by Counseling and Wellness Center of PittsburghDecember 7, 2022 counseling for trauma, help for trauma victims, resilience to trauma, therapy for trauma, trauma, trauma counseling, trauma informed care, trauma therapy, types of trauma, what is trauma0 comments
When you hear the word trauma or trauma counseling what comes to mind? It is common for people to hear the word trauma and think of those one-time catastrophic events (car accidents, assault, robbery, natural disasters, etc.) that result in major injuries like broken bones, head injuries, or lacerations, and symptoms of post traumatic stress disorder such as flashbacks, nightmares, hypervigilance, increased startle response, etc. This perception of trauma causes people to minimize their suffering and postpone receiving treatment that helps them heal and increase their quality of life.
So, what is trauma, and who experiences it? Trauma is anything that overwhelms the mind and body and happens too fast, too soon, or too much. It causes physiological, neurological, chemical, and hormonal changes that impact memory and cognition; often resulting in:
- Emotional dysregulation
- Lack of trust in yourself, others, and the world
- Mental health illness
- Chronic pain
- Inflammatory disease
What Types of Trauma Are There?
“Big T” traumas, like those catastrophic events listed above, are the most obvious and lead people to seek treatment to help them learn to cope and move past the event. “Little t” traumas are the things we experienced regularly throughout our lives that we may have been conditioned to accept as part of life or growing up. Some of these experiences may include:
- Being bullied
- Witnessing violence
- Lack of constant care during childhood
- Lack of emotional validation
- Having a caregiver who struggled with mental illness and/or substance use
- Incarceration or having a loved one who was incarcerated
- Experiencing discrimination due to race, gender, age, socioeconomic status, or religious affiliation
- Lack of autonomy
- Lack of affection
- Being isolated, yelled at, or controlled by others
This does not mean that everyone who has experienced these things is traumatized. Traumatization is dependent on several biological and environmental factors that influence perception and physiological regulation.
What Kinds of Trauma Counseling Can Help?
What kind of help is there? Trauma is a multifaceted and complex phenomenon that traps itself in the body and the brain keeping you in survival mode at a physiological level. Trauma treatment is an evidence-based technique that walks you through specific stages of treatment to ensure a felt-sense of safety, agency, and autonomy, empowering the client to take control of their lives leaving the past in the past. Certified trauma specialists and professionals can help unlock the trauma trapped in your brain, muscles, nervous system, and adrenal/endocrine system so that you can feel safe in your body and the world. Some of the effective treatments include but are not limited to:
EMDR (Eye Movement Desensitization and Reprocessing) targets upsetting life experiences that have not been stored properly in memory areas of the brain and are triggered more easily by similar events or negative personal beliefs. Unprocessed or blocked traumatic memories need help from therapies such as EMDR to become processed or unblocked.
IFS (Internal Family Systems) is an approach to psychotherapy that identifies and addresses multiple sub-personalities or families within each person’s mental system.
Sensorimotor psychotherapy (SP) integrates the body and movement into traditional talk therapy to address and heal ongoing psychological and physical difficulties.
Narrative Exposure Therapy: With the guidance of the therapist, a patient establishes a chronological narrative of their life, concentrating mainly on their traumatic experiences, but also incorporating some positive events. It is believed that this contextualizes the network of cognitive, affective and sensory memories of a patient’s trauma. By expressing the narrative, the patient fills in details of fragmentary memories and develops a coherent autobiographical story. In so doing, the memory of a traumatic episode is refined and understood.
Cognitive Processing Therapy (CPT) is a short term evidence-based treatment for PTSD and other related disorders. CPT is based in cognitive theory and helps individuals to recognize the impact that the traumatic event has had on their thoughts and beliefs, feelings and behaviors.
How Do I Know if I Should Seek Trauma Therapy?
