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Thursday, August 12, 2010

Psychotherapy to Overcome Your Past Childhood Trauma

Many people avoid seeking psychological help for past childhood trauma because they fear that it will be too emotionally overwhelming for them. While it is understandable that someone with childhood trauma would feel this way, the emotional consequences of not dealing with past childhood trauma often far outweigh whatever emotional upset involved with seeking psychological help and overcoming the trauma.


You Can Overcome Your Fear of Dealing with Childhood Trauma
Emotional trauma, by definition, is overwhelming when it occurs, whether it is a single incident of trauma or complex trauma where there was an array of traumatic events.

Dealing with Trauma as an Adult vs. Dealing with Trauma as a Child:
When we're children and we experience emotional trauma, we don't have the emotional or cognitive abilities to cope. A child's emotional system can be easily overwhelmed by emotional trauma, especially if there isn't a competent and caring adult to help the child. Children often react to emotional trauma by dissociating the event (numbing themselves emotionally). They might become very quiet, and what's going on for them in their internal emotional world might not be apparent to adults. Other children who dissociate traumatic events might appear to be functioning at their normal level because they compartmentalize the event, and the effects might not surface until they are adults. Other children act out at home or at school, and this is a signal to parents and teachers that something is wrong, and the child needs help.

While it's true that a child usually lacks the ability to deal with emotional trauma, that same person as an adult usually have coping abilities that he or she didn't have to deal with the same trauma as a child. Often, adults who fear dealing with their childhood emotional trauma fear that they will feel as overwhelmed now as they felt as children.

The fear that dealing with their trauma will be too much for them is often an unconscious fear that they will feel the same feelings in the same exact way as they did when they were children. But, because it's an unconscious fear, what is usually overlooked is that the thing that they fear has already happened. In other words, there is no distinction for them in their internal emotional world that what happened was then and this is now. They might know on an intellectual level that "that was then and this is now," but they don't feel it emotionally.

In addition, adults who fear dealing with their prior childhood trauma often don't know that most psychotherapists who have an expertise in dealing with trauma have careful ways of working to help clients so they usually don't feel as emotionally overwhelmed as when these adults were children.

As a Psychotherapist, How I Work with Trauma:


Developing Internal Resources to Deal with Trauma
When I work with a client who has unresolved childhood emotional trauma, I usually start by making sure that this client has the emotional ability to deal with working through the trauma. As part of the early work, I assess for these capabilities.

If I find that a client lacks the internal emotional resources to deal with the trauma, the early work will be helping the client to develop these internal resources. Internal resources that allow clients to cope with whatever comes up are very important in trauma work.

An example of an internal resource would be the ability to calm yourself by going to a safe or calm place in your mind where you can relax and let go of overwhelming emotions. It's also important for clients to have external resources to help them cope, such as being able to talk to close friends and caring family members, meditating, going to yoga class or the gym or other helpful external ways to manage stress.

Working Gently and Effectively with Childhood Trauma
Also, when I am working with clients who have unresolved trauma, I usually work in a way where the traumatic experiences are titrated so clients are less likely to feel overwhelmed. This titration usually involves dealing with the trauma by working through manageable pieces of the trauma.

After clients have developed internal resources, if they begin to feel overwhelmed in session as we're working on the trauma, I help them to switch from the beginnings of that overwhelming emotion back to their internal resources until they feel safe enough to go back to dealing with the trauma. So, in other words, I help clients to "pendulate" between their overwhelming feelings to a calmer state.

The Negative Consequences of Not Dealing with Unresolved Trauma:
Whether we realize it or not, past unresolved trauma often has negative consequences in our lives. Depending upon the trauma, the following is a list of the negative consequences that people often experience when they do not work through their trauma in therapy:

People with unresolved trauma often suffer from higher rates of anxiety and depression as compared to the general population. Their anxiety or depression make it difficult for them to perform their daily activities of living and compromise their close relationships. This often results in loss of relationships or loss of jobs.

