Rethinking Trauma: The Third Wave of Trauma Treatment

reposting a blog post by Ruth Buczynski, PhD. NICABM

As someone who’s been practicing for a while, I’ve seen our view on the treatment of trauma go through substantial development. Our research, theory and treatments have all advanced considerably in the last 40 years.

And as I reflect upon this, I’m seeing 3 waves in the evolution of our outlook.

Looking back at when I first began to practice (in the late 70’s) our understanding of trauma was really quite limited. Of course we recognized the fight / flight response ever since Hans Selye introduced the notion back in the 50’s.

But our prevailing treatment option was talk therapy.

The thinking at the time was that by getting clients to talk about their traumatic event, we could “get to the bottom of” their issues and help them heal.

We were aware of the body and knew it held some power. But few practitioners used it in treatment (except the relatively few who worked with Bioenergetics, Rolfing, Feldenkrais, Rubenfeld, and to some extent Gestalt therapy).

But we were very limited in our ability to explain how body work, or for that matter, a talking treatment, affected the brain (and we had very little evidence-based research for it either). We just didn’t have much of a roadmap to guide us where we wanted to go.

That was the first wave.

Over time, researchers and clinicians started to recognize the limits of talk therapy. We realized that talking about a traumatic event held certain risks. At times, we inadvertently re-traumatized patients, especially if interventions were introduced too soon, before the patient was ready.

We also saw the memory of trauma as more often held in the right brain, the part that doesn’t really think in words.

So we began to use interventions that weren’t as dependent upon talking, interventions like guided imagery, hypnosis, EMDR, and the various forms of tapping.

And as the science surrounding the brain’s reactions to trauma became more sophisticated, clinicians grew to understand more about what was going on.

We began to realize that not everyone who experiences a traumatic event gets PTSD. In fact, most people who experience a traumatic event don’t get PTSD.

And so researchers started to develop studies to determine who did and who didn’t get PTSD. We looked for what factors might predict greater sensitivity to trauma.

And we modified our thinking to add freeze (later known as feigned death) to the fight/flight reaction.

Just adding that piece clarified our thinking about what triggers PTSD.

It also began to expand our treatment options to include sensory motor approaches.

And we started to see how more vastly intricate and multifaceted multiple trauma was compared to single incident trauma.

But I believe a third wave of trauma research and treatment innovations has just begun to crest.

And it’s only come recently.

We continue to see advances in the field of trauma therapy that are opening up more effective methods for working with trauma patients.

Because of all the research that’s been done, we are much better able to predict who gets PTSD and who doesn’t. Not only that but we’ve got a good handle on why certain people get PTSD.

And as brain science has revealed how different areas of the brain and nervous system respond to traumatic events, we don’t think so often about whether trauma is stored in the left vs right brain.

We think in terms of three parts of the brain, the pre-frontal cortex, the limbic brain and the lower, more primitive brain. And we’re much more sophisticated in thinking about which part needs our intervention.

We understand that the lower brain can command the shutdown response, totally bypassing the prefrontal cortex, totally bypassing any sense of “choice” for the patient.

And we see more clearly the part that the vagal system plays in this shutdown response.

We understand more of the role neuroception plays in feeling safe.

Knowing how the body and brain react to trauma opens the door for the third wave.

We are now beginning to use techniques like neurofeedback (based upon but a long way from the biofeedback we used years ago,) limbic system therapy, and other brain and body-oriented approaches that include a polyvagal perspective.

These are techniques I couldn’t have dreamed of when I began clinical practice.

But these are powerful tools that can offer hope to those who have been stuck in cycles of reactivity, shame, and hopelessness.

 

I am not what happened to me, I am what I choose to become.

This statement may seem simplistic, but it holds a lot of truth. When overcoming trauma, there are many pathways in the brain that are wired to respond to physical, unconscious, reminders of the traumatic event. But there are ways to rewire the brain. They involve going deep into the body and learning to read the body to detect the triggers of the traumatic memory. They involve releasing the stored memories from the body. They involve learning ways to calm down the fight/flight response the traumatic memory has triggered. In time, they involve the brain learning new pathways. This does not happen overnight, and can take months or even years.

