30 Strategies for Rewiring the Traumatized Brain & Undoing the Effects of Trauma | Undo PTSD & cPTSD

CEUs are available at AllCEUs.com/Trauma-CEU hey there everybody and welcome to  today's video on how to rewire the   brain to undo the effects of trauma  i'm your host dr donnelly snipes in this video we're going to review the  impact of trauma on the brain and the person   and identify strategies for healing and  rewiring the brain and the nervous system so let's start out with a brief review on the  impact of trauma and i have a bunch of links in   the video notes if you want to take a deeper dive  into the into the impact of trauma on the body on   the nervous system on the person but that's just  way too much to get into and still get to how to   fix it so you cannot separate the brain from the  body nor can you separate the body from the mind   the brain helps us interpret what we're seeing  the brain is responsible through the hpa axis   of activating or deactivating our stress response  system so we can't separate the two of them when   you have thoughts those thoughts are processed in  the brain and then the brain responds accordingly   whether it's to ramp up the nervous system or to  ramp up the relaxation so we need to recognize   that we can't just say oh we're gonna do  do this over here we're not that simple   so physically trauma impacts the hpa axis your  stress response system when somebody experiences   trauma and doesn't integrate it when somebody has  unprocessed or unhealed trauma that hpa axis or   threat response system stays activated it's not  something that turns on and off like it does for   most people when it stays activated for too long  it naturally starts to become dysregulated think   about a machine at a factory that runs 24 hours a  day seven days a week at a certain point in time   it needs to go down for maintenance it needs  to be recalibrated it needs stuff to happen   but if it's not turning off then it just gets  progressively less efficient and less effective   we also see what's called excitotoxin excitotoxic  shrinking of the hippocampus now the hpa axis   is the hypothalamus pituitary adrenal axis  but the hippocampus is another part of our   brain that's involved in emotion processing and  behavior when we are regularly exposed to stress   those stress hormones like cortisol and glutamate  and even norepinephrine are secreted into the   body into the brain and those stress hormones i  want you to think of them as your hot hormones   and they actually create a situation where your  neurons die we have excito which means excitement   so your excitatory neurotransmitters they're too  hot too high and we start seeing a loss of neurons   we see a strengthening between the dmn the  default mode network which is your autopilot   and the amygdala which is where we process fear so  the fear aspect of your brain is regularly saying   hey buddy check make sure there's not a  problem so you end up paying more attention   and operating from a fear-based standpoint  we also see strengthening of the   amygdala and the connection between  the amygdala and the prefrontal cortex we see hyper vigilance and this is not new  i didn't bother to even hyperlink it because   we know that people who have not effectively  processed trauma are often more hyper vigilant   when we experience trauma whether it is a natural  disaster or victimization doesn't really matter   when we experience trauma at least briefly we  lose our sense of safety and personal empowerment   now when you integrate trauma you reclaim  that sense of safety and empowerment but if   you haven't then you're constantly going to be  on edge you're constantly going to be nervous   waiting for the next bad thing to happen we  also see weakening if you will a vagal tone   now your vagus nerve is the nerve that a lot of  people refer to as the primary driver if you will   of your relaxation response and we see that the  vagus nerve becomes less able to turn off the hpa   axis so the hpa axis is your stress or your threat  response the vagus nerve among and other things   are your relaxation response well when the  autopilot when the default mode network and the   amygdala are working together and they are just  full bore ahead looking for those dangers in the   world and expecting to see dangers in the world  then when the vagus nerve comes knocking and says   hey why don't we just take a break for a little  bit it cannot interrupt that autopilot so the   executive control network where we do all of our  fact-based reasoning has a hard time breaking in   sleep disruption is another side effect of  unresolved trauma when you don't feel safe   you cannot completely relax to get good quality  deep sleep sleep and circadian rhythm disruptions   contribute to cognitive decline by activating  neural inflammation which suppresses neurogenesis   so not only are you not getting good sleep and  you're feeling groggy and it's increasing stress   but this sleep deprivation also creates a  stressor on the body which leads to neural   inflammation we start to see systemic  inflammation and inflammation in in the   neuronal areas and a suppression of neurogenesis  so we're losing neurons but we're not creating   any more so we start to see hippocampal shrinkage  we also see changes in other areas of the brain   we also see systemic inflammation when one system  goes offline and starts experiencing stress   especially that hpa axis under extended periods  of stress cortisol loses its ability to act as   an anti-inflammatory so we start seeing systemic  inflammatory responses now inflammation in and   of itself just like anger anxiety just about  anything else is not a bad thing inflammation is   your body's response to an injury if the brain  thinks that there are injuries then it's going   to send out the paramedics if you will think of  your the inflammatory cytokines as the paramedics   to check and see and triage and try to fix things  so it makes sense that this might be happening   normally um there's an on off switch but  when the fighter flight is constantly on   then you've got the inflammatory cytokines  the paramedics constantly operating in this   battlefield sort of triage scenario which  means we've come we start getting systemic   inflammation they're just always on on rotation  we also see changes in the gut microbiome and   i know you've heard me talk about this before and  i'm going to continue to talk about it henceforth   the microbes