Category Archives: Coping Strategies And Tips

Right Brain Therapy : Is It More Appropriate For Trauma Survivors?

right brain therapy

 

 

 

Why is it that right brain therapy may be more appropriate for trauma survivors as opposed to therapies that concentrate largely upon the left brain?

Right Brain And How We Relate To Others :

One of the main symptoms of complex posttraumatic stress disorder (from which we may suffer if we experienced significant and protracted childhood trauma) is having problems relating to others.

The brain is made up of two halves, called hemispheres : the left hemisphere (or, left brain) and the right hemisphere (or, right brain). It is the right brain that plays a vital role in how we relate to others because it is intimately involved with many functions that affect how we get along, or, don’t get along, with other people. These functions include :

– our ability to empathize with other people

– our ability to trust others

– our ability to identify with others

– our ability to read the emotions of other people from their facial expressions

– our ability to form healthy attachments with others

– non-conscious communication

Because these functions can be impaired if we have complex PTSD, and because they are controlled largely by the right brain, it follows logically that therapy to restore these functions to their optimum levels should, too, concentrate on the right brain.

Why Do These Functions Reside In The Right Brain?

This is because, in the first two years of life, according to psychodynamic theory, our interactions with our primary caregiver very significantly lay the foundations of our emotional life, including our expectations regarding relationships with others ; these expectations are encoded, on an unconscious level, in the right brain.

Right Brain Therapy And Self-Esteem :

Those with complex PTSD also frequently have significant problems in relation to their sense of self-esteem and therapy for this, too, is also likely to be especially effective when it concentrates upon the right brain. Again, according to psychodynamic theory, this is because the foundations of our self-esteem are (and it is worth repeating) acquired in our first two years of life and are encoded, on an unconscious level, in the right brain.

It follows, therefore, that if our interactions with our primary caregiver in the first two years of our lives are dysfunctional in a way that leads us to believe others do not regard us as of value and worth, we are at high risk of developing into adults who have an ingrained, deeply embedded, unconscious set of negative expectations with regard our relationships with others and our self-esteem.

In other words, such poor expectations regarding our relationships with others and low self-esteem have their foundations in a set of unconscious beliefs, stored in the right brain, that were laid down during the first two years of our lives.

Right Brain And Our Sense Of Safety :

Another feature of complex PTSD is that of a constant feeling of being unsafe and under threat. Research conducted by Schorre (2003) suggests that the sense of how safe, or unsafe, we feel is largely dictated by the right brain.

How Does Right Brain Therapy Work?

Right brain therapy can work by modifying behavior patterns encoded on an unconscious level in the right brain.

Right Brain And Implicit Memory :

Memories stored in the right brain before the age of about two years are known as IMPLICIT memories. This means we are unable to articulate them in words as they are not stored at a linguistic level. Therefore, such memories can only make themselves known to us in ways that are non-verbal (e.g. via our feelings, body sensations and mental imagery).

However, when these memories are triggered and give rise to these feelings, body sensations and mental images we are unaware of their origin for the very reason that they derive from these unconscious/implicit memories in the right brain.

Only right brain therapy then, that can modify these implicit memories on an unconscious level, may be truly effective as left brain therapy, relying on language, is unable to effectively connect with such non – linguistically stored memories.

Examples Of Right Brain Therapy :

These include :

– Art therapy

– Play therapy

– Hypnosis

– Mental imagery

David Hosier BSc Hons; MSc; PGDE(FAHE).

 

Complex PTSD Treatment

Complex PTSD treatment

What is the best complex PTSD treatment?

The NHS (UK) recommend that those suffering from complex PTSD undergo three stages of treatment. These are as follows :

1) STABILISATION

2) TRAUMA-FOCUSED THERAPY

3) REINTEGRATION

Let’s look at each of these a little more closely :

REINTEGRATION

NHS guidelines suggest that during the first stage, stabilsation, the individual being treated for complex PTSD may wish to focus on:

– redeveloping an ability to trust others

– reestablishing an emotional connection with friends and family

– learning to live in the present again (as opposed to staying trapped in the past ). This normally involves learning to feel safe again and reducing the level of fear that traumatic memories have hitherto provoked (often manifested in the disturbing form of nightmares and flashbacks).

