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Expressive Therapy Summit 2014 
Treating Trauma 
and 
Emotional Dysregulation 
Using 
Intermodal Expressive Therapies 
Kevin Makarewicz M.A., L.P.C., L.M.T. 
www.KevinMakarewicz.com 
kevin@kevinmakarewicz.com 
(203) 698-2465
Lets take a few 
moments
My Work 
Modalities- 
Expressive Therapies, Biofeedback-HRV, qEEG, Brainwave 
Biofeedback, EMDR, Bodywork, Trauma informed Contextual Family 
Therapy, Group work incorporating the expressive arts, 
Population- 
- Private Practice In Old Greenwich CT, Individuals and Families 
- Seasonal Healing and Celebration Rituals, Drum and Dance 
-12 Years Residential Psychiatric Facility with Children, Adolescents 
and Adults 
- Mankind Project, New Warrior Training, Men’s Support Circles 
- Boys to Men, Initiatory process for adolescents 
- School Residency doing Social Emotional Enrichment through the 
Arts 
- Restorative Justice Circles with “At Risk” youth
Objectives 
• Better understand your own and others 
psychophysiological reactions to situations 
• Be able to be more responsive and alive to 
ourselves and to others 
• Begin or enhance a practice of using 
enactment for enrichment, empowerment and 
renewal. 
• Support and empower others in their practice.
Method 
• We will learn a method of resolving trauma through the 
expressive arts. I will present this in the framework of a 
group therapy model. 
• This method can be fully employed in individual therapy. 
• It can be used on your own for your own healing process. 
• It can also done with a peer, or group of peers.
Bio in a Tale 
• Once upon a time, StarChild was born in an enchanted kingdom. Fogs of 
Madness would drive the King and Queen into stupor, rage and insanity. 
• One day, while the King, Queen and Hilda-the old kind one, were in the 
throes of of their madness, the Dragon came and slayed villagers, 
• In horror, StarChild left the kingdom and searched for the sacred 
mountain of the wise people where he heard that StarMusic was still played. 
• StarChild learned to follow the trail of SongLine across the land. 
• The SongLine led StarChild to the Old tribe that kept the StarMusic alive. 
There StarChild learned to stand in the center of the fire, connect to the Stars 
above and the center of the Earth and come out of the flames unburned. He 
loved it there but they told him, “You must leave and return to your 
kingdom.” “But I will loose myself in the Fog of Madness,” StarChild said. 
So they gave him a buffalo horn, filled with ash and a burning ember. 
• Now back in the Kingdom, StarChild, now a man, blows on the sacred 
embers, and sings the old Star songs. This music pushes back the Fogs of 
Madness. Others join him in this song, the kingdom shines, laughter returns. 
And still when the moon is dark, and winds are strong the Madness creeps 
back into the kingdom. 
• And still there is a dragon who bides his time waiting to find his 
next meal...
Flight Preparation 
• So.. Like when boarding a plane- 
• - know your safety exits, 
• - put your oxygen mask on first, then help those 
around you 
• - your seat cushion may double as a floatation device! 
• This seminar may be challenging or evocative for you. Do 
what you need to do to take care of yourself. 
• Respect your self and only do or share what you are 
comfortable with. You are welcome to pass on anything, 
• Move around as you need to. 
• You are welcome to ask questions, make comments. I will 
do my best to keep our discussion on the track that serves 
the greater good. 
• Use your common sense and clinical judgement about 
where and when you employ any of the techniques or 
processes you learn here. 
• Hand outs
clip from 
“Princess Bride”
Objects 
Pulse 
Rumble if... 
Pass the rumble 
Pass the rumble - match tone, change, 
pass 
Mime Catch w Rumble 
Double Pulse- 
Tell us how it was getting here using your 
drum 
Fluid Sculpture 
Some Action-
Hakomi Technique 
“Taking Over”
Playback Theater- 
“Fluid Sculpture” 
Hakomi Technique “Taking 
Over” 
demonstration
Enactment 
• Externalize experience, have it out 
there, rather than just in here 
• Gain distance perspective and 
connection. 
• It has an edge In time; It has a 
beginning, middle, and end 
• It has an edge In space; an inside and 
outside 
• We can have a relationship with “It” 
• “It” actually becomes a “Thou” 
• We can change it; it can change us
Enactment 
• Objective Correlative- noun, Literature. 
