panelists: margo demont, ph.d. cynthia lemp, m.s.w. kimberlie warren, ph.d

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Racing Pulse, Toxic Stress, Shock: The Effect of Trauma on the Brain Panelists: Margo DeMont, Ph.D. Cynthia Lemp, M.S.W. Kimberlie Warren, Ph.D.

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14 th ANNUAL TRAUMA SYMPOSIUM Racing Pulse, Toxic Stress, Shock: The Effect of Trauma on the Brain. Panelists: Margo DeMont, Ph.D. Cynthia Lemp, M.S.W. Kimberlie Warren, Ph.D. The Effect of Trauma on the Brain Presentation Objectives. The Learner will be able to: - PowerPoint PPT Presentation

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Page 1: Panelists: Margo DeMont, Ph.D. Cynthia Lemp, M.S.W. Kimberlie Warren, Ph.D

14th ANNUAL TRAUMA SYMPOSIUM

Racing Pulse, Toxic Stress, Shock: The Effect of Trauma on the Brain

Panelists: Margo DeMont, Ph.D. Cynthia Lemp, M.S.W. Kimberlie Warren, Ph.D.

Page 2: Panelists: Margo DeMont, Ph.D. Cynthia Lemp, M.S.W. Kimberlie Warren, Ph.D

The Effect of Trauma on the Brain Presentation Objectives

The Learner will be able to:

Describe the effect of stress on the brain

Explain how to alter emotions to minimize the “flight or fight” stress response

Identify at least three symptoms of post-traumatic stress disorder

Describe two physiological changes resulting from using Acute Trauma Incident Processing with a patient

Page 3: Panelists: Margo DeMont, Ph.D. Cynthia Lemp, M.S.W. Kimberlie Warren, Ph.D
Page 4: Panelists: Margo DeMont, Ph.D. Cynthia Lemp, M.S.W. Kimberlie Warren, Ph.D

Bi-directional communication between the brain and the body via Autonomic nervous system (ANS)

Page 5: Panelists: Margo DeMont, Ph.D. Cynthia Lemp, M.S.W. Kimberlie Warren, Ph.D
Page 6: Panelists: Margo DeMont, Ph.D. Cynthia Lemp, M.S.W. Kimberlie Warren, Ph.D
Page 7: Panelists: Margo DeMont, Ph.D. Cynthia Lemp, M.S.W. Kimberlie Warren, Ph.D
Page 8: Panelists: Margo DeMont, Ph.D. Cynthia Lemp, M.S.W. Kimberlie Warren, Ph.D

ALLOSTATIC LOAD

Page 9: Panelists: Margo DeMont, Ph.D. Cynthia Lemp, M.S.W. Kimberlie Warren, Ph.D

Amygdala Hijacking

Page 10: Panelists: Margo DeMont, Ph.D. Cynthia Lemp, M.S.W. Kimberlie Warren, Ph.D

The CEO is out of commission!

Page 11: Panelists: Margo DeMont, Ph.D. Cynthia Lemp, M.S.W. Kimberlie Warren, Ph.D
Page 12: Panelists: Margo DeMont, Ph.D. Cynthia Lemp, M.S.W. Kimberlie Warren, Ph.D

Emotionally traumatic effects

• “Multiple conflicts, wars…and personal trauma from accidents, abuse, disaster, bullying…large numbers of individual psyches and family systems have been traumatized. The emotional devastations come from the same emotions that can be powerful emotional catalysts for healing.” (www.energeticinstitute.com.au)

Page 13: Panelists: Margo DeMont, Ph.D. Cynthia Lemp, M.S.W. Kimberlie Warren, Ph.D
Page 14: Panelists: Margo DeMont, Ph.D. Cynthia Lemp, M.S.W. Kimberlie Warren, Ph.D

Reptilian versus Thinking BrainReptilian and

limbic, sub-cortical areas mediate emotional life.

Healing and rewiring emotional responses and defenses occurs in older brain areas.

Page 15: Panelists: Margo DeMont, Ph.D. Cynthia Lemp, M.S.W. Kimberlie Warren, Ph.D

The heart – brain connection

Page 16: Panelists: Margo DeMont, Ph.D. Cynthia Lemp, M.S.W. Kimberlie Warren, Ph.D

EMOTIONS AS ENERGY SOURCES

Energetic frequencies

Positive (high), negative (low)

Page 17: Panelists: Margo DeMont, Ph.D. Cynthia Lemp, M.S.W. Kimberlie Warren, Ph.D

Emotions and Heart RhythmsEmotions and Heart Rhythms

17Institute of HeartMath

Page 18: Panelists: Margo DeMont, Ph.D. Cynthia Lemp, M.S.W. Kimberlie Warren, Ph.D

CoherenceFacilitates Brain

Function

Heart Rhythms Directly Impact

Physical and Mental Performance

The heart signals especially affect the brain centers involved in social and situational awareness, the capacity to care, and the ability to self-manage.