The old fashioned belief that a traumatised person is ‘damaged’ and will never recover is very disempowering. Giving the traumatised person back their power by allowing them to make a choice and to believe he or she can make a choice is vital.

You may choose not to be governed by our traumatic past, but that will not happen overnight. With counselling, you can slowly make the changes that your brain needs to allow you to be who you choose to become.

The Blue Knot Foundation has world renowed guidelines for working with trauma and trauma recovery. I have been trained extensively in these guidelines and am well equipped to work with traumatised individuals. In addition, I have had my own recovery from a trauma history to give me an understanding of what it is like, but also of what is possible.

If you would like to work through your trauma with me, please contact me on 0409396608 or nan@plentifullifecounselling.com.au

The artist is not a person endowed with free will, who seeks his own ends, but one who allows art to realise its purposes through him. As a human being, he may have moods, and a will, and personal aims, but as an artist, he is “man” in a higher sense: He is “collective man”, a vehicle and moulder of the unconscious psychic life of mankind.

This quote doesn’t just apply to artists. It applies to anyone who sees the beauty in a sunset, who admires the perfection of a flower, who is captivated by the words of a poem, who delights in a beautiful piece of music. We all have the capacity to connect to art. The art that connects all of us in the endless, amazing rhythm of the universe and life. The truly great, timeless art pieces are those that tap into the collective consciousness of all people. When we respond to a piece of art, we are responding to the message of the collective consciousness.

I often use art in my therapy sessions. When asked to paint or draw something, so many people look horrified and say “I can’t paint (or draw)”, but I tell them it doesn’t matter whether they can or not. They can always use stick figures for people. The purpose of the art is to tap into the unconscious. And as a consequence of that process, there is a tapping in to the collective consciousness. What is produced is powerful and, in many cases, illuminating and even cathartic. It is the power of the unconscious mind being expressed.

I love the art that people create in my sessions. The paintings are powerful and beautiful. They express and release so much. Just painting without intention, just focusing on intuition to guide the art work, creates so much that is powerful and healing.

Art provides a different perspective. A way to view life differently. Art can release things a person didn’t realise were there. Art can heal. It doesn’t matter if no one else ever sees your art. It is beautiful.

A man who is unconscious of himself acts in a blind, instinctive way, and is, in addition, fooled by all the illusions that arise when he sees everything that he is not conscious of himself coming to meet him from outside as projections upon his neighbour.

This quote refers to the unconscious or shadow side that forms part of Jung’s theory of personality. Jung theorised that we have a persona that we show to the world. This is the way we wish to be seen by others. Most people have multiple personas. There is the friend persona, the work persona, the parent persona, the child persona, the lover persona to name a few. Our personas express the way we wish to be seen at work, with different friends, with our families and with our intimate partners. Our persona’s emphasise features we wish to have associated with us in given situations and involves accentuating the features we like best in each situation.

Jung saw the shadow side as being unconscious. It was the behaviours that did not fit our idea of how we should live in the world and be perceived by others. He theorised we have aspects of ourselves that we do not recognise and that will motivate our behaviours on occasion, without our being aware of what has triggered the behaviour.

We often see our shadow side in behaviours in other people that we do not like and criticise. Joelle worked as a school counsellor. She became angry with a parent who she felt was neglectful of her child and put him in second place ahead of her career. Her anger at the parent was out of proportion to what the parent was actually doing. Joelle’s teenage daughter came to see me. She was distressed at her mother’s neglect of her and her little brother and her preference to pursue her career instead of care for her children. This was something Joelle was unaware of, yet subconsciously she was. She was getting angry at the other parent when it was she who was the neglectful parent.

Not all shadow sides are so negative. Craig was raised in a family where he was taught never to show sadness. Sadness was seen as an extremely negative thing. So he presented a persona to the world that was happy all the time. He genuinely believed he was a happy person. He came to see me because there were occasions where he had become disproportionately sad about events and had cried uncontrollably. In this case, the sadness was repressed under a rigidly positive persona.