The aim of this first stage of treatment is to improve the individual’s level of functioning to the point whereby s/he is able to start functioning again on a daily basis, no longer paralysed by anxiety.

TRAUMA-FOCUSED THERAPY

These include :

(The importance of engaging with an appropriately trained and experienced professional if considering these treatments is emphasized.)

REINTEGRATION

  • i.e. reintegration into society and the development of improved, more trusting relationships with others (one of the hallmarks of complex PTSD is to avoid others and self-isolate, leading to a vicious cycle driven by operant conditioning and loss of confidence).

What About Medication?

In cases whereby psychotherapy is not helpful or appropriate, the NHS (UK) suggest that antidepressants may be of benefit to some individuals.

Links :

For those who would like extremely detailed information relating to ISTSS ‘s guidelines for the treatment of complex PTSD, it is possible to download the relevant PDF from this here.

The main NHS (UK) website can be found by clicking here.

eBook :

The above eBook is now available from Amazon for instant download. Click on image or here.

 

David Hosier BSc Hons; MSc; PGDE(FAHE).

 

What Is Clinical Hypnosis?

what is clinical hypnosis?

What is clinical hypnosis? In the hypnotic state, the individual becomes extremely relaxed and has an increased ability to concentrate and focus which, in turn, can allow him/her to become more receptive to, and respond more positively to, therapy.

Hypnosis, per se, is not a therapy, but, rather, a tool that can increase the effectiveness of therapies administered to the individual whilst that individual is in hypnosis.

When hypnosis is used in this way (as a medium through which other therapies are delivered), it is referred to as hypnotherapy or clinical hypnosis.

Therefore, a person is not actually treated with hypnosis, but, rather, whilst in hypnosis.

Why Might A Therapy Be More Effective When Received In The Hypnotic State ?

It has been theorized that when in hypnosis the individual enters a state of altered consciousness (see below) that, temporarily, dampens down the activity of the conscious/rational parts of the brain which, in turn, allows the therapy being received greater access to the subconscious and, therefore, makes it more likely to help the individual overcome dysfunctional thoughts, feelings and behaviors.

Hypnosis And Brain Wave Studies: 

When in hypnosis, there is increasing evidence to suggest the individual has entered an altered state of consciousness. For example, there are three types of normal consciousness :

  • rapid eye movement (REM) sleep (dreaming)
  • non-rapid eye movement (non-REM) sleep (non-dreaming sleep)
  • being awake

By using brain scanning techniques to monitor brain activity it has been found that, when in hypnosis, the brain produces a different brain-wave pattern when compared to the brain wave patterns generated by each of the above three states of normal consciousness.

Which Therapies May Be Integrated With Hypnosis In Order To Augment Their Effects?

Hypnosis can be used as a tool to increase the effectiveness of various therapies and therapeutic techniques including the following:

  • cognitive behavioral therapy (CBT)
  • person-centered counselling
  • solutions focused therapy
  • cognitive analytic therapy
  • eye movement desensitization and reprocessing
  • therapeutic suggestions
  • exposure therapy
  • free association
  • physical and mental relaxation
  • exposure therapy

Those trained in the use of clinical hypnosis include some doctors, some psychiatrists, some psychologists, some dentists and some practitioners of various types of psychotherapy.

 

David Hosier BSc Hons; MSc, PGDE(FAHE)

 

 

Ego State Therapy For Treatment Of CPTSD

ego states therapy

EGO STATE THERAPY is an approach to treating complex posttraumatic stress disorder (cPTSD) and is sometimes referred to as ‘parts work.’