1. a completely depicted situation or 
chain of events that objectifies a 
particular emotion in such a way as to 
produce or evoke that emotion in the 
reader. 
• Representation 
• Map or Model 
• Computer- U.M.L. - Universal Markup 
Language- the architecture of a 
program
Medium and Modality 
Medium Modality 
Body/Movement 
Hearing Sound 
Image/SIght 
Smell 
Taste 
Touch / Substance 
Words 
Dance, Drama, Puppet, Art, Sport, 
Pilgrimage, Yoga, Tia Chi, Juggling, Rope 
Walking, Martial Arts, 
Music, Drama 
Visual art, Culinary, Craft, Drama, 
Photography (video in time) 
Perfume, incense 
Culinary arts 
Sculpture, Music, Massage, 
Crafts, Culinary, Martial Arts 
Poem, Story, Graffiti, # 
Song, Drama 
Exists in time and space, 
private or social 
Exists in time, instantly social 
Exists in space, not time, can 
be private and social 
?Space, ?Time 
Exists in space, and time, private 
and social 
Exists in space, can mark time 
private can be social 
Words need a modality to exist 
Modality give them space or time 
can be private or public
2014 et summit_makarewicz
Brodmann Areas 
- 52 regions of the cerebral cortex of humans and 
monkeys that appeared to have different cellular 
morphology and organization. 
- Over the past century clinical findings and 
neurophysiological studies have shown that these 
microstructural differences correlate well with 
cortical function specialization. 
by using different modalities, we engage different 
brain regions 
http://en.wikipedia.org/wiki/Brodmann_area
2014 et summit_makarewicz
Medium and Modality 
High Sensitivity / Low Skill 
Medium Modality 
Body/Movement 
Balance 
Hearing Sound 
Image/SIght 
Smell 
Taste 
Touch / Substance 
Words 
Dance, Drama, Puppet, Art, Sport, 
Pilgrimage, Yoga, Tia Chi, Juggling, Rope 
Walking, Martial Arts 
Music, Drama, 
authentic movement 
simple choreography, 
imitate nature, Playback Theater 
Small Range instruments, call and response, use 
Visual art, Culinary, Craft, Drama, 
Photography ( slide show / video in time) 
Perfume, incense 
Culinary arts 
Sculpture, Music, Massage, 
Crafts, Culinary, Martial Arts, 
Poem, Story, Graffiti, 
#Song, Drama 
recorded music, Playback Theater 
Collage, Decks 
abstract drawing, Playback 
Theater 
selecting smells 
seasoning food 
Ephemeral Altars, Flower 
Arranging, Playback Theater 
McKim process- scribe while person 
touchs things while blind folded 
call and response Playback Theater
Enactment 
is to our psyche 
as the digestive system is to our body. 
We can use it to digest, to take in that which 
nourishes us and to release that which does 
serve us, or even poisons us.
Kinds of Listening and Engagement- 
Intrapersonal and Interpersonal 
• inattentive 
• distracting 
• critical (rejecting, shaming, 
condemning) 
• competitive 
• exploiting (getting a laugh 
at the expense of another) 
• analyzing 
• critiquing 
• advising 
• projecting 
• demanding 
• present 
• curious 
• wonder, awe 
• respect 
• reflecting 
• gratitude, appreciative 
• sympathy 
• empathy 
• compassion 
• blessing 
Why would someone have these attitudes?
“If I really see you 
I will laugh out loud 
or fall silent 
or shatter in a million pieces 
and if I don’t 
I will be locked in my prison of stone 
and cement” 
Rumi 
13th-century poet
22
clip from 
“Finding Joe” 
www.findingjoethemovie.com/ 
introduction to the universality 
of the hero cycle 
Hero Cycle is an analogue 
to trauma treatment stages
In the fairy tale that you are living... 
Who is your prince or princess, or holy grail? 
What is the Road of Trials? 
What is the Dark Night? 
Who is the Old Wise Man/Wise Woman? 
What is the Magic Amulet? 
What is the Dragon? 
What is the Boon or Gift you bring to your 
community?
