The Trauma Recovery Institute

Trauma Recovery

Trauma Recovery

At Trauma Recovery Institute we attempt to get to the root of your life challenging symptoms, discomfort, illness and maladaptive behaviours. This is not another talk therapy, we specialise in personality disorders & complex trauma and focus on the brain, body, mind, diet, lifestyle, relationships and most importantly the nervous system where trauma is held. The definition of trauma is experiences that overwhlem our capacity to cope. Trauma effects all areas of the brain and all bodily systems often manifesting as cancer, IBS and a host of other chronic illnesses and pain syndromes which can not be otherwise explained.

physical-impact

Trauma can be conceptualized as stemming from a failure of the natural physiological activation and hormonal secretions to organize an effective response to threat. Rather than producing a successful fight or flight response the organism becomes immobilized. Probably the best animal model for this phenomenon is that of ‘inescapable shock,” in which creatures are tortured without being unable to do anything to affect the outcome of events. The resulting failure to fight or flight, that is, the physical immobilization (the freeze response), becomes a conditioned behavioral response.

In his book, Affect Regulation and the Origin of the Self, Allen Schore has outlined in exquisite detail the psychobiology of early childhood development involving maturation of orbitofrontal and limbic structures based on reciprocal experiences with the caregiver. Dysfunctional associations in this dyadic relationship result in permanent physicochemical and anatomical changes, which have implications for personality development as well as for a wide variety of clinical manifestations. An intimate relationship may exist, with negative child/care giver interaction leading to a state of persisting hypertonicity of the sympathetic and parasympathetic systems that may profoundly affect the arousal state of the developing child. Sustained hyperarousal in these children may markedly affect behavioral and characterological development.

Many traumatized children and adults, confronted with chronically overwhelming emotions, lose their capacity to use emotions as guides for effective action. They often do not recognize what they are feeling and fail to mount an appropriate response. This phenomenon is called alexithymia, an inability to identify the meaning of physical sensations and muscle activation. Failure to recognize what is going on causes them to be out of touch with their needs, and, as a consequence, they are unable to take care of them. This inability to correctly identify sensations, emotions, and physical states often extends itself to having difficulty appreciating the emotional states and needs of those around them. Unable to gauge and modulate their own internal states they habitually collapse in the face of threat, or lash out in response to minor irritations. Dissociation and/or Futility become the hallmark of daily life.

We use our minds not to discover facts but to hide them. One of things the screen hides most effectively is the body, our own body, by which I mean, the ins and outs of it, its interiors. Like a veil thrown over the skin to secure its modesty, the screen partially removes from the mind the inner states of the body, those that constitute the flow of life as it wanders in the journey of each day. The elusiveness of emotions and feelings is probably . . . an indication of how we cover to the presentation of our bodies, how much mental imagery masks the reality of the body”

Damasio

Part 1 of The New Traumatology & the Trauma Spectrum: A conversation between Dr. Robert Scaer and Anthony "Twig" Wheeler from Anthony Twig Wheeler on Vimeo.

Part 2 of The New Traumatology & the Trauma Spectrum: A conversation between Dr. Robert Scaer and Anthony "Twig" Wheeler from Anthony Twig Wheeler on Vimeo.

Trauma Treatment

Effective treatment needs to involve (1) learning to tolerate feelings and sensations by increasing the capacity for interoception, (2) learning to modulate arousal, and (3) learning that after confrontation with physical helplessness it is essential to engage in taking effective action. Introception is the process of embodied mindfulness, and in neuroscientific terms it is becoming aware of visceral afferent information (bodily sensations)

Being traumatized is continuing to organize your life as if the trauma was still going on unchanged and every new encounter or event is contaminated by the past. After trauma the world is experienced with a different nervous system, a survivor’s energy now becomes about suppressing inner chaos at the expense of spontaneous involvement in life. These attempts to maintain control of these unbearable physiological reactions can result in a whole a range of physical symptoms such as autoimmune diseases, this is why it is important in trauma treatment to engage the entire organism, body, mind and brain. Deactivation of the left hemisphere of the brain has a direct impact on the capacity to organize experience into logical sequences and to translate our shifting feelings and perceptions into words. Without sequencing we cannot identify cause and effect, grasp the long-term effects of our actions or create coherent plans for the future.

