Transcript Document

Strategic Self Regulation Program
May 19-21, 2010
Dr. Elia Vecchione
DAY 1
DAY 2
DAY 3
What do you want to
learn?
Attachment
Talking Through an
Emotional Reaction
Treatment with the Brain
in Mind.
Trauma
Learned Helplessness
“Building Emotional
Alliances”
Interaction: The Effects
of Our Behavior
Putting an End to an
Emotional Reaction:
The Bi-Partisan Brain:
De-Escalation
Helping People Understand
Themselves, Their
Perceptions, Thoughts,
Emotions, and Behavior
Cognition & Emotion
“The Tools”
“The Map”
Molly’s Rules:
He Makes Me Feel Good Because:
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.
Strategic Self Regulation Program
HOPE
ATTACHMENT
FEELING AND THINKING
VERBAL
& NON VERBAL
DE-ESCALATION
MAPPING
Strategic Self Regulation Therapy
State-Stage Model: Regulation, Targets, Treatments, & Outcome s
STATE-STAGE
M ODEL ->>
I.
Wrap the World
Around Them
II.
Help Them Understand
Them selves & the World
I. Attachm ent /
Relationship
Dependence
Self – Regulation with
Significant Others
Self – Regulation with Guidance
and Assistance
III.
Wrap Them Around
the World
Self – Regulation
Independently
Compliance with
Reasonable Rules and
Regulations
II. TARGETS
Emotions / Arousal
Thinking / Understanding
III. TREATMENTS
De – Escalation Tools
Mapping / Negotiation
Presenting the World as it is
IV. OUTCOMES
Arousal Regulation
Understanding / Problem Solv ing
Adaptive and Pro-Social
Behav ior
Verbal Interaction
EVENT
Thinking &
Impulse Control
“Stop”
Limbic System:
Emotions, “Feeling”
Thoughtful
Behaviors:
Future based
Problem Solving
“Choices”
Danger!
Survival Behaviors:
1) Escape
2) Fight
3) Freeze
Frontal Lobes:
$@#&!!!
(Confabulation)
THE BODY
How History Effects Behavior:
Then:
Now:
Trauma
Normal
Stressor
Necessary
Survival
Response
Time
Locked in
the Body
Excessive
Survival
Response
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
The De-Escalation Tools
Building Emotional Alliances
Step 1:
Step 2:
Step 3:
Step 4:
Step 5:
Step 6:
M
A
N
A
G
E
anage Yourself, Model Reasonable Behavio r, and M ake a Plan
gree, Acknowledge, and Listen
avig ate the Thoughts and Perceptions
id in Generating Solutions and Solving the Problem
enerate Reasonable Consequences and Take Personal Responsibility
nd by Repairing R elationships
II. Non-Verbal De-Escalation Tools
1.
2.
3.
4.
Arousal Regulation
Engagement/Disengagement
Distraction/Redirection
Limit Setting
II. Non-Verbal De-Escalation Tools
1. Arousal Regulation
•
•
•
•
•
•
Escape
Humor
Choice
Control
Movement
Manage the Context
– People & Places
II. Non-Verbal De-Escalation Tools
2. Engagement and Disengagement
•
•
•
•
•
•
Posture
Tone
Distance
Engage/Disengage Verbally
Engage/Disengage Physically
Replacement with Significant Other
II. Non-Verbal De-Escalation Tools
3. Distraction and Redirection
• Distraction - Change Thoughts
• Redirection - Change Behavior
II. Non-Verbal De-Escalation Tools
4. Limit Setting
• Safety
• Limits Around Self
• Limits Around Others
The Strateg ic Self-Regulation Program
Context
Background
Noise
Percept ion of
Event
Feeling
Gradient
Behavior
(-)
Pro-Act ive
St rategies
Thoughts
Consequences
De-escalat ion
Problem
Solving
(+)
Health & Wellness
Guideline
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!
Paleo Pyramid: Eat Like Your
Ancestors
Refined, Processed foods.
“Anything in a box, bag, or can”
Foods in their natural,
Unprocessed state
The Health and Wellness
Guide to Eating
Fruits
And
Vegetables
Anything
Fresh or
Frozen
(not potatoes)
Lean
Protein
Turkey Breast
Lean Pork
Chicken
Eggs
Fish
Tofu
Complex
Carbohydrates
Pasta
Barley
Basmati Rice
Whole Grain Bread
Boiled New Potatoes
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
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.
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.
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.
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!
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.