Until quite recently, most trauma treatment did not fully examine the profound psychophysical dysregulation in turn interferes with perception, cognition, affects impact of trauma upon the body, the brain and the mind (Fisher, 2000). The mechanisms of trauma impacting the neurology, brain- memory and body implements long-term treatment applications is a critical centerpiece for Janina Fischer’s Advanced Webinar Program, The Neurobiological Legacy of Trauma: “Trauma and the Body” (Fisher, Webinar, 2010-2011).
Fisher peers inside the mind and the brain to locate and to navigate through crisis with the most effective and healing responses. Important key concepts and study inclusive of the neurological process of the hippocampus consolidation and retrieval of a clear event memory recognizes that under threat and fear, results in a stymied ability for the frontal cortex to witness the experience. Fischer’s advanced webinar regroups the machinery of thought found in details, shapes and patterns pointing to traumatic memories as purely autonomic memories, separated from a narrative that could heal and adapt with responses to heighten resiliency.
The Kolo Trauma Format with over a decade of trauma treatment and training internationally has a role in examining Dr. Fisher’s neuroscience with sensorimotor psychotherapy applications. The result is an exploration of trauma memories as being remembered as ‘implicit” not experienced as memory. This opens up a clinical approach to hone in on trauma disorders, specifically in areas of misinterpretation given in clinical settings to the affected individual and secondly, to discern how autonomic nervous system is shaped by parental attachment behaviors while noting the autonomic adaptation to a threatening world.
Key Words: Implicit Memories, Trauma Disorders, Neurobiology, Sensorimotor-Somatic Psychology, Kolo Trauma Treatment and Training . Attachment, Dissociated, Relationships
Posted Wednesday, August 22, 2012, 02:19 PM
Neuroscience and Trauma: Online coursework with Janina Fischer, PhD
Neurobiological Legacy of Trauma and Body Webinar is a clinical approach to hone in on areas of misinterpretation when treating trauma. The affected individual heals and acquires resiliency and adaptive skills such as to discern how autonomic nervous system is shaped by parental attachment behaviors while noting the autonomic adaptation to a threatening world. Bessel Van Der Kolk, Boston University School of Medicine, Trauma Center validates research portraying the critical role of brain functions for understanding traumatic stresses (Van Der Kolk, 2006, p. 277). According to Van Der Kolk it is the “failures of attention and memory in posttraumatic stress disorders (PTSD)” that decrease the physiological arousal and the ability to have a vocabulary for what occurred (2006, p. 277). Given that the brain functions are incapacitated for the traumatized individuals, talk therapies are ill placed responses. The traumatized basically are unable to be engaged in the present moment or to procure skills to take effective action to mitigate the traumatic impact such as having words for an event that never happened before in their life experiences.
For all the technologies of trauma therapies reviewed, the brain and its functions were previously excluded in clinical trauma treatment and therapeutic sessions. Insofar, as trauma treatment applications are concerned, many healing cults such as the South Slavs and Slavic peoples concentrated on the inclusion of the brain, its neurological network with the body as the focus. Moreover, in the present catastrophic aftermath of three wars in one century in the former Yugoslav region, reference to one’s village of origin and the body defined responses to heal trauma (Anderson, 2011). The allegiance as performed in many rituals and traditions such as the round folk dance or to be in the circle called the kolo, mobilized social roles while publicly sharing knowledge, and the means to empower and heal trauma as a collective. The Kolo trauma applications incorporate a return to the archaic and somatic folk maternal psychological applications that is often buried under disuse and devalued as primitive in the sciences. However, current therapies for trauma are presently researching how the complex multidimensionality of the brain and trauma from so many neurological organized levels has been portrayed in indigenous cultures and religious or spiritual Buddhism (Hanson, Mendius, 2009, p. 9). The folk cross cultural psychological methods have corresponding meta-matrices of the species mind and brain in a very elegant and simple summarization and interpretation of traumatic events. The results with most indigenous wealth of trauma treatments formed through the ages impart an intimate wisdom of the brain functions and the role of the body/mind in healing their communities.
The Kolo Trauma format dealing with tragic trauma injuries such as genocide, gynocide and war crimes victims to those dealing with catastrophic natural events magnify and illuminate within the rituals and traditions, the importance of brain functions in treatment (Fisher, 2001). For instance, the sheer terror and mental illness is considered not so much as a mere process in the body of the traumatized individual but as stemming from a rupture in the relationship between persons and their life-world. The terror, the aggression felt and body schemas acted out in particular signals ceremonies, rituals and kolo dancing reshape the various bodily and sensorial ways in which a person interacts with others and their collective communities.
It is a study of implicit memory functions of the brain, with the amygdale in control and unable to forge neural connectivity to higher levels of cognitive functions that the prefrontal cortex of the brain is known to do. The South Slavic Bosnian war crimes survivors note that inability to forge higher cognitive functions. At this point, enacting the kolo either through their folk round dances or being in a circle collectively, affords South Slavs to seemingly press a pause button, a time and space continuum, to incorporate the kolo. The kolo is a concentric time-space order for transition, cyclical renewal if not an altered physiological state to treat the traumatic physiological symptoms that both Ogden and Fischer researched (Fischer, Ogden, 2006). The revealing implicit memory processes in the brain, specifically the amygdala with its ability to continue to grow throughout a life time and to respond to danger, threat and fear underscores the neurological legacy of trauma in clinical treatment. Furthermore, the hippocampus decides what memories will be recorded. Unless it is of great threat, danger or terror, the hippocampus ignores what is non-essential to allow for the significant long term memories for higher cognitive processes.
Dr. Fischer’s advanced webinar Legacy of Trauma incorporates the working brain to treat the substantial traumatic injuries of mind/body and the brain. Identifying traumatic ‘implicit’ memories experienced as a vast range of emotions ranging from desperation, despair, panic, terror attacks or social anxiety to shame, depression, abandonment, the flight or fight responses, Dr. Fisher identified the process as taking the shape of violence against the body (Fischer, Advanced Webinar, September 30, 2010). Detailed approaches to the mechanisms behind mental illness and what occurs when a memory is triggered or a skill is learned, documents how everyday experiences inscribe minute but permanent marks in the brain (Zeigler, US News & World Report, quotes Guang Yang assistant professor of anesthesiology, 2011, p. 16).
It’s the study of the human living brain and psychology that is seeing the most exhilarating leaps into treatment for traumatic stress. A neurobiological informed treatment and/or psycho-educational approach, any traumatic activation that is usually, interpreted as being unsafe, in danger or in dire threatening conditions can convert into an opportunity for evolving past the implicit trauma brain functions (Fischer, Webinar, 2010). By examining the trauma’s architecture as attempts to minimize dysregulation, clinicians view self-injury or anorexia as a way to discharge tension somatically (Fischer, Webinar, 2010). Below is a chart that maps the implicit trauma architecture.
