The document provides information about an upcoming trauma summit presented by the Trauma Resource Institute. The summit will focus on strengthening community support for those impacted by trauma. It will present the Trauma Resiliency Model, which is a biologically-based intervention for stabilizing, reducing, and preventing symptoms of traumatic stress. The model aims to restore the body's natural resiliency through skills that rebalance the nervous system.
1. Trauma Summit
Iowa Annual Conference
Strengthening the Safety Net of Love
Presented by Laurie Leitch, PhD
Co-Founder and Director
Trauma Resource Institute (TRI)
Website www.traumaresourceinstitute.com
copyright 2009
2. Everything is a possibility in a universe
of interaction and mutuality of all
beings. This optimistic message
allows us to entertain the possibility of
intervening in systems whose rules and
relationships have created conditions
that cause suffering in the world.
Merle Lefcoff
3. CALLS
• Are essentially questions, not to be
answered, but to be responded to
Where am I willing to be led?
Is my energy growing or shriveling?
• The “answers” are usually metaphor, poetic,
paradoxical, dream-like
Song lyrics, recurring dream images, overheard
conversations
• Rock the boat (cocoon & imaginal disks)
• Often require sacrifice
What are you willing to give up to ensure your own
unfolding and the unfolding of what is holy in your life?
• Are like a scavenger hunt
• Come in many disguises
4. The Engaged Citizen: An Emerging
Archetype
• Levoy: see our lives as a process of calls and
responses
“saying yes to the call can put you on a path that half of
yourself thinks doesn’t make sense and the other half
knows your life won’t make sense without it.”
“ Life is a great devourer, and dreams get swallowed at an
alarming rate.”
• Torah: “ if you listen from down below you will hear from up
above.”
• Revelation 21:5: “Behold I make all things new.”
• Old Roman Saying: “ The fates lead those who will,
those who won’t they drag.”
5. Callings
“A mystery that leaves itself like a trail of
bread crumbs and by the time your
mind has eaten its way to the maker of
the tracks, the mystery is inside you.”
Tom Brown The Tracker
6. The Clues are all around us
• Joseph Campbell said we’re having
experiences all the time that hint at our
hungers
• Our practices can help us stay awake and
curious to the soul’s whispers
• Many spiritual traditions say any sign or
story must be examined from 3 points of
view:
Literal
Metaphorical
Universal/transpersonal
7. Essential Principles in Following a
Calling
• Presence- the transition zone between
the fullness of opinions and the
emptiness of no thought.
• “Radical Optimism” (Roshi Joan Halifax) Holding
the vision for a successful future
• Solidarity rather than Charity: Lila Watson
8. Principles continued
• Self-Inquiry/Introspection:
How do my actions prevent or perpetuate
disparities & inequalities?
What are my internalized “isms”?
How do I bring my shadow to my calling?
How does my biography shape what I
bring to the work?
Where have I avoided going in my own
self-inquiry?
Where am I willing to be led?
10. Is the compassion and kindness we talk
about in all spiritual traditions possible if the
mind-body system is contracted due to
traumatic events? Can we live in harmony if
below the level of consciousness lies an
array of perceptions and sensations
biologically imprinted following these
events? What do those of us who attempt to
respond to the suffering of others (and our
own) need to know about the mind-body
system and traumatic response?
11. What is TRI?
• The Trauma Resource Institute (TRI) is a non-
profit organization. TRI’s global mission is to
promote healing in adults and children suffering
from trauma through education and integrative
interventions that link mind, body and the human
spirit.
• TRI’s goal is to expand access to treatment by
training frontline service providers who do the
hardest work with the least resources.
