psychotherapy

Trauma Informed Care; We Have Evolved to be at risk for Trauma; Here is Why

Trauma Informed Care

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.

Generalized Anxiety Therapy

Generalized Anxiety

Generalized anxiety disorder is a mental health concern which brings many people into therapy each year. As many as 1/4^th of people who seek treatment in counseling centers each year do so as a result of wanting to manage symptoms related to Generalized Anxiety Disorder or (GAD). Signs and symptoms of Generalized Anxiety Disorder are free floating thoughts and worries that are not related to a real imminent danger. Those who experience generalized anxiety disorder may find it difficult to distinguish between thoughts and fears which are related to a real possible danger or threat and one that is not. The thoughts, fears, and worries of Generalized Anxiety Disorder co-occur with physical somatic responses such as elevated heart rate, fatigue and restlessness, and or difficulty falling and staying asleep. Individuals who are experiencing this anxiety disorder may also be prone to irritability and may too have a higher incidence rate of other mood and mental health disorders including other anxiety disorders, or depression and substance abuse disorders.

A woman suffering from GAD may say something like “I was always on edge, it was difficult to pin point when the worrying started but it felt like it was one thing after the next. I was worried about getting into college, then how I would manage student and work life after, each test and paper caused me endless worry. It wasn’t just with school either, everything from traffic, to my parent’s health, I wasn’t even able to see the way it was effecting me until things became so bad that I wasn’t sleeping well and started to really feel down. Then I found a therapist and started working on treating my anxiety and along with that I was able to identify how much it had taken over my life.”

Some of the diagnostic criteria for GAD according to the Diagnostic and Statistical Manual, are as follows; Excessive worry for at least 6 months.

The person experiencing the anxiety is not able to control the worries or change the focus of their thoughts. Additionally these worries are accompanied by physical sensations or somatic responses including at least 3 of the following; Restlessness, Fatigue, Concentration difficulties, Irritation of Mood, Tightness in the Muscles, Sleep Cycle Disruptions including Difficulty staying or falling asleep. Remember these symptoms cause significant distress in social, family, or work life and are not caused by another disorder or use of substances. Only a licensed professional counselor, psychologist, or psychiatrist can help you to discern whether you are exhibiting or experiencing the full range or concerns which may mean you qualify for a diagnosis which will then help to guide the treatment for the anxiety disorder.

Treatment for generalized anxiety disorder often involves many therapy and counseling options. Many forms of psychotherapy including, cognitive behavioral therapy, psycho-dynamic therapy, brief solution focused therapy, acceptance therapy, gestalt therapy, rational emotive behavior therapy, are all valid methods to treat anxiety disorders and manage the symptoms associated with it. In other instances, counseling may be used alongside medication therapy, integrative medicine, including mindfulness and meditiation, to achieve a significant and long lasting reduction in the symptoms of anxiety.

Counseling and Wellness Center of Pittsburgh and Monroeville

830 Western Avenue

Pittsburgh Pa 15233

2539 Monroeville Blvd

Monroeville PA 15146

Phobia Therapy & Treatment

Phobia

A phobia is a fear or anxiety response of heighted arousal, ie rapid heart rate, rapid breathing, and thoughts of intense worry and this most likely leads to avoidance of the situation or object. Some examples of typical phobias are fear of public speaking, fear of choking or vomiting, fear of spiders (arachnophobia), fear of enclosed spaces (claustrophobia), fear of bridges, fear of tunnels, fear of large crowds, fear of blushing, fear of water or other natural environments, fear of contamination or germs. Phobia is distinct and much more severe than a natural aversion, for instance in the example of arachnophobia, many people do not like spiders and insects but wouldn’t qualify for a disorder because this doesn’t interfere with their functioning and enjoyment of life. A person who simply doesn’t like spiders may sheik if they encounter one and quickly try to remove it from their environment. A person who has a phobia of spiders may feel anxiety if they think about a spider, they may never go into a forest or stay away from other natural environments, they may start to take precautions like spraying repellant everywhere and have continual intrusive thoughts about the possibility of encountering spiders and even stop leaving home or developing agoraphobia because their wish to avoid the spider is so powerful.

The Diagnostic Criteria for A Specific Phobia are;

1. A continual, persistent, and excessive fear caused by the presence or anticipation of the situation and or object, examples may be choking, bridges, tunnel, flying, insects, fainting, speaking, blushing.
2. When exposed to the object or situation an anxiety or hyperarousal response is invoked. This is also a different response in children.
3. In panic disorder the persona experiencing the disorder does recognize that the fear is unreasonable and the response is excessive.
4. The situation or object may be faced or endured but only with very visible and tangible fear, anxiety and distress.
5. This fear and anxiety interferes with the enjoyment and participation of life, limiting professional, occupational, social, relational, and academic performance and functioning.
6. This can be diagnosed only in individuals who are over the age of 18 and it must be experienced for longer than 6 months.

