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Somatic Experiencing: Using Interoception and Proprioception as Core Elements of Trauma Therapy

Introduction

1. Somatic Experiencing is a form of exposure therapy.

A. True

B. False


2. Clear links have been found between compromised interoceptive function and all of the following psychiatric disorders, except for:

A. Obsessive compulsive disorder

B. Depression

C. Anxiety

D. Addiction


Definitions and Terminology

3. All of the following form the core response network, except for:

A. The limbic system

B. The emotional motor system

C. The somatic nervous system

D. The reticular arousal systems


4. Words are used in the process of SE therapy in order to point to and elicit:

A. Non-verbal experiences of internal bodily sensation.

B. Sense of position and orientation.

C. Sensations of movement.

D. All of the above.


5. Which of the following statements is true?

A. Conscious thought influences unconscious emotional processes.

B. Unconscious emotional processes influences conscious thought.

C. Conscious thought and unconscious emotional processes influence each other reciprocally.

D. None of the above.


6. Under normal circumstances the sympathetic and parasympathetic systems maintain a reciprocal relationship and return to baseline after disturbance, however, following even moderately intense disturbance, they can become “tuned,” chronically biased in one direction, and fail to return to baseline.

A. True

B. False


Discussion of these Concepts in Relation to the Case Study

7. During an emergency, which of the following is activated in response to immediate terror?

A. The emotional motor system

B. The limbic system

C. The reticular arousal systems

D. None of the above


8. Meditation and mindfulness practice have been shown to reduce activity in all of the following, except for:

A. The fronto-parietal network

B. The default mode network

C. The central executive network

D. All of the above have reduced activity


9. The “mindful” aspects of SE, the gentle encouragement of attention to affective and interoceptive experience, may shift the cortex from ventro-medially to dorso-medially controlled cortical networks and facilitate spontaneous self-regulation.

A. True

B. False


10. In SE, symptoms are seen as:

A. Resulting from a simple conditioning process.

B. Due to a disorganized complex dynamical system.

C. Both (A) and (B).

D. None of the above.


11. Conditioning theory states that, in the extinction process, a conditioned fear response is not actually eradicated but only suppressed by competing (positive) conditioned experiences.

A. True

B. False


12. Clinical experience in SE demonstrates a very robust change in fear responses which are remarkably resistant to re-evocation.

A. True

B. False


13. The CRN is:

A. Normally under the direct control of conscious volition.

B. Highly affected by rational thought processes.

C. Both (A) and (B).

D. None of the above.


The Sessions

14. In SE, “resourcing” is putting a person in touch with positive inner feelings of _____ so that they can begin to take the steps which can lead to stable restoration of balance.

A. Safety

B. Strength

C. Comfort

D. All of the above


15. It is suggested that which of the following serves as a complex and nuanced way of inhibiting excess sympathetic activation (“stress”) through engaging socially with others?

A. The sympathetic system

B. The dorsal vagal complex

C. The ventral vagal complex

D. All of the above


16. For the mental health professional, using the phrase “I imagine . . .” is important when describing observations of the patient’s inner state.

A. True

B. False


17. SE defines “pendulation” as:

A. The back and forth process between charge / activation and discharge / deactivation.

B. The process of reaching the extremes of activation and deactivation.

C. A significantly more relaxed and functional state, prepared to go deeper in the SE session.

D. All of the above.


18. The _____ feedback from intense muscular activity is the trigger for the reciprocal activation of the parasympathetic.

A. Interoceptive

B. Proprioceptive

C. Kinesthetic

D. All of the above


19. From an SE point of view, trembling or shivering is a sign of the system’s attempt to begin restoring normal function.

A. True

B. False


20. Affective and ANS activation have a direct and immediate effect on the somatic system by way of the limbic system.

A. True

B. False


21. When the survival response is _____, the preparation for the response may persist indefinitely unabated, resulting in continued sympathetic, and in extreme cases concurrent parasympathetic activation.

A. Incomplete

B. Ineffective

C. Prevented

D. Any of the above


22. The view of SE is that it is possible to facilitate the completion of the biological defensive response through interoceptive and proprioceptive awareness which involves:

A. Re-exposure to memory of the original trauma.

B. A suppression of the original trauma memories and feelings.

C. A reworking, on a felt subcortical level, which enables the person to have, for the first time, an experience of successful completion of the subcortical instinctive defensive response.

D. All of the above.


23. Which of the following is true with regard to procedural memory?

A. It is the memory of how to do things.

B. It is believed to be encoded in the hippocampus.

C. It is accessible via thoughts and images.

D. All of the above are true.


24. Which of the following is a key element of SE?

A. Embodied resource

B. Titration

C. Biological completion

D. All of the above


25. Vocalizations like “vooo,” as well as chanting or even song, help to shift the nervous system out of shutdown and then form a sympathetic-dominant to a parasympathetic-dominant state.

A. True

B. False


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