The newsletter of the
International Trauma Training Institute (ITTI)
Mike Dubi, Ed.D., LMHC, Editor
Jeanne Thomas, MBA, Associate Editor
Spring 2018, Vol. 1, No. 2

WE'VE CHANGED OUR NAME! As of February 1, 2018, our continuing education programs are now under the International Trauma Training Institute umbrella. The same great courses taught by the same outstanding faculty can be found at Check out Upcoming Trainings.

For those of you seeking Certification after completion of our courses, or for Recertificaton, you can still go to . This function is now owned and managed by Evergreen Certifications.

Our next cycle of trainings begins on April 29, 2018. To view the courses and course descriptions, click on

We have some new features on our website: check out Did You Know.... This page is for participant and faculty profiles, for significant events that affect our professions and for any other articles of interest. If you have anything to contribute, please email me at .

Currently on our website at Did You Know... Attachment, Trauma & Neuroscience by Cheryl Paulhus; Sexual Harassment by Debra Leggett, Ph.D.

We at ITTI look forward to working with you as we continue to create and develop new trainings.

Mike Dubi, ITTI President
Safe, Warm, and Traumatized:
The Interplay of Traumatic Stress on the Fetus,
Genetics and Epigenetics
Andy Brown, Ed.D. & Mallorie Hardesty
The feelings associated with safety are closely aligned with protection, acceptance, comfort and hope. Safety is found in our home security systems, our password protections, our closest friendships, and our therapeutic connections. We like to encourage feelings of security in others. Safety, especially in the context of trauma work, is central to the effectiveness of helping trauma symptoms lessen and resolve. As clinicians, we attend conferences, engage in research, and share ideas on how to elicit and foster safety. What happens when trauma pierces the seemingly safest of environments? How then do we reconcile the effects that traumatic stress has on the individual when the last known safe place, the womb, is engorged with stress? In a recent article (Leung, 2017) researchers studying the effects on children who were in utero during the devastating winter of 1998 in Quebec, found similarities in a previous study. Children in utero during the Dutch famine of circa 1945 were found to have altered genetic expression resulting from the mother’s exposure to traumatic stress while in the womb. The two studies are continuing; however, correlative factors between the Dutch and Quebec children are being realized.

            Epigenetics, the cool older sibling of regular genetics, has everyone talking but few really understand. Epigenetics is the study of how individual genes are expressed on our DNA. Essentially, our genes are either prompted to express themselves or inhibit themselves, depending on methylation or demethylation. Through the process of methylation, three hydrogen atoms and on carbon atom (CH3) attach to a gene and prevent that gene from expressing itself. Methylated DNA code will stay unexpressed for the life of the cell and as that cell parents’ other cells, the methylated DNA code will be transmitted to those cells. This process results in genes that stay unexpressed throughout the lifespan (Francis, 2011). Alternatively, demethylation is the opposite process, breaking away from genes and therefore allowing the gene to be expressed.
            Current research states that clinicians can see that the process of gene inhibition and expression begins in the womb (Leung, 2017; Klengel & Binder, 2015). While most genes will stay either unexpressed or expressed throughout the lifespan, the body can jump into either a methylation or demethylation state in response to the environment (Franics, 2011). This is good news to some who are hoping for the gene that controls over spending to finally come alive. However, it appears that maternal stress can impact the expression of DNA in children and influence their development in utero. The take-away, is that even the safe environment fostered by the womb is not resistance to the impact of traumatic stress.

             Early researchers found that pregnant Dutch mothers who experienced severe famine during the end of World War II had children that were more likely to develop diabetes, obesity and high blood pressure to name a few (Francis 2011; Leung, 2017). It is theorized these children struggled with health issues because they were not living in the same, famished conditions in which their mothers lived. The children’s genes coded themselves to be able to survive on very little nutrition while still in utero and because their environment no longer matched the changed coding on their DNA. The children of the traumatized Dutch mothers could not adapt to a plentiful environment as successfully. E ssentially, being born into a healthy environment made everything worse. The womb is an environment that promotes growth and is synonymous with safety. Current literature demonstrates that traumatic stress is a pervasive and insidious invader. The implications of recent stories from Quebec and Ontario that parallel Dutch events that occurred over fifty years prior, illuminate the need for further research and possible proactive protocols for pregnant women and children immersed in traumatic environments. Knowing that trauma can be transmitted genetically and epigenetically may encourage professionals to take a deeper familial trauma history. Exploring what was happening globally and locally during birth years may garner greater insights into our client’s current trauma symptomology. To extend the adage, “If mama isn’t happy, then nobody isn’t happy”; if mama is traumatized, then generations to follow may be negatively impacted (Francis 2011; Leung, 2017).  
Leung, W. (2017). Pregnancy stress during 1998 ice storm linked to genetic changes in children after birth, study suggests. Retrieved from suggests/article20868841/

