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Question 1

3 Part Definition of psychological trauma

Answer 1

1. An event, series of events, or set of enduring conditions
2. in which the body’s ability to integrate his/her emotional emotional experience is overwhelmed (e.g. ability to stay present, understand what is happening, integrate the feelings and make sense of the experience)
3. And animal defenses are elicited

Question 2

Triune Brain model: names of the 3 parts

Answer 2

1. Frontal Cortex
2. Mammalian Brain/Limbic system
3. Reptilian Brain

Question 3

Two ways an individual “remembers” trauma and what happens over time and why

Answer 3

1. Through sensorimotor reliving non‐ verbal iterations of the historical traumatic event (dysregulated arousal, emotions, defensive responses)
2. Through mysterious physical symptoms that seem to have no organic basis.

Traumatic memories typically remain unintegrated and unaltered by the course of time because they are inaccessible to verbal recall.

Question 4

See image

Answer 4

.

Question 5

3 steps of how consolidation of trauma memory is compromised and what happens to amygdala post-trauma

Answer 5

1. Hippocampus is inhibited under threat
2. Frontal Cortex has shut down
3. Post-trauma fear network in amygdala encodes trauma. Non-verbal memories are divorced from narrative. Amygdala becomes sensitized to triggers.

Question 6

How is traumatic implicit memory accessed, what it feels like and what are the consequences of these memories being recalled?

Answer 6

Accessed situationally by internal and external stimuli reminiscent of the trauma.

They do not carry with them the internal sensation that something is being recalled.

The consequence is that people act, feel, and imagine without recognizing the influence of past experience on their present reality.

Question 7

3 functions of the left brain and what is the name of it’s type of processing

Answer 7

1. Cognitive processing and reasoning
2. Verbal ability and language
3. Meaning making

“Explicit” processing

Question 8

What is procedural memory and what are 5 examples?

Answer 8

Procedural Memory is implicit memory based on function.

1. Skills
2. Automatic behaviors and reactions
3. Physical habits
4. Emotional biases
5. Cognitive schemas

Question 9

Top Down Therapy Approach (what level of organization does it address, what is the vehicle of change and how is affect regulated?

Answer 9

• Addresses cognitive and emotional processing
• Changes cognitive distortions and the story.
• Uses uses cognitition to regulate affect and sensorimotor experience

Question 10

Bottom-Up Therapy Approach (what level of organization does it address, what is the vehicle of change and how is affect regulated?

Answer 10

• Addresses sensorimotor processing which, in turn, facilitates the functioning of upper levels of processing
• Identifies and changes somatic patterns
• Uses the body to regulate affect and experience

Question 11

Instead of interpreting experience…

Answer 11

One is taught to be curious about experience.

Question 12

4 physical actions that self-regulate

Answer 12

1. Grounding
2. Breath
3. Alignment
4. Elaborate actions the client is already using in an attempt to self-regulate

Question 13

6 mental and emotional symptoms associated with hyperarousal

Answer 13

1. Emotionally reactive
2. impulsive
3. hypervigilant
4. hyperdefensive
5. intrusive images and affects
6. obsessive or racing thoughts

Question 14

7 Symptoms of Hypoarousal

Answer 14

1. Flat affect
2. Numb
3. Feeling dead
4. Cognitively dissociated or slowed
5. Collapsed musculature
6. Psychomotor retardation
7. Disabled defensive responses

Question 15

“Our brains will continue to take in new information and construct new realities…”

Answer 15

“as long as our bodies feel safe. But if
we become fixated on the trauma, then our ability to take in new information is lost, and we continue to construct and re‐construct the old realities.”

Question 16

What determines how we organize experience, is insight enough and how does change happen?

Answer 16

• Experience is organized based on adaptations to past experience (procedural learning). These are habits which convert events into information, meaning, feeling, and action.
• Insight and analysis are not enough
• Change happens through discovering how a
  client organizes experience and changing how
  they organize experience

Question 17

The 5 Core Organizers

Answer 17

1. Inner Body Sensation
2. Movement
3. Five-sense perception
4. Emotion
5. Cognitions

Question 18

What is one way to build new neural connections?

Answer 18

By changing our awareness. Because where awareness goes, firing goes. And neurons that fire together, wire together.