If you experience any of the following it may be beneficial for you to see a professional who can help you sort through your experiences and move forward in life:
- You are easily startled
- Flashbacks or nightmares of the event
- Feeling afraid but not knowing why
- A generalized distrust in yourself, others, and the world
- You notice a pattern of unhealthy relationships throughout your life
- Feelings of restment
- Unmanaged anger
- Avoidance of certain people, places, or things
- Unexplainable body aches and pains
- Chronic pain, inflammation, or fatigue
- Easily triggered
- Persistent feelings of sadness
If you are experiencing any of these symptoms, reaching out to a professional can help you determine if trauma therapy is right for you.
Interested in Starting Trauma Therapy?
Fill out the form below or contact us at 412-322-2129 to begin trauma counseling.
Centers for Disease Control and Prevention. (2020, September 17). Infographic: 6 guiding principles to a trauma-informed approach. https://www.cdc.gov/cpr/infographics/6_principles_trauma_info.htm
Levine, P. A. (1997). Waking the tiger: Healing trauma: The innate capacity to transform overwhelming experiences. North Atlantic Books.
American Psychological Association (2017, July 31). https://www.apa.org/ptsd-guideline/treatments/narrative-exposure-therapy
Psychology Today (2022, May 20). https://www.psychologytoday.com/us/therapy-types/internal-family-systems-therapy
Bartella, A. (2011, October). Sensorimotor psychotherapy: A somatic path to treat trauma. The Trauma & Mental Health Report. Retrieved from https://trauma.blog.yorku.ca/2011/10/sensorimotor-psychotherapy-a-somatic-path-to-trauma-treatment/
by Counseling and Wellness Center of PittsburghDecember 15, 2021 Adoption, Guardianship, Child Anxiety, children mental health, grief, healthy holiday, holidays, holidays stress reduction, trauma, trauma counseling, trauma informed care0 comments
When most people celebrate the holidays, they are surrounded by loved ones telling stories and laughing over mugs of hot cocoa as they exchange gifts. During this time of holiday cheer, many children who were adopted are faced with the realization that they will not see any of their biological family during the holidays. It is a stark reminder of the grief and loss they have experienced up to and including being removed from their biological family’s home. It is important for adoptive parents to prepare for and remain aware of what they can do to help their newly adopted children during the holidays. Here are some therapist recommendations to follow:
- Talk about the holiday. Help your child understand what holiday traditions and festivities your family participates in and allow them to ask questions. Do you celebrate over many days or just one day? Are there religious customs? Who will they meet and will there be gift exchanges? Avoiding surprises will help decrease anxiety.
- Incorporate traditions that the child celebrates into your holiday. Whether it is an annual watching of Frosty the Snowman or a snowball fight on Christmas Eve, bringing a cheerful memory to life may make a child feel more comfortable. You may even get a smile. Through conversation, you may discover that your child doesn’t celebrate the same holiday you do. Make it a point to learn about their customs and show interest in celebrating them.
- Allow them to grieve. Despite your best efforts, your child may still pull away. This is not intended to be a reflection of their feelings toward you or their new family, but instead a way of coping through this difficult time. Make one-on-one time with your child to talk through what they may be feeling. Be prepared if they shut down the conversation or not know exactly what they need. Give enough space for “downtime” and do not force them to participate in any activities.
- Don’t chase the “perfect” holiday. This not only creates unnecessary stress for you, but also for your child. Be flexible, be realistic, and have a sense of humor when things don’t go as planned! This can also include unexpected responses from extended family who do not understand the child’s behavior.
- Stay Trauma-Informed. Educate yourself on trauma and the impact it has on the dynamics of a family. Trauma can often look like anger, hyperactivity, and defiance. Without an understanding of the effects of trauma, it is likely you will misinterpret your child’s behavior resulting in feelings of anger and resentment. There are many resources online to assist in Trauma-Informed Care such as attachmenttraumanetwork.org or childwelfare.gov.
In summary, there isn’t one right way to raise a child. Remember to give yourself grace and practice self-care! Your child will teach you more about yourself than you may have ever realized previously. With patience, knowledge, and empathy, you can create an open environment that allows an adoptive child to feel comfortable expressing their fears, triggers, and even their feelings about their biological family.
