Understanding Child Trauma and Development

Reflections from: TraumaReflections from: Trauma
Through a Child’s EyesThrough a Child’s Eyes
(DVD), a presentation(DVD), a presentation
given by Peter Levine andgiven by Peter Levine and
Maggie KlineMaggie Kline
Companion Slides for independentCompanion Slides for independent
teachers’ study groupsteachers’ study groups
Created by an elementary teacher, notCreated by an elementary teacher, not
associated with Peter Levine or Melanie Klineassociated with Peter Levine or Melanie Kline
March – May, 2013March – May, 2013

A group of eight elementary educatorsA group of eight elementary educators
used these slides to help usused these slides to help us
understand the ideas in the DVD,understand the ideas in the DVD,
Trauma Through a Child’s EyesTrauma Through a Child’s Eyes..
The DVD was a live recording of a day-The DVD was a live recording of a day-
long workshop given by Peter Levinelong workshop given by Peter Levine
and Maggie Kline at Front Rangeand Maggie Kline at Front Range
Community College in Colorado inCommunity College in Colorado in
2008.2008.

We used the DVDs to exploreWe used the DVDs to explore
questions about how Levine’s andquestions about how Levine’s and
Kline’s work might apply to the workKline’s work might apply to the work
we do with elementary students.we do with elementary students.

For more information about our work,For more information about our work,
visit the blog:visit the blog:
http://mindbodylearning.wordpress.com/http://mindbodylearning.wordpress.com/
For more information about the workFor more information about the work
of Peter Levine and Maggie Kline,of Peter Levine and Maggie Kline,
visit the website:visit the website:
http://somaticexperiencing.com/http://somaticexperiencing.com/

A group of eight elementary educators usedA group of eight elementary educators used
these slides to help us understand thethese slides to help us understand the
ideas in the DVD,ideas in the DVD, Trauma Through aTrauma Through a
Child’s EyesChild’s Eyes..
The DVD was a live recording of a day-longThe DVD was a live recording of a day-long
workshop given by Peter Levine andworkshop given by Peter Levine and
Maggie Kline at Front Range CommunityMaggie Kline at Front Range Community
College in Colorado in 2008.College in Colorado in 2008.
We used the DVDs to explore questionsWe used the DVDs to explore questions
about how Levine’s and Kline’s work mightabout how Levine’s and Kline’s work might
apply to the work we do with elementaryapply to the work we do with elementary
students.students.
For more information, visit the blog:For more information, visit the blog:
http://mindbodylearning.wordpress.com/http://mindbodylearning.wordpress.com/

Session 1:Session 1:
- disc 1, part 1, 0:44-27:16 (26 min)disc 1, part 1, 0:44-27:16 (26 min)
(image from http://banksyposter.net/banksy-balloon-girl-there-is-always-hope/)

ChildChild
Development:Development:
A Hero’s JourneyA Hero’s Journey
Tasks
Challenge
s
Compassion

ChildChild
Development:Development:
A Hero’s JourneyA Hero’s Journey
Bottom-up
Approach
How to create a
field that allows
unmet
developmental
needs to arise
and be re-
negotiated?
Compassion

Trauma:Trauma: anything thatanything that
overwhelms us to aoverwhelms us to a
degree that we’re unabledegree that we’re unable
to fully bounce back.to fully bounce back.
““ordinary” events…ordinary” events…
traumatic to childrentraumatic to children
-invasiveinvasive
MedicalMedical
ProceduresProcedures
- unresponsiveunresponsive
caregiverscaregivers
(heat, cold,(heat, cold,
touch…)touch…)
- accidentsaccidents
problems with
Trauma happens in:
• Nervous system
• Body

Watch DVD:Watch DVD:
disc 1, part 1, 27:50 – 43:47 (16 min)disc 1, part 1, 27:50 – 43:47 (16 min)

Infant’s Brain has limitationsInfant’s Brain has limitations
-- can only take so much arousal, before something-- can only take so much arousal, before something
breaks down in self-regulation system.breaks down in self-regulation system.
- Brain stemBrain stem
- Cerebellum*Cerebellum*
- Able to hearAble to hear
- SomethingSomething
inexplicable?inexplicable?
• Cerebellum: IMPORTANT – coordinatesCerebellum: IMPORTANT – coordinates
everything, including emotional states, and iseverything, including emotional states, and is
essential for learning.essential for learning.
* Image from* Image from http://myqtbabyblog.com/http://myqtbabyblog.com/

Cerebellum:Cerebellum:
-has to do with the body, coordinating-has to do with the body, coordinating
movementmovement
–– IMPORTANT -- coordinates everything,IMPORTANT -- coordinates everything,
including emotional states, and isincluding emotional states, and is
- First learning for a child is sensory-motor- First learning for a child is sensory-motor
learning (Piaget).learning (Piaget).

