is also a trauma specialist who focuses on the body. He believes we do not have to unlock memories to unlock body sensations that are stuck. He believes in working with the sensations. He states: We all have the innate capacity to heal trauma. And when we are unable to flow through the trauma and complete our instinctive responses, then these incomplete actions undermine our lives. That trauma gets trapped in our bodies. The healing process of trauma is a natural process that can be accessed through an inner awareness of the body. He further believes that Post traumatic stress symptoms are incomplete physiological responses suspended in fear. And humans suffer when we are unable to discharge the energy that is locked in the freeze response. We need support from friends and family, as well as nature to begin to trust and honor the natural process that will bring us to completion and wholeness and eventually peace.

27. Medical Trauma Fetal trauma, birth trauma Illness Physical injuries Surgeries Anesthesia Prolonged immobilization Hospitalization can cause trauma. Even though the rational brain understands the necessity of hospitalization, or treatment needed. The unconscious mind is still registering cuts through the flesh, muscle and tendons and it is registering as a life threatening event. On the cellular level, the body perceives that if has sustained a wound serious enough to place it in a life or death mode. Many clinical proceedings needlessly exaggerate the fear of an already frightened child. Infants are often strapped in papooses � with their parents removed from the room. Children are anesthetized while severely frightened�so they wake up fearful or detached. Peter Levine believes this is what happened to Ted Kaczynski � he had a tonsil operation � there were complications and he was in the hospital for 7 days with no contact with his parents. He�s family claims that he never came back the same � he was disconnected. If you read the Patricia Cornwell�s book on Jack the Ripper � you would learn that he spent about 6 months in a hospital in London, away from his family in Germany, because of an operation on his genitals � it was particularly painful and humiliating � and he was very young � maybe about 6. His father, who was stern and unloving visited him once in awhile, but mostly he was left by himself. Put together deformed genitalia and the harrowing hospital stay and you have a serial killer who rips out uteruses. Children need to have their parents with them during procedures. They need calmness and a sense of safety in order to come through some of these medical procedures. Reflecting back on making friends with the body � children need to make friends with the terms they are hearing. I worked with a family who has a son with leukemia. They named their dog Chemo. His worst fear was having his finger pricked � we drew a happy face on the other finger so his sore finger would have a friend. He took comfort items with him for his treatment � his favorite blanket, his favorite movie and so on. Hospitalization can cause trauma. Even though the rational brain understands the necessity of hospitalization, or treatment needed. The unconscious mind is still registering cuts through the flesh, muscle and tendons and it is registering as a life threatening event. On the cellular level, the body perceives that if has sustained a wound serious enough to place it in a life or death mode. Many clinical proceedings needlessly exaggerate the fear of an already frightened child. Infants are often strapped in papooses � with their parents removed from the room. Children are anesthetized while severely frightened�so they wake up fearful or detached. Peter Levine believes this is what happened to Ted Kaczynski � he had a tonsil operation � there were complications and he was in the hospital for 7 days with no contact with his parents. He�s family claims that he never came back the same � he was disconnected. If you read the Patricia Cornwell�s book on Jack the Ripper � you would learn that he spent about 6 months in a hospital in London, away from his family in Germany, because of an operation on his genitals � it was particularly painful and humiliating � and he was very young � maybe about 6. His father, who was stern and unloving visited him once in awhile, but mostly he was left by himself. Put together deformed genitalia and the harrowing hospital stay and you have a serial killer who rips out uteruses. Children need to have their parents with them during procedures. They need calmness and a sense of safety in order to come through some of these medical procedures. Reflecting back on making friends with the body � children need to make friends with the terms they are hearing. I worked with a family who has a son with leukemia. They named their dog Chemo. His worst fear was having his finger pricked � we drew a happy face on the other finger so his sore finger would have a friend. He took comfort items with him for his treatment � his favorite blanket, his favorite movie and so on.