Francis, R. (2011). Epigenetics: How the environment shapes our genes. New York, NY: W.W. Norton & Company, Inc.

Klengel, T., & Binder, E. B. (June 01, 2015). Epigenetics of Stress-Related Psychiatric Disorders and Gene × Environment Interactions. Neuron, 86, 6, 1343-1357.

Roseboom, T. J., Painter, R. C., van Abeelen, A. F., Veenendaal, M. V., & de Rooij, S. R. (2011). Hungry in the womb: what are the consequences? Lessons from the Dutch famine. Maturitas, 70 (2), 141-145.

Dr. Andy Brown is a professor and psychotherapist practicing in Clayton, NC.

Mallorie Hardesty is a Seattle native currently completing her last term in the online Clinical Mental Health Counseling program at The Chicago School of Professional Psychology. Mallorie works with the Washington State Department of Corrections and is an advocate for trauma informed care within state and federal prisons.

The Importance of Understanding Neuro-biological Development with Complex Developmental Trauma, Regardless of Age of Client
Sheila Sturgeon Freitas, Ph.D.
Transparent human head with a brain in 3d space. Blue abstract futuristic medicine_ science and technology background illustration. Depth of field settings. 3D rendering.

We live in an exciting time, clinically speaking, as different sciences come together to build a fuller picture of the human experience. This is especially true within the world of trauma. Numerous disciplines, including developmental, psychological, biological, neurological, physiological, medical and interpersonal, have banned together to form a multidimensional view of trauma. No matter what the situation is, each lens has something of significance to offer with regards to etiology, treatment or prevention. This is encouraging as a practitioner, for the more we can see these various layers, the more able we are to tailor our care to the individual's unique trauma presentation and underlying needs.

      This is particularly important when working with complex developmental trauma. Complex developmental trauma refers to the domino effect across the lifespan for children who are raised in the context of chronic neglect, abuse and chaos. In the absence of supportive and responsive relationships, this context takes center stage by playing the primary and defining role on how the brain is wired, the degree of inter-connectivity between different functions, determining default settings within the nervous system and setting the foundational templates for all aspects of a child's development. 

       Although our brains start off with billions of neurons and a basic genetic blueprint, the wiring between these neurons is sparse. Building the neural networks beyond those supporting autonomic functions is highly dependent on the child's environment and experiences. Through repeated stimulation, simple circuity is established, then stabilized. Over time, more complex circuity is built upon this simple layer, which allows for the development of highly specialized functions. Micro “serve and return” interactions between infant and caregiver are the strongest, most influential, building blocks for the construction and stabilization of all brain-based templates that underlie specialized functions. Moreover, the brain is designed to become a highly integrated organ. A rich and responsive environment is crucial for deepening the inter-connectivity between each of these specialized areas.  This sort of care allows for the development of a more secure, developmentally strong and regulated being. 
        It is also important to understand that the circuitry of the brain is not done at once. It takes time and great deal of repeated stimulation by responsive adults. Furthermore, different areas of the brain become especially thirsty for stimulation at different critical times. These critical windows are when the brain is at it's most receptive for stabilizing the foundational neuronal networks that underlie various developmental skills. When these optimal time periods for wiring are met with minimal stimulation, weak foundational circuitry is established. As that critical time comes to a close, the brain becomes less responsive to environmental input for that particular area. So what was built, was built, regardless of the quality or frequency of stimulation. The circuit is formed, good or bad, and the brain moves on. 