- Brain stemBrain stem
- Cerebellum*Cerebellum*
- Able to hearAble to hear
- SomethingSomething
inexplicable?inexplicable?
* Cerebellum: IMPORTANT – coordinates* Cerebellum: IMPORTANT – coordinates
everything, including emotional states, and iseverything, including emotional states, and is

LimitationsLimitations need to be met in a wayneed to be met in a way
that helps them to regulate.that helps them to regulate.
““The code”:The code”:
- SwaddlingSwaddling
- VestibularVestibular
stimulationstimulation
- Sweet words- Sweet words
- Foundation for all later experience –Foundation for all later experience –
the capacity to self-regulate.the capacity to self-regulate.

This experience of being returnedThis experience of being returned
to a regulated state…to a regulated state…
helps infants learn:helps infants learn:
 Life is good.Life is good.
 No matter how bad things get, thingsNo matter how bad things get, things
will be okay… we’ll be able to comewill be okay… we’ll be able to come
back into regulation.back into regulation.

The Triune BrainThe Triune Brain
Image from: https://sites.google.com/site/iqrquestionreality/26.triune.brain.model.SMALL.bw.small.JPG

Reptilian Brain (Brain Stem) develops first,
in infancy.
Limbic System (seat of primary emotions)
develops next, in first year of life.
Neocortex (thinking, planning, conscious
memory, positive human connections)
develops last.

To have the positive, social emotions
and social connections (all the
wonderful human feelings), we need:
• Integration of all three parts
•All three parts working, as well as
communicating
•(mind-body connection)

Image from: http://nigelkerner.com/Articles/Is_Our_Species_Decaying.htmlImage from: http://nigelkerner.com/Articles/Is_Our_Species_Decaying.html
PFC curves in – right inPFC curves in – right in
contact with Limbic Systemcontact with Limbic System
and Brain Stemand Brain Stem
““location, location,location, location,
location.”location.”
““We are meant to integrateWe are meant to integrate
sensation, motion,sensation, motion,
(emotion), feeling, in a(emotion), feeling, in a
holistic function.”holistic function.”

Pause:Pause:
 What sense do you make of all this?What sense do you make of all this?
 What do you understand?What do you understand?
 What parts are still not clear, whatWhat parts are still not clear, what
questions remain?questions remain?
 What ideas or wondering do youWhat ideas or wondering do you
have about how this materialhave about how this material
connects with our work with ourconnects with our work with our
students?students?

disc 1, 43:47- 55:08 (12 min)disc 1, 43:47- 55:08 (12 min)

Three Nuclei of the Brain:Three Nuclei of the Brain:
(connections with body)(connections with body)
1. Arousal (Sympathetic) System:1. Arousal (Sympathetic) System:
- Reticular SystemReticular System
- Adrenal Response to dangerAdrenal Response to danger
- Fight, Flight or FreezeFight, Flight or Freeze
- Operating in infantOperating in infant

2. Dorsal Motor Nucleus2. Dorsal Motor Nucleus – Vagus Nerve– Vagus Nerve
Connects to:Connects to:
 IntestinesIntestines
 All organs below diaphragmAll organs below diaphragm
 HeartHeart
 LungsLungs
 Operating in infantOperating in infant

3. Nucleus Ambiguous3. Nucleus Ambiguous ––
Connects to:Connects to:
 Larynx, pharynx - vocalizationLarynx, pharynx - vocalization
 Muscles around eyeMuscles around eye
 Muscles in faceMuscles in face
 Social engagementSocial engagement
 Develops later – depending on our experiences inDevelops later – depending on our experiences in
childhood.childhood.
• We cannot be socially engaged if we’re frozen inWe cannot be socially engaged if we’re frozen in
the fight/flight response.the fight/flight response.