28. Resolving Traumatic ReactionsFirst Aid for ChildrenPeter Levine, PhD Body responses that emerge with sensations Trembling, shaking, crying If not discharged can accumulate Allow completion Support child in a nonrestrictive way Excessive patting and rocking may interrupt the recovery process Guide the child through his body sensations Allow a few minutes between questions � this permits the child to complete the sensation Validate physical responses Studies have shown that children who cry after accidents have fewer problems recovering �Just let that scary stuff out.� After the child appears calm and safe � begin story telling his experience Peter Levine compares the human trauma response to those of animals. When an animal is under several stress � being attack by another animal, or being hit by a car � it either fights or flees � however, there are times when an animal plays dead in order to survive � such as an impala, or rabbit � when in the grips of it�s predator it play dead, often leaving the predator uninterested so it drops the animal. When the victim animal feels safe again � it stands up and shakes before it flees. Peter Levine contends that the several shaking process that animals do naturally after they are safe is what is missing the human�s cycle of trauma response � that we often don�t have the chance to shake out our trauma and it gets stuck in our bodies. Hence the name of his book, Waking the Tiger. (In my training we saw video clips of many types of animals who shook after they were frozen.) Our trauma reactions relates to the animal kingdom. Humans have the same instinct set up in their brains as animals in the reptilian brain. However, since humans can think, they often over ride their instincts � which can be good or bad in the face of trauma. When the reptilian brain perceives danger, it activates the adrenaline rush. That in turn gets our bodies ready to defend ourselves. Whatever energy is not used in fight or flight, does not simply go away, instead it lingers in our body, often causing traumatic reactions. For some, traumatic events may not cause problems because they were able to process and respond, using all the energy that was pumped in their body instinctively. For animals it is done by shaking and trembling, then running. For humans, it could be the same � shaking, trembling, moving, crying, sobbing, screaming, running�if this process is stopped before all the energy is discharged � then the energy will be locked in the body. This means it may not be a good idea to try to get a child to calm down and stop crying after a stressful situation � maybe the child needs to let it all out and just be supported by the adult. Children have the least capabilities to carry through during traumatic events � so they are at a greater risk to be traumatized. Let�s a take a flood for example. An adult and child in a car together, their car suddenly gets swept away by water. The adult can unlock his seatbelt. Can physically open the door, has the strength to rescue himself and the child. The child is basically helpless and dependent�so cannot discharge the energy this scenario might bring. My experience with Curt � shaking till I was calm. The steps in helping a child through a trauma would be letting the body responses and sensations emerge and discharge. Support the child, but don�t stop the reaction. Guide the child through his body sensations � what is happening with your heart right now? How is your breathing? Are you short of breath? Do you feel hot or cold? After the child appears calm and safe ask the child to begin retelling his experience.Peter Levine compares the human trauma response to those of animals. When an animal is under several stress � being attack by another animal, or being hit by a car � it either fights or flees � however, there are times when an animal plays dead in order to survive � such as an impala, or rabbit � when in the grips of it�s predator it play dead, often leaving the predator uninterested so it drops the animal. When the victim animal feels safe again � it stands up and shakes before it flees. Peter Levine contends that the several shaking process that animals do naturally after they are safe is what is missing the human�s cycle of trauma response � that we often don�t have the chance to shake out our trauma and it gets stuck in our bodies. Hence the name of his book, Waking the Tiger. (In my training we saw video clips of many types of animals who shook after they were frozen.) Our trauma reactions relates to the animal kingdom. Humans have the same instinct set up in their brains as animals in the reptilian brain. However, since humans can think, they often over ride their instincts � which can be good or bad in the face of trauma. When the reptilian brain perceives danger, it activates the adrenaline rush. That in turn gets our bodies ready to defend ourselves. Whatever energy is not used in fight or flight, does not simply go away, instead it lingers in our body, often causing traumatic reactions. For some, traumatic events may not cause problems because they were able to process and respond, using all the energy that was pumped in their body instinctively. For animals it is done by shaking and trembling, then running. For humans, it could be the same � shaking, trembling, moving, crying, sobbing, screaming, running�if this process is stopped before all the energy is discharged � then the energy will be locked in the body. This means it may not be a good idea to try to get a child to calm down and stop crying after a stressful situation � maybe the child needs to let it all out and just be supported by the adult. Children have the least capabilities to carry through during traumatic events � so they are at a greater risk to be traumatized. Let�s a take a flood for example. An adult and child in a car together, their car suddenly gets swept away by water. The adult can unlock his seatbelt. Can physically open the door, has the strength to rescue himself and the child. The child is basically helpless and dependent�so cannot discharge the energy this scenario might bring. My experience with Curt � shaking till I was calm. The steps in helping a child through a trauma would be letting the body responses and sensations emerge and discharge. Support the child, but don�t stop the reaction. Guide the child through his body sensations � what is happening with your heart right now? How is your breathing? Are you short of breath? Do you feel hot or cold? After the child appears calm and safe ask the child to begin retelling his experience.

29. Language of SensationsPeter Levine, �It Won�t Hurt Forever� Trauma is prevented and resolved through the language of sensations Cold/warn/hot/chilly Shaky/trembly/tingly Relaxed/calm/peaceful Dizzy/fussy/blurry Twitchy/like butterflies Hard/soft/stuck flowing/spreading Numb/prickly/jumpy Sharp/dull/itchy These are the body language sensations Peter Levine talks about in his program for children called �It Won�t Hurt Forever.� They are a little different than what we saw with Rothchild � these are more childlike words. Levine encourages children to use these words when talking about body sensations � Taking it a step further - These could be acted out � then tied to events or the child could Make and illustrate a sensations dictionary � attaching feelings to them.These are the body language sensations Peter Levine talks about in his program for children called �It Won�t Hurt Forever.� They are a little different than what we saw with Rothchild � these are more childlike words. Levine encourages children to use these words when talking about body sensations � Taking it a step further - These could be acted out � then tied to events or the child could Make and illustrate a sensations dictionary � attaching feelings to them.

