1. Neuroscience and Ethics of
Trauma-Informed Practice
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2. Mindsight
• the ability for one person to
perceive the mental state of
another.

3. “Mindsight depends on linking together wide
arrays of neural input – from throughout the
entire body, from multiple regions of the
brain, and even from the signals we receive
from other people.”
Dan Siegel

4.  http://www.youtube.com/watch?v=DD-
lfP1FBFk
 Review 5 - steps

5. Brain Stem (“reptilian brain”)
• Controls body’s energy levels (i.e., regulating
heart rate and respiration)
• Moves information from the body proper to the
brain (i.e., nauseas, hair on the back of your
neck, nervous feeling, rapid heart beat)
• Influences response to flee, fight, or freeze in the
face of overwhelming situation

6. Brain Stem (i.e., “reptilian brain”)
• “Giving” and “receiving” love are the same
• Working together, the brain stem and limbic
areas–
o Push toward deep drives
(i.e., food, shelter, reproduction, safety)
o Influences states (i.e., drive toward vs. satiated) of
arousal (i.e., sexual and appetite)

7. • Emotional center of the brain
• Attributes meaning to feelings (i.e., feelings
have meaning)
• Motivates us to act in response to meaning
we assign (i.e., emotions evoke motion)
• Mammalian lineage – our drive to connect
with others

8. Hypothalamus
• Secretes hormones (i.e., cortisol) to help regulate
the body (i.e., sexual organs, thyroid)
• Small amounts of cortisol enhance functions such
as memory
• Overwhelming situations with which we can’t cope
lead to chronically elevated cortisol.

9. Hypothalamus – High Cortisol Over Time
• Sensitizes limbic reactivity so that minor
adversities spike cortisol.
• Interferes with brain growth and damages neural
tissues
• Self-soothing activities (i.e., meditation, walks in
nature) that draw on higher areas of the brain are
critical to create a “cortical override”

10. Amygdala
• Fear response
• Emotional states can be created without conscious
awareness
• Remembers any and all dangers and generalizes
(i.e., attacker, man who looks like attacker, to
man, etc)

11. Hippocampus
• Organizes explicit memory
• Compares different memories and make
inferences
• Late maturation

12. Cortex
• Abstract and symbolic thought
• Understand concepts such as self, time, others
• Executive planning, social functions
• Consciousness, perception, attention
Middle Prefrontal Cortex
• Integrates cortex, limbic and brain stem

14. Left-right integration enables us to:
• Put feelings into words
• Think about feelings

15. Memory
At birth –
• Hippocampus (memory and learning) not well
developed
• Implicit memory (memories without a “sense” of
recollection)
• Implicit memory enables development of mental
models
i.e., transferring felt experience of pacifier with
nubs to visually recognizing it

16. Memory Cont’d
Implicit memory
• begins in the womb
• predominates through early life
• enables creation of mental models of the way the
world works – no effort on our part
• can continue to shape who we are without our
awareness

17. Mirror Neurons
• Hardwired from birth to detect sequences, make
maps of other’s intentions
• A neuron that mirrors the behavior of others, as
though the observer were doing the behavior.
• Fires when observing intentional behavior
• Same neuron fires when conducting the behavior
• Cross-modal (i.e., vision, touch, smell, etc.)

18. Resonance Circuit
• A neural network called insula (i.e., information
superhighway) runs from mirror neurons to limbic
area which sends messages to the brainstem and
body, then back to middle prefrontal cortex.
• This process informs the cortex of our state of
mind (i.e., energy and information flow).

19. Resonance Circuit Cont’d
• This enables us to resonate physiologically with
others; our respiration, blood pressure, heart rate
changes with other’s internal state.
• When we sense our own state, it is easier to
resonate with others.

20. Resonance Circuit Cont’d
• We come to know our own mind (i.e., energy and
information flow) through interaction with
others.
• It is the awareness of our own body signals that
help us understand the difference between me
and you.
• It is important to track distinction between me
and you, lest we become flooded with others’
feelings, leading to quick burn out.

21. Infant Care-Giver Dyads –
Prelude to Attachment
Neurobiology for Clinical Social Work, Applegate and Shapiro
Neuroscience of Psychotherapy, Cozolino
• Brain structure and processes affected by
microexpressions in infant-caregiver dyads
• Synapses are programmed to receive certain
microexpressions
• If the expected experiences are not experienced, neurons
die
• Death of neurons leads to a smaller volume amygdala and
hippocampus (Glaser)

22. Infant Care-Giver Dyads –
Prelude to Attachment Cont’d
• Microexpressions occur via verbal and
nonverbal responsive communication such as:
o Voice pitch, tone, rhythm
o Pupil dilation
o Movement of eyebrows
o Degree of eye openness
o Fullness or terseness of lips
o Level of muscle tension in the face
o Other verbal and nonverbal communication

23. Infant Care-Giver Dyads –
Prelude to Attachment Cont’d
• Prolonged mutual gazing increases infant’s
metabolic activity and neural growth
• Reflexive smiling evokes positive feelings which
stimulates brain development
• Infant and caregiver adjust to each others’
gestures, behaviors, and sounds in a song and
dance fashion