When something reminds traumatized people of the past, their right brain reacts as if the trauma were happening in the present but because their left brain may not be working very well, they may not be aware that they are re-experiencing and reenacting the past, they are just furious, terrified, enraged, shamed or frozen. After the emotional storm passes, they may look for something or somebody to blame for it, for their behaviour, they may say,

In trauma recovery where the left hemisphere is activated through speaking of the traumatic past and making sense of what happened within a safe environment, the left brain can talk the right brain out of reacting by saying that was then and this is now. This can only happen when safety is establish through attunement with a therapist where the amygdala is down regulated, this can often take some time for traumatized people as the amygdala tends to stay in a heightened state of arousal ready for fight or flight even years after then traumatic event or experience. Even the slightest detection of a threat can cause extreme arousal of this system. Minor stimuli will illicit major responses.

This is why it is important to engage the left and right-brain in trauma recovery, whilst body based interventions are absolutely imperative and ofcourse right brain to right brain affect reglation is critical for rewiring the nervous system contributing to long term character change and critical for trauma recovery, these interventions may be undermined should they exclude left-brain based activities. Body based interventions such as dance; massage and yoga are a fantastic adjunct to psychodynamic psychotherapy. Lazar’s study lends support to the notion that treatment of traumatic stress may need to include becoming mindful: that is, learning to become a careful observer of the ebb and flow of internal experience, and noticing whatever thoughts, feelings, body sensations, and impulses emerge. In order to deal with the past, it is helpful for traumatized people to learn to activate their capacity for introspection and develop a deep curiosity about their internal experience. This is necessary in order to identify their physical sensations and to translate their emotions and sensations into communicable language—understandable, most of all, to themselves.

“I acted this way because you looked at me like that or because you were late”. This is called being stuck in fight or flight.

Traumatized individuals need to learn that it is safe to have feelings and sensations. If they learn to attend to inner experience they will become aware that bodily experience never remains static. Unlike at the moment of a trauma, when everything seems to freeze in time, physical sensations and emotions are in a constant state of flux. They need to learn to tell the difference between a sensation and an emotion (How do you know you are angry/afraid? Where do you feel that in your body? Do you notice any impulses in your body to move in some way right now?). Once they realize that their internal sensations continuously shift and change, particularly if they learn to develop a certain degree of control over their physiological states by breathing, and movement, they will viscerally discover that remembering the past does not inevitably result in overwhelming emotions.

After having been traumatized people often lose the effective use of fight or flight defenses and respond to perceived threat with immobilization. Attention to inner experience can help them to reorient themselves to the present by learning to attend to non-traumatic stimuli. This can open them up to attending to new, non-traumatic experiences and learning from them, rather than reliving the past over and over again, without modification by subsequent information. Once they learn to reorient themselves to the present they can experiment with reactivating their lost capacities to physically defend and protect themselves.

Trauma and the Nervous System

Exposure to extreme threat, particularly early in life, combined with a lack of adequate caregiving responses significantly affect the long-term capacity of the human organism to modulate the response of the sympathetic and parasympathetic nervous systems in response to subsequent stress. The sympathetic nervous system (SNS) is primarily geared to mobilization by preparing the body for action by increasing cardiac output, stimulating sweat glands, and by inhibiting the gastrointestinal tract. Since the SNS has long been associated with emotion, a great deal of work on the role of the SNS has been collected to identify autonomic “signatures” of specific affective states. Overall, increased adrenergic activity is found in about two-thirds of traumatized children and adults. The parasympathetic branch of the ANS not only influences HR independently of the sympathetic branch, but makes a greater contribution to HR, including resting HR. Vagal fibers originating in the brainstem affect emotional and behavioral responses to stress by inhibiting sympathetic influence to the sinoatrial node and promoting rapid decreases in metabolic output that enable almost instantaneous shifts in behavioral state. The parasympathetic system consists of two branches: the ventral vagal complex (VVC) and the dorsal vagal complex (DVC) systems. The DVC is primarily associated with digestive, taste, and hypoxic responses in mammals. The DVC contributes to pathophysiological conditions including the formation of ulcers via excess gastric secretion and colitis. In contrast, the VVC has the primary control of supradiaphragmatic visceral organs including the larynx, pharynx, bronchi, esophagus, and heart. The VVC inhibits the mobilization of the SNS, enabling rapid engagement and disengagement in the environment.

