Trauma Therapy: Using Grounding Techniques Between Psychotherapy Sessions

In my last article, Trauma Therapy: Using the Container Exercise Between Therapy Sessions, I discussed the importance of the preparation phase of trauma therapy and how the container exercise can help with emotional containment and coping with difficult emotions between psychotherapy sessions or at the end of a psychotherapy session.  In this article, I'm continuing to focus on grounding techniques.

Trauma Therapy: Using Grounding Techniques Between Psychotherapy Sessions

What is Grounding?
Just like the container exercise that I mentioned in my last article, grounding is a stress management technique to help you calm down and be in the present moment.

Grounding is especially helpful when you're in trauma therapy.  It helps you to transition from the memories you're working on in therapy to the present moment so that you're not overwhelmed by thoughts, feelings, images, body sensations or other uncomfortable things that might come up when you process traumatic memories in therapy.

Aside from helping you between or at the end trauma therapy sessions, ground techniques can also help you to calm down and cope when you're generally under stress or anxiety.

How Do You Know If You're Not Emotionally Grounded?
People who have experienced longstanding psychological trauma often become "accustomed" to living with high intensity anxiety and this feels "normal" to many of them.

As a result, they might not know when they're not emotionally grounded and might only see the difference once they've experienced what it's like to feel emotionally grounded or calm.

Signs of Possibly Not Being Emotionally Grounded:
Some of the following signs might be signs that you're not emotionally grounded, especially if you experience many of these symptoms:

• Experiencing anxiety and worry most of the time
• Causing or participating in emotional drama much of the time
• Being spaced out (or dissociated) much of the time
• Getting easily distracted often
• Ruminating obsessively 
• Obsessing frequently about how you look or what others think about you
• Having frequent problems falling or staying asleep
• Having chronic pain
• Having inflammation in your body
• Having poor circulation
• Feeling fatigued most of the time

The Benefits of Being Emotionally Grounded
Generally speaking, being emotionally grounded can have the following potential benefits:

• Getting better sleep
• Reducing anxiety and worry
• Improving concentration and focus
• Reducing rumination
• Reducing fears about your image and what others think of you
• Reducing chronic pain
• Reducing inflammation in your body
• Improving circulation
• Reducing fatigue

Grounding Exercises
There are many types of grounding exercises.  I'll mention an easy one, the body scan, in this article that you can practice.  This grounding exercise is often used in trauma therapy, and it can also be beneficial any time you feel the need to calm yourself.

Trauma Therapy: Using Grounding Techniques Between Psychotherapy Sessions

In order for grounding exercises to have a beneficial effect, you need to practice grounding regularly.

If you're experiencing unresolved psychological trauma, it's best to see a trauma-informed psychotherapist before you try anything new.

Before starting any grounding exercises, consult with your psychotherapist.  This particular grounding exercise is generally good for most people, but there might be a particular reason why you shouldn't do it, so speak to your psychotherapist first.

The Body Scan:  

• Sitting up with your feet flat on the floor, start by taking a few deep breaths and, if it feels comfortable for you, close your eyes.  If you feel uncomfortable or unsafe closing your eyes, pick a spot on the floor to focus on so your attention doesn't wander.

• Paying attention to your feet, which are placed flat on the floor, notice how the floor supports the weight of your body.  If it feels comfortable for you, you can imagine that there are vines growing from the soles of your feet which connect to the earth so you feel yourself securely rooted.  If that feels uncomfortable, stay focused on how the floor and the earth below the floor support your feet.  

• Focusing on the crown of your head, move your attention slowly through your body and notice where you're holding onto tension in your body.  Don't forget your eyes, which hold a lot of tension.  Allow the muscles in your eyes to relax instead of holding them fixed (this is easier to do if your eyes are closed or semi-closed).  Also, pay attention to the tension you hold in your jaw and tongue.  Allow your jaw to relax and your tongue to settle at the bottom of your mouth.  Then, proceed throughout the rest of your body.  Wherever you sense tension, picture the tension melting away or going through your limbs and out of your body.  

• Take a few moments to notice and enjoy your relaxed state.

• Before opening your eyes, picture the room that you're in with your mind's eye and be aware of the chair or couch where you're sitting.  

• Opening your eyes gently, take a look around the room and orient yourself to your surroundings.  Continue to feel your feet planted on the ground for a few moments before you transition to doing something else.

If this exercise feels uncomfortable to you in any way, stop doing it until you can talk about it or practice doing it with your psychotherapist.  As I mentioned earlier, it's always best to consult with your psychotherapist before you begin any form of grounding exercise.

Also see my articles:
Coping Strategies in Mind-Body Oriented Psychotherapy
Wellness: Safe Place Meditation
Learning to Relax: Square Breathing

Conclusion
Using grounding techniques, like the body scan, can help to calm you.

If you're struggling with unresolved trauma, it's best to work with a trauma-informed psychotherapist to resolve your trauma.

