This document provides an agenda and information for a conference session on self-care and easing toxic and traumatic stress. The session will include guided imagery exercises, talks on toxic stress and writing for wellness, and a discussion. Speakers Christine White and Kathy MacDonald will discuss topics like adverse childhood experiences, secondary traumatic stress, and ways to reduce stress through practices like guided imagery, neurofeedback, yoga, and equine therapy. References will be made to researchers in the fields of trauma and ACEs such as Belleruth Naparstek, Vincent Felitti, and Rick Hanson.

1. MAWD Annual
Conference /
Christine Cissy White
&
Kathy MacDonald
May 20th, 2016

2. Self-Care is Not a Luxury:
Easing Toxic & Traumatic Stress
Dedicated to:
the Massachusetts
Association of WIC
Directors

3. Christine “Cissy” White
• Heal Write Now, Founder
• Writer, Mother, Trauma
Survivor, Activist & Writing
Facilitator
• Suck at Self-Care (student
with weekly practice)
Kathy MacDonald
• Self-Care Expert (teacher with daily practice)
• Life Coach
• Writer, Mother, Yogi, Writing & Group Facilitator

4. Agenda
9:30a.m. – 10:30 a.m.
Intention & Introduction ( 5 min.)
Guided Imagery (10 min.)
Talk: Toxic, Traumatic Stress &
Ways to Ease Burden on Body (25 min.)
Q&A (15 min.)
10:25 a.m. - 10:35 a.m.
Break
10:35 a.m. – 11:30 a.m.
Guided Imagery (10 min.)
Talk: Writing for Wellness Talk (10 min.)
Writing for Wellness Exercises (25 min.)
Discussion (20 min.)
Reminders
1. Presentation available online at
www.healwritenow.com so no need to take notes.
2. Guided imagery and writing for wellness exercises
are designed to give you the experience of stress
relief. It will be safe and gentle. You will not be
asked or required to share your writing. You can
write about any topic you wish.
3. We will talk about the impact of traumatic stress
and causes (though not in lots of detail).
4. Please take excellent care of you. Adjust seat,
stretch or break as needed.
5. Breathe. 
Please read letter from Heidi on every table. What you do is so important and it matters.

5. 10% of
women will
get Post-
Traumatic
Stress
Disorder
4% of men
with get
Post-
Traumatic
Stress
Disorder
(Dept. of Veterans
Affairs)
Over ½ of us go through some kind of trauma.
8% of us will have PTSD at some point.

6. Traumatic Stress
• Accidents
• Atrocities
• Crimes
• Adverse Childhood Experiences (ACEs)
• Neglect
• Abuse
• Dysfunction
• Violence
• interpersonal
• sexual
• Domestic
• Gang
• Secondary trauma
• Vicarious trauma
• Toxic stress (work, home, etc.)
• Traumatic stress that doesn’t cause PTSD
We ALL have stress.
The majority of us have experienced some trauma.

7. Secondary Stress/Vicarious Trauma/Burn Out
• “It’s a tribute to the human condition
that peoples’ empathy gets them into
so much vicarious pain…. They are at
risk for this (post-traumatic stress)
and need to do some of these stress
hardiness exercises to keep
themselves in emotional shape.”
• Belleruth Naparstek, about first responders
http://upliftconnect.com/hold-space/

8. Can We
Hold Space
for
Ourselves?

9. Guided Imagery
Practice

10. Stress is often the cause of the difficulty we have
regulating stress/stressors.
Not just because of amount being carried, though there’s that.
Also, because when toxic/traumatic stress occurs, particularly
during development, it impacts our system.

11. • Biochemicals collect in the tissue.
• Fibromyalgia
• Migraine
• Chronic fatigue
• Pevlic Pain
• Back Pain
• 78% of these associated with post-
traumatic stress
Often shows
up as pain.

12. Adverse Childhood Experiences (ACEs)
carried into adulthood for many

13. Dr. Robert Anda
(CDC)
Research &
Analysis
in Epidemiology
Co-Principals
of the
ACE Study
Dr. Vincent Felitti (Kaiser)
Clinical Experience
&
Large Group Access

14. 10
Categories
of Adversity
(3 Groups)
Npr.org

15. ACE Study Demographics
(17,421 people / 1998 first study
released, dozens since)
Gender
Female 54%
Male 46%
Race
White 74.8%
Hispanic/Latino 11.2%
Asian/Pacific
Islander
7.2%
African-
American
4.6%
Other 1.9%
Age (years)
19-29 5.3%
30-39 9.8%
40-49 18.6%
50-59 19.9%
60 and over 46.4%
Education
Not High
School
Graduate
7.2%
High School
Graduate
17.6%
Some College 35.9%
College
Graduate or
Higher
39.3%