Enact your Fairy Tale 
or Part of it- 
• Draw it 
• Write it 
• Comic Strip 
• Sculpture 
• Song / Rap 
This need not be the whole 
tale. 
It can be just a chapter. 
It need not make a lot 
sense. # 
You are welcome to totally 
lie- also you are welcome to 
impersonate 
a client or someone else.
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What was writing the 
story of you life as a 
fairy tale like for you?
The Good Earth
clip from 
“The Sound of Music” 
“The hills are alive with the sound of music 
With songs they have sung for a thousand years 
The hills fill my heart with the sound of music 
My heart wants to sing every song it hears”
Clip 
boy conducting beethoven's 5th 
example of emotional 
responsiveness and aliveness 
https://www.youtube.com/watch?v=0REJ-lCGiKU
• “The dyadic relationship, particularly with primary 
caregivers helps to develop the sense of self and 
tone of the prefrontal lobes”. 
• Allen Shore 
• This sense of self becomes a ground of being, an 
essential model of who I am who others are and 
how the world is.
and Suddenly... 
“an suddenly” a common motif in fairy tales which 
is analogue for trauma, particularly single incident 
big T trauma’s
Clip 
Star Wars IV 
Luke returns home 
to find his caretakers killed and 
house burned
clip 
Tv announcer has 
amygdala hi jack 
when a lizard 
jumps on him 
https://www.youtube.com/watch?v=QO0iGlV2wbE
Daniel Goleman 
author of 
Emotional Intelligence 
- Role of the Amygdala
clip 
Goleman 
explains Amygala highjack 
https://www.youtube.com/watch?v=LTItzKrNX68
demonstation 
interaction when we don’t get facial or vocal social 
emotional cues. 
Person wears- mask, doesn’t speak, makes 
ambiguous gestures. 
Notice how this feels.
clip 
Still Face Experiment 
regulatory effect of dyad relationship 
https://www.youtube.com/watch?v=apzXGEbZht0 
note there was a time not that long ago 
when people didn’t think babies 
couldn’t socially interact
Window of Tolerance 
Hyper aroused 
Optimal aroused 
Hypo aroused 
increased sensations 
emotional reactivity 
intrusive imagery 
disorganized cognitive processing 
hyper vigilance 
relative absence of sensations 
emotional numbing 
disabled cognitive processing 
reduced physical movements 
from Pat Ogden
Stephen Porges 
Polyvagal Theory 
Social Engagement- 
Fight Flight- high sympathetic tone 
Freeze- high parasympathetic tone
43
44
45
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47
48
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Allen Shore 
• You cannot develop a sense of self without 
adequate affect regulation 
• Affect regulation in the child depends primarily on 
the mother/primary care giver 
• She/He needs to be able to regulate herself and 
her baby 
• Her alignment with her baby builds brain 
structures and networks 
• Primary organizing structure is the pre-frontal 
cortex
Impoverished Development of the 
Orbital Frontal Cortex causes: 
• Lack on inhibition of fear, rage, 
aggression 
• Decreased awareness of emotional 
state of self and others 
• Decreased empathy and care for social 
rules 
• Lack of cause and effect thinking
Why trauma survivors 
have symptoms 
instead of memories
Implicit Memory 
vs 
Explicit Memory 
(ie. Narrative Memory)
2014 et summit_makarewicz
PTSD 
is a disorder of 
memory
Trauma 
Shame and 
worthlessness 
Hopelessness 
Emotional 
overwhelm 
Decreased 
concentration 
Loss of 
Interest 
Irritability 
Depression 
Little or no 
memories Nightmares 
Flashbacks 
Hyper-vigilance 
Generalized anxiety 
Panic Attacks 
Chronic pain 
Headaches 
Substance 
Abuse 
Eating Disorders 
Feeling Unreal 
Loss of sense 
of “who I am” 
Self Destructive or Out of body 
Behaviour
2014 et summit_makarewicz
60
Trauma-Dysregulation 
Attachment/ 
Developmental 
Needs 
Big T 
Trauma 
Small t 
trauma(s) 
TBI 
Traumatic 
Brain 
Injury
Art/Enactment 
Bridges Conscious Awareness to the 
Silent Depths of the Psyche 
The artistic process then facilitates the dialogue 
between the parts of the brain which rule: (prefrontal) 
and speaks (Broca’s area and Wernake’s area) and 
the parts that KNOW -basal ganglia, insula, and parts 
that sort it out- hypocampus.
