Strategic Self Regulation Program May 19-21, 2010 Dr. Elia Vecchione

2. Strategic Self Regulation Program May 19-21, 2010 Dr. Elia Vecchione DAY 2 Attachment Trauma Learned Helplessness Putting an End to an Emotional Reaction: De-Escalation “The Tools” DAY 1 What do you want to learn? Treatment with the Brain in Mind. Interaction: The Effects of Our Behavior The Bi-Partisan Brain: Cognition & Emotion DAY 3 Talking Through an Emotional Reaction “Building Emotional Alliances” Helping People Understand Themselves, Their Perceptions, Thoughts, Emotions, and Behavior “The Map”

3. 1. He makes me laugh.2. He looks me in the eyes when he talks to me.3. He talks to me about things I’m interested in.4. Sometimes he just sits and listens and smiles. Molly’s Rules:He Makes Me Feel Good Because:

4. Strategic Self Regulation Program HOPE FEELING AND THINKING ATTACHMENT VERBAL & NON VERBAL DE-ESCALATION MAPPING

6. Verbal Interaction

7. EVENT Frontal Lobes: Thinking & Impulse Control “Stop” Limbic System: Emotions, “Feeling” Thoughtful Behaviors: Future based Problem Solving “Choices” Danger! $@#&!!! Survival Behaviors: Escape Fight Freeze (Confabulation) THE BODY

8. How History Effects Behavior: Then: Now: Normal Stressor Trauma Time Necessary Survival Response Excessive Survival Response Locked in the Body

9. Survival Responses of the Nervous System* Fight, flight and freeze are automatic survival actions. They are similar to reflexes, but are much more complex. If the perception of the limbic system is that there is not time to flee, then the body will fight. If the limbic perception is that there is not enough time to flee, but there is adequate strength to fight, then the body will fight. If the limbic system perceives there is neither time nor strength for fight or flight it will freeze. It is important to understand that these limbic system ANS responses are instantaneous, instinctive responses to a perceived THREAT. *“The Body Remembers: The Psychopathology of Trauma and Trauma Treatment” Babette Rothschild

10. The De-Escalation Tools

12. II. Non-Verbal De-Escalation Tools • Arousal Regulation • Engagement/Disengagement • Distraction/Redirection • Limit Setting

13. II. Non-Verbal De-Escalation Tools1. Arousal Regulation • Escape • Humor • Choice • Control • Movement • Manage the Context • People & Places

14. II. Non-Verbal De-Escalation Tools2. Engagement and Disengagement • Posture • Tone • Distance • Engage/Disengage Verbally • Engage/Disengage Physically • Replacement with Significant Other

15. II. Non-Verbal De-Escalation Tools3. Distraction and Redirection • Distraction - Change Thoughts • Redirection - Change Behavior

16. II. Non-Verbal De-Escalation Tools4. Limit Setting • Safety • Limits Around Self • Limits Around Others

19. Health & Wellness Guidelines:

20. Diet: Eat a plate that is 1/2 vegetables and fruits, 1/4 lean protein, and 1/4 UNREFINED carbohydrates. Follow the Paleo Pyramid: Eat Whole, Unprocessed Foods Make olive oil your main source of added fat. Avoid saturated fats (butter, palm oil), trans fats (margarine and hydrogenated oils) and omega 6 oils (corn and soy bean oils). NEVER GO HUNGRY – Eat all the fresh fruit and vegetables that you want!

21. Paleo Pyramid: Eat Like Your Ancestors Refined, Processed foods. “Anything in a box, bag, or can” Foods in their natural, Unprocessed state

22. The Health and Wellness Guide to Eating Turkey Breast Lean Pork Chicken Eggs Fish Tofu Lean Protein Fruits And Vegetables Complex Carbohydrates Anything Fresh or Frozen (not potatoes) Pasta Barley Basmati Rice Whole Grain Bread Boiled New Potatoes

23. Multi Vitamins: Take a daily Multi-Vitamin that delivers at least 100% of the recommended daily allowances (RDA). The best choices are Centrum Performance or generic equivalent. I like Kirkland brand “High Performance” at Costco or ideally the Enzymatic Therapies product “From Fit to Fantastic” available at www.endfatigue.com

24. B Complex Take a B complex daily that delivers at least 100% of the RDA of each of the B vitamins. The best choices are Kirkland brand “B-50” at Costco of equivalent. If ordering multi-vitamins from Enigmatic Therapies separate B complex is included at no extra cost.

25. Vitamin D Take 4000 IU’s of Vitamin D3. The best choices are GNC or equivalent, 2000 IU’s per tablet, NOT with calcium OR vitamin A.

26. Omega 3 Fatty Acid In order to promote physical and mental health in reasonably healthy people 1200 mgs of EPA & DHA in a ratio of 2:1 with greater than 50% of capsule content DHA & EPA. Best choices are pharmaceutical grade Omega’s as they have the least contaminants and the highest grade fish oil. They include “Omega Brite” (available at www.omegabrite.com) and Zone omega’s (available at www.zonediet.com). Costco has a Kirkland brand “Fish Oil Omega 3: One Per Day” Item # 240669, just make sure you take 2 capsules per day.

27. Exercise: Enjoy some from of exercise almost daily, aerobic if possible, for 30-45 minutes, as close as is comfortable to 75% of maximum heart rate. Start SLOW, increase SLOWLY, and ENJOY it!

28. Sleep: Get 7-9 Hours of sleep per night. If you cannot get 7-9 hours, sleep too much, awake still tired, or cannot get to and stay asleep, take 1 mg of melatonin 1 hour before bed and DO LIGHT THERAPY. Expose yourself to 10,000 lumens of bright white light (NOT full spectrum) for at least a half hour at the prescribed distance. If sleep is still a problem, practice good sleep hygiene and have a quick course of sleep oriented cognitive behavior therapy before taking medication.