The best way to treat a phobia disorder is with psychotherapy, your licensed counselor can help you by using a very specific kind of therapy called Exposure Therapy. This is a behavioral therapy which a licensed therapist who specializes in treating anxiety disorders will be able to guide you through. In other instances, medication including anxiolytic medication, anti-anxiety and SSRI’s are best used medication therapy to treat and manage panic disorder. Other forms of therapy which may help to manage specific phobias including meditation, mindfulness, exercise and other integrative options like nutrition counseling and acupuncture.

Melissa Taylor, LMFT

Melissa Taylor, LMFT

Melissa Taylor, LMFT, MS is a very enthusiastic and compassionate professional that believes in the power of combining counseling and physical activity when working through personal issues. As a marriage and family therapist, Melissa works through family system issues that may influence a person’s current life situation, relationship issues, and emotional instability. As individuals, we have grown up with different family dynamics, viewed many family relationships and observed different ways of communicating that influence present time relationships and how we cope with issues. Family patterns exist, so Melissa helps people identify and understand those patterns, and then learn how they influence current problems. Melissa has worked for years with adults and adolescents that have been abused, abandoned, felt depression and anxiety, or struggle with current relationships; therefore, she is very comfortable working with individuals, couples and families that are dealing with past and current difficulties. She encourages self-care practices through counseling and exercise to build self-esteem, trust, communication and coping skills, to improve their own lives. Melissa is a psychoanalytic therapist that also provides CBT and other family system theories in her work. She encourages clients to trust her and themselves in the counseling process to work together towards healing and personal goals.

Melissa has lived in multiple states to complete her education and build her career while learning different cultures. She received her Bachelor’s Degree in Psychology at the University of Kentucky, and completed her Master’s Degree in Marriage and Family Therapy at Drexel University in Philadelphia. She also had the privilege of completing a Master’s degree in Kinesiology at LSU in Baton Rouge, which allows her to integrate physical activity for clients in their therapeutic treatment process. She has provided therapy in Kentucky, Indiana, Louisiana, Texas and now Pennsylvania. She has worked with Rape Crisis Centers, FQHC’s, Inpatient and Outpatient locations, integrated healthcare centers, and group practices. Melissa has experience in different levels and types of mental health care and has learned how mental health symptoms affect all populations.

Melissa recently moved to Pittsburgh from Texas and enjoys exploring her new city with her husband and two young children. She enjoys playing and teaching her children, Zumba and other exercises, and cooking with her family. Melissa is very energetic and is always seeking new experiences for herself and her family.

Counseling Pittsburgh

Our licensed professional counselors are here for the community offering evidence-based therapy, marriage counseling, family counseling,  child therapy, art therapy, premarital counseling, all by top rated clinicians. Our team of therapists has over 150 years of experience between us, we offer therapy to heal from Depression, Anxiety, Obsessive Compulsive Disorder, Post-Traumatic Stress Disorder, and our Couples Therapists can treat a full range of relationship issues from conflict communication, to intimacy enhancement, and parenting concerns. In all of our centers, we also provide a menu of comprehensive wellness services. We offer wellness support including health treatment options from our certified nutritionist, kinesiologist, clinical herbalist who specialize in offering the people of The Greater Pittsburgh and Western Pennsylvania communities providing wellness solutions for mind, body, and spirit. Be well with us!

Contact us at our Pittsburgh location 830 Western Avenue Pittsburgh Pa, 15233 Our Pittsburgh center is located in the northshore of the downtown Pittsburgh. Therapy near Northside, Southside, Brighton heights, Lawrenceville, Shadyside, Bloomfield, Strip District, and Mt. Washington. Our hours are from 7-am-8 pm  Monday through Sunday. We accept UPMC, Highmark, Blue Cross Blue Shield, United, Magellan, Aetna, and Comp Psych as well as Out of Network, Self Pay, and Sliding Scale options.