Question 19

Two part definition of Acts of Triumph

Answer 19

1. Exchanging Immobilizing Defenses for Mobilizing/Active Defenses
2. Regulating Dysregulated Mobilizing Defenses

Question 20

Three categories of Mobilizing or Active Defenses and examples within each category

Answer 20

• Attachment Cry and Seeking Help: using voice, movement towards safe person
• Flight: legs; movement away from source of threat
• Fight: arms, shoulders, movement toward the threat, aggressive action, voice

Question 21

Difference between Trauma, Maladaptive Attachment and Attachment Trauma

Answer 21

• Trauma: overwhelming experiences that cannot be integrated and elicit subcortical animal defensive mechanisms and
  dysregulated arousal.
• Maladaptive Attachment: experiences with early childhood caregivers that cause emotional distress, but that do not overwhelm the individual.
• Attachment Trauma: experiences with caregivers are overwhelming or perceived as dangerous, such that animal defensive tendencies are employed.

Question 22

5 Examples of “Less than Optimal” Experiences with Caregivers that can result in Maladaptive Attachment

Answer 22

1. Inconsistent or inadequate parental
   attachment behavior (overly permissive,
   strict, critical, etc.)
2. Faulty or inconsistent emotional regulation by parents
3. Emotional biases (e.g. don’t be sad or angry)
4. Parents’ stress or ignorance (blind spots)
5. Parents’ own unresolved trauma and/or
   attachment issues

Question 23

Cognitive, Emotional and Sensorimotor impacts on child development when learning tasks at each childhood development state are not successfully accomplished or supported by primary attachment figure or they are missing relational experiences

Answer 23

• Cognitive: Limiting beliefs about oneself and/or the world
• Emotional: Attachment disturbances and emotions that are not integrated into a whole sense of self
• Sensorimotor: Body structure & movement that reflects the impact of these developmental compromises and impasses.

Question 24

What are the 2 goals of attachment-related defenses and what do these defenses develop into?

Answer 24

1. To defend against rejection, abandonment, criticism, etc.
2. To limit the negative impact of painful emotions that evoked inadequate regulation and empathy from caregivers

These develop into affective biases that maximize attachment and lead to the development of a social façade or “false self”

Question 25

5 bodily aspects that can reflect developmental injuries

Answer 25

1. Body structure
2. posture
3. movement
4. gesture
5. expression

Question 26

The 5 Foundational SP Skills

Answer 26

1. Tracking
2. Contacting
3. Framing
4. Mindfulness Question
5. Experiments

Question 27

Tracking Somatic Indicators: 8 Signs of Traumatic Reaction

Answer 27

1. Shaking
2. Sweating
3. Numbing
4. Held breath
5. Energy mobilized upward
6. Wide eyes
7. Jerky movement
8. heart rate

Question 28

Tracking Somatic Indicators: 2 indicators of incomplete Action

Answer 28

1. Bracing or Tension
2. Preparatory movements related to orienting or an animal defense

Question 29

4 somatic indicators of client returning back into the window

Answer 29

1. Breathing
2. Relaxing
3. Smiling
4. Some body organization different from usual pattern

Question 30

Two types of material to contact with contact statements

Answer 30

1. Content/Narrative Statements that demonstrate you
   understand the client: “That must have
   been difficult for you.”
2. Present Moment Experience- Statements that demonstrate you
   understand the client’s present [bodily]
   experience. “Your body seems to be
   tightening up right now.”

Question 31

5 Guidelines for Contact Statements

Answer 31

1. Choose what to contact based on what you believe is important for the client to explore
2. Use short, simple statements commenting on the obvious
3. Statements are not judgmental, critical, coercive or interpretive
4. Use a qualifier when you can: “seems like”, “looks like”, “huh” - this invites and welcome revision by client
5. Track client’s response to contact statements and if needed, recover by making another contact statement if the first one is inaccurate

Question 32

2 ways to alter contact statements to maximize empathetic contact and help keep clients in their window

Answer 32

1. Voice tone/energy level: soft, slow, hypnotic tone vs a strong, energetic, & playful tone
2. Titrate vs. encourage affective expression: contacting “too much” affect can be frightening and dysregulating, leading to fight/flight

Question 33

7 Different Functions of a Contact Statement

Answer 33

1. To help lead to completing an action or regulating arousal
2. To increase client awareness of how trauma manifests through the body (shaking, tension, etc.)
3. To increase client awareness of how resources manifest through the body (deeper breath, relaxation, etc.)
4. To increase client awareness of connections between content, emotions, memories, etc., and physical organization
5. To highlight a significant change in the client’s somatic organization related to what they are feeling or talking about
6. To expand on material that interests the client, potentially indicated by what they have repeated
7. To help regulate the client

