Razão 1: Por que todo psicólogo ou terapeuta precisa compreender sobre trauma?

[00:00:01]Hi, Mom.

[00:00:02]Good afternoon. Hey my love. Give a kiss.

[00:00:06]Mom is going to give a lesson now. I'll be there in a little while. It 's OK. And can I stay a little while longer?

[00:00:18][laughs] Good afternoon, everyone. With a special guest appearance and everything. We're here for another open class, kicking off our mini-series of lessons. A very special week, a new miniseries of lessons, the last miniseries of lessons this year on this topic.

[00:00:37]So, take advantage of this opportunity, there will be no repeat performance, three reasons to work with trauma.

[00:00:43]Three fundamental points to help you understand the importance of this topic in our lives, in the care process, in self-knowledge, and in mental health.

[00:00:58]In terms of emotional health care, everything that encompasses that area, right? Mental health, emotional health, self-knowledge, human development, and how trauma underlies much of what we witness as suffering, as a symptom, which is what we're going to talk about. So, we're bringing you this miniseries with three lessons, covering three themes that we consider essential for understanding the topic of trauma, especially for professionals, segmenting and separating them into three main areas. So, today we're going to talk about reason number one with this topic, because every psychologist and therapist needs to understand trauma specifically, right? We often say, "Wow, but you're a psychologist, you're a therapist, it 's inherent." Not necessarily, right?

[00:01:56]We don't see a specific focus on trauma in training programs, neither in academic training, which is more general, nor in various other training programs and specializations; there is no emphasis on working with trauma. And trauma is a topic that has been growing, let me, let me get this out of the way, it's been growing, and understanding of it has been developing over time, a very relevant perspective at the moment.

[00:02:26]Therefore, examining this topic with a contemporary lens, with a deeper and more specific understanding, is a necessity. We're going to talk about that today. This is the topic of today's lesson, lesson 426, meaning there are already more than 400 open lessons available for you on this channel. Take advantage of this opportunity, because changes are coming; the winds of change are blowing this way. So, take advantage of it while it's available here as an open lesson.

[00:03:03]On Wednesday we'll move on to the second reason, the second foundation, with a very special guest appearance by Liana Neto. We will also be welcoming Liana Neto to this open class at 5:30 PM. So, notice that there is this time difference. We usually have class on Wednesdays at 4 PM, but we'll be doing it at 5:30 PM.

[00:03:25]And the topic of this class, which is a really great class, this class that we give is a class for undergraduate, postgraduate, and specialization courses, is about how trauma underlies mental and psychosomatic illnesses.

[00:03:41]Let's talk about psychoneuroendocrine immunology. Let's talk about trauma in physiology, in the body, its impact and its relationship to expression in the mental and psychological realms. This mind-body connection has been fractured throughout history.

[00:03:58]How can we understand trauma in this bodily function, in our functioning, in its various forms of expression? And we'll wrap up on Friday, a special day, June 12th, a romantic day, Valentine's Day. I'll be here seeing only the strong men and women who will be studying with me the topic of how trauma affects psychologists and therapists in life and in the clinic, the impacts, the intertwining experiences, and we'll also talk about vicarious traumatization, when the therapist or psychologist or professional who is in charge of caring for traumatized people can become traumatized by this careless exposure. So there's a name for this phenomenon. Vicarious traumatization can also include compassion fatigue. There are many things that aren't said, spoken about, or taught, and we need to put them into words so we can better take care of ourselves, better prepare ourselves, and perform our duties with health, joy, fulfillment, well-being, with everything that's possible to experience in this role, right?

[00:05:06]So, those are the three topics, write them down, stay tuned, stay tuned. For everything we're going to cover this week, this lesson deserves a like. Now let's let go of that little finger. Like, like, like, like, like, like, like, like. Comment and share, right? Everything you do for the channel— subscribing, turning on notifications— helps us keep this channel open and continue our commitment to knowledge, bringing you open, complete, and unrestricted lessons.