12. What is the Trauma Resiliency Model?
• A biologically-based intervention
• Focused on stabilizing, reducing and/or preventing
the symptoms of traumatic stress
• Restores the body’s natural resiliency through skills
that rebalance the nervous system
• Demonstrated to be effective in low dosages
• Also used for self-care of practitioner and client
13. Why is a Biological Model needed?
• New information from neuroscience about
the role of the nervous system in situations
of threat and fear
• The value of models that are not primarily
psychological or insight-oriented
• Their efficiency in re-stabilizing people and
giving hope
• Their gentleness…they do not re-traumatize
• The skills-based focus allows individuals and
their families to use the skills independently
14. A Brief History
• Thailand Tsunami
• Catholic Charities USA: Katrina project
• China Earthquake project
• Africa Projects:
Rwanda
Kenya
• Middle East- Gaza
• USA-
Disaster response teams
Community Resiliency Projects
Public training
Veterans Affairs projects: chronic pain, combat trauma
Sex-trafficking of domestic minors
15. • Spiritual leaders as first responders
• High potential for secondary
traumatization
• Potential for burnout
• Importance of self-care skills
16. In your work with trauma:
• What are the common physical reactions?
• What are the common emotional
reactions?
• What are the common cognitive reactions?
• What are the common behavioral
reactions?
• What are the common spiritual reactions?
Orientation to TRI
16
18. Trauma
Trauma =
Too Little
for Too Long!
Nervous system
becomes
dysregulated
19. Big “T” Trauma
Natural Disasters “C” Trauma
Man-Made disasters Homophobia
Disruption Trauma Heterosexism
Sexual Assaults Classism
Acts of Terrorism Poverty
Acts of Violence Little “t” Trauma Neglect
Economic collapse Dog Bites Racism
Child Abuse Dental Procedures Chronic Abuse
Car Accidents Routine Surgeries Colonialism
Physical trauma Falls Forms of Oppression
Minor car accidents Other “isms”
Arguments with significant others
When the nervous system is overwhelmed,
individuals can lose capacity
to stabilize and regulate themselves
20. The Individual’s Perception is
what triggers the cascade of
responses
The perception of
the event as life
threatening
combined with
feelings of
helplessness &
terror
21. Primary Focus of TRM
The patterns that
cause physiological
as well as
psychological
suffering are
entrenched in the
nervous system.
21
22. Autonomic Nervous
System
Sympathetic (SNS) Parasympathetic (PSNS)
Prepares for Action Prepares for Rest
The SNS controls organs during The PSNS controls the body
times of stress during rest
Breathing rate Breathing rate
Heart rate Heart rate
Pupils Dilate Pupils Dilate
Blood Pressure Blood Pressure
Sweating Sweating
Stress Hormones Stress Hormones
Digestion Digestion
Saliva Saliva
Key Concepts of TRM
24. The Autonomic Branch of the
Nervous System
The ANS has 2 important roles:
1. In emergencies, that cause
stress and require us to
"fight" or take "flight
This is the sympathetic branch of the ANS
2. In non-emergencies that allow
us to "rest" and "digest.“
This is the parasympathetic branch of the ANS
25. Rhythmic Cycling
A Natural Process
• Allows the person to respond
to constant input from the
environment in an adaptive
way
• Balance typifies most of nature
(Seasons, Day-Night Cycles,
moon, tides, etc…)
• The human body will regulate
back to balance
26. The Reciprocal Relationship in ANS
sympathetic
Resilient Zone
Balancemind
Release
charge
charge
parasympathetic
27. • ..”Our system is self-regulatory in the
highest degree: self maintaining, repairing,
readjusting and even improving. The
chief, strongest, and ever-present
impression …. nothing remains stationary,
unyielding; and everything could always
be attained, all could be changed for the
better, were only the appropriate
conditions realized.”
Pavlov
27
28. Traumatic Hyperactivity
Hypervigilance
Event! Stuck on “high”
Mania
Anxiety & Panic
Hyper-activation Rage
Resilient Zone
Balancemind
Depression
Disconnection
Exhaustion/Fatigue Stuck on “low”
Numbness
Hypo-activation
Key Concepts of TRM
Graphic adapted from original by Diane Poole Heller
29. When neither resistance nor escape is
(perceived to be) possible, the human
system of self-defense becomes
overwhelmed and disorganized. Each
component of the ordinary response to
danger, having lost its utility, tends to
persist in an altered and exaggerated
state long after the actual danger is
over.
