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The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma

Chapter 4-Running For Your Life: The Anatomy of Survival

1. During disasters, young children usually take their cues from their parents, and as long as their caregivers remain calm and responsive to their needs, they often survive terrible incidents without serious psychological scars.

A. True

B. False


2. Unlike individuals who have an adaptive response to threat or disaster, traumatized people become stuck in their growth because:

A. They do not have the skills to face terrifying and confusing realities

B. Since basic human needs were never met, they do not know how to manage suffering

C. Their fight/flight response was never fully developed

D. They can’t integrate new experiences into their lives


The Brain from Bottom to Top

3. In order for the brain to ensure our survival, it must do each of the following EXCEPT:

A. Generate internal signals that register what our bodies need and develop a map of the world to point us where to go to satisfy these needs

B. Affirm that we can survive as individuals and be independent when necessary

C. Create the necessary energy and actions to get us to where we need to be

D. Warn us of any dangers and opportunities along the way, and help us adjust our actions based on the requirements of the moments


4. The rational, cognitive part of the brain is the oldest part and it occupies about 55% of the area inside the skull, making it especially difficult when trauma interferes with functioning in this area.

A. True

B. False


Mirroring Each Other: Interpersonal Neurobiology

5. The amygdala is considered the “seat of empathy,” and it enables individuals to pick up on the movements and emotional states of others, which is a crucial factor in safeguarding harmonious relationships.

A. True

B. False


Controlling the Stress Response: The Watchtower

6. Executive capacities of the prefrontal cortex enable people to observe what is going on, predict what will happen if they take a certain action, and:

A. Pick up danger clues

B. Plan and reflect

C. Make a conscious choice

D. Use language to communicate experiences


The Rider and the Horse

7. Neuroscience research shows that very few psychological problems are the results of defects in understanding, but rather originate in deeper regions in our brain that drive our:

A. Perception and attention

B. Desires and expectations

C. Motives and experiences

D. Beliefs and actions


Dissociation and Reliving

8. Dissociation is the essence of trauma in that the overwhelming experience is split off and fragmented so that the emotions, sounds, images, thoughts, and physical sensations related to trauma take on a life of their own.

A. True

B. False


Depersonalization: Split Off From the Self

9. One symptom of dissociation created by trauma is depersonalization, where the individual “blanks-out” and is not able to think, feel deeply, remember, or make sense of what is going on.

A. True

B. False


Learning to Live in the Present

10. Although many treatment approaches for traumatic stress focus on desensitizing patients to their past, the author believes that this is based on a misunderstanding of what happens in traumatic stress, and that it is important to help trauma survivors:

A. Bring back the brain structures that deserted them when they were overwhelmed

B. Live fully and securely in the present

C. Find satisfaction in everyday things like taking a walk, cooking a meal, or playing with their kids

D. All of the above


Chapter 5-Body-Brain Connections

11. According to Charles Darwin, behaviors that are used to avoid or escape from danger have clearly evolved to create competition in terms of survival, and prolonged escape or avoidance behavior is necessary to teach organisms how to restore themselves to safety and physical equilibrium.

A. True

B. False


The Neural Love Code

12. Researcher Stephen Porges introduced the Polyvagal Theory which helped look beyond the effects of fight or flight and put ________________ front and center in our understanding of trauma.  

A. Safety and reciprocity

B. Mental flexibility

C. Social relationships

D. Emotional stability


Three Levels of Safety

13. Trauma survivors tend to have an altered perception of risk and safety, and their ability to evaluate relative danger and safety in their own environment, which is known as “survivor radar,” is often faulty.

A. True

B. False


14. 14 Which of the following is NOT one of the reactions that will likely occur when our ultimate emergency system, the dorsal vagal complex (DVC), becomes activated?  

A. The gut stops working or empties

B. Sweat glands are activated and the voice becomes more strident

C. The individual cannot breathe

D. Heart rate plunges and metabolism throughout the body is reduced


How We Become Human

15. Immobilization, which is at the root of most traumas, causes zombielike reactions where victims lose touch with themselves and their surroundings, and may dissociate, faint, or collapse.

A. True

B. False


Defend or Relax

16. People with trauma histories often have a difficult time being able to discern when they are actually safe as well as being able to activate their defenses when in danger.

