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Tag: ptsd

Art Therapy Workshop for Trauma Survivors! 2/23/2017

Art is often a way to express an experience for which words may feel inadequate.  Trauma and the journey of the survivor towards healing can be difficult to articulate; creativity can facilitate the transition from the unspoken subconscious to the expressed metaphor through other means of depiction of experience.

Our upcoming workshop is an opportunity for survivors to be in a safe place, to share in their experience, to find ways to express their process, and to have choice in how to accomplish integration of historical adversity.

Additional information is provided on the attached flyer.  Contact us with inquiries!Art Therapy Workshop

DID, Iatrogenic Trauma, & Healing through Sharing

DID (Dissociative Identity Disorder), previously known as Multiple Personality Disorder, continues to be a diagnosis that is portrayed incorrectly, misunderstood, and or those living with it can be overtly treated as dishonest by their healthcare providers.  Many have been re-traumatized in the pursuit of treatment (this is the iatrogenic trauma part) and have naturally become concerned about sharing in their experience for these reasons as well as others.  Most people with a dissociative disorder present with anything but DID (usually anxiety is the presenting concern) including mood disorders, addiction, eating disorders, PTSD.  Those living with DID have been diagnosed with all of these in addition to a misdiagnosis of bi-polar or schizophrenia.

Constructs of DID can often be fantastical; the greatest irony in this is that it is a very well-hidden disorder effecting 1-3% of the US population (if you do the math, that’s a lot of people!).  It is not an extremely “rare” condition as many believe (for example, 2.6% of the population has a diagnosis of bi-polar disorder within a 12-month range; up to 3.6% within a lifetime range).  Bi-polar exists as frequently, can effect behavior significantly, and is not contested as an illness.  I think the difference likely lies within the cause (DID is caused by trauma, whereas bi-polar disorder is an organic illness).  I could be bold and suggest this is another form of blaming those who have endured unbelievable adversity…perhaps I will be bold and suggest that.

The irony is that DID is an extremely well-hidden experience; considering this is the purpose behind dissociation (to protect ourselves from overwhelming experiences and to hide our pain from others in order to function); it is very atypical to work with someone with DID who also overtly displays or discusses their internal life.  Because hiding has become so necessary, including within the field of mental health, the intricacies of this gift (yes, this is how I think of it because not everyone has the capacity to protect themselves in this way) are a very private experience.  The details are rarely shared with anyone but a trusted therapist, a very close loved one, or maybe a friend or two (maybe…).

The power of groups and connecting with others who share in your experience is known to be powerful.  In an effort to provide an opportunity for people with DID to share in their experience, ITTC offers a bi-weekly group for those with DID who want to be supported by and be supportive of others who understand.  The group is mostly unstructured but is facilitated; the primary purpose is to create a safe space to share in experience.  All participants are required to be actively involved in individual therapy.

The group occurs every other Monday @ 3pm.  Contact athena@traumacenternw.com for further details.

Art Therapy Workshop for Dissociative Identity Disorder

 

Vancouver Integrative Counseling is hosting our next Art Therapy Workshop for those with Dissociative Identity Disorder.  

This is our third workshop and each one has been very fun and safe for participants (and for the facilitators!).

The intention behind the workshop is the offer an opportunity to externalize the internal experience, to share with others, and to have a visual reference.

Contact athena@traumacenternw.com if you are interested in reserving a spot!

February 20th, 10am-noon

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Broccoli, Chocolate & Trauma

Many survivors of interpersonal abuse, in its’ various forms find themselves continually adapting to and evaluating their environment; specifically those in proximity who may cause harm. Anticipating the emotional overlay in an unpredictable setting is clearly proactive and protective in that survivors can identify when risk has elevated and thus plan some sort of intervention. Appeasing the abuser, planning to escape, mitigating arguments or planning for complacency to minimize harm are some strategies utilized by those exposed to chronic threat. Having a nuanced and developed defense strategy is advantageous and can help increase the odds of physical or emotional safety. As we travel into adulthood scanning our environment and reading subtleties in other people’s behavior forces us to detach from our own internal barometer that helps us connect to the basics of who we are as individuals.