16. ACE Test Summarized
Before the age of 18 did you experience….___.
Answer yes/no
Score determined by number of categories (not incidences) of each occurring before the age of 19
1. Family member with substance abuse in home?_____
2. Mother was victim of domestic violence? _____
3. Jailed family member? _____
4. Diagnosed mental illness of a family member? _____
5. Sexual abuse? _____
6. Physical abuse? _____
7. Emotional abuse? _____
8. Physical neglect? _____
9. Emotional neglect? _____
10. The absence of parent (death, abandonment
or divorce? _____ *Other categories considered now but these were original 10

17. ACE SCORE = # of Yes Answers
(10 Questions on ACE Test)
Lowest Score Possible = 0
0 - - - - - - - - - - -> 10
Highest Score Possible = 10

18. DOSE
RESPONSE
CURVE
Higher “dose” of ACE
=
Higher Prevalence
of Certain Behaviors
&
Health Issues
NPR.org 2015

23. Behaviors& ACE Scores

25. “Having an ACE score of 4
or more increases risks for
some conditions as
dramatically as smoking
raises the risk of lung
cancer.”
Maia Szalavitz & Bruce D. Perry, M.D., PH.D, Pgs. 164 & 165

26. “In other words, the
emotional loss we
suffer when we are
seven or ten or
twelve or sixteen
lives forever
– in our cells.”
Donna Jackson Nazakawa

27. •
33%
67%
ACE Score
0 ACE Score 1 or More ACE Score
Majority of
People
Had
At Least
1
Adverse
Childhood
Experience
Only 1 in 3 Had None

28. Early Mortality!
http://www.ncbi.nlm.nih.gov/pubmed/19840693
“People with 6 or more
ACEs died nearly 20
years earlier on
average than those
without ACE’s.”
Dr. Anda & Dr. Felitti (ACE co-principals)

29. “I remember strongly
feeling
this can’t be true…
Someone would have
told me
in medical school
if this were true.”
Dr. Vince Felitti

30. “No single adversity trumped
another. They were almost
equal in their damage.”
Donna Jackson Nakazawa
Not just what did happen - ABUSE
but what didn’t happen – NEGLECT
& the environment where it happened &
we lived – DYSFUNCTION

31. The Null Effect
“With an Ace score of 0
you have a very
medically uninteresting
population. Non obese,
non smoking, non
alcoholic, non diabetic,
non hypertensive…
No internist has a chance
of making a living with
that group. But with an
ACE score of 4 or more,
this is big medicine.”
Dr. Vince Felitti
This is powerful motivation for prevention & for our own parenting
And appreciation if we’ve had great experiences as children.

32. Now What Can WE DO
with All this Information?
PLENTY!

33. “You can recover from posttraumatic stress.
Certainly, you can significantly reduce - not
just manage - its symptoms. But - and here's
the thing - not with traditional treatment. The
problem is, a lot of my colleagues don't know
this yet. So they go about it in traditional ways
and pronounce the condition incurable, based
on the results they get. “
Huffington Post, 2010

34. Interviews
& Research
Prioritizing
Self-Care
Why & How
Portable & Affordable Practices
Collective Wisdom

35. Dr. Vincent Felitti / What Can Help
Books
Scared Sick
Body Keeps Score
Childhood Disrupted
Karr-Morse: Scared Sick
Van Der Kolk
Jackson Nakazawa

36. Dr.
The two most effective treatment
approaches
1.EMDR
Eye-Movement Desensitization
& Reprocessing*
2. Ericksonian Hypnotherapy
Felitti said each of these approaches has “significant
effectiveness and accomplish (much) in a very small numbers
of sessions, making them affordable to more people.”
Dr. Vincent Felitti / What Can Help

37. Dr.
Websites
Jane Stevens
Dr. Vincent Felitti
What Can Help

38. Donna
Jackson
Nakazawa

39. Cheri Huber /
Teaches How to End Self-Hate
Buddhist & Survivor

40. Sebern Fisher
Neurofeedback

41. “We’re saying this to the brain:
– chill – not to the person.
If the person could (chill or not
be afraid) they wouldn’t do or
need neurofeedback.
The person can’t just chill and
that’s the issue.”
Sebern Fisher/Neurofeedback

42. Combat brain's bias for bad
Compassion for Brain
Anxiety isn’t “bad” it’s our brain
Working too hard.
Remind self during worry how
“Most of the time – it’s o.k.!”
Rick Hanson: Neuroplasticity

