For many individuals, just the word trauma can be highly activating. As a trauma specialist, I have gone into many centers over the years and found so much misinformation and retraumatizing that has occurred with clients.
Without the adequate training and experience, many well-intentioned clinicians can retraumatize their clients in their efforts to help them heal. I find two types of approaches with these therapists: those who are not cautious enough; and those who are overcautious. The former being more damaging than the latter.
I strive not to express myself negatively when I have encountered so many clients who were traumatized by a previous therapist. These clients were either flooded with anxiety or dissociated by a therapist not sufficiently skilled in working with trauma. My daughter, who resides in another city from me, contacted me the other day to receive feedback about a session she did with a therapist.
She informed me the woman started doing EMDR (Eye Movement Desensitization Reprocessing) therapy with her in the first ten minutes of their session and ended the session fifteen minutes early without warning. The result was my daughter was flooded with anxiety and spent the next several hours sobbing alone at her apartment.
It took every ounce of emotional regulation I had to refrain from driving up to my daughter’s town to confront this therapist with the anger of a protective father. In addition to this therapist being unqualified to treat trauma, something she was ignorant of was a basic tenant in trauma therapy known as the ‘window of tolerance.’
I was first exposed to this concept through Dr. Daniel Siegel and Dr. Pat Ogden. The ‘window of tolerance’ is a simple but profound concept. Above the window is what is referred to as hyperarousal, which is a high anxiety state. Below the window is hypoarousal, which is a dissociative state that includes feeling flat or emotionally numb to not feeling real or outside of one’s body.
This is the red light, green light of trauma therapy. Prior to this concept, the standard treatment for trauma was some form of exposure therapy. Without an understanding of the ‘window of tolerance’, numerous clients were being retraumatized by being either flooded or dissociated. Furthermore, there was not an suitable understanding of the difference between type one trauma and type two trauma, i.e., PTSD (Post traumatic stress disorder) and complex PTSD.
Type one trauma refers to a single-incident trauma. Type two refers to complex trauma, which occurs primarily from birth through late-adolescence and is recurrent, chronic, and relational, such as severe neglect, physical, emotional, or sexual abuse that takes place in childhood and adolescence. As the designation refers, complex trauma is much more multifaceted and extensive in its impact.
The goal of trauma therapy is not to retell your story endlessly or have to relive the event but, rather, to clear it from your body and integrate the experience neurologically top and bottom and right and left hemispheres in your brain. Any form of post traumatic stress, whether type one or type two, develops from how the brain and body respond to survive the event.
Whenever we experience an overwhelming emotional state or physical threat of some form, we have four basic responses: reach for attachment, fight, flight, or freeze. These are each triggered neurologically and non-consciously through a process called neuroception. The brain decides in fractions of a second what response will give us the best chance to survive or cope with the event.
PTSD or any residual level of trauma, develops as a result of the brain and body going into some level of a freeze state. This occurs in the brainstem through a process defined as dissociation. Animals have a similar response called tonic immobility. If it is not adaptive, or accessible, to reach for attachment, fight or flee, we will go into a freeze state.
Although this helps us survive the event, a part of us is now frozen in time at the incident. The energy and information of the episode that was dissociated goes into our implicit memory network, which is stored as a felt sense in the body with no images, thoughts, or words. Moreover, this type of memory has no ability to differentiate people, time, or place. Anything that is even the remotest of associations will activate the memory in the body like it is happening right now, even if it was decades ago.
In addition, it can trigger every dissociated memory in that emotional theme, such as around safety or inadequacy. This will further result in either the body releasing a flood of adrenaline and cortisol to fight or flee or internal opiates to dissociate. And all this occurs outside of conscious awareness.
Returning to treatment, you cannot resolve this state through a top-down approach. By that I mean talking and thinking. The brainstem cannot reorganize itself in this way. You have to use a bottom-up approach. This is achieved through activating a level of felt-sense in the body and tracking and noticing the sensations as you experience them without interference or judgment. The brain and the body know how to clear the energy from the body and reset itself once you have accessed the felt sense, remain in the window of tolerance, and just allow it to happen.
I have worked with countless clients in substance abuse treatment centers who were fearful and reluctant to process their trauma. As I walked them through this process one small body sensation at a time until we fully resolved their trauma, their common remark was, “That was it?” “Yes.” I would inform them. “No go and tell the other clients it is not that bad.” Contrastingly, I am not saying processing trauma is easy or without its challenges. But it definitely does not have to be retraumatizing.
Just as gravity is a non-negotiable in our universe, your brain and body have to follow these laws. If you haven’t healed yet from your trauma despite numerous attempts, you just haven’t received the correct treatment or been ready to commit to the process. But again, it does not have to be intense. The brain and body actually integrate best in a calm, regulated state.
Once you clear the energy and information held in the implicit memory network, the trauma is over once and for all. You will never again have symptoms related to the event. Daily, I have clients who are astounded or dumbfounded they can no longer bring up their symptoms. They will return to session the following week saying things like, “I tried every day to bring up anxiety or emotion from the incident, and I can’t get anything.”
Healing from trauma does not, and should not, have to be retraumatizing. We are wired to heal once you know how. Whoever you are attempting to work with should be able to outline the concepts I shared in this article. These are basic principles for any qualified trauma therapist.
If you would like to learn more about healing from trauma or schedule an appointment, call Gateway Counseling Center at 561-468-6464 or you can send me a message.