MSca child plant MH900430999It is not a surprise that we have heard much stirring in the last several years about the importance of empathy and its role in everything from attachment, to neural development, to world positivity. There is an empathy shortage in the world, and we are seeing the far-reaching effects. Bullying. Violence. Insensitivity. Selfishness. In practice, we often see the damage done with children who are traumatized because of early life experiences characterized by a lack of empathy. Abuse, neglect, emotional bankruptcy, painful attachments and a violation of trust all contribute to a child’s ability or disruption in naturally cultivating this inherent trait.

As play therapists, we are placed in a critical position to help do something about this. But how do we teach empathy to traumatized children? Because of the unique link between trust and empathy, how do we help them develop a sense of empathy for others without worry that trust will be broken? Aside from the basic child-centered approach that demands an empathic approach from the therapist, we can further this in tangible ways to make it come alive.

First, remember the important points about emotional intelligence, moral development, and capacity for empathy:

Beyond that,  I call my approach “Kindfull” Play, and it looks something like this:

Modeling – It sounds basic, but remember that not only are we as therapists modeling empathy toward the child, but also toward the world in general. Seize opportunities to show kindness – from the stray bug that wanders into the room, to the dolls they are playing with, to a character in a sandtray. Point out feelings and ask children to recognize them in others. You are demonstrating that others can be trusted.

Sensory words and Practices – Remember that empathy is not only a thought or feeling alone; it is an Experience. It is the ability to not only think, but feel kindness, compassion, and concern for another’s situation or being. With that in mind, help the child FEEL this by using sensory words and language to engage that part of their brains. Use poetry and storytelling to enhance this play. Favorite tip:  Present your client with a list of feeling words and ask them to create a poem or write a story based on the words. For older children/teens, ask them to pick a song that instills an empathic feeling. Review the lyrics together and how they are affected by it.

Dolls, Puppets and Faces! – Empathy can be demonstrated most easily through facial expressions. Play facial expression games, faces flash cards, and ask them to create a show for others to guess Feeling Faces. Favorite tip:  Face Focus x 3 – Ask a child to choose a feeling, draw the face of the feeling, and list three possible reasons the face feels that way. Then ask them to list three ways to helpfully respond with kindness and compassion.

Bibliotherapy – Stock your playroom with terrific books on empathy and caring. Use these frequently and strengthen this activity by then engaging your client in creative crafts related to each story. Favorite tip:  Add the titles ‘Understand and Care,’ and ‘Don’t Laugh At Me’ to your collections. Also, see http://booksthathealkids.blogspot.com/ for one of the most comprehensive bibliotherapy resources available for working with children.

Nature Niceness – Bring nature play into your sessions, as it is a resource rich in opportunities for practicing kindness. Introduce them to every form of life and teach respect for it. Engage their senses on an instinctual level with kind words. Let them marvel over a blade of grass, and delight in the ant walking busily over the dirt. Touch the tree bark and notice how hard, rough, or smooth it is. Do not pick flowers, but let the growing petals brush over their skin. How soft is it? What does it smell like?  Favorite tip:  One of my favorite activities is to go on a nature walk with a child and find a special rock. Create a pet rock and design a Care List outlining what the rock needs and how it will feel if it doesn’t receive this.

Caregiver Compassion – Incorporate caregivers as empathy teachers! This is a critical point in order to help empathy grow outside of your sessions. Here, you will want to incorporate elements of filial play within your sessions and also teach parents how to continue this at home so that empathy forms where it will be most important – with their caregivers. Teach parents how to be emotionally in tune by practicing the same kinds of empathy building play you do in your sessions. Favorite tip: Have them plant a seed of any sort together, and nurture it to life. Keep a diary of how the plant feels when it receives water, when its leaves unfurl, or when sunshine warms the soil.

Share Your Self – End every session with your experience and expression of empathy toward what they have completed and accomplished. Favorite tip:  Also ask them to summarize and share, choosing one way they will apply this until the next time they see you.

