NEW THEORIES NEW THEORIES OF DISSOCIATION:OF DISSOCIATION:APPLICATIONS TO APPLICATIONS TO

THERAPYTHERAPYAND HEALINGAND HEALING

ROBERT SCAER, M.D.ROBERT SCAER, M.D.scaermdpc@msn.comwww.traumasoma.comwww.traumasoma.com

THE ROOTS OF THE ROOTS OF TRAUMATRAUMA

A THREAT TO LIFEA THREAT TO LIFE

IN THE FACE OF HELPLESSNESSIN THE FACE OF HELPLESSNESS

THE FIGHT /FLIGHT / FREEZE THE FIGHT /FLIGHT / FREEZE RESPONSERESPONSE

THE FREEZE RESPONSETHE FREEZE RESPONSE

• NUMBING THROUGH ENDORPHINSNUMBING THROUGH ENDORPHINS

• VAGAL (PARASYMPATHETIC) TONEVAGAL (PARASYMPATHETIC) TONE

• BIMODAL SYMPATHETIC / BIMODAL SYMPATHETIC /

PARASYMPATHETIC CYCLINGPARASYMPATHETIC CYCLING

(ACCELERATOR / BRAKE (ACCELERATOR / BRAKE

ANALOGY)ANALOGY)

HYPNOSISHYPNOSIS-- FREUD:FREUD: “…a paralysis produced “…a paralysis produced

by the influence of an omnipotent by the influence of an omnipotent person on a defenseless, impotent person on a defenseless, impotent subject”subject”

- - PAVLOV:PAVLOV: ANIMAL HYPNOSIS - ANIMAL HYPNOSIS - “…a “…a self-protecting reflex of an inhibitory self-protecting reflex of an inhibitory nature”nature”

- PERSISTANCE OF REFLEX MOTOR - PERSISTANCE OF REFLEX MOTOR POSTURES IMITATING THE LAST POSITION POSTURES IMITATING THE LAST POSITION OF THE LIMBS BEFORE HYPNOSIS ENSUEDOF THE LIMBS BEFORE HYPNOSIS ENSUED

LESSONS FROM THE WILD:LESSONS FROM THE WILD:

THE CRITICAL IMPORTANCETHE CRITICAL IMPORTANCE

OF DISCHARGINGOF DISCHARGING

THE FREEZE RESPONSETHE FREEZE RESPONSE

FREEZE/IMMOBILIZATIONFREEZE/IMMOBILIZATIONAND SURVIVALAND SURVIVAL

BABY CHICKSBABY CHICKS

NOTNOTIMMOBILIZED IMMOBILIZED IMMOBILIZED IMMOBILIZED IMMOBILIZED IMMOBILIZED

SPONTANEOUSSPONTANEOUS FORCEDFORCED

RECOVERYRECOVERY RECOVERY RECOVERY

BESTBEST INTERMEDIATE WORST INTERMEDIATE WORSTDROWNINGDROWNING DROWNING DROWNING DROWNING DROWNING SURVIVAL SURVIVAL SURVIVALSURVIVAL SURVIVAL SURVIVAL

ANIMALS THAT DO NOT ANIMALS THAT DO NOT DISCHARGE THE DISCHARGE THE

FREEZEFREEZE• ZOO ANIMALSZOO ANIMALS• LABORATORY ANIMALSLABORATORY ANIMALS• DOMESTIC ANIMALSDOMESTIC ANIMALS• HUMAN ANIMALSHUMAN ANIMALS

Q: WHAT DO THESE ANIMALS HAVEQ: WHAT DO THESE ANIMALS HAVE

IN COMMON?IN COMMON?

A: THEY ALL LIVE IN A CAGE!A: THEY ALL LIVE IN A CAGE!