Treating Trauma 
Slaying or Redeeming 
the Dragon 
Fairy Tales inform us, 
that to handle “the dragon”, 
we must first be prepared
Resource 
If you must face the dragon 
or make a trip to the pit of hell 
What resource would you need to be successful? 
also known as . . . 
How do you keep your left prefrontal lobe active, 
amygdala calm, and your affect balanced?
clip 
Harry Potter 
Prisoner of Azkaban 
Harry learns the Patronus Spell 
"This ancient and mysterious charm conjures a magical guardian, a projection of all your 
most positive feelings. 
This is a great model of learning about using Resources. Also models the Old Wise Man 
process of initiation
Resources 
Theseus -Mitos, ball of yarn to escape the labyrinth, slayed 
Minotaur 
Batman and James Bond’s tech gadgets 
Hobbit - Gandalf, courage, 
Perseus, Hermes - winged sandles, Athena, shield, 
Ender- war games at Battle school 
Harry Potter- cloak of invisibility 
Sound of Music- Song
Relational 
Resources 
Mastery Symbolic Attitude/ 
Postural
2014 et summit_makarewicz
Amy Cuddy TED.com 
Our bodies change our minds 
Physical posture as a Resource
Resource Enactment 
1) Name a resource from your life-relationship 
mastery 
symbol 
2) Draw it or pick a tarot card 
or other icon that holds the image 
find movement that embodies the energy of the resource ( not literally moving the image 
3) Partner up - learn their resource movement and teach them yours 
4) Duo partners with another Duo, learn all four resource movements, put them in a sequence 
5) As ritual of empowerment, group of 4 presents their resource movements to whole group while 
group supports with drumming, clapping chant 
6) Make clear this is not a competition! This not a performance it is a ritual of empowerment where 
we support each other to embody our positive qualities, strength, grounding, courage, grace, 
sensitivity, balance 
7) You can also have people make verbal affirmations 
* explore other intermodal transfers
Facing the Dragon
Trigger 
Break Traumatic Memory in to Components 
SUDS- Subjective Unit of Distress 
Image- (could be in any sense) 
Sensation 
Emotion 
Behavior 
Worst Negative cognition, thought or belief about your self 
While holding this memory what is your positive- belief about 
yourself, emotion, sensation, 
Where are you on the bridge between negative cog and positive
2014 et summit_makarewicz
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What would you like to think about yourself now 
SUDS 
Subjective Unit of 
Distress Scale 
0-10 
Positive Cognition 
in relation to that situation? B 
Image of the 
Trauma/ 
“Face of the Dragon” 
Negative Cognition 
Sensation/ 
Emotion 
Body Map 
Worse Negative Belief about self in relation to the situation? 
r 
i 
d 
g 
e 
b 
e 
t 
w 
e 
e 
n 
C 
o 
g 
n 
i 
t 
i 
o 
n 
s
Processing Sequence 
Form the enactment 
Seperate from enactment get into witnessing perspective 
Witness the enactment 
Was that accurate? Watch for body truth response. 
How was that for you to witness 
Pendulate from resources to trauma 
Is response- merged, contemptuous, judgmental, dissociated, or 
Compassionate? ( Is left frontal or right frontal dominant at this time?) 
If response is merged, contemptuous, judgmental, dissociated,- enact that. 
If response is Compassionate- How would you like to respond to this 
scene? 
(present time adult ego state can transform the scene- this self must be the 
source of agency.) 
Healing interactions- protection, limit setting, explaining, nurturing 
relationship, blessing 
Role reverse to have protagonist receive the healing action that he she just 
gave. 
