Trauma Therapy in Westchester, NY
Offering in-person and virtual therapy for individuals, families, and couples.
Therapy for individuals who have experienced one or multiple traumas and are haunted by intrusive trauma memories, experience intense distress when reminded of their trauma, and/or feel as if they are constantly under threat.
Some of these traumas may include, but are not limited to, physical or sexual abuse or violence during childhood or adulthood, natural disasters, serious, life-threatening accidents (or bearing witness to), and war.
All of these terrifying experiences contribute greatly to a complete loss of control and a sense of utter powerlessness over many aspects of our lives, even affecting our ability to make basic decisions over them.
Trauma therapy is also for individuals who have endured several uncontrollable stressful events in their childhood, adolescence or adulthood.
This could include growing up in families that exhibit criticizing, ignoring, controlling, and blaming behaviors, to name a few. These behaviors, known as traumatic behavior invalidation, tend to cause internal messages such as “you are bad,” “you are not important,” “you are incompetent,” and “you are a problem.”
Research has shown that severe invalidation by caregivers and intimate partners is as or more harmful than sexual or physical violence in terms of its impact on PTSD and other mental health outcomes, such as depression and anxiety.
These internal messages leave persistent traces on our minds and emotions and lead to a distorted and inaccurate way we perceive and experience ourselves, others and the world.
We may see this in present-day life in our difficulty to establish stable, trusting relationships, experience joy and intimacy, willingness to set professional or personal goals because of the looming sense of inner shame that was created by their traumatic experiences.
Trauma, by definition, is unbearable and intolerable.
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It makes sense that a common coping skill when thoughts of trauma arise is to push them away.
While avoidance and pushing away may relieve anxiety in the short term, the part of our brain that is devoted to ensuring our survival is not very good at denial.
Subsequently, long after a traumatic experience is over, it may be reactivated at the slightest hint of danger or threat. This danger could feel as extreme as an alarm going off and a war veteran acting as if it's a bomb to having a sentence corrected in your work report and feeling like you’re not good enough.
Unhealed wounds cause these posttraumatic reactions to feel overwhelming and insidiously impact many aspects of our lives, like how we perceive ourselves, relate to others, respond to stress, experience our bodies, feel satisfaction in ordinary, everyday things, and think about our future. It can create a feeling that life is passing you by.
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Trauma treatment needs to engage the entire organism, body, mind and brain
According to Bessel Van Der Kolk, MD., in “The Body Keeps the Score,” after trauma, the world is experienced with a different nervous system.
The survivor’s energy now becomes focused on suppressing inner chaos, at the expense of spontaneous involvement in their life.These attempts to maintain control over unbearable physiological reactions can result in a whole range of physical symptoms, including fibromyalgia, chronic fatigue and other autoimmune diseases.
This explains why it is crucial for trauma treatment to engage the entire organism, body, mind and brain.”
As part of our trauma work, I will encourage you to take advantage of other resources that can facilitate the healing process, such as trauma massage, yoga, exercise, meditation, and herbs/nutrition. I have resources for all and will go at your speed.
EVIDENCE-BASED TRAUMA TREATMENT
Dialectical Behavior Therapy Prolonged Exposure Protocol
The Dialectical Behavior Therapy (DBT) Prolonged Exposure (PE) Protocol was added to traditional DBT (and the 4 modules of Distress Tolerance skills, Emotion Regulation skills, Mindfulness skills and Interpersonal Effectiveness skills) for those clients who needed PTSD treatment.
The coping skills that are learned in DBT sessions help clients experience and tolerate intense emotions without engaging in maladaptive escape behaviors and/or impulsive and self-damaging behaviors. They learn that while the emotion may be uncomfortable, they can manage the intensity of it. With this realization, they are more willing to experience the process of using exposure to treat PTSD while also correcting the damaging messages of invalidating environments, both necessary components to achieving freedom from trauma-related suffering.
Prolonged exposure typically lasts between 12-16 sessions and uses 3 core procedures to treat PTSD: In Vivo Exposure, Imaginal Exposure and Processing. To learn more about each procedure click below.
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In Vivo Exposure involves confronting situations you avoid in real life. You will be asked to gradually approach people, places and things you have been avoiding because they remind you of your trauma, feel dangerous or bring up distressing emotions. This will help you learn that these situations are not harmful and you can cope with them, which will make them less distressing. Since avoidance keeps people from recovering from PTSD in the long run, exposure allows new learning to occur and new beliefs and interpretations to form.
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Imaginal Exposure, the second part of DBT PE, involves repeatedly describing traumatic events out loud during your therapy sessions. By talking and thinking in detail about what happened to you, your trauma memories will become less overwhelming and will be less likely to come up unexpectedly at other times. It is very common for people to have difficulty remembering all the details of their traumatic experiences, often feeling fragmented, with significant gaps and foggy in places. DBT PE can be used as long as you have at least some memory of the trauma(s) you have experienced.
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Processing involves talking with your therapist about the emotions and thoughts that arise as a result of imaginal exposure. The goal is to help you gain a new perspective about the traumas you have experienced that will cause you less distress and enable you to change unhelpful trauma-related patterns in your life.
The good news is that you can heal from trauma. Humans are incredibly resilient.
Research has shown that about 70% of people who complete DBT PE experience significant improvements in their PTSD, such as a decrease in flashbacks, problematic beliefs about themselves and others. It has also shown to result in improvements in other problems related to PTSD such as depression, dissociation, anxiety, shame, guilt, emotion regulation, and difficulty functioning in relationships and other activities of daily living.
Many of my clients go on to have healthier relationships and work on personal and professional goals that they once didn’t envision or think were possible, as they are able to find safety and connection again. They report feeling more confident, masterful and improved quality of life, as they reconnect to parts of themselves that were lost due to trauma and discover new parts of themselves they respect and love.
Page Citations: The Body Keeps the Score- Author: Bessel Van Derk Kolk, MD; The Boy Who Was Raised as a Dog, Authors: Bruce D. Perr, MD, PhD and Maia Szalavitz; DBT Skills Training Manual (Second Edition) by Marsha D. Linehan; Treating Trauma in Dialectical Behavior Therapy: The DBT Prolonged Exposure Protocol (DBT PE) by Melanie S. Harned