Question 34

4 types of non-verbal contact using parts of the body other than the head

Answer 34

1. Physical proximity
2. Mirroring the client’s body posture
3. Body movements
4. Hand gestures

Question 35

Awareness is curious and interested, rather than…

Answer 35

…interpretive or intent on change

Question 36

Two ways of adjusting mindfulness if general mindfulness increases dysregulation and dissociation

Answer 36

1. Shift to mindfulness of the immediate environment
2. Use “directed mindfulness”: paying
   attention to particular elements of internal
   experience (body sensation, movement, emotion,
   image, cognition) considered important to
   therapeutic goals

Question 37

3 Parts of the Ron Kurtz quote on the impulse to heal/our job related to that impulse

Answer 37

1. The impulse to heal is real and powerful and lies within the client.
2. Our job is to evoke that healing power, to meet its tests and needs and to support it in its expression and development
3. We are not the healers. We are the context in which healing is inspired.

Question 38

4 Ways We Demonstrate Trust in Organicity

Answer 38

1. Encouraging self‐exploration and decision‐making by offering a menu of choices
2. Pacing the process to attune with the client’s present state
3. “Expanding time” rather than trying to “make it happen”
4. Helping to create conditions under which clients will find their own answers

Question 39

Definition of Organicity

Answer 39

The inherent capacity to grow and change while
maintaining integrity in the face of challenge.

Question 40

Two part definition of a non-judgmental attitude

Answer 40

1. Accepting all parts of and responses from the client with compassion, especially aspects that the client cannot accept;
2. “..treat them in an affectionate, non‐violent way.” Thich Nhat Hahn

Question 41

Rather than give advice or interpretations..

Answer 41

Teach clients to be mindful of and change procedural tendencies

Question 42

When clients behave inappropriately, destructively, or unconciously what 2 things do we do?

Answer 42

1. We do our best to refrain from criticizing, judging or pathologizing their behavior.
2. Help them to become curious, to observe themselves more fully and compassionately, rather than simply attempting to change or modify behavior.

Question 43

What are three things about the therapist’s own self they should be aware of in relationship to each client?

Answer 43

1. Our own hidden agendas.
2. Our biases/implicit beliefs regarding the client
3. Our biases/implicit beliefs regarding feelings elicited by counter-transference

Question 44

In sensorimotor psychotherapy, what is considered the primary source of intelligence, information and change

Answer 44

The body!

Question 45

What is Ron Kurtz’s first impulse when starting work with a client?

Answer 45

“My first impulse is to find something to love, something to be inspired by, something heroic, something recognizable as the gift and burden of the
human condition, the pain and grace that’s there to find in everyone you meet.”

Question 46

Two categories of Immobilizing or Passive Defenses and 2 bodily reactions within each category

Answer 46

• Freeze: shallow/fast breathing, tense muscles
• Feigned Death/Submit: collapse, limp/flaccid muscles

Question 47

3 examples of orienting responses in the body

Answer 47

1. eye movement
2. head movement
3. body movement

Question 48

3 functions of Frontal Cortex and how does it communicate?

Answer 48

1. Regulatory abilities
2. Cognitive reasoning
3. Executive functioning

Communicates using verbal language

Question 49

4 functions of Mammalian Brain/Limbic System and how does it communicate?

Answer 49

1. Emotional memory
2. Somatosensory memory
3. Atachment
4. Adds motivational coloring to sensorimotor and cognitive processing

Communicates thru emotion

Question 50

3 functions of Reptilian Brain and how does it communicate?

Answer 50

1. Autonomic arousal
2. Instinctive/defensive responses in the body
3. Motor actions

Communicates thru bodily sensation and movement impulses

Question 51

4 functions of the right brain and what is the name of it’s type of processing

Answer 51

1. Non-verbal emotional & body processing
2. Implicit communication and intersubjectivity
3. Responds to danger
4. Unconscious affect regulation

“Implicit” processing

Question 52

3 examples of non-verbal contact using the head

Answer 52

1. Nods and head shakes
2. Facial expression
3. Eye contact

Question 53

3 non-verbal contact techniques using the voice

Answer 53

1. Voice quality
2. Minimal encouragers (uh‐uh, hmm)
3. Pacing

Question 54

5 general categories of defensive
responses

Answer 54

1. attachment
2. flight
3. fight
4. freeze
5. submit