Category: <span>Trauma</span>

Is Talk Therapy enough for trauma?

Using only a top down approach in psychotherapy sessions isn’t enough for trauma because:

  • When a person is experiencing flashbacks or even recalling a traumatic event their body can literally feel like it’s in the past. All the stored survival stress is back in the form of body sensations. These body sensations can get unbearable. And just talking about all of this won’t help because it doesn’t relieve the body sensations. Without a somatic approach to help handle the body sensations, the client can feel like they’re drowning in the gut wrenching sensations.

 

  • The body sensations can feel very triggering because the client feels as if they’re reliving the entire traumatic event rather than just talking about it. A cognitive approach to make sense of this doesn’t help until the body feels safer to inhabit, until the client can get a grip on the body sensations. No amount of cognitive processing can make the person understand that it’s in the past. While a cognitive approach can help in observing the body’s sensations, the bottom up approach can help in “recalibrating the nervous system” ( Kolk, 2004, p. 63-64) which is vital to begin with.

 

  • During a traumatic event, the body goes into survival mode and the amygdala, the smoke detector of the brain ( Kolk, 2004), only sees the danger and directs the body to escape the danger via FFF. The frontal cortex, especially the medial Prefrontal Cortex goes offline during trauma. Bessel Van Der Kolk calls it the ‘watchtower’ which helps in making important decisions. The trauma is stored in a non linear, fragmented manner and doesn’t have a coherent narrative. So explaining what happened when it’s mostly the fragmented sights, sounds, smell etc of the traumatic event, is very difficult in a talk therapy session.

Sensorimotor Psychotherapy by Pat Ogden, Tapping acupressure points (EFT), Alpha/Theta training, Somatic Experiencing by Peter Levine, Neurofeedback, EMDR, are some of the techniques mentioned in the book, The Body keeps the Score, that are effective in resol

Reference:  van der Kolk, B. A. (2014). The body keeps the score: Brain, mind, and body in the healing of trauma. Viking.

Self-care for Mental Health Professionals

As a psychotherapist how do you self regulate?

How do you keep yourself from getting burnt out?

When there are personal issues, because you’re human and you will have them, how do you balance personal and professional life?

If you’re triggered in a session, feel biased towards your client, have a sudden personal triggering memory pop up, feel agitated, suddenly feel unwell etc, how do you handle it mid-session?

Although we already have coping skills and knowledge about self regulation as psychotherapists, it’s really important to have quick tools that can help us self-regulate prior to, during and after a session as well as have a tapping self-care routine to prevent burnout. This form of regular self-care in turn helps your client. How?

By you being able to hold a safe space for your client during sessions. Being trauma informed means being able to hold a safe space for our clients and in order to do that we need to feel safe in our bodies as therapists, especially if we are working with clients with trauma history. And I believe mostly all clients have some form of trauma background.

Self-regulation also helps in your interactions with your client outside of sessions, for example, scheduling appointments, answering emails, handling conflicts with clients – all this requires you to be in a grounded and calm space.

Another essential aspect of therapy is to have empathy. However, consistently working with clients while being present and empathetic does take a toll on our minds and bodies, especially if we’re not careful and don’t engage in regular self-care practices. We need a form of self care that requires less time, is somatic and helps in processing feelings safely without analysis paralysis.

Let’s say you’re triggered right before a client session due to a personal issue. Now, what will you do? One of the quickest ways to feel calmer is to just tap for a few minutes. It helps in reducing your emotional intensity instantly and is even helpful during a session.

Consider learning foundational skills in EFT for quick reduction in stress and emotional distress.

While mechanical EFT ( which can be learnt just be reading a manual or attending a brief course) is helpful, for effective EFT application a solid base in foundational skills and experiential learning is necessary, otherwise you will not find significant improvements after EFT.

EFT is a research supported, evidence based, somatic-cognitive tool. Since trauma enters through the body and emotions are felt in the body, the best way for trauma and emotions to be processed is through the body and that’s where EFT comes in.

For a short video on this, click on the link below

https://youtu.be/eiJ_XXQ29io

Sharing my personal healing journey

“Owning our story and loving ourselves through that process is the bravest thing that we will ever do” Brene Brown

To tell the truth and own it, is the most liberating gift that you can give to yourself. When you share your healing journey, not only do you own your story but the story also gives hope to others to heal. And that’s exactly what this article is about.
I’m sharing a part of my personal journey to tell you that healing is possible – that recovery from childhood sexual abuse (CSA) is possible.

I was sexually abused from the age of 4- 5 to 11 by three different people, a house help and two relatives. I remember that the abuse started when I was nearly 4 years old. I have strong visceral memories of that time period – the unease, confusion, and disgust (I worked on them with EFT1 later)

I also remember writing on the wall of an old water tank in my home, “Puja is dead”, in my native language, when I was around 7-8 years old or maybe younger.
The clearest memories are those of the abuse by one of my relatives. We had a joint family and he was staying with us. That man always evoked a sense of unease with his presence. After a while, I avoided getting near him but was pulled into a web of secrecy and shame. He made me believe that I would be blamed if I divulged anything to my parents. It was so confusing as a kid because close relatives are supposed to be protective and not exploitative.
Children aren’t in an age where they can fully grasp what’s happening; they can’t give or deny consent because they don’t even know what consent is. When a child is touched inappropriately, forced upon, cornered, threatened and/or shamed to stay silent, it is too overwhelming for the child and often they dissociate to cope with it. This hinders the emotional and psychological development of the child.
For years, I struggled with social anxiety, fear of speaking in public, generalized anxiety, stomach issues and other physical manifestations of the suppressed emotions.

