Complex Trauma How the Brain and the Body Respond
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Complex Trauma
How the Brain and the Body
Respond
What makes trauma complex?
Simple Trauma Complex Trauma
One time, limited duration Repeated
One type, definable Multiple types
INTER_RELATIONAL
Medical trauma Sexual abuse
Car accident Physical abuse
Natural disaster Emotional abuse
Death of a loved one Neglect
Bullying
National Child Traumatic Stress Network
© 2021
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What makes trauma complex?
Complex Trauma
© 2021
Why does complex trauma make life seem so much more traumatic? Dr. Bruce Perry, Neurosequential Network © 2021
What makes
trauma complex?
© 2021
The Brain
Moral order, guilt Shame
Perspective taking
Flawed, worthless
Achieving goals Unlovable
Relational permanence Incompetent
Self centered
Efficacy
Competence, confidence High heart rate and breathing
Worthiness Muscle tension
Empathy, compassion Poor sleep, appetite
Poor GI habits
Normal heart rate and breathing
Healthy sleep, appetite
Healthy GI habits
© 2021
Social engagement Selfishness
Empathy Isolation
Hopefulness Sense of inferiority
Purpose, goals Need for superiority
Guilt
Shame © 2021
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Ventral
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Autonomic N is. . . . . .
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ervous”ISystem
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Sympathetic
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“Safety is the treatment.”
Dr. Stephen Porges
© 2021What are internal
cues of safety?
© 2021Internal Cues of Safety
Interoception – feeling Gentle pressure and cool on the eyes
Color orange
with understanding
Ear massage Chewing and swallowing
humming
Slower heart rate
Slower breathing
Stretching arms and hands Eating and drinking
Stroking, embraces
Proper hydration
Healthy diet and elimination
Movement
Empty bowel and bladder
Muscle relaxation © 2021What are
environmental
cues of safety?
© 2021Cues of Safety - Environmental
• Desk arrangement, individual seating
• Temperature
• Windows
• lighting
• Visual clutter
• Personal items from students
• Auditory background noise
• Area for regulation
• Hallway congestion and clutter
• Cafeteria congestion, chaos
• Bathroom procedures
• Plants
© 2021What are inter-relational
cues of safety?
© 2021Inter-relational Cues of Safety
Perceive and Make Sense
Attune Normalize
P
A
C
E
Respond with empathy
The Power of Showing UP by Dr. Dan Siegel and Dr. Tina Bryson © 2021Empathy Blockers
• Sliver lining the
situation
• Fixing, advising,
opining
• Interrogating
© 2021Consistency
4 Competence
Elements Communication
of Trust
Compassion
Mutual understanding of each other’s intentions
Appreciation of the other’s needs and desires
© 2021What are
emotional
cues of
safety?
© 2021Cues of Safety – Emotional
Willingness to
Emotional safety FEEL
Courage to KNOW
Space to EXPRESS
© 2021Willingness to Feel
• Cue “Notice”
• Calm, unflappable presence
• Emotions are like house guests
• Slowly bringing awareness to the body
and changes in the body
• Progressive muscle relaxation
• Heart rate monitoring
• Noticing before lunch compared to
after lunch
• Notice before a brain refuel break
compared to after break
© 2021Courage to know
• Name it to tame it, bring left brain logic
to right brain awareness
• Adult or child retell the experience
creating a timeline, Social Thinking
behavior maps
• Restorative and community circles
• Journaling
• Drawing or painting the experience
© 2021Space to
Express
A holding space
© 2021Rosie Mann, RN, CCTP 717-419-4580 drmann1@comcast.net
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