Written by: Teresa Gouch, a licensed professional counselor at the Counseling and Wellness Center of Pittsburgh. Teresa specializes in trauma counseling and foster care/adoption counseling.
by Counseling and Wellness Center of PittsburghOctober 7, 2018 abuse, abuse resources, domestic violence, help for trauma victims, rape, resilience, survivors, trauma counseling, validation, victim blaming, victims0 comments
How to Provide Grace and Resiliency to a Friend or Family Member Who Discloses Trauma.
According to the United States Veterans Administration, about 50% of women and 60% of men will experience trauma at some point in their lives. Trauma is defined as an emotional response to a distressing event. Traumatic events can include witnessing or experiencing sexual or physical assault, violence, robbery, or attack. We are not all equipped with a vast understanding of psychology, and when a friend or family member turns to us with their memories of a traumatic event, more than ever we could benefit from some information on how to respond with validation, support, and compassion. The literature on trauma widely cites how important loved ones’ responses are to survivors’ disclosures of the events that they experienced. In fact, in a 2016 study by Lischner and Hong at the University of Washington, invalidating responses of friends, family, and others are correlated with an increased likelihood that the survivor will experience psychopathology including Post Traumatic Stress Disorder (PTSD). With the number of people who have survived trauma growing each year, it becomes ever more likely that someone will turn to you with their memories of a traumatic event. Below we will highlight some invalidating responses and provide validating responses so that each of us can do our best to provide caring support to those who may approach us with their heavy burden.
Validation is defined as responding with empathy, agreement, acknowledgement that we believe what was shared and that it makes sense. We can validate many levels of expression and meaning, feelings as well as thoughts. As a couples counselor, I help couples use the tool of validation to comfort each other in conflict. Validation is powerful. Some validating responses are;
- ‘Thank you for trusting me enough to share this.’
- Summarize the memories that were shared, always referring to them as memories or experiences.
- ‘That must be so (painful, scary, traumatic, other feeling word) for you.’ Summary of emotions, this is to indicate a full understanding of the feelings that the person shared.
- ‘You were so strong and brave in sharing your experiences.’ This is a compassionate response that highlights their survival skills.
- ‘How can I support you further?’ Letting the person know that you are glad to discuss any of it further, that you want to be there for them in any way that they need.
Invalidating responses can cause survivors to feel anxious, depressed, panicked, overwhelmed, and called to defend themselves and their pain. Many trauma survivors cite that invalidation from family or friends of their traumatic event is at times just as distressing as the trauma itself. Invalidation can be consciously used as a tool to manipulate and coerce, and it can be unconsciously done because the recipient to the confidence doesn’t know how to respond or help. Some examples of invalidating responses are as follows:
- ‘Why are you bringing this up right now?’ Every survivor unfolds their trauma memories to different people and in varying times, when and how they will share their trauma and with who it feels safe to share.
- ‘Are you sure you remember this accurately?’ The first duty of love is to listen and validate, provide understanding, care, warmth, and support. It is not a good time to put them on the witness stand for cross examination.
- ‘The perpetrator remembers it differently.’ Attend to the survivor’s feelings first and save the fact checking for a different time and day. Even if you feel called to defend the person or event that is being discussed as the source of trauma, this survivor is sharing something very vulnerable and the immediate need for understanding and care would indicate that we should triage and be delicate.
- ‘Try not to think about it and put it behind you.’ This response indicates that the person’s experience of grief, pain, panic, anxiety, is something that can be dismissed. Working with trauma clinically provides opportunity to experience the depth of the memories and emotions to be reprocessed. There is much evidence that the more we think we should be able to dismiss our responses to trauma, the more likely we develop PTSD.
Don’t be hard on yourself if you recognize after reading this that you may have been invalidating to someone in the past. ‘We all do our best and when we know better, we do better.’ Maya Angelou
Please pass this along. Every day another person survives and attempts to thrive in the wake of pain and anguish. Each of us has the potential power to be a safe zone, to provide support, help, and healing for those who are making sense of traumatic events, we have the ability to provide resiliency against emotional pain and we can create a buffer and reduce the development of Post Traumatic Stress Disorder.