MEMORY IN TRAUMAMEMORY IN TRAUMA

• TRAUMATIC STRESS: A TRAUMATIC STRESS: A LIFE THREATLIFE THREAT WHILE IN A STATE OF WHILE IN A STATE OF HELPLESSNESSHELPLESSNESS

• THIS LEADS TO THE THIS LEADS TO THE FREEZE RESPONSEFREEZE RESPONSE• DISCHARGE OF THE FREEZE RESPONSE DISCHARGE OF THE FREEZE RESPONSE

ALLOWS “COMPLETION” OF ESCAPE ALLOWS “COMPLETION” OF ESCAPE OR DEFENSE IN PROCEDURAL OR DEFENSE IN PROCEDURAL MEMORY, MEMORY, EXTINGUISHES EXTINGUISHES CONDITIONED CONDITIONED SOMATIC CUESSOMATIC CUES

CONDITIONING IN TRAUMACONDITIONING IN TRAUMA

• LACK OF “COMPLETION” IMPRINTS THE LACK OF “COMPLETION” IMPRINTS THE CONDITIONED ASSOCIATION OF:CONDITIONED ASSOCIATION OF:

- THE THREAT- THE THREAT

- ITS SENSORIMOTOR EXPERIENCE- ITS SENSORIMOTOR EXPERIENCE

(OR TRAUMATIC CUES)(OR TRAUMATIC CUES)

- AND THE STATE OF AROUSAL- AND THE STATE OF AROUSAL

WITHIN PROCEDURAL MEMORY!WITHIN PROCEDURAL MEMORY!

THIS ASSOCIATION LEADS TO THIS ASSOCIATION LEADS TO FEAR FEAR CONDITIONINGCONDITIONING, OR , OR TRAUMATIZATIONTRAUMATIZATION

DISSOCIATION:DISSOCIATION:??

THE PERCEPTUAL THE PERCEPTUAL COMPONENT COMPONENT

OF OF THE FREEZE RESPONSETHE FREEZE RESPONSE

??

THE HISTORYTHE HISTORYOF TRAUMA OF TRAUMA

AND DISSOCIATIONAND DISSOCIATIONININ

PSYCHIATRYPSYCHIATRY

CHARCOT AND THE CHARCOT AND THE SALPSALPÊÊTRITRIÈÈRERE

THE STUDYTHE STUDY

OF HYSTERIAOF HYSTERIA

AS A AS A

NEUROLOGICAL NEUROLOGICAL SYNDROMESYNDROME

JANET AND DISSOCIATIONJANET AND DISSOCIATION

• ““FIXED IDEAS”: THE SPECTRUM OF FIXED IDEAS”: THE SPECTRUM OF SYMPTOMS IN HYSTERIASYMPTOMS IN HYSTERIA

• SOMATIC, EMOTIONAL, PERCEPTUAL SOMATIC, EMOTIONAL, PERCEPTUAL SYMPTOMS TRIGGERED BY SYMPTOMS TRIGGERED BY

TRAUMATRAUMA• ““ABSENT MINDEDNESS” AND ABSENT MINDEDNESS” AND ABULIAABULIA- -

THE INABILITY TO INITIATE ACTIONTHE INABILITY TO INITIATE ACTION• TRIGGERING OF HYSTERIA BY CUES IN TRIGGERING OF HYSTERIA BY CUES IN

THE ENVIRONMENTTHE ENVIRONMENT

THE AGE OF HYSTERIATHE AGE OF HYSTERIA

• BREUER, THE “TALKING CURE”, BREUER, THE “TALKING CURE”, AND “REMINISCENCES”AND “REMINISCENCES”

• FREUD, INCEST AND “THE FREUD, INCEST AND “THE AETIOLOGY OF HYSTERIA”AETIOLOGY OF HYSTERIA”

• FREUD AND BREUER: RECANTATIONFREUD AND BREUER: RECANTATION• JANET: PROFESSIONAL OSTRACISM JANET: PROFESSIONAL OSTRACISM

LESSONS FROM WW ILESSONS FROM WW I• THE HELPLESSNESS OF TRENCH THE HELPLESSNESS OF TRENCH

WARFARE AND THE PREDOMINANCE WARFARE AND THE PREDOMINANCE OF DISSOCIATIVE SYNDROMES OF DISSOCIATIVE SYNDROMES (SHELL SHOCK)(SHELL SHOCK)