Behavioral based homework. Given this new healing light- what can you 
practically do to continue to support this.
now - 
click your heals together 
three time 
and say, 
“there’s no place like home”
The End 
www.KevinMakarewicz.com 
kevin@kevinmakarewicz.com 
(203) 698-2465

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Burning Issue presentation of Zhazgul N. , Cycle 54
 

2014 et summit_makarewicz

  • 1. Expressive Therapy Summit 2014 Treating Trauma and Emotional Dysregulation Using Intermodal Expressive Therapies Kevin Makarewicz M.A., L.P.C., L.M.T. www.KevinMakarewicz.com kevin@kevinmakarewicz.com (203) 698-2465
  • 2. Lets take a few moments
  • 3. My Work Modalities- Expressive Therapies, Biofeedback-HRV, qEEG, Brainwave Biofeedback, EMDR, Bodywork, Trauma informed Contextual Family Therapy, Group work incorporating the expressive arts, Population- - Private Practice In Old Greenwich CT, Individuals and Families - Seasonal Healing and Celebration Rituals, Drum and Dance -12 Years Residential Psychiatric Facility with Children, Adolescents and Adults - Mankind Project, New Warrior Training, Men’s Support Circles - Boys to Men, Initiatory process for adolescents - School Residency doing Social Emotional Enrichment through the Arts - Restorative Justice Circles with “At Risk” youth
  • 4. Objectives • Better understand your own and others psychophysiological reactions to situations • Be able to be more responsive and alive to ourselves and to others • Begin or enhance a practice of using enactment for enrichment, empowerment and renewal. • Support and empower others in their practice.
  • 5. Method • We will learn a method of resolving trauma through the expressive arts. I will present this in the framework of a group therapy model. • This method can be fully employed in individual therapy. • It can be used on your own for your own healing process. • It can also done with a peer, or group of peers.
  • 6. Bio in a Tale • Once upon a time, StarChild was born in an enchanted kingdom. Fogs of Madness would drive the King and Queen into stupor, rage and insanity. • One day, while the King, Queen and Hilda-the old kind one, were in the throes of of their madness, the Dragon came and slayed villagers, • In horror, StarChild left the kingdom and searched for the sacred mountain of the wise people where he heard that StarMusic was still played. • StarChild learned to follow the trail of SongLine across the land. • The SongLine led StarChild to the Old tribe that kept the StarMusic alive. There StarChild learned to stand in the center of the fire, connect to the Stars above and the center of the Earth and come out of the flames unburned. He loved it there but they told him, “You must leave and return to your kingdom.” “But I will loose myself in the Fog of Madness,” StarChild said. So they gave him a buffalo horn, filled with ash and a burning ember. • Now back in the Kingdom, StarChild, now a man, blows on the sacred embers, and sings the old Star songs. This music pushes back the Fogs of Madness. Others join him in this song, the kingdom shines, laughter returns. And still when the moon is dark, and winds are strong the Madness creeps back into the kingdom. • And still there is a dragon who bides his time waiting to find his next meal...
  • 7. Flight Preparation • So.. Like when boarding a plane- • - know your safety exits, • - put your oxygen mask on first, then help those around you • - your seat cushion may double as a floatation device! • This seminar may be challenging or evocative for you. Do what you need to do to take care of yourself. • Respect your self and only do or share what you are comfortable with. You are welcome to pass on anything, • Move around as you need to. • You are welcome to ask questions, make comments. I will do my best to keep our discussion on the track that serves the greater good. • Use your common sense and clinical judgement about where and when you employ any of the techniques or processes you learn here. • Hand outs
  • 9. Objects Pulse Rumble if... Pass the rumble Pass the rumble - match tone, change, pass Mime Catch w Rumble Double Pulse- Tell us how it was getting here using your drum Fluid Sculpture Some Action-
  • 11. Playback Theater- “Fluid Sculpture” Hakomi Technique “Taking Over” demonstration
  • 12. Enactment • Externalize experience, have it out there, rather than just in here • Gain distance perspective and connection. • It has an edge In time; It has a beginning, middle, and end • It has an edge In space; an inside and outside • We can have a relationship with “It” • “It” actually becomes a “Thou” • We can change it; it can change us
