Tag Archive for: trauma recovery

Why some develop PTSD and others don’t?

How can two people experience the same traumatic event, and yet have a different response to it?

We all agree that war, for example, is horrific; and yet not everyone develops PTSD. The VA says that 11-20% of vets develop PTSD. Why is that?

In order to understand that we need to look a bit at complex trauma. As a reminder, complex trauma is a repeated event that takes place over a longer period of time, often of an invasive nature and which has an interpersonal element, and has long-term effects. The interpersonal element means that someone trustworthy, a caregiver usually is the perpetrator. In that situation, trust is first and foremost impacted. When this takes place over a longer period of time, it affects children’s ability to form a healthy attachment (white paper from Cook, Ph.D et al., 2003).

In absence of a caring adult, who is able to model emotional behavior, to respond appropriately to the child’s emotional needs, and nurture the child, the individual tends to: feel uncertainty about the reliability and predictability of the world; have problems with boundaries; show distrust and suspiciousness; isolate; they may have difficulty understanding other people’s emotional states, understand other points of view, and enlist others as allies (resource: Domains of Impairment in Children Exposed to Complex Trauma by NCTSN).

In simpler words, when in early childhood, the caregiver who is supposed to be the model of behavior and source of safety is absent or unable to help the child regulate emotionally, the child learns that the world is not safe. Therefore, as an adult, the impact of a traumatic event is more significant, with a high potential for that to result in PTSD.

On the other hand, when children feel safe, the impact of a traumatic event is not as significant. Having a support system is very important in processing the event and mitigating the impact of it. A study done on children during World War II showed that those separated from parents and sent away to be protected from German bombing were affected far more than those who stayed with their parents in bomb shelters (van der Kolk, 2014).

So why is support important? Support here refers not only to the immediate family, but also to extended family, peers, and the larger community. When the interaction with members of one’s support system are positive, when children (and adults) have role models and are able to learn healthy ways to interact and to cope with difficult situations, then their ability to replicate that increases, which leads to an increase in their resilience.

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The Need for Certainty

How do I know if I am making the right decision? How do I know if I am on the right path?

Certainty. We all have this need. If you use the chakra system, it’s part of our first chakra; or if you like Maslow more, it is part of our basic needs: safety, security, the need to belong. Steiner also talks about this. Between the ages of 0 and 7 is when we learn that our world is safe and that we can depend on our caregivers. 

This has also been explored at length by the attachment theory. Developmental psychologist Mary Ainsworth, whose work has been instrumental in developing the attachment theory says that: “An infant whose mother’s responsiveness helps him to achieve his ends develops confidence in his own ability to control what happens to him.” (Note: the quote does say ‘mother’, but it really refers to the main caregiver.)

The “ability to control what happens to him” is what we define as having a sense of agency. When that doesn’t happen, the lesson we learn is that we are not enough and that our needs don’t matter. 

As adults, in our need for certainty and safety, we try to avoid pain. We think that if we can control our environment, our every step, we are able to do that. In reality, trying to control everything not only comes from pain, but it is also causing more suffering because it keep us from finding another way, a better way to live our lives.

So we want to see the whole path ahead of us until the end, before we make a decision, to know whether it is the right thing to do. Well, even if that can be possible on paper – s.a. I go to school, I get a job, I pay my loans etc – this path is rarely a straight line. 

So, what do we do then? Do we get stuck in calculating every possible outcome? Do we get stuck because we can’t see the end result? Or do we just take one step, as uncomfortable and uncertain as it may be? 

I took the picture above one morning and it made me think that Mother Nature always has a metaphor for us. Certainty is like walking or driving in the fog: you can’t see all the way until the end of the street, but it’s always clear a step ahead of you. And as soon as you take another step, another one unfolds. 

I found this poem the other day and I think it fits this topic perfectly:

“My grandmother once gave me a tip:
In difficult times, move forward in small steps.
Do what you have to do, but little by little.
Don’t think about the future or what may happen tomorrow.

Wash the dishes.
Remove the dust.
Write a letter.
Make a soup.

You see?

Advance step by step.
Take a step and stop.
Rest a little.
Praise yourself.
Take another step.
And then another.

You won’t notice, but your steps will grow more and more.
And the time will come when you can think about the future without crying.”

Author: Elena Mikhalkova 

That one step at a time is the sense of agency we are talking about in trauma recovery. You might not be able to control everything, but you are able to control this next step. So if you are looking for certainty, that relies in taking the first step.