• FERENCZIFERENCZI ( (1919):1919): “..TIC..AN “..TIC..AN OVERSTRONG OVERSTRONG MEMORY FIXATION ON MEMORY FIXATION ON THE THE ATTITUDE OF THE BODY AT THE ATTITUDE OF THE BODY AT THE

MOMENT OF...TRAUMA”MOMENT OF...TRAUMA”• HYSTERIA AND MALINGERINGHYSTERIA AND MALINGERING• LOW PTSD INCIDENCE IN PILOTS AND LOW PTSD INCIDENCE IN PILOTS AND

OFFICERSOFFICERS

NEUROIMAGING IN NEUROIMAGING IN CONVERSION DISORDERCONVERSION DISORDER

• fMRI STUDIES IN HYSTERICAL MOTOR fMRI STUDIES IN HYSTERICAL MOTOR PARALYSIS AND ANESTHESIA, WITH PARALYSIS AND ANESTHESIA, WITH CHRONIC PAIN REVEAL:CHRONIC PAIN REVEAL:

- REDUCED SUPRASPINAL - REDUCED SUPRASPINAL RESPONSES IN HYSTERICAL PARALYSISRESPONSES IN HYSTERICAL PARALYSIS

- REDUCED ACTIVATION OF BRAIN - REDUCED ACTIVATION OF BRAIN SENSORY PATHWAYS WITH STIMULATION SENSORY PATHWAYS WITH STIMULATION OF THE HYSTERICALLY NUMB LIMBOF THE HYSTERICALLY NUMB LIMB

i.e.: i.e.: IMPAIRED BRAIN MESSAGE IMPAIRED BRAIN MESSAGE TRANSFER IN CONVERSION DISORDERTRANSFER IN CONVERSION DISORDER

NEUROIMAGING IN NEUROIMAGING IN CONVERSION DISORDERCONVERSION DISORDER

HYSTERICAL PARALYSIS AND SENSORY HYSTERICAL PARALYSIS AND SENSORY LOSS (CONVERSON DISORDER) IS LOSS (CONVERSON DISORDER) IS ASSOCIATED WITH OBJECTIVE, ASSOCIATED WITH OBJECTIVE,

LONG-STANDING DYNAMIC CHANGES IN LONG-STANDING DYNAMIC CHANGES IN REGIONS OF THE BRAIN THAT PROCESS REGIONS OF THE BRAIN THAT PROCESS

SENSORIMOTOR INFORMATIONSENSORIMOTOR INFORMATION

i.e.: i.e.: CONVERSION “HYSTERIA” IS CONVERSION “HYSTERIA” IS PHYSIOLOGICAL,PHYSIOLOGICAL,

NOT “PSYCHOLOGICAL”NOT “PSYCHOLOGICAL”

MANIFESTATIONS MANIFESTATIONS OF DISSOCIATIONOF DISSOCIATION

• DEREALIZATIONDEREALIZATION• DEPERSONALIZATIONDEPERSONALIZATION• DISTORTED TIME PERCEPTIONDISTORTED TIME PERCEPTION• DISTORTED SENSORY PERCEPTIONDISTORTED SENSORY PERCEPTION• AMNESIAAMNESIA• FUGUE STATESFUGUE STATES• CONVERSION REACTIONCONVERSION REACTION• DISSOCIATIVE IDENTY DISORDERDISSOCIATIVE IDENTY DISORDER

DISSOCIATION DISSOCIATION PSYCHOBIOLOGYPSYCHOBIOLOGY

• SCHORE (2005):…”vagal outflow from the SCHORE (2005):…”vagal outflow from the dorsal vagal nucleus …is the dorsal vagal nucleus …is the psychobiological engine of …dissociation”psychobiological engine of …dissociation”

• …”…”early trauma expressed as emotional early trauma expressed as emotional neglect and abuse…predict…neglect and abuse…predict…dissociation.”dissociation.”i.e.: IMPAIRED ATTACHMENT AND RIGHT O.F.C. i.e.: IMPAIRED ATTACHMENT AND RIGHT O.F.C. DEVELOMENT LEADS TO AUTONOMIC DEVELOMENT LEADS TO AUTONOMIC DYSREGULATION, AND THE EMERGENCE OF DYSREGULATION, AND THE EMERGENCE OF DORSAL VAGAL FREEZE / DISSOCIATIVE STATESDORSAL VAGAL FREEZE / DISSOCIATIVE STATES