A. True

B. False


17. Although many of the methods used to treat trauma tend to focus on recruiting the cognitive capacities of the brain, they have a tendency to ignore the need to:

A. Engage the safety system of the brain before trying to promote new ways of thinking

B. Help survivors learn to experience stillness without fear

C. Create opportunities to participate in and embrace the present

D. Have experiences that restore and preserve balance


Chapter 6-Losing Your Body, Losing Yourself

18. The most common response to distress is to turn to internal regulation systems that balance feelings and emotions, a skill that is often absent with trauma survivors.

A. True

B. False


How Do We Know We’re Alive?

19. Brain scans of chronic PTSD patients with severe early-life trauma showed almost no activation of the self-sensing areas of the brain, which indicated a lack of capacity to feel fully alive.

A. True

B. False


The Self-Sensing System

20. In order to maintain inner equilibrium, people need to register and act on ________________ that keep the body safe.

A. Internal messages

B. Thoughts and emotions

C. Conscious and subtle body responses

D. Physical sensations


Owning Your Life

21. Experts have coined the term “containment” to describe the feeling of being in control of your life by knowing where you stand, knowing that you have a say in what happens to you, and knowing that you have some ability to shape your circumstances.

A. True

B. False


22. Even when unable to explain why one feels a particular way, gut feelings signal what is safe, threatening, or:

A. Certain

B. Distressing

C. Life sustaining

D. Essential


Alexithymia: No Words for Feelings

23. Alexithymia refers to the inability to be able to describe feelings and to identify what physical sensations mean, which results in substituting the language of action for that of emotion.

A. True

B. False


Befriending the Body

24. When people are asked to notice bodily sensations for the first time, they may experience distressing somatic reactions of the undigested trauma.

A. True

B. False


Connecting With Yourself, Connecting With Others

25. When studying reactions of chronically traumatized people making face-to-face contact, researchers found each of the following EXCEPT:

A. The subjects with PTSD did not activate any part of their hippocampus, which meant that they could not create any curiosity about the stranger coming toward them

B. They reacted with intense activation deep inside primitive areas of their emotional brains

C. There was no activation of any part of the brain involved in social engagement

D. In response to being looked at, PTSD subjects went into survival mode


Chapter 7-Getting on the Same Wavelength: Attachment and Attunement: A Secure Base

26. As individuals grow and mature, they learn to take care of themselves emotionally and physically, getting the first lessons of self-care from the way they were cared for.

A. True

B. False


27. Research has clearly established that feeling attached and having a safe haven instills a sense of sympathy and helpfulness to others in distress and promotes:

A. Self-desire

B. Self-actualization

C. Self-control

D. Self-reliance


The Dance of Attunement

28. Secure attachment develops when caregiving includes emotional attunement, which starts at the most subtle levels of interaction between babies and their caregivers and gives babies the feeling of being understood.

A. True

B. False


29. When positive attachment is combined with the cultivation of competency, an external locus of control is built and becomes the key factor in healthy coping throughout life.

A. True

B. False


Becoming Real

30. Donald Winnicott, who is known as the father of modern attunement, proposed that the way a mother looks at and speaks to her baby lays the groundwork for the infant’s sense of self, and contributes to the lifelong sense of identity.

A. True

B. False


Living with the Parents You Have

31. Children whose primary caregiver is unresponsive or rejecting learn to deal with their anxiety in two distinct ways, through:

A. Conflicted or fanatical attachment

B. Avoidant or ambivalent attachment

C. Extreme or superficial attachment

D. Apathetic or obsessive attachment


Becoming Terrorized Within

32. One study of attachment patterns in over two thousand infants from “normal” middleclass environments showed that children’s gender and basic temperament had a significant impact on attachment style.

A. True

B. False


33. Which of the following is NOT likely to be one of the possible causes of disorganized attachment according to the author?

A. Mental illness or substance abuse among parents

B. Parental abuse

C. Parents who are preoccupied with their own trauma and are emotionally unstable

D. Having a caregiver who has experienced the recent death of a loved one and is unable to provide comfort and protection


Dissociation: Knowing and Not Knowing

34. The quality of early caregiving is a critical element in preventing mental health problems, independent of other traumas.

A. True

B. False


Chapter 8-Trapped in Relationships: The Cost of Abuse and Neglect-Terror and Numbness

35. When professionals work with trauma survivors, it is not necessary to know every detail of the patient’s trauma, but rather more critical to help the individuals themselves learn to tolerate feeling what they feel and knowing what they know.

