Lvl 1 Manual

Question 1

How does top down suppression affect information processing and integrating experience? Are the client’s presenting issues obviously related to the causative issue?

Answer 1

Top down suppression disconnects the client from the emotional and sensorimotor information and pushes them into the unconscious. This suppression can result in secondary symptoms that have little obvious resemblance to original reactions.

Question 2

Symptoms of being above window of arousal

Answer 2

Dissociation.

Discharging behaviors

Self-medication

Disruption in thinking and feeling

Hypervigilance and hyperorienting

Reactivity

Question 3

Symptoms of being below window of arousal

Answer 3

Numb

Boredown

Dissociation

Attempts to raise activation

Lack of motivation

Inability to sense, think or feel

Question 4

The goal of sensorimotor interventions in terms of awareness of the levels of information processing and unification

Answer 4

Help them learn about the distinct levels and understand how they affect one another. Then to increase the integrative capacity between the layers so that the traumatic effects stored in each layer can be unified and resolved.

Question 5

Why contact statements are made

Answer 5

made to demonstrate understanding of feelings, body patterns, voice quality and words that are indicators of core experience. They are also made to frame what happens in session and lead client into more awareness.

Question 6

What two things to keep in mind when first greeting clients?

Answer 6

1) What is the client’s inner experience during this greeting?
2) What can I do to make them feel I’m attuned to that?

Question 7

Definition of psychological contact from the perspective of a state of being

Answer 7

It is a state of being in which there is a palpable resonance between client and therapist. You do not DO it, you live it. Avoid preoccupation with being skillful or correct.

Question 8

9 Example Categories of Possible Categories to Contact

Answer 8

Content

Movement

Autonomic Nervous System Response (e.g. you are beginning to sweat)

Emotions

Energy

Regressive States

Words

Habits

Beliefs

Question 9

Some ideas on how to choose what to contact

Answer 9

• Elements that might lead to completing actions, such as tension in the arms that might develop

into a pushing action.
• Elements that might lead to appropriately modulating arousal, such as the client spontaneously
squeezing her legs.
• Indicators of trauma, such as shaking, trembling, or tension.
• Indicators of resources, such as deeper breath, a lift of the spine, or relaxation.
• The connections between content, emotions, memories, thoughts, images, and physical organization, such as a collapse in the chest when the client mentions his mother.
• Any signifcant changes in the client’s organization related to the narrative.
• Actions that are repeated, such as a tightening of the shoulders every time the client mentions
her husband’s name.

Question 10

How the belief - “I have to work hard to be loved” is often reflected in the body

Answer 10

Tense physical structure and movements that are fast and focused

Question 11

How the belief - “What’s the use?” is often reflected in the body

Answer 11

Structure that is collapsed and weak, with movement patterns that lack energy and direction

Question 12

When clients behave inappropriately or unconsciously, the principle of non-violence urges us to..

Answer 12

help them to become curious and to observe themselves more fully rather than attempting to change their behavior directly

Question 13

What we have to notice about our inner agendas

Answer 13

Have to notice if they are present and how they manifest in us cognitively, emotionally and somatically to ensure our actions are non-violent

Question 14

Quote: “Selves as well must construct and maintain effective boundaries to be viable, healthy and capable of experiencing fully the unity of which they are individual parts”

Answer 14

.

Question 15

3 core phobias of Phase One trauma treatment

Answer 15

1) Phobia of attachment and detachment with the therapist
2) overcoming the phobia of mental contents
3) overcoming the phobia of dissociative personalities

Question 16

What can be done with patients who mindfulness may be destabilizing?

Answer 16

Practice of new defensive actions can be taught purely as a physical exercise (such as pushing against a wall) without accessing content or affect

Question 17

3 Core Phobias of Phase II Trauma Treatment

Answer 17

1) Phobia of attachment to perpetrator
2) Phobia of attachment to one’s own traumatized parts
3) Phobia of the traumatic memory itself

Question 18

Is Sensorimotor Psychotherapy a reliable way to retrieve true memories?