In particular, this therapy is designed to help treat symptoms of CPTSD which come under the headings of :

  • avoidance symptoms
  • intrusive symptoms
  • depressive symptoms

Let’s briefly look at each of these three types of symptoms :

AVOIDANCE SYMPTOMS :

These include avoiding places, people, events and situations which remind one of one’s past trauma. However, individuals often employ psychological defenses (usually unconsciously) as a way of avoiding accepting the reality of their childhood traumatic experiences; these psychological defenses include :

Finally, people who have suffered traumatic childhoods may use dysfunctional coping strategies to avoid their emotional pain which, in turn, can lead to addictions such as :

  • addiction to alcohol
  • addiction to drugs (both illegal and prescribed such as sleeping tablets and tranquilizers)
  • addiction to gambling
  • sex addiction
  • comfort food / carbohydrate addiction
  • excessive exercise
  • addiction to self-cutting / self-harm with short-term effect of relieving unbearable stress/anxiety

INTRUSIVE SYMPTOMS :

These include nightmares, flashbacks, hypervigilance, anxiety, feelings of aggression and irritablity ; such symptoms can also be categorized as high-arousal symptoms.

DEPRESSIVE SYMPTOMS :

These include despair, shame, inadequacy, unworthiness, hopelessness, helplessness and a sense of being trapped in a tormenting frame of mind, with no escape route (this is sometimes referred to as ‘learned helplessness.’
Feeling one has no hope is a particularly invidious symptom as it is known that feelings of hope, even when highly distressed over long periods, lowers the probability of suicide attempts; logically, therefore, the opposite holds true.

Depressive symptoms can also be categorized as low-arousal symptoms.

‘PARTS’ WORK :

Ego states theory involves a technique known as parts work.

Parts work is based upon the theory that as a psychological defense we unconsciously ‘compartmentalize’ different aspects of our personalities to enable us to ‘mentally partition-off’ the ‘parts’ of ourselves that we find unacceptable, and/or that contain intolerable memories, from the more acceptable ‘parts’ of ourselves that allow (at least a semblance of) day-to-day functioning.

These ‘parts’, or ego states, that hold we find unacceptable and/or hold distressing memories frequently reflect earlier developmental phases in our lives that occurred during our traumatic childhood and that are therefore related to traumatic memories.

How Can These Parts That Reflect Earlier Developmental Phases Manifest Themselves Now We Are Adults?

These parts may manifest themselves when we are under stress in the form of regressive behaviors.

For example, under extreme stress we may display child-like tantrums or behave in an aggressive, rebellious manner like that of a young teenager. Or, when upset, we may curl up on our beds clutching a soft toy.

Internalized Parts :

We may, too, possess ‘parts’ of ourselves that we have internalized from emotionally significant others (usually parents or primary-carers) during our childhood.

For example, if we had a parent who was highly critical of us when we were children, we may find we are prone to judging ourselves with a very unforgiving and self-lacerating attitude, constantly feeling that we failed to meet the exacting standards that we’ve set ourselves.

Or, if we had a parent / primary-carer who was highly religious and regarded us as fundamentally flawed and sinful, we may, as adults, find ourselves tormented by fears of ‘eternal damnation’.

INTERNAL FAMILY SYSTEMS (IFS) THERAPY:

IFS therapy is perhaps the most well known therapy to incorporate ‘parts work.’ It is based on the idea that the individual has three types of parts; these are as follows :

  • Exile parts
  • Manager parts
  • Firefighter parts

ego state therapy

Let’s briefly look at each of these in turn :

EXILE PARTS :

As the name suggests, these are the parts of ourselves that developed as a result of the damage done to our personalities by our childhood trauma and which we largely keep banished and cut off from conscious awareness / repressed / suppressed.

The exile parts are kept closed off from conscious awareness as a means of psychological self-protection as these parts contain distressing memories and painful emotions such as neediness/dependency, intense anger, grief, fear, shame, loneliness and vulnerability.

MANAGER PARTS :

These are the parts of ourselves that try to keep us in control and allow us to function on a day-to-day basis and keep extreme/distressing/counterproductive emotions at bay. Frequently, too, these parts are extremely self-critical.

