When the Past is always Present
Transcript of When the Past is always Present
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When
THE PASTIs Always
PRESENT
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EMOTIONAL TRAUMATIZATION
ORIGINS
CONSEQUENCES
AND CURES
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FELITTI, V.J. (2002)The relationship between adverse childhood events and adult health: Turning Gold into Lead. The PermanenteJournal Volume 6 :1.
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Havening has three components
• Recall and activation of an emotional core
• Distraction / other sensory input
• Havening touch
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TOUCH• Touch modulates GABA release via serotonin
• Increase in Delta wave production
• Depotentiates activated glutamate receptors
THE EXTRASENSORY RESPONSE TO
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Displacement of thought from working memory by distraction
• Humming a tune
• Counting
• Visualizing movement
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Extrasensory Responses of Sensory Input Can Change
the brain
• Smell
• Touch
• Auditory
• Sight
• Taste
• Kinesthetic
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THE PSYCHOSENSORY THERAPIES
• INVOLVE THE APPLICATION OF SENSORY INPUT TO ALTER BIOLOGICAL FUNCTIONING
• ARE SENSORY RECEPTOR DRIVEN• ARE ELECTROCHEMICAL IN NATURE• THE RESPONSE TO THE SENSORY INPUT CAN
BE LEARNED OR INNATE• THE EFFECT DUE TO AN EXTRASENSORY
RESPONSE
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UFS
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Awareness vigilance / salience
Flight or fight /Freeze response \ return to normal behavior
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Ancient Emotions and Survival Reactive Emotions
Fear Defensive rage
-- most primitive
-- predator driven
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Types of Fear
• Freeze, Salience and vigilance
• Flight or fight
• Panic
• Flaccidity / thanatosis
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FLIGHT/FIGHT → PANIC
↓
THANATOSIS
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Panic Prefrontal Cortex taken off line
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Fear is stimulated by our senses
• Olfactory
• Auditory
• Kinesthetic
• Visual
• Gustatory
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Fear Activates Physiologic Changesvia the Amygdala
-- increased heart rate
-- pupil dilation
-- heightened sensory awareness
-- increased oxygen availability
-- increased muscle strength
-- inhibition of all non survival activities
-- increases our ability to store and retrieve events
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The Amygdala Activates our Emotions and Coordinates our Survival Responses
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OUTFLOW FROM CENTRAL NUCLEUS
Emotional StimulusThalamusLA/BLA/AB AmygdalaCe AmygdalaPhysiological Response
RESPONSE BRAIN AREA
Prepare us for Flight or Fight Sympathetic Activation Aid in Danger Evaluation Prefrontal Cortex Motivate us to Action Nucleus Accumbens Increase Salience Ventral Tegmentum Increase Vigilance Locus Coeruleus Cause Freezing Central Grey Mediate Pain Perception Insula and Amygdala
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Encoding a Trauma
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EVENT
• Increases cortisol and norepinephrine, dopamine• Experienced personally or vicariously • Produces intense emotional response
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MEANING
Is about ATTACHMENT
• PHYSICAL• PERSONAL• PUBLIC
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LANDSCAPE
The neurochemical state of the brain at any given time.
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INESCAPABILITY
A perceived inescapable threatening situation has the potential to traumatize. The perception need not last long, nor is it necessary for this perception to reach conscious awareness. The prefrontal cortex does not inhibit amygdala encoding.
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mPFC also inhibits BLC
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A TRAUMATIC ENCODING MOMENT
• Requires four conditions• Remains permanently biologically active• Stimulation activates a part or all of the original physiological response• Emotional component synaptically encoded in
the amygdala
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Mechanism of Traumatization
Event sensed by thalamus as UFS Signal sent to LA
Activation of Ce Release of NE and Cortisol Inhibition of mPFC
Content and context enters amygdala via LA and hippocampus
Requirements met Glutamate receptors in amygdala potentiated
Binding of components of event Traumatization occurs
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Traumatization at the neural level is the process that permanently encodes and synaptically consolidates linkages between the emotional,cognitive, autonomic, and somatosensory components present during the traumatizing event.
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Any of the components recalled, either consciously or subconsciously, activates the amygdala and causes the release of stress hormones.
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For each reactivation, we experience some or all of the components as if they were happening for the first time.