Working with adult survivors of childhood abuse or those who lived with parents who may not have been abusive but perhaps neglectful or narcissistic turns our attention to the external. A common thread that exists is a lost sense of self, of likes or dislikes and a struggle to rely on authentic internal motivation for guidance. Additionally, because we are social animals, connection to others that includes the capacity of the other to tune into our wants, needs, or emotions help us to be appropriately attuned to ourselves. Those who love us and know us well can often see what we feel before we do; empathy and connectivity help us turn inward to become increasingly familiar with our values and who we are.

In the context of therapy, when I ask adult survivors about what they care about, like or dislike or want to do professionally (for example), the answer is often “I have no idea.” So, we begin the dance of determining what it feels like to want something or to have a distaste for something or to care about something. It can feel like a task that has no beginning, so, I have designed a scientifically sound method (this phrase is used loosely) for starting the conversation; it is a measurement tool intended to discern “wants” from “shoulds.” The measurement is called “The Broccoli-Chocolate Test.” I ask people to imagine broccoli and to describe the color, smell, and texture to me and then to notice what their body or mind communicates to them (most of the time it goes something like this…”I really should eat more leafy greens and vegetables.” And then, I ask them to describe chocolate (or something comparable) alongside the associated smells, textures, and flavors. The response to the chocolate is often something along the lines of “yum.” Again, I ask for the associated physical feeling and we talk about the difference between the broccoli and the chocolate.

The step that follows is of course giving permission to enjoy the things that are wants (which are different from coping mechanisms or escape strategies like alcohol or too much television, for example). Shoulds are easier to identify because unspoken and spoken social rules are fairly overt; we don’t have to turn inward to figure out that we are supposed to live our lives in a certain way or abide by the current social norms. Being guided by our value set is different from being guided by a should; an authentic value is generated internally whereas a should is generated and reinforced externally. Something we want or like reflects the little things about us make us unique; connecting to ourselves is not a frivolous pursuit.

So…if you want some chocolate (or some broccoli)….enjoy.

The Recipe for Trauma Recovery; Rwanda and Resilience

Trauma happens on many social levels including very intimate violence, to car accidents, to terrorism, to genocide (and many other levels in between). Following the visit to the Kigali Genocide Memorial as well as talking with Rwandans about the recovery process, we have discovered many parallels in terms of how trauma manifests, when symptoms show up, and what kind of response is effective.

People in this country who survived the genocide have spent the last 20 years rebuilding their country as well as trust between people. The children who were orphaned have grown into adulthood and, while life is clearly not easy for many, there is movement beyond their horror and loss. Re-integration between survivors and perpetrators is occurring now and very strict laws are in place to eliminate racial division (which have been very effective by the way); these two things must occur together in order to prevent further violence. Rwanda has done an excellent job in the first phase of recovery from trauma. Naturally I cannot help but to compare.

Trauma therapists know that there is a certain recipe for recovery that is necessary to lift ourselves out of our past. Here is a general description:

1. Safety must be established first. Basic needs must be met.
2. Acknowledgement that the bad thing happened.
3. Validation that the bad thing was indeed bad and any kind of associated grief is appropriate.
4. An appropriate response must be offered. Responsibility must be appropriately assigned.
5. A plan for justice, reconciliation, forgiveness, letting go must be developed.

Generally if a trauma is acknowledged, that is the first necessary ingredient for moving towards trust (in others and in safety). Often in the United States, we get stuck here. It is very difficult for us to acknowledge the bad thing without blaming the survivor or denying it all together. Unfortunately a survivor of some sort event is often put on a timeline for recovery, is blamed for what happened to them, are not believed, and of course the other ingredients can only be added if the basics are addressed.

