Posts Tagged ‘therapy’


School Shootings: An Open Letter to Parents

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Dear Parents,

  I feel your pain and horror.  I, too, am a parent and have two Juniors this year whose finals week was interrupted by the school shooting at Reynolds high school.  They have been so busy just trying to get through finals week that they haven’t even had time or energy to integrate what is happening in their own community.

 Nothing makes us more anxious than a threat to our children’s safety. Nothing makes us feel more powerless, saddened and enraged then when our schools safe walls are breached by murderous rage and terror.

 Some of us are vulnerable to traumatic stress and anxiety already. Events like this can feel overwhelming to cope with, and even moreso to help our kids to cope.  So what can we do?

As a professional and as a parent, I recommend that you put on the metaphorical oxygen mask first.  Please take the time to do whatever you can to take care of yourself in the coming weeks.  If you feel your own anxiety spiraling out of control, please get some help from a qualified trauma therapist or perhaps some other provider that you feel comfortable with such as an acupuncturist, Reiki practitioner or yoga therapist.  If you feel that you need psychiatric medication, now would be a good time to get a consultation. Practicing mindfulness meditation could be helpful or whatever really helps you calm down and integrate.

 If you are like most Americans you are probably going to want to think your way out of this problem and come up with a snappy and satisfying solution (gun control, armed school guards,  mental health interventions etc).  I would encourage you NOT to jump to this just yet.  First we need to calm ourselves down and become really, REALLY present to ourselves and our families.

 Trauma, like grief, has its own pace and rhythm, and some of us are dealing with both.  Our kids may have known the victim(s) or even been the victim. We need to give healing its full due. If our kids see us stopping, processing and restoring ourselves from trauma, that gives them permission to do so as well.  There are many resources for healing out there, including my book, The Trauma Tool Kit: Healing PTSD From the Inside Out, which has a whole chapter on first-aid for trauma shock, the first stage of trauma.  Reading it will help you cope with the immediate aftermath of trauma. (You can find it in your local library and in all bookstores.)

 Your children are in shock and grief, too.  Like my kids, they may be in the middle of finishing up testing and not really be available for processing their feelings, or they may have a lot of time on their hands and be inwardly stewing over what has happened.  Lately the world seems to have exploded in violence.  Even if they are quiet, they have definitely noticed.

 Make yourself extra available to them.  Depending on age, gender and temperament our children will have varying needs and ways of moving through their own horror, anger and sadness.  Allow them to find their own mode of expression, which may be very different than yours.  But they do need to express in order to integrate.

 As a child and teen therapist, I know that there are very few children who can just sit down and talk about their feelings to their parents in an adult way.  It is best to find activities to do with your kids and let the conversation steer its way naturally to what is troubling them.  You can ask open ended questions and make positive statements such as, “I’m really interested in what you think/feel about this event.” “What are other people saying about what happened on Facebook?” etc.  Good activities can be throwing a ball, shooting hoops (I got really good at this doing inpatient work with boys), going for a walk together, driving somewhere, listening to music together (their choice),  playing a card or board or video game (not too intense so there is room for conversation).  You need to initiate these activities, especially for kids who tend to isolate when they are upset. 

 Allow your children, and especially teens, an uncensored discussion.  If you have rules about swearing or intensity (such as loudness or sarcastic tone), tell your child that you have suspended these rules, so they can say, freely, whatever is on their mind.  Our kids talk very differently to each other than they do in front of us.  If they need to blow off steam but feel inhibited in front of us, they will blow off steam elsewhere. 

 Sometimes stressful events like this show areas of relationships that are in need of work.  If you have been having trouble connecting with your child, this trauma will not automatically draw you closer. It may, in fact, do the opposite.  If so, consider seeking out professional help for yourself and/or the family.

 Put down your cell phone when you are home.  Stay home and make it clear that you are available when they need to talk, even if that need comes up around 10 or 11 pm as they are going to bed (as if often will). Monitor your own need to engage in avoidance activities and choose engagement.

  If you do not already have a self-care routine, now would be an excellent time to start one.  I am a big fan of progressive relaxation exercises and often prescribe them.  You could find some online or buy a CD and practice relaxing your whole body a couple of times a day, to reset your own nervous system.  Allow yourself more downtime than usual.

  Know these signs of acute stress and monitor them in your children.  If they persist past 2-4 weeks they may be cause for concern:

 

–       repetitive talk about the event

–       
repetitive drawing of the event

–       irritable

–       withdrawn


–       needy and clingy


–       more forgetful than usual


–       having trouble regulating emotions: laughing silly “highs” crash into sullen “lows

–       hair-pulling (trichotillomania)


–       disturbed eating

–       insomnia or frequent awakening in fear or tantrums

–       age-inappropriate behavior such as bed-wetting

–       rigid and perseverative play behavior (in younger children)

 

Lastly, know that no matter how upsetting this event is to your family and child, healing is possible. Human beings are incredibly resilient.  In the process of healing you and your family may wish to take some action in the world.  If this feels right to you, do it.  The wound of trauma often demands some response from us – when the time is right.

Blessings on your journey of healing, Sue




Five Questions You Should Ask Your New Trauma Therapist

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Let’s face it, most of us don’t get ourselves into therapy until we are so broken and desperate we can barely get ourselves to the office. We are in a state of extreme need and vulnerability (usually), and the last thing on our minds is interviewing our own therapist. We want answers, and we want help, and we want it now!!!

