Understanding Trauma and Treatment Modalities
Often misunderstood, trauma is the result of overwhelming experiences of fear, helplessness, loss, terror or other intolerable experiences that activates our survival mechanisms of flight, fight, or numb. We may survive the experience through these mechanisms, but often are left with a wordless of experience of body symptoms such as anxiety, numbness, depression, or other leftovers of the traumatic experience without having much access to the story that it came from. People who have been through trauma often do not remember or have clear memory of the story of what happened.
Part of recovering from trauma is working with through this gateway of the body until the unacknowledged pieces of the somatic elements of the trauma can be integrated safely with mindfulness practices, awareness, and techniques specifically developed for working with complex trauma. From this place first, then the integration of the emotional world and the mind’s story of what happened can be fully integrated.
For many years the psychotherapy field has tried to “talk about” these things. Unfortunately, because most therapists are not trained somatically, and do not address the somatic component of the traumatic experiences, clients can report feeling worse, not better and in many cases their traumatic experiences intensify, which is the opposite of what they courageously sought out therapy for in the first place. This can feel like a maddening and terrifying experience for the person who was hopeful about getting help, and then falls into a deeper pit of despair because they deduce that their situation is hopeless and that no one can help them. There are other effective options. The greater community is hopefully starting to open up to integrating the necessity for somatically trained clinicians if we are to truly service the clients that come to see us in great need for relief and clearing of their traumatic events and histories.
I am extremely grateful for the work of Francine Shapiro, founder of EMDR and Pat Ogden, the originator of the Sensorimotor Psychotherapy model and for the opportunity to have studied with them and their top trainers in the Bay Area.
I’ve also spent a great deal of my life sensing into the body through my experience as a performing dancer, top gymnast, athlete, yogi and yoga teacher, and therapeutic body work practitioner. The different nuances of these dimensions have informed me of the many ways the physical and sensate body carry the somatic versions of our otherwise mental, emotional and psychological experience. I utilize these transmissions in my everyday work to support and guide you in your journey each step of the way.
Sensorimotor Psychotherapy and How It Works
Pat Ogden created Sensorimotor Psychotherapy which works centrally with the most granular aspects of human and traumatic experience, body sensations. The approach first works to build safety with clients by helping them to bring a very presently focused experience of mindfulness right into the body sensations that go along with any traumatic memory, story, emotion, mood, thought, perception, idea, picture, or judgment. This helps the body become resourced safely so that it actually has without the client thinking about it a naturally built in safety system based on mindfulness, presence, openness, curiosity and focus. Goals are the establishment of bodily safety, safe environment, emotional stability, and stable life “in the here-and-now.”* All this prepares the clients to remember the trauma so that it does not have to continue to be relived, as if it’s happening now, and therefore re-traumatizing. Then, when there is significant resources safely grounded well within the clients body, the processing of traumatic memories themselves are now able to be part of the work. Clients become able to work to overcome their fear of the troublesome memories so that they can be integrated into the larger whole person. The work utilizes the awakening qualities of presence, opening, curiosity, witnessing, all part of the mindfulness and awareness spectrum which allows the clients to come to terms with their traumatic past. As this completes, clients focus on reducing shame and are able to reduce a sense of isolation. Other integrative functions at this time opening to wishes for new meaning in both personal and professional life,
*Adapted from Judith Herman 1992
EMDR (Eye Movement Desensitization & Reprocessing) & How It Works
As I mentioned above, in the course of our human journey, we can sometimes unfortunately be exposed to events that are traumatic, which can cause us to fight, flight, or freeze and become locked into painful, difficult, and repeating patterns of sensing, thinking and feeling, somatically, emotionally, and mentally. As long as the trauma is unaddressed, the imprint of the most traumatizing part of the incident governs our functioning in a distorted way that causes misinterpretations, negative self-concepts, somatic complaints, and continuous re-traumatization. EMDR unhooks the traumatic attachment from the traumatic memory and restores the memory to a non-traumatized state by reprocessing the trauma so it becomes completely discharged and released.
When a disturbing event occurs, it can get locked in the brain with the original picture, sounds, thoughts, feelings and body sensations. EMDR seems to stimulate the information and allows the brain to process the experience. That may be what is happening in REM or dream sleep-the eye movements (tones, or tactile) may help to process the unconscious material. It is your own Brain that will be doing the healing and you are always in control.
When a traumatic or very negative and overwhelming event occurs, information processing is incomplete, because strong overwhelming survival mechanisms, which is a form of dissociation, interferes with information processing. This prevents the forging of connections with more adaptive information that is held in other memory networks. For example, a rape survivor may “know” that rapists are responsible for their crimes, but this information does not connect with her feeling that she is to blame for the attack. The memory is then dysfunctionally stored without appropriate associative connections and with many elements still unprocessed. When the individual thinks about the trauma, or when the memory is triggered by similar situations, the person may feel like she is reliving it, or may experience strong emotions and physical sensations. A prime example is the intrusive thoughts, emotional disturbance, and negative self-referencing beliefs of posttraumatic stress disorder (PTSD). It is not only major traumatic events, or “large-T Traumas” that can cause psychological disturbance. Sometimes a relatively minor event from childhood, such as being teased by one’s peers or disparaged by one’s parent, may not be adequately processed. Such “small-t traumas” can result in personality problems and become the basis of current dysfunctional reactions.