in the gut break down what you eat in  or into its component parts in order to use those   amino acids those vitamins those  minerals in order to reassemble them   in a format that they need whether it's the format  of glutamate and norepinephrine and adrenaline   in in order to promote the fight-or-flea response  or the format of gaba and serotonin and endorphins   in order to promote the relaxation response  so when we're under stress a different group   of microbes populates and is actually activated  so our brain is focusing or our gut is focusing   on making everything that's needed to  support fight or flea not rest and digest   and there are also alterations in your  thyroid and gonadal hormone levels your   estrogen testosterone progesterone dhea and  even oxytocin under stress so stress and and i   know we're supposed to be talking about trauma  but remember when a person experiences trauma   they lose their sense of safety and empowerment  that leaves the person feeling stressed   vulnerable and that ongoing sense of stress even  if it's not directly related to that trauma that   ongoing sense of unsafeness and disempowerment is  a source of chronic stress and that chronic stress   leads to all kinds of biochemical activations  we know that alterations in thyroid especially   hypothyroid mimic symptoms of depression we  know that alterations and gonadal hormones   estrogen testosterone progesterone the whole  list affects the availability of serotonin   and affects the um reactivity of certain  receptors for certain neurotransmitters   so we know that as other hormones change  in the body it's going to alter the   availability and activity of the neurotransmitters  that are necessary if you will for a feeling of   safety and empowerment and happiness and  all those things that people really crave   affectively if a trauma is not integrated now  remember i said not everybody experiences trauma   and and it results in traumatic injury some people  experience trauma and they're able to process it   and integrate it and regain their sense of safety  and empowerment but for those who can't they have   difficulty feeling positive feelings because  number one the neurotransmitter imbalances   is out of whack number two they've got that fight  or flight system going they've got that threat   response system going and when you are under a  when that system is going when you perceive a   sense of threat then you are going to be more  likely to be scanning and looking for threats   and being aware of threats in the environment  so you start perceiving the world as much   less safe and yourself is much less empowered  so it's this negative spiral that starts   we also see emotional dysregulation and this is  another thing i've talked about in other videos   but when that hba axis starts to become get  out of whack then it turns down the sensitivity   basically the master control center is  saying we can't run this hot this long   so we need to turn down our sensitivity so we  don't respond to everything that comes our way   well that sounds like a great system but when it  does turn down that sensitivity yeah you may not   be responding to things that used to cause you  stress you just don't have the energy but you're   also not able to respond with excitement you  can't you're not responding with as much anxiety   or anger maybe but you're also not responding with  excitement you're feeling more flat now when that   system does get triggered you have a tsunami of  neurochemicals so you go from flat to furious or   flat to really really anxious i don't know  what the f is that i'm looking for there   so emotional dysregulation makes  sense when you look at it from a   biochemical neurological perspective emotional  dysregulation in people who experienced adverse   childhood experiences or early childhood trauma  makes sense because it's a symptom that indicates   partly that their hpa axis is kind of out of whack  and we're going to talk about how to reset that   but it's important to kind of get everything  into perspective cognitively after a trauma   at least in the early period people feel a  sense of pessimism disempowerment inflexible   thinking and have difficulty with memory and  learning now if they integrate that trauma and   they get their sense of safety and empowerment  back then the system recalibrates and a lot of   these things greatly weaken if not go away but  if they don't integrate it then like i said   with that hpa axis on it's kind of like  you're being in a battleship and having that   in the in the movies it's always a red light that  flashes that indicates that you are manning your   battle stations and you're constantly looking for  threats and you're constantly on guard well when   you're constantly looking for threats you're going  to find them normally you may not even notice them   because they're really not you know going to  make that big of a difference in your world but   when you're constantly scanning you're going to  notice the minute threats you're going to notice   when people look at you wrong and probably  interpret it from a pessimistic or disempowered   cognitive standpoint but when you do that  the world starts to feel and i know i said it   earlier starts to feel much much less safe and you  start to feel much much smaller and much much less   powerful and much much less capable of keeping  yourself safe well when all that happens you   stay and fight or flee and that fight or flight  system amps up even more it says oh we're getting   getting into dangerous waters we need to be on  even higher alert when all those excitatory neural   chemicals are just flooding your brain you are in  fight-or-flight mode your brain is saying we need   to defend ourselves or get the heck out this is  not the time to start reading war and peace this   is not not the time that we can focus on learning  something over here we need to protect ourselves environmentally the exponential increase in trauma  triggers can become devastating for a lot of   people and i'm going to try to keep this kind of  short but when somebody experiences a trauma say   it's a car accident and well i'm talking about  a store here so let's say it's a victimization   and the person who victimizes them is  wearing a particular cologne or maybe even   it's not the perpetrator but the person that  they're with is wearing a particular cologne   and you know the trauma happens they you know  emerge from it they heal physically