THE DORSAL VAGUS THE DORSAL VAGUS NERVENERVE

• THE DORSAL VAGAL COMPLEX (DVC)THE DORSAL VAGAL COMPLEX (DVC)- THE DORSAL VAGAL NUCLEUS- THE DORSAL VAGAL NUCLEUS- PRIMITIVE, REPTILIAN- PRIMITIVE, REPTILIAN- LOW O- LOW O2 UTILIZATION2 UTILIZATION- THE DIVE REFLEX (APNEA, - THE DIVE REFLEX (APNEA,

BRADYCARDIA) BRADYCARDIA) - THE FREEZE RESPONSE, THE - THE FREEZE RESPONSE, THE

RISK IN MAMMALS, AND RISK IN MAMMALS, AND ““VOODOO DEATH”VOODOO DEATH”

BUT! BUT! THE DORSAL VAGUS / THE DORSAL VAGUS / FREEZE THEORY DOES NOT FREEZE THEORY DOES NOT EXPLAIN THE OCCURRENCE EXPLAIN THE OCCURRENCE

OF HIGH SYMPATHETIC-OF HIGH SYMPATHETIC-DOMINANT DISSOCIATVE DOMINANT DISSOCIATVE

STATES:STATES:

• HOMICIDAL DISSOCIATIONHOMICIDAL DISSOCIATION• ““BERSERKER” BEHAVIOR IN BERSERKER” BEHAVIOR IN

COMBATCOMBAT

DISSOCIATION DISSOCIATION STRUCTURESTRUCTURE

A CAPSULE, COMPARTMENT A CAPSULE, COMPARTMENT OR OR STATE OFSTATE OF PERCEPTIONPERCEPTION

COMPOSED OF THE VARIED COMPOSED OF THE VARIED PROCEDURAL MEMORIES PROCEDURAL MEMORIES OF THE EXPERIENCES OF THE EXPERIENCES

OF A PAST TRAUMATIC EVENT OF A PAST TRAUMATIC EVENT WHERE A FREEZE RESPONSE OCCURRED WHERE A FREEZE RESPONSE OCCURRED

WITHOUT A FREEZE DISCHARGEWITHOUT A FREEZE DISCHARGE

THE DISSOCIATION THE DISSOCIATION CAPSULE IS COMPOSED CAPSULE IS COMPOSED

OF:OF:• SOMATOSENSORY MESSAGES AND SOMATOSENSORY MESSAGES AND

MOTOR ACTIONSMOTOR ACTIONS• AUTONOMIC STATESAUTONOMIC STATES• EMOTIONS EMOTIONS • ENDORPHINERGIC ALTERATION OF ENDORPHINERGIC ALTERATION OF

PERCEPTIONPERCEPTION• EMOTION-LINKED DECLARATIVE EMOTION-LINKED DECLARATIVE

MEMORYMEMORY

ALL SPECIFIC TOALL SPECIFIC TO

THE TRAUMATIC EXPERIENCETHE TRAUMATIC EXPERIENCE

FEATURES OF THE FEATURES OF THE DISSOCIATIVE CAPSULEDISSOCIATIVE CAPSULE

CAPSULES CONSIST OF CAPSULES CONSIST OF PROCEDURAL MEMORIES PROCEDURAL MEMORIES FOR THE FOR THE PASTPAST TRAUMA, TRAUMA,

BUT ARE PERCEIVED AS BEING BUT ARE PERCEIVED AS BEING PRESENTPRESENT, ,

AND ARE THEREFORE AND ARE THEREFORE DISSOCIATIVEDISSOCIATIVE

EXAMPLES OF CAPSULE EXAMPLES OF CAPSULE PROCEDRAL MEMORIESPROCEDRAL MEMORIES

• PAIN, NUMBNESS, DIZZINESS,PAIN, NUMBNESS, DIZZINESS,• TREMOR, TICS, PARALYSISTREMOR, TICS, PARALYSIS• NAUSEA, CRAMPS, PALPITATIONSNAUSEA, CRAMPS, PALPITATIONS• ANXIETY, TERROR, SHAME, RAGE ANXIETY, TERROR, SHAME, RAGE • FLASHBACKS, NIGHTMARES OR FLASHBACKS, NIGHTMARES OR

