What is Attachment and Trauma-Specific Therapy and Why is it Needed?
Individuals of all ages can experience trauma, including infants and children. Even when we do not consciously recall our trauma experiences (because of our age or protective functions such as repression) our body holds memory, as does our mind. Trauma is a sensory experience and, regardless of the level of perceived intensity of effect on an individual, treatment promotes resilience later in life. There are a wide variety of factors that can impact our brain, nervous system, perceptions, and body inclusive of birth complications, medical trauma, intergenerational transmission of trauma, all forms of abuse and attachment dysregulation, injuries, accidents and traumatic loss just to name a few. At Lori Gill Psychotherapy we are trained in working with all forms of trauma, what this means is that although we all have the more generic counselling skill we have specialized skills in relation to trauma and attachment that allow us to safely and effectively guide clients along their healing journey. Treatment focuses not on avoiding unpleasant or uncomfortable emotions but rather on building awareness and tolerance to hold these emotions and reflect on them with compassion. As a result, the strategies we use focus on regulating the nervous system which is very important to ongoing resiliency and optimal development. To do so we incorporate mindfulness meditation yoga and various other holistic wellness practices to increase attention span, regulate the body and mind, and optimize the individual’s ability to regulate their emotions and behaviours. Current neurocisence research is demonstrating that mindfulness is changing the brain in the areas most effected by trauma (van der Kolk, 2014).
Trauma drastically disrupts our nervous/sensory system. All of our senses are impacted as our brain becomes stuck on high alert constantly scanning for threat or danger (Scarer, 2013; Warner, 2015). Dr. Bessel van der Kolk, (2014), considered to be one of the world’s leading trauma authorities describes a few key brain functions in his latest book The Body Keeps the Score; the amygdala (which he likens to being the ‘smoke detector’ of the brain) has a central purpose of assessing input from our nervous system and determining whether threat exists. The medial prefrontal cortex located in the frontal lobe (referred to as the ‘watch tower’ of our brain) has a goal of helping to mitigate false alarms by helping us to realize when there truly is no threat present. When we are too emotionally overwhelmed this communication to calm the smoke alarm prevents the aborting of the stress response. Several other areas of the brain are impacted by trauma; the medial prefrontal cortex is devoted to self-reflective capacities (your inner experience of yourself). The dorsolateral prefrontal cortex (DLPFC) and the hippocampus are concerned with your relationship with your surroundings. The DLPFC helps us consider how our present experience relates to the past and potential future impact (and is referred to by van der Kolk as the ‘time keeper’ of the brain). Depersonalization occurs when there is a splitting off from the self and is often recognizable when people tell their stories seemingly without any emotional connection to their experience
Post Traumatic Stress Disorder (PTSD) creates shifts in the critical balance between the amygdala and the medial prefrontal cortex making it harder to control emotions and impulses and making it more likely that people will respond to threat disproportionately. Neuroimaging shows us that emotionally charged states such as intense fear, sadness, and anger all increase activation of subcortical (more primitive) brain regions involved in emotions and significantly reduced activity in various areas in the frontal lobe (higher order cause and effect thinking areas of the brain) particularly the medial prefrontal cortex. Essentially the inhibitory capacities of the frontal lobe break down making it so this individual is less able to respond in a socially appropriate manner as their stress system is on high alert and primed for survival (van der Kolk, 2014).
Attachment, Self-Regulation, and Competency® (ARC) Model
The ARC model is an evidence based framework that aims to heal trauma wounds by raising awareness about trauma and its impact for children, professionals, and caregivers. There are 10 building blocks upon which the ARC framework are built upon (see image below). The ARC model is recommended by the American Academy of Paediatrics recommends the ARC model under their 'suggested therapies for the traumatized child' (p.13). Learn more about the ARC model and associated research findings on the Trauma Centre at JRI's website: http://www.traumacenter.org/research/ascot.php
Each of these building blocks are thoroughly expanded upon in the book by Blaustein & Kinniburgh: Treating Traumatic Stress in Children and Adolescents. This is a rich resource that offers a breadth of information to help professionals become adept at healing trauma and attachment dysregulation as well as worksheets to help children and youth better understand the impact trauma has at a neurological, physiological, and behavioural level and what they can do to become more empowered and create change.
I previously had a child I work with in residential treatment tell me that his "brain is broken" which was heartbreaking to hear but given my knowledge of neuroscioence I was able to reframe for him that, although his brain felt like it was broken our brain is actually quite brilliant in that it protects us when we experience overwhelming or terrifying events. I furthermore explained to him that as brilliant as our brain is, it sometimes become stuck perceiving that we remain in a state of danger even after the threat has passed and that we need to help it become unstuck through regulating our body and mind and changing the conscious messages we are sending ourselves. We proceeded to work through the handouts on 'false alarms' in the workbook which were quite reinforcing of the organic conversation that had come up that session. These tools help us to easily communicate the impact that trauma has and help us to form meaningful collaborative plans with children, youth, and their caregivers to reduce arousal, promote regulation, form meaning, and empower children, youth, and their caregivers to create sustainable changes.