  • 13. Enactment • Objective Correlative- noun, Literature. 1. a completely depicted situation or chain of events that objectifies a particular emotion in such a way as to produce or evoke that emotion in the reader. • Representation • Map or Model • Computer- U.M.L. - Universal Markup Language- the architecture of a program
  • 14. Medium and Modality Medium Modality Body/Movement Hearing Sound Image/SIght Smell Taste Touch / Substance Words Dance, Drama, Puppet, Art, Sport, Pilgrimage, Yoga, Tia Chi, Juggling, Rope Walking, Martial Arts, Music, Drama Visual art, Culinary, Craft, Drama, Photography (video in time) Perfume, incense Culinary arts Sculpture, Music, Massage, Crafts, Culinary, Martial Arts Poem, Story, Graffiti, # Song, Drama Exists in time and space, private or social Exists in time, instantly social Exists in space, not time, can be private and social ?Space, ?Time Exists in space, and time, private and social Exists in space, can mark time private can be social Words need a modality to exist Modality give them space or time can be private or public
  • 16. Brodmann Areas - 52 regions of the cerebral cortex of humans and monkeys that appeared to have different cellular morphology and organization. - Over the past century clinical findings and neurophysiological studies have shown that these microstructural differences correlate well with cortical function specialization. by using different modalities, we engage different brain regions http://en.wikipedia.org/wiki/Brodmann_area
  • 18. Medium and Modality High Sensitivity / Low Skill Medium Modality Body/Movement Balance Hearing Sound Image/SIght Smell Taste Touch / Substance Words Dance, Drama, Puppet, Art, Sport, Pilgrimage, Yoga, Tia Chi, Juggling, Rope Walking, Martial Arts Music, Drama, authentic movement simple choreography, imitate nature, Playback Theater Small Range instruments, call and response, use Visual art, Culinary, Craft, Drama, Photography ( slide show / video in time) Perfume, incense Culinary arts Sculpture, Music, Massage, Crafts, Culinary, Martial Arts, Poem, Story, Graffiti, #Song, Drama recorded music, Playback Theater Collage, Decks abstract drawing, Playback Theater selecting smells seasoning food Ephemeral Altars, Flower Arranging, Playback Theater McKim process- scribe while person touchs things while blind folded call and response Playback Theater
  • 19. Enactment is to our psyche as the digestive system is to our body. We can use it to digest, to take in that which nourishes us and to release that which does serve us, or even poisons us.
  • 20. Kinds of Listening and Engagement- Intrapersonal and Interpersonal • inattentive • distracting • critical (rejecting, shaming, condemning) • competitive • exploiting (getting a laugh at the expense of another) • analyzing • critiquing • advising • projecting • demanding • present • curious • wonder, awe • respect • reflecting • gratitude, appreciative • sympathy • empathy • compassion • blessing Why would someone have these attitudes?
  • 21. “If I really see you I will laugh out loud or fall silent or shatter in a million pieces and if I don’t I will be locked in my prison of stone and cement” Rumi 13th-century poet
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  • 23. clip from “Finding Joe” www.findingjoethemovie.com/ introduction to the universality of the hero cycle Hero Cycle is an analogue to trauma treatment stages
  • 24. In the fairy tale that you are living... Who is your prince or princess, or holy grail? What is the Road of Trials? What is the Dark Night? Who is the Old Wise Man/Wise Woman? What is the Magic Amulet? What is the Dragon? What is the Boon or Gift you bring to your community?
  • 25. Enact your Fairy Tale or Part of it- • Draw it • Write it • Comic Strip • Sculpture • Song / Rap This need not be the whole tale. It can be just a chapter. It need not make a lot sense. # You are welcome to totally lie- also you are welcome to impersonate a client or someone else.
  • 29. What was writing the story of you life as a fairy tale like for you?
  • 31. clip from “The Sound of Music” “The hills are alive with the sound of music With songs they have sung for a thousand years The hills fill my heart with the sound of music My heart wants to sing every song it hears”
  • 32. Clip boy conducting beethoven's 5th example of emotional responsiveness and aliveness https://www.youtube.com/watch?v=0REJ-lCGiKU
  • 33. • “The dyadic relationship, particularly with primary caregivers helps to develop the sense of self and tone of the prefrontal lobes”. • Allen Shore • This sense of self becomes a ground of being, an essential model of who I am who others are and how the world is.
