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Friday, December 31, 2010

Psychotherapy for Shock Trauma

In my last blog post, Understanding Shock Trauma, I discussed shock trauma, including the types of traumatic events that can cause shock trauma and its symptoms. In this blog post, I will discuss psychotherapy and shock trauma and the treatment modalities that I find most effective in my psychotherapy private practice in NYC.

Psychotherapy For Shock Trauma

Psychotherapy for Shock Trauma - Initial Phase: Assessment and Developing Resources
When clients come to me to be treated for shock trauma, I assess each client with regard to the nature of the trauma and their internal and external resources. Before any processing of the trauma can begin, clients must have adequate internal and external resources or the trauma processing could be overwhelming for them.

What are Internal and External Resources?
When I refer to internal resources, I'm referring to a person's coping abilities. If the client doesn't have sufficient coping abilities, I assist them to develop them. Internal resources can be any of the following: an ability to meditate or calm oneself by taking calming breaths, visualizations of relaxing places, visualizations of supportive people in their lives, memories or associations of times in their lives when they felt good about themselves (confident, powerful, competent) and so on.

External resources can include friends, family, loved ones, mentors, coaches, or pets. If a client is in recovery for substance abuse or some other form of addiction, it could include 12 Step meetings, peers in 12 Step meetings, and sponsors.

Psychotherapy Treatment Modalities:
When dealing with trauma, I usually use mind-body oriented psychotherapy such as Somatic Experiencing, clinical hypnosis, or EMDR, depending upon the needs of the client. Sometimes, depending upon the needs of the client, I might use a combination of these treatment modalities. The treatment plan is a collaborative effort with the client.

Psychotherapy for Shock Trauma - Processing the Trauma:
Once the client has developed adequate resources, I titrate the trauma work so that it is performed in manageable pieces. (Titration means in manageable doses.) When dealing with the trauma, we're dealing with the reptilian brain (see prior blog post about the triune brain). The reptilian brain processes about 7x slower than the neo-cortex, so trauma work is, by necessity, slower than other types of work that is done in psychotherapy. If the therapist goes too quickly, the reptilian part of the client's brain will be overwhelmed and it will be to0 much for the client.

I help the client to move gently back and forth between manageable emotional activation related to the trauma and a calm emotional state so that the trauma work remains in a tolerable range.

The client is the best judge in terms of what he or she experiences in trauma work, so the client is in charge, and I am guided by his or her feedback during sessions.

Psychotherapy for Shock Trauma - The Goal of Treatment:
Using one of the mind-body oriented psychotherapy treatment modalities, the goal is for the client to process the trauma and to discharge the trauma-related "stuck" energy which is being held in the body so that the client can return to at least as good a level of his or her former level of overall functioning or better.

The discharge of "stuck" energy can come in many forms, including breathing out stressful energy, perspiring, yawning, experiencing tingling, and other forms of discharge. The client often senses when he or she has discharged the trauma-related energy that has been "stuck" in the body because there is a sense of calm or relief for the particular piece of trauma work that has been worked on.

Psychotherapy for Shock Trauma - Developing Self Compassion:
Many clients who begin trauma work blame themselves for what happened to them. They get caught up in negative cycles of self talk where they berate themselves, telling themselves that they should have known better or they shouldn't have gone to a particular place, etc. This only exacerbates their trauma symptoms.

During treatment, I help clients to realize that they're not to blame for what happened to them or for their trauma symptoms. Helping clients to develop self compassion is also part of the way I work with traumatized clients from the beginning so they don't get caught in negative cycles of self blame.

To find out more about the mind-body oriented psychotherapy treatment modalities that I have discussed in this blog post, please see the resource list below:

Resources:
Somatic Experiencing therapy (SE): http://www.traumahealing.com
Clinical hypnosis: http://www.ASCH.net
EMDR: http://EMDRIA.org

I am a licensed psychotherapist, hypnotherapist, Somatic Experiencing therapist, and EMDR therapist.

I have helped many clients to overcome traumatic events in their lives, including shock and developmental trauma, so that they can go on to lead productive and meaningful lives.

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

To set up a consultation, call me at (212) 726-1006 or email me: josephineolivia@aol.com.