2 states of an infant:2 states of an infant:
 SympatheticSympathetic
arousalarousal
 ParasympatheticParasympathetic
relaxationrelaxation
Image from: static.guim.co.uk
Image from: http://www.bendandmend.com.au

disc one, 56:40 – 1:18:10 (21 min)disc one, 56:40 – 1:18:10 (21 min)

Our Nervous System is OrganizedOur Nervous System is Organized
in a Social Contextin a Social Context
 Resonance:Resonance:
 ““deep unconscious”deep unconscious”
Lewis Hine, Little Mother in the steel district,
Pittsburg, 1909, foto: Lewis Hine, George Eastman
House.
http://www.desertimages.com.au/alastair/images/mot
her-child.jpg http://www.sheknows.com/parenting/articles/
5156/play-developmental-games-with-your-
baby

 ““WE ARE ALL BORN TO PARTICIPATE INWE ARE ALL BORN TO PARTICIPATE IN
EACH OTHER’S NERVOUS SYSTEM.”EACH OTHER’S NERVOUS SYSTEM.”
 We are capable of “reading” other people’sWe are capable of “reading” other people’s
intentions and feel within our bodies whatintentions and feel within our bodies what
they are feeling.”they are feeling.”
 ““A sort of direct feeling route into the otherA sort of direct feeling route into the other
person is potentially open, and we resonateperson is potentially open, and we resonate
in their experience, and they in ours.”in their experience, and they in ours.”
 ““Two minds generate intersubjectivity. ButTwo minds generate intersubjectivity. But
equally, intersubjectivity shapes the twoequally, intersubjectivity shapes the two
minds.”minds.”
 ---- Daniel Stern, The Present MomentDaniel Stern, The Present Moment

 Resonance:Resonance:
 ““deep unconscious”deep unconscious”
 ““Nervous system of a dyad”Nervous system of a dyad”
 Social interactionSocial interaction shapes the structureshapes the structure
of our nervous systemof our nervous system

 Excitement: Limbic SystemExcitement: Limbic System
 Excitement, being alive in a socialExcitement, being alive in a social
contextcontext
 Develops in first few monthsDevelops in first few months
 ““Neurons that fire together, wireNeurons that fire together, wire
together.together.
 (Peter Levine refers back to slide 16 –(Peter Levine refers back to slide 16 –
Triune Brain)Triune Brain)

Ventromedial Prefrontal CortexVentromedial Prefrontal Cortex
 Connects all theConnects all the
signals from muscles,signals from muscles,
joints and viscera.joints and viscera.
 HereHere emotionsemotions areare
registered andregistered and
meaningmeaning bestowedbestowed
onon perceptionperception..
1) orbitofrontal cortex
2) lateral prefrontal cortex
3) ventromedial cortex
4) limbic system
thebrain.mcgill.ca

 Feelings meaningsFeelings meanings
associated with feelingsassociated with feelings
 Signals fromSignals from
Vagus Nerve from theVagus Nerve from the
visceraviscera
 We know ourWe know our
feelings fromfeelings from
our bodies.our bodies.
1) orbitofrontal cortex
2) lateral prefrontal cortex
3) ventromedial cortex
4) limbic system
*Levine’s note about primal release
techniques – they don’t address the
need to create meaning.

 FeelingsFeelings dodo come from the gut andcome from the gut and
the heart.the heart.
 These feelings have to do withThese feelings have to do with thethe
highest parts of our brainhighest parts of our brain, and, and
making meaning of how we feelmaking meaning of how we feel..

Limbic System:Limbic System:
 Fascination with the otherFascination with the other
 Structure of the brain being shaped inStructure of the brain being shaped in
social context.social context.

Limbic System:Limbic System:
 Child pulls away in effort to balance tooChild pulls away in effort to balance too
much excitement, too much contactmuch excitement, too much contact
 Good parenting: repairing when there’sGood parenting: repairing when there’s
a mis-match between contact and whata mis-match between contact and what
child can handle.child can handle.

Joy as ResonanceJoy as Resonance
Videos – Notice how we feel the socialVideos – Notice how we feel the social
engagementengagement in our bodies.in our bodies.
Resonance with the child is soResonance with the child is so
important.important.

