Are you dealing with complex trauma and looking for an effective, cost-efficient solution? EMDR intensives may be the answer. EMDR (Eye Movement Desensitization and Reprocessing) is an evidence-based therapy that can help individuals suffering from C-PTSD (Complex Post Traumatic Stress Disorder). EMDR intensives are shorter, more intensive sessions of EMDR, compared to the traditional weekly therapy. In this blog post, we will be discussing how EMDR intensives can provide transformative results and how they are more cost-effective than weekly therapy.
EMDR intensive therapy is a powerful treatment option for individuals struggling with complex trauma or C-PTSD. An EMDR intensive is a condensed and focused period of time for counseling, providing efficient and effective relief for those who are emotionally suffering. This therapy method involves a dedicated period of time ranging from three hours to multiple days in one week.
It’s important to note that EMDR intensive therapy is not for everyone, as the goal is to follow the natural healing process. However, for those who are able to commit to this intensive psychotherapeutic approach, it can help reduce distress around traumatic or adverse events, shift long-held beliefs, and ultimately help approach life and relationships in a more aligned way. Investing in your mental health through an EMDR intensive may be a life-changing decision.
EMDR intensives offer numerous benefits, especially for those suffering from complex post-traumatic stress disorder (C-PTSD). Here are a few key advantages:
1. Condensed format: EMDR intensives allow clients to make significant progress in a shorter period than traditional weekly therapy sessions. This condensed format can help eliminate weeks or months of living with trauma symptoms.
2. Reduced lost work time: Since sessions are completed over two or three days, it greatly reduces lost work time, making it easier to fit treatment into a busy schedule.
3. Cost-effectiveness: Although there is a larger upfront cost, the shorter duration of treatment overall can save money in the long run.
4. Shorter wait times: Waiting lists for good trauma treatment providers can be long. However, with EMDR intensives, clients can get through treatment in the same week they start, reducing wait times.
5. State-of-the-art modality: Intensives are being studied in the literature as a state-of-the-art modality for trauma, making them an effective treatment option.
6. Accessibility: Clients who are out of town or out of state can take advantage of access to excellent treatment quickly, making only one trip to complete treatment. Even local clients with transportation or childcare complications can make arrangements for a single weekend.
Overall, EMDR intensives are an effective and efficient way to address trauma and other mental health concerns, making them a valuable investment in your overall well-being.
While weekly therapy sessions can be highly effective, an EMDR intensive offers a different approach that can provide transformative results for clients dealing with complex trauma and C-PTSD. One of the main benefits of an EMDR intensive is the ability to make faster progress and process traumatic memories at a deeper level. This is because the intensive approach allows clients to fully immerse themselves in therapy and stay focused on their therapeutic goals over a short period of time.
Another key advantage of the intensive approach is the increased accountability that comes with working with a therapist for an extended period of time. Both the client and therapist have a heightened sense of responsibility and commitment to the treatment process. The intensive approach can also be ideal for clients who have one or two specific problems they want to work on.
However, weekly therapy also has its benefits. Gradual progress, better integration of the therapy process into daily life, reduced intensity of emotions, and more flexibility with scheduling can all be important factors for some clients. Ultimately, the choice between an intensive or weekly approach will depend on the client’s specific needs, therapeutic goals, and personal preferences.
Regardless of which approach a client chooses, investing in one’s mental health should be a top priority. By committing to therapy and working with a qualified therapist, clients can make progress towards healing and moving forward in their lives. Don’t let the cost or time commitment deter you from taking the necessary steps towards a brighter future.
When it comes to mental health care, economic value is an important consideration. While weekly therapy sessions may seem like the more affordable option, investing in an EMDR intensive can actually be more cost-effective in the long run. A large, well-designed randomized study found that an intensive 1-week course of evidence-based PTSD therapy had the same outcome as delivery of the same treatment over several months – except that the results were achieved much more quickly in the intensive format (Ehlers et al, 2014). This means that investing in an EMDR intensive can save you time and money, while also providing more rapid relief from symptoms.
But why are EMDR intensives so effective? For starters, they differ from weekly therapy in that they involve a much more concentrated and focused treatment approach. Instead of spreading out treatment over several months, an EMDR intensive condenses treatment into a week-long period, allowing for greater treatment efficiency and a reduced risk of destabilization. Additionally, an intensive format helps to reduce the risk of life crises disrupting treatment, as clients can fully immerse themselves in the therapeutic process (Greenwald et al, 2020).
Perhaps most importantly, EMDR intensives offer rapid results, which can help to prevent further suffering or harm from symptoms of C-PTSD. This is due in part to the fact that the intensive format eliminates time spent on activities like checking in at the beginning of each session, addressing current crises and concerns, focusing on stabilizing and coping skills that the client won’t need after trauma healing and assisting the client in regaining composure at the end of the session. All of these factors help to make EMDR intensives a highly effective and cost-effective option for those looking to prioritize their mental health and well-being.
If you have experienced any type of trauma, including complex trauma, then EMDR treatment could potentially benefit you. Complex PTSD, or C-PTSD, can result from ongoing trauma and can lead to symptoms such as hypervigilance, emotional dysregulation, and difficulty with trust and attachment. EMDR treatment is effective in addressing the symptoms of C-PTSD, as well as other types of trauma.
Some signs that you may benefit from EMDR treatment include:
– Flashbacks or intrusive thoughts related to the trauma
– Avoidance of certain people or situations
– Difficulty regulating your emotions, such as feeling numb or disconnected
– Difficulty sleeping or experiencing nightmares
– Chronic pain or other physical symptoms related to the trauma
EMDR treatment can help to reduce these symptoms and improve your overall mental health and well-being.
EMDR intensives are particularly effective in treating complex trauma, or C-PTSD, as they allow individuals to delve deeper into their traumatic experiences and process them more fully. Unlike weekly therapy, where the focus may be more on managing symptoms, EMDR intensives are designed to target the root cause of the trauma and provide a transformative experience. By dedicating several days or weeks to an intensive EMDR session, individuals can make significant progress in a shorter period and experience a more lasting impact on their mental health. Additionally, EMDR intensives can be more cost-effective than weekly therapy, as the total number of sessions required may be lower overall. Overall, investing in your mental health through EMDR intensives can provide transformative results and lead to a more fulfilling and joyful life.