A. True

B. False


36. Research indicates that the immune systems of incest victims tend to be insensitive to threatening situations and therefore often fail to mount a defense when one is needed.

A. True

B. False


37. Incest victims generally have trouble distinguishing between danger and safety and often have:

A. A great desire to avoid change

B. The inability to trust their feelings

C. Distorted perceptions of outside information

D. Difficulty being assertive


A Torn Map of the World

38. In contrast to children who grow up in healthy, nurturing environments, those who were abused or neglected in childhood often have a sense of self that is marked by contempt and humiliation and may fail to protest if mistreated later in life.

A. True

B. False


39. Our maps of the world form the template for how we think about ourselves and the world around us, and they are encoded by our intellectual brains, so changing them means having to reorganize our cognitions and judgment.

A. True

B. False


Learning to Remember

40. Calming techniques that may help individuals who are remembering, recounting, and processing traumatic experiences include:

A. Focusing on breathing deeply while following the sensations of the breath within the body

B. Tapping acupressure points to decrease feelings of being overwhelmed

C. Mindfulness exercises such as learning to keep the mind alive while allowing the body to feel

D. All of the above


Replaying the Trauma

41. Traumatic experiences are often stored as detailed narratives with a beginning, middle, and end, which frequently lead to flashbacks that contain exhaustive elements of the experience, thus increasing terror and dread.

A. True

B. False


Chapter 9-What’s Love Got to Do With It

42. Each of the following is an accurate statement about psychiatric diagnoses EXCEPT:

A. A psychiatric diagnosis has serious consequences, including informing treatment whether or not the diagnosis is accurate

B. With greater awareness in the mental health community, a diagnostic label is no longer likely to attach itself indefinitely like it once did

C. Diagnostic labels do not take into account the creative energies and talents that patients develop to survive

D. Diagnoses are often mere tallies of symptoms, leaving patients unfairly judged


The Power of Diagnosis

43. Adults who have survived natural disasters often display the same symptoms as adult survivors of child abuse, including trouble concentrating, being on edge, feelings of self-loathing, and experiencing large memory gaps.

A. True

B. False


The Hidden Epidemic

44. When individuals have faced adverse childhood experiences (ACEs), the incidents seem to be interrelated, even though they’re usually discussed separately, and for each additional adverse experience, the toll in later damage increases.

A. True

B. False


45. Vincent Felitti, MD and his colleagues, who extensively studied ACEs, determined that as children mature they do not “outgrow” the effects of their harmful childhood experiences, but those events are often lost in time and concealed by shame, secrecy, and social taboo.

A. True

B. False


46. An increase in high risk behaviors and major health problems rise significantly for victims of adverse childhood struggles, including which of the following?

A. Those who experienced ACEs may have issues with smoking, obesity, unintended pregnancies, multiple sexual partners, and sexually transmitted diseases

B. As the number of ACEs increase, the likelihood of being a victim of violent crime escalates significantly

C. Those with high incidences of ACEs are approximately four times more likely to suffer from heart disease and cancer than those who have not had such experiences

D. None of the above


When Problems are Really Solutions

47. For victims of sexual abuse and childhood trauma, being overweight may serve as a form of self-protection and a temporary solution to their pain and discomfort, although it may create adverse health conditions.

A. True

B. False


Child Abuse: Our Nation’s Largest Public Health Problem

48. Although experts believe that working to negate the adverse effects of child abuse and trauma would significantly reduce health related and social consequences, childhood suffering is not given anywhere near the same attention in the medical and health fields as issues such as smoking, heart disease, cancer, obesity, and others.

A. True

B. False


Chapter 10-Developmental Trauma: The Hidden Epidemic

49. In order to help solve the problems of abused and traumatized children, professionals must move beyond trying to find a genetic link or a new medication to control them, but rather need to find ways to help them lead productive lives that contain positive human connections.

A. True

B. False


Bad Genes

50. For over thirty years, researchers have been searching for genetic patterns to explain mental illness, and although studies have clearly found a hereditary component with schizophrenia and certain traumatic stressors, the quest to find other genetic connections continues.