IncoherenceInhibits Brain

Function

Institute of HeartMath

Page 19: Panelists: Margo DeMont, Ph.D. Cynthia Lemp, M.S.W. Kimberlie Warren, Ph.D

Brain cell death Accelerated aging

Impaired memory or learningAlzheimer's

Hypertension Heart disease

CancerObesity

Diabetes

Impact and outcomes of chronic/toxic stress

Page 20: Panelists: Margo DeMont, Ph.D. Cynthia Lemp, M.S.W. Kimberlie Warren, Ph.D

Stress – cognitive inhibition

Vitality – cognitive facilitation

Page 21: Panelists: Margo DeMont, Ph.D. Cynthia Lemp, M.S.W. Kimberlie Warren, Ph.D

http://assists.blogspot.com/

Synchronize the Autonomic Nervous System

Page 22: Panelists: Margo DeMont, Ph.D. Cynthia Lemp, M.S.W. Kimberlie Warren, Ph.D

Emotional LandscapeAutonomic Nervous System – Sympathetic Pathway

High Arousal - Adrenaline

Hormonal System

Low Arousal - AcetylcholineANS - Parasympathetic Pathway

Relaxation

Stre

ss Z

one

Stress-Free Zone

Cortisol DHEA

AngryHostile

ResentfulJudgmentalFrustratedWorriedAnxiousAfraid

JoyfulHappy

EnergizedExcitedCreative

ProductiveAppreciative

Caring

TolerantCalm

CenteredReflective

CompassionateSatisfiedSerene

ForgivingContent

ExhaustedBored

WithdrawnApatheticShamed

DepressedDespairedHopeless

Burned Out

Neg

ative

Emoti

ons

Posi

tive

E

moti

ons

Vitality /Anti Aging HormoneStress / ‘Belly Fat’ Hormone

Page 23: Panelists: Margo DeMont, Ph.D. Cynthia Lemp, M.S.W. Kimberlie Warren, Ph.D

Negative to neutral, to positive.

EMOTION REGULATION

Page 24: Panelists: Margo DeMont, Ph.D. Cynthia Lemp, M.S.W. Kimberlie Warren, Ph.D

Cortisol

DHEA

Page 25: Panelists: Margo DeMont, Ph.D. Cynthia Lemp, M.S.W. Kimberlie Warren, Ph.D
Page 26: Panelists: Margo DeMont, Ph.D. Cynthia Lemp, M.S.W. Kimberlie Warren, Ph.D
Page 27: Panelists: Margo DeMont, Ph.D. Cynthia Lemp, M.S.W. Kimberlie Warren, Ph.D

TRAUMA

(photo collage)Little t - BIG T

Page 28: Panelists: Margo DeMont, Ph.D. Cynthia Lemp, M.S.W. Kimberlie Warren, Ph.D

Jeffrey Brenner, M.D.Medical Director of the Urban Health

Institute at Cooper University Healthcare

More than 15 years ago . . .

Better care at lower cost in America

The largest and most valuable health study ever done.

Page 29: Panelists: Margo DeMont, Ph.D. Cynthia Lemp, M.S.W. Kimberlie Warren, Ph.D

Adverse Childhood Experiences:

A Chronic Public Health Disaster

Page 30: Panelists: Margo DeMont, Ph.D. Cynthia Lemp, M.S.W. Kimberlie Warren, Ph.D

Adverse Childhood Experiences Study -

the Largest Public Health Study You Never Heard Of

Page 31: Panelists: Margo DeMont, Ph.D. Cynthia Lemp, M.S.W. Kimberlie Warren, Ph.D

Adverse Childhood Events

Kaiser Permanente (1997)

Center for Disease Control and Prevention (2009 publication; on-going)

St. Joseph County Community Health Needs Assessment (2012)

Page 32: Panelists: Margo DeMont, Ph.D. Cynthia Lemp, M.S.W. Kimberlie Warren, Ph.D

Abuse

Dysfunctional Family

Neglect

What Are ACEs?