If you are interested in exploring whether EMDR intensive treatment could benefit you, feel free to give our office a call to set up a free consultation.
Sending Love & Light,
The word trauma is used in many different contexts, and it has recently been more of a topic of conversation in recent years. When people think of trauma, the typical images that may run through their heads are of war veterans, sexual abuse survivors, or even other kinds of abuse experienced. However, I believe that the population of caregivers as well as loved ones of those who are battling a deadly disease or severe medical conditions experience a trauma that does not get noticed enough. This is what can be termed secondary trauma, when one learns about the traumatic experiences of a loved one. Try painting this picture in your head: sitting in a hospital room beside the hospital bed for days in and days out with no end in sight, having not much to do other than observe your loved one in pain while they are in the hospital or at home, as well as even possibly having to dedicate all your time to care for your loved one.
Unfortunately, my family recently experienced a significant loss. My stepbrother, who was battling cancer since November of 2015, had passed away on Christmas Day. His battle with cancer is one that will never be forgotten by those who surrounded him. My stepmom and dad were his caregivers throughout the whole process. As a mental health counselor, I was keen on observing the impacts his battle with cancer had on them. For the sake of their privacy I won’t divulge, however the countless sleepless nights as well as hospital visits speak for themselves.
Our reactions to bereavement vary from person to person, everyone has their own way in which they react to the loss of a loved one. Grief disorders come into play when an individual is experiencing prolonged as well as complex grief symptoms, these symptoms are typically more challenging for the individual to live with as well as may cause significant impairments to your normal functioning.
Some symptoms that are consistent with complex grief are: excessive irritability, consistent insomnia or sleep difficulties, intrusive thoughts about the loss, feelings of futility, as well as having a strong sense of responsibility for the loss. These are just a few of the symptoms that correlate with complex grief; it should be noted that if you are experiencing these symptoms and if they are lasting more than two months after the loss, it can be a signal of a prolonged grief disorder.
It can go without saying that in these kinds of circumstances, we have someone who is ill and may be getting traumatized in the process as well as a caregiver or family member watching all of this play out in front of them, can have a significant impact on how we are perceiving this kind of trauma. I believe that this statement describes the experience of caregivers and loved ones during this time, “for some caregivers and loved ones, watching the death of someone close to them, while making no attempt to stop it, can be excruciating and lead to shock and extreme emotional distress,” (GoodTherapy).
Intrusive thoughts are common when talking about mental health and discussing our emotions. Intrusive thoughts are simply thoughts that enter the mind unwillingly that cause some sense of discomfort, or they can be images or impulsive urges that pass through your mind. In a situation like this, it is common for people to have constant intrusive thoughts about the person who has passed. Those who have a history of addictive behaviors may resort back to old unhealthy habits, and it’s even possible for one to develop a fear that is related to the loss in some way (i.e. if the death was caused by a car crash, a fear of driving may develop).
The history of it all. It’s true, the history that one has with the one who has passed can impact the way that they experience grief. Whether that history is traumatic, joyful, distressful, or filled with unforgettable memories, each has a unique way of causing a domino effect. For example, if the one you have lost was a significant factor in your trauma history it may be difficult for you to wrap your head around how to grieve this individual. Feelings of confusion, conflicting emotions, feeling alone in the grief, as well as feeling guilty for holding negative feelings/thoughts towards who has passed. We see you, and it’s okay to be going through all of these emotions and barriers.
Ultimately, it is up to you to decide how you want to experience grief and how you would like to progress on the path of healing, if needed. Your family may have their own words and ways of going about the loss, but this is not something that needs to be conformed to or feel as though you should be matching the level of emotions of your family members. No. It is your journey. It is your life to drive forward. It is your time to take care of yourself, and if you start questioning the reality of you being able to take care of yourself or if you have hesitations about doing so; just remember how much you have cared for your loved one and pull that energy inwards and direct it towards you.
Grief and loss is unfortunately something that we all come to know all too well. Even with that, it still feels like getting hit with a ton of bricks whenever it happens. Throughout our lives, we make connections, friendships, relationships with people that are not forgotten. It is important not to remember your loved one as they were during their last struggling moments, but to remember them by how they were around you.
Doesn’t it drive you nuts when people tell you to “calm down” when you’re upset, anxious, panicked, or afraid? It drives me insane. I just think to myself, “Okay great…and how do I accomplish that without putting you through a wall?” Of course I don’t act on such thoughts! But I understand the frustration of feeling stuck in a dark, deep hole of anxiety while the bystanders at the top of the ditch are yelling down to me, “calm down!” or “it’ll be fine!” or “you’re overreacting!”. Which is why grounding techniques can be so beneficial when no one else can.
First, we should go over some basics of what anxiety and panic look like so we can better spot them before we feel completely unraveled in our experience with such symptoms.
First, quick side note/science lesson…our bodies yield both the Sympathetic and Parasympathetic nervous systems. Housed in the Sympathetic nervous system is our “fight or flight” that prepares us to respond to danger. While fight or flight has always been essential to survival, the body can’t always tell what is a genuine danger versus when we are just emotionally uncomfortable or going through something. The Parasympathetic nervous system helps our bodies restore back to a state of calm when fight or flight is no longer needed. This information is important because it plays a GIGANTIC ROLE in anxiety, panic, as well as other mental health struggles.
So when we have anxiety, there is constant worry that we can’t seem to shake most of the time in addition to maybe feeling restless, on edge, having a hard time focusing, feeling more irritable, physically tense, having a tough time sleeping and feeling easily fatigued quite a bit. I go through this myself and I can tell you firsthand that ignoring these symptoms will lead to feelings of anger and irritability, scatteredness, constant exhaustion, and like every little thing is an insurmountable task which will negatively affect your life across the board. Trust me, I know.
Panic is a bit different and more intense than your typical anxiety monster impeding on your day to day life. With panic, we actually feel like we’re having a heart attack or like we’re going to die! That’s right…there are instances when people have had to go to the Emergency Room because they thought they were having a medical emergency. Completely understandable given the symptoms of panic. If we look at symptoms of panic that include accelerated heart rate/palpitations, sweating, trembling/shaking, shortness of breath, feelings of choking, chest pain/tightness/discomfort, chills or heat sensations, numbness or tingling, feeling detached from ourselves or reality, fearing we are losing control, and fears of dying….it’s no wonder people may want to seek out a medical professional real quick.