FIREFIGHTER PARTS :

These parts attempt to protect us from the emotional pain the comes upon us when our exile parts start to break through and impinge upon our consciousness and behavior (as may happen,for instance, during periods of intense stress and/or when we are reminded – either consciously or unconsciously – of our childhood trauma).

However, they do this by causing us to behave in impulsive, and, in the long-term, self-destructive ways such as excessive drinking, abuse of narcotics, workaholism, risky, promiscuous sex, gambling and overeating.

Link :

To learn more about IFS therapy and how it works, click here.

EBook:

CPTSD ebook

Above eBook now available on Amazon for instant download. Click here.

 

David Hosier BSc Hons; MSc; PGDE(FAHE).

 

Effects Of Trauma Should Be Addressed Rather Than Its Events

addressing effects of trauma

According to J Fisher, PhD, Assistant Educational Director of The Sensorimotor Psychotherapy Institute and author of the book Healing The Fragmented Selves Of Trauma Survivors, it is of greater importance to address the effects of a person’s traumatic past rather than its specific events. Why should this be?

Sigmund Freud, often referred to as the ‘father of psychoanalysis’, originally treated his patients by helping them to remember, and piece together, their childhood traumatic experiences, the memory of which had been largely repressed.

The idea was that by talking about what had happened to them during childhood, and bringing their traumatic memories into conscious awareness, they would be able to develop a coherent narrative relating to their adverse experiences which would, in turn, alleviate their psychological distress and the symptoms pertaining to their early life trauma.

This kind of therapy is usually referred to as talk therapy or psychodynamic psychotherapy.

Possible long-term effects of childhood trauma

Above : Possible long-term effects of childhood trauma

However, various researchers (e.g. Herman, 1992) have highlighted the fact that many therapists who have adopted this approach to treating their traumatized patients / clients have found that these same patients / clients are made worse rather than better by this ‘talking cure’ strategy.

Specifically, it had been found that patients / clients, when treated in such a way, can become flooded and overwhelmed by the myriad implicit memories this form of therapy is prone, inadvertently, to trigger. To read my article about trauma and implicit (also referred to as non-declarative) memories, click here.

In her book, Fisher takes the view that, rather than bringing into conscious awareness the ‘full narrative’ of our childhood trauma and replaying it in its raw form until we can ‘face-up’ to it, it is more important to learn how to deal with the effects /symptoms of the trauma, such as learning to feel safe,  secure and relaxed in the here and now and to ameliorate present feelings of fear and panic.

Fisher recommends the following cutting-edge therapies for addressing the effects of trauma : mindfulness a based therapies, internal family systems therapy, sensorimotor psychotherapy and clinical hypnotherapy.

 

David Hosier BSc Hons; MSc; PGDE(FAHE).

Hypnosis : Why Some Throw Baby Out With Bath Water

hypnosis

Unfortunately, in the past, hypnosis and hypnotherapy have received a bad press. Why is this? There are, perhaps, three main reasons are :

– Stage hypnotists who claim they are using ‘hypnosis’ to induce volunteers from the audience to do absurd, degrading and demeaning things – in fact, such behaviour is more likely to be play acting or due to the pressure to ‘perform’ once on stage (i.e. compliance with the ‘hypnotist’s’ instructions rather than a genuine, hypnotic response).

– The use of hypnosis to ‘regress people into past lives’

– The use of hypnosis by poorly trained therapists to inadvertently instill false memories of abuse into their patients’ minds during attempted retrieval of ‘buried memories of abuse’ (hypnosis should not normally be used to try to unearth ‘buried memories’ from patients’ minds due to the patients’ high state of suggestibility whilst under hypnosis – to read my article about hypnosis and attempted retrieval of ‘buried memories,’ click here).

hypnosis

However, despite the above, it is important not to throw the baby out with the bath water when trying to ascertain the effectiveness of hypnosis and hypnotherapy.

Indeed, both the British and the American Medical Associations now recognize hypnosis and hypnotherapy as a valid treatment for psychological problems (for example, addictions, eating disorders and phobias).