Chart I Source: Fischer (2011) Advanced Neuroscience March Webinar
The Phase-Oriented Treatment Approach by Pierre Janet in 1898 purported Phase I as symptom reduction and stabilization, Phase II as treatment of traumatic memory and Phase 3 as personality integration. Flashing forward to Judith Herman’s 1992 model of trauma treatment records a need for three stages; stage I covers safety and stabilization to overcome dysregulation, stage II centers on accepting what happened and stage III to integrate and have meaning of what happened (Fisher, Webinar, 2011). Both approaches are the integration of a whole network and incorporate a more thorough in-depth sensorimotor psychotherapeutic and neuropsychological comprehensive approach from a consortium of researchers and clinicians.
Inclusive of its corresponding neurological systems reviewed in Fischer advanced webinar, the ways in which the South Slavs and Slavic people acquire their social and cultural identities is known to be shaped by the seemingly insignificant daily acts in their life world. Slavs’ oral memory traditions and rituals are lineal directions along with a cosmological sense of order in folk talks and folk psychological rituals, and display a concentric and cyclical pattern in the female realms of the conjugal house to that of child rearing where the implicit memory is well noted and acted upon as opposed to acted out. Singing in the fields when planting or dancing the kolo after harvesting the grapes reflect the contrasts between public and diurnal life and especially life at interstices where each person connects with each other and their environment. The detailed mechanisms behind mental illness such as trauma and memory disorders seeks by one means or another to protect and heal with the South Slavic customary practices steeped in an intuitive and vibrant intimacy of the brain.
Clinical Tools for living in a world of violence
For all the clinical applications, critical tools and maps from which to treat trauma, Sensorimotor Psychology Institute stands out with the Optimal Arousal Zone Window of Tolerance. What the Optimal Arousal Zone Window of Tolerance measures is the level of safety when in varying states of feeling (Fischer, Advanced Webinar, September 30, 2010). When feelings can be tolerated, a sense of safety envelops the brain functions, the mind and the body with behaviors and actions that promote resiliency. Victims of severe traumatic stress are honed to hyper-arousal related symptoms such as risk-taking, poor judgment, flashbacks or nightmares and to various addictions (Fischer, 2003). Janina Fischer, PhD., Trauma Center, Boston, reports that “70% of all psychiatric inpatients and 30% of outpatients have histories of psychological trauma; the effects of those histories often go unrecognized or underestimated” (Fischer, 2003).
We live in a world of ever-escalating violence according to Theodore Winkler’s “Women living in an insecure world” (Winkler, 2008). Autonomic is known as the physical and psychological nervous system and brain features of both hypoarousal and hyperarousal related symptoms. This is important for clinicians to map and quickly pinpoint autonomic adaptation to a threatening world are made apparent in the affected individual behaviors or actions that are often self-destructive or flat/numb (Ogden, Minton, 2000). The traumatized patient encounters the clinicians and trauma sessions with their symptoms as their identity of who they are. Therefore most are unable to discern the neurobiological functions of fight/flight/freeze/submit/attach that automatically under stress engage the patient.
As if to self medicate and to attempt to deal with dysregulation, traumatized individuals according to Dr. Fischer (2010) exposes the entirety of the brain’s role when the traumatic reminders are expressed. The traumatic reminders express an opportunity to incorporate optimum and salient treatment and to articulate effective intervention if not prevention (Van der Kolk, 2006, p. 278). Salient and optimal treatment treating trauma working with brain and the neurological network affords the possibility of neuroplasticity to occur.
The Kolo trauma treatment employs the archaic folk psychology already embedded in the culture recognizing the “highest level of integration and coordination depends on prefrontal activity that allows the organism to flexibly adjust to the environment (Van der Kolk, 2006, p. 278-9). A specific and practical interaction with the South Slavic surrounding life-world involves the intricate folk round dances and rituals. When the need is indicated, the kolos are performed in times of situations outstandingly good or in times of suffering. Such rituals and traditions display an awareness of a neurological state such as the “higher nervous arrangement inhibit (or control) the lower, and thus, when the higher are suddenly rendered functionless, the lower rise in activity” (Jackson, J.H., 1958).
Subjective self-reports with Bosnian Muslim women war crimes survivors referred to their prefrontal reduced activity in a collective neurobiological trauma legacy in stating their lives are without any future plans. According to Van der Kolk (2006) this marks the decrease activity of the medial prefrontal cortex that consists of the anterior cingulate cortex and orbitofrontal cortices (ACC). The medial prefrontal cortex and medial sections of the orbitofrontal cortices makeup the anterior cingulate, and research has pointed to the ACC as strongly interfacing with PostTraumatic Stress disorder (PTSD). The interesting role the ACC has is the integration of emotion and cognition akin to a process of conducting a symphonic orchestra (Van der Kolk, 2006, p.286). Oliver Sach’s (2007) book Musicophilia investigates the functional correlates found in music and various mental health disorders. Sach (2007) inquires the difference of those suffering from William syndrome that at its’ base is a neurofunctional architecture skewed in comparison to professional musicians (p. 330). “They employed a much wider set of neural structures to perceive and respond to music, including regions of the cerebellum, grain stem and amygdala which are scarcely activated at all in normal subjects. This very extensive brain activation, particularly of the amygdala, seemed to go with their almost helpless attraction to music and their sometimes overwhelming emotional reactions to it” (p. 330). Referring to these areas of the brain and the corresponding roles and responsibilities, Van der Kolk (2006) observed the relationship of PTSD affecting the integration of emotion and cognition noting the distinctive and neurofunctional systems in relationship to mental, affect at both a macro and micro level (p. 286).
For South Slavs-Bosnian war crimes survivors when words cannot coexist with the suffering or the presence of trauma, being in a circle or dancing the round dance activate control over the emotions not yet processed by the hippocampus and prefrontal cortex. At this point the amygdala rules and controls nonconscious movement that Efrat Ginot (2007) researches. Ginot thoroughly investigates intersubjectivity and neuroscience for dealing with therapeutic materials of the traumatized individual. Ginot (2007) and Fischer’s (2010) clinical pertinence with trauma issues is their realization that the body and the amygdala’s language are not in words or the prefrontal cortex mindful conscious actions. Rather, the amygdales’ function commencing from the utero and onward is to register for any danger, threat or fearfulness to embed survival instincts and neurological programming.
Reading the amygdala in clinical sessions as a rule has the patient overwhelmed, and/or not being in touch with themselves. Ginot (2007) refers to the amygdala neurological programming as evidenced in session as nonconscious rather than unconscious for this specific reason (Ginot, 329-332). Thanks to the innovative neurobiological assessment of trauma impacts, the discernment of nonconscious (amygdala) to that of consciousness or mindfulness, a result of the prefrontal cortex activities, a clinical practice treatment provides accurate information to what was counter intuitive trauma-driven interpretations (Fischer, 2010, September 2010).