While I have never experienced a panic attack myself…I am willing to bet that if I ever do, I’m getting my butt straight to the Emergency Room because as humans, what are we supposed to think when all of that is going on without any clear medical explanation? I highly encourage anyone experiencing such symptoms, especially if this has never happened before, to seek medical attention immediately and rule out medical concerns before chalking this all up to panic!
However, once we rule out medical concerns and have an understanding of panic symptoms, we can better manage them without seeking unnecessary medical attention or escalating our anxiety/panic due to fear of the unknown. It is essential to understand that panic attacks are just that, panic. They cannot physically harm you and they tend to last about 10 minutes (while I’m sure it feels like forever!). So, we have to remember that it will pass and getting comfortable with discomfort is one of the first steps to getting through panic attacks. I’m sure that’s obnoxious to hear, but it’s true.
Much of the time, what I’ve caught myself doing to alleviate my own generalized anxiety is to avoid, avoid, avoid. Whether it be avoiding a deadline or an uncomfortable conversation, dodging obligations/tasks all together feels good in the moment, for sure. While my education tells me that avoiding my anxiety like the plague only makes things worse, I admittedly engage in this behavior. And trust me, the education is correct…avoidance only feeds the anxiety monster that lurks beneath.
Well, a form of coping called grounding skills seems to help many, including myself, to feel more centered in the present moment and ultimately activate my parasympathetic nervous system (that’s what we want). With grounding, we are essentially turning our attention to the present moment so that we can ultimately feel more calm and address potentially anxious triggers.
In grounding, we use our five senses to return to the present moment when feeling overwhelmed and like everything is on top of us. Grounding equips us with several skills to utilize healthy detachment from emotional pain with use of distraction until we feel ready to return to any given problem. The following 5 skills that I will list below can be used any time, in any place, and can be completely discreet. There are many more ways of grounding that will not be covered here but I encourage you to explore ways of grounding with your therapist to find the right fit for you.
This skill invites us to observe 5 things we can see, 4 things we can feel, 3 things we can hear, 2 things we can smell, and 1 thing we can taste. For example, if I am feeling overwhelmed I will stop and look around me, engaging in this technique to focus on something aside from my stressor for a few minutes until I can collect myself and face my problems with my head screwed on right.
Here, we are encouraged to focus our attention on sensations in the body and feeling of calm after the exercise is over. Below, you will find an example cited from Therapistaid.com.
When having anxiety or panic, a way to cultivate acceptance of discomfort and better managing symptoms, we can be kind to ourselves. Does it seem ridiculous? Maybe… but it can work! Focusing on positive words you say to yourself over and over in the midst of anxiety or panic can help you remember that you are strong, resilient, and can overcome difficult things in this life. Some examples of what you might say to yourself would be, “This is uncomfortable but I can accept it”, “I will let my body do its thing and it will pass”, “I survived this before and can do it again”, “this isn’t dangerous”, “no need to push myself, I can take a small step forward as I choose”, “these are just thoughts, not reality”, or “don’t worry, be happy”.
I’m sure mostly everyone has heard of some form of deep breathing and I often hear clients tell me, “this doesn’t work for me”. Upon closer inspection, I find that people may try this once or twice, and when it’s not instantly working, they chuck it out the window. However, this form of deep breathing should be given a fair shot! Let me explain a bit more about how to engage in this skill, then I’ll explain why I feel so strongly that deep breathing really needs to be given a chance.
So, how do we do this one? We put one hand on our chest and the other on our belly. Then, we inhale slowly through our nose, hold briefly, and exhale through our mouth. Some follow a formula of 4-6-4; ie. inhale 4 seconds, hold 6 seconds, exhale 4 seconds). Adjust to your comfort level. Make sure that upon breathing in, your belly is expanding out. Notice how your belly expands and falls with each breath. It is recommended to engage in this skill for at least 2-5 minutes daily.
The reason deep breathing works is because it levels out the oxygen and carbon dioxide in your blood. When you have anxious breathing, your oxygen and carbon dioxide levels are uneven, leading to the physical manifestation of anxiety that we talked about earlier. So to help activate the parasympathetic nervous system (the one we want) and ease the physical parts of anxiety, diaphragmatic breathing is a great one to try. Let me know how it goes!
It has been found that in anxiety as well as trauma, the sense of smell is largely connected to the emotional part of our brains. If you think about it, maybe something that smells oddly familiar to you but you can’t put your finger on it brings a sense of comfort and calm. I know for me, whenever I smell anything that resembles Thanksgiving dinner, I have a sense of ease thinking back to fun childhood memories, enjoying my grandmother’s cooking for Thanksgiving dinner. Her food is always on point!
So when we are feeling anxious and/or triggered in any way, we can use sense of smell to quickly return to the present moment. Ideas that some of my clients have found helpful over time is to keep a perfume and/or cologne soaked handkerchief on them, an essential oil bottle on them, or maybe a favorite kitchen spice. Candles and/or wax warmers at home can also bring a sense of peace and calm using pleasant scents.
While anxiety can sometimes make us feel like we’re in a moving car with no driver, there are ways we can safely get back into the driver’s seat and navigate our symptoms safely, securely, and happily. Your therapist can help you navigate these tools and find out what may be the best suited for you and your needs. Anxiety will not get the best of us!
After a long day, rushing to get your work done, put dinner on the table, and solve the crises everyone runs to you for, you finally get a moment of peace while laying down to sleep. Unfortunately, for many of us, this time can be full of distressing thoughts including memories of the past, fears for the future, and analysis of ourselves. Some even find themselves unable to fall asleep due to these ruminations, making their next day even more tiresome.
Our nighttime thoughts are often a reflection of our daily lives. To a degree, thinking at night is our mind’s attempt to reflect, adapt, and prepare for challenges to come. What this means is that if our days are full of stress then our minds will try to anticipate future stress and prepare us for that stress in our only moment of respite.
Some people find that giving themselves a time, during their waking hours, to feel their stresses and accept them, have less of a tendency to think of these thoughts later on. This can be a difficult task to do, but a number of clinicians at Suffolk Family Therapy can be there to help you get started. Learn about them here.