The Dorsal Vagal State and Manifestation of Autoimmune Disorders

People who are in the dorsal vagal state a lot which is the state when the amygdala is activated due to a detection of a slight threat in the environment consciously or unconsciously through neuroception and the traumatized person goes into a state of learned helplessness or what is called dissociation or freeze response which is an unconscious conditioned fear response, the body’s reflex to an internal or external stimuli from a cue of an original trauma. This will activate all the viscera, your heart, your lungs, your colon, your stomach, all of these are run unconsciously by the dorsal vagal nucleus and if you have syndromes where you are in the freeze response a lot, the dorsal vagal nucleus will be hyperactive and you will get syndromes of hyperactivity within the viscera and that can be characterized by Irritable bowel disease, colitis and other autoimmune diseases.

These are cyclical diseases which means they oscillate between sympathetic and parasympathetic nervous system meaning the symptoms come and go which is why the medical profession very often can not diagnose the problem or refer to it as psychosomatic meaning it is a condition of the mind when in fact it is actually emotionally driven physiological conditions of the gut and the brain. Problems with the gut are common with people who have had trauma, it is the physiology of trauma that drives these conditions and so if you heal the trauma you can heal the disease. These conditions are also referred to as neurosomatic, which means they are brain based conditions, physical conditions caused by abnormal function of the brain.

"An Excerpt from world expert neurophysiologist Dr. Robert Scaer"

The Amygdala is the agent of fear conditioning, it stores emotionally based memory positive and negative, it is also the gate keeper for responding to threat by activating the fight or flight response, when the fight or flight response is not successful, such as you can not escape the traumatic event, the body goes into a freeze response. The freeze response is predicated by the effects of early childhood experiences, the freeze response is also called dissociation. When dissociation happens you are dysregulated, Dissociation is based a lot on what happened in childhood that allowed you to develop the brain in a way to prevent that from happening too easy. This has to do with Allan Schore’s work on attunement, the part of the brain that controls this regulation of autonomic nervous system and emotional system, which is the orbital frontal cortex. This develops in a healthy attuned infant and shrinks in a neglected infant. We need a developed orbital frontal cortex to regulate us over our lifetime and prevent us from going into freeze states and dysregulation. Helplessness is the essential ingredient for the freeze response.

The freeze response is a motor action, which perpetuates the escape behaviour in a way that erases all the procedural (Implicit) memory of that trauma. If you have a threat and don’t discharge the freeze response, you are conditioned thereafter to any body cues related to that traumatic event.

conclusn-shutdwn

Conclusion

Interoceptive, body-oriented therapies can directly confront a core clinical issue in PTSD: traumatized individuals are prone to experience the present with physical sensations and emotions associated with the past. This, in turn, informs how they react to events in the present. For therapy to be effective it might be useful to focus on the patient’s physical self-experience and increase their self- awareness, rather than focusing exclusively on the meaning that people make of their experience—their narrative of the past. If past experience is embodied in current physiological states and action tendencies and the trauma is reenacted in breath, gestures, sensory perceptions, movement, emotion and thought, therapy may be most effective if it facilitates self-awareness and self-regulation. Once patients become aware of their sensations and action tendencies they can set about discovering new ways of orienting themselves to their surroundings and exploring novel ways of engaging with potential sources of mastery and pleasure.