With resiliency and hope,
Stephanie Wijkstrom, MS, LPC, NCC
*The is not a replacement for mental health support provided in a clinical setting by a licensed counselor, psychologist, or clinical social worker. If you or a loved one has experienced trauma and are working through its effects, reach out to a therapist near you.
Thank you to our editor, Dr. Stellan Wijkstrom.
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by Counseling and Wellness Center of PittsburghSeptember 30, 2018 counseling for anxiety, counseling for PTSD, psychotherapist, touch, yoga for trauma0 comments
Hands off-Please Do Not Touch My Body.
Closeness is sacred and powerful, and we should share it however we would like with a partner or partners with whom we have provided consent. Personally, I am a ‘toucher’, meaning I am a person who enjoys touch with my partner, someone who hugs family and friends and genuinely savors safe closeness. As we all know, touch can feasibly happen in many contexts. A recent trip to a local yoga studio has spurned some inspiration for considering consent and what exactly that means within the context of yoga. Consent is one of the topics of the century, the importance of asking for it, and heeding to it are championed issues with personal, psychological, and legal context. When we are on our yoga mat, we are presumably in a safe zone, we practice yoga to be well, to relax, to be inside of our bodies, to give life and expression to what our physical selves need in the moment to create our highest expression of safety, openness, and comfort. We rely upon the professionalism, understanding, and care of our yoga instructors while we are on the mat. When others take liberties with our bodies, reactions can range from uncomfortable to traumatic, yet we shouldn’t need to rely upon trauma informed yoga instructors to be the only providers who can offer a style of instruction which provides opportunity to say “No thank you, please do not touch my body.’ From chaturanga to shavasana, we find our bodies configuration of the posture as the yoga instructor cues. Without making space for hands off adjustments, one well-intentioned yoga instructor can inadvertently have a negative impact upon his or her student’s practice, day, overall wellness by taking liberties with his or her student’s bodies.
Consent means that one has asked for permission to approach another person in any way, whether that be to touch, to enter an intimate encounter, or even to provide unsolicited verbal feedback, we should always ask before encroaching upon others. After asking for consent, we wait and pause for that person to respond with their response of approach or avoid. A key component of consent is that the other person is truly able to say ‘no,’ if we are in a position of power, or if we are asking a person who is intoxicated, a minor, or incapacitated in any way, then the other can not provide for their own consent. Under normal circumstances, then, if and after we have been given permission to ‘approach’ we take it a step further to check in to be completely sure that non-verbal permission has been granted to continue or deepen the exchange. Physical space, proximity, and closeness are very special, they are exchanges which can lead to bliss, warmth, bonding, relaxation and even orgasm in the right time. When touch is used subversively, to coerce, to control, to harm, physical connection can become shrouded in horror, it also has the potential to instill anxiety, fear, terror, panic, and pain.
Consensual sexual intimacy is the gold standard, we should always be sure that we are well within the green zone of any boundaries of any person who we are touching and to also always note that we are creating safety for others as we strive for mutual enjoyment and pleasure. There are many contexts or situations where touch happens from fitness instruction, personal training, yoga instruction, little league coaching, physical therapy, massage, and medical settings. While there are many of the medical and physical instructors listed above who do check in and ask, ‘is it ok for me to adjust you.’ The best ones who follow this question by ‘does this feel ok for you’ and to them I applaud their insight and wisdom to always, in all settings, to ask first and wait for an enthusiastic ‘yes’ or a clear non-verbal head nod which unambiguously encouraging procession. For other yoga and fitness instructors, it may be less obvious that they should ask for consent before breaking the touch barrier with students. Let us examine consent from a trauma informed perspective and look at some ways that we can be sure we are always providing supportive and caring touch.