[00:05:41]So, subscribe, turn on notifications, like, comment, and share. All of this really makes a difference for this channel to exist, right? Great, everything's noted down for you.

[00:05:55]All of these lessons will be fundamental from today onwards, both for your learning, right, of these fundamentals that I will cover in each lesson with you.

[00:06:06]And this miniseries will also be a great help if you decide to participate in our workshop next Wednesday, June 17th, at 8 PM live. Yes, the transmission is via an exclusive link, Liana Neto and I, an evening to learn about psychotraumatology.

[00:06:29]That evening we will present this field of study, this integrative view of working with trauma, and we will also present the training path within psychotraumatology. So, if you are interested in this topic, if you want to learn about this field of study, if you want to learn about psychotraumatology, if you want to participate in this workshop, unlike the open classes, you need to register. There is no cost to participate, however, in order for you to receive the link to this class, this workshop, this exclusive link, you need to register so that we can send it to you and be with those who have chosen and are interested in this study, this field of study which is psychotraumatology, on the evening of June 17th. So, it's a very well-directed, well- guided workshop, and it depends on your choice of participation. Unlike open classes, you need to register.

[00:07:28]Ah, the link to register and guarantee your participation on the 17th is in the comments for you. And if you're watching this class outside of the live stream, it's below our video in the description and also on our Instagram @cilia.laurianoficial.

[00:07:48]Right? Notify us of the data. Let's go to our class. Remember that I divide the class into two parts. Initially, I focus on delivering what I've prepared, presenting the content, and being able to give a focused, high- quality, and engaging presentation. So, I don't check the chat at that time. And then, at a later time, I'll open it up for our interaction, and then I'll look at the chat so you can ask your question, your doubt, your comment, we're really in the mood, right? Having this opportunity that only live classes provide, unlike recorded classes. So, take advantage of this second phase and write down the entire schedule at the end. There's class on Wednesday, there's class on Friday, there's a workshop. Next week, Wednesday the 17th, all of this will be available here for you, okay? Let's go. Paper and pen in hand, the power of paper and pen in hand, or any other form of note-taking you prefer, so that we can focus all our attention on this lesson. Let's leave the chat aside. Write down whatever you want from this lesson, record it, and then you can use it during our interaction. Why do we raise this flag? Because we advocate that all professionals—and we bring here psychologists with qualifications, psychiatrists, psychoanalysts, Jungian analysts, in short, various ways of looking at this work with trauma— Social workers, professionals who work in conflict areas, who are at the forefront of dealing with ongoing trauma, right, happening, because the importance of this immersion in trauma from a deeper, more specialized, direct perspective, and not just an idea within a process, right, within various other areas of knowledge.

[00:09:55]Well, in order for us to draw attention to this, we need to recognize that we are in a moment where the very act of reading, the very way of recognizing this phenomenon of trauma and traumatization, is gaining a lot of space, a lot of spotlight, a lot of attention. And as a consequence of this movement, new formulations and new understandings emerge regarding how traumatization occurs and what effects it leaves on us. What are the impacts that going through traumatic experiences leave on us? What does it mean to experience trauma, and what does it mean to be traumatized?

[00:10:49]And even answering these questions, or rather, the answer to these questions, has been changing over time, as we are exposed to multidisciplinary thinking, especially with the advances in neuroscience, neurobiology, and the understanding of how the brain works in the last 30 to 40 years. In order to deepen our understanding of the functioning of the nervous system, all this imaging technology, the relationship of the hypothalamic-pituitary-adrenal axis in relation to the immune system.

[00:11:38]Well, all this multidisciplinary dialogue has broadened our understanding of phenomena that were previously treated in very separate ways. What is psychological is not physiological. Ah, that's all in your head.

[00:11:54]Or those presentations on the body itself. A person has a pain, has an issue, they undergo a lot of tests, and nothing specific is found to justify the onset of that pain, that issue. Then he says: "That's stress, that's all in your head.