People who suffer from overwhelming life stress, anxiety, depression, and associated insomnia will often say that their unwanted thoughts make it harder for them to get to sleep each night. This insomnia can lead to decreased work or academic performance, depleted mood, low energy and fatigue, or many other functional impacts.
As silly as it may seem: count sheep. More specifically, there is research that suggests repeating a word or phrase at specific rates (usually 3-4 repetitions a second) can impact our brain’s ability to think of other thoughts. This is called articulatory suppression. This phrase should be neutral so that it doesn’t trigger thoughts of other things to come to mind. Some people find syllables or articles (“the”, “an,” or “a”) as helpful choices.
Others find imagery to be exceptionally helpful in maintaining sleep and getting to sleep. Try this exercise: in your mind, craft a story around yourself doing something that you enjoy most. Do your best to picture the details: sights, sounds, smells, or tastes. By practicing this imagery, you are training your brain to use your imagination to distract yourself from your thoughts. If those intrusive thoughts come to mind, accept that they are there, and push them aside as you author your tale.
Remember, this is a learned skill. It may not come naturally and it may not work the first few tries.
Other things that you may be able to do to focus on your sleep include:
Our brains are very much like a river: the water represents our thoughts and the land represents our mind. If we can place ourselves firmly in the river, and not get carried away with the current, then we can improve our wellbeing. For some, the current, or our intrusive overthinking, will carry us into anxiety, depression, and other negative mental places. So, we look to take some control back and stand up.
Some brief activities can help us to control our thoughts and thus improve our nighttime routines.
Everyone ruminates. Whether it’s thinking about something we said to someone, something we did wrong, or some recent event that is stuck in our mind. Ruminating thoughts can be defined as repetitive and recurrent, negative, thinking about past experiences and emotions (Michael, et al., 2007). However, while everyone experiences ruminating thoughts at some point in their life, for some, rumination can be distressing, difficult to stop, and can lead to dysfunction in their day-to-day lives.
When we think about ruminating, it’s important to acknowledge that it often comes from an effort to cope with distress. For instance, analyzing an experience can better prepare us to encounter a similar experience in the future. Or it can help us mend some relationships that were negatively impacted by an event in the past. But, when these thoughts aren’t leading to any productive change we can see individuals obsess over these thoughts, become anxious and depressed, isolate, or begin using / increasing their use of mind-altering substances.
Ruminating thoughts can be very diverse. For some, they may ruminate about their hands being dirty and that they may get sick. Others may ruminate about suicidal thoughts, including existential themes about the meaning of life. Some may continually think about a traumatic experience, like an assault or some form of abuse. As well, some of these ruminating thoughts may be untrue distortions of events. For example, repeatedly thinking about being sexually assaulted may come with false thoughts that the victim somehow provoked their assailant or deserved to be assaulted.
Our experiences mold our self-esteem, or the way we perceive our behaviors, abilities and traits. A traumatic experience can leave individuals with warped perceptions of themselves that can have a detrimental effect on their day-to-day lives. Especially the formation of a negative self-esteem, or negative self-concept, is associated with feeling disempowered, hopeless, and helpless. Ruminating on these experiences, or even these self-beliefs, has been shown to exacerbate and prolong negative moods, and hinder social interaction and problem-solving skills (Wang, et. al, 2018).
Ruminating thoughts can be associated with a number of mental health diagnoses, including:
● Depression
● General and social anxiety
● Substance abuse disorder
● Bulimia
● Binge eating disorder
● Obsessive-compulsive disorder
● Post-traumatic stress disorder
● Personality disorders, like borderline personality disorder
Ruminating thoughts are treatable and manageable. Treatment often aims to interrupt the thought processes and improve coping skills to replace rumination. Some individuals find relief from medication management, cognitive-behavioral therapies, and mindfulness techniques.
If you experience ruminating thoughts and are looking for a way to move forward, please call our office and schedule an appointment. Our licensed clinicians and therapists on staff would be more than happy to work with you.
–Nicholas Costa, SFT Social Work Intern
When we experience trauma, our brains don’t function like they normally do. We go into survival mode: think fight, flight, or freeze. Our brains automatically direct all of our energy toward dealing with this immediate threat until it’s gone. In most situations, this feeling of being in danger fades over time. Maybe it takes a few hours or a few days but you eventually start to feel better and less on edge.
But sometimes that initial trauma sticks, and you just can’t seem to shake the feeling that you’re still in survival mode. Trauma can change the way we think, act, and feel for a long time after the initial event occurred. Things like flashbacks or nightmares, constantly feeling on edge, anger, intrusive thoughts, and self-destructive behaviors are all very normal responses to trauma. You might feel as if you’re stuck living with these symptoms for the rest of your life, but the good news is these patterns can actually be reversed. With the right approach and knowledge, you can shift your brain towards overcoming past trauma and begin your healing journey.
Trauma’s impact on the brain is complex. Let’s talk science for a minute to review some parts of the brain. Trust me, I’m not a fan of science either. But I promise this is helpful to know in terms of healing, so stick with me.
To simplify things, let’s break it down into two parts: the subconscious system vs. the conscious system. Do those terms sound familiar? Your subconscious mind is responsible for any involuntary actions, and your conscious mind is responsible for rationalizing and logical thinking.
Okay, let’s take this one step further. The subconscious part of your brain involves the Limbic System (think automatic) and the conscious part of your brain involves the Frontal Lobe (think choice). Both of these systems work together to help you survive and stay safe. If you’re in trouble, the frontal lobe says, ‘yes, this is dangerous’ and allows the limbic system to react in either a fight, flight or freeze response. On the other hand, if your frontal lobe realizes you are not in any danger, it works to calm down the limbic system’s reaction.
You might be asking why this is relevant. Well, here’s why. Trauma can disrupt the ability of your limbic system and frontal lobe to work together, and this causes you to either go numb or into overdrive.
When we talk about feeling ‘triggered’ in terms of trauma, we are referring to the subconscious response. The limbic system becomes extra sensitive to our triggers (sights, sounds, smells, feelings, etc.). And even though you aren’t in any current danger, the limbic system overreacts and overwhelms the frontal lobe by triggering survival mode. As a result, your frontal lobe either undercompensates or overcompensates (cue feelings of numbness or going into overdrive). You do not know how to move forward and stay safe at the same time.