Regardless of the setting or context, we do not have permission to touch another person until we have asked for it and they have given it. For a trauma survivor it can be very triggering and alarming to feel a person, even a coach or instructor grabbing at them, or tapping on their body, for another person to move ones legs or touch ones hands. Feeling safe and giving permission for these things to happen is vital and walking into a yoga studio to practice does not provide consent for one’s physical boundaries to be violated. Just as walking into a bar or nightclub in a low-cut blouse is not the same as providing consent for someone to touch our breasts. Being a woman out late having drinks is not an invitation to have sex, we need a society which is built upon making space for ‘Yes’, or ‘No’ by always ask first. Yoga and fitness instructors, we are here, we want to participate in a fun and fulfilling way but ask before touching please. Additionally, for some instructors who may have a style of delivering their teaching that is very directive and assertive, it may feel punitive to some students.
Recently, in an all levels class, the instructor was someone I had never practiced with before. The class was much less than an all level class, it was more of an intro in my experience, we were cued to move into postures without much attention to how we flow through the sequencing. In any event, after 15 minutes or so warming up, we were cued to do some Sun A’s. When forward folding the instructor told everyone to grab a two blocks in anticipation of their hands not hitting the ground. I have long arms, and have been doing forward folds for many, many, years, it does not tax my body to fold forward and I find it delicious and restorative. The teacher stomped back to me and said ‘No! get your blocks, do not go into your deepest fold!’ In knowing my body, and knowing that I did not need the blocks I started to reach for them to appease her as she began grabbing my leg and tapping rapidly and harshly onto the front of my quad with her pointed finger tips and squinted eyes, ‘Move! Move! Move!’ she commanded. What started as a day of wellness, mindfulness, and an attempt to let myself feel peace, quickly became a source of discomfort and anxiety.
Being a yoga instructor is a big responsibility, it is a pathway to open ones consciousness, those blissed out happy vibes and chakras can really open up and make others aware of themselves, their feelings as well as anything happening with the instructor. We should encourage yoga instructors to have a higher level of insight into their style of relating to others so that the instructor is not unconsciously projecting their own unmet needs or style onto all of those who they come into contact with. The yoga instructor should be very aware of how of tone and content of speech particularly as adjustments are being made. If an instructor is simultaneously speaking in a critical or cold tone ‘move!’ ‘faster!’ ‘in, in, in;’ in a style that feels like they are spitting commands to the students, if the instructors speak this way while grabbing at a students body, it may become even more likely that they are making others feel tense, uncomfortable for anyone, and furthermore this kind of tone and motion can even be panic inducing for some trauma survivors.
More than ever, we must seek to create safety, to speak with love, to be sure that we are providing physical touch which is tender, and warm, and supportive or not tender and warm, if that is the kind of touch which is consensual and agreed upon by those who can legally and actually provide consent. Speak and act with awareness and care for other people’s feelings, doing fitness, pilates, doing a forward fold or downward facing dog, or even having a suspicious mole removed from our bodies are things that must happen peacefully and respectfully, and always with particular attention to any person’s ability to state, ‘No thank you- please do not touch my body’.
Stephanie Wijkstrom, MS, LPC, NBCC
830 Western Avenue Pittsburgh Pa
2539 Monroeville Blvd Monroeville Pa 15146
For more reading on the ethics of touch in yoga;
by Counseling and Wellness Center of PittsburghJune 21, 2018 counseling for PTSD, psychology, psychotherapy, ptsd, trauma, trauma informed care, trauma therapy0 comments
We have fantastic and astonishing memory abilities, the human mind and its processes, particularly in the way we store and retrieve the effective memories which then effect the way that we store and respond to our other memories and sensory input. Evolutionary psychology examines the way some things that can be problematic are often helpful to us in the past and as we evolved. This is especially true for trauma survivors. According to the American Psychological Association, Trauma is an emotional response to a event like an accident, rape, or natural disaster, abuse or assault. Immediately after the event, shock, emotional upheaval, loss of ability to function, and denial are typical. Trauma is especially present in situations where a person feels powerless and their sense of control are taken. Long term reactions include unpredictable emotions, flashbacks, strained relationships and even physical symptoms like headaches or nausea, nightmares, inability to rest or calm down, feeling tearful, experiencing fear and heightened startle response. While these feelings are very universal response to the paralyzing fear that is associated with trauma even if the survivor reports feeling neutral in the moment. Biology offers some rational for how we can feel afraid but work through it in the moment of the traumatic situation, but it is later when we are safe and comfortable that the panic can emerge, generally emotions are something that can be seen and felt most when everything is alright around us, meaning the traumatic event is over and we are safe. Some people have difficulty moving on with their lives because trauma can result in long term effects such as PTSD, acute stress disorder, anxiety, depression, and addiction.