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What’s the greatest expression of myself that I can be today?

I was listening to an interview with Joe Dispenza and he mentioned this question in one of his answers. I loved it! Read it again and see how it feels in your body. Do your shoulders move forward as a sign of protection, or do you feel yourself standing up straight? Does it feel like a sigh of relief or more pressure?

For me, it feels like a release. Like a permission that I can give myself to release the pressure of all the “should’s” that my mind comes up with. 

In tough moments like the recent events in the U.S., we might feel like we don’t know what to do; and maybe we feel like we “should” be doing something. 

While action is certainly needed, not knowing what the “right” action and what the effect is long term can be daunting. So, the invitation is to go back to this question and ask yourself (and myself included): 

“What is the greatest expression of myself that I can be today?

Then we can look at putting one foot in front of the other, and start there. Step by step, and eventually the whole road will appear ahead of us. 

But for now, let’s go with the highest expression and with today. That means that we are doing our best and there is no need for “should’s”, pressure, attachment, or judgment. And tomorrow is another day.

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Have you ever been called “sensitive”?

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Years ago someone called me an empath. I was like “what is that?!” Back then, it wasn’t a mainstream term. Even as I am typing this, my computer still insists on automatically changing “empath” to “empathy”. All I could find at the time was that an empath was a sensitive person. OK, I had been told I was “sensitive” and “too sensitive” since I can remember…so? Then I learned that an empath was someone who could easily feel other people’s emotions. Ohhhh…

For a while, I felt special and validated that someone called me an empath. All those times when I felt bad about being called sensitive like it was a bad thing. Now look at me, I could feel someone else’s feelings, sometimes before they could even make sense of them themselves. How do you like me now? I thought. But it’s not all as glamorous as it seems to be. 

Empaths make really good teachers, nurses, therapists…you get the idea, the caregiver type. So what do caregivers usually do? They take care of everyone else, put the needs of others first, take on everyone else’s problems, sometimes to the point of burning out. 

My husband asked me the other day whether someone is born an empath. As much as I would like to give the credit to the Universe for this ability, most empaths – and I say most because I don’t like to generalize although my personal belief is that this is true for all empaths – have suffered trauma, especially childhood trauma.

When you experience trauma at a young age, your survival depends on your ability to stay safe. For that to happen you learn to recognize very quickly any sign of danger. Your brain is constantly scanning for any deviation from the baseline: a change in the caregiver’s tone of voice, how heavy the footsteps are, how fast someone is walking, what words they say or not say, any movement in their eyes or whether someone speaks or not etc. That’s how you decide how to respond to the situation in a way that ensures your safety.

Just like any other skill, after years of practice, you become really good at it. And you take this skill with you into adulthood. People will come to you to tell you their life’s story or to get advice. Also, you might draw narcissists into your life because…well, darkness cannot exist without light.

If you think or know that you are an empath, then you probably also like being close to the water. Water purifies and clears the extra energy that you carry. If you don’t live close to a beach (and let’s face it most of us don’t) then I recommend showers to release the stress and energy you don’t need. Place your hands on the ground. Walk barefoot outside. Hug a tree (c’mon it’s a thing now, no one will make fun of you!) Spend time in nature or with animals. Watch movies that make you laugh.

In a word, take care of yourself first.

Photo by Yoann Boyer on Unsplash

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Do you think it can get better?

Do you believe that it can get better? 

This was one of the best questions I’ve heard in my life! It stomped me by how simple and yet revealing it is. In my 40+ years, I’ve seen plenty of health practitioners and no one, NOT ONE, asked me this question. And here I was, talking to my acupuncturist and she asked me: do you think it [i.e. my health] can get better? 😳 I paused and thought “Holy crap!” 

How we think about life is what we get out of life. No, none of us asked for difficult things to happen, and yet, how do we look at them? Is it something that happened to us or something that defines us? 

Think about it. Have you ever talked to someone who’s always overworked, over scheduled, who’s always responding to things because “it’s always something” as if they can’t do anything about it? Why do you think that is? Let me share a short story with you.

Some time ago, I was talking to a potential client and they knew more than I could possibly ever know about their condition. They’ve done their research, they’ve been living with it since childhood so they had all the information they needed. Even more than they needed. They came to me for help, and yet every suggestion I made was met with a variation of “that’s never going to work for me”. And you know what? They were right and I told them that. It was never going to work because they didn’t believe that it could get better. And that’s fine. At that time they were not ready for it to get better or they did not need it to get better. What they needed was someone to listen, to empathize. So I did just that, because that’s what they needed.