Neurobiology and the Body
Fischer (Webinar, October, 2010) specifically inquires clinicians with; “Do we treat the memories? Or the encoding present in the body?” Since trauma symptoms are autonomically and nonconscious in material (Ogden, Fischer, 2009) sensorimotor psychotherapy looks to change neurological brain functions to correct cognitive impairment and incapacitating memories- basically right brain to right brain approach. An example of right brain to right brain approach occurs with the therapist tracking the body for information and to insert narrative so as to develop the most effective treatment (Ogden, Fischer, 2009). Everything from the posture of the body, holding of their breath, trembling and movements are tracked. According to Fischer (Webinar, October, 2010), to have the traumatized patient verbalize what occurred is negating the biological fact of the internal experience as being terrifying.
As with the Kolo trauma survivors in Bosnia and Africa to Sri Lanka, denial is an impenetrable shield along with a low level of verbalization of the traumatic event. However, what is encouraged and a therapeutic skill is to highlight the emergent feeling and body talk with statements of “I notice your face turning red,” to “Your jaws clenched with your anger outburst” (Neurobiology Trauma Legacy Webinar, October, 2010). While the verbal is silenced due to the sheer terror of the internal experience, the language of the body itself talks loudly. The South Slavic folk psychology oral memory traditions found in the kolo utilizes collective social relationships dealing with the encoding present in body of the traumatized individuals. What I term as bricolage-whatever materials happen to be available- heals the trauma in their local communities, especially at points where words are not to be found or easily proffered by the traumatized.
With the focus on somatoform dissociation and the impenetrable shield of denial, numbness, flat affect replete with defensive responses, Pat Ogden and Janina Fischer (2009) note the relational patterns that arise from such disorganized attachment (the severest form of attachment disorders) and how it is driven by the bodily experience (Ogden, Fischer, 2009 p. 4 of Chapter 14). Allen N. Schore, PhD., (Schore, 1994, 2003a, b) has long suggested that intersubjectivity as an integral construct of neuropsychoanalysis of not just for cognitive process and minds but for two bodies. Employing a set of therapeutic alliances with the neurobiological legacy of trauma and the body heightens the demand for a set of observational skills and interventions that was not the standard in psychodynamic psychotherapy but appears in folk cross-cultural psychological rituals and practices (Ogden, Pain, Minton & Fischer, 2005).
Schore’s (Schore, 1994, 2003a, b) work agrees with Ogden and Fischer’s premise that insight and words present a limited trauma treatment. Rather, the fleshing out a trauma therapeutic model for the brain’s neurofunctional architecture, a top-down and bottom up intervention is the best course of treatment. Since, the South Slavic therapeutic model is that of being in a circle or the round dance called the kolo, it has the property of entrainment in that it is a tendency to keep time and to sync our motor activity to the prevailing rhythm (Sachs, 2007, p. 240). Author Oliver Sachs researched studies where such responses to “rhythm actually precede the external beat” (p. 240). Indicating a bottom up and top down neurofunctional process, it establishes that anticipation of the beat, recording in our brain templates, the template is stored for easy retrieval (Sachs, 2007, p. 240-241). The top-down and bottom up kolo trauma interventions are a culturally procedurally learned pattern not requiring narrative except the body’s narrative (Anderson, 2011, p. 188). Regulating the autonomic arousal the somatic involvement of the kolo allows the ‘profound pauses’ any hyper or hypoarousal activity on the part of the trauma survivor.
The neuro-scientific and somatic scars of intergenerational trauma for the South Slavic Bosnian war crimes define the holocaustic violence and their somatic cultural practices to approach healing the trauma (Danieli, 1986, pp. 295-313). What becomes evident is the alignment with the trauma therapeutic top-down and bottom up treatment accurately represented in the kolo somatic folk psychological practices.
Working with Effects of Dysregulation- Addictions and Self-Harm
Dr. Fischer in her paper presented at the International Society for the Study of Dissociation, November, 2000, reported that the research of Bessel van der Kolk, Onno van der Hart and Bruce Perry pointed to childhood trauma as having disruptive effects on the body’s capacity to self-regulate psychologically and somatically. Identified as ‘fault lines’ of dissociative characteristics, Fischer paper explored the compensatory and self-medicating strategies employed by trauma survivors (Fischer, 2000). In the present context of global severe socio-economic crisis and breakdown of various institutions, the disruptive effects on family and kinship solidarity, gender and even seniority relationship present an etiological assessment of ills and societal disorders. The compensatory behaviors according to Fisher (2000) are a conduit to discharge tension in the body and/or to rid fear, powerlessness with excitement or well-being. What is being presented is that all compensatory behaviors and actions are addictive properties founded on survival instincts.
Fisher (2000) argues that all addictive behavior is survival strategy to self-soothe, numb or even to escalate hypervigilance becoming self-destructive over a lifetime. The latter reveals the important role mothers have in their perinatal stages and childrearing. Medical doctor Mona Lisa Schulz (2005) in her book Feminine Brain wrote,” if the mother is stressed, her adrenal glands pump put testosterone-like molecules called androgens that masculanize the developing baby girls’ brain or feminize the a developing boy boy’s brain, increasing his susceptibility to depression, anxiety, language disorder like dyslexia and certain health problems later in life, “ (p. 51). Critical triage and focus is placed on the need to therapeutically attend to addictions at the same time of trauma. The multilayered metaphorical somatic resonance of the addictive behaviors attempts to through poly-substance abuse from drugs to alcohol is a way to treat their trauma. Addictive behaviors flourish because social ills and psychopathological crisis and vacuousness (devoid of meaning) with the tearing down of traditions and cultural practices occurring after traumatic events. This is evident with the South Slavic Bosnian war crimes survivors who sought to rid themselves of the utterly grim social costs of wars by their first aid practice of addictive behaviors to numb or to excite some semblance of life. It is at this point that Fisher instructs the work of a therapist to search for strengths whenever shame or failure occurs citing how the traumatized and addicted individual is attempting to control symptoms (2000).
The solicited cry for help, perhaps both medical and mental health, incorporates a psycho-educational approach and therapeutic response so as to comprehend the connection between addictions and trauma with its neurobiological intricate network and legacy (Fischer, 2000, p 5). The trauma induced neurobiological process is counter intuitive for traditional therapeutic intervention. For instance, considering self-harm and suicides as producing more pain when the neurobiological process within the traumatized envelope actually is to relieve the pain. Otherwise, most therapy text book assumption for additional pain is that it is masochistic, self punitive behaviors and literally a cry for help (Fisher, 2000, p. 5). Shame manifests in the traumatized individual when told of their self-punitive behaviors or cries for help literally actualizing their inability to heal themselves or help themselves forming a lifetime of iron clad victimhood. The latter fuels intergenerational trauma and an ever-increasing repetition of victim stance or offender propensities (Anderson, 2011, in press).
