Children s ability to process experiences at a sensory level

1
Creativity in Counseling

• Amie Kelleher, LMHC
• Rachel Stewart, RMHI

2
Stopping Child Abuse ... One Child At A Time.
3
Goals for Today

• Understand the effects trauma has on the brain.
• Identify how creativity helps the therapeutic
  process.
• Discover a thinking pattern to develop your own
  creative ideas.
• Leave with creative interventions that can be
  utilized in the future.

4
Brain
Pre-frontal Cortex
Hypothalamus
5
Prefrontal Cortex

• Located in the front portion of the brain.
• Is referred to as our thinking brain.
• Responsible for executive functioning including
  forethought, judgment, impulse control, planning,
  attention, and organization.
• Is the last part of the brain to develop.

6
Limbic System

• Lies beneath the prefrontal cortex and is part of
  the primitive brain.
• The primitive brain controls basic instinct and
  functions necessary for survival.
• Is the center of memory and emotion and therefore
  referred to as emotional brain.
• Involved in instinctive behaviors, basic
  impulses, and deep-seated emotions related to
  survival.

7
Limbic System

• Emotions are predominantly unconscious physical
  reactions to threat or opportunity.
• Consists of
• Hippocampus
• Amygdala
• Hypothalamus
• Thalamus

8
Thalamus

• A switchboard for sensory data
• It screens, sorts, and pre-processes the incoming
  sensory information and relays it to the amygdala
  and cortex.

9
Amygdala

• Is responsible for emotional regulation.
• Considered our main sensor for emotions.
• Is the brains alarm system which is activated by
  any threats, then tags it as fear and transmits
  information to other brain systems.
• Detects an emotional stimuli related to fear and
  takes over as the safety autopilot.

10
Hypothalamus

• Located beneath the thalamus.
• Its most important function is to maintain
  homeostasis.
• Controls autonomic functions to include release
  of hormones, regulation of food and water intake,
  and regulation of sleepwake cycle.

11
Hippocampus

• Is the memory indexer.
• Controls how memories are stored, organized, and
  retrieved.
• Connects memories to emotions and senses.

12
Questions ?
13
Creation of a Successfully Stored Trauma Memory

• Thalamus (receives sensory data)
• Amygdala (tags fear)
• Hypothalamus (cortisol
  serotonin)
• Hippocampus (memory indexer)
• Pre-frontal Cortex (evaluates experience)

All clear
14
Questions ?
15
Autonomic Nervous System

• There are two parts
• Sympathetic- regulates the arousal response and
  increases activity as needed during times of
  stress. It prepares us to meet the actual or
  perceived threat.
• Parasympathetic- induces relaxation and helps the
  body become balanced after periods of high
  arousal. It provides a feeling of contentment and
  pleasure and is activated when we are relaxed,
  quiet, or asleep.
• The Parasympathetic and Sympathetic Nervous
  Systems are designed to function in a way that
  maintains a balanced state of being.

16
Sympathetic Dominance

• SympatheticReactiveStress
• Diminished FunctioningLimited Choice
• If a person is functioning in Sympathetic
  Dominance there is
• Fight or flight response
• Chronic muscle tension
• Increased threat perception or hypervigilance
• Diminished brain function
• Loss of language and speech
• Intimacy intolerance
• Similar mistakes are repeated
• Incongruent emotional reactions

17
Parasympathetic Dominance

• ParasympatheticIntentionalComfort
• Optimal FunctioningChoice
• If a person is functioning in parasympathetic
  dominance there is
• Muscle relaxation and comfort
• Problems are seen as challenges
• Mobility in decision-making capacity
• Optimal motor and cognitive skills
• Intentionality or internal locus of control
• Emotional and behavioral self-regulation
• Intimacy tolerance
• Creative problem solving
• Successfully stored traumatic memory

18
Creation of a Successfully Stored Trauma Memory

• Thalamus (receives sensory data)
• Amygdala (tags fear)
• Hypothalamus (cortisol
  serotonin)
• Hippocampus (memory indexer)
• Pre-frontal Cortex (evaluates experience)

All clear
19
Questions ?
20
When a Trauma Memory is Unsuccessfully Stored
(Erratic Memory)

• Sometimes the transition of a traumatic
  experience into the memory is disrupted among
  people suffering from PTSD symptoms.
• As a result the event is repeatedly experienced
  as if it is occurring in the present.
• The memory is not stored as a verbal memory that
  occurred in the past.

