When discussing Post-Traumatic Stress Disorder (PTSD) with clients in the aftermath of their traumatic experience, we have noticed a recurring experience. Many times, clients who meet criteria for the diagnosis of PTSD understand this to mean that they will always suffer from the effects of their trauma. All too often, we see a shadow sweep over our client’s faces as shame and fear rise in their bodies. We want to help clarify this particular diagnosis with a message of hope. PTSD is not a lifelong chronic condition, rather a description of how our bodies work to restore safety after trauma. Let’s talk about Post Traumatic Stress and how we can use this information to work toward healing.
Post-traumatic stress (PTS) is a natural response to experiencing or witnessing a traumatic event, impacting both mind and body. When confronted with trauma, the body's nervous system initiates a complex cascade of responses aimed at survival. Understanding the neurobiological impact of trauma can shed light on the symptoms individuals may experience, such as hypervigilance, flashbacks, and emotional dysregulation. Understanding PTS must involve the nervous system's role in trauma, which illuminates how our body reacts to perceived threats. Traumatic experiences can dysregulate the autonomic nervous system, leading to a state of hyperarousal or dissociation. This dysregulation can disrupt the body's ability to distinguish between real and perceived danger, resulting in ongoing feelings of fear and vulnerability. By learning about the nervous system processes at play, individuals can gain insight into their symptoms and recognize that they are not signs of weakness but rather adaptive responses to overwhelming circumstances. This knowledge can also inform treatment approaches, emphasizing interventions aimed at regulating the nervous system's stress response. Treatment for PTS often involves therapeutic modalities that target both the mind and body. Polyvagal theory helps to pay attention to nervous system signals and to use this information to create safety in the mind and body. Dialectical Behavior Therapy (DBT) helps individuals become skillful in mindfulness, emotional regulation, interpersonal skills and distress tolerance, while somatic experiencing focuses on releasing stored trauma from the body. Eye Movement Desensitization and Reprocessing (EMDR) and Brainspotting harness the brain's natural healing mechanisms to reprocess traumatic memories and alleviate distress. These approaches not only address psychological symptoms but also aim to restore balance to the nervous system. Despite the challenges posed by PTS, there is hope for recovery. With the right support and resources, individuals can learn to regulate their nervous system responses, reduce symptoms, establish safety and cultivate resilience. It's essential to approach treatment with compassion and patience, recognizing that healing is a gradual process that unfolds over time. In conclusion, understanding the neurobiological impact of trauma is crucial for navigating post-traumatic stress with compassion and efficacy. By integrating this knowledge into psychoeducation and treatment approaches, we can empower individuals to reclaim agency over their healing journey. Remember, recovery is possible, and there is hope for a brighter future beyond trauma's shadow. Next week’s blog post will be about Post Traumatic Growth.
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Healing from the effects of trauma can be terribly daunting. In "8 Keys to Safe Trauma Recovery," author Babette Rothschild invites us to navigate trauma healing with wisdom and compassion, offering a roadmap to reclaiming safety, empowerment, and wholeness. Therapists in our practice often recommend this book for clients who are wanting to understand the basics of trauma recovery. Below is a short summary of the 8 keys to safe trauma recovery:
Key 1: Plot Your Course With Mindfulness Mindfulness is awareness of the present moment, and includes an awareness of emotions, body sensations and cues and more. Using mindfulness to observe our physiological cues can give us vital information to keep us safe and regulated in our post-traumatic life. Inherent in this point is a permission to make choices to keep our bodies and minds regulated, to preserve our peace and safety. Key 2: Begin with Your Epilogue This chapter speaks to the importance of noticing that our traumatic experience has ended. Healing can only happen when we know that we are no longer being traumatized and that we made it through the terrible experience. Making these realizations also helps us recognize the internal and external factors that