What is Trauma?
Trauma is the response to a deeply distressing or disturbing event that overwhelms an individual's ability to cope, causes feelings of helplessness, diminishes their sense of self and their ability to feel a full range of emotions and experiences. It does not discriminate and it is pervasive throughout the world ...
Peter Levine
Symptoms of trauma and treating trauma
Psychological trauma is a response to an event that a person finds highly stressful. These types of events can range from one of trauma's such as an accident, medical procedures, natural disasters or any other violent events. A person can also experience trauma after witnessing something traumatic happening to someone else. Or we may experience prolonged trauma in the form of domestic violence, combat, physical emotional and sexual abuse. The above are just some examples. Trauma can cause a wide range of physical and emotional symptoms. We each respond to trauma differently and there are Many different factors which determine how a traumatic experience/event event affects a person.
Some symptoms can include ; chronic pain, digestive issues, racing heart (among many others) and some psychological and emotional symptoms include; flash backs, intrusive thoughts and images, anxiety, depression, sleep disorders and insomnia, dissociation, DID. EUPD, BPD, numbness, confusion, sadness and hopelessness - these are just some of the symptoms we may experience as a result of trauma.
When working with trauma I integrate somatic experiencing, sensorimotor psychotherapy and internal family systems therapy. These approaches are widely recognised as effective ways to work with trauma. Additionally I use a well established and recognised 3 stage model to work with with trauma
Stage 1 : Stabalisation and building safety
We start by developing an understanding of how trauma impacts the system through the use pf psychoeducation and practical skills and exercises to stabilise some of the symptoms. We will work together to both identify overwhelm and triggers and learn strategies and resources, such as grounding skills etc, to regulate the nervous system and bring you to a felt sense of “safety”. This stage enables you to regulate overwhelming feelings and symptoms so that we can move into the processing stage in a safe way.
STAGE 2 : Trauma processing
Once safety has been established within the nervous system and you are able to resource yourself and both expand and stay within your window of tolerance, we can then move towards safely processing your trauma which avoids overwhelming your system and/ or re-traumatisation. The processing stage allows us to work with your trauma on a deeper level and address and face what may have previously been too overwhelming.
STAGE 3 : Re building your life
In the third and final stage we look at integrating your new insights and self awareness so that you can begin to rebuild your life - here we recognise that we have choices. We are no longer reacting to and stuck in patterns of our past.
FAQ
What is the Polyvagal Theory in therapy?
To very briefly summarise- the Polyvagal Theory is a tool for working with trauma and social connection based on how our nervous system reacts and responds to external stimuli varying from safety to danger. More information: https://www.rhythmofregulation.com
What is the window of tolerance?
The window of tolerance is a concept originally developed by Dr. Dan Siegal to describe the optimal zone of arousal for a person to function effectively in every day life. When a person is operating within their window of tolerance they can effectively manage and cope with their emotions.
However, for clients who have experienced trauma, it is often difficult for them to regulate and manage their emotions and their window of tolerance becomes narrowed- we might experience our world as, "getting smaller". In therapy, we work on widening your window of tolerance (through resourcing and both learning and integrating ways to self and co- regulate) we work on increasing your resilience, capacity and ability to stay present.
However, for clients who have experienced trauma, it is often difficult for them to regulate and manage their emotions and their window of tolerance becomes narrowed- we might experience our world as, "getting smaller". In therapy, we work on widening your window of tolerance (through resourcing and both learning and integrating ways to self and co- regulate) we work on increasing your resilience, capacity and ability to stay present.
what is resourcing?
Resourcing in trauma therapy is the process of working to identify and implement safe ways of regulating the nervous system and both creating and restoring a sense of safety. We will each have our own unique ways of resourcing, often things we may not even think about such as burning candles or walking in nature etc- essentially the things we do (perhaps unconsciously) which help us to feel "better". Resourcing is an essential element of trauma therapy as it enables us to stabilise our nervous system and thus move towards processing our trauma in a safe way to avoid re traumatisation.
what does bottom up processing mean?
The limbic brain is where our trauma responses originate. This part of the brain is the earliest part of our brains to develop. It is the limbic part of the brain which instinctively responds to threat through the fight/ flight/freeze "playing dead" responses. These instinctive responses happen before we are cognitively aware of them. When trauma symptoms are activated we may feel overwhelmed by anxiety, anger, fear the urge to flee/ escape (flight) or fight. We may be overwhelmed by body sensations such as nausea, headaches, muscle tension, racing heartbeat, and many other physical symptoms. We are often unaware of what has triggered our past trauma, especially if we are typically disconnected from our bodies.
"Trauma survivors – they’re living so much of their life in the bottom part of their brain… with the amygdala, the smoke alarm of the brain, shooting off [signals of] ‘danger, danger, danger,’ that they can’t access that top part to be able to start there.” (Robyn Brickel, MA, LMFT)
Trauma responses are automatic and unconscious, the prefrontal cortex (thinking/rational )part our brain is not involved
A bottom-up approach to trauma therapy aims to undo trauma’s imprint on the body by directly accessing the limbic system and sensory receptors located throughout the body and in doing so regulate and adjust the visceral responses associated with complex trauma
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"Trauma survivors – they’re living so much of their life in the bottom part of their brain… with the amygdala, the smoke alarm of the brain, shooting off [signals of] ‘danger, danger, danger,’ that they can’t access that top part to be able to start there.” (Robyn Brickel, MA, LMFT)
Trauma responses are automatic and unconscious, the prefrontal cortex (thinking/rational )part our brain is not involved
A bottom-up approach to trauma therapy aims to undo trauma’s imprint on the body by directly accessing the limbic system and sensory receptors located throughout the body and in doing so regulate and adjust the visceral responses associated with complex trauma
.
Mindfulness in therapy
The use of mindfulness exercises in trauma therapy allows us to be more aware of the present moment and in doing so "orient" to safety in the here and now (i.e. the absence of threat). This strengthens our ability to self regulate by taking us out of the thinking mind and into the safety of the here and now. There are different types of mindfulness based exercises such as grounding and using the five senses to bring us into the present moment.
what is dysregulation
Dysregulation is the term used to describe the experience of being unable to regulate or tolerate overwhelming emotional and physical responses.