Page 33: Panelists: Margo DeMont, Ph.D. Cynthia Lemp, M.S.W. Kimberlie Warren, Ph.D

Prevalence of Adverse Childhood Experiences

Substance abuse 27% Parental sep/divorce 23% Mental illness 17% Battered mother 13%

Adverse Childhood Experiences Are Com m on

Household dysfunction:

Criminal behavior 6%

Abuse: Psychological 11% Physical 28% Sexual 21%

Neglect: Emotional

15%

Physical 10%

Page 34: Panelists: Margo DeMont, Ph.D. Cynthia Lemp, M.S.W. Kimberlie Warren, Ph.D

ACEs Research: >37,000 Subjects

Adverse Childhood Experience

Social, Emotional, & Cognitive Impairment

Adoption of Health-risk Behaviors

Disease, Disability & Social Problems

Early Death

Scientific Gaps

Death

Conception

Page 35: Panelists: Margo DeMont, Ph.D. Cynthia Lemp, M.S.W. Kimberlie Warren, Ph.D

Implications

Those with four categories of ACEs 240% higher risk of hepatitis 390% higher risk of COPD (emphysema or

chronic bronchitis) 240% higher risk of STDs Twice as likely to smoke Twelve times as likely to have attempted suicide Seven times higher risk to be an alcoholic Ten times higher risk of injecting street drugs

Page 36: Panelists: Margo DeMont, Ph.D. Cynthia Lemp, M.S.W. Kimberlie Warren, Ph.D

Trauma, Toxic Stress and the Brain

Orbitofrontal Cortex Pathological Aggression

Amygdala Fear Anxiety

Page 37: Panelists: Margo DeMont, Ph.D. Cynthia Lemp, M.S.W. Kimberlie Warren, Ph.D

Executive Function

Page 38: Panelists: Margo DeMont, Ph.D. Cynthia Lemp, M.S.W. Kimberlie Warren, Ph.D
Page 39: Panelists: Margo DeMont, Ph.D. Cynthia Lemp, M.S.W. Kimberlie Warren, Ph.D

Reversing the Trajectory

Post Traumatic Stress Disorder

Eye Movement Desensitization and Reprocessing

Page 40: Panelists: Margo DeMont, Ph.D. Cynthia Lemp, M.S.W. Kimberlie Warren, Ph.D

Post-Traumatic Stress Syndrome

Reliving

Avoiding

Increased Arousal

Page 41: Panelists: Margo DeMont, Ph.D. Cynthia Lemp, M.S.W. Kimberlie Warren, Ph.D

Eye Movement Desensitisation & Reprocessing

Introduction to EMDR

Page 42: Panelists: Margo DeMont, Ph.D. Cynthia Lemp, M.S.W. Kimberlie Warren, Ph.D
Page 43: Panelists: Margo DeMont, Ph.D. Cynthia Lemp, M.S.W. Kimberlie Warren, Ph.D

Acute-Trauma Intervention and Processing

Crisis ManagementImpact of Event Scale53 subjects randomly assignedImmediate/Wait-list

Self Reported Distress from Trauma was statistically significant at p=< .001

Page 44: Panelists: Margo DeMont, Ph.D. Cynthia Lemp, M.S.W. Kimberlie Warren, Ph.D

Elementary Children

12% ≥ 3 ACEs

1. Health, attendance,

behavior 2. Academic

failure

Court-Involved

YouthHigher ACE ScoresAmong those with

≥4:51% special ed. (vs.

33% 0-1)

74% below 2.0 GPA (58%)

85% suspended by 2nd (71%)

33% re-offend in 2 years (13%)

Adult AdversityIncarceration

Victim of Intimate Partner Violence

Drug/Alcohol Mental Illness

Divorce

Parenting Adults

with ≥5 ACE

14 TIMESmore likely to

have two or more conditions that make ACEs for

kids

Work injury- illness

HomelessnessDisabilityPoverty

Health limits activity

Unemployment

High School Youth42% ≥ 3 ACEs

Page 45: Panelists: Margo DeMont, Ph.D. Cynthia Lemp, M.S.W. Kimberlie Warren, Ph.D

Community Partnerships to Build a Network for ACEs Intervention and

Prevention

We are committed to Trauma-Informed Care:

Proving a safe environment that promotes healing and

recovery

Page 46: Panelists: Margo DeMont, Ph.D. Cynthia Lemp, M.S.W. Kimberlie Warren, Ph.D
Page 47: Panelists: Margo DeMont, Ph.D. Cynthia Lemp, M.S.W. Kimberlie Warren, Ph.D

EMDR in Practice

Demonstration

Cynthia Lemp, MSW, LCSWMemorial Hospital of South

BendTrauma Center Social Worker