Herman 1992
30. • Some have a very shallow Resilient Zone where even small stressors
bump you out of the Zone.
Resilient Zone
Balancemind
• Some have a deep Resilient Zone where there is a higher tolerance for a
wide range of stressors.
Resilient Zone
Balancemind
30
31. THE NERVOUS SYSTEM AND HUMAN
RESPONSES TO TRAUMA
• The nervous system (NS) unconsciously and
continually evaluates risk
• Traumatic events unbalance the NS, which
affects perceptions of safety, danger, or life
threat
• Practitioners can use TRM to help stabilize the
NS and promote social engagement and positive
attachment.
S. Porges, 2004
Slides by Miller-Karas&Leitch 2008(c)
33. The Triune Brain
• Neo cortex: Thinking
Cognition, beliefs, language,
thought, speech
*Integrates input from all 3 parts
• Limbic Area
Emotional - Expression and
mediation of emotions and
feelings, including emotions
linked to attachment
* Assess risk….negative focus
• Survival Brain
Instinctual/unconscious -
Digestion, reproduction,
circulation, breathing, and
the execution of the "fight or
flight"
34. “We have a brain that was field-tested
millions of years ago in the wild. I call it the
wild brain to distinguish it from the logic
brain that so many people revere. The
logic brain can’t do much for you once the
situation becomes critical…”
Lt. Col. Dave Grossman
35. POTENTIAL PATHWAYS FOLLOWING A TRAUMATIC EVENT
Traumatic
Stress
Traumatic Event Responses
Little “t” Mind and Body
& Self-Regulation
Big “T” Grief Homeostasis Returns
&
Reactions
“C” Trauma
Somatic
Complaints
Not every one who experiences a traumatic event will develop PTSD
36. What Are the Three Resiliency Models?
The Trauma Resiliency Model (TRM) is a condensed
course designed to teach skills to stabilize and
reduce and/or prevent the symptoms of traumatic
stress
The Veterans’ Resiliency Model (VRM) is focused on
combat-zone trauma
The Community Resiliency Model (CRM) helps create a
network of trauma-informed community members
and organizations using the biologically-based skills
Key Concepts of TRM
37. The Trauma Resiliency Model™
Key Concepts of TRM
are based on:
1. Laws of Nature
2. Human Anatomy and Physiology
3. Current Scientific Research on the Brain
4. Somatic Experiencing® & Sensory
Integration Theory, Gendlin’s Focusing
38. Biological Focus
• TRM uses observation and knowledge of
neurobiological patterns
• TRM brings the client’s awareness to sensation
to help interrupt the disorganized automatic
nature of the traumatic responses
• The client learns:
• to attend to the non-traumatic sensations
• to regulate affect and internal sensations
39. Goals of TRM
To depathologize trauma symptoms by focusing on the
biology rather than the psychology of trauma response
To teach TRM skills to clients and practitioners so that use
the skills to self-regulate
To elicit release of blocked energy from the nervous
system, to reduce or eliminate symptoms
To work gently without re-traumatizing
To restore balance and resiliency to the Nervous System
40. Who does TRM treat?
• TRM can be used to treat any person who has
experienced or witnessed any event that was
perceived as life threatening or posed a serious
injury to themselves or to others
• TRM can be used with immediate as well as past
trauma
• Adults and children
41. The Importance of Information
Education about the human responses
to trauma….normalizes
Education about the psychobiology of
trauma
Education shifts perceptions from
pathology to biology…reduces shame
and restores hope
42. Restoring the body to equilibrium can be
accomplished gently
Frozen in trauma A smiling child after treatment
43. The Underlying Principle of TRM
The human body
has the inner
capacity to heal
and restore itself!