support our ongoing survival. Key 3: Remembering is NOT Required Although there is much discussion about this in the mental health community, the author makes the argument that remembering and revisiting traumatic experiences is not required for trauma healing. This argument builds on the skills developed in the first two chapters, stating that developing mindful observation of nervous system cues and using that information to create safety can be enough to heal and move forward. Also inherent in this argument is a question of consent: do you want to revisit your traumatic memories? Key 4: Stop Flashbacks Trauma flashbacks are one of the hallmark side-effects of trauma, and they are intrusive and highly disruptive. The author works to reduce and eliminate flashbacks by focusing on the language we use to process them. Are we describing the flashback to ourself in present or past language? Is there a negative or critical message we have internalized when we see our trauma replay in our mind? Moving a flashback from present moment to memory and bringing in compassionate language can make all of the difference for our post-traumatic life. Key 5: Reconcile Forgiveness and Shame Oftentimes, healing from a traumatic experience will require us to reconcile our feelings of guilt and shame. The author recommends bringing self-forgiveness and self-compassion to our limitations and sharing about our shame. Both of these gentle practices reduce the lasting impact of shame and guilt. Key 6: Take Smaller Steps for Bigger Leaps This chapter speaks to the overwhelm so many feel toward trauma recovery. The author validates the common desire to rush through trauma recovery and, in doing so, taking big steps that end up creating more distress and overwhelm. She advocates for small steps that work to keep trauma survivors feeling safe and regulated, which actually serves to establish nervous system trust and healing. Key 7: Get Moving Trauma reverberates throughout our physical bodies, and because of this, physical activity can have a lot of potential to heal our physical selves. Physical activity not only moves us out of the nervous system freeze response, but building strength and endurance can also provide a sense of physical empowerment and even safety. Each individual heals from different types of movement, so this concept also provides an invitation to explore what types of movement are right for each trauma survivor. Key 8: Make Lemonade This chapter highlights the benefits of finding the growth opportunities that exist in our post-traumatic life experiences. While no traumatic experience is primarily beneficial, we may be able to find ripple effects in our lives that leave us in a more resilient, wholehearted or healed state of being. Conclusion: Embracing Gentleness and Safety for Trauma Recovery Babette Rothschild reminds us that a slow, gentle and common-sense approach to trauma healing is possible. Her 8 Keys invite the trauma survivor to collaborate and even lead the healing journey. May we walk this path together, empowered by the keys to safe trauma recovery, and emerge stronger, wiser, and more resilient than ever before. In the ups and downs of our lived experience, our nervous system translates and stores the impact of what we experience. Trauma disrupts the delicate balance of our nervous system, leaving behind discordant echoes that reverberate through our bodies, minds, and spirits. Today, we explore a healing journey informed by Polyvagal Theory, illuminating the pathways to safety and healing after trauma.
The Polyvagal Perspective on Trauma Polyvagal Theory, pioneered by Dr. Stephen Porges, offers a revolutionary lens through which to understand the impact of trauma on the nervous system. At its core lies the recognition that our autonomic nervous system – comprised of the sympathetic and parasympathetic branches – plays a pivotal role in regulating our responses to threat and safety. Trauma hijacks the autonomic nervous system, propelling us into states of hyperarousal or hypoarousal. Hyperarousal, characterized by the activation of the sympathetic "fight or flight" response, plunges us into a state of vigilance and reactivity. Conversely, hypoarousal triggers the parasympathetic "freeze" response, leading to dissociation and disconnection from our internal landscape. The Quest for Nervous System Safety In the aftermath of trauma, reestablishing physical, emotional and relational safety becomes top priority– not just as a concept but as a physiological imperative. Nervous system safety transcends mere physical refuge; it encompasses the restoration of neurophysiological equilibrium, allowing us to navigate the