Stopping Child Abuse ... One Child At A Time. Understand the effects trauma has on the brain. Identify how creativity helps the therapeutic process. Discover a thinking pattern to develop your own creative ideas. Leave with creative interventions that can be utilized in the future. Pre-frontal Cortex Hypothalamus Located in the front portion of the brain. Is referred to as our “thinking brain”. Responsible for executive functioning including forethought, judgment, impulse control, planning, attention, and organization. Is the last part of the brain to develop. Lies beneath the prefrontal cortex and is part of the “primitive brain”. The “primitive brain” controls basic instinct and functions necessary for survival. Is the center of memory and emotion and therefore referred to as “emotional brain”. Involved in instinctive behaviors, basic impulses, and deep-seated emotions related to survival. Emotions are predominantly unconscious physical reactions to threat or opportunity. Consists of: Hippocampus Amygdala Hypothalamus Thalamus A switchboard for sensory data It screens, sorts, and pre-processes the incoming sensory information and relays it to the amygdala and cortex. Is responsible for emotional regulation. Considered our main “sensor” for emotions. Is the brain’s alarm system which is activated by any threats, then tags it as “fear” and transmits information to other brain systems. Detects an emotional stimuli related to fear and takes over as the “safety autopilot”. Located beneath the thalamus. It’s most important function is to maintain homeostasis. Controls autonomic functions to include: release of hormones, regulation of food and water intake, and regulation of sleep–wake cycle. Is the memory indexer. Controls how memories are stored, organized, and retrieved. Connects memories to emotions and senses. Thalamus (receives sensory data) All clear Amygdala (tags fear) Hypothalamus (cortisol & serotonin) Hippocampus (memory indexer) Pre-frontal Cortex (evaluates experience) There are two parts: Sympathetic- regulates the arousal response and increases activity as needed during times of stress. It prepares us to meet the actual or perceived threat. Parasympathetic- induces relaxation and helps the body become balanced after periods of high arousal. It provides a feeling of contentment and pleasure and is activated when we are relaxed, quiet, or asleep. The Parasympathetic and Sympathetic Nervous Systems are designed to function in a way that maintains a balanced state of being. Sympathetic=Reactive=Stress= Diminished Functioning=Limited Choice If a person is functioning in Sympathetic Dominance there is: Fight or flight response Chronic muscle tension Increased threat perception or hypervigilance Diminished brain function Loss of language and speech Intimacy intolerance Similar mistakes are repeated Incongruent emotional reactions Parasympathetic=Intentional=Comfort= Optimal Functioning=Choice If a person is functioning in parasympathetic dominance there is: Muscle relaxation and comfort Problems are seen as challenges Mobility in decision-making capacity Optimal motor and cognitive skills Intentionality or internal locus of control Emotional and behavioral self-regulation Intimacy tolerance Creative problem solving “Successfully stored” traumatic memory Thalamus (receives sensory data) All clear Amygdala (tags fear) Hypothalamus (cortisol & serotonin) Hippocampus (memory indexer) Pre-frontal Cortex (evaluates experience) Sometimes the transition of a traumatic experience into the memory is disrupted among people suffering from PTSD symptoms. As a result the event is repeatedly experienced as if it is occurring in the present. The memory is not stored as a verbal memory that occurred in the past. When your brain is in sympathetic dominance a false alarm is happening, the prefrontal cortex is skipped and the memories of the event become foggy and are stored erratically in the hippocampus. Sympathetic Dominance http://www.youtube.com/watch?v=HnbNcQlzV-4 Thalamus (receives sensory data) Explicit- Involve the conscious recollection of facts, memories, events, and ideas. Language allows for the verbal communication of these memories Implicit- Memories are generally unconscious. Stored as senses, sensations, emotions, moods, images, pictures, metaphors, and actions. Traumatic experiences are initially implicit. A trauma memory is mainly sensory with limited language. Trauma is what we experience, not what we know, understand, or can comprehend. Thalamus (receives sensory data) All clear Amygdala (tags fear) Hypothalamus (cortisol & serotonin) Hippocampus (memory