Working with traumatized individuals entails several major obstacles. One is that, while human contact and attunement are cardinal elements of physiological self-regulation, interpersonal trauma often results in a fear of intimacy. The promise of closeness and attunement for many traumatized individuals automatically evokes implicit memories of hurt, betrayal, and abandonment. As a result, feeling seen and understood, which ordinarily helps people to feel a greater sense of calm and in control, may precipitate a reliving of the trauma in individuals who have been victimized in intimate relationships. This means that, as trust is established it is critical to help create a physical sense of control by working on the establishment of physical boundaries, exploring ways of regulating physiological arousal, in which using breath and body movement can be extremely useful, and focusing on regaining a physical sense of being able to defend and protect oneself. It is particularly useful to explore previous experiences of safety and competency and to activate memories of what it feels like to experience pleasure, enjoyment, focus, power, and effectiveness, before activating trauma-related sensations and emotions. Working with trauma is as much about remembering how one survived as it is about what is broken.

Drawing on his work with patients who have survived a variety of traumatic experiences — from plane crashes to rape to torture — Van der Kolk considers the great challenge of those of us living with trauma:In response to the trauma itself, and in coping with the dread that persisted long afterward, these patients had learned to shut down the brain areas that transmit the visceral feelings and emotions that accompany and define terror. Yet in everyday life, those same brain areas are responsible for registering the entire range of emotions and sensations that form the foundation of our self-awareness, our sense of who we are. What we witnessed here was a tragic adaptation: In an effort to shut off terrifying sensations, they also deadened their capacity to feel fully alive.

body-adaptiv-respons

While this dissociation from the body is an adaptive response to trauma, the troublesome day-to-day anguish comes from the retriggering of this remembered response by stimuli that don’t remotely warrant it. Van der Kolk examines the interior machinery at play: The elementary self system in the brain stem and limbic system is massively activated when people are faced with the threat of annihilation, which results in an overwhelming sense of fear and terror accompanied by intense physiological arousal. To people who are reliving a trauma, nothing makes sense; they are trapped in a life-or-death situation, a state of paralyzing fear or blind rage. Mind and body are constantly aroused, as if they are in imminent danger. They startle in response to the slightest noises and are frustrated by small irritations. Their sleep is chronically disturbed, and food often loses its sensual pleasures. This in turn can trigger desperate attempts to shut those feelings down by freezing and dissociation.

In a passage that calls to mind philosopher Martha Nussbaum’s excellent subsequent writings on the nuanced relationship between agency and victimhood, Van der Kolk adds: Agency starts with what scientists call interoception, our awareness of our subtle sensory, body-based feelings: the greater that awareness, the greater our potential to control our lives. Knowing what we feel is the first step to knowing why we feel that way. If we are aware of the constant changes in our inner and outer environment, we can mobilize to manage them. But one of the most pernicious effects of trauma, Van der Kolk notes, is that it disrupts our ability to know what we feel — that is, to trust our gut feelings — and this mistrust makes us misperceive threat where there is none. This, in turn, creates an antagonistic relationship with our own bodies. He explains:

If you have a comfortable connection with your inner sensations — if you can trust them to give you accurate information — you will feel in charge of your body, your feelings, and your self. However, traumatized people chronically feel unsafe inside their bodies: The past is alive in the form of gnawing interior discomfort. Their bodies are constantly bombarded by visceral warning signs, and, in an attempt to control these processes, they often become expert at ignoring their gut feelings and in numbing awareness of what is played out inside. They learn to hide from their selves. The more people try to push away and ignore internal warning signs, the more likely they are to take over and leave them bewildered, confused, and ashamed. People who cannot comfortably notice what is going on inside become vulnerable to respond to any sensory shift either by shutting down or by going into a panic — they develop a fear of fear itself.