My experience has taught me that there is a clear link between empathy, resilience,  and post traumatic growth. Higher levels of empathy for self and others appear to strengthen a child’s ability to heal and find trust in the world again. When we cultivate empathy in the play therapy room, not only is a child then more able to experience empathy for others, but he can experience it for himself and translate it into self-compassion and gentleness. Because empathy itself is an experience, play and play therapy are the perfect places to integrate this important healing step. In so doing, we will help set their personal stages for a lifetime of resilience, aid in moral development and values clarification, and strengthen the cycle of kindness for generations ahead. Wishing you Kindness in all things!

Related Articles:
Play is Important for Children & Their Parents
The Spirit of a Play Therapist
Moving Out From the Shadow of Trauma

Extradyadic involvement (EDI), also known as infidelity, occurs in many relationships. At times, the infidelity is known to both partners, and at other times, only the participating partner is aware of the EDI. Regardless, EDIs have significant negative consequences. “Many negative emotional and behavioral correlates of EDI have been documented including partner violence, acute anxiety, depression, suicidal ideation, and symptoms similar to those of posttraumatic stress disorder,” said Christina M. Balderrama-Durbin of the Department of Psychology at the University of Colorado. “Relationship distress and dissolution are also commonly associated with EDI, with infidelity being the most frequently cited cause of divorce.”

Poor communication, often exhibited in couples with EDI, can also be a predictor for infidelity. “Dissatisfied couples are more likely to engage in negative conflict communication behaviors including criticism, defensiveness, contempt, and withdrawal,” she said. The most common pattern of communication in conflicts is known as the demand/withdraw pattern. “During conflict interactions, distressed couples often display a dyadic conflict pattern in which one spouse blames, nags, criticizes, or pressures the other for change, while the other spouse withdraws or avoids conflict,” said Balderrama-Durbin, who observed demand/withdrawal behaviors in couples who had a disclosed EDI, couples with an undisclosed EDI, and couples with no EDI.

After observing 170 couples during a conflict, Balderrama-Durbin found that the couples who had undisclosed EDIs used demand/withdrawal behavior the most frequently. “Specifically, male and female demand behaviors, and male withdraw behaviors, were significantly higher within couples where there had been an unknown EDI compared with those in a relationship with no history of EDI,” said Balderrama-Durbin. She also discovered that the participating partners with undisclosed EDIs were more demanding than those with disclosed EDIs. “Conversely, demand behaviors were higher for nonparticipating partners who knew his or her partner engaged in EDI compared with nonparticipating partners who did not know his or her partner engaged in EDI.” Balderrama-Durbin added, “The present study affirms that even undisclosed aspects of a couple’s relationship can be associated with observable negative conflict communication behaviors. Findings indicate the importance of investigating unique interaction patterns in relationships when an EDI has not yet been revealed or discovered.”

Reference:
Balderrama-Durbin, C. M., Allen, E. S., & Rhoades, G. K. (2011, December 26). Demand and Withdraw Behaviors in Couples With a History of Infidelity. Journal of Family Psychology. Advance online publication. doi: 10.1037/a0026756

Woman sitting looking sad

Individuals who are “symptomatic” of post-traumatic stress disorder (PTSD) may seem sick, crazy, or irrational. They might appear dissociative, clinically depressed, anxious, highly reactive, or rageful (or all of the above). In addition, it’s common for an individual to cultivate a sense of self-loathing for displaying these characteristics. During treatment, both therapist and survivor may agree that these symptoms are a mark of disease, making it their goal to alleviate the symptoms. Alternatively, both may choose to believe that these symptoms are an expression of health versus illness. This could enable more directed treatment, internal compassion, decreasing fear of symptoms, and a relationship between survivor, therapist, and trauma.