indexer) Pre-frontal Cortex (evaluates experience) Repeated exposure to trauma leads to a change in overall brain structure, function, and chemistry. When people remain in Sympathetic Dominance the following have been shown to occur: A volume reduction of the hippocampus The hippocampus has difficulty in storing and recalling information The hippocampus has difficulty forming new memories. The pre-frontal cortex is skipped and executive functioning is suddenly rendered functionless, then the primitive brain rises in activity. The amygdala enlarges and becomes hyperactive The hypothalamus repeatedly excretes stress hormones which makes it difficult to distinguish between danger and safety. The combination of the disturbances in the functioning of the amygdala, hippocampus, and prefrontal cortex explain the reason as to why the memory is continually experienced for years and easily aroused by triggers and emotions that are difficult to describe in words. The perception of the threat and the actual threat is what puts a person in Sympathetic Dominance. Perception is influenced or changed by the brain structure and chemistry. The stress reaction can be seen as a conscious reaction; however it is an automatic survival response. Trauma affects you cognitively, behaviorally, socially, and emotionally. These reactions are survival reflexes. Behavioral Social Emotional Cognitive Aggression or Overly Difficulty making and Irritability Difficulty recalling Submmissive keeping friends information Impulsive acts Difficulty following Hopelessness Not completing tasks rules assigned Defiance Difficulty adjusting to Shame Flighty thoughts or social interactions disorganized thought patterns Lying, stealing, Difficulty trusting Guilt Struggle to accept cheating others responsibility for process triggering event Hyperactivity or low Become isolated due Extreme worry Indecisive energy to constant intense emotions Increase or decrease Isolates themselves Fearful Intrusive memories in appetite or to gain control of and flashbacks restricted eating their internal state Poor sleeping Vulnerable to re- Emotionally numb patterns victimization Promiscuity Dissociation Self-injury Mood swings Poor hygiene Incongruent emotional reactions Creativity- the ability to approach an object or situation from an alternative perspective. Creative Counseling- counseling that incorporates the expressive arts in order to help access, give form to, and understand experiences, memories, and emotions. Types of Expressive Arts: Art (paint, draw, sculpt) Dance or movement (yoga) Music Poetry/Journaling Drama Photography Guided Imagery An adult’s pre-frontal cortex is better developed which can hinder creative thinking. A child’s underdeveloped pre-frontal cortex makes them less likely to have rigid thinking patterns thus allows for a more natural creative expression. This limitation can be used as a strength to promote creativity. Creative interventions must influence the limbic system in order to access sensory experiences (implicit memories) that then can be converted to explicit memories by providing understanding and verbal language to the experience. Having both an implicit and explicit memory of the experience allows for an integrated connection between senses, images, behaviors, affect, and meaning. In this process the memory is now stored successfully because it was given language and now can be accessed as a past experience and a resource for future challenges. Children’s ability to process experiences at a sensory level helps facilitate the shift from Sympathetic Dominance to Parasympathetic Dominance. Through creative interventions children are better able to self-regulate and self-soothe. Using creative interventions is a powerful tool which provides benefits including: Helps capture and maintain interest and motivation in the counseling experience. Allows for an accepting, respectful, and safe environment Helps gain mastery through senses Allows the processing of the traumatic experience to be contained and not become overwhelming Inspires creative problem solving Promotes feeling identification Makes the unconscious conscious Supports emotional and behavioral self-regulation Promotes arousal reduction Appears less threatening or intimidating with special populations. Potential obstacles to utilizing creative interventions include: Cost of materials and supplies Not perceiving self as creative/artistic Self-conscious or a fear of judgment on abilities Hesitation of going outside of the box of traditional talk therapy Concern about having less control of the session in regards to the unpredictability