    As a child grows, more complex skills are then layered upon these foundational weak circuits. These layers are undeniably influenced by the weaker foundation. The developmental trajectory has now been influenced. To get back on track, accommodations have to come from higher level circuitry, which is also best developed during times when they are most receptive to the environment. This requires active and responsive adults who help the child to strengthen these developmental weaknesses. It now takes much more effort, as those lower levels circuits are no longer as flexible or responsive as they were when their windows were open. Overtime, these accommodations can be established. 
        However, if the child remains in a neglectful or chaotic environment, this trajectory becomes further skewed as the domino effect of trauma continues. Various critical windows will again be missed, another layer of weak circuitry is established and minimal inter-connections between various systems are made. 

        Please note, that stimulation that is occurring does so via the context of traumatic or neglectful experiences. When this occurs, the circuitry for survival, stress and fear is repeatedly stimulated by the child's environment. These circuits become overly strengthened because our brains are built to efficiently do what we do most often. The more neglect or trauma, the more the client's biology, brain and development are designed to cope within this environment. These then become our complex developmental trauma kids, who grow up to be our most complex adult clients. Healing and treatment is possible, but it requires focused neuro-biological and developmentally informed interventions on addressing these underlying issues.
        Understanding the building blocks for development and neurodevelopment become a key component for understanding and, ultimately, treating complex developmental trauma without shame. By looking at the full-life picture, time periods of less optimal care-giving or environmental stimulation can be identified. Critical milestones across all domains of development can then be identified, their trajectories explored, and their impact understood – all within a context of how their individual brain and nervous system managed the overwhelming stress they experienced. This allows for a reassuring and genuine explanation that their bodies and brain did an excellent job of developing in response to their individualized experiences. The question now is if their current environment matches the environment in which they were developed. Are their established patterns of relating to others, or their distress management skills still effective? If not, identifying and tracing the trajectory of underdeveloped skills give clinicians an excellent place to start. 
About the Author
Dr. Sturgeon Freitas is a clinical psychologist who specializes in the treatment of complex trauma with children, adolescents, adults and families. Her practice is located in Meridian, Idaho, a suburb of Boise, Idaho.

Trauma Symposium in Sarasota, FL
Argosy University is sponsoring the Trauma Institute, a one-day event in conjunction with ITTI. Click on the link below for more information on the presenters and objectives. The event is $25 per person, including lunch; 7 CEUs awarded for full day attendance.

Mike Dubi, Ed.D., LMHC, President of the International Trauma Training Institute (ITTI)
William Clough, D.Min. – Crisis in the Church
LeeAnne Cravey, M.S. – Crisis Response after National Disasters
Julie O’Brien, Ed.D. – EMDR in Trauma Treatment
Debra Leggett, Ph.D. – The Effects of Toxic Stress on Children
Ann Tilman, Ed.D. – The School Counselor’s Role in Childhood Crisis and Trauma Response
Bev Mustaine, Ed.D. – Crisis Counseling

Date: April 20, 2018; 8:30am - 4:30pm

Location: Child Protection Center, 720 South Orange Avenue, Sarasota, FL 34236 

April 29 - June 9, 2018
All courses are NBCC approved
(ACEP# 6674)
The following trainings lead to certification:
  • Clinical Trauma Professional (CTP), 13 CE hours
  • Anger Management Treatment Professional (AMTP), 13 CE Hours)
  • Child & Adolescent Trauma Professional (CATP), 13 CE Hours

April 29 - June 23, 2018
All courses are NBCC approved
(ACEP# 6674)

  • Sex Offender Treatment Provider (SOTP), 24 CE Hours

April 29 - August 4, 2018
All courses are NBCC approved
(ACEP# 6674)

  • Expert Trauma Professional (ETP), 36 CE Hours
April 29 - June 9, 2018
All courses are NBCC approved
(ACEP# 6674)

Additional trainings:
  • Attachment & Trauma (AT), 13 CE Hours)
  • Neurobiology for Mental Health Professionals (NB), 13 CE Hours
  • Preparing Forensic Assessments (PFA), 13 CE Hours
  • Clinicians in the Courtroom (CIC), 13 CE Hours
  • Victimology (VIC), 13 CE Hours
  • NEW!! Treating Sexual Addiction (TSA) 13 CE Hours


  • Clinical Trauma for Social Workers, 13 CE Hours
  • Neurobiology of Addictions, 13 CE Hours