The point of the story is that when we are ready for things to change, they can change. The first step is in our conscious mind. Then the subconscious will make it happen. So what do you say? Do you believe that “it” can get better? Whatever your “it” is…

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Study: Trauma Center Trauma-Sensitive Yoga as effective as CPT for PTSD

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Some people hear yoga and they think “ugh, that’s for fit people who are super flexible and can sit still to meditate. I can’t do any of those!” Some have maybe attended classes which were labeled trauma-sensitive yoga only to feel triggered and not safe. Or maybe you were one of the people who at some point thought, how can yoga help, it’s not therapy?! To all of that, let me say 3 things: 1) yoga is for everyone; 2) not all classes and practitioners are the same, so find the right one for you and 3) trauma-sensitive yoga is an evidence-based, adjunct treatment for PTSD, meaning it is an alternative or complementary treatment to therapy. 

Before I share a recent article which was published by Emory University regarding TCTSY (trauma center trauma-sensitive yoga), let me say this: Hi, I am Simona and I have suffered from PTSD. I have used (and have been using) TCTSY not only for my clients, but also with myself. How did it help me?

  • I regained a sense of power and agency and I don’t feel helpless anymore.

  • I know that when I am triggered that it is only temporary and that I have the tools to stay present. 

  • I sleep better.

  • I feel safer and am no longer afraid of the “other shoe dropping”.

  • I am still aware of my surroundings but no longer hypervigilent.

  • I can respond to situations instead of reacting. 

Now here’s something that just came out this week and I am happy to share with you. As a certified trauma-sensitive yoga facilitator (TCTSY-F) who works with veterans with PTSD, I am glad to see this method not only highlighted as an evidence-based, peer reviewed adjunct treatment, but also the subject of a recent study by Emory University, which shows how effective it is. I see it every day in my practice. Proud to do this work and be able to support our vets! See the highlights from the article below and the full article here, or click on the picture above.

“Post-traumatic stress disorder (PTSD) is a sizeable issue in the United States military, affecting approximately 20 percent of all Veterans. Among women, the primary cause of PTSD is sexual abuse or harassment by colleagues while on active service—and it is common. Research suggests as many as one in four servicewomen experiences sexual assault, while more than half are victims of sexual harassment.

Until now, the standard treatment for female Veterans with PTSD has been cognitive processing therapy (CPT), a science-based approach that teaches patients practical tactics to help challenge or neutralize negative thoughts tied to their trauma. Seen as the “gold standard,” in PTSD treatment by the Department of Defense and the Veterans Heath Administration, CPT has its merits, but also flaws. Researchers find more than half of female Veterans enrolled in government-backed CPT programs drop out of treatment. Half of those who complete treatment report continued PTSD symptoms.

The early results tell a clear story. Working with colleagues from Emory University and the Atlanta Veteran Associate Health Care System, Kelly has found empirical evidence yoga can be just as effective as CPT in the treatment of PTSD.

Not only that, the study shows TCTSY delivers positive results considerably faster than cognitive therapy; and that more than 60 percent of patients are seeing the treatment through to completion compared to just 34 percent of those in cognitive therapy programs.”

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We never know how high we are till we are called to rise

This time of the year we usually do a recap of what has happened this year, maybe our accomplishments or our dreams, etc. But this has been one heck of a year, hasn’t it?

We have all been affected by it, so in that regard, we are all in the same boat. Yes, perhaps you have heard that before. And yet, everyone has been affected differently, depending on our resources, financial, emotional, and physical. 

“We never know how high we are
Till we are called to rise;
And then, if we are true to plan,
Our statures touch the skies – “
Emily Dickinson

Even though these words were written in 1800’s, to me they never sounded more current and relevant than now. We’ve all been asked to dig deeper this year, so it’s possible to feel a bit depleted. A bit “over it“. However, if you are doing an inventory of 2020 and setting intentions for 2021, maybe consider this invitation to reflect on your “stature” this year.

We never choose to go through unpleasant experiences. If someone asked you if you wanted to grow spiritually or become stronger, or more resilient, you’d probably say, “yeah, that would be useful”. But then if you were told that you’d have to go through a situation that will test your patience, your limit, and deplete your resources in order to expand, maybe you’d say “no thanks!” 