According to the DSM IV (American Psychiatric Association, 1994) criteria for diagnosing PTSD includes intrusive memories, thoughts, or dreams of an event, a sense of reliving the event, and intense distress in response to both internal and external cues that resemble an event(s).  Individuals may thus avoid triggers or cues, increase isolation or have a sense of ‘waiting for the other shoe to drop’ (a foreshortened future), and detachment.  Sleep difficulties are common; mood liabiality, and hyper vigilance are also common (American Psychiatric Association[DSM-IV], 1994). When a survivor feels hopeless, confused, and self-loathing because of the manifestations of their trauma, the initial layer of treatment is frequently the unraveling of self-loathing for the expression of symptoms themselves.

To begin to evaluate trauma and develop a relationship with its influence on survivors, we can draw from the practice of narrative therapy and the concept of externalizing a problem, which recognizes that the person is not the problem; the problem is the problem (Playful approaches to serious problems: Narrative therapy with children and their families. Freeman, Jennifer C.; Epston, David; Lobovits, Dean New York, NY, US: W W Norton & Co. (1997). xvii, 321 pp.). PTSD, as a character in a survivor’s life, uses symptoms as tools to protect us, remind us of our core values, and ensure that what happened before won’t happen again. The trauma response could even correspond to the level of violation on self and values; from this perspective, a profoundly disturbing event calls for a profoundly disturbing response. Flashbacks, dreams, invasive thoughts, and triggers provide specific information about the violation the client’s event(s) infringed upon them. These also exemplify the concept of “stuck points” in Trauma-Focused Cognitive Behavior Therapy (Akin-Little, Angeleque (Ed); Little, Steven G. (Ed); Bray, Melissa A. (Ed); Kehle, Thomas J. (Ed), (2009). Behavioral interventions in schools: Evidence-based positive strategies, School Psychology (pp. 325-333). Washington, DC, US: American Psychological Association, xi, 350 pp.)

The aspect of a survivor’s past that is troublesome can be quite specific and idiosyncratic. Groups of people exposed to the same event often are disturbed by different parts of it. Interpersonal trauma such as child abuse, domestic violence, or sexual assault may render someone feeling responsible for what happened to them, feeling dirty or shameful, betrayed, foolish, unimportant, or completely exposed.  Trauma might be conveying to someone that they are at fault for an assault because it wants the individual to have a sense of mastery or agency.  Helplessness is too passive, so self-blame is an acceptable tone to assume. An individual might also begin to associate a traumatic feeling of betrayal with a feeling of foolishness, ensuring s/he does not trust people too easily and maintaining inner safety.

The way in which a survivor expresses their PTSD can vary widely and presentations can be very complex and oppressive.  It is common for survivors to blame themselves for their past experiences, and they often enter into treatment with a great deal of shame because they feel they should have “gotten over it” without help. A therapist can offer some relief from shame by viewing survivors’ symptoms as useful, even critical to their treatment.

Through the process of healing, a survivor can learn to establish trust in self to clearly identify his/her core values, to reflect his/her significance in the world, and to maintain personal safety. The character of trauma will refrain from presenting images (flashbacks and dreams) when the stuck point has been identified, and will cease making statements that the individual is culpable for what happened once there is a demonstration of mastery over the event. It will hold back on invasive, persistent thoughts once the survivor is able to look at the event rather than avoiding it.  PTSD symptoms reflect individual values and provide explicit guidance for healing; if therapist and client are willing to work with trauma, and absorb the information it has to offer, it will not invade with such rigor.

 

Dyadic play therapy is a form of play therapy that allows parents who have themselves suffered trauma, the opportunity to address their own symptoms and attend to the strained attachment with their child. But very often, the parents are resistant to this form of treatment. “For adult survivors of childhood trauma, psychotherapy can be both necessary and highly threatening,” said Mirisse F. Foroughe and Robert T. Muller of York University. The researchers authored a paper that explains the obstacles and benefits to dyadic play therapy. “The conditions and processes of dyadic play therapy may be experienced as threatening to parents by triggering early memories of intra-familial trauma while challenging avoidant defenses. Yet these very processes may be helpful in facilitating therapeutic change.”