[00:12:15]Well, having this very important separation, right, of these two dimensions of the human being, and today, having the conditions to see through these advances, these new instruments, this multidisciplinary understanding, that it's not as separate as it once was thought, right? It's no longer possible to talk about psychological trauma. A person has psychological trauma. There is no psychological that isn't also physiological, right? And it's an intrinsic relationship, an integrated relationship. But of course, for a long time, throughout history, these two things were very separated to the point that we had this nomenclature for trauma being of psychological presentation.

[00:13:11]Or, as was used until quite recently, psychosomatic, right? So, a presentation of an illness with a more physical expression, whether it's a migraine, irritable bowel syndrome, fibromyalgia, uh, in short, a diverse illness, diabetes, high blood pressure, whatever it may be, and then to say: "Ah, that's psychosomatic, right?"

[00:13:40]The term psychosomatic is no longer used, because what is soma is psyche. What is psyche is soma, right? So we've been making progress in this understanding and in the specific studies of trauma, which saw a great advance, a great boom, from the 70s onwards, mainly with studies on the presentation of the disorder and then the development of a nomenclature for post-traumatic stress disorder, the famous PTSD, right?

[00:14:22]Posttraumatic order, which you, who likes those police and investigation series, must have seen them talking about at some point, right? How many times does a police officer involved in an investigation develop PTSD, and Is it the same one mentioned? PTSD, post-traumatic stress disorder.

[00:14:48]So, there was a big boom in that phase with the study of war veterans, of war combatants who returned and presented this disorder, this expression of the pain of having gone through a war, and in very different ways, some fitting very well into this description of the phenomenon of post-traumatic stress disorder. attic and others with other presentations or low presentations. So, in the beginning, when these people returned and presented with PTSD, post-traumatic stress disorder, right, as it was described as a nozological category in the DSM, trauma came to be understood as this presentation of being traumatized.

[00:15:50]I have trauma, right? The idea was that a person could be traumatized because they had gone through an experience that exceeded their processing capacity, an unusual experience, an extraordinary experience, that placed the person in extreme suffering and contact with terror, with fear, in a threatening situation. life. So, the person goes through such a terrifying, frightening situation, a life-threatening situation, that experiencing that situation would be a trauma in itself, and the person would then develop trauma, also using the idea of becoming traumatized.

[00:16:40]So, that's the first big idea about trauma, right? The first description of this. But if we stop and look at it and this happened, it's not me saying this, it's the development of the nomenclature over time, the change in description from DSM3 to DSM5, for example, which shows that not only these terrifying, frightening circumstances can leave trauma or traumatization as a consequence. So, why trauma or traumatization? So, first of all, we're going to talk a lot about this.

[00:17:21]We're going to repeat this information several times. So, I'm going to talk today, I'm going to talk Wednesday, I'm going to talk Friday, and I'm going to talk tonight to learn about psychotraumatology, because if we don't start with this understanding, everything else will become very confusing, because we need to update our understanding, right? So, this understanding that trauma is an experience outside the human condition, very terrifying, tragic, placed trauma as an event, right, as a specific circumstance, that those who went through it have trauma, those who did n't don't have trauma, and other life experiences that can leave marks didn't really fit into this lens, into this definition.

[00:18:05]So, what we need to differentiate from that understanding now is the trauma of this order, of this nature of event, even if it is terrifying, even if it is something, you know, a person went through a war, went through a kidnapping, went through rape, through interpersonal violence, went through torture, the chances of them being traumatized are high, because it really is a very impactful event.

[00:18:35]for the person to absorb. But even under those circumstances, having gone through such experiences, there were people who were left deeply traumatized, even developing post-traumatic stress disorder.

[00:18:49]There were people who were only slightly traumatized, and people who weren't necessarily traumatized, although they experienced some impact from it, but often showed such a change in behavior, an increase in their resilience, in their sense of purpose in life. They developed new skills, including post-traumatic growth, which made it possible to realize that these traumas of this nature—shocking, impactful, terrifying, outside the usual human experience, as initially described— were not the only factor that determined the effect of having lived through these experiences.