You Can Overcome the Depression and Anxiety Related to Unresolved Childhood Trauma
Untreated emotional trauma can result in fear of getting close to other people. This might mean that the people with unresolved trauma fear getting involved in intimate relationships or they are unable to form close friendships. They might keep people at a distance from them because of their fear of getting hurt again, which could cause them to feel lonely and sad.

Even when people with unresolved trauma do get involved in intimate relationships, they often, unconsciously, choose people who will be emotionally and or physically abusive to them in similar ways to how they were abused as children. This often happens repeatedly, even though these people might tell themselves that they don't want to choose abusive partners again.

People who have unresolved trauma often have higher rates of substance abuse problems, as compared to the general population. They often use alcohol or drugs to numb their overwhelming emotions.

Unresolved trauma often results in physical problems, including high blood pressure, headaches, asthma attacks and other medical problems. Even though people with unresolved trauma might not be consciously thinking about or remembering their trauma, their bodies "remember" the trauma in ways that make them sick physically.

Many medical doctors who are savvy about the mind-body connection and how trauma affects people on both emotional and physical levels will refer their patients for psychotherapy with psychotherapists who have an expertise in trauma. But many doctors are not knowledgeable about the mind-body connection, and they continue to treat their patients only on a physical level with medication. The medication, while important, is only treating the physical symptoms of trauma--it's not helping the patients to resolve the trauma.

People with unresolved trauma often feel less resilient so they have a hard time "bouncing back" from current problems. They're so overwhelmed with the old trauma that they haven't dealt with that new problems are often too much for them. So, other people, who might not know that a person has prior unresolved trauma, might think that this person is overreacting to current problems. They might not see that this person is reacting not only to current problems but that the unresolved trauma is getting triggered too. To outsiders, these people often appear to be behaving in emotionally irrational ways. The person with the unresolved trauma might not understand himself or herself what's happening and it can be frightening.

You Can Become More Resilient with Mind-Body Oriented Psychotherapy
Unresolved trauma is often passed on from one generation to the next. Of course, this isn't intentional. It happens unconsciously as children often absorb their parents' fears. This can happen even if a parent never talks to his or her child about what happened to the parent when he or she was younger. It happens because children are often exquisitely attuned to what's happening emotionally to their parents and they "pick up" on trauma more easily than most people realize. For instance, this is often seen among children of Holocaust survivors or survivors of other man-made or natural disasters. The parents might never talk about their experiences, but children can often intuit that their parents have overwhelming fears. When they sense this, they often grow up to feel that the world is not a safe place for them, and something bad and overwhelming could happen at any time.

The above list will begin to give you an idea of how unresolved trauma can affect you and those that you love.

The following scenario is a composite of many different cases and should serve to illustrate the consequences of unresolved trauma as well as how trauma therapy can help:

Ann:
When Ann was 21, she was relieved to be able to move out of her parents' home. She had lived all of her life with an alcoholic father who was emotionally and physically abusive to her as a child and a mother who was extremely passive and emotionally beaten down herself from her husband's abuse. After saving up enough money to get her own apartment, Ann vowed that she would look upon her childhood as a chapter in her life that she was closing, never to be looked at again. Moving out for Ann was a new beginning and she never wanted to look back at the abuse that she experienced growing up.

Ann took a lot of satisfaction in being able to set up her apartment the way that she wanted and the freedom of coming and going as she pleased without anyone, like her abusive father, being able to tell her what to do or to put her down.

Ann had a couple of friends that she talked to and socialized with now and then. But, usually, she felt too afraid to form close or intimate relationships. When she was growing up, she could never bring friends over because she never knew when her father was going to be in an alcoholic rage and she felt too ashamed to allow other people outside of the family to see this. So, she might go to other children's houses to play, but she never invited them to her house.

Often, this became uncomfortable because children would ask her about her parents and her home, and she didn't know what to say. She felt too embarrassed to tell them that her father drank a lot and he was abusive, so she would make up excuses, even though she knew that the other children didn't always believe her. At times, she would overhear some of the children talking and laughing about her and her parents, and this hurt her feelings and made her want to keep to herself.