Session 3Session 3
disc 2, 0:43 – 16:10 (28 min)disc 2, 0:43 – 16:10 (28 min)

ResourcesResources
It Won’t Hurt Forever.It Won’t Hurt Forever. audio cdaudio cd
Trauma Through a Child’s Eyes: AwakeningTrauma Through a Child’s Eyes: Awakening
the Ordinay Miracle of Healing.the Ordinay Miracle of Healing. bookbook
– Chapter for EducatorsChapter for Educators
Trauma-Proofing Your Kid: A Parent’s GuideTrauma-Proofing Your Kid: A Parent’s Guide
to Instilling Confidence, Joy andto Instilling Confidence, Joy and
Resilience.Resilience. bookbook

Dopamine SystemDopamine System
Age 12-18 monthsAge 12-18 months
 ““The world be me oyster”The world be me oyster”
 Excitement about the world, “intoExcitement about the world, “into
everything!”everything!”
 Learning about the world and how itLearning about the world and how it
works.works.

 Danger – needs boundaries and limits!Danger – needs boundaries and limits!
(many more negative interactions, “No!”)(many more negative interactions, “No!”)
 IndividuationIndividuation andand learning about boundarieslearning about boundaries

 Without appropriate sense of boundaries,Without appropriate sense of boundaries,
child will experience “pre-narcissistic rage.”child will experience “pre-narcissistic rage.”
http://img.hsmagazine.net/2012/04/rage-baby-300x225.jpg

 How to deal with a child in pre-narcissisticHow to deal with a child in pre-narcissistic
rage?rage?
 Set boundaries well, consistently to avoid theSet boundaries well, consistently to avoid the
rage states.rage states.
 Don’t try to reason when they’re in this state.Don’t try to reason when they’re in this state.
 Resonate with their high-level energy, thenResonate with their high-level energy, then
give a choice.give a choice.
– Harvey Karp www.thehappiestbaby.comHarvey Karp www.thehappiestbaby.com

disc 2, 16:10-disc 2, 16:10-

Socialization: ShameSocialization: Shame
Age 3-4Age 3-4
 Present in all mammals who live in groups;Present in all mammals who live in groups;
sets up hierarchies and sense of “right andsets up hierarchies and sense of “right and
wrong.”wrong.”
 Strong “no” produces a freeze in our bodies –Strong “no” produces a freeze in our bodies –
just like the freeze in trauma.just like the freeze in trauma.
 Shame is supposed to feel bad, necessary toShame is supposed to feel bad, necessary to
grab attention.grab attention.

Shame, RepairShame, Repair
Age 3-4Age 3-4
http://www.markfulton.org
http://www.nativeartsofamerica.com/products/after-scoldinghttp://www.nativeartsofamerica.com/products/after-scolding

Chronic Shame - ProblematicChronic Shame - Problematic
 Shame-basedShame-based
child: everythingchild: everything
they do, theythey do, they
are shamed.are shamed.
 Child becomesChild becomes
withdrawn.withdrawn.
 To prevent this,To prevent this,
repair is sorepair is so
important.important.

Chronic Shame - ProblematicChronic Shame - Problematic
 Such a strongSuch a strong
emotion, can getemotion, can get
frozen,frozen,
introjected.introjected.
 To prevent,To prevent,
parents need toparents need to
be sensitive andbe sensitive and
help child returnhelp child return
to equilibriumto equilibrium
afterward.afterward.

Flirting – Ages 4+ - adolescenceFlirting – Ages 4+ - adolescence
(“through midlife crises”)(“through midlife crises”)
 Important developmental processImportant developmental process
 Needs to be handled with awareness andNeeds to be handled with awareness and
sensitivity.sensitivity.
Questions:Questions:
How to help chronic shame?How to help chronic shame?
How are male and female responses to shameHow are male and female responses to shame
different?different?
Handling children who put fingers in mouth?Handling children who put fingers in mouth?
More…More…

Ethology:Ethology:
Nature’s Lessons in HealingNature’s Lessons in Healing
TraumaTrauma

disc 2, 43:50 – 1:11 (15 min)disc 2, 43:50 – 1:11 (15 min)

Predator-PreyPredator-Prey
http://www.walldesk.com.br/papel-de-parede/wallpapers-lei-da-selva-03.asp?f=380http://www.walldesk.com.br/papel-de-parede/wallpapers-lei-da-selva-03.asp?f=380

 What do you feel inWhat do you feel in
your body?your body?
– EmotionsEmotions
– Sensations –Sensations –
(physiologically based:(physiologically based:
how your bodyhow your body
respondsresponds))
– ThoughtsThoughts
 What happens now?What happens now?
What happens next?What happens next?
http://www.post-traumata.com