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Traumatic Memory
Conscious activation or inadvertent reminders lead to the recalling of the event and its emotional content.
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Components of a traumatic memory
• Emotional – the affective response to an event
• Autonomic – automatic brain functions that regulate body functions
• Cognitive – both conscious and subconscious
• Somatosensory – sensed throughout the body as in pain, tingling, numbness and other sensations
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Dissociated Traumatic Memory
Thoughts, feelings and sensations that are experienced when activated by subconscious stimuli that arise from abnormal retrieval.
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POTENTIATION OF AMPA GLUTAMATE RECEPTORS AND THEIR STABILIZATION THAT MAKES THEM PERMANENT THE ABSENCE OF FORGETTING
REQUIRES PHOSPHORYLATION OF RECEPTORS
PROTEIN KINASE Mζ –EXPRESSED ONLY IN NEURALTISSUE
PROTEIN KINASE Mζ CONTINUALLY PHOSPORALATESAMPA RECEPTORS BECAUSE IT LACKS A REGULATORY DOMAIN
DURING ELECTRICAL STIMULATION AT 100Hz THE TRANSLATIONOF THE PROTEIN KINASE Mζ FROM RNA TO PROTEIN IS ACTIVATED
PROTEIN KINASE Mζ STABLIZES AND MAKES PERMANENT POST-SYNAPTIC AMAPA RECPTORS.
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Mechanism of Traumatization
Stimulus [ unimodal and UFS ] pass through thalamus Signal toAmygdala Fear / defensive rage generated increases NE andCortisol in amygdala Inhibition of mPFC Complex content andContext enter amygdala Four requirements met AMPA GlutamateReceptors in BLC amygdala potentiated BLC modulates binding ofthe components of event A traumatic memory is stored
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Thalamo-Amygdala Pathway Generated During Traumatization
CORTEX
Complex Content and Context (directly and via hippocampus)
Thalamus Emotion Producing Stimulus
Electrochemical Transduction
Sensory Input Components
Emotional
Somato- sensory
Autonomic
Cognitive
Lateral Nucleus of Amygdala
AMPA ReceptorAMPA Receptor
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Disrupting A Traumatization
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Recalling and activating of a traumatic memory requires working memory
• Cognitive conscious / subconscious (feelings)
• Autonomic
• Somatosensory
• Emotional
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Retrieval of cognitive and somatosensory component into working memory
• Limited storage focus on one thought
• Short term usage
• Part of the pre frontal cortex
• Controlled by central executive which modulates attention
• Phonological loop auditory and speech information i.e. Verbal commands
• Visual spatial sketchpad visual and spatial information i.e. Ride a bike, imagine doing a physical task
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EFFECT OF STIMULATION OF VARIOUS AREAS
DELTA WAVE POWER GENERATED AS MULTIPLE OF RESTING STATE
CHEEK 90X SHOULDER 5-38XPALMS OF HANDS 5X BACK OF HANDS 1.1XKNEE 1XVIBRATING PADS ON PALMS 3-4XLATERAL EYE MOVEMENT 12-20XGAMUT POINT 1.1X MERIDIAN POINTS VS NON MERIDIAN POINTS 1X
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Amygdala Pathway Is Disrupted During Depotentiation
STIMULUS AMPA
Receptor Internalized
AMPA
Receptor Internalized
Emotional
Somato- sensory
Autonomic
Cognitive
Lateral Nucleus of Amygdala
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DE-POTENTIATION OF AMPA RECEPTORS BY LOW FREQUENCY WAVE
LOW FREQUENCY WAVE OPENS CALCIUM CHANNELS IN ACTIVATED NEURONS
THIS ACTIVATES CALCINEURIN FOR WHICH THE AMPARECEPTOR IS THE CRITICAL SUBSTRATE
PARTS OF AMPA RECEPTOR DEPHOSPHORYLATED
REMOVAL FROM SURFACE AND THUS NO LONGER ABLE TO TRANSMIT… RECEPTOR IS DE-POTETNTIATED
CALCINEURIN INHIBITORS BLOCK THIS EFFECT
THE TIME COURSE IS IN MINUTES, CONSISTENT WITH CLINICAL OBSERVATIONS
ACTIVATION OF POST-SYNATPTIC NEURON BY RECALL
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