on the   outside but there's still a lot of anxiety a lot  of stress because it came from out of the blue   and they weren't able to protect themselves  so they still feel a sense of disempowerment   well so sometime later they're in a store and they  smell that same smell they smell that same cologne   and it triggers the memory of that incident and  maybe even a flashback it doesn't necessarily have   to trigger a huge flashback but it can trigger  that memory and that anxiety reaction like oh crap   something bad's really fixing to happen that's  traumatizing because the person's now standing   in the middle of walmart going i don't feel safe  or target or home depot or wherever they're at   i'm not just picking on anyone's store but this is  normally a very benign situation but now they had   that anxiety attack and they're like maybe i'm  not safe here so they've been retraumatized now   they're in a benign situation and they've lost a  sense of safety and empowerment oh that's not good   so then now not only are they afraid of  encountering somebody who's going to victimize   them but now they also may start becoming afraid  of being out somewhere in public being in a store   and having that feeling triggered so they  start to want to avoid places because   they don't want to experience that anxiety feeling  and they don't want to experience memories of the   trauma so you see that each situation kind of  re-traumatizes the person and adds to the number   of things that trigger that stress reaction  this can lead to isolation or agoraphobia   if it goes on for too long but it's important  to recognize that sometimes seemingly benign   people places things events triggers can  trigger that stress response for somebody and   they may not exactly realize where it  came from so we need to do what's called   backward chaining to say okay well this  is what's going on what's that related to   and see if we can figure out why that became  a trauma trigger or a stress trigger for them   and relationally or interpersonally after a  trauma the impact varies part of it depends   on what kind of a trauma the person experienced  if it was victimization the person may have   difficulty trusting others especially people that  are similar in some way to the offender and it   could be their gender it could be their race their  ethnicity their height the way they dress the   way they talk it doesn't have to be somebody who  looks exactly like the offender it can be any um sensory trigger for lack of a better word  anything that reminds the person of someone   the person who victimized them can end up  triggering a sense of distrust and a sense of fear   if the trauma was caused by a disaster  like a fire or a hurricane or tornado the   ability to trust others and organizations  depends on the aftermath of the event   if the community bonded together and  everybody helped one another and it was this   empowering situation then guess what their ability  to trust may be actually enhanced however their   ability to trust if there was looting if there  was blaming if there was discontent or violence   in some way then their ability to trust others  may have been um diminished and that can even mean   a lack of a sense of caring if your entire  neighborhood gets wiped out by a tornado   and everybody else in the county is like ah  sucks to be you that sense of being safe in that   community is probably going to dissipate and it's  going to be replaced by a sense of anger and fear   and regardless of whether it's a  victimization or a disaster of some sort   separation and safety anxiety for self and  significant others is going to likely increase   in some people if you've been victimized then  when you're not with your significant others the   people you care about the people you trust the  people you love you may be worried that they're   going to be victimized so you start feeling  very anxious when they're not in your presence   same thing for yourself i mean you obviously may  have some safety anxiety but a lot of times the   um what's described sometimes is clinginess or  neediness we can see a separation anxiety because   the survivor is so worried that somebody  that they love is going to experience   something bad whether it's the  same exact thing or something else   they feel powerless they feel unsafe so they are  assuming everyone else is disempowered and unsafe so let's talk about the goals okay as i  mentioned i have several videos that are noted   in the video notes that talk about in depth the  impact of trauma on the brain and on the person   so if you want to get more in depth on that you  can go to those videos but let's talk about what   we can do and it has to be a holistic approach  you can't just say okay do this one thing here   and you're going to rewire your brain or do  this one thing over here and you'll make it   you'll fix it and make it all better because  everything is interconnected it's like if your car   is breaking down and this metaphor may not  go very far but and you change the oil well   yeah the oil needs to be changed to keep things  going well but you also have to pay attention to   other fluids and rotate the tires and tune up the  engine in order to keep the car running smoothly   so after a trauma it's kind of like a car  that is been run into the ground for 10 years   never been to the mechanic and maybe even  been in an accident there's ju there's not   one thing that we can do to make it brand new  again there's there's a rebuilding process   so one of the first things that we can help  people start doing and probably one of the easiest   things is to start strengthening their vagal tone  getting that vagus nerve that relaxation response   to be able to kick in when they start feeling  anxiety being able to trigger that vagus nerve so   they can get into their wise mind and say okay i'm  feeling anxious right now it's what i'm feeling   now what is there a threat and what can i do about  it recognizing that just because you feel anxiety   doesn't necessarily mean that there's a threat  at this time and this context so strengthening   vagal tone is a i consider it a distress tolerance  skill because it helps people feel like they won't   be completely overwhelmed by their emotions  they can sit with it they can acknowledge it   but they don't have to you know take a deep dive  down into it strengthening vagal tone means being   able to reliably get from your emotional mind into  your wise