44. Life Trauma in Humans
• A series of traumas or one trauma
can:
Lead to an alteration in the cycle of
homeostasis and regulation
Produce a process that is self-
perpetuating in the absence of
ongoing external stressors or threats
For many, these symptoms cannot
be “talked away”
Although insight is helpful, it may
not lead to regulation of the NS
Key Concepts of TRM
45. Three Symptoms Categories of Post-Traumatic
Stress & Acute Stress Disorders
Re-living the Event Avoidance of Reminders
“I have nightmares and it pops in “I can’t go back to that
my mind and feels place where it happened
like it’s happening again.” and often I just feel numb.”
Increased Arousal
“I am always afraid something
bad will happen and I jump at any
loud noise .”
“I can’t sleep and can’t
concentrate on my work.”
Slides by Miller-Karas&Leitch 2008(c)
46. Trauma and Development
• As the brain grows and organizes, the higher, more
complex areas begin to control and modulate the more
reactive, primitive functioning areas like the Survival
Brain.
• The person becomes less reactive, less impulsive, and
more thoughtful as the brain becomes more complex.
• Shock and Developmental Trauma can increase the
activity or reactivity of the brainstem level and
decrease the moderating capacity of the cortical areas
• Thus, as children develop, this can increase the
likelihood of aggression, impulsivity, and capacity to
be violent on one end of a continuum and depression
and disconnectedness on the other end.
47. Developmental & Shock Trauma
Two Kinds of Trauma
Developmental Trauma
and
Shock Trauma
Many children have experienced both
Slides by Miller-Karas&Leitch 2008(c)
48. Children’s Defenses
• Parents, family members
and teachers often
underestimate children’s
reactions to a traumatic
event
• Children may not show their
true feelings to protect their
parents and other family
members
Slides by Miller-Karas&Leitch 2008(c)
49. Stages of the Defense Response Cycle
High Activation is Designed to Enable Short-Term
Defensive Actions
Stage 1: Prepare for Defensive Action
Muscles tense, orient to source of threat
Stage 2: Mobilization
Production of Adrenalin and Cortisol in order to
provide energy needed to defend
Stage 3: Release of Energy through Fight or Flight
Running, Defensive Responses, Vocalizations
Stage 4: Return to Central Nervous System Equilibrium
Parasympathetic responses-Homeostasis
50. Fight, Flight and Freeze
• TRM works with the
understanding of the
natural defensive
responses of fight,
flight and freeze
• TRM helps relieve the
traumatic stress
symptoms through
restoring regulation to
the nervous system
Key Concepts of TRM
51. The Freeze Response
THE FREEZE RESPONSE happens
when both the Parasympathetic and
Sympathetic are activated and
overwhelmed at the same time.
• Fear and Terror overwhelm biological
& psychological coping
• Freezing during a traumatic event is a
major predictor of who develops
more serious symptoms as described
as Post-Traumatic Stress Disorder
52. The Freeze Response
The Freeze Response may be
experienced as:
• An altered state of reality
• The slowing down of time
• Diminished awareness of fear &
pain
The Freeze Response may
increase the chance of surviving
a traumatic event
Slides by Miller-Karas&Leitch 2008(c)
53. Traumatic Symptoms & the Nervous System
Symptoms arise when residual energy from
the experience is not released from the body
The Goals of TRM are:
1. to educate the client about the normal and
automatic defensive responses of fight, flight,
& freeze….depathologizes
2. use TRM skills to elicit release of thwarted
defensive energy, to reduce symptoms, and to
restore balance to the nervous system
Key Concepts of TRM
54. The Sensations of the Nervous System Release
Sensations can include the following:
• Tingling • Crying
sensations • Laughing
• Warmth • Burping and
• Vibrations or stomach gurgling
Trembling • Itching
• Shaking • Yawning
• Expanded • Cooling
breathing
Slides by Miller-Karas&Leitch 2008(c)
57. Implicit Memory: essential in
understanding trauma
IMPLICIT MEMORY(IM)
We use IM in learning most
physical activities like
walking, skating, & biking
Mental models are formed
from the experience
Body memories are created
during traumatic events
including sensations
associated with Big “T”,
little “t”, and “C” traumas
Key Concepts of TRM
58. “Some aspects of traumatic events
appear to get fixed in the mind,
unaltered by the passage of time or by
the intervention of subsequent
experience.”