43. Rick Hanson
Brain Bias for
Bad
“negativity
sticks”

44. Celebrate
Survival
Having
post-
traumatic
stress
means
there’s a
post. We
survived!
Rick Hanson: Neuroplasticity (2)
Grow Feel-Good
Resilience
Give to Ourselves:
• Safety
• Joy
• Comfort

45. Rick Hanson
Marinate in &
on the good. Gratitude.

46. Your Life After
Trauma:
Powerful
Practices to
Reclaim Your
Identity
Michele Rosenthal

47. Michele
Rosenthal

48. Zahabiyah Khorakiwala
“Trauma symptoms
are registered as
sensations in the
body.”
-Zabie
Transcending Sexual
Violence through Yoga

49. Carol Redding (top 5)
ACEs Pioneer (ACE score, 10)
1. Love Keep an open heart.
2. Learn Keep an open mind.
3. Hope Dream.
4. Remember Happy memories (dwell).
5. Enjoy Life is full of beauty. See it. Contribute to it.

50. “Horses will
react to what
you’re feeling
inside not
just what
you’re saying
so that’s big.”
Julie Lovely
Wild Hearts,
Therapeutic Equestrian
(Equine-Facilitated
Individual (insurance) and
group (free for veterans)

51. Guided Imagery
“”For a technique to work it
must be taught as a skill
and not as a cure for
pathology.
It must first and foremost
find ways to re-regulate
the nervous system.”
Belleruth Naparstek,
Health Journeys

52. Guided Imagery:
“You just have to press play and it
will do the work for you.”
Belleruth Naperstek
As described by Belleruth Naperstek
Webinar, 2013

53. Belleruth Naperstek
• Lisc. Social worker and
psychotherapist
• Created Health Journeys
which distrubutes guided-
imagery audio programs
by various people
• Used by the Red Cross,
Columbine High School,
Oklahoma City Disaster
Services and the Veteran’s
Administration
• www.healthjourneys.com
• Wrote Invisible Heroes:
Survivors of Trauma and
How They Heal, Staying
Well With Guided Imagery
and Your Sixth Sense.
• She tested scripts on trauma
survivors and took their
feedback on images/language.

54. Effectiveness of Guided Imagery
• Guided Imagery is a Relaxation Technique (like yoga, meditation, tai chi,
massage & others which has been found to :
• Reduce anxiety & Reduce depression
• Lower blood pressure & cholesterol
• Speed healing (of cuts, burns, blood loss)
• Reduce length of hospital stays
• Increase short-term immune function
• Reduce pain from arthritis and fibromyalgia
• Increase comfort during medical procedures
• Reduce fear of children getting MRI’s/needles
• Improve recovery from bulimia, stroke and diabetics
• Improve fertility
• Improve weight lose in those trying to lose
• Improve concentration in developmentally disabled adults

55. Lisa Vasile, NP
DINE on Health
D = Detox
(get toxins of all kinds out)
I = Inflammation
(address)
N = Nutrition
(improve diet (eat lots of colors, food with stickers,
look at vitamins/minerals)
E = Energy Work
(exercise, spiritual, getting toxins out of body, joy)
http://4betterhealth.biz/

56. Guided Imagery
Practice

57. Two Kinds of Telling
1. Therapy
• Traditionally Talk
• Diagnosis
• Pay
• Isolating
2. Groups
(Healing/Creative)
• Peers/Equal
• Free/Low Cost
• Giving/Receiving

58. PTSD is Not Incurable
It turns out that people headed for a diagnosis of post-
traumatic stress can't just "talk about it"- the trauma isn't even
stored in the parts of the brain where language can access it.
Instead it's been cached as frozen, primitive, pre-language
experience - sensation, perception, emotion, images and
motor reactivity - in the survival-based structures of the brain.
In fact, if survivors can talk about traumatic events with
appropriate feeling and clear, sequential memory, it's a good
bet they're not going to acquire PTSD anyway.
• Huffington Post, 2010
“Talk therapy basically doesn’t cut it with this particular affliction, Post-Traumatic
Stress.”
• April 2013, “Downloading Treatment for PTS, Belleruth Naperstek

59. PTSD is Not Incurable
Threads of what she suggests as most helpful to veterans in particular but those
with PTSD in general are techniques that do the following:
1. They first and foremost find ways to re-regulate the nervous system.
2. They de-stigmatize and normalize the experience by explaining PTS as the
somatic and neurophysiologic condition it is.
3. They offer simple, self-administer-able tools that empower the end-user and
confer a sense of mastery and control.
4. The interventions are cast as training in skill sets, not the healing of
pathology.
So, hopefully those of my colleagues who aren't up to speed will soon be learning
some new skills. And hopefully they'll stop talking to reporters and soldiers until
they do. In the meantime, the general public and our military need to demand
treatments like the ones cited above, and reject the idea that this condition is
incurable.
Huffington Post, 2010