Generally, the body scan grounding exercise is safe for most people, but speak to your therapist before beginning any grounding exercises.

Getting Help in Therapy
Unresolved trauma doesn't resolve on its own.  It can be debilitating on an emotional and physical level.  We also know now that it can have intergenerational effects and affect your children and generations that follow, so it's important to get help (see my article: Psychotherapy and Transgenerational Trauma).

Rather than struggling on your own, you could benefit from getting help from a licensed mental health professional who specializes in helping clients to overcome trauma (see my articles: The Benefits of Psychotherapy and How to Choose a Psychotherapist).

After you have worked through your trauma, you'll have a chance to live a more fulfilling life.

About Me
I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist (see my article: The Therapeutic Benefits of Integrative Psychotherapy).

I specialize in helping individual adults and couples to overcome unresolved trauma.

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

To set up a consultation, call me at (917) 742-2624 during business hours or email me.

Trauma Therapy: Using the Container Exercise Between Therapy Sessions

Processing unresolved trauma with a skilled trauma-informed psychotherapist can be one of the most healing things that you do for yourself.  Over time, unresolved trauma can have detrimental emotional and physical effects.  It can also have unintended repercussions for your children (see my article: Your Unresolved Trauma Can Have Repercussions For Your Children).  

Although working through psychological trauma is beneficial for you and your family, you need to know how to take care of yourself between your psychotherapy sessions, which is why I'm discussing the container exercise in this article (see my article: Is Self Care Selfish?).

Using the Container Exercise Between Psychotherapy Sessions

Why is the Preparation Stage of Trauma Therapy Important?

The concept of emotional containment is very important when you're working on psychological trauma in therapy because processing trauma doesn't stop when you leave your psychotherapist's office.  It continues between sessions, sometimes consciously and often unconsciously.

Having a way to cope with whatever comes up between therapy sessions is essential and, hopefully, your psychotherapist has taken time in the preparation phase of trauma therapy to teach you various coping skills to deal with whatever comes up when you're not in therapy (see my article: Developing Internal Resources and Coping Strategies).

In my opinion as a trauma therapist, some therapists rush too quickly to process the trauma before they have helped clients with the necessary preparation work.  This tends to occur with psychotherapists who might have been trained to do trauma work a long time, before there was less of an emphasis on preparation, and they haven't updated their skills.

Also, some therapists want to respond to clients' demands that they start processing trauma immediately before clients are emotionally prepared to do the work. While it's understandable that clients want relief from the effects of unresolved trauma as soon as possible, trauma therapists need to explain why it's important to help clients prepare to do the work and assess a client's readiness.

Clients who aren't sufficiently prepared during the preparation phase of trauma therapy are often overwhelmed by processing their trauma.  If they haven't gone through the preparation phase of trauma therapy, they often don't have the skills to cope with the emotions that come up.

The worst part is that some clients, who aren't sufficiently prepared and who feel overwhelmed in trauma therapy, leave prematurely and they might be too afraid to see another trauma therapist (see my article:  When Clients Leave Therapy Prematurely).

What is the Container Exercise?

The container exercise is one way to cope with difficult emotions that come up between psychotherapy sessions.

This exercise can also be used at the end of a trauma therapy session.  In a prior article, I discussed other helpful coping strategies that might be useful to you.

The container exercise is a simple yet powerful coping strategy where you use your imagination to create a container to temporarily place any disturbing thoughts, feelings, memories, images, physical sensations, dreams or whatever is disturbing to you so that you don't feel overwhelmed until your next psychotherapy session.

Some people like to imagine that their container remains in their psychotherapist's office so that they leave whatever comes up that's disturbing with their therapist until the next time. Where you decide to imagine your container is up to you.  Choose a place that feels right.

Steps For Doing the Container Exercise

The following steps are part of the basic container exercise and you can enhance them in whatever ways feel meaningful to you:

• Begin by taking a few deep, cleansing breaths and, if it feels comfortable for you, close your eyes.  If closing your eyes doesn't feel comfortable, you can focus on a particular spot on the floor so that your attention doesn't wander.

• Now imagine a safe and secure container of whatever type, size, color feels right for you. Take whatever time you need to make this personally meaningful and decide where you want to imagine keeping it.

• Imagine yourself placing whatever is disturbing you in this container.

• Imagine yourself shutting the container and making it secure in whatever way feels right to you (e.g., locking it, locking it and burying it underground or in the ocean, etc).

• If anything else comes up that's disturbing to you during the week, you can place it in your container until you're ready to talk to your therapist about it at your next session.

Conclusion

The preparation phase of trauma therapy is an important part of getting ready to do trauma work so that you don't feel overwhelmed.  

Some clients need more time in the preparation phase than others.  This is something that your psychotherapist will assess before you process trauma.