mind one of the easiest ways to do this   is through respiratory vagus nerve stimulation  which is a fancy way of saying deep breathing your   vagus nerve has little projections that go into  your gut your diaphragm so when you're breathing   shallowly and quickly it registers stress when  you're breathing deeply and slowly it registers   relaxation so you are manually overriding  the stress response you are manually if you   will turning on the vagus nerve a lot of people  benefit from just kind of wrapping their head   around that that's why we deep breathe how many  times when you were growing up did your parents   or your doctor or teacher or somebody say take a  few deep breaths honey maybe that's just me but   um and i never knew why i was like well what's the  point of that it doesn't make any sense there's a   reason for it when you breathe slowly and deeply  you start triggering that relaxation response   so you can get the adrenaline flood to subside  and you can see more clearly what needs to be done   respiration you've got wherever you are whether  you're in the car or you're at your kids ball game   or you're in the middle of the store or you're in  bed you're breathing so you don't need anything   special which is great because people know they  always have a tool with them that they can use   transcutaneous vagus nerve stimulation has gotten  a lot of publicity lately and that is using a tens   unit and attaching it through a an ear clip to  your tragus which is the little flap on your ear   and stimulating your vagus nerve here that can  work for people but you've got to have the tens   unit with you and there's some research that's  indicated that the wave amplitude and frequency needs to be fine-tuned in order to have it work  most effectively so you can look at the video on   vagus nerve stimulation that i've got you can do  some research on it there's lots of videos on that   you can also massage the vagus nerve and i  encourage people put their middle finger on   their tragus and their index finger behind their  ear and gently you know just hard enough to make   the skin move you're not trying to push down the  little ear flap just hard enough to make the skin   move rub there and your vagus nerve comes up and  connects to other nerves on your face so when you   start rubbing here you're actually triggering  that vagus nerve biofeedback is another way of monitoring the vagus nerve you're not actually  really um triggering the vagus nerve with   biofeedback you're monitoring how effective  you are so as you start to breathe slowly you   can monitor your heart rate for example and or  you can monitor just your breathing and you can   notice as you start to breathe more slowly what  it does to your body so the next tool is or thing   that needs to happen is to reduce inflammation  remember we talked about how persistent stress and   persistently feeling unsafe and disempowered keeps  that hpa axis active which ultimately ends up   leading to systemic inflammation all right so we  got to reduce inflammation the good news is that   by strengthening vagal tone you're going to start  reducing inflammation why is that because when you   turn on the vagus nerve when you strengthen that  vagus vagal tone then you're actually turning off   that hpa axis you're giving it a chance to  rest you're giving it a chance to rebalance   so vagal tone is a tool that can be used to not  only help the person tolerate the stress reaction   and feel empowered to endure their the emotional  state but it's also helpful at reducing systemic   inflammation nutrition is another tool that is  very helpful at reducing systemic inflammation   remember i said when people are experiencing  trauma their gut microbiome changes   and a lot of times they eat high fat high sugar  foods because those are immediate sources of   energy and when you're stressed your bodies  and fighter flee what do we need to fight   or flee we need energy and fat and sugar give  us really fast energy and long enduring energy   so it makes sense why people when  they're stressed crave those things   however both of those things are inflammatory  and focusing on a anti-inflammatory low-fat moderate fat diet has been shown to be  helpful with reducing inflammation and you know   you can look at the anti-inflammatory diet the  mediterranean diet and there's a lot of research   that has shown that when we cut out those highly  processed carbs or at least significantly cut down   on them and we switch our fats to high omega-3s  and reduce our omega-6s we see an improvement   systemically in inflammation we see a reduction  in the amount of inflammatory cytokines that are   detectable in the blood we also want  to pre preserve neurons and increase   neurogenesis remember again under stress hpa  axis active excitatory neurotransmitters just   coursing through the brain to make  sure that we stay on high alert but things start to become uninhabitable after  a while or you know all the workers start   to get tired and drop off however you want  to envision it so we start to see neurons   dying well we want to keep those  neurons which means we've got to   turn down the intensity and ideally the frequency  of the hpa axis make it less excitotoxic up there   but not only do we want to preserve neurons keep  the keep them from dying or dying as quickly but   we also want to increase neurogenesis and yes  your brain can create new neurons it's possible   we see it after stroke we see it after traumatic  brain injury we see it after a lot of things   we know our brain can heal itself to a certain  extent so how do we do this aerobic exercise   and i don't mean you've got to go out and run five  miles aerobic means with oxygen walking dancing   vigorously cleaning house that's one of my  favorites so i always throw that one in there   things that you enjoy at least 30 to 45 minutes  a day and again it doesn't have to be super   intense it has to be something that's going  to increase the rate at which you're breathing   so instead of breathing you know six times  a minute you're breathing 10 times a minute   nutrition i know this one came up again low  fat low glycemic index foods tend to be most   helpful for the preservation of neurons  and increasing neurogenesis in the brain   alcohol sorry guys alcohol has been shown to  be neurotoxic when alcohol comes into the body   well number one the ethanol is a poison so  that's kind of no good and that promotes   inflammation