world with a sense of calm and connection. Central to Polyvagal Theory is the concept of ventral vagal engagement – a state of social engagement and connection fostered by the parasympathetic nervous system. Cultivating ventral vagal pathways is essential for re-establishing safety after trauma, facilitating intimacy, trust, and attunement in our relationships. In the realm of Polyvagal Theory, healing unfolds within the crucible of safe and supportive relationships. Co-regulation – the reciprocal exchange of physiological and emotional cues – serves as the cornerstone of healing, offering a roadmap for navigating the complexities of interpersonal connection with grace and compassion. Embodied Resilience and Empowerment Resilience, from a Polyvagal perspective, is not merely a psychological construct; it's an embodied state of being. Embodied resilience entails attuning to the wisdom of our bodies, harnessing the innate capacity for self-regulation, and integrating our experiences into the tapestry of our being with gentleness and acceptance. Empowerment begins with understanding. Polyvagal literacy equips us with the knowledge and insight to navigate the terrain of trauma with clarity and agency. It invites us to become fluent in the language of our nervous system, attuning to its cues and messages with curiosity and compassion. Nurturing Hope Through Nervous System Awareness In the vast expanse of trauma's aftermath, hope emerges as a guiding light – a beacon of possibility beckoning us towards healing and wholeness. Polyvagal awareness infuses hope with substance, grounding it in the neurophysiological realities of our embodied experience and illuminating the path towards transformation. In closing, the journey of healing after trauma, as illuminated by Polyvagal Theory, is a testament to the resilience of the human spirit and the transformative power of connection. May we remember that healing is not just a destination but a sacred unfolding – a journey of rediscovery, reclamation, and profound self-compassion. So, to all those embarking on this nervous system healing path, know that you are not alone. Within the wisdom of your nervous system lies the map to healing and wholeness. And as you navigate the terrain of trauma with courage and grace, may you find solace in the knowledge that safety, connection, and resilience are not just within reach – they are your birthright. Embrace the journey, dear reader, for within its twists and turns lies the promise of a life reclaimed, a spirit renewed, and a heart restored to its truest rhythm. And it is our privilege to provide guidance, safety and relational support on the path of healing and restoration. Introducing Radical Acceptance Radical Acceptance is a core skill in Dialectical Behavior Therapy (DBT). This skill falls into the category of Distress Tolerance skills. We reach for this skill when we are navigating something big and hard in our life that is outside of our control or influence. The idea behind Radical Acceptance is that we can work to improve our wellbeing even in the midst of the big and hard things. To appreciate what Radical Acceptance can offer us, we must first understand the difference between pain and suffering. Pain is an inevitable part of being human in our world. We will all experience pain at different times in our life. Suffering, however, is caused when we make choices that make painful circumstances harder for ourselves. Radical Acceptance seeks to accept pain and reduce suffering. When we reduce suffering, we grow in emotional resilience and wellbeing. Understanding Radical Acceptance Radical Acceptance is the act of fully acknowledging and embracing reality without judgment or resistance. In other words, Radical Acceptance is a choice to stop fighting against reality. Likely something is happening in our life that is hard and beyond our ability to change it, and we are left with the decision to accept (radically) or reject the reality of the situation. The radical part of Radical Acceptance speaks to the complete and total nature of our choice to accept reality. Radical Acceptance is not resignation or apathy, rather it is a conscious choice to yield to what is real. Radical Acceptance also does not require our stamp of approval on the difficult circumstances, instead a simple acknowledgement that it exists and that we will stop fighting against it. Suffering comes when we fight against painful events that we don’t have the power to change, and Radical Acceptance offers us a peaceful alternative. Cultivating Radical Acceptance DBT offers us some step-by-step guidance on how to execute the choice to Radically Accept painful circumstances.