The container exercise is one way to deal with anything disturbing that comes up between psychotherapy sessions.  It can also be used at the end of a trauma session to help you to de-stress.

Getting Help in Therapy

If you have been struggling with unresolved trauma, you could benefit from working with a skilled trauma therapist who can help you to overcome your trauma (see my article: What is a Trauma Therapist?).

There is no quick fix for overcoming trauma, especially developmental trauma, but a skilled trauma therapist can help you to overcome trauma with safe and effective trauma therapies, including:  

• EMDR therapy (Eye Movement Desensitization and Reprocessing)

• Somatic Experiencing

• Parts Work

• Clinical Hypnosis (also known as hypnotherapy)

• AEDP (Accelerated Experiential Dynamic Psychotherapy)

About Me

I am a licensed New York psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist (see my article:  The Therapeutic Benefits of Integrative Psychotherapy).

I work with individual adults and couples, and I specialize in helping clients to overcome both shock trauma and developmental trauma.

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

To set up a consultation, call me at (917) 742-2624 during business hours or email me.

How Developmental Trauma Affects How You Feel About Yourself

Psychological trauma, especially developmental trauma, usually has a negative impact on your perception of yourself.  This is one of the reasons why your beliefs about yourself are addressed in trauma therapy. 

For instance, in EMDR therapy, an important part of therapy is asking about your negative belief about yourself in relation to the traumatic memories that you and your psychotherapist are working on.

How Developmental Trauma Affects How You Feel About Yourself

It's not unusual for people who have experienced developmental trauma, which is childhood trauma, to have one of the following beliefs about themselves:

• "I'm unlovable."
• "I'm powerless."
• "I'm no good."
• "I'm a terrible person."
• "I'm weak."

and so on.

Objectively, these same people might know that their beliefs about themselves are distorted but, at the same time, they still have these negative self perceptions, and trying to rationalize it away doesn't help them.

Clinical Vignette: How Psychological Trauma Affects Your Perception of Yourself
The following clinical vignette illustrates these points:

Cindy
Cindy decided to start psychotherapy because she knew that her low self esteem was creating problems for her in her personal life as well as in her career.

Whenever she dated a man that she really liked, she worried that after he got to know her, he wouldn't like her and he would stop seeing her.  There wasn't anything in particular she dreaded that he would find out.  It was more a general feeling that she had about herself (see my article: Overcoming the Fear That People Wouldn't Like You If They Knew the "Real You").

As a marketing representative, she often had creative ideas about how to market the company's products, but she hesitated to talk to her manager about her ideas because she second guessed herself.  But when one of her colleagues came up with a similar idea and received praise from the manager, Cindy regretted that she didn't speak up when she had the idea.

When Cindy started therapy, she didn't know why she had such low self esteem but, as she talked to her psychotherapist about her family background, she began to see the connection between her low self esteem and her childhood history.

She told her psychotherapist that she was aware from a young age that her parents never wanted to have children and she was considered "a mistake."

Her parents provided for her basic needs, but they weren't loving and nurturing towards her.  She spent most of her time with her nanny or the housekeeper because her parents told her that they were too busy to spend time with her (see my articles: What is Childhood Emotional Neglect? and What is the Connection Between Childhood Emotional Neglect and Problems Later On As An Adult?).

As an only child, Cindy often felt lonely.  She used to love going to her best friend's house because her friend's mother was kind and affectionate.  Her friend's mother would read stories to Cindy and her friend and play with them.

After Cindy moved out to go to college, she never moved back home again.  Instead, she and some of her college roommates got an apartment together in New York City and shared the rent.  She went home on holidays for the "obligatory family visits," but her relationship with her parents remained strained (see my article: How to Cope With Difficult Family Visits).

As Cindy and her psychotherapist talked about her memories of childhood, Cindy realized that ever since she could remember, she felt unlovable.

Even as a child, she felt that if she was a lovable child, her parents would care more about her.  She blamed herself for their emotional neglect, as young children often do.

At her psychotherapist's suggestion, Cindy chose a childhood memory to work on with EMDR therapy (Eye Movement Desensitization and Reprocessing) that was emblematic of her childhood experiences (see my articles: How EMDR Therapy Works: EMDR and the Brain and EMDR Therapy: When Talk Therapy Isn't Enough).

Cindy was five years old in this memory.  She remembered that it was a rainy day so she couldn't go outside, and she felt lonely and bored at home, so she told her mother that she felt "all alone" and "bored."

She hoped that her mother would spend time with her, read a story to her or just talk.  But her mother gave Cindy an annoyed look, "Cindy, can't you see that I'm busy reading?  Go to your room and find a book that you can read on your own and don't bother me."

Cindy remembered going to her room, throwing herself on the bed and crying.  Her mother was in the next room and she probably heard Cindy crying, but she didn't come to Cindy's room to try to soothe her.  Instead, Cindy was left on her own to cry it out.