Previous clinical treatment for trauma training and through constant application makes it difficult to exile from the therapy sessions. Yet, the counter intuitiveness for modulating trauma behavioral responses which solicits and aligns with the inherent neurobiological trauma process makes profound sense along with mediating progress. Fischer (2000) charts specific hyperarousal and hypoarousal behaviors charted on the optimal window of tolerance. Situated in the hyperarousal behaviors are attempts to regulate by decreasing with the effects of alcoholism, marijuana, heroin, and planning suicide and self-sacrificing noted with care giving (Fisher, 2000). For hyperarousal, it is decreased with cocaine, speed, hyper-activity, all high risk behaviors, re-enactment, constant victimization and self-harm.
Encountering many of the hyperarousal behaviors in Bosnian war crimes survivors and war survivors quickly acquires an insight to their daily life in the aftermath of wars and resulting catastrophic poverty. The combined observation of trauma treatment applications and the war survivors own observations were diagnostic oracles of the same meta-matrices found in Sensorimotor Psychotherapy and Fishers’ research on the neurobiological legacy of trauma. Specifically in this case for the optimal window of tolerance, the repeated lengthy conversations with many of the addicted Bosnian males presented a universal colloquial saying; “I drink, I take drugs because there is a tomorrow.” The South Slavic archaic kolo rituals and tradition are considered a form of ensorcellment by the science field. However for the South Slav facing grim social costs and traumatic stress widespread despair their autochthonous-present from the earliest times- incorporating their birthplace origins, physiological and physical disorders originating in the body. What occurs for ritual purposes it assimilates the confluence of their birthplace origins and their physiological to physical disorders of the body to cycle into their lives their matrilineal heal the collective community (Anderson, 2011, in press).
At the domestic level, an elderly Bosnian grandmother as if she took the neurobiology legacy of trauma webinar, admonished her alcoholic adult son stating that he almost got it right with all the drinking to forget the war. Instead she inquired her son if his numerous attempts of self-harm and the slow death of drinking and smoking gave him relief from his pain. Imploring him to look at another way of providing relief was had by asking him to figure out a way to keep the horrific trauma memories away and develop another effective healing treatment to plan recovery not suicide. In observing the interaction, I noted the learning opportunity as opposed to another tragic traumatized person and more importantly, her ability to reframe the symptoms or according to Diane Fosha to entrain the positive (Fosha, 2000, p 223).
Traumatic Memory Defined and Techniques
The internal terror of traumatic memory is so frightening to the individual that a myriad of ways are summoned to avoid, deny and not face the constant intrusion of the crisis event. According to Van der Kolo and Fisler (1995) traumatic memory is dissociated and initially stored as sensorial aspects not having coherency or narrative (p. 506-508). However, while many therapists and traumatized individuals surmise that once a narrative is had, traumatic memory and/or the intrusive flashbacks are to be abolished. This is not the case and it is a contradiction.
Defining explicit and implicit memory allows the therapist to recognize the territories and principalities involved when discerning between them. Basically, memory’s two areas of explicit and implicit are a neurological and brain process and function. Implicit memory according to Fisher (Webinar, January 2011) is a subset of emotional, visceral, perceptual, muscle memory, autonomic with sympathetic-parasympathetic patterns and procedural memory to form habit and function. Explicit is both conscious and verbal while having the principalities of declarative verbal narrative and ordered with autobiographical narrative of personal life experiences.
Strongly noted is how the storage of memory residing in the brain is interconnected. The frontal cortex for long term narrative memory is connected to the Hippocampus, the organized filing cabinet that is constantly contextualizing. The Amygdala with its implicit memory and emotions interconnects with the Putamen’s brain function for procedural memories of which it is about what we do immediately, what to do and how to act. Finally, the Caudate nucleus part of the Brain stores our instinctual responses.
The interconnectivity in the brain memory processing is noted in the South Slavic Bosnian war crimes survivors’ kolo practices. The texture that engenders new meaning, relations with all others (interconnectivity), their environment and even renewed contact with the life source to reinforce the wounded is the habitus to render life experiences as meaningful and intense learning applications. The healing practices of the South Slavic war crimes survivors are referred to as oral memory traditions due to a view of culture as a collective resource to create memories and integrate both past and present memories. In doing so, the South Slavs and most healing cults reassert the basic function of the brain and the neurological network to transmit life and self-sustainability in their life world. This makes sense of the fact that South Slavs did not have a written alphabet until the late 1800’s and preserved their oral memory traditions (McDaniel, p. 31). More importantly, it is how the implicit memory was not lost with the non-verbal aspects or the lack of a written alphabet. If anything, guardianship on integrating implicit memory and explicit memory is continued through their Slavic traditions; utilizing a dependency on sensorimotor experience.
The interconnectivity of the brain functions for memory processing demonstrates the hierarchically organized processes. The brain integrates higher level processes garnered from the dependent integrity of lower level structures such as the sensorimotor experiences (Fisher, Minton, 2000). Fisher notes Maclean’s (1985) work stating three levels of information processing; sensorimotor, emotional, and cognitive. The brains’ architecture with sensorimotor sensation and programmed movement impulses, is the same hierarchical process initiated by lower rear portions of brain, emotional processing intermediate limbic sections of the brain and frontal cortical functions for cognitive processing (Fisher, Minton, 2000).
Fisher (Fisher, Minton, 2000) posits with the architecture of the brain and interconnectivity of its processes results in the foundational sensorimotor psychotherapy. It is foundational since it directly utilizes and includes the body processes for the patients’ defensive states and autonomic nervous system activation. Given the interconnectivity of all the brain and body processes along with PTSD noted as dissociation, clinical techniques need to provide association (Fisher, Minton, 2000).
Disorganized Attachment and the Traumatic Transference
With the leaps and bounds scientists are making in neuroscience, their findings underline the extreme importance of the mother and child bonding- the attachment process. Going beyond the neutral stance of the scientist engendering the relevant role of the maternal attachment in the first year of life has been determined to have lifelong impacts upon the child. The infant and fetus with the amygdala’ s processing for danger, fear or threat for the pre-verbal child is consumed with the need for survival and safety (Fisher, February Webinar, 2011).
The concomitant forces of the mother and child to include perinatal constitute the crux of recent neuroscience findings. The recent neuroscience research and findings serve to validate the reverence of the South Slavic archaic oral memory traditions for the Slavic maternal term “Moist Mother Earth.” Joanna Hubbs’ (1993) book Mother Russia noted that the land and soil were called Mother and in the Slavic peasant tradition all things borne by the earth and derive from fertility, the soil is known as the great baba (woman) (p. xiii). Stating the “umbilical” love of motherland, Hubbs (1993) notes the metaphoric representation of the female’s perinatal propensities within the Slavic culture and oral memory traditions (p. xiii). Embodying the sacredness of the body requires the higher cognitive functioning for spiritualism and mindfulness. This is evident in the Slavic key symbolic themes that correlate to neuropsychological and somatic processes. This is apparent in a Psychotherapy Networker article, where Dr. Fisher inquires why she needed brain science to be informed about grandparenting and what does it have to do with psychotherapy (Fisher, 2010)? Combined with Dr. Schore ‘s interdisciplinary interpretive studies, if not an internal approach with an emphasis on metaphoric production of meaning towards integrating psychological and biological models across life spans, asserts that attachment behavior, the maternal mother and child bond, etches a permanent trace in the developing child’s brain (Schore, 1996, p.13-21).