Rwanda has been able to do several things that has allowed the country to move towards healing. The first, as mentioned before is the acknowledgement that racial division is dangerous; it is not allowable to identify people based on ethnicity. One Rwanda One People. The second is responding appropriate by building community and helping people in concrete ways. There has been a significant effort to provide justice to survivors at a community level; survivors have a voice in that process and it is very intimate. As a result, Rwanda is now the safest country in Africa and has crime rates lower than the majority of states in the U.S. Citizens are required to give back to their community every month (it’s the law!). As a result, Rwanda is spotless; there is no trash anywhere! Rwanda’s economy is stable and strong and growing. There are laws supporting women~for example there must be a certain percentage of women in governing positions. Leveling the playing field between ethnic groups and gender has fostered a very stable and growing economy; one of the strongest in region.

Rwanda has figured out how to recover and thrive following a very recent and horrific tragedy in their country; we can all learn from what they have done.

Rwanda's recipe for recovery
Rwanda’s recipe for recovery

Rwanda Day 2: Compassionate Curiousity

Our first venture in Rwanda was the iconic safari trek. This allowed us to quietly wander through this new landscape while we appreciated its natural beauty and animal inhabitants.

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We came here to learn from and exchange information with the people in this resilient community…however, watching animals in their natural habitat set the stage for a sense of wonder, admiration and curiosity that we will most certainly take with us in our professional meetings this week.

Even the animal kingdom here is in a revival phase, since many animals were killed in the genocide along with their human neighbors. There are also stories of targeted assaults on specific species, such as the lions, due to the threat they posed to the local livestock. The backlash of farmers poisoning their own cows totally eradicated lions from this area. Just last summer, seven were “re-introduced” to the protected land in the national park we visited, a gift from South Africa, and existing relatively hidden to visitors as they roam the property. Imagine our awe and excitement when we happened to spot one and watch as it sunbathed some 30 yards from our vehicle!

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One chord that reverberated from our safari experience was the practice of being with other beings in a way that’s respectful of their unique experience — sensitive that it is VERY different from our own. We found ourselves naturally speaking in soothing, hushed tones to the animals, or simply sitting totally still and silent, in respect for their territory and existence. We asked basic questions of our guides, purposefully leaving behind our presuppositions and entering wholeheartedly into a world that’s very different from our own.

We held our curiosity with a sense of compassion, attempting to understand creatures we easily admitted were foreign, yet important in a way that’s difficult to articulate in words. This ability, this altruism, is something we will intentionally carry over into this coming week … A willingness to enter generously into another’s point of view with humble, compassionate curiosity.

Rwanda Day 1: Listening and Being Listened To; a Western Luxury

On the second leg of my flight to Rwanda, I sat next to a 25 year-old woman who was traveling from Luxembourg to Rwanda for her wedding. I asked what seemed to be a fairly innocuous question; “Why do you live in Luxembourg and why are you getting married in Rwanda versus your home?” She responded that because her parents were murdered in 1995 during the genocide she had been adopted by a family from Luxembourg, however her fiance resided in her home country. Oh. How do you continue a conversation after an acknowledgement of such horror? She talked about the fact that she cannot visit Rwanda during the month of April because 20 years later, she is still terrified (April is the month during which the genocide took place).

I stumbled through the conversation with as much sensitivity as I could; I didn’t want to ask to much or ask too little. I did tell her my intentions in visiting Rwanda, which are essentially to explore the possibility of providing some sort of specialized support to survivors of the genocide and their children. She told me she didn’t know how someone could recover from the kind of atrocity faced by this country, which prompted a brief conversation about parental attunement, listening, and being heard.

She noted the differences between her white adoptive parents and her Rwandan birth parents; one of which was they had luxury to tune into her needs, listen and be able to provide an appropriate response. In countries that struggle economically, the primary concern of the parent is to feed and house their children. Emotional support is last on the list.