There are many different ways these two parts of the brain work together when we talk about trauma and healing. Everyone’s experience is different, but many of the changes we see in the brain are similar. Here’s one common example.
Jane is out shopping and passes someone in the store who is wearing cologne. The smell of that cologne reminds her limbic system of her past trauma, and the limbic system now believes Jane is in danger. Jane feels her heart race, her mind starts spinning, and she feels like she wants to run away to be anywhere but here.
This is a completely normal reaction for Jane’s body and brain to have to a potential threat, even though she wasn’t in any danger. It’s an automatic reaction. And that’s not necessarily a bad thing. In the past, the smell of cologne was associated with a threat, so the brain triggered a response thinking it had to do something to keep Jane safe. If you think about it, your brain is doing exactly what it should be doing. It’s just still thinking the smell of that cologne means danger, even though Jane knows otherwise.
You might be thinking, ‘great, so I’m stuck like this?” In short, no you’re not! It is possible to help your frontal lobe and limbic system heal and work together more efficiently.
You may have heard the term neuroplasticity before. This simply means our brains are able to modify, adapt, and change throughout life. Some things changed in your brain when you experienced trauma, and we can appreciate that as it was necessary for survival at the time. But now that that experience is behind you, you probably want to leave it there and stop feeling such strong emotions at simple reminders. And I don’t blame you! The good news is, that is very possible. Maybe your triggers are similar to Jane’s triggers, or maybe it’s completely different for you. Either way, it is possible to rewire and retrain your brain again.
So, where do you begin? For starters, it’s always a good idea to process any past trauma in therapy. If you haven’t already, find yourself a trusted therapist to support you through your healing journey.
The next step here is really going to be identifying where you’re having difficulty. Is it similar to Jane’s experience where you see or smell something that triggers you? Or maybe your past experiences are affecting your ability to focus, make decisions, and resist impulses. These are all things that can be worked on and improved with practice.
During the healing process, your brain can create new pathways, increase function in some areas (like your frontal lobe!!) and strengthen connections. There are many different ways you can work on improving brain function. I’m sure you’ve heard of ‘brain games’ before, right? They’re basically games that stimulate your mind and help you practice certain cognitive functions like memory, problem solving, or critical thinking.
There are similar exercises you can do on a daily basis that will be ‘training’ one or more parts of your brain. Here’s one example. We’ll call this exercise ‘Planning Ahead’.
Is there something you want or need to get done this week? Picking a day or time to sit down and accomplish that task can help to actually push yourself to do it, but it’s also a really simple exercise for your brain. When you write down even one reminder of what you want to focus on, you’re strengthening the connection between your limbic system and frontal lobe.
You can practice this by using the calendar or reminder app in your phone, or print out a good old-fashioned calendar from google. Maybe start by penciling in any appointments you have, and scheduling some of your household chores around them. Or maybe you want to schedule some time to sit down and read a book. Whatever it is, make a plan to do it, and follow through with that plan.
When you make conscious choices by planning, tracking, and following through, you’re strengthening your frontal lobe. This added strength builds new connections in your brain and creates positive experiences for you to look back on and feel proud of.
With time and practice, these connections will get stronger and you’ll continue to feel empowered to act on your plans and dreams. And if those plans and dreams include overcoming your past trauma, you’ll feel empowered to take continued steps towards healing.
If you’re interested in learning more about how to reverse the impacts of trauma, I’m facilitating a group called Finding Hope for women survivors of childhood sexual abuse this fall. Visit our website or call (631) 503-1539 for more information!
Art therapy is a newer form of therapy. It is an integrative mental health practice that is designed to improve the lives of individuals, families, and communities through the process of art-making, creative process, applied psychological theory, and human experience within a therapeutic relationship.
Art therapy should be done by a trained professional of art therapy. This will improve the effectiveness as art therapists are trained to create art therapy exercises that are designed to not only support you but also to help move deeper into your therapeutic goal. Art therapists are trained to use their knowledge to support your personal and therapeutic treatment goals throughout treatment. Art therapy has been used to improve cognitive and sensorimotor functions, help support a better relationship with self-esteem and self-awareness, produce emotional resilience, promote insight, enhance social skills, reduce and resolve conflicts and distress.
Art therapy is a wonderful tool therapists use to help patients interpret, express, and resolve their emotions and thoughts. This is a newer type of therapy and was first established in the 1940s however the practice did not become more widespread till the 1970s. Like other expressive arts therapy, such as dance therapy or music therapy, it draws on creativity.
Often people mistake “Art therapy” for things that are not necessarily due to a lack of knowledge about the profession. However these situations provide an opportunity to offer accurate information and educate the public. This modality must be done by a trained art therapist or it is technically not art therapy. Some products that are mistaken for art therapy are adult coloring books and paint by numbers. Art therapists are not art teachers, their goal is not to make you a better artist but to help you improve your mental state through the use of art.
Many people ask “What is art therapy and how does it work?” It is all about expression. The process of creating is the most important thing, not the end product which is why anyone can do it. Often many people shy away due to a fear of not being an artist but this type of therapy is for anyone. It is designed to use the expressive arts as a way for people to understand and respond to their emotions and thoughts with a valuable new perspective, not only that artistic expression is good for mental health as it is often related to relaxation.
During a session, an art therapist works with clients to understand what is causing them distress. Then the therapist guides the client to create art with an art directive that addresses the cause of their issue or explores it further. During a session, art therapists may:
Through different mediums and art techniques art therapy engages the mind, body, and spirit in ways that are not dependent on verbal articulation alone. Due to the way it engages the body and mind it causes various symbols to be created through the art process, this process also invites modes of receptive and expressive communication, which can benefit those who have limitations of language.
Art therapists are clinicians who are trained both in traditional clinical therapy and art therapy. Art therapists work with people of all ages and various populations. All art therapists are required to follow an ethical code. All art therapists are also required to have a master’s level education, as well as engage in supervision hours under a trained professional in order to obtain their license. This prepares them for various populations and gives them the ability to perfect their work.
Art therapists work with individuals, couples, families, and groups in diverse settings. Some examples include:
There is growing evidence that art therapy helps conditions such as anxiety and depression, trauma, low self-esteem, PTSD, Bipolar and similar disorders. It has also been used with those facing terminal illnesses such as cancer and those hospitalized experiencing pain, as well as it has been used with people working to develop effective coping skills, including prison inmates
Many clients are reluctant to explore art therapy because they think that they have to have artistic talent for it to work or see it as “arts and crafts” rather than see it as an effective tool. This mindset can be very limiting and can hinder the effectiveness for these clients. It is important to go in with an open mind.