The Slavic uterine filiations of physical life focused on the maternal despite the brutal preference of agnatic descent attempts to undermine the sacred maternal attachment process has the parental instructions for the developing child and the brain (Mertus, 2000, p. 14). In fact, Julie Mertus, Fulbright Scholar and human rights activist, discusses the South Slavic refugee women as “the “small talk” of women belongs to those songs which make life more bearable, the lullabies which comfort us that everything will eventually pass, the bad we are enduring now, the good we have lost. They trust emotions, common sense and the common denominator of humanity, “Don’t kill.” Mertus attests to her own neurobiological legacy and perhaps permanent etching on the brain formed in early attachment period. Mertus’s work on the humanitarian challenge after the Balkan War identified the point of transmission for intergenerational trauma in the early development years and perinatal stages for South Slavic war survivors.
Schore (2003) discusses attachment and brain development as the ultimate survival model dependent on early social environment and the wiring of neurological networks. Neuroscience is very much aware that order, health, life needs balancing of polar elements or values, the uterine life line via the mediation of the primary source of life set the stage for mother and child’s self-development and regulatory ability (Schore 1994). Interactive regulatory ability interfacing with relationships mitigates any holes in the window of tolerance and auto-regulation so that the child can self-regulate and calm down.
What Fisher (Webinar February, 2011) is looking for are strategies for healing attachment issues. Four categories are listed. The first listed is the secure attachment where the child show a preference for being regulated by the mother in the first year of life and caregivers. The second is insecure-ambivalent attachment where the infant is anxious to be in the vicinity of the mother or caregiver and the third is insecure-avoidant attachment where the infant’s preference for the mother is apparent but the infant avoids the mother or caregiver and cannot be self-soothed. The fourth category is disorganized attachment where the infant has not adopted interactive and auto-regulation and already shows signs of freezing, distancing or avoidant behavior. The latter is the most destructive.
It is a most complex picture. And in line with the significance of attachment for the development of the brain and neurological networks, Dr. Fisher notes her foundation based on the infant-mother “interactive neurobiological regulation” as absolutely necessary to even begin to know how we ourselves are biologically dysregulated. Dr. Fisher (2010) provided the example of what occurs as when the infant cries to be regulated. The latter demonstrates the interactive neurobiological regulation occurring between mother and infant while providing a fertile ground for transference to occur. The behaviors of a traumatized individual’s intense internal struggles according to Fisher (Webinar, February, 2011) require two important guidelines. One is to triage and/or prioritized neurobiological signposts to regulate distress and to accentuate areas of positive affect while balancing between closeness and distance. The second is to apply “right brain to right brain” expression where it is not about the “words” rather it is body language, the tone of voice and all the nonverbal behaviors that often are gone unnoticed (Webinar, February, 2011).
The disorganized and unresolved attachment issues in adults are found to alternate between hyper and hypo-arousal responses. Dr. Fisher (Webinar February, 2011) points out alternating proximity-seeking and clinging to avoidance, the internal conflicts versus the distance and closeness, and the resulting deficits in identity and self-development. The manifestations of the disorganized attachment in clinical venues have the transference of not attending treatment, and/or chronic ambivalence or clinging (Webinar February, 2011). Dr. Fisher’s response for clinical treatment is to have equal opportunity for both defensive postures and attachment to provide mastery and control towards self-regulation skills for the traumatized individual (Fisher, 2005).
With three wars in one century, the South Slavic mothers and grandmothers universal appeal to evoke assistance in terms of their maternal care and infant/child bonding during violent eras is often termed as “collateral damage,” due to wars and conflict. Notwithstanding the fears the South Slavic women feel towards unending wars and destruction, intergenerational trauma is perpetuated. The young consider their home as an ontological space where life, meaning, replenishment with healing occurs. However, life-threatening illness or misfortune, principally originate at their mother’s breast due to the surrounding stressful environment filled with constant wars and increasing attacks on civilians titled collateral damage (Anderson, 2011). The attachment of early childhood and development of neurological networks are grievously affected as a result.
Reviewing crayon drawings from elementary school aged children in 2003 Novi Travnik, Bosnian-Herzegovina, revealed attachment disorders stemming from a disturbance in the relationship between their mother, major caregivers and their life world. While the children were born years after the war, the various bodily and sensorial ways in which each has relationship and interfaces with each other left a permanent mark on their neurobiological process just as Dr. Schore stated and researched (Schore, 1996, p.13-21). The indelible ink of impacted attachment and bonding during wars and in the aftermath of wars was strong enough to have the crayon drawings of children depicting guns, heads cut off, rubble for homes and graves.
Recognizing and Treating Dissociative Phenomena: The Structural Dissociation Model
The DSM-IV-R-2000 succinct dissociation definition is a disruption in the usually integrated functions of consciousness, memory, identity or perception” (American Psychiatric Association, 1994, p. 477). In a paper delivered at the Boston University Medical School Psychological Trauma Conference, May 2001, Dr. Fisher further adds that dissociation is in some fashion attempting to organize information and compartmentalizes experiences in maladaptive behaviors (Fisher, 2001). Again, Dr. Fisher (2001) figures in a nurturing therapeutic intervention by viewing the dissociative symptoms as adaptive capabilities not pathological.
Notwithstanding the difficulties in working with dissociative traumatized patients, their ability to constantly ‘multi-task’, play to joking so as to draw away from the intrusive affects and/or memories, is a legitimate peritraumatic dissociation and depersonalization attempt (Fisher 2001). In other words, compartmentalizing allows for distance from events that do not hold a narrative for the catastrophic crisis or events. For the detachment from the self Fisher (2002) relies on the research from Van der Hart, Nijenhuis & Steele (2006) to emphasize the ability for the traumatized patient to have different identities. Actresses in their role of a character having mastery and refined ability to portray a character totally opposite of themselves are a good example.
The ways in which any person acquires a social identity and their individuality are viewed in clinical sessions through their behaviors and actions. Fisher (2002) states the acquisition of new and more adaptively healthy self-regulatory capacitates fosters internal connectedness. Observing the signs and indicators of dissociative symptoms is crucial in clinical sessions. Below is a chart of dissociative symptoms developed by Fisher (2002).
Clinician’s Chart for Indications of Dissociative Symptoms
• Above average number of clinicians & multiple diagnoses
• Level of pain tolerance such as sudden headaches, narcoleptic type symptoms in therapy or home.
• Abruptly leaving the session, regressed cognition or language. Mute
• Unable to integrate behavior, affect, perception or experience but can have high functional level elsewhere.
• Either entitled or devaluing of oneself. Idealizes and devalues the clinician. May illustrate borderline to probability of dissociative symptoms as characterological in nature
• Stuck- cannot move forward or evolve. Difficulty in big decision making or indecisive,
• Memory difficulties, blackouts not remembering how they drove to a destination. Cannot remember conversations, social engagements
• Internal conflict shown by being calm and then exploding into rage or anger.