Almost nine years ago I experienced one of the most difficult losses of my life and the circumstances made it even more difficult. I felt like I was spinning, losing control, and I remember the pain of my grief being so unbearable that one day I literally felt that I couldn’t breathe anymore. I was on the floor, in my home office, and was not able to move. At that moment, I thought that I was never going to be able to move again. 

What I didn’t realize at the time was that in that moment I was both dying and rebirthing. I had to fall to the ground, literally, in order to shed my shell and start growing. That experience wasn’t something I wished for and yet, now that I am on the other side of it, I am grateful for the lessons that it brought to me. I am not saying that I am grateful that it had to happen that way, I don’t think anyone wants to go through hardship, but I am grateful for my lessons, because without this experience and everything that I learned going through it, I would not be who I am today. 

I learned that I am stronger than I ever thought I could possibly be, and also that I am never alone, not even in that experience. Whatever experience you may be going through or have been going through, while it is unique to you, there’s always someone that can help or that can relate to it. So find that someone.

So now, as you are reflecting on this one-heck-of-a year, do you see how you’ve grown? How much stronger you are? How much more resilient you are? “We never know how high we are till we are called to rise;”

Thank you to everyone who has worked with me this past year, everyone who reads these notes from the heart, and I wish you all a healthy new year!

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NEW COURSE: How to Make Your Practice Trauma-Sensitive

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We created How to Make Your Practice Trauma-Sensitive, based on our experience as practitioners trained in trauma and working with trauma survivors. We think that this work is so important now more than ever, and we want to support other practitioners and organizations in their mission to help trauma survivors, by offering practical tools that can be applied instantly.

We start with trauma theory and then go into what makes a practice trauma-sensitive. Everything from the recovery process and establishing safety, to language, environment, and how to support your clients when they get triggered.

If this sounds like something you would benefit from, please check out the course page for details. Pre-orders get 20% off with code “trauma-sensitive” until 12/7.

We hope you find it helpful and if you have questions, we are here for you! Also, if you know anyone who could benefit from this, feel free to share with them. Or if we can speak at your organization, event, or podcast, let us know. We love this work and more than that we want to support other practitioners and organizations to do it, so help us spread the word!

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Self-Care Lessons I Learned from a Puppy

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Yes, we have a new family member…Meet Qi (or Chi), sometimes called Chewie for reasons you can probably suspect.

This little fur ball joined our family a few weeks ago and changed everything! That cute face can make anyone let their guard down and forget that you need to be the one setting the tone in the house.

They say that when the student is ready the teacher will appear. I can’t say that I was ready, but I definitely learned some lessons quickly.

Lesson 1: Prioritize sleep!
It’s been a while since we had a baby in the house so I forgot how important sleep is for us. We had to shift our schedule around and prioritize sleep for everyone, so that we can be resourced enough for the next day. Getting enough sleep is the different between a “bad day” where any interaction is a trigger, not to mention additional stress and calories (did you know that when you sleep less than what you need, you tend to eat 500 calories more a day? Also, sleeping 5 hours a night has the same effect on the brain as being drunk?) and a day when you feel resourced enough to handle life.

Lesson 2: Establish boundaries
Oh, how many times did you find yourself in a situation – whether attending an event you didn’t have the energy for or helping someone when you were depleted – because you had a hard time saying ‘no’? Well, having a puppy – yes, even a cute one like this one – definitely challenged my ability to establish boundaries. To a puppy, ‘no’ means nothing at first until you make it clear that it actually means what you said.

Lesson 3: Be short, clear, and firm
Part of establishing boundaries is being short, clear, and firm. But first, you need to know your limit, check in with yourself to understand what you need, and then saying it clearly and firmly, while keeping it short, with no need to over-explain. Keep the focus on yourself by stating what is true for you. Remember that event you did not want to attend? Next time, you can say “I appreciate the invitation and it sounds great, but right now I need some time for myself.” Short, clear, and firm.

Lesson 4: Practice, practice, practice
This is pretty self explanatory, but sometimes we can be tough on ourselves when we don’t do it “right”. The point is not to do it right, but to practice. Any skill takes time. At first it might feel awkward and then, it can feel empowering.

My learning continues…and so does my work. Next week, I’ll share some news! In the meantime, take care of yourselves and please reach out if you need support!

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