21
When a Trauma Memory is Unsuccessfully Stored
(Erratic Memory)

• When your brain is in sympathetic dominance a
  false alarm is happening, the prefrontal cortex
  is skipped and the memories of the event become
  foggy and are stored erratically in the
  hippocampus.
• Sympathetic Dominance
• http//www.youtube.com/watch?vHnbNcQlzV-4

22
Creation of a Unsuccessfully Stored Trauma
Memory

• Thalamus (receives sensory data)

Amygdala
Hippocampus
Hypothalamus
Pre-frontal Cortex
23
Implicit vs. Explicit Memory

• Explicit-
• Involve the conscious recollection of facts,
  memories, events, and ideas.
• Language allows for the verbal communication of
  these memories
• Implicit-
• Memories are generally unconscious.
• Stored as senses, sensations, emotions, moods,
  images, pictures, metaphors, and actions.
• Traumatic experiences are initially implicit.
• A trauma memory is mainly sensory with limited
  language.
• Trauma is what we experience, not what we know,
  understand, or can comprehend.

24
Creation of a Successfully Stored Trauma Memory

• Thalamus (receives sensory data)
• Amygdala (tags fear)
• Hypothalamus (cortisol
  serotonin)
• Hippocampus (memory indexer)
• Pre-frontal Cortex (evaluates experience)

All clear
25
Questions ?
26
Trauma Impact on the Brain

• Repeated exposure to trauma leads to a change in
  overall brain structure, function, and chemistry.
  
• When people remain in Sympathetic Dominance the
  following have been shown to occur
• A volume reduction of the hippocampus
• The hippocampus has difficulty in storing and
  recalling information
• The hippocampus has difficulty forming new
  memories.
• The pre-frontal cortex is skipped and executive
  functioning is suddenly rendered functionless,
  then the primitive brain rises in activity.
• The amygdala enlarges and becomes hyperactive
• The hypothalamus repeatedly excretes stress
  hormones which makes it difficult to distinguish
  between danger and safety.

27
Trauma Impact on the Brain

• The combination of the disturbances in the
  functioning of the amygdala, hippocampus, and
  prefrontal cortex explain the reason as to why
  the memory is continually experienced for years
  and easily aroused by triggers and emotions that
  are difficult to describe in words.
• The perception of the threat and the actual
  threat is what puts a person in Sympathetic
  Dominance.
• Perception is influenced or changed by the brain
  structure and chemistry.
• The stress reaction can be seen as a conscious
  reaction however it is an automatic survival
  response.

28
What does trauma look like?

• Trauma affects you cognitively, behaviorally,
  socially, and emotionally.
• These reactions are survival reflexes.

29
(No Transcript)
30
Questions ?
31
What is Creativity?

• Creativity- the ability to approach an object or
  situation from an alternative perspective.
• Creative Counseling- counseling that incorporates
  the expressive arts in order to help access, give
  form to, and understand experiences, memories,
  and emotions.
• Types of Expressive Arts
• Art (paint, draw, sculpt)
• Dance or movement (yoga)
• Music
• Poetry/Journaling
• Drama
• Photography
• Guided Imagery

32
Creativity and the Brain

• An adults pre-frontal cortex is better developed
  which can hinder creative thinking.
• A childs underdeveloped pre-frontal cortex makes
  them less likely to have rigid thinking patterns
  thus allows for a more natural creative
  expression.
• This limitation can be used as a strength to
  promote creativity.

33
Creativity and the Brain

• Creative interventions must influence the limbic
  system in order to access sensory experiences
  (implicit memories) that then can be converted to
  explicit memories by providing understanding and
  verbal language to the experience.
• Having both an implicit and explicit memory of
  the experience allows for an integrated
  connection between senses, images, behaviors,
  affect, and meaning.
• In this process the memory is now stored
  successfully because it was given language and
  now can be accessed as a past experience and a
  resource for future challenges.

34
Creativity and the Brain

• Childrens ability to process experiences at a
  sensory level helps facilitate the shift from
  Sympathetic Dominance to Parasympathetic
  Dominance.
• Through creative interventions children are
  better able to self-regulate and self-soothe.

35
Questions ?
36
Benefits of Using Creativity

• Using creative interventions is a powerful tool
  which provides benefits including
• Helps capture and maintain interest and
  motivation in the counseling experience.
• Allows for an accepting, respectful, and safe
  environment
• Helps gain mastery through senses
• Allows the processing of the traumatic experience
  to be contained and not become overwhelming
• Inspires creative problem solving
• Promotes feeling identification
• Makes the unconscious conscious
• Supports emotional and behavioral self-regulation
  
• Promotes arousal reduction
• Appears less threatening or intimidating with
  special populations.

37
How can you be More Creative?

• Potential obstacles to utilizing creative
  interventions include
• Cost of materials and supplies
• Not perceiving self as creative/artistic
• Self-conscious or a fear of judgment on abilities
• Hesitation of going outside of the box of
  traditional talk therapy
• Concern about having less control of the session
  in regards to the unpredictability of the results
• Time for the prep and cleanup
• Reluctant clients

38
How to be More Creative?

• Ways to overcome obstacles of creativity
• Pay attention to the client interests
• Create a predictable and safe environment for the
  child
• Be enthusiastic for the creative intervention
• Pace the session based on the childs
  developmental level, engagement in therapy, and
  ability to manage arousal response
• Allow for spontaneity and flexibility
• Outline instructions of the intervention clearly
• Recycle or reuse generic materials
• Practice interventions and participate in
  supervision
• Trust the creative process!