A. True

B. False


Monkeys Clarify the Old Question about Nature Versus Nurture

51. Numerous years of work by Stephen Suomi at the National Institute of Health’s Laboratory of Comparative Ethology has demonstrated that safe and protective early relationships are critical to protect children from long-term problems, and even parents with genetic vulnerabilities can pass on such protection to their children if they are given the proper support.

A. True

B. False


The Power of Diagnosis

52. Which of the following is NOT a correct statement about diagnosing PTSD in children?

A. Even when the traumatic event has passed, children may experience symptoms such as increased arousal, intrusive thoughts and feelings, and persistent and crippling avoidance

B. After a single traumatic event, even children who grow up in safe and supportive homes may develop basic PTSD symptoms similar to those of adults, but with a proper diagnosis they can be treated effectively

C. Troubled children with histories of abuse often do not talk about their experiences, even when asked, which makes PTSD diagnosis difficult

D. Because traumatized children are frequently shut down and are perceived as being uncooperative, they are often misdiagnosed with avoidant personality disorder or conduct disorder, and effective PTSD treatments such as medication and behavior modification are overlooked


53. Thousands of children who were studied through the National Child Traumatic Stress Network exhibited consistent profiles that included a pervasive pattern of dysregulation, problems with attention and concentration, rapid mood changes and:

A. Demonstration of regressive behavior

B. Difficulty getting along with themselves and others

C. Extreme anxiety, irritability, and sadness

D. Poor sleep and eating habits


How Relationships Shape Development

54. In an intensive study of nature versus nurture and temperament versus environment that continued for almost 30 years, Alan Sroufe and his colleagues discovered that by far the most important predictor of how well individuals coped with life’s inevitable disappointments was the level of security established with their primary caregiver within the first five years of life.

A. True

B. False


The Long-Term Effects of Incest

55. In contrast to nonabused girls, sexually abused females do not have friends of either gender because they can’t trust, they hate themselves, their biology is against them, and they tend to:

A. Choose unhealthy relationships that don’t last

B. Be socially inexperienced or incompetent

C. Overreact or numb out

D. Have numerous cognitive difficulties that inhibit relationships


56. Girls who have a history of incest tend to mature sexually a year and a half earlier than non-abused girls, which speeds up their biological clocks and their sex hormones, fueling sexual desire.

A. True

B. False


The DSM-5: A Veritable Smorgasbord of “Diagnosis”

57. Opponents of the reliability of the DSM-5 question its benefit because:

A. It overlooks the social causation of many diagnoses while focusing solely on biology

B. Of its inability to produce consistent, replicable results since it lacks scientific validity

C. Improper interpretation of the DSM-5 leads to misdiagnosis and mistreatment

D. All of the above


What Difference Would DTD Make

58. In addition to recognizing the profound effects of trauma and deprivation on child development, experts must understand that maintaining flexibility while helping to rewire faulty emotional regulation is a biological necessity and should be the backbone of all prevention and treatment.

A. True

B. False


Chapter 13-Healing From Trauma: Owning Your Self

59. The challenge of recovery from trauma is to reestablish ownership of the body and mind, which usually involves each of the following strategies EXCEPT:

A. Finding a way to be calm and focused and learning to maintain this calm in response to negative traumatic images

B. Understanding and coming to terms with distressing events that occurred in the past

C. Finding a way to be fully alive in the present and engaged with other people

D. Not having to keep secrets from oneself, including survival secrets


A New Focus for Recovery

60. Trauma survivors must revisit their trauma histories, as the emotions and physical sensations that were imprinted during the ordeal will continue to be experienced as thoughts and memories that must be addressed.

A. True

B. False


Limbic System Recovery

61. According to neuroscientists, the only way that individuals can consciously access the emotional brain is through self-awareness that comes through activating the part of the brain that notices what is going on inside and allows people to feel what they are feeling, which is known as:

A. Interoception

B. Self-examination

C. Reflection

D. Contemplation


Befriending the Emotional Brain-No Mind Without Mindfulness

62. Body awareness is essential because it can put trauma survivors in touch with their inner world so they notice their annoyance, nervousness, or anxiety and can shift perspective and open up new options other than automatic, habitual reactions.

A. True

B. False


63. Mindfulness has been shown to have a positive effect on numerous psychiatric, psychosomatic, and stress-related symptoms, including depression and chronic pain, and has broad effects on physical health and emotional regulation.

