2025 prepare for national certification
Dissociative disorders - ✔✔✔-repeated discontinuity or disruption of the normal integration of
consciousness, memory, identity, emotion, perception, body representation, motor control, and
behavior
-characterized by dissociative symptoms that occur as an adaptive defense response to trauma
-may impede various elements of psychological functioning, such as consciousness, memory, emotion,
identity, & motor control
-Stigma may hinder tx
• myths about the existence & validity of these disorders
-primary considerations: Safety & social problems
crucial to managing dissociative responses: - ✔✔✔-Trauma-informed care
-Dissociation-specific psychotherapy
Somatic symptoms or psychophysiological disorders - ✔✔✔-challenging to dx & treat
-characterized by physical symptoms or dysfunction linked to psychological factors or emotional stress
-Psychotherapies such as CBT & stress management
• important to reduce symptom burden & promote health
How the nervous system responds to trauma - ✔✔✔Flee
Fight
Freeze
Collapse
Freeze vs Shutdown - ✔✔✔Freeze
-HYPERaroused
-muscles tense & full of energy, but can't release it
-similar levels of sympathetic & parasympathetic activation
,-Increased HR/BP
-client might say, "I feel stuck," "I can't move," or "I feel like I am encased in cement."
-Eyes widen
-body is ready to return to fight/flight as soon as the threat passes
Shutdown
-HYPOaroused
-muscles flaccid & loose
-parasympathic nervous system is dominant
-Decreased HR/BP/temp
-client may not be able to speak at all
-Blank stare
-Sensory info stops at the thalamus. It doesn't reach the cortex (so it's not integrated).
• client less aware of their internal & external world.
-Endorphins release to numb pain.
• Dynorphins release, can make the client feel detached from their body.
-Can result in fainting
How trauma impacts the 4 different types of memory: Semantic memory - ✔✔✔-How Trauma Can
Affect It
• prevent info (like words, images, sounds, etc.) from different parts of the brain from combining to
make a semantic memory.
-Related Brain Area
• temporal lobe & inferior parietal cortex
• collect infor from different brain areas to create semantic memory.
How trauma impacts the 4 different types of memory: Episodic memory - ✔✔✔-How Trauma Can Affect
It
• shutdown episodic memory & fragment the sequence of events.
, -Related Brain Area
• hippocampus
• responsible for creating & recalling episodic memory.
How trauma impacts the 4 different types of memory: Procedural Memory - ✔✔✔-How Trauma Can
Affect It
• change patterns of procedural memory
• example: person might tense up & unconsciously alter their posture, which could lead to pain or even
numbness.
-Related Brain Area
• striatum
• associated with producing procedural memory & creating new habits.
How trauma impacts the 4 different types of memory: Emotional Memory - ✔✔✔-How Trauma Can
Affect It
• person may get triggered & experience painful emotions, often without context.
-Related Brain Area
• amygdala
• plays key role in supporting memory for emotionally charged experiences.
Window of tolerance - ✔✔✔-When you are in your Window of Tolerance, you feel like you can dealwith
whatever's happening in your life.
• You might feel stress or pressure, but it doesn't bother you too much.
• the ideal place to be.
-Working with a practitioner can help expand your window of tolerance
• so you are more able to cope with challenges.