There is also a growing body of scientific evidence to show how powerful the effect of hypnosis can be in bypassing our conscious awareness to have a profound influence on our thoughts, feelings, behaviours and beliefs. For example, individuals can be hypnotized to see black and white images as if they were in colour (click here to read my article about this experiment).

Other research has found individuals can use hypnosis to alter their body temperature and blood flow, as well as reduce their experience of physical pain (Casiglia, University of Padua, Italy).

Such studies suggest that hypnosis may be more than ‘just’ a highly focused and relaxed state and that, when hypnotized, something significant and special is going on in the brain which allows us to achieve things over and above what we can achieve using our non-hypnotized brain.

David Hosier BSc Hons; MSc; PGDE(FAHE).

 

 

Why Some Individuals ‘Bounce Back’ And Thrive After Trauma

thriving after trauma

I have already published many articles on this site showing how significant and protracted trauma during childhood can lead to the development of a complex form of post traumatic stress disorder in later life. But some ‘bounce back’ and even go on to thrive.

Interest in post traumatic stress disorder really took of in the 1980s and, during the 1990s, researchers noted that whilst post traumatic stress disorder shattered many lives, some individuals eventually found that their lives were enhanced following their traumatic experience. This may, at first, seem counter-intuitive, so I explain how this how positive transformation following trauma may come about.

Researchers O’Leary and Ickovics developed a categorization system to highlight the difference between individual responses to trauma. This system involved four categories :

Category One – Succumbed :

Those who had their ability to function in life devastated were said by O’Leary and Ickovics to have ‘succumbed’. (NB. this word is in no way a suggestion that individuals who who fall into this category are in anyway weak or deficient in any way whatsoever – after all, everyone’s life and ability to function can be devastated by trauma; nobody is immune).

Category Two – Survival With Impairment :

This second category represents those who, after their traumatic experiences, were able to resume some semblance of their former lives, but were not able to function as well as they had previously.

Category ThreeResilient :

This category comprises those individuals who were resilient enough to the effects of their traumatic experiences to carry on with their lives with a similar level of functioning to that displayed previously.

Category FourThrive :

Individuals in the fourth and final group were actually able to become more fulfilled in life, and function at a higher level, than prior to their traumatic experiences.

bounce back

Why Are Some Individuals Able To Bounce Back And Thrive As A Result Of Their Traumatic Experiences?

As one might very well expect, psychological researchers quickly became very interested in trying to discover just exactly what factors were at play that allowed some people to actually improve their quality of life as a result of their traumatic experiences.

Research carried out to date suggests that about seven out of ten people who have experienced significant trauma derive at least some benefit to their lives as a result.

Those who are more resilient are likely to benefit most from their experience of trauma. So what factors help to make a person resilient?

Factors That Help A Person To Be Resilient:

Research suggests that the following factors help a person to be resilient to the adverse effects of trauma :

– on optimistic nature

– a high level of self-esteem

– a sense of humour

– strong relationships / secure attachments with significant others

– the ability to be capable of trusting others

– a sense of one’s own control (psychologists refer to this as having an internal locus of control)

– a strong sense of self-reliance / self a sufficiency / perceived ability to cope / resourcefulness

– good interpersonal / social skills

In What Ways May People’s Lives Improve After Trauma?

First, the experience of significant trauma can help the individual to put the smaller problems in life into their proper perspective.

Second, because the love and support of others is so crucial to recovery from trauma, many come to more fully appreciate the vital importance of their relationships with others, which, in turn, can make them work harder to maintain and strengthen such relationships. (This may not be applicable to all trauma survivors, such as those with Asperger’s syndrome)

Third, by surviving significant trauma, many individuals gain a new sense of their inner strength in a similar way to how a person who gets through an SAS training course may gain a strong belief in their powers of endurance.

A final example of how a person’s life may actually be enhanced by surviving trauma is a greater appreciation of life in general, the development of a more helpful ‘philosophy of life’ and a strong desire to make the most of every single day.