A. True

B. False


Relationships

64. Although human contact and attunement are the wellspring of physiological self-regulation, fear of getting hurt, betrayed, and abandoned is often evoked by:

A. The desire for friendship and intimacy

B. Forming new attachments

C. The promise of closeness

D. All of the above


Communal Rhythms and Synchrony

65. Trauma-Focused Cognitive Behavioral Therapy is an interactive therapy that helps traumatized parents and children focus on sensory integration and the experience of reciprocity so that they may learn to experience a sense of connection and joy.

A. True

B. False


Getting in Touch

66. Mainstream trauma treatment often fails to help terrified people safely experience their sensations and emotions, which can most naturally occur by encouraging individuals to be touched, hugged, and rocked.

A. True

B. False


Taking Action

67. When people are forced to submit to overwhelming power during abuse situations, they often survive with resigned compliance, and the best way to overcome ingrained patterns of submission is to restore the mental capacity and desire to fight back. 

A. True

B. False


Integrating Traumatic Memories

68. Although telling a trauma story does not guarantee that the traumatic memories will be laid to rest, it is still important because without stories, memories become frozen, and without memory it is impossible to:

A. Imagine how things can be different

B. Make sense of present circumstances

C. Deeply understand oneself

D. Find meaning in life experiences


Cognitive Behavioral Therapy (CBT)

69. CBT has proven to be particularly effective in treating those with histories of childhood abuse and PTSD by helping them replace terrifying memories with corrective feelings of safety.

A. True

B. False


Drugs to Safely Access Trauma

70. MDMA (ecstasy), used in pilot studies with PTSD sufferers and victims of assault, was shown to enable patients to stay within a window of tolerance so they could revisit their trauma memories without suffering overwhelming physiological and emotional arousal.

A. True

B. False


What About Medications

71. Each of the following is an accurate statement about medications used to treat traumatic stress EXCEPT:

A. Drugs cannot “cure” trauma, but can dampen the expressions of a disturbed physiology

B. Although medications can help control feelings and behavior, they also inhibit individuals by blocking the chemical systems that regulate engagement, motivation, pain, and pleasure

C. SSRIs target the autonomic nervous system and can help to decrease hyperarousal and reactivity to stress

D. Antipsychotic medications can significantly dampen the emotional brain and make patients less skittish or enraged, but may also interfere with being able to appreciate subtle signals of pleasure, danger, or satisfaction


Chapter 14-Language, Miracle, and Tyranny: The Unspeakable Truth

72. Although many therapists have an undying faith in the capacity of talk to resolve and release the burdens of trauma, traumatic events are often impossible to put into words.

A. True

B. False


Breaking the Silence

73. The ability to use language to name what happened during trauma opens up awareness and allows individuals to have their feelings and experiences recognized and to reestablish feelings of belonging.

A. True

B. False


Knowing Yourself or Telling Your Story? Our Dual Awareness System

74. While a person’s autobiographical self keeps track of connections and experiences across time based on physical sensations, moment-to-moment self-awareness is based on interpretations of language and communication.

A. True

B. False


The Body is the Bridge

75. Many people find it difficult to tell their trauma stories because they can’t put their feelings into words, so it may help to get past the need to describe what occurred, but rather to engage the body-based self system which speaks through sensations, body tensions, and:

A. Self-talk

B. Tone of voice

C. Energy levels

D. Unconscious reactions


Writing to Yourself

76. Writing about trauma may help survivors express their deepest thoughts and feelings, improve their mood, result in a more optimistic mood, and promote better physical health.

A. True

B. False


Art, Music, and Dance

77. Art, music, and dance therapies are used among various cultures throughout the world to help circumvent the speechlessness that comes with the terror that is associated with trauma.

A. True

B. False


The Limits of Language

78. Although it may be an enormous challenge to find safe places for trauma victims to express the pain of trauma, it is very important to encourage such expression as it will likely help to establish community and inspire acceptance.

A. True

B. False


Dealing with Reality

79. Irrational thoughts that occur as the residue of traumatic incidences need to be treated as “cognitive flashbacks” since they are as real as visual flashbacks and are reactivated under stressful conditions.

A. True

B. False


Chapter 15-Letting Go of the Past: EMDR-Learning About EMDR

80. Eye movement desensitization and reprocessing (EMDR) has been used successfully for years by professionals to help people revisit their traumatic past without being retraumatized, and to make painful recreations a thing of the past.