For a therapist near you – Call us at 412-322-2129

Love, Aspires, Inspires, A Verb from the Muses

Love, Aspires, Inspires, A Verb from the Muses

              Love, Sacrifice, Couples

There are relationships, there are couples, marriages in fact which succeed in months, years, decades even in commitment and in monogamy without living in love. Let us not confuse the fact that because we have created a relationship that we are loving another person. Just as we know sex can exist without love, long and short term relationships exist, co-habitation, partnerships, they are aplenty without love. Often as therapists, we see couples in crisis, they bring in the scathing shards of their shattered romance and wonder how they can rebuild the faith in their affection. Across America the typical couples make a beeline for argumentative conversation which meanders around topics of how can we get our partner to hear, to see, to acknowledge our needs and to change their behavior. Certainly, these lines of inquiry have their place in the creation of meaningful bonds, we expect and validate that there must be a mutual and respectful collaboration and a relationship is a place where both member’s voices are heard, understood, and at the minimum respectfully entertained. For this essay, let us examine the relationship from a separate space, in recognition that true love isn’t about what we can get, how we get our partner to put down the toilet seat or offer more physical intimacy, it is within what we can give, as at its root, love is not about us as individuals it is about the other, the beloved other.

Love is Patient

Love is patient, love does not make unnecessary demands upon time or attention as love remains present when hearing “no”, “not right now”, “maybe tomorrow” or another day. Love excites to hear no because it is within “no” that an opportunity to understand a boundary exists. Love listens and can hear the fears and anxieties beneath the shaking words of long and difficult days, and with best intention, love seeks to sooth anxiousness and fear. Love is the gentle nuzzle which brings the sharp wail of the crying baby closer into bosom. Love is the gracious wind which billows atop positive intentions, the sweet breezes which pollinate The Delicate Cherry Blossom and The Mighty Japanese Maple, alike.

Love is Kindness

Love is kindness and the assumption that our beloved is offering to us goodness. Love is so infinitely gentle in its delivery of words and connection; it is lovingness which exudes its feather tipped delivery, not sharp needling. Love is inquisitive and present; she is the instillation of hope. Love connects and harmonizes towards natures bountiful flow. Love is abundant and shares in the quest for greater understanding and timely compassion.

Love is Sacrifice

Love is sacrifice, the ultimate sacrifice indeed because love makes no room for the egos demands and rigid preconceived notions of personal expectations. To love is to receive and respond to another person’s needs. Love is a beacon and a refuge, the replenishment of optimism, as indeed there are many who would proffer that love is a delusion and perhaps it is true. Perhaps there could be no love in the universe if it weren’t for the proverbial rose colored glasses that tinge our earthen bonds with eternal delight. We can see it in those who share in it, as there are indeed relationships, there are passionate romances and sexually fueled emissions of pleasure but many or most of those are not in fact love. Love is connection, love chooses us and then we choose to make the leap of faith offering our brittle bones in their vulnerable frailty to the source of human faith.

For many lofty philosophical types and religious leaders, love is indeed The Source, it is the meaning for human existence, love, the elixir of the gods is all plentiful but sometimes too the well runs dry. Yet I can promise any reader this; that if we have come to a place where we question the integrity, the meaning, the strength of our connection in our relationship, that we have in fact moved away from these necessary components, these loving heart swelling calliopes. Sometimes too, that is for the best, not every person, place or moment is deserving of love and this thing which is so pure and grand, this glimmering star dust may not be within the reach of capacity for each of us or in each moment, dear mortals, this too is much more than ok. Let us all be cautiously aware of loves impostors dressed as the fool, searching for easy answers, demanding knowingness, the ego, suspicions and cruelty, violating boundaries, dismissal, withdrawing, manipulation, these, none of these deserve the association to loves eternal expansiveness. When we speak of boredom and unmet needs we are no longer singing the praises of love, these are only ego.

We always know most immediately those who are vibrating near the pulse of loves harpsichord, their eyes shone a bit more brightly, they are willing to look beyond the shadowy valleys to take in the vistas of the cloudless sky, yes, yes, just perhaps that is it, the source of it all, love a gift pluming and cascading like the most precious gift, the rays of sun dancing down from way, way, up there.

Your friends The Troubadours of The Millennium

In love and light,

The Counseling and Wellness Center of Pittsburgh

830 Western Avenue

Pittsburgh Pa 15233

412-322-2129

4 Lessons on Life from Farmer Jim; The Hawaiian Vanilla Farm

4 Lessons on Life from Farmer Jim; The Hawaiian Vanilla Farm

Family and growing ones wealth on the vanilla farm!

As a lifelong lover of all things Vanilla on a recent travel excursion in Hawaii, I opted to spend an afternoon at The Hawaiian Vanilla Companies’ farm. The farm which is a true artisans purveyor of some of the world’s best small batches of vanilla bean goodness. What was most striking about that afternoon wasn’t the lush tropical vistas, although the altitude and sea views were indeed stunning. Nor was it the fantastical process of cultivating Tahitian vanilla, which is in fact an orchid, the coveted vanilla bean are the tiny seeds which grow in the orchids stem. Botany and Geology aside, I am psychotherapist, for me, character succeeds setting, the man behind the bean is most noteworthy about that afternoon.