Parents with traumatic childhoods may see the tools used by their children in play therapy, such as toys and artwork, as triggers for their own pain and may experience overwhelming and frightening memories and emotions. “Dyadic play therapy, with its focus on parent-child attachment, tends to activate the attachment system, making the process of therapy especially challenging for those who are much more comfortable closing themselves off from painful relational experiences.” The authors advise clinicians to realize this and take the necessary steps to be prepared for varying reactions from parents.

Several components of play therapy can prevent progress for parents. “In contrast to individual psychotherapy, the dyadic condition also inherently places the parent in a position of vulnerability, in part because they are ‘under the spotlight’ as a parent but also because, with the child present, the parent cannot dismiss attachment-related issues as readily.” However, they added that the benefits of this type of therapy can be enormous, for both the child and the parent. They said, “The pattern of interactions between parent and child often brings the parent’s own trauma history to light, and, with the acceptance and support of the therapist through this process, the parent can then become an agent of change in the parent-child relationship.”

Reference:
Foroughe, M. F., & Muller, R. T. (2011, March 28). Dismissing (Avoidant) Attachment and Trauma in Dyadic Parent-Child Psychotherapy. Psychological Trauma: Theory, Research, Practice, and Policy. Advance online publication. doi: 10.1037/a0023061

painting white heart on wallMost people would agree that having a compassionate stance towards oneself is desirable. But how do you cultivate self-compassion?

Let’s quickly define the term. In this article, “compassion” means tenderhearted recognition of pain or distress, coupled with a desire to alleviate it. Each component of this definition—recognition, tenderheartedness, and a desire to alleviate distress—offers opportunities for cultivating compassion. This article will look at how the skill of “recognition” can help you grow self-compassion.

The ability to recognize your pain or distress requires that you embrace your limits. Each of us has inherent human limits, as well as personal limits that are rooted in our personalities, life experiences, knowledge, skill levels, and more.

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For example, one obvious human limit is that everyone needs sleep on a regular and consistent basis. A less obvious human limit is that everyone needs some amount of play. Other examples may include the amount of money you need in your savings account in order to feel prepared for a “rainy day,” your tolerance for grumpy individuals, the patience you have for slow drivers, and more.

Some people have a difficult time accepting these human and personal limits. This desire to have no limits stems from a variety of sources. One common reason is that people confuse limits, which are neutral facts, with weaknesses. To put it another way, some people (falsely) believe that if they have limits, they are somehow flawed, weak, insufficient, or not capable of great things—therefore, they deny the reality of their limits. Denying your limits does not enhance your worth or value, but does block you from having genuine self-compassion.

By recognizing that you have limits, you can notice when you have been pushed beyond them, and then deem your ensuing emotions as legitimate. For example, if you know one of your limits is that you need a break every three or four hours of work, and you have to work a full day without breaks, you will know it is legitimate to feel exhausted.

Understanding this emotional distress as legitimate sets you up for the next component of compassion, which is tenderheartedness. In order for you to have compassion towards your distress, you must recognize your distress as legitimate: worth noticing, worth caring about, worth turning towards, and worth alleviating. It is by acknowledging, accepting, and allowing your limits to exist that you bestow legitimacy onto your distress.

Another piece of “recognition” is granting yourself permission to accept your limits as they are in the here and now. Your limits are not what you desire them to be or think they should be. Some limits, such as how much sleep you need, cannot be changed. Other limits, like patience for slow drivers, can be changed—but regardless of the flexibility of the limit in question, if you’ve exceeded your limit, you are beyond it.

While it is entirely appropriate, and a sign of maturity, to work on expanding limits, you can’t do that by denying that you have exceeded a limit. Instead, practice noticing when you have passed a limit and acknowledging it, instead of judging yourself harshly for having it in the first place. Rather than berating yourself for being exhausted at the end of a work day that had no breaks, recognize that you are bone-tired not because you are incompetent, but because you eclipsed your work-break limit.