We can draw upon other DBT skills as tools to help us in this process. Mindfulness skills help us notice what is happening internally and externally and bring awareness to the present moment. Additionally, mindfulness skills call us to self-compassion and nonjudgmental observation of emotions. We may have an opportunity to reframe negative thoughts about our reality and notice growth opportunities or unexpected benefits. Some nourishing activities like journaling and spending time in nature can help promote acceptance. Often times, Radical Acceptance requires patience and practice, as most painful events will require us to choose acceptance over and over again. Disclaimer: Radical Acceptance is not an excuse for harmful or abusive dynamics, but it may be a starting point for being honest about the harm that exists. May this honesty open doors for healing and support. Losing loved ones is an inevitable part of living as a human. The times surrounding a loved one’s death can be the most challenging seasons in our lives. Even though loss is a universal human experience, people who are grieving often feel alone and isolated because it seems like no one understands what they are going through. Having a supportive community can provide comfort, solace and opportunities for healing. Finding a grief-oriented community can maximize healing opportunities. Grieving and healing in community is an ancient practice.Grieving and healing in community is an ancient practice. Before the rise of individual achievement focused societal structures, there were community gathering places and multigenerational homes where people knew how to hold other’s grief. Grief begins healing when it is externalized. We call this expression of grief mourning. We also know that healing happens when our suffering is witnessed and received by a compassionate party. Perhaps more than any other condition, a community of compassionate and understanding witnesses can unlock the power of healing for those who are grieving. We believe that healing in community happens by both hearing and being heard.We believe that community offers opportunities to heal by both hearing and being heard. When we resonate with the stories others are telling, we learn that we are not alone. Sometimes community members verbalize a part of our own experience we haven’t been able to speak about yet. When we are able to see ourselves in another’s story, we are bolstered by the togetherness we find in our common experiences. We also heal when we are able to share our own story in the safety of a group who will hold our experiences with tender compassion. We believe in the power of story-telling; that when we speak of our internal experiences, we are empowered to metabolize and release the pain. And when our sharing is witnessed in a caring and understanding way, we are more able to accept our painful circumstances. When the bereaved are able to give and receive in these ways, the strength of the group can carry all forward in healing. We invite all those who are navigating the grief related to the loss of a loved one to join our next Understanding Your Grief Support Group. More information can be found HERE. Written by Christian Swan on July 30, 2017
Last night, I had the opportunity to watch the Colorado Symphony perform the score from Harry Potter and the Chamber of Secrets while the movie itself played behind them. It was a really fun night out with my sister-in-law, as we both love the Harry Potter series and also gained appreciation for the stunning John Williams score. As I reflect on the movie today, there is one line that continues to repeat in my head. At the end of Harry's confrontation with Lord Voldemort, Ginny Weasley is revived and Harry Potter's basilisk injury is healed. Harry looks up at Ginny and says "It's alright Ginny, It's over. It's just a memory." Harry and Ginny have just suffered immense traumas that included actual threat to their lives, and yet in this moment, the traumatic memory is consolidated. Harry recognizes that he is safe, and that the events will now only exist in a memory in his mind. The memory remains, but it has no power over him. In one line, Harry Potter summarized the goal of trauma therapy: successful recognition of one's safety. As many of us know, recognizing that you are safe after experiencing trauma is much easier said than done. Sure, you may have the cognitive realization that you are no longer in danger, but the nervous system often operates as if the trauma is ongoing. This sense of ongoing trauma manifests itself in the form of post-traumatic symptoms such as sleeplessness, panic attacks, flashbacks, irritability, fearfulness, or compulsive behavior. The goal of trauma therapy, then, is not only to know on a cognitive level that one is safe, but to develop coping skills around the post-traumatic symptoms so that the nervous system can start signaling that one is truly safe. Each individual heals from trauma differently. Some, like our friend Harry Potter, may integrate the traumatic story more quickly. However, others may continue to suffer from post-traumatic symptoms for months or years after the traumatic event. Where are you in your healing from trauma? Perhaps you have achieved complete healing and can say confidently, "This event happened to me and is part of my story, but it is now only a memory." Perhaps you are experiencing some of the symptoms I mentioned above. It's also possible that you fall somewhere in the middle. Some traumatized individuals may function at a high level, while frequently feeling blindsided by irritability, anxiety, or memories of the traumatic event. If you are considering whether or not you might pursue counseling for your trauma, I encourage you to think back on the event and try Harry's statement: "it's alright; it's over; it's just a memory." How does that sit with you? Are you able to believe yourself, visiting the memory from a distance, or do thoughts of the event trigger anxiety and fearfulness? If you responded with the latter, I want you to know that there is hope, and that you don't have to live a life haunted by your trauma. With counseling, you can begin the healing work of returning to a safe place not only in the world, but also within your own body. Written by Allison Harvey