After Cindy and her psychotherapist completed the preparation phase EMDR therapy to work on this memory, as part of the EMDR protocol, Cindy's psychotherapist asked Cindy, "What's the negative belief you have about yourself?" in relation to this memory.

Cindy responded, "I'm unlovable" (see my article: Overcoming the Emotional Pain of Feeling Unlovable).

This was the first time that Cindy connected her feelings of being unlovable to how she was treated by her parents when she was a child.  Now, it made sense to her why she would feel this way about herself.

Cindy and her therapist continued to work on her feelings of being unlovable using EMDR therapy.  Many other similar memories came up as well as a deep sense of shame for feeling that she wasn't a lovable child.

How EMDR Therapy Can Help You to Overcome Developmental Trauma

After several months, Cindy and her therapist completed the EMDR therapy, and Cindy no longer felt unlovable.  Her self esteem improved so that she felt more confident when she went out on dates.  She also felt that she was a lovable person and she deserved to be loved.   At work, she was more assertive about making suggestions, and her manager recognized her work by promoting her.

Conclusion
Many people who experienced developmental trauma as children don't connect their poor sense of self and negative beliefs about themselves to their unresolved trauma.

EMDR therapy explores these feelings and beliefs directly so that clients can begin to make the connection and, eventually, work through them.

There is no quick fix for overcoming unresolved trauma.  Even though EMDR therapy tends to be more effective and tends to work faster than regular talk therapy, each person processes trauma in his or her individual way and in his or her own time.

Getting Help in Therapy
A negative belief or self perception is often linked to unresolved trauma.

If you have been struggling with feelings of low self worth, you could benefit from working with an experienced psychotherapist who has an expertise in helping clients overcome traumatic experiences (see my article: The Benefits of Psychotherapy).

Rather than suffering on your own, you can work with a skilled psychotherapist who can help you to overcome your history of trauma so you can lead a more fulfilling life (see my article: How to Choose a Psychotherapist).

About Me
I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist (see my article: The Therapeutic Benefits of Integrative Psychotherapy).

As a trauma-informed psychotherapist, I work with individual adults and couples.  

I have helped many clients to overcome their traumatic experiences.

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

To set up a consultation, call me at (917) 742-2624 during business hours or email me.

Intergenerational Family Dynamics

Intergenerational family dynamics is an important factor in understanding yourself as well as understanding your family.  This includes developing an appreciation for intergenerational trauma in your family and how it affects you (see my articles:  Psychotherapy and Intergenerational Trauma and Overcoming Dysfunctional Ways of Relating in Your Family).

Intergenerational Family Dynamics

What is a Genogram?
One of the best ways for seeing and understanding intergenerational family dynamics is to draw a genogram.

A genogram is a diagram of your family for at least three generations.  It is a graphic representation with symbols for repetitive intergenerational dynamics in your family.

A Genogram is a Family Tree Where Repetitive Intergenerational Dynamics Are Added 

The diagram above shows an ordinary family tree.  To make a family tree into a genogram, symbols are added to reveal repetitive intergenerational dynamics (see below: Drawing Your Own Genogram).

One of the best books for understanding genograms is Genograms in Family Assessment by Monica McGoldrick and Randy Gerson.  This book is often used in social work graduate programs when graduate students study family dynamics.

This book also provides the symbols most used for showing family dynamics like estrangement, divorce, death, suicides, fused relationships, conflictual relationships and so on (due to the limitations of this blog, I'm unable to provide these symbols, but they are readily available online).  But you can make up your own symbols.

Understanding Intergenerational Family Dynamics From Genograms
A genogram is a useful tool when clients come to therapy to change longstanding dynamics that have played out in their family.

Genograms capture dysfunctional patterns, life changes, trauma and family triangles as well as successful and positive patterns for multigenerational families.

In Genograms in Family Assessment, one of the examples used to show intergenerational family dynamics is a genogram for Eugene O'Neill's family (see my article about O'Neill's play: Denial and Illusions in the Iceman Cometh).

These dynamics are also captured in O'Neill's most autobiographical play, Long Day's Journey Into Night.

The genogram for the O'Neill family is a graphic representation of repetitive intergenerational patterns, including alcohol abuse, drug abuse and other destructive patterns.

It also reveals a generational pattern of marital instability.  In addition, there is an intergenerational pattern of the oldest sons dying young in that family, which is depicted in that genogram.

There was also an intergenerational pattern of estrangement between fathers and sons in the O'Neill family as revealed in the book's genogram for the O'Neills, which is also captured in Long Day's Journey Into Night.

Why Use Genograms to Understand Intergenerational Family Dynamics?
As mentioned earlier, genograms are graphic representations of a family tree for at least three generations.  They include symbols between generations to show intergenerational patterns.

One of the values of using genograms in psychotherapy is that they provide a succinct picture which reveals how complex repetitive patterns evolve in a family over time.  This provides a more in-depth appreciation of why some individual and family patterns are so entrenched and difficult to change.