(van der Kolk, Blitz, Burr & Hartmann, 1984).
59. External Trigger Internal Trigger
Internal body sensation
Sounds
-tightness in stomach
Smells -muscle tension
Visuals(people, places
-headache
& things)
Dissociative Capsule of Trauma
Pain, numbness, dizziness
Trembling, paralysis
Nausea, palpitations
Anxiety, terror, shame, anger, rage
Flashbacks, nightmares or
intrusive thoughts
Robert Scaer, MD
Slides by Miller-Karas&Leitch 2008(c)
60. Sensory images, sounds
Motor actions
Sympathetic/Parasympathetic
symptoms
Perceptual alterations
Emotions linked to the
traumatic experience
Scaer, R,(2007) The Body Bears the Burden
61. External Trigger Internal Trigger
Internal body sensation
Sounds
-tightness in stomach
Smells -muscle tension
Visuals(people, places
-headache
& things)
Dissociative Capsule of Trauma
Pain, numbness, dizziness
Trembling, paralysis
Nausea, palpitations
Anxiety, terror, shame, anger, rage
Flashbacks, nightmares or
intrusive thoughts
Robert Scaer, MD
Slides by Miller-Karas&Leitch 2008(c)
63. How does TRM work?
• TRM works with the patterns of response that are stuck in
implicit memory that cause suffering in the present
• TRM uses observation and knowledge of neurobiological
patterns to bring the client’s attention to the internal
sensation associated with the implicit memory system
• TRM brings the client’s awareness to sensation associated
with resources to help interrupt the automatic nature of the
implicit memory of their trauma…and extinguish cues that
trigger the memories
Key Concepts of TRM
64. THE TRM Model
• It is skill based so that at the end of the
training, the participants are prepared to
incorporate skills into their scope of
practice
• It provides basic information about the
neuroscience of the brain that is easily
understood and can be translated to
clients
• Concrete educational tools are given to
help participants teach their clients about
their symptoms and their inherent
resiliency…promotes independence
• Can be used for clinician self-care
Key Concepts of TRM
65. THE SEVEN CORE SKILLS*
* TRM includes the skills of Somatic Experiencing
TITRATION
TRACKING Working with small increments of
Using observation as a diagnostic traumatic material and activation
tool
PENDULATION
Alternating between traumatic and
GROUNDING resource sensations
Being fully present in the
moment
SHIFT AND STAY
Shifting attention from traumatic sensation and
staying with neutral or positive sensations
RESOURCING
Using positive or neutral factors to COMPLETION OF
create non-traumatic sensations DEFENSIVE RESPONSES
Inviting completion of motions, vocalizations, actions
that were blocked during the event
Trauma Resource Institute
66. “The range of what we think and do is
limited by what we fail to notice.”
RD Laing
67. Telling the Trauma story
• Must be titrated
T-1 T T+1
• Starts with a resource:
When did help come?
When did you know you had survived?
Who else lived?
What is giving you strength now?
What do you notice having told me just this much?
• Focuses on telling the story from inside the
Resilient Zone
69. HEALING
The individual can:
• learn to distinguish between
sympathetic and
parasympathetic responses
and
• Learn to apply the TRM
skills to daily life to reduce
or eliminate the symptoms
that emerged in the
aftermath of the trauma
• Hope and relief from shame
Key Concepts of TRM
70. O God who makes days and pronounces them
good, who sings in the everlasting rhythm of
dark and light, of risings and fallings, of
cycles, of one thing following another, who
makes time for all things in the cycle of
seasons and tides, break the plane of our
quiet desperation and lift up our brief years
that we may find peace, and trust in the
Everlastingness of your purpose.
Iona Center, Spring/summer 2009