Sometimes, the shadow side is expressed in uncharacteristic behaviour. Other times it is expressed in pain in the body. I see many clients who have stored their repressed behaviours in their bodies.

Other people find their shadow side appears in their dreams. This can be disturbing, particularly if the repressed behaviour is one that the individual believes is wrong.

One thing I teach clients is to become aware of the feelings underlying behaviour so that, instead of acting blindly and instinctively, they can act with full awareness and control of their feelings. As a result of this learning, clients can learn to accept their shadow side.

There is no coming to consciousness without pain. People will do anything, no matter how absurd, in order to avoid facing their own soul. One does not become enlightened by imagining figures of light, but by making the darkness conscious.

Buddhist philosophy, from which mindfulness meditation comes, holds that suffering is caused by our resistance to the things that happen to us in life. If we accept what is and strive to work with it, then we suffer less than if we fight against the things that happen. We think avoiding dealing with the things that happen in life is easier, but it is actually much more difficult because of the suffering it causes. Not just suffering in the present, but suffering in the future as well.

Jung was an avid student of Eastern Philosophies. He considered western thought had deviated from such truths in life and he was keen to reclaim some of that ancient wisdom. Jung believed resisting the difficult things of life blocked us from our connection to our bodies and therefore to ourselves, to our soul and spirit.

There is much we want to hide from: the argument we had with our friend; the way we spoke to that shop assistant (you know, the way that is not the person you like to believe you are); the pain in our knee. We avoid, cut off contact, justify, take medications, to try to push those unpleasant things aside. We change the way we live our lives, we go on great detours to avoid reminders of unpleasant situations, we cut off contact with people we care about, we angrily defend ourselves against the signs we are less than perfect, we take more pills for that knee and never consider there may be another way to deal with it. We tell ourselves everything is fine.

While we hide and suppress our difficult feelings around the things that happen to us, we lose connection to who we really are. We become highly stressed and do not understand why. We become irritable and restricted in how we lead our lives. We become desperately unhappy, an unhappiness that no amount of ‘feel good’ activities or changes in our lives help. We continue to hide and suppress the difficult feelings and our live gets harder and harder.

Jung wrote a lot about our shadow sides. This is the part of us that does not fit the ‘nice’ person we like to think we are. We all have a shadow side. We all need to accept that shadow side. But it is challenging to do that. Meanwhile we hide that side with all the difficult things we are hiding.

If you are unlucky, you will live out an increasingly restricted and unhappy life. And you will never fulfil what you were capable of fulfilling in life. If you are lucky you will end up in a counselling room seeking help to unravel the mess you find yourself in. Then you will be able to explore what is underneath your unhappiness. You will find the suffering within. And you will be able to address that suffering. You will be surprised to discover facing that suffering was not as awful as you thought. If you continue to work through that suffering, you will rediscover the real you as you reconnect to your spirit and soul.

I have many ways I work with people to find a way through the suffering. I use sand play, art, movement and symbols, for those who come to see me. I also teach mindfulness meditation and self compassion as essential skills for connecting to self and others.

If you would like to work with me to find a way through your suffering please contact me on 0409396608 or nan@plentifullifecounselling.com.au to arrange an appointment.

What usually has the strongest psychic effect on the child is the life which the parents have not lived.

This statement has many meanings. The most obvious meaning is the parents who whether knowingly or unknowingly, pressure their children to fulfil their unfilled dreams. This is seen as having a negative effect on the child and the child’s development.

Jodie came to see me because of the damage done to her by a mother who pressured her to do the things the mother could never achieve. This caused great distress to Jodie because she was forced to follow a path in life that was not of her own inclination. She found herself pursuing a career path that she had no desire to follow. After counselling she felt empowered enough to stop pursuing her mother’s desired career path and instead follow her own. She was also able to set loving boundaries around her mother’s behaviour and continue a relationship with her.