Drawing Your Own Genogram
A genogram is a tool.  There is no agreed-upon method for drawing a genogram.

You can start by drawing a family tree of both sides of your family and then choosing your own symbols to mark intergenerational patterns for major life events, behavioral patterns and other repetitive patterns.

You can also look at the book, Genograms For Family Assessment, where, aside from the O'Neill family, the authors provide genograms for other well-known families like the Roosevelts, Gandhi's family, Freud's family, Katherine Hepburn's family, the Bronte sisters, the Kennedy family and many others.

There are also some online programs that allow you to draw genograms.

When you have marked the intergenerational patterns in your genogram, you will have a better understanding of your family, a new appreciation of how these repetitive patterns occur over time, and why these patterns might be so difficult to overcome.

If you're in therapy or you're thinking about starting psychotherapy, bringing in your genogram to your psychotherapist will serve as a valuable shorthand to illustrate the dynamics in your family.

There are also some therapists who will draw a genogram in your therapy sessions, based on the information that you provide, to help both you and her to understand your own and your family's history.

Getting Help in Therapy
Whether you use a genogram or not, if you have been unable to resolve your problems on your own, you could benefit from seeking help from a skilled psychotherapist (see my article: The Benefits of Psychotherapy and How to Choose a Psychotherapist).

When you have worked through the problems that are holding you back, you can live a more fulfilling life unburdened by your history.

About Me
I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist (see my article: The Therapeutic Benefits of Integrative Psychotherapy).

I work with individual adults and couples.

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

To set up a consultation, call me at (917) 742-2624 during business hours or email me.

When You Shut Down Emotional Pain, You Also Shut Down Potential Pleasure

There are many people, who have a history of traumatic experiences and who could benefit from psychotherapy, but they never come to therapy.  Instead, they do whatever they can to try to suppress and avoid feeling their feelings, but what they usually don't realize is that when they shut down their emotional pain, they're also shutting down the potential for feeling pleasure (see my article: What Happens When You Numb Yourself Emotionally).

When You Shut Down Emotional Pain, You Also Shutdown Potential Pleasure

In addition, what many of people don't know is that a skilled trauma-informed psychotherapist knows how to help clients to develop the ability to expand their "window of tolerance" so they can work through their traumatic experiences in an emotionally-safe therapeutic environment (see my article: Expanding Your Window of Tolerance in Psychotherapy).

What is the Window of Tolerance?
In my prior article, I explained that, according to Dr. Dan Siegel, the window of tolerance is a term that refers to the optimal level of arousal or the optimal zone.

When clients are in their optimal level of tolerance, they are neither hyper-aroused nor hypo-aroused.  They are able to deal with problems as they come up because they're at their optimal level of arousal.

During times of extreme stress, if clients are experiencing hyperarousal, they're in the flight/flight mode, which includes hypervigilance, anxiety, racing thoughts and possibly panic. If they're experiencing hypoarousal, they're in the freeze mode, which includes emotional numbness, feelings of emptiness or emotional paralysis.

Fictional Clinical Vignette: When You Shut Down Emotional Pain, You Also Shut Down Potential Pleasure
The following fictional vignette illustrates how suppressing emotional pain also suppresses pleasure:

Rena
After Rena's mother died in a car accident, Rena would wake up each morning feeling that she had nothing to look forward to and she lacked purpose and meaning in her life.

She told her new psychotherapist that everything felt "blah" and no sooner did she wake up in the morning than she felt like hiding under the covers (see my article: Coping With the Loss of a Loved One: Complicated Grief).

When You Shut Down Emotional Pain, You Also Shut Down Potential Pleasure

She explained to her therapist that she didn't always feel this way.  For most of her life, she looked forward to the joy that each day would bring and she was able to take emotional challenges in stride.  But she was very close to her mother and after her mother died in a car accident, her grief was unbearable.

Rena realized that she had never experienced such raw sadness and anger before.  Her new psychotherapist explained to Rena how emotional numbing numbed joy as well as pain.  She recommended that they use EMDR therapy to help Rena overcome her trauma (see my article: How EMDR Therapy Works: EMDR and the Brain).

Over the next several months, as Rena worked with her therapist on the unresolved grief, her therapist titrated the work so that it was manageable for Rena.

Rena's psychotherapist worked in a way that was within Rena's window of tolerance so that, although Rena still felt very sad when she processed her grief, she didn't feel overwhelmed.

Gradually, Rena was able to expand her window of tolerance so that she could tolerate dealing with deeper levels of emotion without feeling overwhelmed.

Psychotherapy Can Help You to Overcome Traumatic Experiences 

Over time, Rena felt as if she was coming back to life again.  Although she continued to feel sad, she also had moments of happiness.  She felt like she was coming out of a period of time when everything felt gray.  Now, she was beginning to notice colors, nature, music--all the things she enjoyed in her life before her mother died.