As an adult, Ann's two friends would often tell her that they felt that she was emotionally distant from them. They liked her and wanted to get closer to her, but they felt that she managed to keep her distance. Whenever this topic came up, Ann felt very uncomfortable. She had a sense that what her friends were saying was true, but she found it was too emotionally overwhelming to deal with it, so she denied it to herself and to them. At the same time, she felt very lonely and wanted and needed to feel close to someone, but she was too afraid to allow herself to get close to anyone.

Then, one day, when Ann was out with her two friends at a bar, she met Bill. Bill was so friendly and charming that Ann found him hard to resist, in spite of her usual very cautious nature. From the moment that she met Bill, Ann felt that there was something so familiar about him, as if she had known him for years. She had never felt this way before, and she was amazed and taken off guard.

Ann and Bill began dating, and she found herself falling in love with him quickly. Her friends, who thought that Ann would never allow anyone to get that close to her, were thrilled that she met someone who was so loving and attentive towards her. Ann felt like a whole new world had opened up for her both internally and externally, and she realized that she had never felt this way before.

A year or so later, Ann and Bill decided to get married. Ann dreaded having Bill meet her parents, but she had visited Bill's parents numerous times, and she knew she couldn't avoid having Bill meet her parents indefinitely. On the day that Ann brought Bill to meet her parents, Ann's mother greeted them at the door looking anxious. She told them that Ann's father wasn't feeling well and he was upstairs in the bedroom sleeping.

Ann knew instantly that this meant that her father was sleeping off an alcoholic binge. She felt very angry that her father couldn't stay sober long enough to meet Bill, but she kept these feelings to herself and tried to make the best of it. Her mother made an effort to appear chipper and carefree, but she looked like a nervous wreck. When Ann saw how her mother was acting, she felt very ashamed. All of her old childhood fears of allowing other people to meet her parents came rushing to the surface. She felt that bringing Bill to her parents' home was a big mistake. For his part, Bill was his usual charming self and he handled the situation well.

Throughout dinner, Ann felt like she was part of some surreal play in which all of the characters were playing their parts and doing their best to ignore the emotional environment around them. After they finished dinner, Ann couldn't wait to leave, so she turned down her mother's dessert and made up an excuse to leave early. Ann felt that her mother said all the right things to encourage them to stay, but Ann felt that, underneath it all, her mother was just as relieved to have them leave. Once she was out the door, Ann breathed a sigh of relief and she and Bill went back to her apartment.

After they got married, things seemed to be going well, at first. But, over time, Ann began to suspect that Bill had a drinking problem that he had managed to keep hidden from her while they were dating. At first, she didn't want to see how much Bill was drinking when he got home from work. She made excuses to herself about his behavior because it was too much for her to see.

But one night it all came to a head at a dinner in their home with Ann's two friends and their boyfriends. Bill started out the evening being charming, gracious host, but as he continued to drink, he became loud and argumentative. Ann felt close to tears, and she put her head down and hoped the evening would pass quickly. But before the night was over, Bill nearly punched one of the friend's boyfriends, and Ann's guests left abruptly with her friends telling her that they would call her tomorrow.

At first, Ann told herself that this was only one night and Bill had never behaved in this way before. Bill was very apologetic and promised her that it would never happen again. She forgave him, called her friends to apologize, and she decided to put the whole incident behind her as if it had never happened. But these incidents began to happen more regularly whenever they had his or her friends over, as Bill began to drink more and more. And Ann was beginning to run out of excuses that she made to herself and to her guests for Bill's behavior. Finally, after an incident where Bill got so drunk that he was abusive to her in front of their guests, shouting at her and attempting to take a swing at her, Ann couldn't remain in denial any longer. One of Bill's friends grabbed hold of Bill and told him to calm down or he would call the police. Then, he helped Bill to stagger up to the bedroom where he fell into a drunken stupor.

