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QUESTIONS WITH CORRECTLY VERIFIED ANSWERS
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What happens in the brain during a potentially traumatic event - -brain stem is critical in
fast, defensive responses. It's directly connected with the retina
• retina sends visual info to the brain stem immediately, before higher levels of brain are even
aware of threat.
-If predator moves closer, periaqueductal gray initiates a fight or flight response.
• periaqueductal gray activates the sympathetic nervous system
➣HR goes up, Blood flow to muscles increases, BP increases, Pupils dilate.
-Not always safe or possible to fight or escape.
• may enter the freeze response, or feigned death.
• periaqueductal gray activates the parasympathetic nervous system as well.
➣Muscles get tight & freeze, Both gaze & breath may freeze, not cognitive choice
-"decisions" made at the level of the brain stem & nervous system
-Predator doesn't move away, the person may shutdown completely
• Hr drops. RR drops. Some people stop breathing. Muscles become limp. Metabolism shuts
down. Endorphins released.
• person enters state of "no pain", no longer aware of their surroundings.
• During inescapable trauma, this is a very adaptive way for the brain and body to respond.
Four Key Ways Collapse/Submit Can Present in a Client - 1. Compliance / Obedience
2. Treatment-Resistant Depression
,3. Interpersonal Conflict
4. Social Avoidance / Desire to Isolate
Brain-based approaches to trauma - -Top-down approaches
• Encourage different ways of thinking
• Cognitive-Behavioral Therapy (CBT)
• Dialectical-Behavior Therapy (DBT)
• Mindfulness-based Cognitive Therapy (MBCT)
-Bottom-up approaches
• Ways to cope with emotions & defenses
• Eye Movement Desensitization and Reprocessing (EMDR)
• Yoga
• Trauma Resiliency Model (TRM)
CDC has declared violence in the United States: - an urgent public health concern
affecting people in all stages of life
Violence - -extreme form of aggression
• can lead to trauma & lifetime of psychological, physical, & economic burdens for individuals,
families, & communities
What Happens When People Experience Violence or Trauma - polyvagal theory
-nervous system attempts to regulate a traumatic event by activating the social engagement
system using relational cues
• facial expressions, vocalizations, & language
-social engagement system can only be activated when ind is within their window of tolerance &
views the threat as manageable given their skills and resources.
• when client perceives trauma or threat as unmanageable, they leave their window of
tolerance & nervous system moves into a state of defense
➣triggering a sympathetic or dorsal vagal response
,➣sympathetic state can lead to fear, panic, and irritation, while the dorsal vagal response can
lead to a collapse/shutdown response
Nervous System's Response to Trauma - -polyvagal theory
• nervous system has three pathways, each designed to protect you:
➣ventral vagal
➣sympathetic pathway
➣dorsal vagal pathway
-ventral vagal
• nervous system's optimal state
• state from which we can engage socially, and connect and co-regulate with others
• we often feel more calm, curious, grounded, and safe
-sympathetic pathway
• defensive pathway that gets the body to mobilize into a fight or flight response, or an
attach/cry-for-help response
• we might feel fear, panic, irritation, anger, or even rage
-dorsal vagal pathway
• defensive pathway that gets the body to immobilize into a collapse/shutdown response
• we may feel numb, depressed, ashamed, hopeless, or lethargic
• We may dissociate
polyvagal theory: ventral vagal - -ventral vagal
• nervous system's optimal state
• state from which we can engage socially, and connect and co-regulate with others
• we often feel more calm, curious, grounded, and safe
polyvagal theory: sympathetic pathway - -sympathetic pathway
, • defensive pathway that gets the body to mobilize into a fight or flight response, or an
attach/cry-for-help response
• we might feel fear, panic, irritation, anger, or even rage
polyvagal theory: dorsal vagal pathway - -dorsal vagal pathway
• defensive pathway that gets the body to immobilize into a collapse/shutdown response
• we may feel numb, depressed, ashamed, hopeless, or lethargic
• We may dissociate
Risk Factors Related to Violence: Individual - -History of victimization
-ADHD or learning disorders
-Substance use
-Low intelligence
-Emotional distress
-Exposure to family violence
-Social or cognitive deficits
Risk Factors Related to Violence: Family - -Authoritarian parenting style
-Inconsistent or harsh discipline
-Low parental involvement
-Low parental income & education level
-Dysfunctional family functioning
Risk Factors Related to Violence: Community - -Gang involvement
-Social rejection
-Lack of economic opportunities
-Neighborhood poverty
-High level of transient people
-Low community participation
-Low school support