Day Three

Trauma-Informed Psychotherapy &  Somatic Experiencing Therapy

Somatic Experiencing Therapy addresses core nervous system functioning. It resolves stuck symptoms of past adverse events that remain in non-cognitive regions of the brain, such as; relational or shock trauma. A somatic approach allows us to get more and more settling with every session around the felt-sense of our physical restrictions and emotional contractions.

Agenda - Day Three

9:00 – 10:00

Introductions, Expectations & Experiential Exercise

Check-in

10:00 – 11:00

Common Therapy Approaches to Intergenerational Trauma / PTSD

11:00 – 11:15

Break

11:15 – 12:15 PM

Internalized Oppression  /  Five life tasks / Five Natural Emotions

12:15 – 1:00

Lunch

1:00 – 3:00

Meditation/Breathing/Grounding/ focussing

The Split Self

Experiential Seeking Safety group

3:00 – 3:15

Break

3:15 – 4:00

Individual check-in

Feedback and a Brief Evaluation of the Day

Common Therapy Approaches to Trauma / Intergenerational Trauma

Trauma can also be the direct result of colonization/historical. Colonization has been defined as “a process whereby one group of peoples assumes control over another group of people” (Blue Quills First Nations, 2011). Historical trauma has been defined as “a collective complex trauma inflicted on a group of people who share a specific group identity or affiliation- ethnicity, nationality and religious affiliation. It is the legacy of numerous traumatic events a community experiences over generations and encompasses the psychological and social responses to such events” (Evans-Campbell, 2008). In Canada the legacy of colonization and historical trauma involved the use of residential schools and separating children from their parents, communities and cultures. This could also include genocide that countries such as Rwanda and Dafur have experienced. In addition the Holocaust would be another example of a historical trauma.

Pharmacotherapy

Pharmacotherapy is the use of medications to manage disruptive trauma reactions. Medications have been shown to be helpful with the following classes of reactions/symptoms:

  • Hyperarousal
  • Emotional reactivity
  • Heightened arousal
  • Irritability
  • Depression
  • Intrusive symptoms

Taking medication does not make one’s trauma reactions and pain evaporate. Medications can only help make the symptoms less intense and more manageable.

If you decide to use medications, consult a psychiatrist and continue working with that psychiatrist for as long as you take the medications. Inform the psychiatrist of how the medications are impacting you. Some medications have side effects that may or may not be tolerable to you, and some people do not respond favorably to medications. Medications are most effective when individuals pursue therapy concurrently.

Behavior Therapy

The most common form of behavior therapy is exposure. In exposure therapy, one gradually faces one’s fears–for example, the memories of a traumatic event–without the feared consequence occurring. Often, this exposure results in the individual learning that the fear or negative emotion is unwarranted, which in turn allows the fear to decrease.

Exposure therapy has been found to reduce anxiety and depression, improve social adjustment, and organize the trauma memory. There are various forms of exposure therapy:

  • Imaginal exposure: An individual imagines the feared event as vividly as possible.
  • In vivo exposure: The exposure occurs in the therapy.
  • Systematic desensitization: The individual is exposed to successively more fear-inducing situations. This exposure is paired with relaxation.

Exposure therapy is a highly effective treatment for posttraumatic stress (PTSD).

Another form of behavior therapy is Stress Inoculation Training (SIT), also known as relaxation training. Stress Inoculation Training teaches individuals to manage stress and anxiety.

Cognitive Behavioral Therapy

Cognitive behavioral therapy (CBT) is grounded in the idea that an individual must correct and change incorrect thoughts and increase knowledge and skills. Common elements of cognitive behavioral therapy trauma therapy include:

  • Teaching individuals how to breathe in order to manage anxiety and stress
  • Educating individuals on normal reactions to trauma
  • Exposure therapy
  • Identifying and evaluating negative, incorrect, and irrational thoughts and replacing them with more accurate and less negative thoughts

Eye Movement Desensitization and Reprocessing (EMDR)

Therapists who perform EMDR first receive specialized training from an association such as the EMDR Institute or the EMDR International Association. An EMDR session follows a preset sequence of 8 steps, or phases. Treatment involves the person in therapy mentally focusing on the traumatic experience or negative thought while visually tracking a moving light or the therapist’s moving finger. Auditory tones may also be used in some cases. Debate regarding whether eye movements are truly necessary exists within the field of psychology, but the treatment has been shown to be highly effective for the alleviation and elimination of symptoms of trauma and other distress.

Hypnotherapy

There is no one guiding principal for hypnotherapy. In general, a hypnotherapist guides the individual in therapy into a hypnotic state, then engages the person in conversation or speaks to the person about certain key issue. Most hypnotherapists believe that the emotions and thoughts that an individual comes into contact with while under hypnosis are crucial to healing.

Psychodynamic Therapy

The goal of psychodynamic trauma therapy is to identify which phase of the traumatic response the individual is stuck in. Once this is discerned, the therapist can determine which aspects of the traumatic event interfere with the processing and integration of the trauma. Common elements of psychodynamic therapy include:

Taking the individual’s developmental history and childhood into account
Placing emphasis understanding the meaning of the trauma
Looking at how the trauma has impacted the individual’s sense of self and relationships, as well as what has been lost due to the traumatic event

Group Therapy

There are a variety of different groups for trauma survivors. Some groups are led by therapists, others by peers. Some are educational, some focus on giving support, and other groups are therapeutic in nature. Groups are most effective when they occur in addition to individual therapy. It is important for a trauma survivor to choose a group that is in line with where one is in the healing journey:

  • Safety/victim phase: Choose a group focused on self-care and coping skills.
  • Remembering and mourning/survivor phase: Pick a group focused on telling the trauma story.
  • Reconnection/thriver phase: Join a group that aims to create connection with people.
  • Educational groups are appropriate during all phases.