INTRUSIVE THOUGHTSINTRUSIVE THOUGHTS

THE DISSOCIATIVE THE DISSOCIATIVE CAPSULE IS BROUGHT CAPSULE IS BROUGHT

INTO CONSCIOUS INTO CONSCIOUS AWARENESSAWARENESS

(THE PRESENT MOMENT) (THE PRESENT MOMENT) BY EXTERNAL BY EXTERNAL

REPRESENTATIVE CUES REPRESENTATIVE CUES OR INTERNAL KINDLEDOR INTERNAL KINDLED

MEMORIESMEMORIES

THE SIZE, SPECIFICITY THE SIZE, SPECIFICITY AND STRENGTH AND STRENGTH

OF A DISSOCIATIVE OF A DISSOCIATIVE CAPSULE DEPENDS ON CAPSULE DEPENDS ON

THE INTENSITY THE INTENSITY OR REPETITIVE OR REPETITIVE

EXPERIENCE OF THE EXPERIENCE OF THE TRAUMA THAT CAUSED ITTRAUMA THAT CAUSED IT

THE NUMBER THE NUMBER OF ONE’S DISSOCIATIVE OF ONE’S DISSOCIATIVE

CAPSULES CAPSULES IS DETERMINED BY IS DETERMINED BY

THE SUM TOTAL OF ONE’S THE SUM TOTAL OF ONE’S CUMULATIVE LIFE CUMULATIVE LIFE

TRAUMASTRAUMAS

THE MORE THE MORE THE NUMBER OF THE NUMBER OF

DISSOCIATIVE CAPSULES, DISSOCIATIVE CAPSULES, THE LESS TIME ONETHE LESS TIME ONE

IS ABLE TO SPEND IN IS ABLE TO SPEND IN CONSCIOUSNESS CONSCIOUSNESS

(THE PRESENT MOMENT)(THE PRESENT MOMENT)

THE PRESENT MOMENTTHE PRESENT MOMENT

• 1-10 SECOND PERIOD OF AWARENESS OF 1-10 SECOND PERIOD OF AWARENESS OF “NOW”“NOW”

• A “A “LIVED STORY”LIVED STORY”• BACKGROUND FEELINGS FROM THE BODYBACKGROUND FEELINGS FROM THE BODY• AUTOBIOGRAPHICAL MEMORYAUTOBIOGRAPHICAL MEMORY• CHANGING INTERNAL AND EXTERNAL CHANGING INTERNAL AND EXTERNAL

PERCEPTIONSPERCEPTIONS• CONCEPTS OF TIME, INTENTIONALITY, CONCEPTS OF TIME, INTENTIONALITY,

SHIFTING EMOTIONAL TONESHIFTING EMOTIONAL TONE• A MEASURE OF A MEASURE OF CONSCIOUSNESSCONSCIOUSNESS• OUR CHANGING SENSE OF SELFOUR CHANGING SENSE OF SELF

THE SELFTHE SELF

ANTONIO DAMASIO:ANTONIO DAMASIO:

““THE EMBODIED MIND”THE EMBODIED MIND”

SOMATIC SENSATIONS (SOMATIC SENSATIONS (FEELINGS)FEELINGS)