Self-compassion is grounded in the ability to recognize that you are in pain or distress and that this pain or distress deserves and requires attention. Recognizing your limits as they are in this moment in time, personally and as a human being, allows you to acknowledge the legitimacy of your pain and the ensuing need to attend to your distress. You are entirely capable of growing into a person with more self-compassion, and I encourage you in this work. If you desire or need the guidance of a trained professional, do not hesitate to reach out.

Group therapy can be the most nurturing and also the most challenging form of therapy. It is highly effective. While it doesn’t replace individual therapy, it can be a great adjunct and a final step in the healing process.

Group therapy is very relevant for survivors of childhood abuse and in fact for any traumatized individual. Isolation and separation from communal support is a primary characteristic of trauma, and that is exactly what group therapy provides. Enduring recovery cannot occur in isolation, it can only take place within the context of relationships. The group serves as a symbolic societal witness to each victim’s experience, as it is retold and relived in the group process. Fundamental societal functions – being made to feel safe and seen, sharing emotional distress, validating one’s experience, minimizing shame, recognizing and encouraging strengths and taking personal responsibility are now played out within the group interaction. The successful group environment provides a corrective emotional experience in which past dynamics of self-blame, lack of trust, and silencing of the victim will be evoked and then worked through. These groups offer a quality of support and understanding that is simply not available in the survivor’s regular social environment. (more…)

New research suggests that stressful events may cause delayed increase in panic symptoms. Because the effect of stress on panic symptoms has not been studied extensively, researchers wanted to determine if people with panic problems experienced immediate increase or a gradual increase in symptoms following a stressful event. “We definitely expected the symptoms to get worse over time, but we also thought the symptoms would get worse right away,” said Ethan Moitra, a postdoctoral researcher in the Department of Psychiatry and Human Behavior at the Warren Alpert Medical School of Brown University. But the findings revealed that stress does not always cause an immediate panic attack. Dr. Martin Keller, principal investigator of the research and professor of psychiatry and human behavior, warns family members and clients to watch for signs of panic over the several months following the stressful event. (more…)

Simply put, when it comes to traumatic experiences, there is no hierarchy of pain. Many survivors believe—or want to believe—that trauma is scalable and therefore more or less extreme than that of someone else. While this belief is understandable and does offer some benefits, it is ultimately more flawed than accurate.

For many life events as well as emotions, it is possible to create a hierarchy and use it to determine if event/emotion A is more or less than event/emotion B. One can look at happiness and stress to see how this scaling occurs. For example many would agree that receiving the perfect gift on your birthday falls below the happiness you feel on your wedding day, while the stress you go through on your wedding day exceeds the stress you have on your birthday. This scalability can add perspective, meaning, and depth to happenings that are within the realm of ordinary, expected, and standard.

Yet trauma lies at the utmost extreme of human experience; for the individual, there is nothing ordinary, expected, or standard about it. The severity of trauma, the danger, horror, and fear involved cannot be compared—regardless of what the content of the traumatic occurrence was. Regardless of how much or how little was endured, all traumatic experiences lie within the category of utmost extreme. Therefore, creating a hierarchy of traumas is not possible, since every trauma is an extreme life event. Once something is extreme, ranking its extremeness is a futile exercise.

Phrased another way, trauma is trauma; how you sustained a traumatic event does not alter the fact of the trauma. Imagine for a moment, a gorgeous glass vase, which becomes shattered; how this vase shattered—by wind gusting through an open window, a child bumping the table the vase sat on, or you dropping it while changing out the flowers—is of no import to the shattered vase.

Many survivors of traumatic life experience(s) find comfort and protection in maintaining the belief that because he or she did or did not experience certain components in the traumatic event(s), then the trauma is less than someone else’s. And, if it is less, it is a minor, even inconsequential moment in time that does not need to be acknowledged, let alone healed through. Despite the apparent protection that this belief brings, sustaining it prevents you from engaging in your healing, and healing is the only means by which to detoxify trauma.