EMDR Treats:
- Developmental traumas and painful traumatic memories that impair current functioning.
- Overwhelming body sensations. Panic, anxiety, depression. A feeling of deadness.
- Trauma event victims (auto or work related accidents, natural or man-made disasters, combat veterans, crime victims, police officers, and field workers)
- Persons with phobias and panic disorders
- Persons experiencing excessive loss or grief of a loved one, or line of duty deaths or accidents
- Sexual assault victims
- Accident, surgery, and burn victims suffering from emotional or physical debilitation
- Victims of marital and sexual dysfunction
- Clients in various stages of chemical dependency recovery and pathological gambling recovery
- Persons engaged in business, performing arts, and sport who’d like to benefit from EMDR as a tool to help enhance performance.
- Persons with somatic problems, including chronic pain who would like to attain rapid relief from suffering
- Other persons with a wide variety of PTSD who may experience substantial benefits from EMDR
“The United States government has recommended EMDR for the treatment of trauma populations at all times – EMDR has a broad base of published case reports and controlled research which supports it as an empirically validated treatment of trauma. The Department of Defense/Department of Veterans Affairs Practice Guidelines has placed EMDR in the highest category, recommended for all trauma populations at all times. In addition, the International Society for Traumatic Stress Studies current treatment guidelines have designated EMDR as an effective treatment for PTSD (Chemtob, Tolin, Van der Kolk & Pitman, 2000) as have the Departments of Health of both Northern Ireland and Israel (see below), which have indicated EMDR to be one of only two or three treatments of choice for trauma victims. Most recently, the American Psychiatric Association Practice Guideline (2004) has placed EMDR in the category of highest level of effectiveness.”
EMDR Testimonial
“My relationship with my adolescent step-son can very stressful at times, especially because he can be aggressive, and it reminds me of my relationship with my father, who was verbally abusive. I knew, as a parent, I needed to find a way to respond to my son, in the moment, with less reactivity from my past, but I was having difficulties managing my feelings. With Joanna’s help, I have become less irritable with my son and more attentive to his needs, even when he is expressing feelings of anger or is loud or brash. Using a technique called EMDR she guided me through a special process that can be especially helpful to persons who have had stressful or traumatic experiences with persistent after-effects. I began to feel noticeably more relaxed with my son after one session. In addition to her skill, Joanna is warm and engaging. It is clear she not only enjoys her work, but feels a special calling to helping others. I would recommend her unequivocally to anyone desiring help with difficulties in their lives.” —Stephanie Miller, client
What Top Mental Health Practitioners and Researchers Have Reported About the Efficacy of EMDR:*
“The speed at which change occurs during EMDR contradicts the traditional notion of time as essential for psychological healing. Shapiro has integrated elements from many different schools of psychotherapy into her protocols, making EMDR applicable to a variety of clinical populations and accessible to clinicians from different orientations.” —Bessel A. van der Kolk, MD, Professor of Psychiatry, Boston University School of Medicine
“EMDR assists survivors in the immediate aftermath of violent trauma by breaking through the walls of denial, shock, grief and anger. Ideal for those who have been unable to forget past traumatic life events, as it allow for a rapid processing of even deeply rooted memories, giving individuals back control of their lives and their emotions.” —Dusty Bowencamp, RN CTR
Disaster Mental Health, American Red Cross
“EMDR is a significant component of treatment in the Trauma Recovery Program at the Menninger Clinic.” —Bulletin of the Menninger Clinic
“Francine Shapiro has made an enduring contribution to the field of psychotherapy.” —Jeffrey K. Zeig, Ph.D., Director, The Milton H. Erickson Foundation
“Dr. Shapiro’s work has proven invaluable to clinicians around the world in helping people following trauma.” —Atle Dyregrov, Ph.D., Consultant to UNICEF
“A lifesaving process for battered women…everyone who has experienced the psychological pain from abuse or knows someone who has should know about EMDR!” —Lenore Walker, Ed.D. ABPP, Domestic Violence Institute
“EMDR provides a proven approach to address the trauma that can interfere with healthy grief and mourning following the loss of a loved one.” —Therese A. Rando, Ph.D.,
Founder and Executive Director, The Institute for the Study and Treatment of Loss
“EMDR is proving to be the silicon chip of psychotherapy; it allows people to process incredible amounts of material in a shockingly short time.” —Michael Elkin,Ph.D.
Director, Center for Collaborative Solutions
“EMDR quickly opens new windows on reality, allowing people to see solutions within themselves that they never knew were there. And it’s a therapy where the client is very much in charge, which can be particularly meaningful when people are recovering from having their power taken away by abuse and violation.” —Laura S. Brown, Ph.D.
“EMDR is the most revolutionary, important method to emerge in psychotherapy in decades.” —Herbert Fensterheim, Ph.D., Cornell University
“Joanna brings a tremendous back round, professionally and personally. I would recommend her highly. She is intuitive and highly educated. Her wisdom goes way beyond her years on this planet.” —Darcy Elman, Owner of Being in Balance