Rewire Your Brain Practical Implications of

Brain Research

Presented by Mary Sise, LCSW, DCEP

What do we really know? The bad news… • Brain focuses on what is wrong – we are hardwired that

way! • It looks for “bad news” – not set up to be or act rational • Negative interactions have more impact on the

relationship than positive ones – • We are like velcro for negative – teflon for the positive • Impulse and inclination precede conscious thought

What do we really know? The good news…

• Brain is not “fixed” it has plasticity (Norman Doidge) • You can use the mind to change the brain • You can retrain your brain • Brain loves routine/habits – it takes 30 days to change

a habit • Basic organizer of the brain is habit (We are creatures

of habit) • Have to repeatedly retrain it – not once in awhile/ not

once a week

It’s really not this simple…..

• Brain research is very new • Brain research is changing rapidly• It really isn’t this simple…. • Most of us (including clients) glaze over with the details

Simple Neurobiology

AMYGDALA Smoke Detector

Clinicians job is to help re-set it

Brain in the Palm of Your Hand Dan Siegel, MD

Neo-cortex

Brain Stem

www.drdansiegel.com

Dan Siegel, MD continued

Limbic Region

I just pushed your buttons (I didn’t install them!)

What About Beliefs?

• Where did they begin?

• Under the age of 7?

• In a traumatic event we move into a theta state –

(Anything said here is programmed)

Implications for Practice: • Educate our clients – it is never about today • What does this remind you of….when have you felt this way

before? • There is nothing WRONG with them, it is what happened to

them • This does not imply they are not responsible for their behavior • What you observed or were told under the age of 7 is what you

will believe about yourself• Children – Dad’s reaction is because DAD was triggered • Domestic Violence – partners reaction/behavior was because

the partner was triggered • Focused sustained attention - imagery, role play not talk & logic • Distress Tolerance not problem solving • Rewire them - not held hostage by automatic reactions

Trauma Game

Changer

The Brain on Trauma • Brain freezes – you go into fight, flight or freeze • Time expands, theta state – anything said here registers

as a program with the same intensity as the trauma (terror/rage)

• If you can’t fight or flee you freeze and leave the body • Dissociation, Fragmentation….. • Overload – too much to handle – I’ll deal with this later • Depending on the AGE of the person, will depend on how

well they can dissociate…..(under 7 very easy) • Nightmares, Intrusive thoughts, & trauma re-enactment is

about the person trying to master/heal the trauma

Fragmentation of Consciousness •Fight – Flight - Freeze

•Age of incident and body damage are factors in fragmentation

•Split off part has the memory with all the emotions as if it is happening over and over

•Once the pattern is set, that becomes the default….

Owned & Disowned Parts of Self

Use Metaphors for Understanding Trauma & Fragmentation

Leave A man behind

Implications for Practice

• Educate your clients – they are not crazy • Underneath all of their bravado is a loving heart • It is not who they are, it is what they did to cope • Don’t fall for the costume they are wearing • Safe to be angry now, not hold it inside and be

triggered • Anger turned inward is depression • Cutting, addictions are so they do not feel this • Find the missing dis-owned parts, and re-integrate • KEY: Work on building a safe relationship – mirror

neurons

Treatment of Trauma Four Staged Model

Treatment of Trauma

Different Types of Trauma: 1. Small t trauma eg. If you see a car accident, violence - images

might be frozen or if you hear a car accident, violence sounds might be frozen

2. Big T trauma – eg. If your body is hurt in the car accident – violence much more fragmentation, dissociation. Too much coming in

Four Stages of Treatment:

1. Assessment 2. Stabilization 3. Trauma Processing 4. Reconnection

Growth of Brain Neurons

Newborn 3 mo. old 2 yr. old

Moment of Trauma

KNOWLEDGE

Behavior AFFECT

SENSATION

Neuropath

B A S K Model

Defenses of Trauma Memory

“Hurt spot”

Memory

“Defenses”

Treatment of Trauma Memory

“Hurt spot”

1. Access neuropath 2. Work through defenses 3. Bridge neuro-gap

1

2 3

“Defenses”

“Bridge”

Nightmares/Flashbacks?

• How does the brain process trauma?

• What is the purpose of dream sleep?

• Why do flashbacks occur?

• Why do clients re-enact the trauma?

Stage 1: Assessment

• Assessment Stage:

• Assess patients coping strategies today – addictions, cutting, eating disorders, suicidal?

