Trauma Informed Therapy
If you have experienced a difficult or scary circumstance in your past, you know that it can have impact on you today. You might notice it when you are in situations or dynamics that remind you of those scary past experiences. You might have feelings that are connected to our reflexive “fight, fright, or freeze” response. It might feel confusing when your body is reacting as if the scary event is happening today, especially if you are now in a relatively safe environment.
In those scary experiences or dynamics, you may have needed to hide your body’s responses or your emotions because it wasn’t safe to feel or to show how scared or sad you were. Maybe there were so many other pressing needs at the time. Maybe when the scary event happened it was confusing and it didn’t make sense, so you couldn’t process what was happening.
Whatever the reason was, you may have needed to push aside vulnerable feelings and vulnerable physical sensations to be able to get through it. This strategy may have be an effective tool during that period of time. However, when you can no longer override those physical and emotional feelings and feelings of panic attacks, anxiety, losing time and space, remembering difficult circumstances, develop, it can impact your life. The amount of energy your nervous system is utilizing regularly can feel exhausting and overwhelming.
Questions about therapy?
Why a trauma informed therapist?
If you are a trauma survivor, it is important to find a trauma informed therapist because the context for your behavior and your responses need to be understood from why it was important to keep you safe in the past. Therapy also can look different for individuals with a trauma history, the therapist can keep in mind your history and track you and your regulation during session. Behaviors such as hypervigilance, feeling on the edge, panic, or fight, flight, freeze responses need to be understood from the perspective of your lived experience. These responses could have been important tools, helping you survive and to move forward.
What is Post Traumatic Stress Disorder?
Sometimes it can be helpful to understand what symptoms are included in a diagnosis as a reference. Ive included the DSM-V Diagnostic Criteria list below again only as a reference of symptomology, not as a diagnosis. Please be kind to yourself as you read the list below. PTSD is treatable.
DSM-5 Diagnostic Criteria (APA) for PTSDNote: The following criteria apply to adults, adolescents, and children older than 6 years. For children 6 years and younger, see the DSM-5 section titled “Posttraumatic Stress Disorder for Children 6 Years and Younger” (APA, 2013a).Exposure to actual or threatened death, serious injury, or sexual violence in one (or more) of the following ways:Directly experiencing the traumatic event(s).Witnessing, in person, the event(s) as it occurred to others.Learning that the traumatic event(s) occurred to a close family member or close friend. In cases of actual or threatened death of a family member or friend, the event(s) must have been violent or accidental.Experiencing repeated or extreme exposure to aversive details of the traumatic event(s) (e.g., first responders collecting human remains; police officers repeatedly exposed to details of child abuse). Note: Criterion A4 does not apply to exposure through electronic media, television, movies, or pictures, unless this exposure is work related.
Presence of one (or more) of the following intrusion symptoms associated with the traumatic event(s), beginning after the traumatic event(s) occurred:Recurrent, involuntary, and intrusive distressing memories of the traumatic event(s). Note: In children older than 6 years, repetitive play may occur in which themes or aspects of the traumatic event(s) are expressed.Recurrent distressing dreams in which the content and/or affect of the dream are related to the traumatic event(s). Note: In children, there may be frightening dreams without recognizable content.Dissociative reactions (e.g., flashbacks) in which the individual feels or acts as if the traumatic event(s) were recurring. (Such reactions may occur on a continuum, with the most extreme expression being a complete loss of awareness of present surroundings.) Note: In children, trauma-specific reenactment may occur in play.Intense or prolonged psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event(s).Marked physiological reactions to internal or external cues that symbolize or resemble an aspect of the traumatic event(s).
Persistent avoidance of stimuli associated with the traumatic event(s), beginning after the traumatic event(s) occurred, as evidenced by one or both of the following:Avoidance of or efforts to avoid distressing memories, thoughts, or feelings about or closely associated with the traumatic event(s).Avoidance of or efforts to avoid external reminders (people, places, conversations, activities, objects, situations) that arouse distressing memories, thoughts, or feelings about or closely associated with the traumatic event(s).
Negative alterations in cognitions and mood associated with the traumatic event(s), beginning or worsening after the traumatic event(s) occurred, as evidenced by two (or more) of the following:Inability to remember an important aspect of the traumatic event(s) (typically due to dissociative amnesia, and not to other factors such as head injury, alcohol, or drugs).Persistent and exaggerated negative beliefs or expectations about oneself, others, or the world (e.g., “I am bad,” “No one can be trusted,” “The world is completely dangerous,” “My whole nervous system is permanently ruined”).Persistent, distorted cognitions about the cause or consequences of the traumatic event(s) that lead the individual to blame himself/herself or others.Persistent negative emotional state (e.g., fear, horror, anger, guilt, or shame).Markedly diminished interest or participation in significant activities.Feelings of detachment or estrangement from others.Persistent inability to experience positive emotions (e.g., inability to experience happiness, satisfaction, or loving feelings).
Marked alterations in arousal and reactivity associated with the traumatic event(s), beginning or worsening after the traumatic event(s) occurred, as evidenced by two (or more) of the following:Irritable behavior and angry outbursts (with little or no provocation), typically expressed as verbal or physical aggression toward people or objects.Reckless or self-destructive behavior.Hypervigilance.Exaggerated startle response.Problems with concentration.Sleep disturbance (e.g., difficulty falling or staying asleep or restless sleep).
Duration of the disturbance (Criteria B, C, D and E) is more than 1 month.The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.The disturbance is not attributable to the physiological effects of a substance (e.g., medication, alcohol) or another medical condition.
How therapy can look in sessions together
In our therapy sessions together, the work is to understand not what is wrong with you, but to understand what happened to you and how your system is processing that. Recognizing that your experiences have informed you in many different ways. It may have helped you with resiliency and perseverance and it may have caused burdens and difficulties. Together, we will work with your system in understanding those internal protectors and defenses that helped you along the way. As well as re-assessing some of the strategies that you feel no longer serve you as they once did.
While recognizing that our systems are wise and that it is optimized to help us get through, I will support you in turning towards your experience with curiosity, clarity and compassion.
Crisis Hotline: 988
For emergency please dial 911
