Saturday, June 28, 2014

A Brief History of Trauma

We have learned a lot about treating trauma since PTSD was first introduced in the Diagnostic and Statistical Manual of Mental Disorders in 1980. The condition was conceptualized to diagnose and treat veterans suffering from what was formerly known as "shell shock." The women's movement and clinicians like Judith Herman helped us see that not only combat but abuse can also result in PTSD.

Some say that we are in a golden age of neuroscience. At the same time, it seems the more we know, the more we realize we don't know. It can be hard for a counselor such as myself to keep up with all of the advances in the field. Perhaps the most encouraging news is regarding the changeable nature of the mind, referred to as neuroplasticity. In a nutshell, we now believe that we can rewire our brains- just as the brain is hurt from trauma, it can heal from it.

In trauma treatment, we rewire our minds by practicing safe coping in the present when we feel dis/stressed and then, once we have a few safe coping tools under our belt, processing the traumatic memories of the past. We can think of trauma treatment in three phases: present, past, and future. By practicing safe coping in the present, we are then able to process the past. By processing the past, we are then able to create the future we desire by living out our values.

When I say process, I mean desensitize the traumatic memory. Becoming able to stay grounded in the presence of triggers. For example, a survivor of physical abuse may have learned to numb out or shut down as a coping strategy. In her life after abuse, confrontations may continue to trigger this so called freeze response. With treatment, she can learn to stay with herself and respond how she chooses.

The vast majority of people with PTSD don't get the help they need. Common obstacles include fears that it won't work or what people might think. The truth is, if you are able to stay in treatment, whether it's individual or group therapy, it can help you feel better- whether or not PTSD has been diagnosed. Are people "cured" from PTSD? Certain treatments have proven track records of helping most people who complete them. The hardest thing is getting in treatment and staying there.

I look forward to sharing more with you about advances in the field, including more about the specific treatments I referenced, in future posts. If you or someone you know has been impacted by trauma, have hope. Effective treatments exist. The hardest part is behind you. From here on out, it's establishing safety, putting away the past, and truly living your life. You are much more than your trauma.

Friday, June 13, 2014

Transcending Childhood Trauma

So called "adult children" of dysfunctional households share certain characteristics. Can can see yourself in the tendencies listed below? If so, it may be a time to "heal the child within" so you can finally create the life and relationships that you desire! Don't forget to breathe as you read this list, as the traits described below can be painful to read. We will go on to explore how to deal with and heal from these behaviors:
  • Feeling that you are always waiting for "the other shoe to drop," feeling that you are constantly "on edge," "walking on eggshells," or "hyper-vigilant"
  • Marrying or becoming a person with addictions or compulsions of your own (cleaning, working, picking, drinking, drugging, watching Netflix, you name it)
  • Tending to be on the lookout for reasons not to trust those close to you, as well as distrusting your own behavior 
  • Having difficulty discerning healthy from unhealthy behavior in those around you
  • Expecting abnormal rather than normal behavior, expecting things to be unpredictable and chaotic
  • Experiencing difficulty setting appropriate boundaries with others, taking on too much, which makes you feel resentful, or saying "no" to everything, even when it could be beneficial
  • Keeping your true self, feelings, or inner experience hidden, keeping your guard up
  • Overreacting when you didn't mean to, feeling easily set off or triggered
Childhood abuse and neglect is traumatic and can result in a condition called Complex Post Traumatic Stress Disorder. What we know about psychological trauma is that it is a normal reaction to abnormal events. It makes sense to develop these strategies to survive growing up in a tumultuous family system. However, as adults, these behaviors can keep us from living the lives that we desire- but they are not terminal!

We can "heal the child within" as adults. Like anything, it takes time and practice but it's definitely do-able! First, we have to recognize what's happening- we're stuck in the past trying to fight, flight, or freeze our way out of conflict with our current partner. Then, we can realize that we're actually safe, now- unless we're in an intimate partner violence situation, which is entirely different and you can read more about here. Finally, we can center or ground ourselves and choose to work towards our healing in the form of a new response.

For example... When your partner triggers you and you instantaneously feel like a scared and angry child who wants to shut down, rage, or run away (your partner is a good source of feedback if you're not sure how you come across), you can notice this old pattern, take a break, and come back when you're ready to talk about it. Together with your partner, you can distinguish the past from the present by having a conversation about what happened and creating new solutions in the here-and-now.

I know, I know. Easier said than done! It's true that this is deep and life-changing work that takes time and effort. There is a lot that goes into it. Learning how to notice what's happening in the moment, how to self-sooth, and how to effectively communicate your experience to your partner are all skills that require training and practice. I keep the following tools in my counselor's toolbox to assist clients with this empowering work:
  • Mindfulness
  • Non-Violent Communication
  • Acceptance and Commitment Therapy (ACT)
  • Cognitive Behavioral Therapy (CBT)
  • Trauma Treatment
If you are an "adult child," know that you're not alone. Hope and healing are most definitely possible! Counselors such as myself are here to assist you and there are free and confidential 12 step groups in the community, as well. Only you will know what's right for you. As always, I am wishing you only good things. Until next time, be well!