in and of itself but when the  alcohol leaves the body it leaves the body   faster than the body can compensate so you  go from feeling relaxed to feeling anxious   you go from feeling somewhat relaxed to triggering  that hpa axis in high gear which is why when   people detox from alcohol their high risk of  stroke their their blood pressure goes way up   that is that hpa axis kicking into over overdrive  so you do want to try to eliminate alcohol   if you've been drinking heavily it's strongly  adamantly i can't stress it strong enough that you detox from alcohol under medical supervision  because alcohol detox can be life-threatening   however getting alcohol out of  the system is can be another tool   and eating antioxidant rich foods that are  high in omega-3s antioxidants are colors   so you want to eat colorful foods and  ideally some that are high in omega-3s   like flax seeds or chia seeds um olive oil you  have walnuts walnuts are another great one that   you can easily get your omega-3s in your body  now if you are an omni omnivore fatty fish are   excellent sources of omega-3s but not everybody is  down with eating animals so whatever you feel like   but antioxidant rich you eat those colorful  foods orange green purple see how many colors you   can get on your plate at any one meal i always  aim for three colors on my plate at every meal   but all of those things are going to promote a  reduction in inflammation no matter what it's   caused by and neurogenesis which is super awesome  so now just to kind of summarize we're not really   adding all that many things we are strengthening  vagal tone we are improving nutrition and adding   a little bit of movement aerobic exercise the  next thing we're going to talk about is sleep   we all need sleep this is not anything new that  we're really asking somebody to add we may be   asking them to change their sleep hygiene  some and it's really important to evaluate   a person's sleep quality most of the time yeah i'm  pretty comfortable saying that most of the time   people who have unresolved trauma do not sleep  well and so they need to figure out how they can   feel safe when they're sleeping so they can get  good quality sleep without medicating ideally and   set their circadian rhythms so the video i have  on sleep hygiene can walk you through the steps   of doing that that's a process if a person hasn't  been sleeping well for months or years they're not   going to suddenly read a handout you give them and  be like oh thanks doc and sleep through the night   it's going to be a process but what you want to  look for is improved sleep quality when we do that   remember sleep deprivation contributes to neural  inflammation and neuronal death so good quality   sleep promotes neurogenesis and helps reduce  inflammation so that's wonderful so vagal tone   nutrition aerobic exercise sleep hormone balance  now this is a as as they go kind of an easier one   go to their doctors if their estrogen or  testosterone or progesterone are out of   balance then the doctor can advise them on steps  to take to get those back into balance and i'm not   necessarily saying hormone therapy sometimes there  are natural approaches that the person can do   but making sure that your gonadal hormones and  your thyroid hormones are in optimal range for you   is really important to making sure that hpa axis  can function effectively it's really important to   have good hormone balance to promote neurogenesis  and there were some fascinating studies about how   imbalances in gonadal hormones impacted the body's  ability the brain's ability to form new neurons   now one of my favorites is hobbies and interests  and you may be scratching your head going   preserve neurons yes hobbies and interests  encourage neurogenesis when you're learning   new things your brain forms new connections  and it actually promotes neurogenesis   and those things those neurons that are  developed according to at least one study i read   neurons that are developed as a result  of learning tend to be more resistant to   dying off later on so hobbies and interests one of  the reasons that they are excellent for preventing   late life dementia is because they help form  these really strong really resistant neurons   in your brain we learn more we learn more  effectively and we have better neurogenesis   when we're doing things that make us happy  so whatever your hobby is if it's woodworking   if it's singing if it's gardening engaging in  those things actually promotes brain recovery   so who doesn't want to have a prescription  for engaging in their hobby for an hour a day   socialization is another way to actually preserve  neurons because when we interact with other people   it promotes oxytocin our bonding hormone and  oxytocin actually acts as a neuroprotectant so   it helps preserve neurons and when we are more  relaxed when we're engaging with others we're   often having more fun and theoretically we are  increasing neurons we're learning things we're   laughing um so there are a lot of benefits to  socialization not everybody is going to want to   get on the socialization bandwagon right away so  that's cool however remembering that oxytocin is   really important to preserving neuro neurons what  else can you do to promote oxytocin doing things   that are kind for others snuggling with an animal  that's an another one that i'll never turn down   um even well those are some of the big things that  that people can do in order to promote oxytocin so   just to summarize because i know it looks like a  lot but we're talking about strengthening vagal   tone mainly through regular deep breathing  and aerobic exercise decent nutrition sleep   and doing things that are fun and hanging  out with friends or snuggling with an animal   all of those things are tools that can help  preserve neurons and increase neurogenesis   which helps start repairing the brain remember  we already had hippocampal shrinkage we already   had shrinkage in our brain as a result of  ongoing trauma so we need to build it back we also want to reduce unnecessary hpa  axis activation and i emphasize unnecessary   our threat response system our hpa axis is there  for a reason and we need it we just don't want to   have it on all the time practicing mindfulness  or learning mindfulness can be very helpful at   reducing unnecessary hpa axis activation  because as we become more mindful of self   we become more aware of our early stress  warning