A. True

B. False


EMDR: First Exposures

81. EMDR allows patients to stay fully focused on their internal experience and:

A. Frees up something in the mind/brain that gives people rapid access to loosely associated memories and images from the past

B. Enables people to heal from trauma without talking about it, while observing their experiences in a new way that does not require verbal give-and-take

C. Can help even if the patient and the therapist do not have a trusting relationship or have language barriers

D. All of the above


Studying EMDR

82. One key finding of numerous studies is that adults with histories of childhood trauma respond very similarly to EMDR as those who were traumatized as adults, with overall positive results.

A. True

B. False


83. Even though some behavioral health clinicians remain skeptical about the effectiveness of EMDR, research has shown a positive outcome for people who have developed PTSD in reaction to a traumatic event that occurred in adulthood, and it has become one of the treatments for PTSD sanctioned by the Department of Veterans Affairs.

A. True

B. False


Is EMDR a FORM of Exposure Therapy?

84. EMDR focuses on regulating the intense memories activated by trauma but also on creating an ownership of the body and mind that restores a sense of agency, engagement, and:

A. Commitment

B. Attentiveness

C. Perseverance

D. Promise


Processing Trauma with EMDR

85. One feature of EMDR is its capacity to activate a series of unsought and seemingly unrelated sensations, emotions, images, and thoughts in conjunction with the original memory, and to free the mind to activate new pictures and feelings, and create new possibilities.

A. True

B. False


Exploring the Sleep Connection

86. Each of the following is a correct statement about the connection between EMDR and sleep EXCEPT:

A. Researchers have found a connection between EMDR and Rapid Eye Movement (REM) sleep, with the eyes moving quickly back and forth in each

B. Evidence clearly states that participating in EMDR treatment decreases anxiety, depression, and irritability, as does increasing time in REM sleep

C. With EMDR and REM sleep, distant associations are activated, which may play a role in mood regulation

D. Dreaming occurs during REM sleep, and experts suggest a connection between EMDR and memory processing in dreams


Association and Integration

87. While EMDR is similar to exposure therapy in that participants spend significant time revisiting the original trauma, the focus ultimately changes in EMDR to stimulating and opening up the associative processes in order to heal.

A. True

B. False


Chapter 16-Learning to Inhabit Your Body: Yoga

88. One calming technique used to help trauma survivors is Nadi Shodhana, which involves using the fingers to tap various parts of the body in order to help slow the chaos and stay within a window of tolerance.

A. True

B. False


The Legacy of Inescapable Shock

89. Child abuse victims often blame themselves for the offenses that occurred, because although their rational minds know it wasn’t their fault, deep within the emotional, survival brain, self-blame tends to linger.

A. True

B. False


The Numbing Within

90. Trauma memories are often stored as muscle tension or feelings of disintegration in affected body areas, and one goal of working with survivors is to help them:

A. Be able to label the feelings with appropriate judgment of what they mean in the present

B. Recognize how these memories can threaten harmony and healing if not learned to be tolerated

C. Calmly accept their symptoms for what they are-sensations with a beginning, middle, and end

D. All of the above


Finding Our Way to Yoga: Bottom-Up Regulation

91. When a person with chronic PTSD is reliving a trauma memory, breathing is initially labored and deep, and then the heart races out of sync with the breath, followed by rapid, shallow breathing and slow heart rate, which indicates that the person is shutting down.

A. True

B. False


Exploring Yoga

92. Which of the following is NOT one of the findings that the author and his colleagues found when studying how those with trauma histories responded to participating in yoga?

A. Even when participating in yoga exercises and mindfulness techniques, traumatized people had a very difficult time feeing completely relaxed and safe within their bodies

B. Although there were no formal studies in this area, yoga participation for veterans with PTSD appears to be at least as effective as it has been for women trauma survivors

C. Monitors that measured level of relaxation at the end of yoga sessions indicated that instead of going into a state of quiet repose, trauma students’ muscles remain active

D. Participation in yoga and dialectical behavior therapy (DBT) had very similar results in significantly improving arousal problems in PTSD and improving the subjects’ relationships to their bodies


Learning Self-Regulation

93. One of the reasons that yoga is recommended for trauma victims is that it encourages the student to look inward instead of outward and to listen to the body as a means to promote healing.