There’s no way to tell for certain whether art therapy is a good fit for any given person. Therapy is not one-size-fits-all, and a client and therapist may need to use multiple different approaches and techniques in order to find what works best for you. However, if a patient is drawn to art or has had trouble expressing with traditional therapy, art therapy may be a wonderful fit for you.
When choosing a therapist it is good to consider the following. As a potential client, ask about:
Often you should be able to tell in 1-3 sessions if this works for you.
If you feel like art may be a good avenue for you to work through your mental health concerns please call our office and ask for Jillian Martino. Jill is our art therapist on staff and would be more than happy to help you work through your concerns through art. Jill specializes in LGBT issues, trauma, children and couples. Contact our office today to set up a free 15 minute consultation.
Mindfulness is the ability to be fully present and aware of where we are and what we’re doing. One important aspect of mindfulness is to not be overly reactive or overwhelmed by what’s going on around us or in our mind. It is important to just observe without judgment. Mindfulness is a quality that we can all tap into, we simply just need to learn to access it. The following prompts are designed to help you begin becoming more mindful in just 15 days!!
This is one of my favorite personal practices. Write this letter as if you are writing it to a friend. Write everything you are grateful for as well as everything you are grateful to be working towards. After you do this, read it aloud. I like to do this practice daily.
Meditation is a difficult one and can be difficult for people, often we believe that the brain should turn off during meditation. However it is quite the opposite, often our mind will start racing, the buddhist call this monkey brain. It is important during this practice to notice whatever may be coming up for you without engaging or giving the thought energy. After bringing your attention back to your breathing. If this practice is hard for you start small. Start with five minutes and then slowly increase the more you practice. There are also a ton of videos online and apps that can help support you through your meditation.
Take this time to really connect with yourself and your garden. Notice the smells, what you feel in your body. Maybe how your skin feels in the sun etc. Mindfulness is all about giving ourselves a moment to pause and appreciate everything, the good, bad and everything in between. Allow yourself to express without judgment.(If you don’t have a yard pick somewhere in nature)
Really make your food an experience here. Just like meditation, focus on every sensation. How does it taste, how does it feel etc. Be present. Thank yourself for the nutrition!
Here is a simple Practice, set your intentions. Setting goals will help us be more mindful of actually making them happen. If you want to add an artistic flare to this exercise, turn this list into a vision board. This is a super fun activity for date night, girls night or just a little self care for you!
When decluttering the mind it can be helpful to have our living spaces match this energy. Get rid of all the things making energy shifts in your space, I promise you don’t need those pants that are too small on you that you keep as motivation. Focus on the now.
Good and bad, this is about bringing attention to our critical voice. Be honest with yourself. Remember NO JUDGMENT.
Notice your value: if this is hard examine that. Start small if you can only think of two things that’s okay. Continue to revisit this exercise as you move through the practice. I like to make positivity jars for myself where I put little notes of wins I had over a whole year and read them at the end of the year. Sometimes we let the good we do go unnoticed, this time is for you.
Mandala’s have been known for their meditative properties, they have been recognized by psychologists like Carl Jung for their therapeutic benefits. While creating your mandala again notice what maybe coming up for you.
Again, full transparency here. Want to go even deeper with this exercise? Follow this question up with why do I have these fears? Where did they start?
SELF CARE!!! Do I even need to explain? Not only should you write what you can do for yourself here but also examine what you can do in order to start integrating these things into your day to day.
Spirituality states that our hips hold a ton of our trauma. Moving these parts of yourself will help you release some of those big feelings. Pay attention to whatever comes up for you. You may feel awkward or may even feel uncomfortable with seeing your body moving through the mirror. Pay attention to this, bring awareness to it. Meet it with the question why as well as some compassion.
Everything needs rest, even you! It is scientifically proven that we are more productive when we rest, this helps us avoid burnout. There is an awesome book called “How to Do Nothing” by Jenny Odell that further explains this.
Yoga is a wonderful practice for mindfulness, if its not your thing though do something else to get that blood pumping.This can be walking around your neighborhood or HIIT, whatever makes you feel good! Examine how your body feels before and after your workout.
Cultivating happiness. Abraham Hicks has a ton of videos speaking of the importance of following our happiness. Happiness is our driving force so lets bring our awareness to it.
When someone survives a traumatic event, it can be beneficial to have both personal and professional support through recovery. Leaning on personal supports can be just as important as speaking with a therapist, but as a friend or family member looking to provide support, it can be difficult to find the right words to say. These conversations can be uncomfortable and difficult to navigate, but it’s important to choose your words wisely as to not further harm or re-traumatize the survivor.
In this blog post, I list a number of phrases you should avoid when speaking with trauma survivors, as well as a few things you can say in order to best support your loved one. Let’s start with the former.
“Why didn’t you say anything at that time?”
It’s incredibly common for survivors of trauma not to disclose what they’ve been through right away. Sometimes it takes years to work up the courage and speak with someone about it. Sometimes people don’t have any memories of their trauma, and sometimes these memories come back way later on in life.
It can also be very painful to talk about past trauma, especially when it feels like no one else can possibly understand what you’re going through. If a loved one has opened up about past trauma, don’t question why it took them as long as it did to speak up. Simply be grateful they feel comfortable enough to talk to you now, and try to support them as best as you can.
“I know what you’re going through”
Chances are, no you don’t! Unless you went through the exact same trauma, and have the same physical and emotional responses to trauma as your loved one, you do not know what they’re going through. Everyone responds to trauma differently, and comments like this tend to come across as minimizing the effects of the trauma. For the survivor, this trauma is theirs, and while it may not be something they are proud of, they are most likely working on owning their experience and their emotions. It’s important not to take that away from them.
“Let it go” or “Get over it”
Unfortunately, these are words that many survivors have heard from someone they’re close with. It is common for survivors of trauma to be diagnosed with Post Traumatic Stress Disorder, or PTSD, and because PTSD is an invisible wound, it is often misunderstood as something that is being exaggerated. Just because you cannot see it, doesn’t mean it isn’t there.
