1 Finish this sentence: "we will also see that the imprints from the past can be transformed by having __ that directly contradict the helplessness, rage, and collapse that are part of trauma, and thereby regaining self-mastery." physical experiences psychoanalytic talk therapy sessions emotional experiences theater workshops 2 Which population did van der Kolk work with at the beginning of his career? troubled children teenagers suffering from depression sexual assault survivors combat veterans 3 What did van der Kolk and his colleagues determine about trauma through the use of Rorschach ink blot tests in the study on nightmares? Most people just see ink blots. Traumatized people have a tendency to superimpose their trauma on everything. Most people see whimsical images. Most people see ordinary images. 4 Define "superimpose." To make an unusual physical pose with one's body To layer two things so that the bottom layer becomes invisible To not allow two things to come together To place one thing over another, typically so that both are visible 5 What does van der Kolk recall being surprised by while working as an attendant on a research ward at the Massachusetts Mental Health Center? The patients and doctors largely ignored ward attendants. The patients always willingly shared about past traumatic experiences at any time of the day or night. He heard doctors empathetically discuss the plights of their patients. He never heard doctors discuss the patients' stories of abuse during care meetings. 6 Early in his career, what did van der Kolk eagerly embrace as the surefire way to conquer human misery? Psychopharmacology Talk Therapy Embodied Therapies Psychoanalysis 7 What opened van der Kolk's mind to the possibility of somatic therapy? A revelatory dream Clinical practice only Changing therapeutic guidelines and a widespread cultural shift in how trauma should be treated Apart from his clinical practice, learning about learned helplessness and how to resolve it in a presentation given by Steven Maier 8 What should the stress hormone system ideally do? Provide a lightning-fast response to threat, but then quickly return us to equilibrium Never change from initial priming Respond more to imagination than to reality Wait for the rational prefrontal cortex to pass judgement on a potential threat 9 What did innovative technologies like neuroimaging do for trauma research? Cause people to pass out in response to metacognition Prove that psychopharmacology is the pinnacle of treatment Map brain changes and validate treatment approaches Prove that talk therapy is the pinnacle of treatment 10 The study van der Kolk conducted at the VA started out as research about nightmares but ended up exploring how trauma changes people’s ___. experience of time relationships memory perceptions and imagination 11 Van der Kolk uses which word to describe how trauma is not just a past event, but an ongoing experience? Ghost Imprint Memory Superimpose 12 Which of the following did van der Kolk not notice in the patients while working as a recreation leader at MMHC? Their hallucinations were simply signs of how disturbed they were The patients' were strikingly clumsy and physically uncoordinated The patients often shared midnight confessions The patients' most relaxed conversations seemed stilted, lacking the natural flow of gestures and facial expressions that are typical among friends 13 Which reveals the power imbalance between doctors and patients? "I always felt sad at the end of these meetings, knowing that the treatments that would be administered the following morning would erase all memory of our conversation." "I was surprised and alarmed by the satisfaction I sometimes felt after I’d wrestled a patient to the floor so a nurse could give an injection" "the job of therapists is to help people 'acknowledge, experience, and bear' the reality of life—with all its pleasures and heartbreak" "Trauma is held in people’s bodies." 14 What core factor changes the way that medicine approaches human suffering? the doctor's mood empathy food and nutrition the technology available at any given time 15 What is the amygdala? a part of the brain that is involved in many higher-order cognitive processes such as decision making, reasoning, and personality expression, and social cognition a relay station of all incoming motor (movement) and sensory information a low part of the brain that controls vital functions such as breathing, heart rate, and blood pressure a cluster of brain cells that determines whether a sound, image, or body sensation is perceived as a threat 16 What else does van der Kolk write that pharmaceutical interventions do apart from provide a tool beyond talk therapy? Produce income and profits for pharmaceutical companies Solve trauma Provide community resources for patients Increase empathy 17 Why does van der Kolk ultimately state that the drug revolution in psychiatry did as much harm as good? They contribute to addiction. Pharmaceuticals have potentially harmful side effects and they do not address underlying issues. They are a root-cause solution. Van der Kolk is actually indifferent. 18 What value does van der Kolk convey when he says, "The brain-disease model takes control over people’s fate out of their own hands and puts doctors and insurance companies in charge of fixing their problems." Human agency Reaping profits Scientific recognition Control over his patients 19 What is Broca's area? a region of the brain concerned with speech production and language processing a part of the brain that is involved in many higher-order cognitive processes such as decision making, reasoning, personality expression, and social cognition a low part of the brain that controls vital functions such as breathing, heart rate, and blood pressure a cluster of brain cells that determines whether a sound, image, or body sensation is perceived as a threat 20 What happens to Broca's area in traumatized individuals? It becomes permanently damaged Trauma strengthens it over time Trauma can temporarily impair its function It becomes hyperactive 21 Which Shakespeare play does van der Kolk mention with regard to "speechless terror"? Romeo and Juliet A Midsummer Night's Dream Macbeth Hamlet 22 Which hormones are critical in the fight/flight response? Insulin, thyroid hormones Estrogen, testesterone, and progesterone Adrenaline, noradrenaline, and cortisol Growth hormone, melatonin 23 What does trauma do to a person's stress response? Cause them to always shut down in response to stress Prime them to handle stress better than other people. None Cause that person's hormones to take longer to return to baseline as well as spike quickly and disproportionately in response to mildly stressful stimuli 24 Which quote demonstrates why van der Kolk believes that talk therapy alone is ineffective? "We can also make a strong case that Marsha is hypersensitized to her memories of the past and that the best treatment would be some form of desensitization." "For a hundred years or more, every textbook of psychology and psychotherapy has advised that some method of talking about distressing feelings can resolve them." "the rational brain is basically impotent to talk the emotional brain out of its own reality." "I am continually impressed by how difficult it is for people who have gone through the unspeakable to convey the essence of their experience." 25 At the end of Part One, what harmful effect of trauma does van der Kolk describe? Trauma impairs relationships. Trauma lowers self-esteem. Some traumatized people cannot "be 'here'—fully alive in the present." Trauma can cause depersonlization.