Any therapist, regardless of which type of therapy she or he works from, desires to help you grow and heal through your traumatic experience.

Together, you and your therapist will strive to acknowledge and identify:

  • Where you are at in your healing journey
  • Who you would like to be and what you would like to be doing when you enter into the thriver stage
  • How you can get to that place from where you are now
  • How to guide you through this healing work

As always, reach out for help and know that you do not need to go it alone.

SHAME

“For I can see that
in the midst of death, life persists
in the midst of untruth, truth persists
in the midst of darkness, light persists.”
Gandhi

The experience of shame—a feeling of being unworthy, bad, or wrong—can be extremely uncomfortable. Shame has the potential to change the way we see ourselves and may lead to long-lasting social, professional, and sexual difficulties and also affect other areas of life.

According to renowned psychiatrist Carl Jung, “Shame is a soul-eating emotion.” Simply, shame feeds on itself. Shame survives in the darkest recesses of one’s insecure, self-loathing and self-doubting mind. Shame needs fear and negativity to survive.

The word “shame” may mean different things to different people, and shame is different from guilt and embarrassment: Guilt is usually understood to involve negative feelings about an act one has committed, while embarrassment deals with a societal reaction. Shame, on the other hand, involves negative feelings about oneself, and although peers or society can shame an individual in general, shame can also be experienced secretly.

Shame may serve a social function, especially in shame cultures such as Japan, by encouraging negative emotions as a consequence of certain behaviours, such as breaking sexual taboos, insulting a group member, or disobeying a traffic law. In a shame culture, an individual's fear of being shamed by society may prevent him or her from transgressing, as only time can repair the individual's offense. This differs from guilt cultures, in which an individual can generally atone for their wrongdoing with some form of penance.

Where Does Shame Come From?

Chronic shame usually originates in childhood, and uncovering the experiences that led to shame can help relieve it, as can engaging in new experiences that foster a sense of goodness and worth. Shame is sometimes rooted in experiences of a sexual nature that were, in the child’s perception or understanding, not accepted by or acceptable to adults. In other words, children who engage in sexual activities at a young age or who were abused sexually may develop a sense of shame about their role in these acts, especially if adults shame them on purpose or do not take steps to reassure them of their blamelessness in these acts and their innocence in the abuse.

Some level of shame often reveals itself in people engaged in therapy, and becoming aware of shame is generally the first step towards working through it.

Experiencing Shame

Shame may last a brief time, or it may be a core experience of the self. For some people, feelings of shame may begin in childhood and continue well into adulthood. These individuals may be conscious of such feelings, and they may also experience depression or some form of anxiety as a result. They might also be unconscious of the shame and hide it under a mask of narcissism or extreme behaviours, such as addictions or episodes of anger. Shame can also lead to the development of self-harming behaviours and eating disorders.

Living with shame can be painful and difficult, as it can prevent people from meeting core needs, such as the maintenance of self-esteem, hope for the future, friendship and intimacy, productivity, and love.

How Therapy Can Help with Shame

Therapy can help people overcome feelings of shame by providing a healthy and objective perspective of the situation that causes them to feel shameful. People who have been abused, victimized, or harassed often feel shame to a significant degree. Life circumstances such as job loss; infidelity, divorce or even problematic children can cause someone to struggle with intense feelings of shame. Regardless of whether the shame is self-induced or the result of someone else’s actions, overwhelming shame can affect every area of a person’s life. Getting help for those feelings can provide freedom from shame.

Therapists can help people learn how to accept responsibility for their actions and put their shame and guilt into perspective. Additionally, therapists who work with survivors of abuse or those who feel ashamed of another's wrongdoing can help these individuals understand that they did not cause the trauma. This fundamental release of blame can help individuals to reach a point where they can liberate themselves from any negative effects shame, and conditions such as anxiety or depression that can result from it might have on their lives.

Feedback From The Group On Shame 

  • I was shamed in school by my teacher and was introduced to shame: I walked out of that school and said that I would never go back and I took my spirit back
  • To me shame is feeling deeply unloved and unworthy. There is a connection between shame and embarrassment. Many clients present with both
  • I believe that shame drains people and leaves them stuck and this leads to unhealthy behaviours
  • When people say that they feel ashamed they are feeling the depth of shame: it is beyond embarrassment
  • It’s a feeling of less than and it affects everything within us
  • It has to do with self confidence and self esteem: its more than self esteem and need to come from within
  • My partner had deep shame and I could see how it affected his relationship with the children
  • It’s a low sense of self
  • Its very deep in the core
  • I worked in a prison for women and they shared their shame, being incarcerated as Indigenous women: not being able to care for their children. We must find that language of gentle and loving-kindness to help out clients.

FIVE NATURAL EMOTIONS GIVEN TO US TO NEGOTIATE LIFE 

  1. GRIEF         repressed             Sadness and Depression

  2. FEAR          repressed             Panic and Anxiety

  3. ENVY          repressed             Jealousy

  4. ANGER       repressed             Rage and/or Violence

  5. LOVE          repressed             Possessiveness