signs if we start feeling oh yeah   we become more aware of our vulnerabilities we  know if we didn't sleep well the night before   that we may tend to be crankier today we  may tend to restruc respond more strongly   to stress today so we can take steps  to kind of head that off at the pass   so self-awareness self-mindfulness is  super important to reducing unnecessary   hpa axis activation it also helps us  identify triggers in our environment   if we're mindful and we notice oh i'm starting  to feel kind of anxious wonder why you know i'm   in the middle of this store i'm in the middle of  this situation what about this is triggering my   anxiety and at that point we can address those  triggers and either identify them as irrelevant   or recognize that they remind us of something  in the past and figure out how to deal with them   and mindfulness of the moment is also important  to reduce hpa axis activation and what i mean   by that is when you when people do start to feel  triggered mindfulness in the moment recognizing   okay non-judgmentally accepting i feel anxious  right now it is how i feel it is what it is now   mindfulness of the moment says at this time and  in this context is there anything to be anxious   about is there a threat or said a different way  am i safe and if not what can i do to get safe   mindfulness at the moment helps people start  recognizing the false alarms and as they start   becoming more aware of the false alarms then  they have the ability to trigger that vagus nerve   and turn off the false alarm and say nope  in this context at this time i'm safe yes   i recognize why my anxiety was triggered and that  sucked but at this time i'm safe so let's move on   so they haven't created another situation  that's going to trigger their anxiety   grounding is another great tool and this goes  along with mindfulness but sometimes people start   to feel anxious and part of what they can do when  they're breathing you know sometimes you want to   have something to focus on when you're breathing  and practice doing that slow breathing four in   hold for four four out hold for four but also  noticing five things they see four things they   hear three things they smell two things they  can feel and that can really help people get   refocused in the moment and re-grounded so they're  like okay this is where i'm where i am right now   i'm not back there in that unsafe place and time  i'm right here right now i'm not an eight-year-old   child that's lost in the mall i am a 28 year  old person who is sitting at her desk at work   physically we already mentioned these sleep and  nutrition super important when you are sleep   deprived your body very helpfully turns on the  hpa axis in order to give you sort of a internal   or a natural hit of excitatory neurotransmitters  when you drink caffeine it triggers the hpa axis   to release adrenaline and cortisol so when your  body recognizes that you're sleep deprived without   you even having to drink caffeine it says oh hey  i know what i need to do here let me give you a   hint of all these excitatory neural chemicals well  again sounds great in theory but it stresses the   hpa axis so if you're getting enough sleep then  the hpa axis doesn't need to turn on for that   it can say okay we've had plenty of sleep  you've got plenty of energy no worries   when you are nutrient deprived the hpa access  registers that as a threat um especially if you   are like your blood sugar's low or or something  else the hpa axis recognizes when the body doesn't   have all of the tools and ingredients it  needs if you will to make the hormones   neurotransmitters to keep functioning optimally  and when that happens it goes into stress mode pain management is one we haven't  talked about yet but it is important   inflammation causes pain so as we start to  reduce inflammation with vagus nerve activities   nutrition sleep you know that's wonderful and  that should help some however it's unreasonable   to expect to go your entire life without having  pain you're gonna wake up with a kink in your   neck you're gonna have pain here and there  so pain management tools are really important   we when we feel pain that's our body's  cue that something's wrong it may not   be completely broken it may just be a little  out of kilter but something's wrong and that   triggers the hpa axis for some people that  really ramps up the hpa axis because they have   health-related anxiety so every time they feel  pain they start expecting the catastrophic end   and so pain management is really important to  be able to recognize pain for what it is to   develop strategies to cope with the pain  in a healthy way recognizing that sometimes   you're going to have pain and you can still have  a rich and meaningful life sometimes you're going   to have a headache or even a migraine and as  soon as it passes you can get back to your rich   and meaningful life relaxation is another tool  and relaxation is triggering that vagus nerve   but it's also triggering the release of what  we'll call cool hormones and neurochemicals   like gaba and your endorphins that help you  feel relaxed and calm and happy and blissful   relaxation exercises you can do progressive  muscular relaxation you can do yoga you can   do painting whatever it is that helps you feel  relaxed that helps you feel de-stressed sometimes   a lot of us will carry our stress like in our  chest and in our muscles and stuff and in our neck   when you've relaxed you don't feel that tension  anymore so making a list of the things for each   person that helps them feel relaxed what can you  do when you come home after a hard day of work   that helps you feel relaxed is it a hot bath   is it playing with your dog is  it painting what works for you affectively we want to help people  improve their emotional intelligence   by doing this what we're doing is helping  them first increase their emotional awareness   what is the purpose of this emotion too often we  just have these emotions anger anxiety guilt grief   all these labels but what's the purpose why do we  have them emotions are designed to motivate us or   to inform us so anxiety that is your body's smoke  alarm that is your body saying hey pay attention   there might be a threat just like a smoke alarm  says there might be a fire it doesn't mean there   is means there might be anxiety is your body's  smoke alarm once people recognize that that   anxiety does does not mean there is a threat it  