New Zealand Trauma Conference 2024
Speaker: Bessel van der Kolk
An engaging and informative day. Much of the content is what Bessel van der Kolk talks about in his book ‘The Body Keeps The Score’, but presented live with case examples made the content land more strongly.
I was especially moved by the opening waiata with over 1000 delegates singing together with the wonderful acoustics of the venue.
I took 6 pages of notes and have done my best to summarise these here.
Image description: event banner for the NZ Trauma Conference 2024. Blue text on a white background.
Overview of Topics
The origins of PTSD, PTSD is for more than the military; limitations of the PTSD diagnosis and what it misses:
Trauma has a different impact based on developmental level
The past is relived as if it is the present, not a memory diagnosis
More common than originally thought, not always an extraordinary event
Doesn’t take attachment into account, connection, collaboration, available support, cultural practices for managing trauma
No attention to somatic dimensions, the bodily responses continue
Diagnostic and statistical manual of mental disorders (DSM) was never meant to be used for insurance or forensice purposes, need to change the system
Tried to get CPTSD into the DSM-5 as it explains more than PTSD does, unsuccessful
Trauma - cumulation of experiences, trauma gets stored in the body if you’re not able to fight back or do something, changes your reward system, may not have memories but the body remembers and reacts; lose access to the frontal lobe as limbic system takes over, cannot be reasonable in this state or use thinking brain techniques like CBT, sensations are the triggers not the stories
Brain changes - cortical timing is different in those with PTSD, when emotional areas of the brain are in charge cognitive work won’t be as effective, different parts of the brain out of sync, makes it harder to take in new information, changes the way we can pay attention
Attachment as a critical variable, with trauma get out of sync with environment and the people around you, creates brain changes; attachment system trumps trauma system, we take safety cues from our attachment system (if our attachments are safe, tend to run towards home; examples:
World War II - children evacuated for the London bombings experienced trauma from the separation, those who stayed did better
September 11 - people who were able to run and act had lower rates of PTSD, many who experienced a trauma response were unsafe at home
Memory and dissociation - suffering that cannot be expressed in words, remember the body sensations and emotions but not the story; traumatic memories are emotions and sensations, different to other types of memory, stronger sensory experiences without a narrative; exposure therapy can encourage dissociation as the person continues to re-experience without resolving - “telling the story doesn’t make the trauma go away”
Sensations in the body send messages of safety and danger, the function of emotions is to create movement towards or away from something, getting stuck in avoidance and escape responses (trauma) can impact connection, this can happen through generations with intergenerational trauma; changing the posture can help change the emotion
Working with the body, vagus nerve 20% of fibres signal from the brain to the body, 80% from the body to the brain
Reconnecting with the body to be able to do trauma work, need the medial prefrontal cortex online to be connected to self and experience
Treatments and Tools
Focus on feeling alive and present in the now, increase awareness within everyday activities
Neurofeedback to change the reward system and automatic reactions, rate of brainwave firing linked to state of arousal; games to change the brainwaves, helps change perception of the world, can help with mood/pain/regulating arousal/attention
Going below the frontal cortex to the survival parts of the brain, creating safety in the body, having safe relationships, looking at attachment
Imagining another reality and other possibilities - imagination central to recovery e.g. art therapy, theatre, improvisation, martial arts, music, sand tray, play
Eye movement desensitisation and reprocessing (EMDR) - doesn’t rely on narratives, call things to mind, evoke the sensations, follow therapist finger side to side, process the trauma and then can access the narrative and tell the story so that it becomes a memory, put it in the past where it belongs, connects the bodily experience area of the brain with the area that knows what is past and what is present; EMDR better than placebo or prozac, works better for those who are traumatised as adults, less so for childhood trauma as it doesn’t change the impact of insecure attachment
Collective practices for increasing safety, learning from other cultures e.g. qi gong, tai chi, acupressure, yoga, singing, dancing
Reconnecting to the body slowly, being in stillness, sitting with vulnerability, listening to your body and bringing experiences to conscious awareness, paying attention to responses, slowing down to allow for choice, invitation and choice, noticing how an invitation lands so you can make a choice
Holding space nonverbally, sitting with people, practice being present in your own body so you can sit with and hold space for others, helping people discover things about themselves
Learning an internal vocabulary, words for internal experiences, locate them in the body and defining sensations
Learning what helps your body to calm down, internal resourcing, co-regulation and self-regulation, building coping mechanisms and acceptance of survival responses, increased pleasure and meaning, learn to live with feelings, build a sense of competency
Acupressure or tapping to shift sensations
Psychedelics - creating access to different realities, MDMA assisted psychotherapy supported with processing and reconnecting to self; has demonstrated efficacy with developmental trauma; method and setting are key, needs to be well supported and connected, not something to be done in isolation
Case example - client with therapist
Dipping into an experience, noticing where in the body is holding the experience, staying with it and noticing sensations/images/thoughts, track autonomic arousal and regulate, staying present in the now while also going into sensations/thoughts/feelings, fragments of a trauma or thoughts can come up, not talking someone out of these cognitions, telling current brain that that was in the past, notice and sit with, ride the wave, compassion for the stuck part, naming what they needed, self-compassion for the hurt; once in a different brain state, calm and self-compassionate then can tell the story and place it in the past.
