2025 prepare for national certification
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