I understand; I have been there. That is why I am giving you a list you can bring with you to your first two or three sessions so that you can really make an informed decision about how well you and your therapist are a fit. If the first session, you are in total crisis, don’t worry! You can ask these questions any time. But the sooner, the better. It is awful to get into a therapy and then realize you don’t like this therapist, don’t find them helpful, or, even worse, that they don’t like or ‘get’ you.

Remember that your therapist is YOUR hire. You are paying them to render a service, and you are in charge. If you like or don’t like what they are doing, talk to them about it! Just like with hairdressers or massage therapists, monogamy is not required. It’s therapy, not marriage.

OK, then. Here are some excellent questions to ask:

1) What professional organization(s) do you belong to? A mature and successful professional will always want to be part of a professional group larger than themselves. Professional groups provide leadership, advocacy and ongoing education to their members. Really invested professional trauma therapists should belong to at least one professional trauma organization such as the International Society for the Study of Stress and Dissociation (ISSTD); the International Society for Traumatic Stress Studies (ISTSS); the American Professional Psychology Division 56 (Division of Trauma Psychology) or one of many others. Hopefully they also belong to their local professional chapter: for social workers NASW, for psychologists, APA, the AMA if they are a psychiatrist, and so on. If they rattle off a bunch of names and letters you do not understand that is probably a good sign. They all have websites. Feel free to check them out. Many of these organizations have their own lists of providers. If they are expert presenters for these organizations, even better!

2) Do you have any special certification or training in Trauma therapy?beautiful therapy Good answers:
Specialized supervision (regular meetings to review cases and learn from them) provided by an experienced trauma therapist or internships in trauma treatment centers. ISSTD and other organizations offer specialized courses and certifications. Also, the American Academy of Experts in Traumatic Stress certify practitioners in a number of traumatic specialty areas including crisis response, child, etc. based on their accomplishments and years of work in the field.

Bad answers:
No. Or I understand trauma because I had a lot of it. Or I’m a good therapist and good therapists can treat anything (run away).

Trauma therapy is an advanced practice specialty area that always requires special training to be good at. You wouldn’t go to a general family doctor for a heart attack, so don’t think that any therapist can do this work. They can’t and may do you more harm than good.

3) Do you understand and treat dissociative disorders?
A surprising number of therapists have never been taught to work with dissociative disorders, don’t recognize them when they see them, and can waste years of patients’ time (not to mention money) by this lack of understanding. Dissociative disorders and traumas go hand in hand. There is even a dissociative subtype for PTSD in the latest diagnostic manual (DSM 5). If you know you have lots of trauma, or lack a significant portion of childhood memories (dissociative amnesia) you have a higher likelihood of a false and unhelpful diagnosis if your therapist does not specialize in trauma and dissociation. Common misdiagnoses are bipolar disorder, borderline personality disorder and schizophrenia.

4) Have you completed your own course of therapy?
This is an awkward but TOTALLY FAIR question, one, quite frankly, that I wish more people would ask. In the good old days, in the heyday of amazing long term therapy, it was considered on the verge of malpractice and utter ignorance not to complete one’s own therapy before embarking on treating other people. Now it is rather the norm. Very few therapists I supervise have had much of their own treatment.

There is a misconception out there that therapists are sicker than the general population and become therapists to cure themselves. After 40 years in the field, I do not subscribe to this idea. Almost everyone in society has been exposed to trauma and mental illness in their families. Very few of those people want to understand it and go on to help others – those special few are therapists.

But being a psychotherapist working with traumatized people is an incredibly challenging calling. It’s easy to make mistakes, mostly unconscious or ignorant ones. So it is important that the therapist has had enough of their own therapy to understand how their own mind defends itself and operates unconsciously so that they can work well with other minds. This is a long and arduous task requiring many hours of training and work over a period of years.

So don’t be put off by a therapist who had a lengthy therapy themselves. Chances are good that somebody in therapy for 10 years will be a much better therapist than someone who went to treatment for six months and called it ‘good’.

5) Do you believe that people can have repressed memories of trauma that they recall later in their life?

There has been a big debate in the media about this, but in the world of professional trauma therapy the debate has been over for a while. The answer is “yes, of course”. Jennifer Freyd, cognitive psychologist at the University of Oregon, and editor of the ISSTD journal, did a great deal of work in the area of what she calls “betrayal trauma”, the trauma inflicted by a caregiver. She has showed in numerous studies that the closer the relationship of the abuser to the abused, the more likely the victim will have traumatic amnesia for the event.

If memories start to surface in your therapy, you will want to make sure that you will be believed and helped. It is extremely poor therapy to answer ‘no’ to this question, because that indicates the presence of dogma and a closed mind. You may have some very challenging and unusual things to tell your therapist, and you need to trust that they can hear those things and continue to work with you in a safe and containing way.

If you don’t feel like you can ask these questions in person, there is always email! Or go to your therapist’s website and investigate them deeply. You will save yourself some emotional distress and money by being proactive in your search for a truly helpful trauma therapist. Good luck!

Susan answers all of these questions in the affirmative and would be happy to answer more here!




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