The experience of fear derives from primitive responses to threat where escape is thwarted in some way. People’s lives will be held hostage to fear until that visceral experience changes… Self-regulation depends on having a friendly relationship with your body. Without it you have to rely on external regulation — from medication, drugs like alcohol, constant reassurance, or compulsive compliance with the wishes of others. In its extreme, this lack of internal regulation leads to retraumatizing experiences: Because traumatized people often have trouble sensing what is going on in their bodies, they lack a nuanced response to frustration. They either react to stress by becoming “spaced out” or with excessive anger. Whatever their response, they often can’t tell what is upsetting them. This failure to be in touch with their bodies contributes to their well-documented lack of self-protection and high rates of revictimization and also to their remarkable difficulties feeling pleasure, sensuality, and having a sense of meaning.

One step further down on the ladder to self-oblivion is depersonalization — losing your sense of yourself.

What, then, can we do to regain agency in our very selves? Pointing to decades of research with trauma survivors, Van der Kolk argues that it begins with befriending our bodies and their sensory interiority: Trauma victims cannot recover until they become familiar with and befriend the sensations in their bodies. Being frightened means that you live in a body that is always on guard. Angry people live in angry bodies. The bodies of child-abuse victims are tense and defensive until they find a way to relax and feel safe. In order to change, people need to become aware of their sensations and the way that their bodies interact with the world around them. Physical self-awareness is the first step in releasing the tyranny of the past. In a sentiment that calls to mind Schopenhauer’s porcupine dilemma, Van der Kolk writes: The most natural way for human beings to calm themselves when they are upset is by clinging to another person. This means that patients who have been physically or sexually violated face a dilemma: They desperately crave touch while simultaneously being terrified of body contact. The mind needs to be reeducated to feel physical sensations, and the body needs to be helped to tolerate and enjoy the comforts of touch. Individuals who lack emotional awareness are able, with practice, to connect their physical sensations to psychological events. Then they can slowly reconnect with themselves. How we respond to trauma, Van der Kolk asserts, is to a large extent conditioned by our formative relationships with our caretakers, whose task is to help us establish a secure base. Essential to this is the notion of attunement between parent and child, mediated by the body — those subtlest of physical interactions in which the caretaker mirrors and meets the baby’s needs, making the infant feel attended to and understood.

Attunement is the foundation of secure attachment, which is in turn the scaffolding of psychoemotional health later in life.

secure-attachment

A secure attachment combined with the cultivation of competency builds an internal locus of control, the key factor in healthy coping throughout life. Securely attached children learn what makes them feel good; they discover what makes them (and others) feel bad, and they acquire a sense of agency: that their actions can change how they feel and how others respond. Securely attached kids learn the difference between situations they can control and situations where they need help. They learn that they can play an active role when faced with difficult situations. In contrast, children with histories of abuse and neglect learn that their terror, pleading, and crying do not register with their caregiver. Nothing they can do or say stops the beating or brings attention and help. In effect they’re being conditioned to give up when they face challenges later in life. With an eye to the immensely influential work of psychoanalyst Donald Winnicott, who pioneered the study of attachment and the notion that attunement between mother and infant lays the foundation for the child’s sense of self later in life, Van der Kolk summarizes these foundational findings: If a mother cannot meet her baby’s impulses and needs, “the baby learns to become the mother’s idea of what the baby is.” Having to discount its inner sensations, and trying to adjust to its caregiver’s needs, means the child perceives that “something is wrong” with the way it is. Children who lack physical attunement are vulnerable to shutting down the direct feedback from their bodies, the seat of pleasure, purpose, and direction.

The need for attachment never lessens. Most human beings simply cannot tolerate being disengaged from others for any length of time. People who cannot connect through work, friendships, or family usually find other ways of bonding, as through illnesses, lawsuits, or family feuds. Anything is preferable to that godforsaken sense of irrelevance and alienation. Although we can’t prevent most traumatic experiences from happening, having a solid formative foundation can make healing much easier. But what are those of us unblessed with secure attachment to do? Pointing to his mindfulness-based work with trauma survivors, Van der Kolk offers an assuring direction: Nobody can “treat” a war, or abuse, rape, molestation, or any other horrendous event, for that matter; what has happened cannot be undone. But what can be dealt with are the imprints of the trauma on body, mind, and soul: the crushing sensations in your chest that you may label as anxiety or depression; the fear of losing control; always being on alert for danger or rejection; the self-loathing; the nightmares and flashbacks; the fog that keeps you from staying on task and from engaging fully in what you are doing; being unable to fully open your heart to another human being.

