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How to Find the Right Therapist

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Transcript

How do you find the right therapist for you? The first thing to know is that there is no single right way to approach therapy for PTSD. In fact, there are quite a few different approaches, and I'll speak about a few of those here. Importantly, fairly therapy for trauma usually has three stages. The first of these stages is what we call the preparation stage. At this point, it's about finding a therapist that you feel safe with, that you have a relationship with, and developing the resources that you need to be able to turn toward the difficult event, the painful emotions, the sensations that you haven't been able to tolerate, and to be able to know that you can go toward that without becoming overwhelmed.

The second stage of trauma processing is actually working Through the memories themselves, talking about the traumatic event, writing about it, processing through the emotions and because trauma is not all in your head working through the physical experience related to that traumatic event. The third stage of healing from PTSD involves integration. At this point integration asks you to take away what it is that you learned from that processing stage, and bring that back into your life. This can be incorporating a new sense of self into your identity into your relationships into your workplace into who you are as a parent, as you attend to your children, or who you are as a spouse. This might also involve a new sense of self and capability for the future. For example, if you experienced yourself as maybe never being able to find a meaningful relationship, to come away, saying, you know what, I'm ready now.

I'm ready to go seek that and have that for myself in my life. Maybe you thought after the loss of a child that you could never go back forward and have another child, and after that trauma processing, you might be ready to proceed for. What can be surprising about the integration phase of trauma healing, is that at that stage, it's common for grief to show up, attending to your wounds once you have addressed them, and mourning the losses that you have faced is a very important piece. therapists in the treatment of PTSD often use a variety of different approaches. The first that I'd like to speak to is cognitive behavioral therapy, or CBT. CBT is a way of working with those inaccurate thoughts that we spoke about earlier, the way that you might have misattributed blame on yourself or a sense that because you weren't safe then that you might not be safe in the future.

Sometimes we carry beliefs in the world such as I am not enough, I am too much I'm unlovable. We want ways to work with and challenge those inaccurate beliefs and replace them with more positive, life affirming beliefs about ourselves and the world. When that doesn't get addressed, we can carry those negative beliefs and they can color a sense of self now, a sense of your current life and a sense of what's possible in your future within CBT. A common way that you will address trauma is to talk about it, to write about it to review the traumatic event. Sometimes this is referred to as exposure therapy. And it's a way to challenge yourself to think about what you have been avoiding, and to work through the thoughts and feelings that come up in that process.

Some people find that CBT exposure therapy can be a little too direct and a little too fast and can sometimes feel re traumatizing in the process itself. important to know your pace and what's right for you. A related form of therapy to CBT is what is called EMDR therapy. EMDR stands for eye movement desensitization and reprocessing, like CBT EMDR will also involve turning toward the traumatic event. However, there's a tremendous emphasis in the first phase of preparation, where you will learn the resources necessary before you begin the exposure process and desensitization. Another aspect that's unique to EMDR therapy is the use of bilateral stimulation.

Bilateral stimulation involves the movement of eyes from left to right and back. Or sometimes bilateral stimulation can be accomplished by holding tactile pulsars or tones that go back and forth in the ears. The purpose of the bilateral stimulation is to mimic the way that the brain naturally processes traumatic events, or are life events in general, if you think about REM sleep and the rapid eye movement of eyes from left to right, bilateral stimulation will mimic that action. In addition, bilateral stimulation relies upon a foundation of what we call dual awareness state. Dual awareness means that we are keeping one foot in the present knowing I am safe now I'm feel comfortable with my therapist. I know that this room is a very safe place to talk about a difficult event, and we're turning toward the unsafe moment of the past the traumatic event.

If we get to fi in the past, then it is more likely that you will feel flooded or re traumatized by talking about the traumatic event. However, keeping yourself grounded in the present moment makes that process safer, and for many people an easier way to approach it then the direct exposure of CBT another approach to working with PTSD that's becoming increasingly common in the field right now is somatic psychology. somatic psychology understands that the brain alone, the mind alone is not sufficient to process the experiences of a traumatic event. Because the experience is felt somatically it's felt in the body, it's felt as sensations that are uncomfortable or even intolerable. And so we need ways to be able to work with that actively. From a resourcing perspective, somatic psychology invites you to work on grounding, the ability to feel safe and relaxed in your body.

Now, this becomes a reference point, especially for people who have experienced childhood trauma where their entire life is one of lack of safety, one of being in that fight, flight or activated situation, there might not be a sense that there's another way to live, that there is an alternative so being able to access a sense of grounding and relaxation in the body can be fundamental in the process of healing. In addition, somatic psychology can help you work through traumatic events by accessing how it feels in the body and finding some healing movements that allow you to move that through and out. In somatic psychology, this is referred to as sequencing. Often the impact of traumatic events is held in the core of the body, we might freeze and feel all of the tightness in the belly, in the chest, in the throat in the head. However, we need our arms and legs to allow that to move all the way through us.

So sometimes when we're working through a traumatic event, the arms will start to tremble and shake or the legs will do the same. If you start to feel that kind of trembling in your jaw, your arms or your legs, that is a sign that the trauma is releasing, and rather than being afraid of it, either invite you to let that happen to know that that's a sign that you feel safe enough to release. Now, another fundamental principle introduced by somatic psychology is the idea of titrate. titration is actually a scientific term that says that when you add just a little bit of a chemical to a mixture, you want to observe the small impact of that. And it's the same way with healing from trauma. If we try and go for the entire event all at once again, you might feel flooded or overwhelmed.

What we want to do is approach a little bit at a time, let your nervous system accommodate that, integrate that in notice how attending to just a small amount of that traumatic event feels and allow yourself to come back to that sense of safety and being grounded. Sometimes this is also referred to as pendulum motion. And we'll use this actively to pendulum a between that sense of I'm safe now to I wasn't saying Then and how do I feel that in my body and then once I feel a little bit of that, I come back to I'm safe now, how do I feel that in my body so that we have a reference point for healing

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