Now when I look back I feel a lot of compassion for my younger self and I know what a brave little girl she was to have gone through whatever she had to.

Facing the abuser
When I was 11 years old, I gathered the courage to stop the abuse. One day when my relative was forcing me against a wall, I shouted at him and threatened to expose him to his wife (he had just got married and had moved to a new house). And that’s when the abuse ended. This was the first step towards my healing journey. I refused to touch his feet after that (an Indian custom where you pay respect to a ‘respectable’ elder by touching his/her feet).

Healing begins
My memories of CSA started re-surfacing in my college years and since then I have been very vocal about spreading awareness about CSA.
In my college, I took up psychology and that helped tremendously in understanding what I was going through. I did my internship at RAHI in Delhi (a support group for survivors of CSA). The full impact of what had happened in my childhood – the powerlessness, helplessness, shame, guilt, disgust, pain and loss finally sunk in when I read stories by survivors of CSA. As children we often dissociate from the abuse to cope with what’s happening and the encoding of the trauma happens very differently than that of normal events. Usually the traumatic events are encoded as bodily sensations without many words and images attached to them. Hence the body carries the visceral memories of the abuse.  The narrative isn’t linear but comes in bits and pieces. There were some events that were very clear in my head and there were some that were very fragmented. I remember flashes of some coercive abusive episodes.
I read a lot in my graduate years and used a lot of self-help techniques to handle social anxiety, tendency to self harm, anger/rage, insecurities, and fear. My thesis on Feminism further helped me to develop a stronger sense of self.

Disclosure and Facing the abuser again
After my post graduation, I decided to face my relative one last time. I disclosed everything to my parents and they were shocked and felt really guilty for not noticing what was happening. But they supported me unconditionally. I called the abuser, and gave him a piece of my mind over the phone. Of course, he tried to blame me and told my parents that I was being disrespectful and that I was the problem child etc. But my parents cut him off. They’ve always stood by me in all my decisions and have supported me throughout.

Emotional Freedom Techniques1
In 2003, I was introduced to EFT and that’s when the next healing phase began. I did intensive EFT sessions on myself for a year and processed most of the traumatic memories. It helped tremendously in reintegrating the disowned parts of myself and shedding the guilt and shame.
Then I started my private practise as a psychologist and EFT practitioner and worked with a lot of survivors of childhood sexual abuse.
I also swapped sessions with EFT practitioners to work on the remnants of traumatic memories and their effects.

(Added on Dec 2020) I continue to have sessions with EFT practitioners/mentors regularly as it’s very important to keep doing our inner work as therapists while we work with clients.

Krav Maga2
I learnt and practiced Krav Maga on and off for nearly 5-6 years. It helped tremendously in increasing my body confidence and dissolving the remaining unhealed trauma. I’ve been triggered several times during the Krav Maga classes but the triggers were eased and resolved with my trainer’s support and with the self-defence moves and techniques.

Owning your story
There is a stigma attached to speaking up and owning your story. I don’t buy this archaic mentality.
I was abused as a child and I have no shame in owning my story because the shame lies fully and squarely with the abusers.
I have gone from being a survivor to a thriving person and that’s why I can say that healing from trauma is possible.
Coming to terms with my abuse has made me stronger and more compassionate to people around me. Something like this should never happen to any child, but it is possible to move on and leave it behind and use that reservoir of resilience and tenacity to live your life the way you want. Finally, adverse circumstances can either harden you or soften you, as Dalai Lama says. And this has certainly softened me, made me more compassionate as a person.

If you’re a survivor, remember it’s not your fault; it’s not your shame to carry. Assign the shame and blame to the abuser(s) where it belongs and then leave it behind. Heal it, don’t carry it. It’s not yours to carry. You’re not damaged; you’re a whole person as worthy as anyone else.

Meaning of certain terms used in this article:
1 – EFT stands for Emotional Freedom Techniques, a mind-body tool to dissolve stress and trauma.

2- Krav Maga is an Israeli form of Martial Arts, a practical street smart self-defence system.

Shower exercise to Connect with your Body

WHAT IS TRAUMA?

When a situation exceeds the person’s ability to cope with it, and he/she feels helpless and unable to escape, then it results in trauma. It’s said that trauma does not lie in the event but in the response to that event.

WHAT IS DISSOCIATION?

Dissociation, in other words disconnection from the feelings and body, is a way to escape the inescapable. It is a mode of survival. Trauma and dissociation go hand in hand; when the trauma is over, the person can still be dissociated from that incident. According to Dr. Scaer, “Our brain is strongly wired to protect us from life threats through a series of message systems in the limbic brain that allow us to assess danger and then institute a self-preservation response.” Dissociation is a form of self-preservation response.

If you’ve been through trauma and your body initiated a survival response, dissociation, to cope with the trauma, then you’ll habitually disconnect from your body. However, even if we aren’t dissociated, we have a tendency to disconnect from our bodies. We’re in our minds most of the time, hardly in our bodies.

Here’s a simple and gentle exercise to bring your awareness back to your body. This exercise is by Peter Levine and outlined in his book, In an Unspoken Voice.

In his words,

Take a gentle pulsating shower in the following way – at a comfortable temperature, expose your body to the pulsing water. Direct your awareness into the region in your body where the rhythmical stimulation is focused. Let your consciousness move to each part of your body.

Try to include each part of your body  and pay attention to the sensation in each area, even if it feels blank, numb, or uncomfortable. While you are doing this say, “ this is my arm, head neck, etc “ “i welcome you back”

You can also do this exercise by gently tapping some parts of your body with fingertips.

When done over time this exercise will re-establish awareness of your body boundary through awakening skin sensations.