In addition to blocking your healing journey, this belief robs you of self-compassion. The reason this belief precludes compassion, is that compassion requires reckoning. This belief prevents you from truly acknowledging and owning your hurt, pain, and suffering. It is only after acknowledgment has arisen that the second component of compassion can come forth: turning toward distress. This turning toward allows you to potentially alleviate your pain. Self-compassion not only validates your wounds, but it also opens a deep reservoir of gentleness. Holding and extending gentleness toward yourself, as well as regarding yourself through a compassionate lens, provides you with unshakeable stamina to engage in as well as endure your development into a thriving post-trauma individual.

Believing in a hierarchy of human suffering and pain seems to grant you peace as well as protection, but in the end it shortchanges you out of the health and wellbeing you have an inherent right to. Feel free to slowly begin letting go of this belief and replacing it with a more accurate acknowledgment of your past, and while you do this, aim to grow compassion as well as gentleness within yourself. If you want or need a compassionate guide to help you through, know that there are many qualified professionals who believe in your inherent right to compassion, gentleness, healing, and growth who can and will assist in this undertaking.

For the past two decades, science has been uncovering some important features of traumatized clients. There is mounting evidence that traumatized individuals vary widely in their ability to adapt to trauma, in part due to underlying physical factors. For instance, some see the presence of chronic emotional trauma as having the potential to cause permanent physical damage in at least the hippocampus (Sapolsky, in Why Zebras Don’t Get Ulcers (1994) argues that chronic stress is a significant cause of aging in several species). This might mean that some individuals who have gone through multiple traumas or what in the DSM V will likely be called Disorders of Extreme Stress NOS, because of a changed hippocampus, might have diminished abilities to perceive or recover from subsequent stressors.

Other studies have show that certain traumatized populations (traumatized women and combat veterans) show similar characteristics of neurological dysregulation. Susan Johnson noted (Emotionally Focused Couple Therapy with Trauma Survivors, 2002) that one implication is that such individuals may be unable to use their emotions as an appropriate danger signal to prompt adaptive action. The chronic activation in their brain systems seems to result in overreactions to non-emergencies and freezing responses in the presence of real danger. (more…)

Woman with curly hair sitting on therapist's couch with head leaned on hand. Sitting next to her, a female therapist in a grey coat is listening and taking notes on a clipboard.Learning about the stages of healing can be distressing, motivating, upsetting, or uplifting. No matter how you feel, your reaction is not wrong. Acknowledging your emotional response to the stages of healing can allow you to harness your emotions’ energy and reach out to a trained therapist.

When looking for a therapist, it is vital to keep in mind that, regardless of what type of psychotherapy you pursue, your therapist should empower you and welcome you as a collaborator in your therapy, not attempt to impose control over you. Studies have found that individuals who are active participants in their therapy are more satisfied with the therapy. In addition, it is crucial that you feel safe in your therapeutic relationship.

There is no magical treatment that will heal you overnight, nor is there one form of psychotherapy that is right for everyone, but you should be able to find a therapist, as well as a therapeutic approach, that works for you. Healing is like a marathon. It requires preparation, repeated practice, courage, determination, and the support of others—including that of a professional coach or therapist.

While there are numerous therapy approaches, the purpose of all trauma-focused therapy is to integrate the traumatic event into your life, not subtract it. This article discusses the most common forms of trauma therapy. Each approach is described in its most pure form, but keep in mind that many therapists combine different types of therapies.

Pharmacotherapy

Pharmacotherapy is the use of medications to manage disruptive trauma reactions. Medications have been shown to be helpful with the following classes of reactions/symptoms:

Taking medication does not make one’s trauma reactions and pain evaporate. Medications can only help make the symptoms less intense and more manageable.