She memorialized her mother by writing short stories about her from the time her mother was a young girl up until the time she died so unexpectedly.  This felt healing to Rena (see my article: Writing About Your Mother After Her Death).

Conclusion
Shutting down often occurs when people feel overwhelmed by emotion.  It starts as a protective defense mechanism.  Over time, it can develop into an emotional and physical numbing that shuts out pleasure as well as pain.

When this occurs, some people feel their life has no meaning.  The more they try to avoid feeling, the more exhausting it becomes to try to suppress their feelings.

There is no quick fix for overcoming an overwhelming traumatic event, but trauma therapy can help.

Getting Help in Therapy
While it's understandable that people who have experienced trauma want to protect themselves from feeling the emotional pain, avoiding feeling emotions only makes it worse.

A skilled trauma therapist knows how to work with trauma in a relatively manageable way.

This doesn't mean that there is no emotional pain involved, but an experienced trauma therapist can work in a way to minimize a client getting overwhelmed by working within the client's window of tolerance and helping the client to expand that window of tolerance (see my article: The Benefits of Psychotherapy and How to Choose a Psychotherapist).

If you're feeling stuck with unresolved trauma, you could benefit from seeking help from a licensed mental health professional who has an expertise in helping clients to overcome trauma.

Working through psychological trauma allows you to work through the emotional pain so that you can feel like yourself again and you can lead a more meaningful life.

About Me
I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist (see my article: The Therapeutic Benefits of Integrative Psychotherapy).

I am a trauma-informed psychotherapist who works with individual adults and couples.

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

Why Experiential Psychotherapy is More Effective Than Talk Therapy Alone to Overcome Trauma: A Clinical Vignette

In my prior article, Why Experiential Psychotherapy is More Effective to Overcome Trauma Than Talk Therapy Alone, I began a discussion about experiential therapies like EMDR therapy, Somatic Experiencing and clinical hypnosis and why experiential therapy is more effective than talk therapy (psychodynamic or cognitive behavioral therapy) alone.  As I mentioned in my last article, I'm providing a clinical vignette to illustrate these points in this article.

Why Experiential Psychotherapy is More Effective Than Talk Therapy Alone to Overcome Trauma

Fictional Clinical Vignette: Why Experiential Psychotherapy is More Effective Than Talk Therapy Alone to Overcome Trauma:

Tia
Tia began psychotherapy with an experiential psychotherapist after having been with prior psychotherapists who practiced psychodynamic psychotherapy and cognitive behavioral therapy (CBT).

Although she felt she gained valuable insights in her therapy with a psychodynamic psychotherapist and she learned some helpful tools with her CBT therapist, she felt that her core problem, which was a fear of being sexual with her current boyfriend as well as, in the past, with her previous boyfriends.

In her prior psychodynamic psychotherapy, she learned that her fears stemmed from early sexual molestation by her maternal uncle.  Prior to attending this therapy, she had always known about the sexual molestation, but she never connected it to her fear of being sexual.

Although this insight was valuable to her, Tia still got emotionally triggered in her relationship with her boyfriend, John, especially when they made love.  She loved John and she had no doubt that he loved her.  She felt close to him most of the time, but when they had sex, she felt numb and there were times when she had to ask John to stop making love to her because she felt overwhelmed with fear.

Even though she understood the origin of her fear of making love with John, it didn't help her to overcome the emotional and physical numbing that she experienced when he touched her sexually.

After being with her psychodynamic psychotherapist for several years, she went to a therapist who practiced CBT.  Her CBT therapist provided her with tools for anxiety and tried to use desensitization  techniques to help Tia overcome her fear of being sexual with John.

But when Tia was with John and they attempted to be sexual, she continued to feel fearful and then numb, even though she tried using the tools that she developed in CBT.  The CBT desensitization also didn't help her outside the therapy room.

Since Tia wanted to overcome her fear of being sexual, she decided to try experiential psychotherapy after hearing from a friend that it was helpful to her.

After several sessions of providing the history of her problem, family history, and preparation to do trauma work, Tia's experiential psychotherapist recommended that they use EMDR therapy (see my articles: EMDR Therapy - When Talk Therapy Isn't Enough, How EMDR Therapy Works: EMDR and the Brain, and EMDR Therapy For Big T and Smaller T Trauma).

As they worked on Tia's problem using EMDR therapy, Tia's therapist did a "float back" (similar to the affect bridge in clinical hypnosis) to see if there were any earlier memories (also called "feeder memories") that were affecting Tia.  

As Tia focused on whether there were any earlier memories where she had the same emotions and negative beliefs about herself that she had related to her memory of her uncle sexually molesting her, she remembered that when she was a few years younger, an older cousin sexually molested her and threatened to hurt her if she told anyone about the sexual abuse.