There is no ‘just get over it’ with trauma. Survivors do not choose to have these symptoms, and symptoms can be intrusive and incredibly debilitating. By saying things like ‘let it go’ or ‘get over it,’ you’re telling them that their feelings are too much, too dramatic, and taking too long to resolve. Each healing journey is unique, and you have no way of knowing how much work someone has already put in to get to where they are now.
“Did that really happen?”
It is common for survivors of trauma to experience shame and guilt throughout the healing process. Many people blame themselves for what happened even if it may seem clear to you who is actually to blame in the situation. By questioning if it really happened, you’re validating and reinforcing any self-doubts the survivor has experienced over the years. This will ultimately slow the healing process, and maybe even cause your loved one to regress on their healing journey.
“It could have been worse”
This is another comment that minimizes the effects of the trauma and sends the message that the person is overreacting. What is traumatizing for one person may not be for someone else, and that is okay. Each person responds to trauma differently, but there’s absolutely no sense in comparing one trauma to another. Any survivor is hurting and trying to heal. It does not matter whose trauma was ‘worse.’ It can trigger feelings like shame and guilt, and really hinder the survivors healing journey.
“You should do/try _______”
As a loved one, the most important role you can play is being there for support, not giving advice on how to heal. Even if you’ve gone through something similar and feel like you understand, there’s no guarantee that what worked for you will work for them. And if they end up taking the advice you give but it doesn’t work out as they hoped, this can really hinder the healing process, and may even impact your relationship with your loved one.
“Do you want to talk about it?”
Oftentimes with trauma, survivors lose a sense of being in control when they went through that situation. If they feel forced to talk about it with loved ones, it can be triggering and bring up all of those old feelings of not being in control. Asking this question gives the survivor a chance to decide what they would like to do. Maybe they’re not feeling up to talking about it right now, and that’s okay. Giving them a sense of control in regards to this topic can be really helpful for their healing process.
“I hear you”
One of the most difficult parts of the healing journey is feeling like you’re going through this alone. Sometimes being there with a listening ear is the best support you can provide your loved ones. Try practicing Active Listening. Active Listening means making a conscious effort to hear, understand, and retain the information being relayed to you. It does not always mean you have a response or advice to give. Instead, pay attention, show that you’re listening with feedback, and ask questions if there’s something you don’t fully understand. Simply saying, “I hear you” can mean the world.
Are you a trauma survivor, or looking to better support a loved one struggling through their recovery? We can help. Give our office a call at (631) 503-1539.
About the Author, Jennifer Tietjen, LMSW
Jennifer Tietjen is a Licensed Master Social Worker (LMSW) at Suffolk Family Therapy and is currently receiving supervision towards her clinical license under Kristy Casper, LCSW. She helps clients by providing the support, acceptance, and empathy they need as they face challenging life experiences. Jenn is passionate about helping clients overcome past trauma and make positive change in their lives. She is trained in EMDR therapy and is currently focusing her future training and experience on women’s issues. This includes maternal health concerns such as antepartum and postpartum depression and anxiety, and reproductive health issues including infertility.
What is C-PTSD? How is it Similar and Different from Post-Traumatic Stress Disorder (PTSD)?
Post-traumatic stress disorder (PTSD) and complex post-traumatic stress disorder (C-PTSD) are both neurobiological disorders that occur when someone experiences or witnesses a traumatic event. Examples include, but are not limited to, war or combat, natural disasters, physical or sexual assaults, and life-threatening accidents.
Almost all of us associate PTSD with veterans. We understand combat is gruesome on the body and devastating to the psyche. We realize war is hell, if only we look at the faces of our veterans when they return. We know, even without words, that they went through something far beyond the scope of normal human experience. In fact, generations before the term “post-traumatic stress disorder” became public knowledge, and added by the American Psychiatric Association to the Diagnostic and Statistical Manuel of Mental Disorders in the 1980s, PTSD was known by other names: war neurosis, shell shock, soldier’s heart, or combat fatigue. Furthermore, much of the research, advocacy, awareness, and treatment options for PTSD have been through means such as the U.S. Department of Veterans Affairs. Thus, it makes sense we as a collective society to visualize a soldier in battle when we think of PTSD.
However, across the general population and in terms of numbers, PTSD is most prevalent in people who have experienced dangerous, life-altering events. It seems to be most frequent in survivors of sexual assault or those who went through or witnessed violent car accidents, both which involve powerlessness, danger, and terror. Furthermore, PTSD can occur in populations that often are forgotten to be traumatic, such as ICU stays.
It is believed most people will experience at least one traumatic event in their lives, and a fourth will develop PTSD. It is not known how many people live with C-PTSD.
People who suffer from trauma may feel its impact for days; this is called acute trauma. If the symptoms continue for weeks or longer, and if they are disruptive to daily living, that is suggestive of PTSD.
There are three types of PTSD symptoms:
Hyperarousal symptoms. People with PTSD may have sense-of-threat symptoms, as if they are on edge and hypervigilant of their environment. They can have a startled response such as jumpiness.
Re-experiencing symptoms. Nightmares and flashbacks are the hallmark symptoms of PTSD. The individual may “go through” the trauma again via memories, via sensory experiences and emotions. The individual may feel the same smells, sights, sounds of the trauma.
Avoidance symptoms. Those living with PTSD will participate in avoidance symptoms, as in avoiding triggers associated with the trauma. This is broad, and can include places, situations, people, or events (i.e., holidays). They may also attempt to drown the symptoms through self-medicating with alcohol or other substances.
C-PTSD is a messier, multilayered version of PTSD which involves prolonged or chronic attacks on an individual’s sense of safety, self-worth, and integrity. This is dissimilar to PTSD, which is the result of one traumatic event. The ongoing maltreatment causes a multitude of additional symptoms, which shape neuropsychological development such as personality.
C-PTSD results from situations of chronic powerlessness and a lack of control, such as long-standing domestic violence (whether experienced or witnessed), sex trafficking, or child maltreatment. However, it is most common in those who were subjected to child abuse or neglect beginning in the earliest formative years, especially if the harm is by a caregiver or other significant adult, and there is a lack of hope for escape or that the situation can otherwise improve. Also, multiple traumas increase the risk of developing C-PTSD too.