of the results Time for the prep and cleanup Reluctant clients Ways to overcome obstacles of creativity: Pay attention to the client interests Create a predictable and safe environment for the child Be enthusiastic for the creative intervention Pace the session based on the child’s developmental level, engagement in therapy, and ability to manage arousal response Allow for spontaneity and flexibility Outline instructions of the intervention clearly Recycle or reuse generic materials Practice interventions and participate in supervision Trust the creative process! Don’t limit yourself by negative thinking. “I’m not a good artist” Do invite clients of any age to exercise their creativity Do seek supervision, research, and consult on the appropriateness and effectiveness of the method Do ask clients to try only those activities for experiences that you feel comfortable with experiencing Do be aware of the depth that the creative process may lead to the client to experience Do tie creative interventions to evidence-based practice Do seek out resources Don’t judge or assess clients work Don’t force the client to create if they are not ready to or are invested Don’t underestimate your own creativity and ability to develop creative interventions (Shallcross, 2011) For additional information about topics discussed today, please feel free to utilize the reference list and Creative Interventions Catalog. The body as a resource. (2010, August). Retrieved from http://www.tlcinstituteonline.org/courses/mod/resource/view.php?id=203. Bowirrat, A., Chen, T., Blum, K., Madigan, M., Baily, B., & Lih Chuan Chen, A…. (2010). Neuro-psychopharmacogentics and neurological antecedents of posttraumatic stress disorder: Unlocking the mysteries of resilience and vulnerability. Current Neuropharmacology, 8, 335-358. The biology of trauma. (2012). Retrieved from http://www.natal.org.il Campbell, J. (2012, April). Trauma and the brain. Healing Magazine. Conger, K. (2007, July). Severe trauma affects kids’ brain function, sayStanford/Packard researchers. Retrieved from http://mednews.stanford.edu. Corbett, H.C., (2009, March). Project (E)motion. Fitness Magazine. Gantt, L., & Tinnin, L.W. (2009). Support for a neurobiological view of trauma with implications for art therapy. The Arts in Psychotherapy, 36, 148-153. Interventions. (2010, August). Retrieved from http://www.tlcinstituteonline.org/courses/mod/resource/view.php?id=219. Kendall, J. (2002, September). How child abuse and neglect damage the brain. The Boston Globe. Lowenstein, L. (2010). Creative interventions for children, youth, and families. Retrieved from http://www.insswa.org/Newsletter/Creative_Interventions_for_Children_and_Fa milies.pdf Lowenstein, L. (2010). Favorite therapeutic activities for children, adolescents, and families: Practioners share their most effective interventions. Retrieved from http://www.lianalowenstein.com/e-booklet.pdf Korlin, D., Nyback, H., & Goldberg, F. S. (2000). Creative arts groups in psychiatric care: Development and evaluation of a therapeutic alternative. Nord J Psychiatry, 54(5), 333-340. Pretorius, G., & Pfeifer, N. (2010). Group art therapy with sexually abused girls. South African Journal of Psychology, 40(1), 63-73. Raider, M.C., Steele, W., Delillo-Storey, M., Jacobs, J., & Kuban, C. (2010). Structured sensory therapy (SITCAP-ART) for traumatized adjudicated adolescents in residential treatment. Retrieved from http://www.tlc.org. The roots of trauma. (2008, August). Retrieved from http://www.tlcinstituteonline.org/courses/mod/resource/view.php?id=201. Schimmel, C.J., & Jacobs, E. (2011). Ten creative counseling techniques for helping clients deal with anger. Retrieved from http://counselingoutfitters.com/vistas/vistas11/Article_53.pdf Shallcross, L. (2011, February). Working outside the box. Retrieved from http://counseling.org Shen, Y., & Armstrong, S. A. (2008). Impact of group sandtray therapy on the self- esteem of young girls. The Journal for Specialists in Group Work, 33(2), 118- 137. Shonkoff, J.P., & Garner, A.S. (2012). The lifelong effects of early childhood adversity and toxic stress. The American Academy of Pediatrics, 129(1), 233- 246. Talwar, S. (2007). Accessing traumatic memory through art: An art therapy trauma protocol (ATTP). The Arts in Psychotherapy, 34, 22-35. Trauma as an experience. (2010, August). Retrieved from http://www.tlcinstituteonline.org/courses/mod/resource/view.php?id=213. Van Der Kolk, B. (2006). Clinical implications of neuroscience research in PTSD. New York Academy of Sciences, 13(1),1-17.
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