Tia's psychotherapist explained to her that, based on feedback from Tia, her earlier psychodynamic therapy provided Tia with insight and helped her to understand the unconscious emotions that were affecting her.  And CBT provided her with some tools, but that therapy remained superficial.

As a result of both therapies, Tia could talk about her problem, but her understanding remained intellectual.  Neither therapy helped her when she froze in fear physically and emotionally when she and her boyfriend tried to have sex.

In addition, and this was important--neither therapy got to the earlier memory of the sexual molestation and threats by her cousin.

After they discovered that there was an earlier memory of sexual molestation when she was younger, Tia's psychotherapist focused on that memory first and when they completed the work on that memory, they focused on the later sexual molestation involving the uncle.  This took several months.

Since EMDR therapy focuses on the past, present and future, after they worked through both memories, they focused on Tia's fear and numbing in the present with her boyfriend.

Why Experiential Psychotherapy is More Effective Than Talk Therapy Alone to Overcome Trauma 

Having worked though the earlier memories of abuse, the present and future/anticipated situations were easier.  And Tia reported to her therapist that she was no longer feeling fearful and numb when she had sex with her boyfriend, and they were enjoying an active sex life.

Conclusion
In this particular scenario, I used an example of EMDR therapy, but the same could apply to clinical hypnosis, Somatic Experiencing, Coherence therapy, and Ego States therapy (also known as Parts Work).

Some people respond better to one type of experiential therapy than another.  For the sake of brevity, I used a scenario where the client responded well to EMDR, but I could have also given a scenario where the therapist either switched to one of the other types of experiential therapies or used these experiential therapies in combination as many integrative psychotherapists do.

As I mentioned in my prior article, there are many reasons why experiential psychotherapy is more effective than talk therapy alone, including the fact that talk therapy tends to remain on a cognitive level whereas experiential therapy gets to the root of the problem on a deeper (limbic brain) level where the problem exists.

Also, both EMDR therapy and clinical hypnosis have particular methods to discover whether there are "feeder memories," which are earlier memories that are affecting the trauma.  In clinical hypnosis, the method is called the affect bridge and in EMDR the method is called the float back technique.

Unless the earlier feeder memories are worked on, the problem will only be partially solved and the client is still likely to get triggered.

In the scenario above, if the psychotherapist had not looked for feeder memories, Tia and her therapist would only have worked on memory that Tia came in with, but that earlier feeder memory would have continued to affect her when she was sexual with her boyfriend.

Although experiential psychotherapy tends to be more effective and work faster in helping clients to overcome trauma as compared to talk therapy alone, experiential therapy isn't a quick fix, and everyone processes their problems differently with experiential psychotherapy.

Getting Help in Therapy
If you have been suffering with unresolved trauma, you could benefit from getting help from a licensed mental health professional who practices experiential psychotherapy.

To overcome trauma, you need more than just insight.  You need psychotherapy that will get to the root of the trauma in the limbic brain, which is what experiential therapy does (see my articles: The Benefits of Psychotherapy and How to Choose a Psychotherapist).

After you have overcome your traumatic experiences, you can be free from the emotional burdens of your history and live a more fulfilling life.

About Me
I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist (see my article: The Therapeutic Benefits of Integrative Psychotherapy).

I am a trauma-informed experiential psychotherapist who works with individual adults and couples.

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

To set a consultation, call me at (917) 742-2624 during business hours or email me.

Why Experiential Psychotherapy is More Effective Than Talk Therapy to Overcome Trauma

I have discussed the use of experiential psychotherapy for overcoming psychological trauma in prior articles.  In this article, I'm focusing on comparing talk therapy alone to experiential therapy and discussing why experiential therapy tends to be more effective than talk therapy alone for overcoming psychological trauma (see my article: Experiential Psychotherapy Helps to Achieve Emotional Breakthroughs).

Why Experiential Psychotherapy is More Effective Than Talk Therapy to Overcome Trauma 

My Background as a Trauma-Informed Psychotherapist

As I have stated before in prior articles and in my biographical information for this blog, my original training from almost 20 years ago was in psychoanalysis.  Back then, after completing graduate school, I was a psychoanalytic candidate in training and I used psychodynamic psychotherapy and psychoanalysis with clients from the institute's center, including clients with psychological trauma.

While I loved my training and still like applying contemporary Relational psychoanalytic concepts, especially Winnicottian concepts, over the years I discovered that psychoanalysis by itself was not as effective in helping traumatized clients to overcome their problems as compared to experiential psychotherapy or the combination of contemporary psychoanalysis and experiential therapy (see my article: Contemporary Psychoanalysis and EMDR Therapy: A Powerful Combination to Overcome Trauma).

In those early years of my training to be a psychoanalyst, it was frustrating to see that clients in developed insight into their problems, which was an important step, but it often didn't change their problems.