[00:19:33]So, a distinction begins to be made between trauma and events. I went through trauma, I went through a kidnapping, I went through a war, I went through violence, you know? I was abused. And the trauma effect, which is what remained with me as an impact, as a record, as a consequence of having gone through these experiences.

[00:19:58]And the way that psychotraumatology helps us understand, then, making this distinction in the word trauma, trauma as an event from trauma as an effect, is to talk about trauma and traumatization, right? So trauma is the event, the person went through the war.

[00:20:15]Traumatization refers to the lasting impact on a person as a result of having experienced war.

[00:20:22]And this understanding, that is, this difference in the effects for each individual who went through this... I fell for that, didn't I? Everything here has disappeared for me. I'm back for you. For me, everything went black. I went back. I fell, oh. Little cable. No, I crashed.

[00:21:19]It was a tom-tom. Such a terrible fall.

[00:21:22]Tombom. How do you speak? Big fall.

[00:21:24]A big fall. A tumble. So, so good.

[00:21:28]I've never said "fall" while actively participating; it must feel so good. So, where was I? Uh, I was talking about understanding this difference, uh, between these events, having gone through the event and the result, the consequence, the effect of the event, right? Very good. So, from this understanding, we begin to see that this original definition of trauma, this event outside the extraordinary, the ordinary, right, an extraordinary tragic event, was not sufficient to determine whether the person was traumatized and whether this traumatization would have an outcome such as post-traumatic stress disorder, so good.

[00:22:20]Look, Erica already helped me a little here by giving me some answers. So good. Yeah, that would help. Let me leave the chat, otherwise I'll get distracted. I will keep my promise to focus here.

[00:22:29]Come back here. Bye, chat. Well, the effects of trauma can be different for each person, each individual processes that event differently, right? So, we see people who become very traumatized, people who become somewhat traumatized, and people who don't become traumatized at all. Then, one begins to realize that the event alone is not sufficient to determine the effect. There's the personal factor, and there's how that person processes the event, right?

[00:23:10]And then there's another group of experiences that also begins to recognize itself. There are people who don't, if you take that list, right? So there was a list in the second version of DCM, there was a list, the list grew, it wasn't so restricted to war trauma, a trauma of that order, oh my God, the imponderable, the unthinkable.

[00:23:33]The list of events that a person may have gone through increases, but still within that idea, right, of what is very significant: great losses, accidents, abuse, and everything you can imagine that is most challenging in life. And again, this understanding. Even so, there are people who go through these experiences, do not suffer trauma, and do not develop post-traumatic stress disorder.

[00:24:03]And what's worse, there are people who haven't gone through this type of experience. If you look at her biography, she hasn't been through a war, she hasn't been kidnapped, she hasn't been raped, she hasn't been in an accident, she hasn't been through these immense things, but she has presentations of post-traumatic stress. So, that's how it is, right? So how are we going to define this whole trauma thing if the event alone doesn't explain its effect?

[00:24:33]Does the event alone not determine its effect?

[00:24:39]And so we evolve and understand that the trauma that impacts us, the various experiences that impact our functioning, are not limited to those extraordinary, immense, and tragic traumas, but to continuous chronic experiences that place the individual and the organism under continuous pressure, in a state of continuous alert, in a state of continuous defense, fight, and flight. Remember that fight or flight isn't just about fighting, it's about survival responses, right? Fight, flight, disconnection, dissociation. It's not just about literally fighting with our arms or running away.