Chart 2 Source: Taken from Dr. Fisher’s Paper presented at the Boston University Medical School Psychological Trauma Conference, May 2001
Compartmentalization according to Dr. Fisher (Webinar, March, 2011) is all about survival. Based on neuroscience, Fisher (Webinar, March, 2011) notes that the Corpus Collosum, the middle-brain or what Dr. Mona Lisa Schulz’s (1998) research refers to as the wise mind due to its role in having both left and right brain interfacing with each other. Revealing neurological studies on the brain show the Corpus Collosum as not being fully developed until the age of twelve (Webinar, March, 2011). If anything, the understanding of the length of time for the full development of the Corpus Collosum for traumatic memories in the developing brain and child allows for the clinician to comprehend that the memories in the right brain are without the higher cognitive functioning of the left and pre-frontal cortex. Literally, the traumatic memories are outside of conscious awareness (Fisher, Webinar, March, 2011). The left brain’s process and what it stores of the same experience will be different in properties in comparison to the right brain’s storage and role of the same experience.
Fisher (Webinar, March, 2011) points out to clinicians that the traumatized patient’s affects ranging from despair, shame, self-loathing, rage and helplessness are accompanied with hypervigilance- a posttraumatic paranoia, somatic sensations and somatic movements such as dizziness, jaw clenching, nausea, shaking and restlessness. The posttraumatic somatic sensations and movements to the various behavior and affect represent violence against the body. Past clinical practicum and training assert the need to pathologize, basically judge the symptoms and be able to fit into a DSM code to having a therapeutic plan to attend to the pathological tendencies of the patient. However, what Dr. Fisher employs with the neuropsychological clinical work is to take what is maladaptive dissociativeness through a refined clinical lens to incorporated adaptive skills (Fisher, 2001). This is the point in sessions to engage in psycho-educational information for the client and have the patient track their somatic indicators encouraging curiosity and compassion (Webinar, March, 2011).
Working with Ego States Advanced Webinar April 2011
Dr. Richard Schwartz’s article The Larger Self discusses attunement with the patient and substituting judgment to one of learning and healing opportunity. Developer of the Internal Family Systems, IFS, basically mindfulness techniques takes survival behaviors and instinctual drives to reach towards a higher self. The IFS model is founded on the Bowenian family therapies. Bowen’s family therapies observed the various subpersonalities and conflicted parts that were present (retrieved online- http://www.selfleadership.org/about-internal-family-systems.html). Dr. Fisher’s (Webinar, April 2010) clinical approach in dealing with the implicit states and segmented identities describe a similar understanding of object relations and internal objects. When we review what object relations are, we understand the focus as being emphasized on interpersonal relations, more specifically, on the mother and child bond. The interpersonal relations actually encompass the past relationships that appear in the individual in the present moment, a map according to Dr. Fisher (Webinar October 2010) attachment and dissociative treatment issues.
Neurological insights can be traced within the object relations to Melanie Klein, once a Freudian analyst, who is responsible for the initiation of the object relations theory proper (retrieved online from http://www.sonoma.edu/users/d/daniels/objectrelations.html). Clearly, with Dr. Fisher’s neurobiological legacy and attachment clinical trauma work, the awareness for the need to survive and to feel safe, examines the same outstanding contributions of Melanie Klein. It was Klein who noted the infant experiences as the “death instinct” or fear of annihilation (retrieved online from http://www.sonoma.edu/users/d/daniels/objectrelations.html). As stated above, Dr. Richard Schwartz recognized the same instincts for survival but added the striving for the higher self (Fisher, Webinar April 2011).
According to Dr. Fisher (Webinar April 2011) IFS recognizes the adaptation a child embarks on as parts that are exiled, isolated, or perhaps protected by other parts to be socially acceptable behaviors. The latter defines IFS concept of defenses. The Neurobiological Legacy of Trauma April webinar (2011), also defined transformation as inner healing, the compassionate connection between parts and self that is immersed in safety, trust and let go of the past. The latter literally fosters the safety to express all of our parts and shows the same ontological organization within Sensorimotor Psychotherapy with that of IFS since it fosters mindfulness (Fisher, Webinar April 2011).
Dr. Fisher (April, 2011) in the Neurobiological Legacy of Trauma identifies the transformational aspect of humanity to undergo treatment so as to cultivate self-energy. Noting the dissociative patterns of shifting of states, that is blending, shifting and switching, Dr. Fisher reports that blending is an obstacle to discern from “me” from “part” (Webinar April 2011). With patients that shift states observes how the adult can shift into a sad or panic child but is aware of doing both states. Reporting that dissociative patients get “hijacked” by becoming the part and have no awareness of the actions or behaviors, Dr. Fisher, notes that feelings are also not made aware of by the patient (Webinar April 2011). Critical to treatment is the awareness that the frontal lobe cannot witness and the Self that is in charge of inner community –the various parts- cannot attempt to regulate or cultivate mindfulness (Webinar April, 2011).
Research shows that mindfulness and sensorimotor psychotherapies and Advanced Neurobiological Legacy of Trauma September 2010 (Fisher, 2010) states the witnessing Self is the going on with normal life. Siegel (1999) has provided compelling literature and studies for adaptation towards mindfulness and neuroplasticity along with interpersonal regulation (p. 107). Fisher (April Webinar 2011), mindfulness based treatments are most appropriate for trauma since the frontal lobes are severed and limbic system goes awry with trauma. Applications of these modalities are attempts to spark curiosity, interest and courage in the lives of those traumatized.
As with IFS, Dr. Fisher’s treatment of trauma is about allowing space or to make more room for the Self without judging pathology (Webinar April 2011). Yet, more importantly, Dr. Schwartz’s IFS is based on his premise that mindfulness is never erased despite traumatic events and periods (Webinar April 2011).The psycho-educational piece to Fisher’s trauma treatment is about providing the information and teaching to procure for the patient adaptive skills (Webinar April 2011). Noticing the brain in sessions at a simple level deals with the inner conflict among the various parts which Fisher relates as leading to a frontal lobe shutdown (Webinar April 2011). Fisher’s work is more so about noticing not narrating to calm down the parts embedded in the “irritable amygdala” (Webinar April 2011). The sensorimotor approaches to working with Dissociation are about regulating arousal and paying great attention to the neurological network connecting to the frontal lobes (Webinar April 2011). Additionally, Dr. Fisher’s treatment modalities hooks into curiosity and interest directing the holistic approach to integrate all the child parts into a safe adult body (Webinar April 2011). Art to physical activities are encouraged as a part of treatment since it is inclusive of the body.