OF THE PRESENT MOMENT OF THE PRESENT MOMENT SUPERIMPOSED ON OUR SUPERIMPOSED ON OUR

AUTOBIOGRAPHICAL MEMORYAUTOBIOGRAPHICAL MEMORY

THE PRESENT

MOMENT

AUTONOMIC CUES

SOMATOSENSORY CUES

LIMBIC CUES

SHAMING, GRIEF

THE STRUCTURE AND RELATIONSHIPS OF DISSOCIATIVE CAPSULES

INCEST

MVAINJURY

PROCEDURAL MEMORYCUES

- SOMATOSENSORY-LIMBIC/EMOTIONAL

-AUTONOMIC - EMOTION-LINKED

DECLARATIVE MEMORY

PROCEDURAL MEMORYCUES

- AUTONOMIC- LIMBIC/EMOTIONAL- EMOTION - LINKED DECLARATIVE

MEMORY

PROCEDURAL MEMORY CUES

- SOMATOSENSORY- LIMBIC/EMOTIONAL

- AU TONOMIC- EMOTION-LINKED

DECLARATIVE MEMORY

PROCEDURALMEMORY CUES

-SOMATOSENSORY-LIMBIC/EMOTIONAL

-AUTONOMIC- EMOTION-LINKED

DECLARATIVE MEMORY

DEATH OF PARENT

PROCEDURALMEMORY CUES

-AUTONOMIC-LIMBIC/EMOTIONAL-EMOTIONA-LINKED

DECLARATIVE MEMORY

WHAT IMPLICATIONS WHAT IMPLICATIONS DOES THE DOES THE

DISSOCIATIVE CAPSULE DISSOCIATIVE CAPSULE HAVE FOR HEALING HAVE FOR HEALING

TRAUMA?TRAUMA?

TO HEAL TRAUMA TO HEAL TRAUMA

WE MUST EXTINGUISH WE MUST EXTINGUISH POSTTRAUMATIC POSTTRAUMATIC

PROCEDURAL MEMORY PROCEDURAL MEMORY CUESCUES

AND YOU CAN’T DOAND YOU CAN’T DO

THAT WITH THAT WITH WORDS WORDS

ALONE!ALONE!

SENSORY INPUT –

HEAD AND NECK

AMYGDALA EMOTIONALCONTENT

ANTERIORCINGULATE GYRUS

MODULATES AMYGDALA

CEREBRAL CORTEXHYPOTHALAMUS

HPA AXIS

HIPPOCAMPUSDECLARATIVE MEMORYCOGNITIVE MEANING

ORBITOFRONTALCORTEX

ORGANIZES RESPONSETO THREAT

LOCUS CERULEUS

EARLY WARNING

THE KEY INGREDIENT IN THE KEY INGREDIENT IN HEALING TRAUMAHEALING TRAUMA

EXTINGUISHING THE EXTINGUISHING THE

DISSOCIATIVE CAPSULEDISSOCIATIVE CAPSULE

CONTENTSCONTENTS

BYBY

DOWNREGULATING/DOWNREGULATING/

INHIBITING THE INHIBITING THE AMYGDALAAMYGDALA

DURING IMAGINAL EXPOSURE DURING IMAGINAL EXPOSURE TO ITS CONTENTSTO ITS CONTENTS

TRAUMA THERAPY:TRAUMA THERAPY:THEORETICAL CONSIDERATIONSTHEORETICAL CONSIDERATIONS

• EXTINCTION OF CONDITIONED CUES: IMAGERY EXTINCTION OF CONDITIONED CUES: IMAGERY WHILE INHIBITING THE AMYGDALAWHILE INHIBITING THE AMYGDALA

- - THE POWER OF RITUALTHE POWER OF RITUAL

- - INTEGRATING THE CEREBRAL HEMISPHERESINTEGRATING THE CEREBRAL HEMISPHERES

- - EMPOWERMENT THROUGH AFFIRMATIONEMPOWERMENT THROUGH AFFIRMATION

• RECONSOLIDATION OF MEMORYRECONSOLIDATION OF MEMORY• “ “COMPLETION” OF DEFENSE/ESCAPE: COMPLETION” OF DEFENSE/ESCAPE:

THE “THE “DISCHARGE”DISCHARGE”• RESTORING HOMEOSTASISRESTORING HOMEOSTASIS• TRANSFORMATION AND WISDOM THROUGH TRANSFORMATION AND WISDOM THROUGH