30. Guided Rhymes Pretend you�re a tree with your branches so high That you can reach up and tickle the sky. What�s it like to be strong like a big old oak tree? With roots in your feet and your leaves waving free? Now you�re connected to the earth and the sky. It may make you laugh, it may make you cry. It doesn�t matter when you go with the flow With your branches up high, and your roots way down low Hear the breath in your body, if you listen it sings Now you are ready for whatever life brings. Peter Levine uses guided rhymes with the children he treats - this is an example. (Read from slide.) Most that he uses have animals and their animal instincts are developed in the poems�like running, jumping and getting out of the way. I haven�t used them yet, they aren�t something I�m comfortable with � however, I have done this poem with a child � then we drew a picture of the tree. Peter Levine is a name that is highly regarded in the field of trauma treatment and I thought I needed to share his technique on guided rhymes with you. Actually rhyming itself is not new dealing with trauma � do you recognize: Ring around the Rosie, pocket full of poesy, ashes, ashes, we all fall down. This is the story of the black plague � rosie � the lesion of the plague, poesy � the flower of the dead, ashes, ashes, the burned bodies � we all fall down. We all die. Rhyming and movement�dealing with trauma Jack and Jill went up the hill, to fetch a pail of water, Jack fell down and broke his crown and Jill came tumbling after. Polly at the railway, picking up stones, Along comes a train, and breaks Polly�s bones, Oh, said Polly, that�s not fair Oh, said the engine driver, I don�t care How many bones did Polly break? 1,2,3,4� Again rhyming and movement. How about classic old folk songs: �Old Dan Tucker was a mighty mean man, He beat his wife with a fryin� pan She hollered and she cried, �I�s going to go, They�s plenty of men, won�t beat me so. Got out the way, Old Dan Tucker, You come too late to get yo� supper. Old Dan Tucker, he got drunk, Fell in the fire, kicked up a chunk, Red-hot coal got down his shoe. Oh, Great Lord, how the ashes flew. Get out the way, Old Dan Tucker, You come too late to get yo� supper. Again rhyming and movement � And in the history or our country, where we see the great therapeutic use of rhyme and movement dealing with trauma are the Negro Spirituals � this was a song slaves sung on a boat: I WANT TO GO HOME."Dere's no rain to wet you,O, yes, I want to go home.Dere's no sun to burn you,O, yes, I want to go home ;O, push along, believers,O, yes, &c.Dere's no hard trials,O, yes, &c.Dere's no whips a-crackin',O, yes, &c.My brudder on de wayside,O, yes, &c.O, push along, my brudder,O, yes, &c.Where dere's no stormy weather,O, yes, &c.Dere's no tribulation,O, yes, &c." In the Bible �in the book of Psalms � you will see poetry, sensations, imagery, and movement all connected with distress and finding relief in God. Peter Levine uses guided rhymes with the children he treats - this is an example. (Read from slide.) Most that he uses have animals and their animal instincts are developed in the poems�like running, jumping and getting out of the way. I haven�t used them yet, they aren�t something I�m comfortable with � however, I have done this poem with a child � then we drew a picture of the tree. Peter Levine is a name that is highly regarded in the field of trauma treatment and I thought I needed to share his technique on guided rhymes with you. Actually rhyming itself is not new dealing with trauma � do you recognize: Ring around the Rosie, pocket full of poesy, ashes, ashes, we all fall down. This is the story of the black plague � rosie � the lesion of the plague, poesy � the flower of the dead, ashes, ashes, the burned bodies � we all fall down. We all die. Rhyming and movement�dealing with trauma Jack and Jill went up the hill, to fetch a pail of water, Jack fell down and broke his crown and Jill came tumbling after. Polly at the railway, picking up stones, Along comes a train, and breaks Polly�s bones, Oh, said Polly, that�s not fair Oh, said the engine driver, I don�t care How many bones did Polly break? 1,2,3,4� Again rhyming and movement. How about classic old folk songs: �Old Dan Tucker was a mighty mean man, He beat his wife with a fryin� pan She hollered and she cried, �I�s going to go, They�s plenty of men, won�t beat me so. Got out the way, Old Dan Tucker, You come too late to get yo� supper. Old Dan Tucker, he got drunk, Fell in the fire, kicked up a chunk, Red-hot coal got down his shoe. Oh, Great Lord, how the ashes flew. Get out the way, Old Dan Tucker, You come too late to get yo� supper. Again rhyming and movement � And in the history or our country, where we see the great therapeutic use of rhyme and movement dealing with trauma are the Negro Spirituals � this was a song slaves sung on a boat: I WANT TO GO HOME."Dere's no rain to wet you,O, yes, I want to go home.Dere's no sun to burn you,O, yes, I want to go home ;O, push along, believers,O, yes, &c.Dere's no hard trials,O, yes, &c.Dere's no whips a-crackin',O, yes, &c.My brudder on de wayside,O, yes, &c.O, push along, my brudder,O, yes, &c.Where dere's no stormy weather,O, yes, &c.Dere's no tribulation,O, yes, &c." In the Bible �in the book of Psalms � you will see poetry, sensations, imagery, and movement all connected with distress and finding relief in God.

31. Everything flows, out and in; everything has its tides; all things rise and fall; the pendulum-swing manifests in everything; the measure of the swing to the right is the measure of the swing to the left; rhythm compensates. The Kybalion