Rwandans have recovered from the genocide remarkably and with a great deal of grace. I am not familiar enough with the culture to understand what is happening emotionally beneath the surface or how trauma has manifested here. I also don’t know how many have told their story and how many have had the opportunity to have someone listen or even if that would be useful. Perhaps there is something I can learn from this culture about alternative forms of healing and meanwhile, whenever a local tells me their story, I certainly plan to listen.

Managing Trauma Triggers in the Context of Terrorism

The recent terrorist attacks can effect all of us in different ways, one of which is the compromise of our collective sense of safety. Going through our day-to-day activities without worry or threat is a basic assumption for many Westerners that when something happens, it can be unsettling. Those who have a history of traumatic experiences can experience the threat to safety in a more heightened way. If your basic assumption is that you are not safe (versus that you are) and something happens that reinforces that orientation, it can feel terrifying. Essentially the message to survivors is that they are right; they are in danger and need to be vigilant. As a therapist, a lot of our work surrounds increasing trust in your environment and other people to allow the central nervous system to quiet a bit. Statistically, the west remains one of the safest places in the world to live, but terrorist attacks can make it feel unsafe, primarily because of the random nature of the attacks and associated feelings of helplessness. Mitigating trauma triggers when being bombarded with the details of trauma can be difficult. Here are some basic suggestions to manage triggers:

1. Turn it off. Continued exposure to the details of a traumatic event is often re-traumatizing. Minimize exposure to traumatic material. Easier said than done!
2. Maintain routine. There is a great deal of comfort and safety routine.
3. Connect with friends and family. Isolation can fuel negative thought.
4. Connect with our furry friends. Animals can offer a great deal of comfort and nurture.
5. Play. Being playful is the opposite of being fearful. Engage in activities that are fun, make you laugh, and bring you joy.

Safety is never a guarantee, regardless of geography. The only thing we know for sure is what we see in front of us in the here and now, so don’t travel too far into the future or the past; we have little control over what has happened or what will.

Workshop for Trauma Survivors

Coming Soon….Honoring your Internal Warriors: Preparing for Trauma Work from an Internal Family Systems Perspective.”

Athena Phillips, LCSW will be offering a workshop for trauma survivors who are in the early stages of recovery. The decision to engage in therapy is in itself a tough decision and in my opinion, courageous. Revisiting painful memories is counter-intuitive~avoidance is probably more natural. In order to alleviate the influence trauma can have over our lives, we need to go against what our thoughts might be telling us to do (avoid, get away from, never go back). Typically it’s our bodies that won’t allow us to leave trauma behind until we have successfully processed and made some meaning of profound experiences. The conflict between our thoughts that tell us to forget about it or get over it and our body’s unrelenting reminders that we need to tend to our past creates significant internal tension.

The beginning of trauma work should be housed in establishing safety with the therapist as well as trust in ourselves in being able to handle the material we intend to revisit within the therapeutic context. Setting this intention naturally activates our protective mechanisms; the parts of ourselves that understandably have some concern about looking at trauma again. Our internal warriors have likely worked very hard at ensuring safety, at staving off overwhelming emotion, at maintain a safe distance between people, at scanning the environment for potential harm, or at helping keep things stable through numbing and avoidance. Sometimes these efforts can take a more extreme form, like dissociating from trauma, self-harm, excessive use of drugs or alcohol, suicidal fantasy. Many of these coping strategies are cause for concern, naturally, however there is generally some sort of positive intention behind them. Understanding the intention of the parts of self who are often trying to protect (Internal Warriors) and using them to guide safe trauma work is the goal of this workshop.

Participants must be actively engaged in individual therapy and must be able to interact with other group members in an emotionally safe way. Traumatic memories will not be discussed during the workshop, rather we will focus on how to prepare to do so in the context of individual psychotherapy.
Creativity, play and art will be utilized for the workshop and our hope is to have fun.

The workshop will be held July 18th from 1-4 pm. Cost is 125.00 and must be paid in full a week prior to reserve space. Maximum of 8 participants. Location TBA (either our Portland or Vancouver location depending upon number of participants). Call 971.266.6910 ext 301 for inquiries.