Trauma survivors have gone through something that challenged every part of them, most significantly their sense of safety. Their needs are personal, unique to their personality and circumstances, and often quite delicate. Naming these needs creates space for trauma survivors to feel safe, work toward healing and maintain connection with loved ones. Physical Needs On a very basic level, trauma survivors have a need for safety and security. Through their traumatic incident(s), they learned to be on guard and watchful. Trauma survivors need a physical location where they can let their guard down and rest. Trauma survivors also need access to medical and psychological care—professionals to come alongside them and nurture their physical and emotional self back to health. Trauma survivors also need adequate nutrition and sleep. Tending to these basic needs helps to heal a nervous system that felt a strong lack of safety. Emotional Needs Those who have survived trauma(s) have a strong need for emotional understanding, empathy and validation. When they are ready to share about their story, they need to be received with compassion, support and validation that says “what you are feeling makes sense to me.” Trauma survivors can also be supported with emotional skills that help them navigate trauma triggers and a large emotional burden while they are healing. Social Needs Trauma healing happens within a safe, understanding and supportive relationship(s). Those who have survived trauma need their people to remain open to them. Trauma healing can be messy and indirect, so survivors need compassion and grace to learn to feel safe in relationships again. Survivors may need more accommodations so that they can stay regulated, and this may look like them setting boundaries or asking for certain changes. Connecting with others who are healing from trauma can be very beneficial as well. Psychological Needs Professionals who are supporting trauma survivors should be trauma-informed and have a path toward healing in mind. Psychological care should be gentle and paced by the survivor. Professionals should respect the trauma survivor’s wishes to tell their story or not, knowing that healing can happen either way. Trauma survivors benefit greatly from learning and practicing coping mechanisms and stress management techniques. All of these activities support the survivor to rebuild trust, regain resilience and personal strength. Written by Christian Swan on March 16, 2017
I still remember my exact location and can nearly return to the sensations I felt in my body the moment I got the text message. I remember reading the words, "active shooter," from my husband who was in his office on that sunny day in June. While my husband returned home safely that evening, there is no arguing that he suffered a major traumatic incident. In the days and weeks that followed, my husband and I received an overwhelming amount of support. Our phones were overloaded with text messages and calls from loved ones, and we even received a few free meals. I was very thankful for the community we had at the time, and yet noticed a common thread in all of the support we were receiving. "How is your husband? Is he doing better?" people would ask me. I would answer their questions, and they felt relieved to hear that my husband was healing well. However, I was still suffering, and I struggled to advocate for the support I needed at the time. As the loved one of a survivor of trauma, I also became a survivor of secondary/vicarious trauma. Secondary trauma occurs as a result of secondary exposure to traumatic content. When our loved ones are impacted by trauma, we want to listen to their story and help in any way possible. And yet, it is too easily to overlook the effects their stories have on our own bodies. These effects can manifest themselves in various ways, from sleep disturbance to irritability to excessive fear and worry. Do you have a loved one who recently survived a traumatic event? Perhaps you are feeling overwhelmed and excessively tired as you seek to provide care. You may also find yourself struggling to find meaningful ways to support your loved one. Below are some ways that you can support yourself during this time: 1.) Honor your experience as a secondary survivor of trauma. Often, secondary survivors feel guilty when they become overwhelmed by their loved one's story. It is too easy to say, "I need to stop feeling badly because the trauma didn't happen directly to me." Instead, consider the effects that these stories are having on your body and take time to name your own traumatic experiencing. 2.) Seek activities that nourish you. Some ideas may be getting outside, practicing yoga or meditation, going to a concert, calling a close friend, or taking a nap. What activities help you feel refreshed? Pursue them. 3.) Consider professional counseling. Taking time to focus on your own experience will not only help you to heal but will also give you more freedom to care for your loved one. "Traumatic events are extraordinary, not because they occur rarely, but rather because they overwhelm the ordinary human adaptations to life."
