Trauma Therapy | EMDR

My treatment approach to Post Traumatic Stress Disorder (PTSD) and Complex PTSD is a somatic and integrative approach that focuses on stability, building coping skills and improving self-awareness, self-acceptance, and emotional capacity.  Some of the techniques used, and the associated disorders, are discussed below.

 

EMDR

Eye Movement Desensitization and Reprocessing (EMDR) is an evidence- based treatment that is highly effective in recovering from trauma and PTSD.  EMDR engages bilateral stimulation to engage both brain hemispheres, which facilitates processing traumatic experiences and integration of thought and current somatic experience.  Bilateral stimulation involves engaging the senses, typically visual, touch, audio, or a combination of stimuli, alternating between the left and right sides of the body or visual field.  Through EMDR, positive thoughts and somatic experience are integrated with the processing of traumatic experiences, lessening the emotional dysregulation and sensitivity to the traumatic experience.

 

​PTSD

In PTSD, and Complex PTSD, the brain has encoded certain trauma triggers as “red flags” to protect from perceived threats to safety.  Common triggers are loud noises, places where a traumatic event occurred, as well as odors, tastes, and visual stimuli associated with the experience of trauma.  The brain works to circumvent full cognitive function when it is triggered, mobilizing the limbic system, and inhibiting the prefrontal cortex, or thinking part, of the brain.  In PTSD, “red flags” trigger the body to fight, flight, freeze or fawn, and are experienced as emotional reactivity, being unable to speak or move, tension, dissociation, or extreme people-pleasing behaviors.  

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Furthermore, PTSD triggers negative thoughts related to the traumatic experiences.  There are just a few common negative thoughts experienced by those who have experienced trauma, directly or indirectly:

“I am in danger”

“I should have”

“It is my fault”

“It is not okay to express my emotions”

“I don’t belong”

“I am invisible”

"I am not important"

"I am damaged"

 

In PTSD, excessive emotional and physiological responses lead to disordered thoughts, maladaptive behaviors, and conflicts in relationship with self and others.  Generally, one finds that current situations and positive thoughts do not align with the actual risk and triggered negative thoughts.  Beyond reality and thought incongruence, physiological experiences of tension, hypervigilance, difficulty sleeping, headaches, fatigue, gastrointestinal issues, breathing difficulty, and dizziness often accompany trauma triggers and can lead to chronic health issues, especially in Complex PTSD.

 

Complex PTSD

Complex PTSD is the experience of chronic traumatic experiences, including a loss of sense of safety with one’s emotional experience.  Some examples of traumatic experiences in Complex PTSD are chronic emotional neglect, financial scarcity, bullying, and disordered parent-child or sibling relationships.  Treating Complex PTSD often requires a multi-faceted approach of somatic techniques, cognitive behavioral therapy, expressive and narrative therapies, and EMDR. 

 

Somatic Therapy

Somatic therapy is the foundation of treatment, and builds self-awareness of emotion in the body, greatly facilitating the ability to connect with oneself and build cohesion with self.  Somatic therapy involves building knowledge and awareness of the language of emotion within the body and increasing one’s sense of control in engaging physical experiences of grounding and regulating the nervous system.  Regulating the nervous system includes techniques aimed at resetting the flow of energy in the Vagus nerve.  Learn more here.  

 

Somatic therapy also facilitates the integration of early experiences of trauma, preceding the full development of language and abstract thought.  Likewise, it is a valuable technique in trauma treatment which does not require verbal processing to be effective.  Engaging expressive therapies also builds self-awareness and the capacity to integrate positive experiences, not just positive thought, in younger parts, or layers, of self.  Expressive therapies include movement, art, and narration.

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​Skill Building | DBT

Skill building in working with PTSD covers a broad scope of techniques, typically including Dialectical Behavior Therapy (DBT) techniques of mindfulness, emotion regulation, conflict resolution and boundary definition and engagement.  Techniques engaged include somatic visualizations, thought redirection, acceptance, and identifying and understanding emotional triggers and responses. 

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With Complex PTSD, skill building also focuses on improving patterns of attention often disrupted by a hypervigilant nervous system.  DBT skills focused on improving attention might include learning to prioritize activities, list making, tethering (anchoring attention with somatic stimuli), and coupling tasks.  Skill building in working with PTSD also includes a focus on the physical wellness that greatly contributes to mental and emotional functioning.  Wellness skill building involves improving acceptance and awareness of biorhythms supporting optimization of introspection, movement, and social connection.  Improving sleep hygiene, frequency and quality of nutrition, and movement, are key foundations of wellness that support recovery from PTSD.

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CBT | ACT | Narrative Therapy

Throughout the process of building and honing coping skills, Cognitive Behavioral Therapy (CBT), Acceptance and Commitment Therapy (ACT), and Narrative Therapy are utilized to support one’s sense of agency in their story through meaning making, psychoeducation, normalization of shared experiences, and supporting the alignment of behavior with values and spiritual beliefs.  CBT also promotes self and other awareness by challenging thoughts which are incongruent with behavior, identifying root causes of emotions, noticing relational power differentials, and evaluating possible solutions.

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Self-Awareness and Acceptance | Dissociation

With Complex PTSD, extra focus on self-acceptance and self-awareness is often necessary, due to the experience of dissociation, which can erode one’s sense of congruence and agency.  My approach to working with dissociation involves building skills of grounding and building a sense of curiosity and hospitality for the different ways one might “show up” in their life and in session.  The work will involve a client engaging in self-expression and exploration outside of session, to improve self talk and acceptance of different ways of being, or parts of themselves.  An important resource in this work is Suzette Boon, Kathy Steele, and Onno Van Der Hart’s Coping with Trauma-Related Dissociation workbook and Dissociation Made Simple by Jamie Marich, PhD.

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Summary | Outcomes | Treatment Duration

In summary, my approach to trauma therapy is integrative and generally improves one’s sense of self and emotional capacity, which is often a catalyst for a richer, fuller life.  It is one of my deepest joys to share the journey of a life blooming as disabling tethers of incongruency are cut away.  The duration of therapy for PTSD can be as brief as four sessions, or perpetual, depending on clinical necessity and resources.  Longer durations of therapy are necessary for Complex PTSD.  I provide a free consultation and will provide an estimate of duration prior to beginning therapy.