Lesson 1

Jim Reddenkopp, farmer, my host, owner of the Vanilla Company is a man whose adult life began after he had acquired a dangerously steep, craggy, and startlingly cheap and unruly plot of Hawaiian land. Why purchase such a plot, a tour goer dared ask, his blank honesty, Lesson 1, ‘I had only one dream, to raise a family in Hawaii, with just enough money to buy this soil that nobody else was crazy enough to want, my wife and I were well on our way to dreams come true, we lay under glistening stars in our tent while building our home here happy as can be.’ As Jim implicitly seemed to know, the first lesson is that in mindful living every endeavor should first be aimed at cultivating our inner principals, most of the time, the rest will take care of itself if we toil hard enough.

Lesson 2

With the thrill of striving for his goals steaming his sails he didn’t think too much about the ‘how.’ It was only in later conversation with his two university professor parents who looked to Jim, their long haired, increasingly thin, patchouli wearing son, living out his dreams in a tent in Hawaii. As good parents do, they lectured Jim and provided him with Lesson Number 2, “Better figure some things out Jim, what are you going to do with your life?” Lesson number 2 is that there will be naysayers and hurtles, Jim had been thinking about this, with lots of trial and error under his belt he had acquired a long list of all of the things which could not be done on this rocky plot of earth. It took years of failed crops for Jim to reply to his parents that he had a solution for the impossible bit of land he had been toiling, “I am going to grow Vanilla!” An excellent but complex choice, the elusive and exceptionally valuable vanilla orchid, a matter which would be much more challenging than he had anticipated.

Lesson 3

Jim eventually mastered his craft, mastered in ways he had never thought possible in looking back. Yet the vanilla is not the thing of which Jim is most proud, closest to his heart is that his adult children have decided to stick around on the farm where they had grown up. They can be found working in the kitchen and grounds of the farm. The other tour goers kept astonishing with their consumer values, “why aren’t you growing more vanilla?” “yours is thought to be some of the best in the world! Surely there is a demand for it!” Master chefs reach out to Jim, buying out his stock of vanilla bean in advance of its harvest. Jim in his humble flannel looked to them with such brightness in his eyes, “yes, yes, but the thing is that I am already rich! My family is here with me, I like to take days off and on them I enjoy surfing. I get to grow vanilla and curate other products in a way that is comfortable and enjoyable. Work life balance is important to me.” Lesson number 3; less is often more, we should strive for balance in all things. The crowd of tour-goers looked at him curiously, some in wide eyed admiration, as though he had come to embody some elusive and novel concept, an unsung anthem which some of us had all been waiting all of our lives to hear!

Sometimes we wonder what happened to good old fashion family values, well sometimes they clock out with the 60 hour work week, we work, toil away to put food on the table, to get that bigger house, bigger promotion, yes to win at the game of life, to have that comfortable retirement and with any luck we will actually live to our 70’s to enjoy those golden years, that is a gift in itself. Yet Jim, he was living with that joy and comfort now, by embracing the values of a simple life, remaining surrounded by his loved ones, making contact with nature and his passions, his eyes seemed to sparkle with the happiness of embodying his values and don’t we all know what a tremendous accomplishment it can be to simply hold tight to our values in today’s fast paced world.

Lesson 4

The tour continued on, we meandered over hills on a cloudless day, we walked passed a smallish house on the farm and Jim paused there, ‘this is where my father lived, he died last year.’ Myself and the other tour goers offering sad expressions, condoling comradery in understanding such loss. Jim, with dignified melancholy, gently waved it off. “Dad is gone but he died of natural causes at 88 years old right here while we held him in our arms, it was a beautiful thing and we are forever changed by it.” I paused in thinking about that, yes death is an agonizing loss for those alive to be touched by it, yet it is indeed the cost we pay to live life, the finality of it. Jim offered yet another lesson, lesson 4, that there is integrity to a long life, well-lived, clinging to loss would dishonor his father’s life. At that moment, Jims’ son popped out of the house’s shabby front door, holding the hand of a petite framed women who was waddling along with an enormous bulge in her belly. Jim waved proudly, “that is my son and daughter in law, they live there now and they are expecting their first child in a few weeks.” Ah, and now we see the circle of life continues, yes, there is so much honor in that, in a life well lived.

Wishing you all vanilla skies and sweet dreams,
The Counseling and Wellness Center of Pittsburgh
Contributed by;
Stephanie McCracken MSPC
830 Western Avenue
Pittsburgh Pa 15233
412-322-2129