[00:25:31]We fight for our positions, we fight for our ideas, we run away when we're here, but when we're not, we withdraw. So it is a spectrum of presentation of our survival responses. So, this drive to keep fighting despite life's circumstances, let's take an example. A person who literally had to fight a lion to survive. She only fought with lions, and she thinks she didn't manage to survive. But let's imagine she's in a situation where the animal ran away from the safari, she had to run, she climbed up, she went, she managed to escape alive from a lion chase. What did this person's body experience? She experienced a high level of nervous activation, an increase, you know, in her nervous activation, including enabling her to have a sufficiently quick, sufficiently competent, strong escape from that life-threatening situation. So, her body reached a physiological state unlike anything seen before, a state she wouldn't reach under natural, ordinary conditions in life, right? this level of activation. So, this extreme situation, that is, when she goes beyond her window of tolerance, of nervous activation, to deal with this unexpected situation, with this inescapable attack, is something that can happen. So, her body will need time to release the amount of strain it generated to deal with this inescapable attack, to process and reorganize its functions, which it had to move from the ordinary to the common to deal with an extraordinary situation. And if this processing and restoration of function is successful, even after going through such a significant ordeal, the person will not necessarily be traumatized.

[00:27:40]Then she accesses an unusual activation, she experiences terror, panic, an immense threat to her life. She can survive and get out of the situation, and she can switch off those functions, return to a state of safety, so she won't necessarily be traumatized. She may be scared and impacted for a while, but if she allows her body the time and conditions to process this experience, she won't necessarily be traumatized. Alright, let's save this image of the lion. A person who grows up in a home where there is a recurring threat to their integrity, their existence, their sense of security, where they suffer violence, where they witness violence, and they constantly need to activate these fight, flight, or dissociation functions, so that their body cannot return to a state of safety, becomes chronically stressed.

[00:28:48]Chronically activated, metaphorically, it's as if she were living with the lion and the lion keeps escaping from the room and she constantly has to run away, disconnect, dissociate. So, her physiology, her body, is crystallizing this state of alert, this altered state, which is not the state in which it necessarily needs to be functioning. And this person will experience the impacts of this process on them.

[00:29:20]It's going to have aftermath, right? It's going to have ways of functioning. because it is in this chronically activated state.

[00:29:31]But when you ask that person when they started feeling that way, they can't pinpoint a timeline before and after. She can't say, it was the day I ran from the Lion, like in the episodic event I brought up as an example of the Lion, after that I was never able to deactivate it again, I was never able to feel safe again. No, that information becomes diffuse and pervasive throughout its history.

[00:29:59]So this person, they're not going to fit on that list, right? She's not going to say, "I have such and such trauma." She will be in a heightened state of alert, she will be functioning in a traumatized way.

[00:30:11]And these understandings are now beginning to include stress, chronicity, adverse childhood experiences, structural traumas—all of which lead to this extreme state of chronic stress. And that's why we're going to talk a lot about this in Wednesday's class, how trauma is at the root of mental and psychosomatic illness, or, using a more modern term, psychoneuroendocrinoimmunology, explaining a little more about how this affects the nervous system, the HPA axis, and the immune system. We'll go into more detail about that in the second class, but here I'm already sowing the seeds, preparing things so that all of this will become clearer.

[00:31:07]This more up-to-date understanding will say: "Hey, trauma isn't just that list of the Hunger Games of life, but anything that causes the organism to become fixated, blocked, continuously defending itself, even when it's not in a situation where it needs to be defending itself." And then you'll hear current events used as triggers, right? Emotional triggers, uh, reaction. The person is overreacting today to a circumstance that doesn't fit the situation. So, a person who has this chronic state of alertness, sometimes is in a situation, in a meeting, in an interaction with someone, and due to the way they are approached, they end up having a disproportionate reaction that seems out of sync with what they are experiencing now, but which is very, very, very familiar to them in terms of how they function, how they feel in their own body, in their own way of functioning.

[00:32:14]right? So, this advancement in understanding, these new nomenclatures, and here we can cite authors like Gaborat, who says: "Trauma is not what happened to you, it's what happened inside you because of what happened to you." So, the effects that remain from having gone through certain experiences will also encompass a greater number of experiences than the initial definitions. Stephen Porges, in speaking about polyvagal theory, provides a deeper understanding of our nervous system and these activation and discharge curves, and how the sense of security needs to be restored to emerge from a traumatized state.

