Trauma - What is PTSD Therapy?

I kept away from trauma treatment for a long time; I thought it would make me depressed.

Yet now that we're in a pandemic, I decided to dive in.  More and more of my clients were presenting with symptoms of PTSD.

Thanks to the pioneer Bessel Van Der Kolk we have a model for trauma treatment that finally makes sense.

Rather than just reciting the trauma, with the real danger of re-triggering the client, we take it slow as molasses until the client is ready to reveal their trauma story.  They can only do this when they feel SAFE.  Once I discovered yoga, I understood why this made sense.

I came to yoga close to 20 years ago because of sciatica pain all the way down my leg.  No other remedy helped.  And believe me I tried.  But it was yoga that CURED it.  Again and again yoga gave me benefits I could never have imagined.  It's not about the workout.  It's about quieting your mind IN SYNC with your body.  It's that simple.  You have to do it over and over to see that yoga contains an inherent truth: The Body Keeps the Score.  This seminal book, which shot up the best seller list during COVID, instructs us to RELAX the breath/body and the mood will follow.  It could have been called the mood cure for our time.  For therapists who are afraid of body work, don't be.  You can stop the session to help the client prevent "flooding" or send them home with simple videos for rest, restoration, self-care, yoga, and meditation. Right now you can do a neck roll or legs up the wall or a child's pose and feel the benefits. What else do you know that gives you such instant gratification, and is free too!

Did I have trauma?  I never thought so.  I had lots of losses, bouts of depression and up and down anxiety, but trauma?  Well it turns out I did.  The pain I was holding in my body was unlocking and I was scared.  I cried.  But release I did.  The major trauma of my childhood, my parent's divorce, had followed me into every relationship. The fear of abandonment governed my decisions, and my sciatica came back.  Slowly slowly I worked it out.

According to the book Stolen Tomorrows I realized that my patients with histories of sexual abuse were going to take a lot more time.  After all, how could I not educate myself about this pressing issue while working with young adult females during the #metoo era?  Stories kept coming.  And the book says, for every major developmental milestone that a girl missed (or a boy) as a teen and young adult during the time the abuse took place, that's how long it will take to undo it, and go back and reintegrate the missing years.  Wow.  And it worked.  My first trauma client (a social worker!) sat with her discomfort for a year.  She brought her mother in at last, and laid the blame at her feet.  It went well.  The mother took it in.  She tried and they cried a lot.  The girl made boundaries for her abuser and continued to do therapy and body work, moved away and formed her first successful adult relationship.  She told me she would never forget the moment when I simply said, can you sit with that?  That was the beginning of un-freezing.

Here are some of the incredible insights from the trauma training with Van Der Kolk.  See if it fits and see yourself as healing on a journey.  It's your life.

1. Physical helplessness

2. Left hemisphere goes off line

3. What is the thought from before -- cognitive flashback

4. Whole body trauma story comes at the end

5. Brain set to see danger

6. Wake yourself up to the feelings in your body

7. Split off parts of yourself (longing to be touched - exiled bc it was your fault)

8. Dorsolateral prefrontal cortex is off line - this connects the past to the present

9. You can regulate yourself

10. You cannot analyze yourself out of it

11. Notice without reacting - prefrontal cortex

12. Can't go into the trauma until person can look inside herself 

13. Make the memory of the trauma go to the past (not exposure) but feeling safe again

14. Repetition compulsion to repeat the trauma

15. Educate the primitive brain to come into the present (calm down/tapping/breathing/yoga)

16. Open up the heart to self-compassion

Right now we endure fires, hurricanes and viruses, war veterans, genocides, starvation and systemic racism from a leader who failed to lead, a failure of basic empathy.  We must try to help our clients overcome existential fear with gentle understanding and wisdom from inside - the demand is greater than ever...