A. True

B. False


Chapter 17-Putting the Pieces Together: Self-Leadership/Desperate Times Require Desperate Measures

94. Trauma survivors use adaptations such as being tough, invisible, or __________ until they feel safe enough to begin to deal with the overwhelming memories of the past.

A. Absent

B. Indifferent

C. Desensitized

D. Isolated


Mind is a Mosaic

95. According to the Internal Family Systems (IFS) Model, dissociation occurs on a continuum, and includes each of the following consequences EXCEPT:

A. The self-system breaks down, and parts of the Self become paralyzed and go to war with one another

B. Self-loathing coexists and fights with grandiosity, loving care with hatred, and numbing and passivity with rage and aggression

C. In IFS, a part is considered a passing emotional state rather than a distinct mental system with its own history, abilities, and needs, and its lack of constant presence negatively impacts the Self

D. When individuals are abused, their childlike and fun parts are hurt the most and become the toxic parts that are denied and buried


Self-Leadership

96. Experts contend that mindfulness enables the Self to be a passive observer as it works toward cultivation and development.

A. True

B. False


A Life in Parts

97. Although behavioral health therapists cannot replace the caring and love that victimized individuals missed as children, they can work toward helping them heal by recruiting the individual’s own:   

A. Self-protection and adaptations

B. Energy and hope

C. Strength and self-love

D. Wisdom and independence


The Burden of Toxicity

98. “Managers” are the parts of the self that hold memories, sensations, beliefs, and emotions associated with trauma, which often reveal themselves in the form of crushing physical sensations or extreme numbing.

A. True

B. False


Unlocking the Past

99. One positive aspect of IFS is that it can help family members mentor each other as they learn to observe how one person’s parts interact with another’s, and it enables them to hear themselves and each other from a new, compassionate perspective.

A. True

B. False


The Power of Self: Compassion

100. Some of the strategies that have used to help trauma survivors have also been implemented for patients with rheumatoid arthritis (RA) in order to help them accept and understand the fear, hopelessness, and anger that is associated with their disease.

A. True

B. False


Liberating the Exiled Child

101. During the therapeutic process, trauma survivors may revert to old habits where they fail to take care of their wounded parts, and they may need help nursing those exiled parts back to health, in a process known as:

A. Relinquishing

B. Discharging

C. Relieving

D. Unburdening


Chapter 18-Filling in the Holes: Creating Structures

102. In psychomotor therapy, microtracking refers to following subtle shifts in body posture, facial expression, tone of voice, and eye gaze, which are the nonverbal expressions of emotion.

A. True

B. False


Restructuring Inner Maps

103. Which of the following is NOT one of the objectives when creating a three-dimensional “structure” as a way to role-play trauma experiences?

A. The structure helps give a clearer perspective on reactions and to people and events of the past

B. It allows for unexpected memories, thoughts, and emotions and the creation of relief

C. It serves as a way to explain or interpret the past in a safe environment

D. The structure provides an opportunity for the individual to feel what was felt in the past, visualize what was seen, and say what could not be said in the past


Rescripting Your Life

104. The more early pain and deprivation someone has experienced, the more likely he or she will be to interpret other people’s actions as being directed against them, and the less understanding they will be of others.

A. True

B. False


105. Because of trauma, people are often hesitant to welcome new experiences that might change their basic worldviews, as they often anticipate:

A. Rejection

B. Ridicule

C. Deprivation

D. All of the above


106. Structured experiences of psychomotor therapy are valuable and are designed to call forth the split-off parts of the Self that were created in order to survive and to enable the individual to identify and talk to them.

A. True

B. False


Daring to Tell the Truth

107. Survivors of trauma and abuse often face realities that they are not allowed to acknowledge to themselves or others, but nevertheless become the templates of their lives.