• Most trauma patients are suicidal – the thought of it gives comfort • When did their coping strategy start? (clue to age of trauma) • When asking questions re trauma, instruct them not to give details, just

an overview. Watch them closely, go slow & give them permission to stop

• Do they have a support system now? • Key factors:

• Age of trauma (younger = more dissociation) • Damage to the body • Relationship to the perpetrator • Single incident or multiple traumas?

Stage 2: Stabilization & Safety

This stage can last for years • Retrain the brain • Teach patients how to have a feeling and to reduce their

distress…Not mental - have to be on the circuitry to change it

• Stay in present time: Use future imaging to deal with current stressors (job, being alone in the house) a life worth living

• Give a measure of relief before beginning trauma processing

• Teach self-empowering, techniques used at home for nightmares, flashbacks

• Relationship is KEY to doing the work

Stage 2: Stabilization & Safety

• Medication if needed • Sleep • Body work • Meditation – mindfulness (practice 3-5 min a day) • Focused sustained attention • Music, dance, movement • Yoga, karate, breathwork • Neuro-feedback, bio

feedback • KEY: If they are not in the

body nothing will help

• 5 min a day of gratitude – strengthens circuits

• Guided Imagery – Belleruth Naparstek tapes

• Role Play • EMDR or Energy Psychology

for positive visualization • Monroe Institute • Brain Gym • Tomatis Method

BSFF: Energy Psychology Method to de-stress or enhance a visualization

1. To reduce distress when upset, angry, afraid:

• Notice where your body is holding the distress • Rate it from 0-10 • Rub the sore spot over the heart or the back of your neck and

say: “Even though I am upset (angry, afraid etc) I accept myself”

2. To enhance a visualization:

• Picture something you would like to do • Rate it’s clarity 0-10 • Rub sore spot over the heart or the back of your neck: “Even though I cannot picture this clearly I accept myself”

Larry Nims: www.besetfreefast.com

1. Tap Inner Eyebrow point: “I am releasing all the sadness in all the roots and the deepest cause of all of this problem”

2. Tap Under Eye Point: “I am releasing all the fear in all the roots and

the deepest cause of all of this problem” 3. Tap Little Finger point: (side of the nail, next to ring finger) “I am

releasing all the anger in all the roots and the deepest cause of all of this problem”

4. Tap Inner Eyebrow point: “I am releasing all the trauma in all the roots and the deepest cause of all of this problem”

5. Tap Index Finger point: (side of the nail, next to thumb) I forgive myself for having this problem” (3 times)

Note: For visualization substitute words –” deepest cause of why I cannot picture this yet”

Implications for Practice

• Educate your clients – we have to build strengths before we talk about your trauma

• Small progress is still progress • Addictions are how they coped, they are the solution to the

problem not the problem itself • Off of the addiction, the trauma will surface • Have to feel it to heal it…not talk • Don’t go logical on them….Listen with both ears • Can you tolerate emotions? • Do you feel safe? Are you triggered? Do you need support? • They are not hopeless…trauma is treatable

Stage 3: Trauma Processing

• Do not talk about the trauma until you are ready to process it

• Get training in a trauma processing method – EMDR, TFT, TAT, IET, IFS, Sensory Motor Processing, Somatic reprocessing, CBT - flooding

• You access the neuropath and help them to see/face/be with the emotions, sensations, behavior and knowledge that they couldn’t take in during the trauma.

• Safety concerns: • Be sure you have enough time in the session (longer session) • Never before going on vacation • Emergency contact, ride home

Stage 4: Reconnection

• In this stage, the client begins to face life without the terror,

shame & unworthiness • This is frightening because it is new (Remember -brain likes

what it knows!!) • Use visualization to create a new life • Can talk about God in this stage – if you do this before

trauma processing it can be spiritual bypass and anger continues to be dissociated

• Often wish to serve others – give back – make meaning • They are more than anything that has happened to them or

anything they have done – this is the Gift

For Further Info, Supervision & Training

Mary T. Sise, LCSW, D.CEP

596 New Loudon Rd. Latham, New York 12110

(518) 785-8576 marysise100@aol.com

www.MarySise.com

(Next training: April 12 & 13, 2014)

TAB I: General Public TAB II: Professionals Saturday, April 12, 2014 Sunday, April 13, 2014 9am - 5pm Fee: $125 9am - 5pm Fee: $175 Prerequisite: TAB I

Special ACE conference discount: $25 off each workshop, must register at MarySise.com by March 11, use the code “spring”