Caspar came to see me because his father pressured Caspar’s older brother to follow his dreams to be a professional footballer. The sad thing about that was that Caspar’s brother was not good at football. Caspar, however, was an excellent footballer. Caspar’s father, instead of encouraging Caspar to pursue the dream, instead set out to suppress Caspar’s abilities. He ignored anything good Caspar did and instead celebrated every little thing his brother did, sometimes dragging the same event out to be talked about to cover up mention of Caspar’s achievements. He even told Caspar he was no good at football. Caspar believed his father and felt he was no good at football and suffered from low self esteem as a result of his father’s behaviour. He found he became extremely nervous whenever out on the football field and frequently was unable to play well due to the belief he was making mistakes. After counselling, he started to see his abilities as they truly were and was able to go and play football without being nervous.

There is another meaning to Jung’s saying. That is that parents frequently stop pursuing their own dreams because of parenthood. Life just gets too busy. Of course there are people who pursue their dreams despite the busyness. But many people find it hard to step outside their comfort zones and find the busyness of life with children is a handy excuse to not pursue their dreams. Instead the parent places all their focus on their children. This actually harms the children.

The purpose of our lives is to fulfil them. But if we fail to fulfil our lives by putting our own dreams aside then we deny our lives meaning and risk teaching our children to lead meaningless lives. If our children do not see us following our dreams, they can never learn that they can do this too.

Many people tell themselves they are virtuous to sacrifice their dreams to care for their children. But there is a problem with that. It is not possible to love others if you do not love yourself. If you value yourself so little, you are prepared to give up your dreams, how can you love others?

If you do not strive to fulfil your own dreams, how can you help your child fulfil theirs? If you don’t know how to help your child. If you have never struggled and succeeded how can you understand that struggle does not mean defeat? If you do not understand that, how can you teach that to your child.

Too many parents put their dreams aside and focus everything on their child. They become obsessed with their child. That obsession is seen in the behaviour I mentioned at the beginning of the article.

There is another dark side to that obsession. Patty came to see me because her mother was unable to function without her and never wanted her to grow up. Her mother would take her to school in the morning and hang around. Patty just wanted to play with her friends but her mother would be constantly there. She would constantly ask if Patty was okay, would she be alright if Mum left. Mum would leave and come back to ask if Patty was sure she was okay. Mum would leave again and come back and leave again and come back until Patty would cry and cling to her mother. As she grew up her mother tried these tactics every time she wanted to go out with friends, or on a date, or move away to university and later to get work. She was constantly led to feel she has to cling to her mother, even though she wanted to have a life of her own. With counselling she was able to learn new skills to allow her to set firm boundaries around her mother’s behaviour. She moved away, made new friends and found a partner. She also learned not to fall for her mother’s manipulative tactics any more.

Parents, follow your dreams. You may find that, after your children are born, you may have to pursue them more slowly. But don’t stop completely. Follow your dreams and let your child learn from that. Let your child have a happy, fulfilled parent who does not cling to their child and make every move to stop that child from growing up. Instead celebrate the joy of parenting your child and delight to watch them pursue their own dreams. Instead of being like Patty’s mother, be like Emma who came to see me to find the courage to continue to fulfil her dreams and to balance that with parenting her children.

If our religion is based on salvation, our chief emotions will be fear and trembling. If it is based on wonder, our chief emotion will be gratitude.

This quote is based on the premise that gratitude is an essential aspect of life. There is a lot of literature out there that promotes the idea of being grateful for all that we experience in life. Perhaps one of the most recent and popular books, and subsequent movie, was “Eat, Pray, Love”. This book, as with much other literature on the subject, supports the idea that being grateful for what you have is the best path to happiness. If you look at the world’s religions, you will find that message of gratitude is quite prominent. Yet in our modern, frantic, materialistic world gratitude is often overlooked.