The crucial point is that trauma robs us of what Van der Kolk terms “self-leadership” — the sense of having agency over ourselves and being in charge of our own experience. The path to recovery is therefore paved with the active rebuilding of that sense. He writes: The challenge of recovery is to reestablish ownership of your body and your mind — of your self. This means feeling free to know what you know and to feel what you feel without becoming overwhelmed, enraged, ashamed, or collapsed. For most people this involves (1) finding a way to become calm and focused, (2) learning to maintain that calm in response to images, thoughts, sounds, or physical sensations that remind you of the past, (3) finding a way to be fully alive in the present and engaged with the people around you, (4) not having to keep secrets from yourself, including secrets about the ways that you have managed to survive. One of the paradoxical necessities of the recovery process is the need to revisit the trauma without becoming so overwhelmed by sensations as to be retraumatized. The way to accomplish this, Van der Kolk argues, is by learning to be present with these overwhelming emotions and their sensorial counterparts in the body. He writes: Traumatized people live with seemingly unbearable sensations: They feel heartbroken and suffer from intolerable sensations in the pit of their stomach or tightness in their chest. Yet avoiding feeling these sensations in our bodies increases our vulnerability to being overwhelmed by them.

Traumatized people are often afraid of feeling. It is not so much the perpetrators (who, hopefully, are no longer around to hurt them) but their own physical sensations that now are the enemy. Apprehension about being hijacked by uncomfortable sensations keeps the body frozen and the mind shut. Even though the trauma is a thing of the past, the emotional brain keeps generating sensations that make the sufferer feel scared and helpless. It’s not surprising that so many trauma survivors are compulsive eaters and drinkers, fear making love, and avoid many social activities: Their sensory world is largely off limits.

Another paradox of healing is that although contact and connection are often terrifying to the traumatized, social support and a sense of community are the foundation upon which a health relationship with our own feelings and sensations is built. Half a century after Dorothy Day’s memorable assertion that “we have all known the long loneliness and we have learned that the only solution is love and that love comes with community,” Van der Kolk writes: All of us, but especially children, need … confidence that others will know, affirm, and cherish us. Without that we can’t develop a sense of agency that will enable us to assert: “This is what I believe in; this is what I stand for; this is what I will devote myself to.” As long as we feel safely held in the hearts and minds of the people who love us, we will climb mountains and cross deserts and stay up all night to finish projects. Children and adults will do anything for people they trust and whose opinion they value. But if we feel abandoned, worthless, or invisible, nothing seems to matter. Fear destroys curiosity and playfulness. In order to have a healthy society we must raise children who can safely play and learn. There can be no growth without curiosity and no adaptability without being able to explore, through trial and error, who you are and what matters to you.

traumatized-people

Another paradox of healing is that although contact and connection are often terrifying to the traumatized, social support and a sense of community are the foundation upon which a health relationship with our own feelings and sensations is built. Half a century after Dorothy Day’s memorable assertion that “we have all known the long loneliness and we have learned that the only solution is love and that love comes with community,” Van der Kolk writes: All of us, but especially children, need … confidence that others will know, affirm, and cherish us. Without that we can’t develop a sense of agency that will enable us to assert: “This is what I believe in; this is what I stand for; this is what I will devote myself to.” As long as we feel safely held in the hearts and minds of the people who love us, we will climb mountains and cross deserts and stay up all night to finish projects. Children and adults will do anything for people they trust and whose opinion they value. But if we feel abandoned, worthless, or invisible, nothing seems to matter. Fear destroys curiosity and playfulness. In order to have a healthy society we must raise children who can safely play and learn. There can be no growth without curiosity and no adaptability without being able to explore, through trial and error, who you are and what matters to you.