[00:33:09]Well, we're going to have Daniel Sigel introducing the concept of a tolerance window, which is the range of data that can be processed. And when we start to go beyond that range and also understand how this has been developing since childhood, from our relationships with our caregivers, then it engages a lot with the idea of ​​adverse experiences in childhood. And then we'll have Alan Shore, a neuropsychiatrist, discussing the impacts on development with an in-depth conversation about attachment theory and psychoanalysis. We're going to have Bruce Limpton bringing Paul Gilbert bringing the three, the three, the three functions, right? Threat, reward, calming system, bringing this neurobiological conversation to the table to say: "Hey, trauma is in life."

[00:34:06]And if we don't see this in our training, right, and it's natural that we haven't seen it, because again, these are new dialogues, this is multidisciplinary thinking. I mentioned neuroscientists and neuropsychiatrists here; there are several fields of knowledge coming together to answer what makes us emotionally and mentally ill, since mental illness cannot be understood from a biomedical perspective, something that you develop out of nowhere. It has a relationship with our experiences, with what came before, with the context; it's not just genetics, there's epigenetics.

[00:34:51]So, look at how many dimensions of dialogue we can have to better understand what makes us sick, right, throughout our history. Therefore, this is why the professionals who will be in charge of trauma care will be there when the person is already showing the effects of the trauma. Therefore, a person who carries the effects of traumatization may present with various outcomes. She may present with post-traumatic stress disorder, the well-known PTSD, as an outcome of the trauma, but perhaps she doesn't meet the diagnostic criteria for PTSD. She may have post-traumatic stress, she may have depression, she may have panic disorder, she may have other presentations and not just PTSD, which is a consequence of this history of trauma, which is a consequence of a spectrum of experiences that can be better understood through this lens of trauma than was understood until now.

[00:35:56]So, it's very important that the professionals who will be in charge of caring for the outcomes—that is, the person who comes seeking care— have access to this entire perspective, both for the development of multidisciplinary thinking and for the need for updating and understanding, right, everyone?

[00:36:19]Remember that in Wednesday's class I will go into more depth on this idea of ​​closure. Liana and I will be together to talk more about outcomes, about these forms of presentation, how all of this can have an impact, and we will also bring this up in the workshop on Wednesday the 17th, an evening to learn about psychotraumatology.

[00:36:41]Now I want to hear from you. The time has come for us to interact.

[00:36:47]Lete, will this class be recorded, Cecilia?

[00:36:50]Yes, it's recorded and available here on our channel. There's a playlist, there will be one, you can join the playlist, three reasons, uh, to learn. Or I work with trauma, to learn about trauma. And this playlist will have the first lesson today, and the other two will be added later.

[00:37:09]So you can watch it too, you can share it and then comment, it will be available here on the channel, okay? Very good.

[00:37:26]Ah, I came back to that. I came back quickly, huh?

[00:37:29]He disappeared and then came back.

[00:37:31]Very well, Elbert Cecília, could traumatization be the origin of borderline personality disorder?

[00:37:41]There is a profound relationship; you can look at studies on borderline personality disorder, and you will see a positive correlation between primary attachment relationships, significant traumas at that stage of development, especially in present relationships, in people who have developed borderline personality disorder. Now, we need to know how to differentiate between correlation and causality.

[00:38:16]Why do we need to know how to differentiate? Although there is a positive correlation, meaning that the vast majority, or almost all, of the people who develop this disorder have a history of significant attachment wounds, right? In other words, relational issues with primary caregivers or traumas during development cannot be stated as a direct causality, because that would imply that all people who have attachment wounds would necessarily develop bline personality disorder, but remember that there is what is the event and what is the effect?

[00:39:01]So, these adverse childhood experiences, these attachment relationships, these attachment wounds, these developmental issues are an important predictor, that is, they are within the spectrum of trauma, and have an important relationship with the development of personality disorders. But because we don't know exactly what causes one person to develop presentation A and another person who goes through similar experiences to develop a different presentation, we can't assert causality.

