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Healing therapies for PTSD

Moving Beyond Trauma: Healing Therapies for PTSD

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According to the U.S. Department of Veteran’s Affairs, it is estimated that approximately 6% of the population will experience Post-Traumatic Stress Disorder (PTSD) at some point in their lives. By some estimates, that percentage more than doubles for people who have been exposed to a traumatic event.

To be diagnosed with PTSD one must meet a specific set of criteria which includes:

  • exposure to a traumatic stressor;
  • a re-experiencing of symptoms (physical and/or emotional);
  • avoidance behavior and emotional numbness;
  • hyperarousal;
  • symptom duration of at least one month; and
  • significant distress or impairment of functioning.

How does one move beyond this emotional pain, or provide support to the most vulnerable population, our children? The following 3 therapies have shown to be effective in treating PTSD in clinical settings for both adults and children.

Family or Couples Therapy

PTSD is a family illness. Family members often experience feelings of guilt, sadness, and isolation when a loved one is suffering. A safe setting where emotions, fears, and concerns can be communicated under the guidance of a therapist can help strengthen relationships and promote group healing during difficult times.

Mindfulness-Based Stress Reduction (MBSR)

MBSR is a program that uses meditation, breathing techniques, and movement, such as yoga, to bring awareness to the present moment, without judgment. There is a growing body of medical research that shows that a mindfulness-based meditation practice can help people bounce back after highly stressful situations.

  • A 2015 study reported that veterans suffering from PTSD who participated in a mindfulness-based stress reduction program for a period of 8 weeks, reported a decrease in symptom severity.
  • A 2018 review confirmed that mindfulness-bases therapies are “effective in reducing PTSD symptomatology” and indicated that additional studies should be done to investigate its role as a first line treatment.
  • Children can also benefit from the practice. This 2017 review of research concluded that “high-quality, structured mindfulness interventions improve mental, behavioral, and physical outcomes in youth.”

Eye Movement Desensitization and Reprocessing (EMDR) therapy

EMDR is an integrative psychotherapy that has proven highly effective for the treatment of trauma. Traumatic memories are memories that tend to be “frozen in time” and each time they are triggered a person may re-experience the same disturbing sights, sounds, smells, feelings, and sensations suffered during the original event. Traumatic memories have a long-lasting impact because they change core beliefs that we hold about ourselves and the world around us.

EMDR helps the brain adaptively process traumatic information by replicating what naturally happens during dreaming or REM (rapid eye movement) sleep. During EMDR therapy, a person is asked to bring a difficult thought or memory to mind, holding it in awareness, while also following the therapist’s hand movements across the field of vision, mimicking the biological process of REM sleep. Over time, though an event may remain as a bad memory, it eventually ceases to be a physiological stressor, because the person has learned to experience disturbing events or memories in a new and less distressing way.

Left unresolved, PTSD can be devastating, but with appropriate support, there are ways to move beyond the pain. If you or a loved one may be affected, please seek help – no one needs to suffer alone.

Additional Resources:

National Suicide Prevention Lifeline –24-hour hotline for anyone in emotional distress: 1-800-273-TALK (8255).
National Alliance on Mental Illness (NAMI) – Helpline: 1-800-950-NAMI (6264)
TRE® – Tension and Trauma Releasing Exercise methods by Dr. David Berceli
Veterans Crisis Line –  For veterans and their families and friends: 1-800-273-8255

We are here for you, and we want to help.

Our goal is to return you to optimal health as soon as possible. To schedule an appointment please call: 703-532-4892 x2

This article was published in May 2017. It was reviewed and updated in June 2023.

 

Stress and Covid-19

Life, Stress and COVID-19

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It’s safe to say that the last few months have been very challenging. Whether you’re a stay-at-home parent, a business owner, a waitress or a student, it’s quite likely that over the past weeks, something in your life has fundamentally changed. In small ways and large, we’ve all been affected by COVID-19.

New stresses may have appeared. Old routines have been forgotten only to be replaced by new ones. These sudden changes can leave many feeling anxious or stressed. So, while it’s important to recognize the unfamiliar ground that we suddenly find ourselves on, it’s equally important to pay attention to our stress levels and our health.

What’s Keeping You Up at Night?

The answer to this question will differ from person to person. Yet when asked, many patients will respond with answers that revolve around the same themes:

  • Current stressors – COVID-19 has added even more stress to our daily lives.
  • Prior wounds – Current events may act as a trigger for past life events and bring back uncomfortable memories.
  • Loneliness or feelings of isolation.
  • Chronic illness that has been made worse in recent months.