The Default Mode Network

Is the major rest state network of the brain, when we are in a resting state, the default mode network is most active. The default mode network is composed of three brain regions called the posterior singulate cortex in the back of the brain and is responsible for helping us with self relevance. Often a traumatised person will have difficulty figuring out what is self relevent. For example, if someone was raped in the forest and then goes back to a forest years later, they may think they're going to be raped again because they think the forest is self-relevant even though it isn't at all. Another region of the default mode network is the dorsal medial prefrontal cortex which is located in the front of the brain in the middle. This area of the brain helps us to know what we feel and helps us to know our internal emotional life. Traumatised people find it very difficult to know internal emotional states. The third area of the brain that is part of the default mode network is the parietal cortex which allows us to have an embodied sense of self in space. Very often with Traumatised people , it can be difficult to know where the body starts and ends because of the disconnect from the body and how it relates to the environment. All of these areas are most active when we are at rest , when we are thinking or planning these areas are quiet. when someone experiences trauma very early in life, these three areas get so disrupted and do not connect at all and this disconncetion can have major implications. This disruption in the default mode network may be very important in the disruption of the sense of self often seen as a result of trauma. The whole funcion of this network is engaging in self-reflective functions – so, figuring out what's self-relevant and knowing our internal emotional life. It really reflects the fact that traumatised people are not able to do this very often. If you don't know what you're experiencing emotionally, if you're disconnected from your body, if you don't know where your body begins or ends, if you can't recall memories appropriately, if you can't look into the future, your sense of self is going to be very much affected. We know that trauma very much affects the sense of self.

The Salience Network

Is a really important network in the brain that helps us figure out what's most important – both in the environment and internally which helps us to guide our behavior. The Salience Network has been implicated in detection and integration of emotional and sensory stimuli, as well as in modulating the switch between the internally directed cognition of the default mode network and the externally directed cognition of the central executive network. For example – if I decide what's most important right now is that there's a guy standing there that's about to break into my house, all my behaviors will be guided towards getting myself into safety. The salience network is really important and includes the substantia nigra, ventral tegmental area, ventral striatum, amygdala, dorsomedial thalamus, and hypothalamus. . It also includes the anterior singular cortex that modulates heart rate responses and also figures out whether there are errors that we have to sort out. The insula is also part of the salience network and that part of the brain really helps us to be aware of what we feel inside. When a person experiences trauma, the salience network goes offline. And that can happen in two different ways, hyperarousal and hypoarousal. When we're really hyper-aroused and really hyper vigilant, the salience network can actually be overactive which also increase dorsal vagal tone which can lead to syndromes of autoimmunity such as Ibs and other issues with the viscera such as lungs and heart , but the salience can also be underactive which also means shutting down the dorsal vagal which leads to immobilisation, the fear response and difficulty sleeping . When we disconnect and when we numb out, the salience network is underactive. So our task is often to balance this network and and the client’s optimum window of tolerance- where our client isn’t too revved up or too dulled down.

Treatment of Relational and complex Trauma at Trauma Recovery Institute

Trauma Recovery Institute offers unparalleled services and treatment approach through unique individual and group psychotherapy. We specialise in long-term relational trauma recovery, sexual trauma recovery and early childhood trauma recovery. We also offer specialized group psychotherapy for psychotherapists and psychotherapy students, People struggling with addictions and substance abuse, sexual abuse survivors and people looking to function in life at a higher level. Trauma recovery Institute offers a very safe supportive space for deep relational work with highly skilled and experienced psychotherapists accredited with Irish Group Psychotherapy Society (IGPS), which holds the highest accreditation standard in Europe. Trauma Recovery Institute uses a highly structured psychotherapeutic approach called Dynamic Psychosocialsomatic Psychotherapy (DPP).

At Trauma Recovery Institute we address three of the core Attachment Styles, their origin’s the way they reveal themselves in relationships, and methods for transforming attachment hurt into healing. We use the latest discoveries in Neuroscience which enhances our capacity for deepening intimacy. The foundation for establishing healthy relationships relies on developing secure attachment skills, thus increasing your sensitivity for contingency and relational attunement. According to Allan Schore, the regulatory function of the brain is experience-dependent and he says that, as an infant, our Mother is our whole environment. In our relational trauma recovery approach you will learn to understand how the early patterns of implicit memory – which is pre-verbal, sub-psychological, and non-conceptual – build pathways in our brain that affect our attachment styles. Clinically, we can shift such ingrained associative patterns in our established neural network by bringing in new and different “lived” experiences in the Here and Now.