[00:39:34]So I can't say for sure that trauma is the cause of the development of personality disorders. I can't make that definitive statement, but what we can say for sure is that there is a very important correlation between trauma and the development of personality disorders. Is the difference between causality and correlation clear now?

[00:40:00]So yes, you can look at the studies, then go to PubMed, Google Scholar and search for what science has already discovered, do research on what is at the basis of development. So there will be genetic factors, there will be predispositions, and there will be the person's history, the history of the people studied, according to scientific studies, a very important relationship with early experiences.

[00:40:29]in the bonding process and adverse childhood experiences. Okay, Cris Cecília, attend to a person who ran over a motorcyclist, and the motorcyclist died.

[00:40:47]He developed anxiety and a fear of driving. So this is a characteristic of a trauma that falls more into the first classification, which is episodic trauma, shock trauma. In other words, there is an event, a temporal marker in the person's history that has since affected their functioning. So there's a good chance she developed the symptom as a result of the trauma. So, the trauma event, the accident, whatever happened, right?

[00:41:18]He ran him over, the motorcyclist came to the construction site, the full impact of that experience. The effect is that he may not have developed post-traumatic stress disorder, but anxiety and these other symptoms arise after this event. So, there is a correlation that can be observed and addressed, both in the processing of the trauma and in the possibilities that this processing will bring about in changing this pattern of anxiety and even this impediment to driving that arises as a direct consequence after the event, right? So this is a characteristic of shock trauma, episodic trauma, different from developmental trauma, which are experiences so chronic that they don't have this temporal marker of before and after. Okay, Sula? Cecilia, is there a difference between digital borderline personality disorder and borderline personality disorder?

[00:42:19]I don't know what a digital border is to answer that question, Sula. I only know borderline personality disorder, which is called borderline, right? But I don't know what a digital border is. Sorry.

[00:42:29]I think I'm either out of date or I don't know if it's within the descriptive manual of mental health, or something like that. Well, I really don't know him well enough to answer.

[00:42:43]What else?

[00:42:53]Lana, is it Lana or Iana?

[00:42:57]Lana, it's Lana. VGP. [snoring] I have a history of trauma due to, I think it's Lana, right? I'm not sure if it 's Lana or Iana. Well, I have a history of trauma. I think it's Iana.

[00:43:09]I have a history of trauma due to beatings from my father, who didn't know how to communicate. I developed the tag. GAD stands for generalized anxiety disorder, a constant state of alertness. So, the recurrence of inescapable attacks, like being beaten by the primary caregiver, is a type of trauma that we study within psychotraumatology, by category. So, we're going to look at this experience both through the lens of development, which has a greater impact, because the brain is still developing and not yet mature enough to respond to this event, integrate it, process it, defend itself, and do many other things that we are able to do in adulthood. We can't do it at the beginning of life, so the impacts are greater, right? I often say, if you take a hammer and hit a sprout that has just been born, and then take the same hammer and hit a tree, it's obvious that the hammer, which is the same, will do more damage to the sprout than to the tree, because the tree is better able to absorb impact than a sprout that has just been born, right? So there's this issue of development and the constant episodes, right, the constant events.

[00:44:29]And within that category are inescapable attacks, which is when I can't escape and then I get caught and then I can't fight back, I can't run away. These responses become interrupted, leaving dissociation as a survival response to cope.

[00:44:50]And the amount of contact with that experience, with that anxiety, that's when both the pain of what was lived through and the expectation of it happening again begin to generate this anxious internal state. So it makes perfect sense to present TAG as a consequence of these effects, right? So, trauma work will aim both at releasing this amount of activation and at supporting the body in restoring the sense of security that the events have ended and now I can feel safe, right? Because traumatization is an event that has ended, but the body continues to respond to the event, as if it were still under threat.

[00:45:36]So restoring a sense of security is one of the elements of this work that supports dealing with anxiety in a different way, right?

