Keep Pain in the Past. Dr. Chris Cortman

Чтение книги онлайн.

СКАЧАТЬ for instance. It’s also possible that your therapist does not endorse a particular approach or theoretical construct to treat trauma. In either case, as a client, you’re in the dark, and you shouldn’t be.

      •How long were you in therapy? Did you stop for a particular reason?

      You may have been in therapy for many years and continued to wait for it to work. You may have also tried therapy for a short period of time and quit because you weren’t seeing any results. In either case, the lesson learned is that time is not a predictor of effectiveness. Every client is different, and it takes longer to heal some emotional traumas than others. That said, the right therapy should work relatively quickly.

      •Are you a serial therapy-seeker? How many different therapists or types of therapy have you had?

      Bouncing around from one therapist to another is incredibly frustrating, and if this has been your experience, I apologize on behalf of our profession. The odds are that if you’ve seen multiple therapists without much success, then you probably didn’t feel safe or heard when you were in therapy. With Jim, I assured him that effective trauma treatment existed for his particular issues and that healing was possible, and I did this in our very first session. Without believing a therapist “gets” what you’ve been through and that (s)he can help you, you won’t feel safe or heard and will leave, usually sooner rather than later. Maybe therapies you’ve experienced have been focused on coping instead of healing. Remember, many therapists focus on coping rather than healing, as such therapists don’t believe that you can really heal from emotional trauma.

      •Have you been prescribed any medications to help you deal with the problems stemming from your trauma? What are the medications, and how effective have they been, both in addressing the short-term symptoms as well as in helping you to heal and lead a fulfilling, successful life?

      If you have tried medications, I hope that they helped at least somewhat. Zoloft, Prozac, Wellbutrin, Abilify, Seroquel, Effexor, Trazodone, Ambien, and others are all typically prescribed for a diagnosis of PTSD. Again, I think medications can assist in trauma treatment, but as you may have experienced, medications may work, but only until you stop taking them, either because you don’t like the side effects, hate being dependent on them, or even become frustrated with the whole process. Medications may help with some trauma symptoms, but as soon as you stop the medications, your symptoms will return. As previously referenced,3 most medications will help some, however, without the addition of effective psychotherapy, all medications are prone to a relapse in symptomology when the medication is stopped.

      •How much work on your issues have you done on your own? Did your therapist suggest you should be working on healing outside of his/her office? Did your therapist give you any tools or techniques to use on your own?

      If you have attempted to work on these issues on your own, kudos to you, because that requires a great deal of courage. The odds are, though, that your therapist didn’t encourage this or didn’t provide you with tools and techniques to do so. Healing can be done at home, and I will often recommend that people use various techniques such as cognitive exercises or writing letters to help themselves when they are not in session. While the typical Cognitive Behavior (CBT) therapist will assign you homework to complete (e.g., thought records, behavioral interventions, and various worksheets), remember that it’s not simply the amount of time you spend on healing, but how you spend the time. Working to heal through remembering, feeling, expressing, releasing, and reframing are critical, active techniques, and so using these techniques is far more important than spending huge amount of times doing less critical activities.

      •How has the emotional trauma you suffered affected your life negatively? Has it negatively affected you in terms of careers, relationships, moods, or your ability to enjoy life? Has therapy helped you deal successfully with any of these problems, especially in the long-term?

      There are subtle ways and then there are obvious ways that experiencing trauma can impact one’s life. Working too much, as Jim did, is an example of an obvious response to his trauma. More subtly, he lost his enjoyment of life because his mind was anchored in the past. Therapeutic treatment is designed to address and permanently resolve these issues. Anything less is ineffective treatment.

      Many people are dissatisfied with their emotional trauma treatment; and people who have stopped treatment or never bothered with it may grit their teeth and try to muddle through life with all the burdens that trauma creates.

      It doesn’t have to be this way. To help make the case for an effective alternative and a model for trauma treatment, let me share six different approaches that have contributed to my model on healing from emotional trauma. In this way, I think you’ll start to understand the roots of trauma and how it might respond to the right treatment protocols.

      Six Contributions to My Understanding and Treatment of Emotional Trauma

      Before introducing my model for treating trauma, let’s explore trauma from six distinct perspectives: those of stress response, neuroscience, cognitive behavioral theory, Gestalt Theory, Freudian psychoanalysis, and religious training. Each of these topics will provide insight into the method I use and why it is so effective in the treatment of all types of emotional trauma.

      The Stress Response

      In 1956, Dr. Hans Selye at the University of Montreal described in his book a three-step response to challenges, which he called the stress response5. More specifically, he coined the term General Adaptation Syndrome6 (GAS) to illustrate a three-step progression of what happens to an organism (including you, the human) when stressed. Selye noted that stress is a specific, predictable, internal response to a non-specific stimulus or threat. In other words, whatever threatens you, be it a subpoena, an IRS audit, or an episode of Real Housewives of New Jersey, evokes a predictable physiological response: secretion of stress hormones like norepinephrine and cortisol, accelerated heart rate and respiration, shutdown of digestion and sexuality, and increased blood flow to the major muscle groups, including the chest, back, arms, and legs, all of which prepares the organism for “fight or flight.”

      This first stage is called the alarm reaction, and it is entirely normal and appropriate. The extra fuel you receive from norepinephrine, for instance, aids you in staying up all night for the final exam or rescuing a child from a burning house. When the threat is over, the body returns to homeostasis.

      The second stage of the GAS is the “resistance stage.” Here, the stressor is ongoing, so your nervous system remains in high gear. For example, your high-conflict marriage becomes a high-conflict divorce, your financial woes worsen, or your child’s hyperactivity continues unabated. This stage lasts as the perceived stressor goes on—or until the body’s coping mechanisms give way to the third stage, “exhaustion.”

      Exhaustion is exactly what you think it is, a breakdown of the nervous system resulting in fatigue, dysphoria (low mood), anhedonia (an inability to experience pleasure from previously rewarding activities), free-floating anxiety, insulin spikes, panic attacks, infections of all kinds (since your immune system no longer fights off intruders), muscle cramping and aching, every one of your least favorite gastrointestinal symptoms, and so much more. People in the third stage are hospitalized or suffer from “nervous breakdowns,” depressive episodes, psychotic breaks, or panic attacks. Our coping mechanisms are temporarily defeated and require help.

      So what does this have to do with treatment of trauma? Unresolved trauma causes the stress response to be left in the “on” position, or perhaps it is like a faucet that is continually running. A primary goal of treatment is to shut off the stress response, return it to the “off” position, or shut off the faucet, whatever analogy you prefer.

      And СКАЧАТЬ