There are so many events that we experience which are traumatic, whether these develop into the more complex constellation of behaviors which we identify as PTSD, really depends on an interplay of biological, social, and other environmental factors. Some of the situations which can cause a trauma response include, domestic violence, sexual violence or assault, car accidents, national tragedies, serving in war, robberies. It is possible that we can experience a traumatic response my witnessing these events even if we are not the direct recipient of the threatening attack.
People who later feel the emotional and physical effects of trauma may wonder, what is wrong with me? Also, even if the event seemed manageable in the moment, it seems bizarre that they keep seeing flashes of it months or years later. The answer is while the effects of trauma can be debilitating, our cognitive processes are primed to be traumatized. Evolution explains that we and our ancestors are wired to hold tight to frightening or threatening experiences, imagine what happened to all of the humans who did not startle and produce massive amounts of cortisol and adrenaline at the sight of the saber toothed tiger just through the northern passage on the savannah. They died and did not evolve to have offspring in our gene pool. Having memory of dangerous events, people, situations, and gearing up to flee or protect one’s self is a sign of an evolutionarily healthy adaptation, it allows us to stay safe by avoiding possibly dire situations. In fact, our Vagal nerve which communicates directly to our bodies, without having to yield the advice of our logic, there are long term changes in the way that our Vagal nerve responds to triggers after we have experienced trauma. The vagal nerve is what allows healthy people to experience the ‘startle response’ for example when someone sneaks up behind you, usually we respond with a physical jerking motion in our bodies, and literally jumping. In domestic violence survivors, being ‘jumping’ and easily startled when a person raises their hand, is a well noted phenomenon that may last an entire lifetime.
We are wired to remember traumatic events. Survivors of trauma know that the sight of the perpetrator of their violence, even a coat that’s the same color as the one their attacker had worn can evoke the fear response. ‘Triggers’ are any stimuli which we associate with the traumatic event. These triggers and their associated memories can and do produce a jolt to the vagal nerve resulting in heightened, panicked, and anxious response in the person who is perceiving them. The biological response when we encounter a trigger are a plenty, our bodies enter a state of hyper-arousal, respiration becomes more shallow, heart beat rises, and fear settles in, even cognitive function is impaired as our higher order reasoning is impeded and all neurological resources are yielded to the hind brain and its motor and autonomic functions. The one and only thought becomes fight, flight, survive, and in some cases freeze. Remember, just like on the savannah in the seat of civilization, the extra energy our bodies create allow us to escape danger.
Cognitive processing therapy, systematic desensitization, and exposure therapy, and some therapies which aim to change the tone of the vagal nerve are recommended ways to work through the trauma and empower the survivor to be able to withstand exposure to triggers and regain emotional wellness. It is recommended that trauma survivors do their best to limit exposure to triggers as they heal from the event and associated memories. If you feel that you may be experiencing long term effects from a traumatic situation, it is recommended that you work with a therapist who is specifically trained in trauma informed care. Healing will allow the processing of the entire event, client and therapist will identify triggers, developing the capacity to respond to triggers with mindful balance, and work through the effects of any other psychological effects from the trauma.
Counseling and Wellness Center of Pittsburgh, Serving Western Pennsylvania with Individual Therapy, Couples Therapy, Family Therapy and Wellness Services.