David Hosier BSc Hons; MSc; PGDE(FAHE)

Does Trying To Relax Paradoxically Increase Your Anxiety?

Paradoxically, trying to relax can actually make some people feel more anxious and stressed, not less.

Indeed, when I was extremely ill and in hospital (I was hospitalized on several occasions due to the seriousness of my condition), I was encouraged to attend certain therapeutic classes (which, because I was almost catatonic with severe clinical depression and anxiety, I most resolutely did not want to do –  amongst other myriad other symptoms, I had no motivation whatsoever, together with an unshakable belief that there was no possibility at all of me getting even very slightly better (such thinking is almost universal amongst the seriously, clinically depressed).

However, I eventually agreed to attend a class in which the therapist tried to guide me (and the other patients who had attended) through a relaxation exercise. Just a minute or so into the exercises, I felt so overwhelmed by anxiety that I had to excuse myself and leave the room, seeking, instead, refuge in the smoking room where I chain-smoked innumerable cigarettes.

In fact, this such a paradoxical reaction to an attempt to relax is not especially rare – a small percentage of those with anxiety will react in a similar manner.

So, what is the cause of this paradoxical response? Several ideas have been proposed, and I briefly look at some of these below:

POSSIBLE CAUSES OF A PARADOXICAL RESPONSE TO ATTEMPTS TO RELAX :

  • Trying to relax and ‘let go’ of stressful mental activity can induce in some individuals a feeling of loss of control. Related to this is the phenomenon whereby some people feel that, if they stop worrying about things, something terrible will happen and that their constant worrying is therefore somehow ‘protective’. Psychologists sometimes refer to such mistaken belief systems ‘magical thinking’.
  • Fear of loss of identity – for some, being stressed (eg always busy, ‘driven’, ”keyed-up’ etc) forms part of their identity and they feel uncomfortable relinquishing this identity, fearing that if they do so others may see them as complacent, indolent etc rather than as the ‘dynamic’ individual they hope others perceive.
  • Brain wave activity – becoming relaxed correlates with a shift in brainwave activity from beta-waves to alpha-waves which may cause thinking to become cloudy, hazy and foggy; some individuals find this disconcerting.
  • Frustration – if we try to relax, and find we cannot immediately do so. this can lead to frustration which makes relaxation even more difficult; this can quickly develop into a vicious circle.
  • Fear – similarly to the above, we may fear we will not be able to relax (by thinking things like : ‘If I don’t relax soon, I’ll go completely and irreversibly insane’ – which was the kind of thing I used to think) thus putting too much pressure on ourselves. In this way, the fear that we will not be able to relax can rapidly become a self-fulfilling prophecy.
  • Depersonalization – relaxation techniques can lead to feelings of ‘depersonalization’ in some people. Depersonalization can manifest itself as feeling of being ‘detached from one’s body‘ or as being an ‘observer of oneself.’ Many find such a sensation unpleasant.
  • Derealization –derealization’ can manifest itself as a feeling that ‘the world is not real’ and more like a nebulous, hazy, dreamworld. Again, many find this unpleasant. (‘Dearealiztion’ is a type of ‘dissociation.‘)
  • Distraction – for some individuals, certain types of stress (such as always ‘keeping busy’) can operate as a distraction from problems and worries the person finds hard to face (in extreme cases, this may result in workaholism‘). In this way, the stress/’keeping busy’ works as a psychological defense mechanism – the sudden dropping of this defense may lead to the person becoming vulnerable to being overwhelmed by floods of previously suppressed anxiety.

In response to the problem of the possible paradoxical effect a small minority of individuals may suffer as a result of trying to relax, some hypnotherapists have been trained in technique of inducing what is referred to as an ALERT TRANCE which some may find to be helpful.

RESOURCES :

Related Post :

Fighting Anxiety Can Worsen It’. Why Acceptance Works Better.’

Click here to read.

eBook :

depression and anxiety

Above eBook now available from Amazon for instant download. Click here.

David Hosier BSc Hons; MSc; PGDE(FAHE).