39
10 tips to increase creativity

• Dont limit yourself by negative thinking. Im
  not a good artist
• Do invite clients of any age to exercise their
  creativity
• Do seek supervision, research, and consult on the
  appropriateness and effectiveness of the method
• Do ask clients to try only those activities for
  experiences that you feel comfortable with
  experiencing
• Do be aware of the depth that the creative
  process may lead to the client to experience
• Do tie creative interventions to evidence-based
  practice
• Do seek out resources
• Dont judge or assess clients work
• Dont force the client to create if they are not
  ready to or are invested
• Dont underestimate your own creativity and
  ability to develop creative interventions
• (Shallcross, 2011)

40
Questions ?
41
Activity Time!!
42
Affirmation Chain
43
Feelings Hand
44
Puppet Person
45
Light in the Darkness
46
Thanks!

• For additional information
• about topics discussed today,
• please feel free to utilize the
• reference list and Creative
• Interventions Catalog.

47
References

• The body as a resource. (2010, August).
  Retrieved from http//www.tlcinstituteonline.org/c
  ourses/mod/resource/view.php?id203.
• Bowirrat, A., Chen, T., Blum, K., Madigan, M.,
  Baily, B., Lih Chuan Chen, A. (2010).
  Neuro-psychopharmacogentics and neurological
  antecedents of posttraumatic stress disorder
  Unlocking the mysteries of resilience and
  vulnerability. Current Neuropharmacology, 8,
  335-358.
• The biology of trauma. (2012). Retrieved from
  http//www.natal.org.il
• Campbell, J. (2012, April). Trauma and the
  brain. Healing Magazine.
• Conger, K. (2007, July). Severe trauma affects
  kids brain function, sayStanford/Packard
  researchers. Retrieved from http//mednews.stanfo
  rd.edu.
• Corbett, H.C., (2009, March). Project (E)motion.
  Fitness Magazine.
• Gantt, L., Tinnin, L.W. (2009). Support for a
  neurobiological view of trauma with implications
  for art therapy. The Arts in Psychotherapy, 36,
  148-153.
• Interventions. (2010, August). Retrieved from
  http//www.tlcinstituteonline.org/courses/mod/reso
  urce/view.php?id219.
• Kendall, J. (2002, September). How child abuse
  and neglect damage the brain. The Boston Globe.

48
References Continued

• Lowenstein, L. (2010). Creative interventions
  for children, youth, and families. Retrieved
  from http//www.insswa.org/Newsletter/Creative_Int
  erventions_for_Children_and_Families.pdf
• Lowenstein, L. (2010). Favorite therapeutic
  activities for children, adolescents, and
  families Practioners share their most effective
  interventions. Retrieved from
  http//www.lianalowenstein.com/e-booklet.pdf
• Korlin, D., Nyback, H., Goldberg, F. S. (2000).
  Creative arts groups in psychiatric care
  Development and evaluation of a therapeutic
  alternative. Nord J Psychiatry, 54(5), 333-340.
• Pretorius, G., Pfeifer, N. (2010). Group art
  therapy with sexually abused girls. South
  African Journal of Psychology, 40(1), 63-73.
• Raider, M.C., Steele, W., Delillo-Storey, M.,
  Jacobs, J., Kuban, C. (2010). Structured
  sensory therapy (SITCAP-ART) for traumatized
  adjudicated adolescents in residential treatment.
  Retrieved from http//www.tlc.org.
• The roots of trauma. (2008, August). Retrieved
  from http//www.tlcinstituteonline.org/courses/mod
  /resource/view.php?id201.

49
References Continued

• Schimmel, C.J., Jacobs, E. (2011). Ten
  creative counseling techniques for helping
  clients deal with anger. Retrieved from
  http//counselingoutfitters.com/vistas/vistas11/Ar
  ticle_53.pdf
• Shallcross, L. (2011, February). Working
  outside the box. Retrieved from
  http//counseling.org
• Shen, Y., Armstrong, S. A. (2008). Impact of
  group sandtray therapy on the self-esteem of
  young girls. The Journal for Specialists in
  Group Work, 33(2), 118-137.
• Shonkoff, J.P., Garner, A.S. (2012). The
  lifelong effects of early childhood adversity and
  toxic stress. The American Academy of
  Pediatrics, 129(1), 233-246.
• Talwar, S. (2007). Accessing traumatic memory
  through art An art therapy trauma protocol
  (ATTP). The Arts in Psychotherapy, 34, 22-35.
• Trauma as an experience. (2010, August).
  Retrieved from http//www.tlcinstituteonline.org/c
  ourses/mod/resource/view.php?id213.
• Van Der Kolk, B. (2006). Clinical implications
  of neuroscience research in PTSD. New York
  Academy of Sciences, 13(1),1-17.