If you decide to use medications, consult a psychiatrist and continue working with that psychiatrist for as long as you take the medications. Inform the psychiatrist of how the medications are impacting you. Some medications have side effects that may or may not be tolerable to you, and some people do not respond favorably to medications. Medications are most effective when individuals pursue therapy concurrently.

Behavior Therapy

The most common form of behavior therapy is exposure. In exposure therapy, one gradually faces one’s fears–for example, the memories of a traumatic event–without the feared consequence occurring. Often, this exposure results in the individual learning that the fear or negative emotion is unwarranted, which in turn allows the fear to decrease.

Exposure therapy has been found to reduce anxiety and depression, improve social adjustment, and organize the trauma memory. There are various forms of exposure therapy:

Exposure therapy is a highly effective treatment for posttraumatic stress (PTSD).

Another form of behavior therapy is Stress Inoculation Training (SIT), also known as relaxation training. Stress Inoculation Training teaches individuals to manage stress and anxiety.

Cognitive Behavioral Therapy

Cognitive behavioral therapy (CBT) is grounded in the idea that an individual must correct and change incorrect thoughts and increase knowledge and skills. Common elements of cognitive behavioral therapy trauma therapy include:

Eye Movement Desensitization and Reprocessing (EMDR)

Therapists who perform EMDR first receive specialized training from an association such as the EMDR Institute or the EMDR International Association. An EMDR session follows a preset sequence of 8 steps, or phases. Treatment involves the person in therapy mentally focusing on the traumatic experience or negative thought while visually tracking a moving light or the therapist’s moving finger. Auditory tones may also be used in some cases. Debate regarding whether eye movements are truly necessary exists within the field of psychology, but the treatment has been shown to be highly effective for the alleviation and elimination of symptoms of trauma and other distress.

Hypnotherapy

There is no one guiding principal for hypnotherapy. In general, a hypnotherapist guides the individual in therapy into a hypnotic state, then engages the person in conversation or speaks to the person about certain key issue. Most hypnotherapists believe that the emotions and thoughts that an individual comes into contact with while under hypnosis are crucial to healing.

Psychodynamic Therapy

The goal of psychodynamic trauma therapy is to identify which phase of the traumatic response the individual is stuck in. Once this is discerned, the therapist can determine which aspects of the traumatic event interfere with the processing and integration of the trauma. Common elements of psychodynamic therapy include:

Group Therapy

There are a variety of different groups for trauma survivors. Some groups are led by therapists, others by peers. Some are educational, some focus on giving support, and other groups are therapeutic in nature. Groups are most effective when they occur in addition to individual therapy. It is important for a trauma survivor to choose a group that is in line with where one is in the healing journey:

Any therapist, regardless of which type of therapy she or he works from, desires to help you grow and heal through your traumatic experience.

Together, you and your therapist will strive to acknowledge and identify:

As always, reach out for help and know that you do not need to go it alone.

Reference:

  1. What is the actual EMDR Therapy session like? (n.d.). Retrieved from http://www.emdrresearchfoundation.org/for-the-public/what-is-the-actual-emdr-therapy-session-like

A close-up picture of a paint brush dipping into a palette of mixed pain colors.Full permission has been given by the client to tell this story on GoodTherapy.org. All identifying information has been changed.

Images hold keys that unlock our inner experiences. Images can penetrate mental defenses that have been dispelling or diminishing the importance of feelings and experiences in our lives. During a traumatic event(s), images, sounds, textures, smells, and tastes can become hardwired in the brain to the event. At the time of a trauma, the body internalizes feelings that might otherwise overwhelm normal ego function. Later those traumatic experiences can be accessed voluntarily, or triggered involuntarily, through the senses or movement.

People usually come into therapy for help to alleviate problems, such as depression, anxiety, anger, or rage. A person may come into therapy seeking help to change the dynamic of a relationship, or to make better choices in their daily lives. Oftentimes, therapy involves working on current issues, while at the same time drawing parallels to earlier life experiences. In art therapy, a person may create a piece of artwork during a session by drawing with markers, ink, pencils, or watercolor. The person may do this while talking about events that are causing distress. The artwork can become a record of the session thereby providing a visual link to what was discussed.