We move through responses by:We move through responses by:
 Taking a step back toTaking a step back to
observeobserve
 Having extra timeHaving extra time
 Having human contact –Having human contact –
sensing another person’ssensing another person’s
body coming back tobody coming back to
equilibriumequilibrium
(note: dance-like movement –(note: dance-like movement – Trauma toTrauma to
Awakening and Flow)Awakening and Flow)

Predator-Prey/ Fight-FlightPredator-Prey/ Fight-Flight
ResponseResponse
 Self-regulation –Self-regulation –
knowing that weknowing that we
can have badcan have bad
feelings and thatfeelings and that
it will still beit will still be
okay.okay.
Image from: http://cruises2tourstravel.com (?)

ResponseResponse
 When we work withWhen we work with
children who didn’tchildren who didn’t
have parents whohave parents who
could self-regulate,could self-regulate,
weren’t able to helpweren’t able to help
the child’s nervousthe child’s nervous
system develop thatsystem develop that
sense that they cansense that they can
come back tocome back to
equilibrium…equilibrium…
image: tcpalm.com

ResponseResponse
 We have the power to help them, forWe have the power to help them, for
the first time perhaps, to calm downthe first time perhaps, to calm down
by the way we calm our bodies, useby the way we calm our bodies, use
our faces and voice tone. We canour faces and voice tone. We can
give a sense ofgive a sense of
safety.safety.
image: ehow.com

Response – When children get ourResponse – When children get our
of control:of control:
 We need to de-escalate and repair. WhenWe need to de-escalate and repair. When
they are in a rage, take a step back andthey are in a rage, take a step back and
breathe.breathe.
Image:Image: www.gozen.comwww.gozen.com

Response – When children get ourResponse – When children get our
of control:of control:
 Just look at them, give them a chance toJust look at them, give them a chance to
also repair and save face (rather thanalso repair and save face (rather than
making it worse and getting more ragefulmaking it worse and getting more rageful
and ashamed.)and ashamed.)
 (more in the chapter for Educators)(more in the chapter for Educators)
Image: ehow.comImage: ehow.com

ResponseResponse
After movingAfter moving
through thethrough the
cycle, we maycycle, we may
feel expansion,feel expansion,
alive, real, full ofalive, real, full of
vitality. (“blissvitality. (“bliss
bunny”)bunny”)
Image:Image: www.arkive.orgwww.arkive.org

Session 4: ContinuedSession 4: Continued
disc 3, 0:11 – 5:40disc 3, 0:11 – 5:40

Topics of Questions from audience:Topics of Questions from audience:
Video games – shutting out outsideVideo games – shutting out outside
world, not really leading us to feelworld, not really leading us to feel
alert and relaxed.alert and relaxed.
Violent Programming – can relate toViolent Programming – can relate to
attachment difficulty. Violentattachment difficulty. Violent
TV/Movies create stimulation, andTV/Movies create stimulation, and
people may be trying to feel bypeople may be trying to feel by
“amping things up.” Important to“amping things up.” Important to
work with the whole family system.work with the whole family system.

Responding to Natural DisastersResponding to Natural Disasters
 Tracking sensation through physical activities:Tracking sensation through physical activities:
“Tiger Chases Bunny”“Tiger Chases Bunny”
 Engaging movement and power – “What animalEngaging movement and power – “What animal
would you like to be?” “How does it move?”would you like to be?” “How does it move?”
 Holding as a container for feelings, hand contactHolding as a container for feelings, hand contact
 Using parachute to re-create tsunami wave, beingUsing parachute to re-create tsunami wave, being
in control, being part of a team and having toin control, being part of a team and having to
stay activate to focus and think at the same time.stay activate to focus and think at the same time.
 Not “debriefing” or talking about trauma.Not “debriefing” or talking about trauma.

 Tracking sensation through physicalTracking sensation through physical
activities: “Tiger Chases Bunny”activities: “Tiger Chases Bunny”
 Engaging movement and power – “WhatEngaging movement and power – “What
animal would you like to be?” “How doesanimal would you like to be?” “How does
it move?”it move?”
 Holding as a container for feelings, handHolding as a container for feelings, hand
contactcontact
Related videos online:
http://www.youtube.com/watch?v=CjZEfR4lC7E
http://www.youtube.com/watch?v=E7Q6cteCWX8

 Activating the child with excitement,Activating the child with excitement,
then watch to see how childthen watch to see how child
responds – shutting down, orresponds – shutting down, or
becoming over-excited? For cues onbecoming over-excited? For cues on
where in the process he or she gotwhere in the process he or she got
stuck.stuck.