Answer 18

No. We cannot have confidence that the exact meaning of somatic sensations or the veracity of memories that come up. However, the wisdom of the body can be trusted in service of healing.

Question 19

One suggestion for working thru the phobia of attachment to the perpetrator

Answer 19

Experiments with somatic interventions such as reaching out and pushing away which helps resolve conflicting animal defenses (attach/cry, fight/flee).

Question 20

Are integrative sessions needed in phase II and why?

Answer 20

Yes, they are needed so that the memory-related dysregulation is given time to settle and the window of tolerance to expand.

Question 21

4 Core Phobias of Phase III Trauma Treatment

Answer 21

1) Daily life
2) Healthy risk-taking
3) Change
4) Intimacy

Question 22

4 Guidelines For How Much and What info to provide in Psychoeducation

Answer 22

1) Provide info according to what the patient can synthesize and apply at a given time, taking into account client’s fund of knowledge, cognitive ability, regulatory capacity and integrative capacity
2) Less is more
3) Repeat new information frequently because learning often requires repetition
4) Never assume the client has completely understood

Question 23

5 Categories of Resource indicators and examples within each category

Answer 23

1. Thoughts: “I am lovable”; “My feelings are OK”; “I am safe here”; and so forth.
2. Body: Openness, relaxation, flowing energy, vitality, tonicity, expansion, flexibility and free movement, alignment or groundedness, and so forth.
3. Emotions: Love, joy, laughter, peace, playfulness, compassion, trust, creativity and, in general, the authentic experience of all primary emotions.
4. Memories and images of satisfying experiences: often of nature, being loved, safe, cared for, met,and so forth.
5. Child-Like Awareness: the “wise child or the sense of wonderment that is often connected to nature and spirituality, and to feeling open and trusting

Question 24

5 Categories of Indications of Developmental Issues and examples within each category

Answer 24

1. Thoughts: “I’m not good enough”; “Others are unsupportive”; “It is not OK to express my feelings,” and so forth.
2. Body: Contraction, tension or undertoned, blockage of energy, lack of vitality, restricted movement patterns.
3. Emotions: Habitual or patterned emotions; painful feelings that are unhealed or chronic, such as sadness, fear, hurt, or anger.
4. Memories and Images: Of unfulflling relationships; of being treated in a hurtful or unsatisfying way, of not getting needs met, of alienation.
5. Inner Child Awareness: The hurt child, misunderstood, alone at some level, disconnected from the self and others

Question 25

What is meant by a person’s modulation style?

Answer 25

How change happens (abrupt, flowing, gradual, unexpected, dysregulated) and where it happens in relation to frequency levels - more toward an over or under activated level.

Question 26

How does developmental injury influence modulation patterns?

Answer 26

They typically don’t propel arousal outside the window of tolerance but they do contribute to the modulation patterns and tendencies towards a particular portion in the windo of tolerance.

Question 27

5 Categories of Indications of Trauma and Examples within each category

Answer 27

1. Thoughts pertaining to a pervasive feeling of impending danger: “I’ll never be safe”; “The world is a dangerous place.” Trauma-related beliefs about the self, such as “I’m dirty, bad, damagedgoods, a victim, helpless,” or about others, such as, “Others will only hurt me; I will never be safe in a relationship.”
2. Body: Dysregulated physiological arousal (hyper- or hypoarousal or body); tension patterns (such as tension in arms or legs) that indicate truncated defensive responses; flaccidity and immobility in the musculature and facial expression that might indicate submissive defensive response; immobility or stiffness in the neck that may indicate truncated oriented response, or continual scanning that may indicate hypervigilance; changes in posture and movement that may indicate the emergence of dissociated parts.
3. Emotions: Habitual trauma related emotions; terror, rage, panic, dread, and despair.
4. Trauma-Related Memories and Images: Often experienced with partial recall or as flashbacks rather than coherent narratives placed in time.
5. Structural Dissociation: Manifesting as various EPs and ANP(s)