People with C-PTSD have compounded symptoms of both PTSD and those from other mental health disorders. These may include the following:
Psychosomatic issues: Psychosomatic issues are physical issues without a medical explanation, caused or worsened by a psychological reason such as stress. It is common for people with C-PTSD to have vague physical symptoms such as dizziness, chest pains, abdominal aches, and headaches.
Emotional flashbacks: A flashback is a vivid, intense experience in which a person will relive some parts of a trauma or feel as if it is happening in the present. Stereotypically, people tend to think of the war veteran who is having a “movie-like” flashback in which the event unfolds again in its entirety. However, a flashback does not need to be so extreme – and usually they are not.
People with C-PTSD are likelier to experience what is called an emotional flashback – that is, the emotions experienced during the trauma, such as shame or fear. Such individuals may react to these events in the present, unaware they are having a flashback.
Difficulty regulating emotions: Those with C-PTSD may experience sharp, vivid emotions which can be inappropriate for the situation. These rapid shifts in mood can be misdiagnosed as bipolar disorder or borderline personality disorder, which can have similar features but are not the same.
Flat affect: People with C-PTSD may also have a flat affect, meaning they appear numb, somber, or emotionless to others. This body language can be misinterpreted by others, making people think the individual is feeling a certain way or is aloof. In truth, the person may have a rich, complex inner world of their emotions and be feeling very differently than how they are expressing themselves.
There are several reasons for a flat affect. One powerful reason is because the individual may not have witnessed emotional expression in their formative years, thus in turn they have been sharpened to be “flat” as an adult. To explain it plainly, imagine a primary caregiver not smiling at their baby. The baby mimics and responds to the caregiver by also not smiling. This is sharpening the baby to respond such a way going forward.
A lack of emotional vocabulary: Finally, individuals with C-PTSD may have difficulty with articulating their emotions or they may not understand what they feel; that is, there is an absence of an emotional vocabulary. They may struggle in therapy when asked “what are you feeling?” and respond with “I don’t know” or they may describe a physiological feeling instead (i.e., tiredness, nausea). This is because in the context of prolonged trauma they had to adapt to shutting down their emotions to survive. For example, they may have been programmed in their earliest years to think “emotions are bad” because they were consistently invalidated or punished for emotional expression by their caregivers.
Dissociation: Dissociation happens to everyone. Dissociation is a sensation of feeling disconnected from oneself and the world through a sensory experience, thought, sense of self, or time. A person who dissociates may feel depersonalization (detached from their body) or derealization (feeling as if their surroundings are unreal). And at one time or another, all of us have dissociated. Getting lost in a daydream, forgetting the details of a car drive, or spacing out during a boring class lecture are all examples of dissociation.
When applied to trauma, dissociation is an innate coping mechanism. It is a protective action taken by the mind to let an individual survive a traumatic experience. At the time of the event, dissociation is beneficial, especially for children as they often lack insight and more sophisticated coping skills. However, the downside of dissociation is that when someone has dissociation and is at risk of developing C-PTSD or another trauma-related disorder, the dissociation does not resolve the trauma. In adulthood, the effects of dissociation can negate the ability to trust, form and maintain healthy relationships, and prioritize self-care. Through the phenomenon of mind-body separation, individuals may develop self-destructive behaviors such as ones that keep them dissociated (“I can’t tell when I’m feeling hungry, so I eat less than I should”) or ones to make them dissociate (“I drink alcohol to numb myself so I don’t have to feel my despair”).
(Dissociation is a complicated phenomenon which cannot be fully explained in a few paragraphs. The article writer will make a detailed blog entry dedicated solely to dissociation in the future.)
Negative core beliefs: Individuals with C-PTSD may have the core belief “I am not safe” or “the world is unsafe.” Alternatively, they may have other core beliefs (“I am unlovable” or “I am not worthy of respect”, for example). These core beliefs are deeply ingrained, at the pool of their identities, which can mean the individual is unaware they even carry such beliefs until they develop more insight.
Relationship difficulties: Individuals with C-PTSD can struggle with developing and maintaining healthy relationships. Such individuals struggle with feeling able to trust others due to their traumatic histories; thus, they may isolate themselves or feel intensely uncomfortable with “opening up” to others. Or they may respond inappropriately in a social situation. Unfortunately, these factors only enhance their risk of disapproval or misunderstanding by others, which makes them more susceptible to social isolation or ridicule.
Additionally, people with C-PTSD are more susceptible to entering and remaining in abusive relationships – especially those who already experienced abuse.
C-PTSD is a treatable condition. However, clients (patients) should be cautious when selecting their therapist. The treatment of complex trauma is a specialty, and not all therapists have the knowledge, skills, or experience to adequately support those who have C-PTSD. Thus, it is encouraged to “screen” the therapist during the consultation session by asking for their background in treating C-PTSD. Much like we may make thoughtful, careful choices about our medical doctors, the same should be done for therapists too!
Ask the therapist about their intervention styles (treatment approaches) as well.
The following treatments are frequently employed for C-PTSD treatment:
There is hope for healing from complex post-traumatic stress disorder!
All of our counselors here at Suffolk Family Therapy specialize in trauma work. We have a variety of sub-specialities within that including sexual assault, domestic violence, infertility, childhood abuse/neglect, loss of a loved one and bullying. Contact our office today to schedule with a therapist who meets your needs and start living the in the present.
Websites:
American Psychological Association (APA) – PTSD Treatments
https://www.apa.org/ptsd-guideline/treatments
CPTSD Foundation: https://cptsdfoundation.org
Healing From Complex Trauma & PTSD/CPTSD
(Complex) Post Traumatic Stress Disorder
Mind – Complex post-traumatic stress disorder (complex PTSD)
https://www.mind.org.uk/information-support/types-of-mental-health-problems/post-traumatic-stress-disorder-ptsd-and-complex-ptsd/complex-ptsd
U.S. Department of Veterans Affairs – National Center for PTSDhttps://www.ptsd.va.gov/index.asp
WebMD – What to Know About Complex PTSD and Its Symptoms
https://www.webmd.com/mental-health/what-to-know-complex-ptsd-symptoms
Books:
Pete Walker – Complex PTSD: From Surviving to Thriving
Arielle Schwartz – The Complex PTSD Workbook
Bessel van der Kolk – The Body Keeps the Score