24. Infant Care-Giver Dyads –
Prelude to Attachment Cont’d
• A responsive song and dance (i.e., exchange of
microexpressions) sets children up to experience
secure attachments. (Cozolino)
• Good-enough parenting

25. Attachment Patterns &
Emotional Regulation
Attachment patterns arise as a result of infant caregiver
interactions and establish neural networks:
• Secure attachment sets the stage for integrated
neural networks.
• Insecure attachments sets the state for
unintegrated neural networks.
Behavioral Videos Neurobiology Videos
(7:15) Avoidant (2:04)
•Secure http://www.youtube.com/watch?v=qgYJ82kQIyg&feature=result
•Insecure/Avoidant s_video&playnext=1&list=PL1A32ED7EF5F192F2
Ambivalent Ambivalent (1:56)
http://www.youtube.co http://www.youtube.com/watch?v=nGhZtUrpCuc&feature=related
m/watch?v=PnFKaaOS Disorganized (4:48)
Pmk http://www.youtube.com/watch?v=zovtRq4e2E8&feature=related

26. Attachment Patterns Summary
Secure –
• Uses caregiver as a secure base for exploring.
Insecure –
• Unable to use caregiver as a secure base (true for
ambivalent and disorganized)
• Little distress on departure, little response to return
• Little effort to main contact. Low attachment equals low
affect, low self-esteem.
• Parent has little response to distressed child.

27. Attachment Patterns Summary
Ambivalent –
• Seek contact upon return but reluctant, or angrily resistant
when contact is achieved.
• Children are more anxious. Parent is inconsistent with
dismissive and attentive responses.
Disorganized –
• Freezing or rocking. Contradictory, disoriented behaviors
such as approaching but with the back turned.
• Parent likely violent, intrusive, role confusion, negativity,
contradictory affective communication.

28. How Trauma Affects Emotions
• Early deprivation or chronic stress increases the
chances of damage to the brain, deficits in
memory, and prolonged use of primitive defenses.
• Through the connect-disconnect-reconnect
pattern, our experience with a “good-enough”
parent establishes the neural networks for healthy
affect regulation (i.e., being able to tolerate
negative affect).

29. How Trauma Affects Memory
Two primary implicit/explicit response patterns
1. Recall what happened and separate physical,
emotional sensations
• Describe traumatic event in matter-of-fact w/o making implicit body
memories explicit
2. Inability to recall what happened (i.e., explicit
memory) yet retain physical, emotional
senses)
• i.e., abusive childhood isn’t a problem, yet person is profoundly
negative, critical, etc./acting out their implicit memories

30. How Trauma Affects Memory Cont’d
• Inability to recall traumas that occurred in infancy,
may lead children to internalize the somatization
of their implicit memories and conclude they are
bad.
• Ambiguous stimuli (i.e., silence) activates implicit
memory
• Smaller hippocampus (i.e. responsible for memory
and learning) due to chronically high cortisol
levels, toxicity and cell death

31. Responses to Trauma
Lack of vertical neural integration
• Affect dysregulation i.e., inability of the cortex to process,
inhibit and organize information from brainstem and
limbic system such as reflexes, impulses, and emotions.
• Trauma or living in an “emotional desert” leads to being cut
off from bodily sensations, leading to poor judgment, lack
of wisdom.

32. Responses to Trauma Cont’d
Lack of horizontal neural integration (i.e., one side
dominating) leads to:
• Inability to put feelings into words
• Somatization (i.e., manifestation of emotional conflicts
into bodily illnesses)
• Loss of creativity, richness, and complexity that results
from integration
• Inability to understand the nonverbal world of self and
others

33. Healing Trauma: Strengthening Neural
Integration
Interpersonal Neurobiology Series (Cozolino, Siegel)
Restoring neural integration requires simultaneous
reregulation of networks on vertical and horizontal planes.
This may occur through:
• Strength of the therapeutic alliance
• Moderate levels of stress
• Narrative which involves emotion and cognition
• Mindsight (i.e., ability to perceive the mental state of another
person)
These same factors are at work across psychodynamic,
systems, and cognitive approaches to treatment.

34. Healing Trauma: Narratives and Neural
Integration
Narratives are powerful tools for high-level neural
integration because they contain:
• Linear storyline and visual imagery, woven with
• Verbal and nonverbal expressions of emotion

35. Healing Trauma: Narratives and Neural
Integration Cont’d
Narratives facilitate neural integration by using
circuitry from:
• Left and right hemispheres
• Cortical and subcortical networks
• Amygdala and hippocampus

36. Healing Trauma: Narratives and Neural
Integration Cont’d
Narratives facilitate
• Integration of neural networks
• Combining sensations, feelings and behaviors
with conscious awareness
• Individuals placing themselves in alternate
points of view

37. Hope is Present!
• Based in neuroplasticity research, Dr. Siegel
explains in this video explains how “making sense
of what happened to us as a child” is more
important than actually what happened.
• “Become a Better Parent”
http://www.youtube.com/watch?v=JNNT7loaQAo&feature=bf_prev
&list=PL1A32ED7EF5F192F2&lf=results_video