South Slavic Bosnian war crimes survivors and war survivors, just as the neurobiological components and the body are neglected, the inherent gender issues arises in healing trauma modalities. Women’s bodies have long been under assault (Winkler, 2008). For instance, females especially mothers related extreme suffering and impact from conflict and natural disasters. Loving their bodies is difficult to practice in poverty, conflict, wars, natural disasters and the aftermath of catastrophic events. The body schema of the females and their response to stress hormones differing from males increases submissiveness, shame and martyrdom responses requiring a somatic healing approach such as sensorimotor psychotherapies. Shame to anger is triggered for females especially after rapes or domestic violence that instructs hatreds of their female bodies (Barstow, 2000, p. 57-62). The simplest items such as the ability to procure menstruation pads or diapers for children, let alone food stuff, are not available. The dissociative parts of the Self are exiled, isolated and turned in the classical South Slavic epitome of a martyr and /or self-sacrificing mother (Barstow, 2000, p. 84-92).
One of the frequent and almost universal statements Bosnian women war crimes and war survivors would comment on was how clean the ex-patriots and humanitarian force appear to be. Love and compassionate attunement cannot appear in their lives to heal the trauma such as to have the ability to let go of the past or to love themselves. Tracking their body schemas encounters primarily shallow breath with a bowed posture accompanied with the head bowed down requiring the eyes to look up under their brows. The Kolo trauma format approach at this point is more of a sensory re-education or conscious sensing, more identified with Elsa Gindler, Germany development of Sensory Awareness (SA) (Knaster, 1996, p. 226-228). In the same scenario of violence and war, SA developer Gindler had survived the bombing in WWII, taught Jewish students during the war, fed them at her own peril. SA was developed through her own life experiences into intensified somatic exercises.
Evolutionary Psychology research redresses gender bias which validates the sensorimotor and somatic psychological approaches to healing trauma. Anne Campbell (2002), Durham University Psychology, examined evolutionary theory to learn and research more on the development of the female mind. Understanding that mothers matter greatly in the rearing of children not just the birth and gestation, Campbell (2002), summarized Geary’s research, as “In a comprehensive review of paternal investment, Geary reports that in all cultures so far studied, mothers are more available to and engaged with their children than their fathers” (p. 44).
Campbell (2002) reminds us that an infant demands an extended period of maternal care and the evolution of the human brains acquiring unusual intelligence; the larger brains are a large expenditure of energy/calories (p. 39). The human brain is capable of storing massive amounts of information, “representational thought (the ability to perform safer off-line ‘thought; experiments rather than costly trail-and-error learning), consciousness (the ability to represent ourselves in our internal model of the world), language (and through this speedy cultural transmission, a theory of mind (the ability to accurately impute mental states to others and metacognition) the ability to reflect on what we know and how we know it (Campbell, 2002, p. 39-40). However, humanitarian policies or helping aid and governing agencies to clinical trauma treatment methodologies ignore the role of the mother and child special needs and how important the role of the mother plays in the development of the child, the future. Somatic psychological venues are an important portal towards inclusivity of body schemas with neuroscience partnership. Research and studies in the somatic psychology discipline and neuroscience procured insights opening new temporal modalities creating havoc with the current temporally bound logic that subsumes the perinatal and female body.
What becomes evident is how the sciences are compelled to flow into a single stream of consciousness. Since the sciences and most academic thought neutralizes gender or avoids the term by its entitled common reference ‘mankind’, a silencing of research and scientific studies have neglected to fully comprehend of how mothers are responsible for the totality of infant/child brain and higher self development. The female body exists as extreme fragmentation according to psychiatrist Clifford Scot, Gestalt therapist, who stated that the “body schema” was spilt, disorganized or disintegrated (Martin, 1987, p.76). These are the very issues IFS and Fisher’s neurobiological legacy of trauma cite in their patients. Dr. Fisher in the April Webinar 2011 succinctly derived that the founders of the methodologies are simply their projections. Using an amalgam of treatment modalities, Dr. Fisher (April Webinar 2011) reports that no system is perfect.
Alexandra Stiglmayer (1993), in her book Mass Rape: the War against Women in Bosnia-Herzegovina, identifies the same silence and assault on the female body as historically cloaked cruelty toward women (p. 66). Stiglmayer (1993) writes, “This silence, too, has a deep-seated cultural meaning and can in no way be attributed to coincidence, embarrassment, or the pain of the women in question” (p. 66). A grandmother from Novi Travnik, Bosnia at a 2005 kolo treatment and training gathering, realized how she had been complicit in teaching her children hatreds. Kolo trauma training for the grandmother provoked an exploration of Self experiences, Self States and how it impacts her vitality in old age (Fosha, 2000, p 147). Accelerated experimental-dynamic psychotherapy (AEDP) in the Kolo trauma training according to Diane Fosha is allowing the grandmother to embark towards “the mutative spontaneous moment the first step in restoration of his/her capacity to experience compassion, first for others and eventually for him[her] self” (Fosha, 2000, p. 145). A heightened example of the latter resulted in the grandmother reporting that her children are flung across the globe, a diaspora that has spilt and disintegrated the South Slavic intergenerational cultural way of life in raising children. Additionally, she referred to her own grandmother’s portrayal of WWII as lost and invisible. How much of silencing women’s experience of the Self to their bodies and child rearing in the sciences and research or what Stiglmayer (1993) states as the “subjectivity of women denied the ability to control perception itself” is yet, to be frankly included in clinical methodologies (Stiglmayer, 1993, p. 67).
Working with Same and Self-Loathing
Despite the work with processing memories and relationships work, shame complicates thing. Barrier – completion barrier, a pattern in sensorimotor therapies, can’t any further, no full resolution. Any glitches, in performance, triggered by any slight criticism, better read professional, etc. Trigger shame with self care, recognized, accomplishment, The relationship with trauma and shame. Herman describes the relationship humiliation, degraded and devaluation- shame is like anxiety operates the same way, autonomic nervous system. Like anxiety it is contagious. Neuro-biological purpose of functioning as a danger signal.
Anxiety is sympathetically-medicated, core belief with this system is all connected to safety. Shame para-sympathetic system, slow thinking, move slowly – flooded with shame and guilt.. conditioned response, non-responsiveness. Go into numbing, children disconnect. Sympathetic heart beats fast, do something… not helpless but with para-sympathetic system more shut down, wordless. Ability to collaborate, healthy pride in mutuality otherwise a legacy of shame and doubt leading to low self-worth.
Schore (2003) purpose of shame – most useful according to Fisher, in the 2nd year of life. The child needs inhibition response- not be in danger at that time traumatogenic environments. Shame is not to be over-used to down-regulate states of fear/anger or any behavior unacceptable in the environment.
What is shame doing hanging around- or not erased. Shame an animal response – of submission, a part of a survival response. It always feels personal; an embodied response accompanied by movement impulses, hiding the face, intensity of shame reaction.
Piaget stage of formal operations—cannot hold two concrete models- he is disgusting then I am disgusting instead of he is disgusting, not me. This underlies the disorganizaed attachment- child cannot organize responses to a parent who is the source of fear and then for safety.