means there might be okay well that's that's a   good piece of information to have anger is the  same way some people respond with anger they   start getting angry because they feel like there  might be a threat and they've got to look and see   is there something i need to fight off right now  and if not okay cool but once people recognize   the purpose of the emotion what's it there to do  how is it designed to help me stay safe to help me   procreate and keep the species going on that  can be helpful then helping them identify their   indicators how do you know when you feel anxious  what's your first early warning sign that you're   starting to get anxious what's your next  warning sign that way they can intervene early   before they are completely overwhelmed  with terror they've already intervened and becoming aware of their triggers  now that i know the purpose of anxiety   you know it's there to keep me safe to let me  know if i need to fight or flee and i know what it   feels like when i start to get anxious well that's  great as soon as i start to get anxious i can   look around and i can say okay what's causing this  what is triggering this feeling for me now and why   and then i can address it tolerance is  another skill we need to have people develop   because we will have emotions our body is designed  to feel emotions to motivate us to do things   it's not designed to give us emotions that we just  sit with that we become overwhelmed or drown in   it's they're designed to the the  emotions are designed to help us   understand it's communication it's the  way our body communicates without words   so distress tolerance skills thoughts distress  tolerant ones i can do this this too shall pass   i can experience this pain and still  have a rich and meaningful life activities like breathing that can help the person  get into their wise mind you know sit through   tolerate the flood of the excitatory  neurochemicals until they dissipate and they can   get out of that adrenaline haze and they can see  clearly and assess the situation guided imagery   or even sensations like splashing cold water on  their face problem solving so you've identified   the emotion you know what it is you're aware  of it you sit with it you tolerate it until   the emotion subsides and you can get into  your wise mind and then you move on to problem   problem solving all right i feel anxious in this  situation what can i do to improve the next moment grief and trauma processing is something  else if people have experienced trauma then   they need to process that trauma they need to  feel safe and empowered one of the keys is that   feeling safe and empowered in the present you  know i can look and objectively say as a 50 year   old person in this situation i am safe and i am  empowered and this trauma is not happening again   but there is a part of me that experienced  that trauma that needs to process it   so that that nine-year-old girl needs to feel safe  again and so grief and trauma processing involves   helping the person process that experience from  the perspective of when they had that experience   for a lot of people not everybody needs to do that  but for a lot of people it's helpful some people   say helping the inner child process that grief  however you want to phrase it it's important   and grief we're going to lose things we're going  to experience losses and that will trigger the hpa   axis that is likely a necessary triggering  of the hpa axis when you experience a loss   and then you integrate it holding on to that  grief prolonged grief extended intense grief   that is unnecessary axis activation now how  long is appropriate to grieve depends on the   situation and the person is not for me to  say but it's important for the person to be   able to look at it and say okay is continuing  to grieve what i need to be doing right now   vulnerability awareness and management i mentioned  triggers and i already mentioned vulnerabilities   a little bit vulnerabilities are things that  make you more likely to be triggered so for me   being in pain or being tired are my two biggest  vulnerabilities i know that i tend to be   much more irritable much and i respond much  more strongly to things that irritate me   when i am either in pain or when i'm tired  therefore so i'm aware of my vulnerabilities   therefore when i am in pain or  entire or i'm tired i take steps to   protect myself from extra steps to protect  myself from stressors i ask myself you know   well do i really have to do this today or do  i really have to go to this meeting and it's   important to recognize what those vulnerabilities  are for you and it's not just physical states it   can also be places my daughter for example um is  an introvert and she gets overwhelmed when she   is in huge crowds you know she doesn't have  it's not agoraphobia she just the energy   is just overwhelming to her so she knows that  when she's in large crowds it's easier for her   to get have her anxiety triggered know what your  vulnerabilities are and positive affect activities   this can kind of go back to those hobbies and  interests those can all help promote the release   of some of those cooling neurotransmitters to  balance out the heat of the stress hormones we want to promote efficacy and empowerment  help people identify and address their cognitive   distortions what do they have control over in the  current context based on the available facts what   are some alternate explanations for what might  be going on besides this catastrophic one or   this personal one that it's all about them and  what are some exceptions to the rule instead of   saying every place i go is dangerous what are some  safe places that you've gone tragic optimism and   radical acceptance are forms of cognitive  restructuring that can be very helpful too   recognizing yes this happened and i can live a  rich and meaningful life recognizing that yes   this happened and i can move forward into feeling  safe and empowered again tragic optimism means   recognizing the problem that's the tragic part and  having hope that you can improve the next moment   radical acceptance means accepting what is and not  trying to convince yourself that it doesn't exist   so you're saying all right it is what it is and  there's hope hardiness and a rich and meaningful   life is also important encouraging people to  recognize what is important to them in their rich   and meaningful life and how many of those things  do