My trauma studies and experiences working with my clients have solidified my belief in a strong mind-body connection and that therapy must often go beyond talk, and explore messages from our physical selves that may provide clues to where we are most “stuck”. Although I believe strongly in the power of psychodynamically-informed traditional psychotherapy, I also utilize the following methods.
EMDR (Eye Movement Desensitization Reprocessing)
I use EMDR to directly address specific traumatic memories, or develop internal external strength resources. EMDR does not just use eye movements – it uses many forms of “bilateral stimulation” – which means stimulation (e.g., right-left tapping or tones) that direct attention to both sides of the body, and therefore across the midline of our brain and nervous system, while processing traumatic memory. It has a strong research base and has been shown to be effective for PTSD and related traumatic stress reactions. EMDR integrates the thinking and emotional parts of our brains when processing difficult memories and feelings. In EMDR, clients “reprocess” these memories and feelings in ways where resolution is possible, in ways that it was not when the original situation or event arose. It can help us become “unstuck” and render these memories less powerful and frightening.
Watch this brief video documentary on the development and healing capacity of EMDR, introduced by Bessel van der Kolk, one of the world’s leading trauma experts.
See the national EMDR Institute website for more information. http://emdria2.affiniscape.com/displaycommon.cfm?an=1&subarticlenbr=120
Sensorimotor Psychotherapy (SMP)
I help my clients locate how their feelings and memories may be manifesting in their bodies in the form of pain, tightness, movement, or posture, and utilize principles of SMP to help them stop “living from the neck up” and experience their body’s “wisdom” – sensations that may be clues to past trauma or loss, in a safe way. This involves not only working for the top down, as in talk therapy, but from the bottom up, directly with body sensations. We as mammals have a built-in alarm system, our nervous system, which prepares us for flight or flight or shuts us down in times of danger. When the danger comes from outside, this is necessary for survival, but if we are exposed to repeated trauma, abuse, or emotional or physical violence as young people we remain in a constant state of hyperarousal, or hypoarousal (shut down). Principles of SMP help us work with those feelings in the present, when they are no longer necessary for survival but act as triggers disproportionate or unnecessary for our current situations. For more information about SMP, watch an interview with SMP creator Pat Ogden, PhD below.
Internal Family Systems (IFS)
I apply principles of IFS, which synthesizes family systems theory with theories about the natural multiplicity of our minds, or “self states”. I help my clients to safely explore their inner psychic world and explore why “parts” of themselves developed in response to traumatic, shaming, or frightening events, or traumatic losses, and how these parts developed at a particular time to “protect” them from harm but may actually hold them back. IFS can also be de-shaming, in that is helps us avoid the destructive internal meta-narrative, “I am so impulsive person – I have no control” and instead acknowledge to ourselves, for example, that “a part of me can be impulsive”.
IFS can help us explore the development and influence of our internal parts, and begin the journey to gain access to our True Selves. Read and hear more from IFS creator Richard Schwartz here. http://www.selfleadership.org/about-internal-family-systems.html.
Somatic Experiencing (SE)
I utilize principles of SE, similar to SMP, to help my clients release and integrate the stored energy associated with traumatic experiences and memories in a titrated, gradual way. It can also be sued to “uncouple” events or feelings from our past experiences with those in our current adult lives, which can be particularly helpful when current events are a trigger for early trauma, loss, or shame experiences. SE helps to “reduce interference” from the nervous system by helping us change our expectations, and become more aware of where we hold our traumatic memories and to expand our orienting capacities to the present. In addition, it can help us stay in our own comfort zone and avoid hyperarousal during challenging times, by fostering the use of imagery to prevent the “snowball” effect of experiencing multiple overlapping stressors. See an interview with SE creator, Dr. Peter Levine, below.
I may recommend books, DVDs, or CDs or between session activities to expand the work we do in sessions. I may also suggest adjunctive treatment with a specialist in a particular area if my client and I agree that these recommendations may help.