Sometimes a person will bring in content from a recent dream. He/she may bring in a piece of artwork that he/she has created off site, and use that to delve more deeply into the experience. In art psychotherapy we pay close attention to the meaning images hold for the individual. The meaning of an image may be obvious or logical to the person. Sometimes the meaning of an image can evolve or change. Oftentimes an image is felt through a connection, but the meaning becomes known, later, through interacting with it.

[fat_widget_left]A man I see in therapy is making a video as part of his treatment. He came into therapy suffering from depression, anxiety, anger, and rage. He often brings his laptop or a thumb drive into session. Sometimes he addresses issues that are current in his life, and at other times he shows his work-in-progress and processes memories and experiences unearthed by his video project. Therapy is a process of trust-building, not only between the client and the therapist, but between the client and him- or herself. For this man, identifying the project that he wanted to work on and following through with it, helped him to build self-trust. Trusting that the project was going to be useful, trusting that he could execute it, trusting that he would complete it, and that he would learn something of himself helped shift his self perception of someone who never completes anything, to someone who has something to offer others through his video narrative.

This person had been traumatized throughout his childhood by relatives who inflicted physical and psychological pain upon him. A few years ago he acquired Super 8 film footage that included a clip of him when he was approximately 6 years old. In the short film clip that he transferred to video he is seen actively running around with other children. Since he was not the focus of the camera’s eye, the clip of him is very brief. He does not have other images of himself as a child, because his mother was mentally ill and incapable of operating a camera, and his father is unknown. The video clip captures his innocence, in a sense, because he wasn’t performing for the camera, he was simply being himself.

This man has looked at the short clip many times in session, while editing it into his larger video piece. He was able to incorporate other footage to create associations that refer more specifically to his experiences. He slowed down footage and sped it up. He made clips fill the screen and then vanish from sight, over a few seconds. He added a sound track of his voice, as well as music, that had personal relevance to him. He used transitions that helped him piece together events that spanned most of his life.

The few frames of Super 8 footage taken at an age when his memories were being formed, allowed him to connect to his experience and integrate them into his life. He processed his emotions and understood that his behavior was his way of numbing the pain. He was able to acknowledge his skill, having created a coping methods that, as a child, was necessary for survival. He learned that many of those early coping methods created other problems, such as drug addiction, incarceration, anger, rage and isolation. Through years of recovery and therapy he is now thriving and giving back to others, He volunteers and shares his story with those who have experienced similar traumas.

Images connect to the deeper recesses of who we are through the meaning we attach to them, both consciously and unconsciously. In therapy meaning is unique to the individual. An image can invite a conversation about meaning without a battery of forms or diagnoses that are necessary and useful for treatment, but in themselves often neglect the humanity and life experience of the person in front of us.

A good therapist wouldn’t treat his or her clients like a science project. Though there is a scientific basis for how brain chemistry and feelings correspond, we don’t experience our world through chemicals. We experience it through pain and sadness, joy, and relief. These are the mediums that the psychotherapist works with, and these are where we make sense of our world.

But that doesn’t mean that better understanding of brain chemistry and neurology can’t inform even more effective therapy. Take, for example, post-traumatic stress disorder. Those who’ve lived through trauma know that their experiences are the cause of their flashbacks, moodiness and other symptoms. But severe forms of PTSD can be very hard to work through, even with the help of a great psychotherapist. Late last year, scientists performed experiments with rats to better understand how the brain processes memory in relation to stress. Physically documenting changes between experience and brain behavior can help therapists better understand how things like PTSD work and, therefore, develop specific therapeutic strategies in light of that new knowledge. Those strategies don’t manifest through scientific terminology—they may be as simple as changing the therapy setting—but they use the science as a jumping off point for real-world strategies. (more…)

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