My experience in those early days was that many clients "felt better" and that psychoanalysis was useful, especially back then when clients came multiple times per week.  But I wasn't satisfied that most clients, who experienced trauma, made significant experiential shifts.

After my psychoanalytic training, the mental health field was changing rapidly, and I decided to find out what other types of psychotherapy were being used effectively for PTSD (posttraumatic stress disorder) and trauma.  That's when I heard about EMDR therapy, which stands for Eye Movement Desensitization and Reprocessing (see my articles: How EMDR Therapy Works: EMDR and the Brain and What is Adjunctive EMDR Therapy?).

Since being trained in EMDR in 2004, I have used it regularly and found it to be an effective therapy for helping clients to overcome trauma, including PTSD.  I was fascinated to see that clients were overcoming their traumatic symptoms faster than most clients in talk therapy alone, and the results lasted over time.

In subsequent years, I obtained training in other forms of experiential therapy, including clinical hypnosis, Somatic Experiencing, Ego States therapy and Coherence therapy, which has been invaluable in helping traumatized clients to overcome their problems.

Using these experiential therapies over the years has been pivotal in becoming a trauma-informed psychotherapist who has been able to help many clients who have a traumatic history.

At this point, after using these experiential therapies consistently for several years, I consider myself to be an integrationist who often combines these therapies when it is most effective to do so based on the needs of each client.

Why Experiential Psychotherapy is More Effective Than Talk Therapy to Overcome Trauma

There are many reasons why experiential psychotherapy is more effective than talk therapy alone to overcome psychological trauma:

• Whereas talk therapy alone tends to help clients to develop intellectual insight into their problems, experiential therapy, by definition, uses the mind-body connection so that clients experience their emotions on a physical as well as an emotional basis which allows access to the unconscious mind (see my article: Experiential Psychotherapy Offers a Window Into the Unconscious Mind).

• With talk therapy alone, many clients remain "in their heads." If they have been in talk therapy before, they know the psychological lingo and can explain their problems well, but they might be cut off from their emotional and physical experiences.  Since experiential therapy focuses on clients' embodied experiences, there is a more integrative experience that combines intellectual insights with embodied experience.

• Whereas clients in talk therapy alone can gloss over their emotions by intellectualizing, experiential psychotherapy helps clients to slow down to get deeper into their embodied experience.  Slowing down to experience the felt sense of their emotions allows clients to make deep psychological connections that they often don't make with talk therapy alone.

• Whereas certain forms of talk therapy can pathologize clients' problems, experiential psychotherapy is nonjudgmental and compassionate.  Rather than making judgments about the clients' problems, experiential psychotherapy tends to have a strengths-based perspective.  It also helps clients to become aware of their internal experiences in more body-mind integrated way (see my article: A Strengths-Based Perspective in Psychotherapy).

• Experiential psychotherapy focuses on healing clients as opposed to talk therapy alone which, as previously mentioned, tends to focus on helping  clients to develop intellectual insight.

• Experiential psychotherapy provides clients with skills and tools that they can use on their own without the psychotherapist.  As previously mentioned, it doesn't rely solely on insight as talk therapy alone tends to do.

• Experiential psychotherapy helps clients to go beyond their "story" about themselves.  This is especially important for clients who have had a lot of therapy before and who have developed a particular narrative about themselves which they tell each therapist that they work with.  Rather than keeping clients stuck in an old "story," experiential psychotherapy helps clients to experience their shifting sense of self on a profound level.

• Experiential psychotherapy tends to facilitate transformational and breakthrough moments for clients in therapy in a more timely manner than talk therapy alone.

Conclusion

Talk therapy like psychodynamic psychotherapy, including psychoanalysis, and cognitive behavioral therapy (CBT) are effective types of therapy for many clients.  However, for clients who want to overcome traumatic experiences, including PTSD, experiential psychotherapy used on its own or in combination with talk therapy is more effective.

In my next article, I'll give a clinical example of how experiential psychotherapy is more effective than talk therapy alone in helping clients to overcome trauma (see my article: Why Experiential Psychotherapy is More Effective to Overcome Trauma Than Talk Therapy Alone - A Clinical Vignette).

Getting Help in Therapy

If you have been struggling on your own with emotional problems, you could benefit from working with a licensed mental health professional with the experience and skills you need to overcome your problems (see my article: The Benefits of Psychotherapy).

The first step in getting help in therapy is calling a psychotherapist for a consultation.  During the consultation, you can ask the therapist about her background, training, skills and how she works with your particular type of problem (see my article: How to Choose a Psychotherapist).

Effective psychotherapy helps to free you from your history of problems so you can lead a more meaningful and fulfilling life.

About Me

I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist who uses integrative psychotherapy in a contemporary, dynamic, interactive and collaborative way (see my article: The Therapeutic Benefits of Integrative Psychotherapy).

I work with individual adults and couples.

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

To set up a consultation, call me at (917) 742-2624 or email me.