A. True

B. False


Antidotes to Painful Memories

108. In order to change and heal, people need to become viscerally familiar with realities that directly contradict the static feelings of the panicked self of trauma, and replace them with sensations rooted in safety, delight, and:

A. Equilibriumand reassurance

B. Mastery and connection

C. Adaptation and comfort

D. Stability and affirmation


Chapter 19: Rewiring the Brain: Neurofeedback

109. For many decades, EEG patterns in “behavior problem” children, specifically those with ADHD, have shown slower than normal waves in their:

A. Cerebellum

B. Frontal lobes

C. Hypothalamus

D. Temporal lobes


Seeing the Symphony of the Brain

110. Which of the following is NOT an accurate statement about neurofeedback?

A. Neurofeedback enables circuitry in specific parts of the brain to be tracked and brain wave changes to be recorded

B. Neurofeedback may help trauma victims by intervening in the circuitry that promotes and sustains states of fear, and traits of fearfulness, shame, and rage

C. Neurofeedback stabilizes the brain and increases resiliency, allowing us to develop more choices in how to respond

D. Neurofeedback eliminates the brain’s tendency and bias toward over self-regulation which in turn enhances creativity and awareness


The Birth of Neurofeedback

111. As questions about the effectiveness of psychiatric drugs increase in the behavioral health field, neurofeedback is once again becoming a respected option, with many insurance companies covering it in their policies.

A. True

B. False


Getting Started

112. Although objective changes in behavior are a good indication if neurofeedback is helping, self-reports are the most reliable and important form of evaluation.

A. True

B. False


The Rate of Brainwave Firing is Related to Our State of Arousal

113. While activation of alpha waves produces a sense of peace and calm, dominate beta waves enhance the ability to engage in focused attention while performing a task.

A. True

B. False


Helping the Brain to Focus

114. Neurofeedback has received positive results as an alternative to conventional drugs for the treatment of ADHD because it can be used to produce lasting changes in brain patterns, whereas drugs work only as long as the patient is taking them.

A. True

B. False


How Does Trauma Change Brian Waves?

115. Research indicates that calming the fear center of the brain decreases trauma-based problems and:

A. Encourages clarity of thought

B. Enhances pleasure-seeking abilities

C. Improves executive functioning

D. Promotes resiliency and engagement


Neurofeedback and Learning Disabilities

116. Chronic abuse and neglect in childhood interfere with the proper wiring of sensory integration systems, which may result in learning disabilities and include faulty connections between auditory and word-processing systems as well as:

A. Poor hand-eye coordination

B. Delayed executive functioning

C. Working memory deficits

D. Visual-motor deficiencies


Neurofeedback, PTSD, and Addiction

117. The relationship between PTSD and substance abuse is circular in that while drugs and alcohol may provide temporary relief from trauma symptoms, withdrawing from them increases hyperarousal, thereby intensifying nightmares, flashbacks, and irritability.

A. True

B. False


The Future of Neurofeedback

118. In addition to trauma-related symptoms, neurofeedback has shown good results in each of the following areas EXCEPT:

A. Relieving tension headaches

B. Increasing motivation and drive in depressed individuals

C. Improving cognitive functioning following traumatic brain injury

D. Reducing anxiety and panic attacks


Chapter 20-Finding Your Voice: Communal Rhythms and Theater

119. An individual’s sense of agency and how much he or she feels in control is defined by the relationship with the body, and its:

A. Energy

B. Responses

C. Rhythms

D. Spirit


Treating Trauma Through Theater

120. Traumatized people who are afraid to feel deeply and who avoid conflicts out of fear of losing control may find comfort in theater programs where they can embody their emotions and have a voice to express themselves and connect with others.

A. True

B. False


Making it Safe to Engage

121. Theater directors who have worked with traumatized adolescents report various behaviors and emotions with this population, including:

A. They tend to be out of tune, inarticulate, inhibited, and purposeless

B. They are too hyperaroused to notice what is going on around them

C. They are easily triggered and rely on action rather than words to discharge their feelings

D. All of the above


Urban Improv

122. When comparing the results of an Urban Improv program for 4th and 8th graders, the 8th graders were much more engaged and willing to participate, which leaders attributed to them feeling more confident and less frightened of their experiences due to age and maturity.

A. True

B. False


The Possibility Project

123. For foster children who have experienced abandonment and mistrust throughout their lives, the greatest sense of permanency that they can achieve is to find one caring adult who will help them strive to achieve security and independence.

A. True

B. False


Sentenced to Shakespeare

124. One of the benefits of theater for troubled adolescents is that it allows them to experience a new type of __________ as they are given the opportunity to begin to trust themselves, and many are presented with a new eagerness to succeed.  

A. Vulnerability

B. Hope

C. Faith

D. Confidence


Therapy and Theater

125. As a form of therapy, theater performers are given an opportunity for deep, subjective resonance and a chance to experience a sense of truth and value.

A. True

B. False


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