- Judith Herman, Trauma and Recovery When you hear the word, "trauma," what comes to mind? Growing up, I placed trauma in a category of things I only heard about on the news. Events like plane crashes, robbery at gunpoint, or natural disasters made sense to me. Of course they were big and terrible and traumatic--the news said so! However, as I got older, I realized that there was much more grey area about what was actually considered trauma or not. Some trauma is publicized, but other times thoughts about it can become so difficult that even one's closest friends do not know about it. Furthermore, trauma to one person may not be considered trauma to another. In these cases, is it still considered trauma? While some trauma can take a very clear and pervasive form, like in the cases I mentioned above, it can also be more subtle and even happen over a period of time. Often, individuals do not seek out the counseling treatment they need because they do not feel like their experiences were "bad enough." If you are wondering if you have experienced trauma and should consider counseling, I recommend asking yourself two questions. First, do you have experiences in your life that you would define as traumatic? I'm not asking whether your aunt or the newspaper or your Facebook feed calls it traumatic. Instead, I want to know how YOU feel about your experiences. If you have experienced an event in your life that you define as traumatic and want to talk about it, I would urge you to consider calling a counselor. You may be surprised by how healing it is to have your story of trauma validated by an objective individual. Perhaps you are certain you have experienced trauma, but still do not know if you should consider counseling. In that case, my second question to you is this: are you having difficulties in life that you did not have before the trauma occurred? For example, you may find that you struggle to sleep through the night, have an increased/decreased appetite, or have difficulty completing tasks efficiently at work or school. Or maybe the experience of the trauma has become so pervasive that you can't seem to stop thinking about it. By seeing a counselor, you can begin to develop coping skills that will reduce your post-traumatic symptoms and help you feel more functional in your daily life. If you can answer yes to one or both of these questions, it may be time to consider reaching out for trauma therapy. Healing is possible when you are willing to commit the time to properly honor your story in the context of a safe relationship. Written by Christian Swan on March 09, 2017 Practicing this DBT Skill can help us stay grounded and connected this holiday season! Mindfulness is a skill that, when practiced regularly, is a great tool to reduce stress, connect with our personal goals and create genuine connection with others. The holidays can be rich in memory, sentiment and relationship. They can also be full of family expectations, grief and reminders of trauma. These, and many more experiences, can overwhelm, cause us to disregard our own needs, and flood us with many different emotions. In order to enjoy the positive aspects of the holiday and skillfully navigate the challenges, try practicing mindfulness throughout your holiday season!
Mindfulness has three components:
Mindfulness as Stress-Reduction For many, the holiday season means a busy schedule and many more tasks and to-dos than normal. Practicing mindfulness in the midst of the whirlwind helps to produce moments of calm to catch our breath and remember our priorities. Mindfulness also helps us evaluate where our time and energy are going and make the most intentional decisions for ourselves in this season. Mindfulness as Social Support Paying attention to the present moment, without judgement can give us a lot of important information about what is happening in a room, or in a conversation. In the midst of a holiday gathering, take a moment to simply observe what is happening inside and outside of yourself. Allow yourself the gift of a few deeper breaths. Notice who is talking with who, and what those dynamics are like. Notice what is happening inside yourself as you connect with different people. Hold this information lightly and without judgement, and allow this information to guide your interactions. Mindfulness to support Intentional Decisions If you find yourself navigating a lot of spoken and/or unspoken expectations over the holidays, mindfulness skills can help you identify your needs and desires and to stay connected to them throughout the season. Spend some intentional moments noticing where you would like your time and energy to go this season, what would make it memorable and special for you and yours. Notice how other’s expectations are making you feel, especially if those expectations cause you to disregard your own needs and desires. Give yourself the gift of staying connected to yourself and your values, which becomes a much more congruent and grounded holiday experience. |
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