 Not “debriefing” or talking aboutNot “debriefing” or talking about
trauma.trauma.
 Can be effective after just oneCan be effective after just one
session for one-time traumasession for one-time trauma

Preventing ViolencePreventing Violence
 Activation-Deactivation cycleActivation-Deactivation cycle
 If floppy, low energy, trying to activateIf floppy, low energy, trying to activate
and bring more energy - Fun and Play–and bring more energy - Fun and Play–
then resting.then resting.
 Repairing attachment:Repairing attachment:
– Turn-takingTurn-taking
– Eye contactEye contact
– Rapport, enjoying each others’ companyRapport, enjoying each others’ company

Reflections from Therapy Work –Reflections from Therapy Work –
Maggie KlineMaggie Kline
Learning toLearning to
observe andobserve and
notice ownnotice own
sensations –sensations –
use of stickuse of stick
figurefigure
(Gingerbread(Gingerbread
person)person)
Image from: http://www.eightelementswest.com/wp-Image from: http://www.eightelementswest.com/wp-
content/uploads/2012/11/BenSE.jpgcontent/uploads/2012/11/BenSE.jpg

Violence Prevention:Violence Prevention:
Body-Based Awareness MeditiationBody-Based Awareness Meditiation
- When we haveWhen we have consciousnessconsciousness ofof
what’s happening at thewhat’s happening at the reptililanreptililan andand
cerebellumcerebellum level –putlevel –put wordswords to ourto our
sensations and feelings– we deepen oursensations and feelings– we deepen our
awarenessawareness of “what makes us tick.”of “what makes us tick.”
-
BringingBringing consciousnessconsciousness to these levelsto these levels
brings together the parts of the triunebrings together the parts of the triune
brainbrain. (the Insula…). (the Insula…)

Body-Based Awareness PracticeBody-Based Awareness Practice
- People who practice body-basedPeople who practice body-based
awareness change the structure ofawareness change the structure of
their brains, developing a thickertheir brains, developing a thicker
insula – which is associated withinsula – which is associated with
more empathy, more empathicmore empathy, more empathic
connection.connection.
Image from: genutsu@blogspot.comImage from: genutsu@blogspot.com

Body-Based Awareness PracticeBody-Based Awareness Practice
- Near the prefrontal cortex, theNear the prefrontal cortex, the
insulainsula helps us be aware of what’shelps us be aware of what’s
going on ingoing on in reptililanreptililan andand cerebellarcerebellar
levels.levels.
Image from: http://neuro.questionsthatmatter.info/Image from: http://neuro.questionsthatmatter.info/

Body-Based Awareness MeditiationBody-Based Awareness Meditiation
- When talking about anWhen talking about an
anti-violence curriculumanti-violence curriculum ––
Maggie Kline asserts that she knows ofMaggie Kline asserts that she knows of
“nothing better”“nothing better” than noticing about howthan noticing about how
one’s body feels and how it can change.one’s body feels and how it can change.
Image from: photocase.comImage from: photocase.com

Tracking breathTracking breath
• Learning to observe and notice ownLearning to observe and notice own
sensations – use of stick figuresensations – use of stick figure
(“Gingerbread” person)(“Gingerbread” person)

Tracking breathTracking breath
 In order to get energy going to focusIn order to get energy going to focus
– Get a little stress going.– Get a little stress going.
 She gives each child a sticky note –She gives each child a sticky note –
tells them the questions she’ll give attells them the questions she’ll give at
the end.the end.
– What did you notice at the beginning?What did you notice at the beginning?
– What changed?What changed?
– What did you notice at the end?What did you notice at the end?

Ball GameBall Game
 Making contactMaking contact
 Can slow it down or speed it upCan slow it down or speed it up
 Social engagement in a pleasurableSocial engagement in a pleasurable
activityactivity
 Raise energyRaise energy
 Auditory stimulation with name –Auditory stimulation with name –
saying their name – “self-hood”saying their name – “self-hood”

Understanding Child Trauma and Development

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