Mindfulness-Based Stress Reduction (MBSR)
I help my clients learn and use mindfulness-based stress reduction techniques, to help them have greater access to their capacity to live in the moment, avoid rumination and negative thought cycles and reduce their stress levels overall. Mindfulness involves simply being present with one’s immediate experience of thoughts, feelings, and body sensations in a non-judgmental way, and using the breath as an anchor. John Kabat-Zin, an American physician responsible for bringing MBSR to mainstream medicine and mental health, gives a brief introduction below.
Mindfulness has been shown to actually change the brain – thereby helping us have a stronger relationship with and eventually more influence over the content of our thoughts, our stress levels and our emotional reactivity. Watch the brief clip below for a quick explanation.
You can read an interview with noted trauma specialist John Briere, PhD about mindfulness and meditation specifically for the treatment of trauma.
In addition to using MBSR I also help my clients develop the capacity for increased stability through mental imagery – of peace, tranquility, wisdom, strength, and groundedness, and connections to the internal and external resources they have in themselves and in their lives. I will often create voice memos with patients of their own imagery in my voice for them to use in times of stress, or to enter a calmer and more peaceful state. This can help obtain greater peace during times of increased stress and life challenges, and also reduce anxiety and panic. This kind of stabilizatiation work is also necessary for preparing to directly process traumatic experiences.
Sand Tray Therapy
The psychoanalyst Carl Jung once stated, “Often the hands will solve a mystery that the intellect has struggled with in vain.” Sandplay therapy, also called sand tray therapy, is an adjunct to talk therapy and is a powerful hands-on method that facilitates access to our unconscious minds.
Sandplay has its roots in early 20th century Europe and was developed as a means of communicating non-verbally for both children and adults to give expression to emotional issues and memories that are difficult to access with language. Dora Kalff, a Swiss Jungian analyst, expanded on sandplay and contributed to the form it takes today. In sandplay, psychotherapy clients create, in a three-dimensional space, a representative “world” using archetypal images (figurines and a range of objects) that appeal to the unconscious across gender, nationality, ethnicity and culture, in the protected presence of a skilled practitioner In a 28”-19” tray, filled with sand, clients chose figures and objects that “appeal” to their unconscious without deliberation and judgment, and create scenarios to give pictorial representation to some of their deepest conflicts. During the process, the psyche utilizes its own potential to heal and grow and is actually moving and changing, and conflicts are resolves through a series of trays. During the session, the therapist creates a “free and protected space” and “holds the process” silently and with presence. Following a sandplay session, therapist and client process the world created by the client in a non-intrusive and non-interpretive way. Sandplay looks simple, but it requires not only extensive training on the part of the therapist, but an open, containing, aware, holding presence to facilitate the process and let the unconscious “speak” its own language.
For a brief but thorough description and presentation on sandplay for children and adults, watch Dr. Barbara Turner here.
Hypnotherapy
I use hypnotherapy based on Milton Erickson’s theoretical approach, which can be a powerful and effective means of treating a variety of behavioral (smoking, weight management, performance), emotional (anxiety, phobias, emotion regulation), cognitive (self-esteem, pessimism), and medical (pain, surgery and dental preparation, childbirth) issues. This type of hypnotherapy is also referred to as “suggestive” or “conversational” hypnosis. It does not rely on orders or prescriptions (e.g., “you will feel”) but instead utilizes suggestion and metaphor (e.g., “you may notice yourself feeling…”.
Hypnotherapy based on these principles can make use of characteristics, preferences or historical events specific to each client, and developing hypnotic scripts can be a collaborative process between patient and therapist. Hypnotic suggestions appeal to the type of processing that occurs below conscious awareness, when in a trance-like state. Erickson believed that we all have the capacity to enter trance, and that we do so intermittently throughout our daily lives. For example, we may place ourselves into a trance-like state while daydreaming, watching TV, listening to music, or even driving a familiar route. In a hypnotherapy, trance is induced by the therapist who makes suggestions based on the particular needs of each patient, utilizing language patterns that appeal to the unconscious while the conscious mind is “resting”. This can help our unconscious mind “remember” these suggestions, thereby reminding us to behave, feel, or perceive a challenge in a different way when such situations arise.
I may recommend books, DVDs, or CDs or between session activities to expand the work we do in sessions. I may also suggest adjunctive treatment with a specialist in a particular area if my client and I agree that these recommendations may help.