60. Write Heavy
Live Light

61. Make
Create
Play
(Psychiatrist & Expressive Arts Facilitator & Trauma Survivor)

62. Most Affordable & Effective To Self-Soothe
While Post-Traumatically Stressed?
1. Guided Imagery (twice a day)
2. Expressive Writing with Friend
3. Yoga (works for me but only after I’m calm enough to do it)

63. “After a traumatic event, people much more likely
to get sick if they keep the event secret than if they
talk to other people.
Keeping a secret it seems is somehow
toxic.”
Dr. James Pennebaker
James Pennebaker, Univ. of Texas
Professor, TED Talk

64. Stress impacts way we see world. Writing can help us shift focus.

65. WRITING FROM THE HEART
“People carry around
their stories forever in
their cells. And once
you get it out of you
and onto the page,
you’re never going to
forget it, but it’s not
as heavy. A lot of
writing is lightening
the load.”
Nancy Slonim Aronie
Photo by Eli Dagostino

66. Donna Jackson Nakazawa
Why it’s hard

67. Ways to Increase Our Own
Power
Donna Jackson Research
(childhood disrupted)

68. Expressive Writing to Ease Trauma
New York Times Nancy Slonim Aronie Natalie Goldberg

69. Expressive Writing to Ease Trauma
/ James W. Pennebaker, Ph.D.
Technique to Improve Health
• 20 min. a day
• 4 days in a row
• Don’t stop writing
• Write about trauma
• Express feelings
• Affordable & Accessible

70. Write to Relieve
Traumatic Stress
“The first studies indicated that
writing about traumatic experiences
for as little as twenty minutes a day
for three or four days can produce
measurable changes in people’s
physical and mental health.”
Expressive Writing, Words that Heal, James W.
Pennebaker, Ph.D. & John F. Evans, Ed.D.

71. Healing Benefits of Writing
Improved Physical Health
• Improved immune function
• Reduced blood pressure (up to
six weeks)
• Reduced doctor visits
• Reduced missed school/work
“Not only helps patients to get better, keeps them from getting worse.”
Nakazawa

72. “There is no greater agony
than bearing
an untold story
within you.”
Maya Angelou
Maya Angelou
American author, poet born 1928

74. Guided Imagery
Practice (2)

75. Expressive Writing
Practice

76. Expressive Writing
Practice (2)

77. I want to unfold.
I don’t want to stay folded anywhere,
because where I am folded, there I
am a lie.
and I want my grasp of things to be
true before you. I want to describe
myself
like a painting that I looked at
closely for a long time,
like a saying that I finally understood,
like the pitcher I use every day,
like the face of my mother,
like a ship
that carried me
through the wildest storm of all.”
Rainer Maria Rilke
Write to
Unfold

78. Survivor Community

79. Presentation is all online.

80. Online Communities ISurvivor Led, Partnered or Safe:
AcesConnection Beating Trauma Trigger Points Anthology Parenting with ACEs
Say It, Survivor Report It, Girl Voices & Faces Project Mama Bear Effect
RAINN PTSD:Gift from Within Surviving in Numbers #FacesOfPTSD
Bill Murray SNAP Laura Davis Writer’s Journey Chilmark Writing Workshop
Health Journeys Buddha’s Brain The Breathe Network Wild Hearts
Transcending Sexual Violence with Yoga
Heal Write Now (my own)
There are SO MANY Fabulous Online Activists & Silence Breakers & Supporters if they are not here it is MY oversight!

81. • Mindfulness (can be hard if you have PTS because requires focus,
discipline)
• Trauma Incident Reduction (TIR)
• Tapas
• EMDR/EFT
• Breathwork
• Yoga, Tai Chi, Yoga Nidra
• Biofeedback, Neurofeedback
• IRT
• Somatic Processing, Trauma Releasing Exercises
• Prolonged Exposure (*can be triggering though)
• Therapeutic Massage (with Guided Imagery)
• Reiki & Energy Healing
• Guided Imagery
• As described by Belleruth Naperstek Webinar, 2013
What Else Helps Post-Traumatic Stress
per Belleruth Naparstek

82. Apps Belleruth Naperstek Recommends
Breathe to Relax
Mood Tracker
PTSD Coach
CBT Prolonged Exposure
PTSD Eraser
My Vet Advisor (coaching, not therapy)
No insurance but a coaching model
As described by Belleruth Naperstek Webinar, 2013

83. Kathy Page (her blog, any links to
Spark?)