Some of these themes and how we can help are explored in greater detail below:

  • Finding New Coping Mechanisms
    COVID-19 has taken away many activities that we previously used to help deal with stress. Left unchecked, chronic stress can have significant impacts on our health. Stress raises the level of cortisol in our body while simultaneously reducing the levels of DHEA. This means we age faster, gain weight, and worsen existing health problems. Now more than ever, it’s critical that when dealing with high levels of stress, we find effective ways of dealing with it.
  • Safety and Security
    Feelings of safety and security also play a role in our overall well-being. The unexpectedness of COVID-19 has made us all feel less safe and more helpless. This can present with many different emotions or behavior that we wouldn’t otherwise turn to.
  • Social connections and isolation
    Meaningful connection with other people is not a luxury but essential to our survival. Human beings are social creatures. Apart from the sense of community and belonging that we naturally crave, we also get a sense of self-worth from our interactions with those around us. The isolation that COVID-19 has imposed on us can increase anxiety and reduce our ability to cope with it.True, meaningful social interactions can counteract the negative effects of isolation. In fact, studies show that those with more meaningful social connections tend to sleep better, have an improved mood and lower rates of depression. Unfortunately using social media and texts does not compensate for face to face interactions. 

Steps You Can Take to Deal with Your Stressors

  • Talk therapy — discussing problems with a licensed professional can help patients unwind and keep a healthy perspective.
  • Meditation / Yoga – These activities are much healthier outlets than drinking alcohol or overeating. Meditation and Yoga are great relaxation tools to use.
  • Psychotherapy – Talking with an objective observer can relieve anxiety, decrease depression, and help individuals make choices that are more beneficial to their cognitive and emotional health.Therapy can also help patients deal with high stress levels and learn effective coping techniques such as guided imagery, autogenic biofeedback, HRV and self-hypnosis.Knowingly or unknowingly many of us carry past childhood traumas. These traumas can affect the way we lead our lives as adults. A therapist can help patients confront these traumas in a safe and secure environment. Ultimately, healing these traumas can make living easier today, and in the future.

Our Approach to Treatment

At The Kaplan Center, our staff members use a comprehensive and flexible approach that is designed to help each individual person heal themselves. Healing involves the mind, body and spirit. All techniques are tailored to individual needs and designed to help people effectively manage distress, dysregulation and build confidence.

Many patients find the psychotherapy component and its use of biofeedback techniques that involve measuring skin temperature, blood pressure and heart rate simple, fun, and effective.

Modalities that may be used include: Eye Movement Desensitization & Reprocessing (EMDR), Psychodynamic psychotherapy, Sensorimotor psychotherapy, mindfulness, HRV biofeedback, Interactive Guided Imagery and Self-Hypnosis. All these techniques help clients connect to their mind’s bodies and emotions.

In particular, EMDR is a therapy that helps heal wounds from disturbing life experiences. It has been extensively researched and proven highly effective at helping people heal from distressing life experiences, including PTSD, anxiety, depression and panic disorders. Since our emotional well-being is tied with our physical (somatic) state.

EMDR is especially helpful because it uses a body-based technique called bilateral stimulation using eye movements, taps or tones. This stimulation helps a person adaptively process information that may be incorrectly stored in the mind and body. That incorrect storage can make past memories feel like they are happening in the present and people re-experience the same awful feelings (shame, fear, anxiety, and anger) along with the same negative beliefs about themselves. The brain feels as if that past distressing event is happening at the current time. EMDR therapy corrects the storage problem so that past painful memories associated with past traumas lose their charge.

Patients can react to stimuli in the present without the past interfering. The healing that occurs when that information is stored in a more functional part of our brain is a permanent fix. EMDR heals trauma and attachment wounds and allows people to take back their lives.

As we try to navigate our lives into a new semblance of normal, stress, illness and mental health shouldn’t be forgotten. One reason to consider seeing a psychotherapist is that speaking to a professional can relieve anxiety, decrease depression, and help you see how to make choices that are more beneficial to your cognitive and emotional health.

We are here for you, and we want to help.

Our goal is to return you to optimal health as soon as possible. To schedule an appointment please call: 703-532-4892 x2

helping_someone_with_destructive_behavior

How to Help Someone Who Exhibits Destructive Behavior

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Q: Someone near and dear to me suffers from such powerful, long-standing shame that he cannot, or won’t, admit engaging in behaviors that are destructive to his personal relationships (e.g., verbal abuse). Is there any way to confront him gently, in a way that helps him feel safe so that he and his loved ones can start healing their respective relationships?

Jodi Brayton, L.C.S.W., M.S.W.:

This is such a great question on many levels. It involves a universal emotion – to be human is to feel shame – and the very wording of the question shows that the writer already understands the antidote to shame: love, connection, and compassion. I like that the writer gets the fact that destructive behavior should be confronted (in a safe way) in order to begin healing any relationship. There are some very thoughtful experts exploring current research on the issues of shame and compassion and I want to share some information that may be useful to you.

One of my favorite writers from a psycho-therapeutic point of view is Janina Fisher, Ph.D., a therapist who looks at the shame and self-loathing associated with childhood trauma from a neurobiological perspective. Fisher does a beautiful job of explaining that many of our negative behaviors are, or were at one time, beneficial adaptations to traumatic circumstances. Anger, for instance, may be a self-protective maneuver designed to push people away before they can hurt us. She explains how shame and perfectionism are adaptive strategies that drive responses such as hypervigilance, automatic obedience, and total submission; strategies that help young victims survive abuse[i].