The message of gratitude is that, instead of fighting against our inability to achieve unrealistic, materialistic goals in our life, we should instead be mindful of the many things we have to be grateful for. To understand that every day, in myriad ways, there is much to be grateful for. That stopping to acknowledge those moments and be grateful for them builds up a sense of the positive things in life. It also helps to turn our attention to what is important in life, rather than the often unattainable material things of life. There is also a message to look back at those disastrous moments and acknowledge the positive impact their aftermath has had on our lives. Even the act of just surviving a bad experience has a positive impact because you cannot survive a bad experience and not become stronger.

Many people choose to write gratitude journals, or challenge themselves to write a gratitude post on social media daily for a period of time. The people I know who have done this find it improves their sense of satisfaction and happiness with life. They find their focus switches to what they really value: family, friends and enjoying life. Their focus switches away from the pursuit of money, possessions and power. They also reported the realisation that the goals of earning big money, owning expensive things and holding a powerful position were empty goals that brought stress and fear, not satisfaction and happiness.

So the message of Jung is to stop and notice the things in life to be grateful for. Stop and smell that sweet perfumed rose. Stop and take joy in watching that gorgeous toddler play. Stop and admire the antics of a tiny puppy. Stop and be enthralled by the colours of the sunset. Stop and watch the amazing clouds in the sky. Stop and enjoy the sun as you sit on the beach and listen to the waves rising and falling. Stop and think about how great it is to be enjoying a conversation with friends. The list is endless.

The first half of life is devoted to forming a healthy ego, the second is going inward and letting go of it.

Jung believed in the Psychodynamic approach to the person. This approach, originally devised by Freud, believed we formed an ego as part of our normal development in childhood. It held that problems in adulthood stemmed from faulty completion of each developmental stage in childhood. Today, it is known that a child’s brain forms and makes connections, but not all people believe in the psychodynamic perspective. There is an understanding that things that happen in childhood can influence the way a child’s brain forms. However, not all problems faced in adulthood are the result of childhood problems.

Looking at Jung’s statement from today’s perspective it can be seen to mean the following:

A child grows in relationship to at least one significant adult, the primary care giver. The child learns about the safety of the world and how to relate to others from that primary care giver. If the primary care giver is loving and supportive, and is reliably there for the child, the child learns that the world is a safe, secure place and is able to form healthy trusting relationships. If the primary care giver does not provide love and security and is unreliable in supporting the child, the child learns that the world is not a safe place and that people cannot be trusted and will not be able to be trusted. The security of that bond to the primary care giver influences how the child’s brain develops. Trauma suffered in childhood that is not adequately processed through a loving, supportive relationship with a primary care giver will influence the child’s brain development.

Children form neural connections in their brains, up to the age of 25. The brain may have healthy connections, or it may not.

Once in adulthood, there is a need to live life and learn how to navigate the adult world. For those with trauma in their pasts, there is a need to rewire the brain away from those unhelpful neural connections and learn new, more helpful connections.

So what Jung’s quote is really saying is that we spend our childhood and early adulthood years forming neural connections in our brains. These dictate our behaviour and our relationships with others. We then spend the rest of our lives healing the areas where the neural connections did not form properly.

One of the biggest causes of unhelpful neural connections is trauma in childhood. It is possible to heal those connections. It is also important to know that the memories of those events are stored in the body and they will continue to impact adult functioning until they are released. Working with trauma involves releasing those memories from the part of the body in which they have been stored and allowing new neural connections to form in the brain. There are many ways to release those memories. Talking is useful, but not on its own. It is important to reconnect to your body and learn to understand what you feel inside your body. There may be physical movements needed to release trauma. Just observe film of an animal being chased by lions. If the animal gets away you will notice it shake itself. This is how it releases trauma from the body. A person who has been through a scary event will often shake afterwards. Stopping the shaking prevents the person from releasing the trauma from their body.

Another way I find useful for people is to use Reiki. The simple act of gentle touch on parts of the body allows body memories to be released.

Clients who come to me to process trauma can use a number of methods to express that trauma. They can learn to tune into their bodies, they can use sand tray, they can use art, they can use movement or I can give them a Reiki treatment. All methods work well for different people. Please feel free to make an appointment to see me to discuss different methods of treatment that may suit you.