MEANINGMEANING

THE DILEMMA OFTHE DILEMMA OFPHARMACOTHERAPYPHARMACOTHERAPY

• SRI’s, ANTICONVULSANTS, SRI’s, ANTICONVULSANTS, BENZODIAZEPINES, BENZODIAZEPINES, ANTIPSYCHOTICS, ANTIPSYCHOTICS, BETA BLOCKERSBETA BLOCKERS

• TREATING A BIPOLAR SYNDROMETREATING A BIPOLAR SYNDROME• RECIPROCAL SIDE EFFECTSRECIPROCAL SIDE EFFECTS• SIDE EFFECTS AS TRAUMATIC SIDE EFFECTS AS TRAUMATIC

EXPERIENCES DUE TO EXPERIENCES DUE TO NEUROSENSITIZATIONNEUROSENSITIZATION

• NARCOTICS IN CHRONIC PAIN NARCOTICS IN CHRONIC PAIN

TRAUMA THERAPYTRAUMA THERAPY• PSYCHOTHERAPYPSYCHOTHERAPY

- COGNITIVE/BEHAVIORAL THERAPY: - COGNITIVE/BEHAVIORAL THERAPY: MOST THOROUGHLY EVALUATEDMOST THOROUGHLY EVALUATED

- EXPOSURE THERAPIES: - EXPOSURE THERAPIES: - IMAGINAL EXPOSURE- IMAGINAL EXPOSURE- IN-VIVO EXPOSURE- IN-VIVO EXPOSURE

- SYSTEMATIC DESENSITIZATION- SYSTEMATIC DESENSITIZATION

BEST FOR AROUSAL AND ANXIETY, BEST FOR AROUSAL AND ANXIETY, LESS EFFECTIVE FOR AVOIDANCE AND LESS EFFECTIVE FOR AVOIDANCE AND DISSOCIATION; ? LONG-TERM EFFICACYDISSOCIATION; ? LONG-TERM EFFICACY

TRAUMA THERAPYTRAUMA THERAPY

• RECONNECTING WITH THE BODYRECONNECTING WITH THE BODY- - SOMATIC DISSOCIATION AND THE SOMATIC DISSOCIATION AND THE

FELT SENSEFELT SENSE- THE USE OF MOVEMENT THERAPY:- THE USE OF MOVEMENT THERAPY:

YOGA, DANCE, BALANCE, YOGA, DANCE, BALANCE, EQUESTRIAN THERAPYEQUESTRIAN THERAPY

- THE USE OF THERAPEUTIC BODY - THE USE OF THERAPEUTIC BODY WORK AND EXERCISEWORK AND EXERCISE

- THE USE OF ARTISTIC MEDIA- THE USE OF ARTISTIC MEDIA- BIOFEEDBACK- BIOFEEDBACK

GUIDED IMAGERYGUIDED IMAGERY

• USED IN ALMOST ALL TECHNIQUESUSED IN ALMOST ALL TECHNIQUES• DERIVING THE SUD’s SCALEDERIVING THE SUD’s SCALE• ACCESSING THE MEMORY TO BE ACCESSING THE MEMORY TO BE