Note: different with childhood abuse, as big internal self-hatred needs to be worked on first.
Group Practices done in the session after lunch - Licia Sky
Interoceptive awareness
Notice how you’re sitting, take a snapshot of your experience, make adjustments for comfort
Notice the sense of weight and balance and how it is connected to breath, take a deeper breath if needed and adjust posture
Notice the tailbone, where it is in space, follow the line of the spine up to the neck and skull, notice/sense/imagine sensations in the back side of the body
With your hand on your belly, notice the volume between your spine and belly, notice the movement of the breath and any thoughts, feelings, sensations
With your other hand on your heart, notice any differences
Notice the sensations of holding, hold yourself with kindness and respect, notice the sensations of being held
Hover your hands in front of your belly and heart a bit away from the body, move hands around the outline of the body, building awareness of where things are, an awareness of space and its overlap with others’ space
Sway, move gently as needed and come back.
Visual awareness
See the room as if you’ve never seen anything like it, let your eyes lead the head and neck, look all around, be curious, get a sense of the space above and below you
Notice how your insides feel, push your feet into the floor, imagine standing or physically stand, move weight side to side, sway your arms, push the air from hand to hand
Hands to belly and chest, humming or ah, feel the vibration
Key areas for overcoming trauma according to Bessel van der Kolk
(Re)establishing community - mutuality, reciprocity
Effective action - doing something, reciprocal relationships
Dealing with affect regulation - learning to calm yourself down
Accessing the emotional brain - knowing yourself, building language
Dealing with parts - acknowledging different parts
Processing traumatic memories (once someone is resourced)
Re-wiring neural circuits (neurofeedback)
Key takeaways
The trauma field is still young, we need to stay curious
People who are traumatised as children in their own attachment systems have a different response and constellation of symptoms to those who are traumatised as adults
Need to change the diagnostic systems, include CPTSD
Trauma as a filtering issue, don’t know what to tune out
People can be retraumatised by reliving the experience, talking it through brings up the sensations, need to work on resourcing and other practices before processing traumatic memories
Importance of movement, taking action, finding meaning, rewards, mindfulness
Importance of creating safe spaces and schools
Can’t change the past or what happened, but can work with responses in the present
Efficacy of new treatments but also cautions, e.g. can’t just give psychedelics in isolation in a room alone
How I supported myself to attend
Prior to the conference - I paced my travel to Christchurch over two days and had a rest day the day before the conference.
On the day - used my new wheeled bag so I didn’t need to carry things on my back, wore my sunflower lanyard and used the disabled toilet during breaks so I avoided standing in line and the noise of the bathrooms, used Loop earplugs during conference sessions and noise cancelling headphones during breaks, used new finger splint and new pens to make writing easier, snacks, water, fidgets.
After - got takeaway for dinner and had a chilled evening. Was not able to pace the return trip very well due to a commitment the next day and woke up early to drive the whole way home in one go. I thought I had got away with repercussions, but PEM was delayed by 72 hours and I had a bit of a flare, but it was worth it.
Reminder that breath and body based practices (along with other strategies) often need adaptions for neurodivergent people and that every one is an individual and will need different combinations of supports.
I have some resources related to building wellbeing, increasing nourishing activities, developing awareness of sensory needs and adapting breath and body based practices available in my resources shop.
Additional resources (no affiliate links)
Learn more about Bessel van der Kolk’s work here
To learn about EMDR
To learn about somatic experiencing
For more on interoception - Kelly Mahler
NICABM often have free webinars as well as a range of paid courses, many on trauma
For more about polyvagal theory
The Being Well Podcast with Rick Hanson and guest Steven Porges
Deb Dana and nervous system regulation
Neurodivergent Insights on the ADHD and Autistic nervous system - along with many other resources
Trauma Geek for deep dives into trauma and neurodivergence
The information is this blog is a summary from a conference I attended, it is not therapy advice. Please check in with your own therapy supports before trying out any of the practices mentioned here. If you are a therapist, please seek formal training in working with trauma to best support those you work with.