  • 34. and Suddenly... “an suddenly” a common motif in fairy tales which is analogue for trauma, particularly single incident big T trauma’s
  • 35. Clip Star Wars IV Luke returns home to find his caretakers killed and house burned
  • 36. clip Tv announcer has amygdala hi jack when a lizard jumps on him https://www.youtube.com/watch?v=QO0iGlV2wbE
  • 37. Daniel Goleman author of Emotional Intelligence - Role of the Amygdala
  • 38. clip Goleman explains Amygala highjack https://www.youtube.com/watch?v=LTItzKrNX68
  • 39. demonstation interaction when we don’t get facial or vocal social emotional cues. Person wears- mask, doesn’t speak, makes ambiguous gestures. Notice how this feels.
  • 40. clip Still Face Experiment regulatory effect of dyad relationship https://www.youtube.com/watch?v=apzXGEbZht0 note there was a time not that long ago when people didn’t think babies couldn’t socially interact
  • 41. Window of Tolerance Hyper aroused Optimal aroused Hypo aroused increased sensations emotional reactivity intrusive imagery disorganized cognitive processing hyper vigilance relative absence of sensations emotional numbing disabled cognitive processing reduced physical movements from Pat Ogden
  • 42. Stephen Porges Polyvagal Theory Social Engagement- Fight Flight- high sympathetic tone Freeze- high parasympathetic tone
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  • 52. Allen Shore • You cannot develop a sense of self without adequate affect regulation • Affect regulation in the child depends primarily on the mother/primary care giver • She/He needs to be able to regulate herself and her baby • Her alignment with her baby builds brain structures and networks • Primary organizing structure is the pre-frontal cortex
  • 53. Impoverished Development of the Orbital Frontal Cortex causes: • Lack on inhibition of fear, rage, aggression • Decreased awareness of emotional state of self and others • Decreased empathy and care for social rules • Lack of cause and effect thinking
  • 54. Why trauma survivors have symptoms instead of memories
  • 55. Implicit Memory vs Explicit Memory (ie. Narrative Memory)
  • 57. PTSD is a disorder of memory
  • 58. Trauma Shame and worthlessness Hopelessness Emotional overwhelm Decreased concentration Loss of Interest Irritability Depression Little or no memories Nightmares Flashbacks Hyper-vigilance Generalized anxiety Panic Attacks Chronic pain Headaches Substance Abuse Eating Disorders Feeling Unreal Loss of sense of “who I am” Self Destructive or Out of body Behaviour
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  • 61. Trauma-Dysregulation Attachment/ Developmental Needs Big T Trauma Small t trauma(s) TBI Traumatic Brain Injury
  • 62. Art/Enactment Bridges Conscious Awareness to the Silent Depths of the Psyche The artistic process then facilitates the dialogue between the parts of the brain which rule: (prefrontal) and speaks (Broca’s area and Wernake’s area) and the parts that KNOW -basal ganglia, insula, and parts that sort it out- hypocampus.
  • 63. Treating Trauma Slaying or Redeeming the Dragon Fairy Tales inform us, that to handle “the dragon”, we must first be prepared
  • 64. Resource If you must face the dragon or make a trip to the pit of hell What resource would you need to be successful? also known as . . . How do you keep your left prefrontal lobe active, amygdala calm, and your affect balanced?