[00:45:51]Children who spend prolonged periods in front of screens may develop [relationship issues]. So, it's possible, right? Because it's difficult for us to make these correlations, right? Anything that generates paralysis, anything that generates... what kind of screen is this child exposed to, the disconnection from their loved ones, right?

[00:46:13]So, the screen is used as a way of saying, "Don't bother me, don't give me trouble, don't have anything to do with me."

[00:46:21]Well, all of this, the lack of connection with their caregivers is the big issue, right? It 's not the screen itself. Then the screen can make things worse because, depending on the information the child receives, the types of games, the violence involved. So there are several factors that can generate this presentation in borderline personality disorder, right, on the edge where I can't establish relationships or everything becomes very difficult, right? Emotions become very boundless, don't they? So all these elements come together, it's not the screen display itself, but where are the adults to look after this child, right? for the mammalian connection essential to development. So, it's a bit wider than the screen, right? The screen is one element of this story.

[00:47:18]Claudete, a person who has experienced many traumas, can become a special person. Oh dear, I didn't understand that one.

[00:47:29]A person who has experienced a lot of trauma and has become a special person can still emerge as such.

[00:47:36]I didn't understand, Claudete. Your question was quite confusing to me. I do n't know what that disease is, if I don't know, I really don't understand. If I can quickly rewrite this since we're almost at the end, I can reply.

[00:47:58]Iana asked: "Can trauma lead to schizophrenia, or is it directly genetic?" It has a genetic component. There is no such thing as a statement that schizophrenia is genetic; it does have a genetic component. A component means that everyone can have a component, but how will this develop? It will depend on other factors. Therefore, genetics alone is not enough to explain schizophrenia. There must be other factors related to life experience, environment, and development that will contribute to this genetic factor having a significant impact, right?

[00:48:43]Well, any presentation in healthcare, the answer is the same as the one I gave about borderline personality disorder.

[00:48:51]We cannot make a statement of causality.

[00:48:56]We can make a statement of correlation. There is a significant correlation with early trauma. You can, we'll talk about this in Wednesday's class, the exposure to fetal stress, in development, during gestation, that can have this correlation, right? People who have a history of schizophrenia may exhibit this.

[00:49:26]So, there is this correlation, but there is no causal correlation today. What causes what? What does that mean? It's the same as that. What is a causal relationship? You were exposed to the Covid virus, you develop COVID. So, what caused COVID? The virus. It's causal. The virus causes COVID. Full stop.

[00:49:49]What we're talking about are correlations, and the impacts of these experiences reveal important correlations, right?

[00:50:04]So, Leira and Laninha, a person who has autism may have suffered from impaired empathic ability.

[00:50:15]No, I read two together. A person with alexithymia may have suffered complex traumas. That would explain it. It can, it may have suffered in the question "can," the answer will necessarily be "can."

[00:50:29]What I can't say is that there's a correlation.

[00:50:33]It is possible for empathic capacity to be altered, for the sense of self to be completely changed. We 'll be talking about this a lot, Alê. Come to class on Friday when I talk about vicarious trauma and compassion fatigue, because I'll go into that right away. How easily can we lose connection by entering a process of traumatization, right? Very well, everyone. We are now coming to the end of this first lesson. We got off to a great start, didn't we? Beautiful thing.

[00:51:03]Big class. There will be three big classes. Please don't miss it. Share, comment, spread the word. We'll be back on Wednesday for the second class, where we'll be talking about how trauma underlies mental and psychosomatic illnesses, and we'll be joined by our diva, Liana Neto, for a fantastic lecture for you all to watch. And we'll wrap up on Friday with the third and final class on how trauma affects psychologists and therapists in life and in clinical practice – simply unmissable. The three classes will also be very helpful for those of you who want to participate in the evening to learn about psychotraumatology. The broadcast we'll be doing on the 17th at 8 PM, Liana Neto and I, will be a complete class on this field of study, psychotraumatology, giving you the opportunity to explore this path as well, okay?

[00:51:58]Big kiss and see you there. And for those who missed it, to wrap things up here, go to the channel, go to the playlist and watch the full lesson.