The dilemma with confronting people who struggle with shame is that even the kindest, most gentle approach can confirm their worst beliefs about themselves. The thought, “it’s my fault,” can activate areas of the brain that lead to emotional and autonomic reactivity, according to Fisher, which may explain reactions that are destructive to personal relationships, such as verbal abuse.

Curiosity and mindfulness, on the other hand, tend to activate the medial prefrontal cortex, the part of the brain that regulates such emotional and autonomic reactivity[ii]. The job of a therapist is to help clients remain in the medial prefrontal cortex part of their brain because when we are curious and mindful we find meaning and gain perspective. Your friend is more likely to accept a recommendation of therapy if you come from the approach that he is not where he wants to be. The website janinafisher.com has several informative articles that can be downloaded for free.

Questions? Give Us a Call!

703-532-4892 x2

Understanding the hard science behind behavior can help many people recognize and accept the need for change and there is fascinating research on the physiology behind the healing power of self-compassion. It seems that our body responds to an emotional attack of self-criticism just as it would to the physical threat of having a gun pointed in our direction. The fight or flight response is triggered and the stress hormone cortisol is released in order to mobilize our body to avoid or confront the threatening situation. We all know that too much cortisol over a long period of time can be destructive to our bodies; however, recent research shows that generating feelings of self-compassion can actually decrease those cortisol levels and increase the release of the hormone oxytocin in our system. When we increase the level of the oxytocin we increase feelings of calm, trust, safety, generosity, and closeness to others – all of which are needed to counter the painful emotion of shame[iii].

Kristen Neff, Ph.D., one of the leading researchers on the physiology of self-compassion, has a website – self-compassion.org – that many of my clients find useful. It offers several guided meditations and various exercises designed to help people increase their self-compassion skills. There’s also a self-administered test that measures the elements of self-compassion, as well as the things that hinder our self-compassion, such as self-judgment, isolation, and over-identification. You can recommend this site not only to counter the effects of shame but to anyone who wants to live a more contented and fulfilling life.

The last writer I want to mention is a researcher who has an exceptional ability to inspire people to go to those deep, dark places of shame and fear. Brené Brown, Ph.D., believes that we begin healing by sharing our difficult stories with appropriate others in order to feel worthy, connected, and lovable. She gave a 2010 TEDx Houston talk on the power of vulnerability that was one of the most popular talks on TED.com. She followed up with a second talk in 2012 called Listening to Shame, and together these talks have received over 25 million views. They are chock-full of humor, humanity, and interesting information and you can recommend these talks based on the entertainment value alone.

Another thing I hope you consider reading, and/or offering to your friend, is Brené Brown’s book, The Gifts of Imperfection: Let Go of Who You Think You’re Supposed to Be and Embrace Who You Are. Brown has devoted most of her professional career to the study of human vulnerability, courage, worthiness, and shame, and she really leads by example in this book. In order to help others find the courage to explore their own feelings of inadequacy, Brown fearlessly, and wholeheartedly shares hers. This leaves the reader with a sense of connection to our common humanity, as opposed to the feeling of isolation and alienation that results from keeping things hidden. Many people find this book a valuable tool for self-exploration.

The concept that permeates all the works cited above – and that can help your friend find the non-judgmental state of mind he’ll need in order to observe his own thoughts and behavior in a safe way – is mindfulness. Suggesting mindful practices, such as meditation, prayer, and journaling (especially a gratitude journal) could prove most valuable in helping your friend gain perspective and find a sense of peace even in the most complicated and difficult situations.

Thank you so much for this opportunity to share this information. Your question is important and the task is a challenging one, but Brené Brown sums up what is at risk with the following quote[iv]:

“Owning our story can be hard but not nearly as difficult as spending our lives running from it. Embracing our vulnerabilities is risky but not nearly as dangerous as giving up on love and belonging and joy – the experiences that make us the most vulnerable. Only when we are brave enough to explore the darkness will we discover the infinite power of our light.”

– Jodi Brayton, L.C.S.W., M.S.W.

We are here for you, and we want to help.

Our goal is to return you to optimal health as soon as possible. To schedule an appointment please call: 703-532-4892 x2

[i] Fisher, J. Working with the Neurobiological Legacy of Early Trauma: Paper presented at the Annual Conference, American Mental Health Counselors July, 2003.
[ii] Fisher, J. Brain to Brain: The Therapist as Neurobiological Regulator. Psychotherapy Networker. 34:1, January 2010.
[iii] Neff, K. D. (2012). The science of self compassion. In C. Germer & R. Siegel (Eds.) Compassion and Wisdom in Psychotherapy. New York: Guilford Press.
[iv] Brown, B. (2010). The Gifts of Imperfection: Let Go of Who You Think You’re Supposed to Be and Embrace Who You Are (p. 6). Center City, Minnesota: Hazelden Publishing.