  • 65. clip Harry Potter Prisoner of Azkaban Harry learns the Patronus Spell "This ancient and mysterious charm conjures a magical guardian, a projection of all your most positive feelings. This is a great model of learning about using Resources. Also models the Old Wise Man process of initiation
  • 66. Resources Theseus -Mitos, ball of yarn to escape the labyrinth, slayed Minotaur Batman and James Bond’s tech gadgets Hobbit - Gandalf, courage, Perseus, Hermes - winged sandles, Athena, shield, Ender- war games at Battle school Harry Potter- cloak of invisibility Sound of Music- Song
  • 67. Relational Resources Mastery Symbolic Attitude/ Postural
  • 69. Amy Cuddy TED.com Our bodies change our minds Physical posture as a Resource
  • 70. Resource Enactment 1) Name a resource from your life-relationship mastery symbol 2) Draw it or pick a tarot card or other icon that holds the image find movement that embodies the energy of the resource ( not literally moving the image 3) Partner up - learn their resource movement and teach them yours 4) Duo partners with another Duo, learn all four resource movements, put them in a sequence 5) As ritual of empowerment, group of 4 presents their resource movements to whole group while group supports with drumming, clapping chant 6) Make clear this is not a competition! This not a performance it is a ritual of empowerment where we support each other to embody our positive qualities, strength, grounding, courage, grace, sensitivity, balance 7) You can also have people make verbal affirmations * explore other intermodal transfers
  • 72. Trigger Break Traumatic Memory in to Components SUDS- Subjective Unit of Distress Image- (could be in any sense) Sensation Emotion Behavior Worst Negative cognition, thought or belief about your self While holding this memory what is your positive- belief about yourself, emotion, sensation, Where are you on the bridge between negative cog and positive
  • 76. What would you like to think about yourself now SUDS Subjective Unit of Distress Scale 0-10 Positive Cognition in relation to that situation? B Image of the Trauma/ “Face of the Dragon” Negative Cognition Sensation/ Emotion Body Map Worse Negative Belief about self in relation to the situation? r i d g e b e t w e e n C o g n i t i o n s
  • 77. Processing Sequence Form the enactment Seperate from enactment get into witnessing perspective Witness the enactment Was that accurate? Watch for body truth response. How was that for you to witness Pendulate from resources to trauma Is response- merged, contemptuous, judgmental, dissociated, or Compassionate? ( Is left frontal or right frontal dominant at this time?) If response is merged, contemptuous, judgmental, dissociated,- enact that. If response is Compassionate- How would you like to respond to this scene? (present time adult ego state can transform the scene- this self must be the source of agency.) Healing interactions- protection, limit setting, explaining, nurturing relationship, blessing Role reverse to have protagonist receive the healing action that he she just gave. Behavioral based homework. Given this new healing light- what can you practically do to continue to support this.
  • 78. now - click your heals together three time and say, “there’s no place like home”
  • 79. The End www.KevinMakarewicz.com kevin@kevinmakarewicz.com (203) 698-2465

Editor's Notes

  1. Welcome Notice what is happening inside you. Welcome what ever is happening with you- fear, excitement, boredom, frustration, distraction and simply welcome it in a friendly way
  2. In a weeks send me an email
  3. The arts can be used as container that can hold tragedy, comedy, conflict, betrayal, loss, suffering, joy- redemption , the mysteries of life and death. @@@ The grand father character (the old wise man or the crone) also models an energy or archetype that we as therapist can call upon to respond to our clients stories with a greater perspective, wisdom and most importantly- enthusiasm. @@@ We are all living a story- Wow look at the journey that you are on.
  4. we are going to work the process of enactment. I think will be most useful to first experience these processes then reflect on them. Object- say your name and one or two sentence about why you choose that object Low skill, high sensativity, modulate affect
  5. apologize for the chart, volley ball drill w Gary case for playback, Action verses Enactment profane
  6. set up relationships
  7. the compassion rumble if: this has been done to you, if you have done it to someone, if you do it to yourself
  8. poem
  9. Announce transition- where we have been, where we are going.- Hero Cycle provides a MAP of treating trauma= Break?
  10. Finding Joe- if you study any piece of enactment you can find something of this pattern or algorithm
  11. break 12 minutes
  12. talk about my squiggle drawing, You are welcome to totally lie- also you are welcome to impersonate a client or someone else.
  13. Break
  14. THe good the hills are alive, I go the hills when my heart is lonely What is the trauma being resolved in the sound of music?
  15. Please bare with this clip- its about 6 minutes and slightly dis-organized Still it hits may significant point that underly dynamics that go in any social situation.
  16. Big T trauma
  17. Freeze a reaction to overwhelming stress Fight Flight filters how we sense - fails to distinguish between what is present and what is memory Social Engagement- allows the highest levels of social exchange- tone, intentions
  18. Prodisy- singing in tune, flow state of an athlete
  19. THis is how you may learn that client has trauma. particularly weak attachment or early repeated small t trauma, people with big T trauma more know who they have changed.
  20. Be very elementary and clear chick in the chair
  21. End of Science-
  22. Here Harry Potter is learning the patronus spell to learn to fight the dementor ( dementor makes you feel like you have never been happy)
  23. sketch
  24. Traing
  25. Draw, or object or write, or Card Movement- sounds, or chant, gesture, words Drums “Im going to be the best I can”
  26. From adaptive information
  27. take what they give you