Ten questions to help you declutter

Clutter in your home can have many consequences. The obvious one is that it makes it hard for you to keep your home tidy. It also makes it hard for you to find anything. The available space you have to complete tasks if also limited when there is a lot of clutter. But clutter has another impact. That is the impact on your sense of well being. This affects how you feel about yourself and your ability to make decisions. It can also be associated with depression. Often, people accumulate clutter because of bad things that have happened. The clutter represents the reaction to the bad thing. Decluttering means letting go and that can be hard. That type of decluttering is difficult to do on your own and this is where a counsellor can be helpful. Identifying whether the clutter is due to things you can’t let go of is difficult. The only way you can know is to try to declutter and see whether you can do it.

Start by writing up a plan to approach the clutter. Writing things down is helpful to give yourself a visual reminder of what needs to be done and what you have achieved. That is important to encourage you to keep decluttering. Plan the decluttering room by room. Break each room up into smaller chunks. You want to have tasks that do not take too long, maybe a maximum of an hour. This makes the tasks easier to achieve and gives you more ticks on your list as you complete each task.

Below are ten questions to ask yourself as you declutter.

1.Is this item something I use regularly?

2.If not, is it something I love?

3.Am I keeping this because I feel I should keep it, or because I am expected to keep it? (Either I expect myself to keep it or am expected to by someone else, or think I am expected to by someone else.)

4.Am I holding on to this because I think I should love it?

5.Am I keeping this ‘just in case’?

6.Do I have multiples of this thing?

7.Could something else I own do the same job?

8.Is this item broken and am I holding on to it because I intend to fix it?

9.Is this item worth the time I spend cleaning it and storing it?

10.Could I use this space for something else?

Many people report they feel a great sense of release and freedom when they start clearing out clutter. But some people find it too hard to deal with it. Melissa started cluttering her house after her husband died. She made several attempts to clear the clutter, but each attempt failed. She found it impossible to move on in life after his death. After 7 years of increasing clutter she was threatened with eviction from her house. Melissa had reached a stage in her life where her clutter was holding her back from moving on. Initially it had been because she could not bear to part with anything that reminded her of her husband. But over time the clutter became a trap, she didn’t want the constant reminders of her husband, but she could not bear to throw anything out. With counselling she was able to process her feelings around her husband’s death and find the courage to face the reminders of his existence and also let go of the things that reminded her of him.

Quotes by Carl Jung – To be normal is the ultimate aim of the unsuccessful.

This statement can be a bit confronting. Firstly, what is normal? Normal will vary depending on who you speak to. Secondly, what is wrong with being normal?

Normal is something that is defined by groups of people. In a group of friends there will be one definition of normal. A group of work colleagues will have another definition. A community will have another definition. A different community will have another definition. There may well be an overlap in the definitions but each will be individual and will be influenced by cultural beliefs and people’s experiences.

So what did Jung mean by this statement?

He spoke in his writings about people finding their true self. Once they had found their true self they were to live according to that true self. To live in your true self means to be yourself, which is rarely normal. Normal is conforming to expectations of others. It does not involve being who you truly are.

A lot of people who come to see me are miserable with their lives. They are not living their lives according to what they really want. Instead they are living life according to what other people expect of them. That is certainly a safe way to live. But it is ultimately unsatisfying and leads to depression.

Living a fulfilled life means living life according to your true self. A fulfilled life is seen as being the mark of success. Striving to fit in and be seen as ‘normal’ by your group is the way to live un unfilled life. Therefore, striving to be normal is the way to lead a life that is unsuccessful.

Many people struggle to change the way they live their lives. They stick to practices, jobs, locations they don’t like. Change is too hard, too scary, to try. So they remain stuck in places where they are unhappy. Ultimately it impacts every aspect of their lives.

I frequently coach people through changes in their lives. It can be very helpful to get help to make those changes. If you would like me to help you please contact me on 0409396608 or nan@plentifullifecounselling.com.au