Shame a belief system- intial shock and flooding of emotion- speech and thought inhibited. Afterwards we put language to shame, words will reflect sick to stomach, exposed, small belief systems – there is something wrong with me- or not loving. Day after day, becomes cognitive schemas, resulting in vulnerability to shame and self-hatred. Hearing words through a belief system, she heard shame triggers into responses with their cognitive schemas. What a shame, you is used a lot, the more she said that the more diminished she felt.
Meaning-making begins in the body, it is how it feels then what it is. Making meaning at the body level (kolo dancing). Reflect the body state- notice when you say you are worthless.. feel helplessness, do you feel heavier, chin want to lift..drop in energy. I’m stupid—feel angry with oneself. Body sensations over time are coupled with the body—I make a mistake, that word triggers the body responses. Over association – with the body, I believe it. Procedurally learned because shame is adaptive functioning. Sensorimotor, work on my shame, anger, can go you back to a time bring up an image, rather than talking about – take me to where the shame troubles you.. example- controlling husband tells her what to do, I feel angry and feel ashamed. Feelings a sensation of shame, unable to say I am not an employee- she regresses. Notice what happens if she sat up straight—took up this posture to your father- he would have beaten me and wipe that look off your face. In this posture what would have happened, it would not prevent me being hurt, but it diminished. Shame is a part of your story, you would have been in big trouble. Urinating in pants, fear and shame response—You are a hero. It is automatic, non-conscious, it is in her frontal lobe to say something but shame adaptation takes over.
Procedural learning is prior to declarative earning. Shame and hope – hope to improve lovability. Whenever I was happy beaten or too threatening for parents. Listen to clients cognitive schemas. Express opinions in an unsafe world. Belief that I am not lovable leads to da
Anderson, D. (2011). The Transformation from Holocaustic Intergenerational Trauma to Non-Killing Intergenerational Wisdom Springer Peace Psychology Series, In Press.
Barstow, A., L., (2000). War’s Dirty Secret: Rape, Prostitution and other Crimes against Women. Cleveland: the Pilgrim Press.
Campbell, A., (2002). A Mind of her Own: The evolutionary psychology of women. Oxford, London: Oxford University Press.
Danieli, Yael. “The Treatment and Prevention of Long-Term Effects and Intergenerational Transmission of Victimization: A Lesson from Holocaust Survivors and Their Children.” Trauma and Its Wake. Ed. C. R. Figley. New York: Brunner/Mazel, 1986. 295-313. Print
Ginot, E., (2007). Intersubjectivity and Neuroscience: Understanding Enactments and Their Therapeutic Significance Within Emerging Paradigms. Psychoanalytic Psychology, Volume 24, No. 2, 317-332.
Fosha, D., 2000. The Transforming Power of Affect. Basic Books.
Fisher, J., 2000. Paper presented at the International Society for the Study of Dissociation, November, 13, 2000, San Antonio, Texas
Fisher, J., 2001. Paper presented at the Boston University Medical School Psychological Trauma Conference, May 2001.
Fisher, J., 2003. Paper presented at the Annual Conference, American Mental Health Counselors July 2003
Fisher,, J., 2005. “Dissociative Phenomena in the Everyday Life,” NASW Home-Study Program.
Fisher, J., 2011. Advanced Webinar Program working with the Neurobiological Legacy of Trauma: Trauma and the Body.” 09/2010 to 06/2011.
Hubbs, J., (1993) Mother Russia: The Feminine Myth in Russian Culture. Bloomington and Indianapolis: Indiana University Press.
Knaster, M., 1996. Discovering the Body’s Wisdom. New York: Bantam Books.
Mertus. J., 2000. The Suitcase: Refugee Voices from Bosnia and Croatia. Berkley: University of California Press.
Ogden, P., Minton, K., 2000. Sensorimotor Psychotherapy: One Method for Processing Traumatic Memory. Hakomi Somatics Institute and Naropa University, Boulder Colorado Traumatology, Volume VI, Issue 3, Article 3 (October, 2000).
Ogden, P., Pain, C., Minton, K., Fischer, J., 2005. Including the Body in Mainstream Psychotherapy for Traumatized Individuals. Psychoanalytic Research Volume Fall 2000.
Ogden, P., Fischer, J., 2009. Treating Complex Traumatic Stress Disorders: An Evidence –Based Guide. Chapter 14 Sensorimotor Psychotherapy. New York: The Guildford Press.
Jackson, J.H., 1958. Evolution and dissolution of the nervous system. In Selected Writing of John Hughlings, J.J. Taylor, Ed., 45-118. Stapes Press. London.
Maclean, P.D., (1985). Brain evolution relating to family, play and the separation of call. Archives of General Psychiatry, 42. 405-417.
McDaniel, G.,L., The Glagolitic Alphabet and its Use in Croatian Church Records, FEEHS journal Volume XII, p. 30-37.
Sachs, O., (2007). Musicophilia: Tales of Music and the Brain. New York: Alfred A. Knoff, Inc.
Schore, A.N., (1994). Affect regulation and the origin of the self. Mahweh New Jersey: Erlbaum.
Schore, A.N., (2003a). Affect dysregulation and disorders of the self. New York: W.W. Norton & Co.
Schore, A.N., (2003b). Affect dysregulation and disorders of the self. New York: W.W. Norton & Co.
Schore, A. N., (2006). Notes from Allan Schore’s Groups in Developmental Affective Neuroscience and Clinical Practice. Psychologist Psychoanalyst, 2006, XXVI, No. 2, 13-21.
Schulz, M.L., (1998). Awakening Intuition: Using your mind-body network for insight and healing. New York: Three Rivers Press.
Schulz, M. L. (2005). The New Feminine Brain: How Women Can Develop their Inner Strengths, Genius, and Intuition. New York: Free Press.
Schwartz, R., 2010. http://www.selfleadership.org/about-internal-family-systems.html
Siegel, D., J.s, (2010). Mindsight: The New Science of Personal Transformation. New York: Bantam Books Trade Paperbacks.
Stiglmayer, A., (1993). Mass Rape: The War against Women in Bosnia-Herzegovina. Lincoln and London: University of Nebraska Press.
Winkler, Theodor. “Violence Against Women in Armed Conflict.” Due Diligence and Its Application to Protect Women from Violence. Ed. Carin Benninger-Budel. Leiden, The Netherlands: Brill, 2008. 265-72. Print.
Van der hart, O., Nijenhuis, E.R.S., & Stelle, K. (2006). The haunted self: structural dissociation and the treatment of chronic traumatization. New York: W.W. Norton.
Van Der Kolk, B., Annuals of New York Academy Sciences, 26 JUL 2006 DOI: 10.1196/annals.1364.022, Volume 1071 Psychobiology of Posttraumatic Stress Disorder: a Decade of Progress, pp. 277-293.
Van Der Kolk, B., Fisler, R., (1995). The psychological processing of traumatic memories: Review and experimental confirmation. Journal of Traumatic Stress, 8, 505-525.
Zeigler, B., 2011. US News & World Report, News Special Edition, Volume 2, 2011.