they actually have going for them right now   and then deciding when stuff comes up you know  am i going to use my energy am i going to let   my energy my anxiety overwhelm me right now or am  i going to take that anxiety and put it over here   and use that energy on something i can control  and get curious and and i mean this literally   behavior is communication and our bodies  communicate through us through sensations   when we feel a certain way get curious why is  it that i'm feeling this way right now that   will help you understand yourself understand your  triggers and be able to respond more effectively environmentally have people identify  their triggers and figure out how to   manage them this means not only distress  triggers you know what things in your   environment trigger physical distress like  pain or discomfort and emotional distress   but also what triggers can you add or keep in  your environment that help you feel safe empowered   and content you want to walk into a room and feel  safe empowered and content so what can you do   to make that happen make sure they  have access to shelter and basic needs   211.org is a great place to go to get  started to find out about community resources   patient assistance programs are available through  most pharmaceutical companies if your patient   is having difficulty getting affording their  medication and it's like a one one page sheet   just go to the pharmaceutical company website and  look for the patient assistance programs if they   are in jeopardy of homelessness go to the local  housing authority there may be grants to prevent   homelessness or to help people stay in their  homes if they are are in jeopardy of eviction and relationally inner child work is important  in my opinion um having the person become   aware of their inner child we all have one some  are really happy some are traumatized some are   somewhere in between becoming aware of your  inner child and re-parenting that child and   and what i mean by that is developing a secure  attachment being consistently aware of that child   being responsive to that inner child if they  want to um go out for ice cream then you know   maybe figure out if you can go out for ice cream  so being consistently available being responsive   being encouraging being validated and being  attentive paying attention to that inner child   and when it wants to come out not always pushing  it down going no there's no time for fun develop   once you've developed secure attachment with your  inner child once that inner child feels safe a lot   of times you'll start to feel more integrated and  less stressed because you don't have that thing   in the back of your head always telling you oh are  you sure we're safe are you sure we can do this   secure attachment with others is the next step and  this helps people address their abandonment fears   and recognize that not everybody's going  to be around all the time but developing   secure relationships with a few people can  help people feel safer and more empowered   learning how to set and maintain boundaries is  also really important uh so people feel safe   and empowered they don't feel like their physical  boundaries are being invaded they feel like they   can have their own thoughts and feelings with  that thoughts and feelings without having those   um invalidated or stomped over by somebody else  and so they start to feel safer in their body   becoming aware and manage interpersonal triggers  and what i mean by those i know we've talked a   lot about a lot of triggers but interpersonal  triggers are like micro expressions that people   make that just make them want to climb the wall  becoming aware of those and if somebody does them   recognizing them for what they are my so and  so used to do that and it drives me up the wall   and and separating it so they recognize that in  this context at this time that micro expression   may mean something completely different developing  assertiveness and addressing their fear of   being assertive because a lot of people may know  how to be assertive but they're afraid to do it   so working through that because if we can't  communicate our thoughts wants and needs we   can't get them met if we can't get them met then  we don't feel safe or empowered and learning how   to listen without defensiveness learning how to  listen without assuming that disagreement is a   rejection of us recognizing that disagreement  is a rejection of an idea not of us as a person   activity get a thousand dollars of monopoly money  in 10 bills these are your energy credits and   a stack of blank index cards these are your i o  u's and an envelope each time something increases   stress or activates your hpa axis pla place one  of the ten dollar monopoly bills in an envelope   if you run out of those bills before the  end of the week use the blank index cards   include things like poor sleep poor nutrition  alcohol use and over caffeination that trigger   your hpa axis that way you can get an idea  about how often that thing is being turned on   the goal is to spend less than a thousand dollars  of your energy credits each week this is just   one of those awareness activities that's a  little more fun than just keeping a journal trauma impacts people physically  affectively cognitively environmentally and   relationally rewiring the traumatized  brain is like recovering from a sprint   the more you reduce or slow reduce stress  or slow down the faster it'll happen if   you're recovering from a sprint by jogging  it's going to take a little while longer   recovery requires reducing the stress and  allowing the brain and body to heal and rebalance   creating new schema that promote empowerment  and safety so you start seeing the world as   safer and more controllable and becoming more  mindful to reduce autopilot based responding

Channel: Doc Snipes

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Keywords: Dawn Elise Snipes, Cheap CEUs, NCMHCE, unlimited ceus, hpcsa, crcc, lcsw ceus, lcdc ceus, lmft ceus, lmhc ceus, ce broker, addiction ceus, LADC CEU, MAC CEU, counseling techniques, counseling skills, online counseling, yt:cc=on, donnelly snipes, doc snipes, counselor education, mental illness, allceus, all ceus, cognitive behavioral, certificate programs, counselor certification, online course, trauma informed, vagus nerge, cognitive behavioral therapy, neuroscience

Id: 84HkD8j248Q

Length: 63min 24sec (3804 seconds)

Published: Wed Aug 03 2022