After that night, Ann had the painful realization that she had married a man who was a lot like her father. She could hardly believe that Bill had this other side to him that she had never seen before when they were dating. She also couldn't believe that she was behaving just like her mother with the same resignation, passivity, and denial. Even though she had told herself when she was growing up that she would never be like her mother and never marry anyone like her father, here she was in the same situation that she vowed she would never be in.

Ann realized that she needed help, and she found a psychotherapist who specialized in working with trauma
Subsequently, Ann made what were some painful decisions for her: She decided to find a psychotherapist who could help her. She also told Bill that he needed to go to an alcohol program and go to A.A. if he wanted to save their marriage. Bill was not at all open to getting help and told her that he felt he could control his drinking on his own. A part of Ann felt that if Bill wasn't going to get help, why should she? After all, in her eyes, he was the one with the problem. But Ann was in an emotional crisis, and she didn't want to confide in her friends so, with some resentment towards Bill, she found a psychotherapist who specialized in the problems that she felt overwhelmed by and started therapy.

Her psychotherapist, who was a trauma expert, helped Ann to develop coping skills that she never had. Her therapist knew that Ann was not ready to leave her marriage, even though she was in an emotionally abusive relationship. So, she helped Ann to deal with the day-to-day crises in her marriage, and she told Ann about Al-Anon and encouraged her to attend. As Ann developed better coping skills, she began to feel stronger emotionally and more able to deal with the problems in her marriage. When Bill continued to refuse to get help, Ann proposed a trial separation, which Bill did not want. He realized that Ann was serious and he could lose her, so he began attending an outpatient substance abuse program and going to A.A.

As the situation at home calmed down, Ann's therapist helped her to explore her childhood issues which had lead Ann, unconsciously, to repeat her childhood trauma in her adult life. Whenever Ann began to feel overwhelmed by emotions that felt like they were going to overtake her, she was able to tell her therapist and her therapist helped her to manage those feelings by temporarily entering into a meditative state to calm down until she felt calm enough to continue dealing with the childhood trauma.

As Ann's therapist helped her to "pendulate" back and forth from discomfort to comfort, Ann began to realize that she could manage and, eventually, overcome these emotions that she had avoided dealing with for years. Ann's therapist also helped Ann to deal with her childhood trauma in "manageable bites" so that Ann didn't feel like she was on a runawsay train of emotional trauma.

As Ann continued in her therapy, she learned about the mind-body connection in trauma. She learned that the body holds the memories of the trauma, even when she wasn't consciously thinking about it. She began to realize that her headaches and body aches were often the result of her tremendous efforts to hold back these traumatic memories from consciousness, and when she allowed herself to deal with the trauma in a manageable way, she often felt calmer and her body felt less tense than when she braced herself against feeling her feelings.

As she continued in her therapy work and her marriage improved, Ann realized that she had kept her world very small because of her trauma and shame. Gradually, she began to allow others to get to know her better. Her friends began to comment that she seemed more relaxed and open with them. While her trauma work in therapy wasn't easy, she began to discover that it was easier for her to deal with it than to continue to avoid it, so she felt encouraged to continue.

Overcoming Childhood Trauma
The above composite account of a psychotherapy case illustrates how unresolved childhood trauma can continue to affect an adult even when that person is no longer in their old environment. It also demonstrates that there is hope and the possibility of living a more meaningful life when people make a choice to get psychological help to overcome their trauma rather than continuing to avoid it out of fear.

Overcoming Childhood Trauma:  You're Not Alone
Getting Help
If you have unresolved trauma, you owe it to yourself and the people that you love to get psychological help from a licensed mental health professional who has an expertise in trauma. The renewed energy and peace of mind that people regain after they have overcome unresolved trauma usually outweighs the discomfort of working out these problems in therapy.

I am a licensed NYC psychotherapist, hypnotherapist, and EMDR therapist who works with trauma using mind-body psychotherapy.

T o find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist

To set up a consultation, call me at (212) 726-1006.


Also, see my article:  Overcoming Childhood Trauma that Affects Your Adult Relationships


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