EXTINGUISHEDEXTINGUISHED• MANIPULATING THE MEMORY MANIPULATING THE MEMORY

THROUGH IMAGINAL REVERSALTHROUGH IMAGINAL REVERSAL• FACILITATING THE FELT SENSEFACILITATING THE FELT SENSE

SOMATIC EXPERIENCINGSOMATIC EXPERIENCING

• ACCESSING THE FELT SENSEACCESSING THE FELT SENSE• TRACKING AND TITRATION TRACKING AND TITRATION

THROUGH “PENDULATION”THROUGH “PENDULATION”• ELICITATION OF SOMATICELICITATION OF SOMATIC

SENSORIMOTOR RESPONSES: SENSORIMOTOR RESPONSES: THE FREEZE DISCHARGETHE FREEZE DISCHARGE

• AUTONOMIC RESPONSESAUTONOMIC RESPONSES• CONCEPTS OF COMPLETION,CONCEPTS OF COMPLETION,

UNCOUPLING, EXTINCTIONUNCOUPLING, EXTINCTION

ENERGY ENERGY PSYCHOLOGYPSYCHOLOGY• THOUGHT FIELD THERAPY (T.F.T.), THOUGHT FIELD THERAPY (T.F.T.),

EMOTIONAL FREEDOM EMOTIONAL FREEDOM THERAPY (E.F.T.), HEALING THERAPY (E.F.T.), HEALING TOUCHTOUCH

* * USE OF SUD’s SCALEUSE OF SUD’s SCALE

* * AFFIRMATIVE STATEMENTS, AFFIRMATIVE STATEMENTS, MERIDIAN TAPPING, SINGING, MERIDIAN TAPPING, SINGING, VOCALIZATION, EYE MOVEMENTS AND VOCALIZATION, EYE MOVEMENTS AND IMAGERYIMAGERY

* EMPOWERMENT, HOMEOSTASIS, * EMPOWERMENT, HOMEOSTASIS, INTEGRATING THE HEMISPHERES, INTEGRATING THE HEMISPHERES, RITUAL, EXTINCTION RITUAL, EXTINCTION

EMDREMDR• USE OF SUD’s SCALEUSE OF SUD’s SCALE• ALTERNATING EYE MOVEMENTS,ALTERNATING EYE MOVEMENTS,

AUDITORY OR TOUCH STIMULI LINKED AUDITORY OR TOUCH STIMULI LINKED TO IMAGERY OF THE TRAUMATO IMAGERY OF THE TRAUMA

• POSITIVE AND NEGATIVE COGNITIONSPOSITIVE AND NEGATIVE COGNITIONS• THE THE REMREM CONNECTION: CONNECTION:

- PROCESSING AROUSAL MEMORY- PROCESSING AROUSAL MEMORY- MEMORY RECONSOLIDATION- MEMORY RECONSOLIDATION- CEREBELLAR – CINGULATE - CEREBELLAR – CINGULATE CONNECTIONCONNECTION

• AFFIRMATION, RITUALAFFIRMATION, RITUAL

NEUROFEEDBACKNEUROFEEDBACK

• DRIVING THE BRAIN INTO THE PRESENT DRIVING THE BRAIN INTO THE PRESENT MOMENTMOMENT

• ALPHA/HIGH THETA ENHANCEMENTALPHA/HIGH THETA ENHANCEMENT• COMPARISON TO DEEP MEDITATIONCOMPARISON TO DEEP MEDITATION• APPLICABLE CONDITIONS:APPLICABLE CONDITIONS:

- - ADD/ADHD, OCDADD/ADHD, OCD- ADDICTIONS- ADDICTIONS- CRIMINAL BEHAVIOR- CRIMINAL BEHAVIOR- FIBROMYAGIA/CFS- FIBROMYAGIA/CFS- MOOD DISORDER, PTSD, ANXIETY- MOOD DISORDER, PTSD, ANXIETY- SOMATIZATION - SOMATIZATION - MTBI- MTBI

RESTORATIONRESTORATIONOF THEOF THE

TRIUNE BRAINTRIUNE BRAIN

THE ROLE OF THE ROLE OF COGNITIVE MEANING COGNITIVE MEANING

AND THE AND THE ACQUISITION OF WISDOMACQUISITION OF WISDOM

TRANSFORMATION ANDTRANSFORMATION ANDWISDOMWISDOM

• 1. 1. THE RECOGNITION AND THE RECOGNITION AND MANAGEMENT OF UNCERTAINTIES MANAGEMENT OF UNCERTAINTIES

• 2. THE INTEGRATION OF AFFECT 2. THE INTEGRATION OF AFFECT AND AND COGNITIONCOGNITION

• 3. THE RECOGNITION AND ACCEPTANCE 3. THE RECOGNITION AND ACCEPTANCE OF HUMAN LIMITATIONS, OF HUMAN LIMITATIONS, INCLUDING THE FINITUDE OF LIFE INCLUDING THE FINITUDE OF LIFE

i.e.: i.e.: LIFE IN THE PRESENT MOMENTLIFE IN THE PRESENT MOMENT