The Central Executive Network

is in the upper part of the brain and it contains the front part of the brain and the parietal cortex part of the brain. It's an area of the brain that's absolutely critical in helping us think and plan. It's really important in short term memories – remembering phone numbers or names. It's also really important in helping us sustain attention, and really focus on something. People who have experinced trama often find it diffiiclt to sustain attenion and can have huge difficulty with short-term memory and planning. The more a person dissociates or zones out and is not present, the less able to function that central executive network seems to be.

The Role of the Therapist in transforming attachment trauma:

Healing into wholeness takes the active participation of at least one other brain, mind, and body to repair past injuries – and that can be accomplished through a one-to-one therapeutic relationship, a therapeutic group relationship or one that is intimate and loving. In exploring the “age and stage” development of the right hemisphere and prefrontal cortex in childhood, we discover how the presence of a loving caregiver can stimulate certain hormones, which will help support our growing capacity for social engagement and pleasure in all of our relationships. Brain integration leads to connection and love throughout our entire life span. At trauma recovery institute we bring a deep focus to the role of Neuroscience in restoring the brain’s natural attunement to Secure Attachment. Our brain is a social brain – it is primed for connection, not isolation, and its innate quality of plasticity gives it the ability to re-establish, reveal and expand one’s intrinsic healthy attachment system.

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Dynamic Psychosocialsomatic Psychotherapy (DPP) at Trauma Recovery Institute Dublin

Dynamic Psychosocialsomatic Psychotherapy (DPP) is a highly structured, once to twice weekly-modified psychodynamic treatment based on the psychoanalytic model of object relations. This approach is also informed by the latest in neuroscience, interpersonal neurobiology and attachment theory. As with traditional psychodynamic psychotherapy relationship takes a central role within the treatment and the exploration of internal relational dyads. We also adhere to the polyvagal theory principles promoting safety as the first step in our treatment approach. Our approach differs in that also central to the treatment is the focus on the transference and countertransference, an awareness of shifting bodily states in the present moment and a focus on the client’s external relationships, emotional life and lifestyle.

Dynamic Psychosocialsomatic Psychotherapy (DPP) is an integrative treatment approach for working with complex trauma, borderline personality organization and dissociation. This treatment approach attempts to address the root causes of trauma-based presentations and fragmentation, seeking to help the client heal early experiences of abandonment, neglect, trauma, and attachment loss, that otherwise tend to play out repetitively and cyclically throughout the lifespan in relationship struggles, illness and addictions.

Nervous System Regulation Exercise 1.

Write down What are your “rules of play”? In each of the following categories identify what cues of danger shut down play, what cues of safety support an experience of play, and what beliefs are associated with both the shut down and cues of safety in each category.

Understanding Your Nervous System Exercise 2.

Think about when each state ventral, sympathetic and dorsal is most alive and write down with Who, with What, Where and when is each stage of nervous system most alive ?

Understanding Your Nervous System Exercise 3.

In each of the nervous system states ventral, sympathetic and dorsal , write down some words which describe this sate and in each of these states write the following which may speak to an internal belief.
I am .....
The world is ....
*It is healthy to come through all states of the nervous system, for example we activate the sympathetic nervous system in the gym, we activate the dorsal vagal system when digesting food and going to sleep, these examples are working and operating along with ventral vagal. These States become problematic when safety is gone, when there is danger or perception of danger via neuroception thus ventral vagal goes offline and now sympathetic state or dorsal state is now dominant.*

The Trauma Recovery Institute A Neuro-Scientific Based PsychoSocialSomatic Approach

Dynamic Psychosocialsomatic Psychotherapy - Working on The Mind & all Bodily Systems

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