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Exposure types of therapies such as Eye Movement Desensitization and Cognitive Restructuring have the best outcomes in the treatment of Post therapy. Exposure therapy might be good with an accident victim who is afraid of driving through an intersection. The therapy is combined with desensitization strategies and relaxation techniques so the person can safely visualize driving successfully through the point of an accident. However, with more complex PTSD cases related to long term abuse or with a person who has long term symptomology, exposure therapy could be dangerous.
I recently began using EMDR after beginning my training in this phenomenal approach. I also utilize ongoing clinical training from two mentors. One has been providing EMDR treatment for 20 plus years plus another who specializes in the field of clinical hypnotherapy in the treatment of trauma. It was drilled into my head many years ago to constantly seek clinical training because the lives therapists serve are actually very fragile.
So far I have helped a few people along the way. In using any type of new approach my policy is to seek guidance from the experts. EMDR is is no exception. One needs to use caution any time a traumatic memory is explored. With EMDR images and memories emerge. It is like riding on a train gazing out the window as one’s life experiences pass them by. I’ve been a psychotherapist for 20 years and a PTSD survivor as well, so I am very cautious with every person I serve.
EMDR or Eye Movement Desensitization and Reprocessing is more than just an approach. It is the belief of myself and others that EMDR is a successful means of treatment for PTSD and for those who are affected by unresolved childhood issues.
Trauma, critical childhood experiences, memories of abuse or neglect, and the associated feelings become stored in the amygdala part of the brain. A scent in the air, the time of year, a simple taste or a sound can bring the experiences to consciousness often in the form of anger or fear! People who have been affected also tend to redefine who they are and what they can do. Irrational thinking errors and beliefs evolve, often affecting esteem, level of confidence and social, vocational and recreational functioning. An example of an irrational belief would be “I’m not important. I’m a failure, I’m defective or I’m worthless.”
Irrational beliefs can also evolve from something a person in authority might say on a continual basis. For example, I was never good at math but my high school algebra teacher made the statement, “I don’t know how someone could be so stupid and still breathe.” Another person I knew was a great baseball player in grade school. He won awards, etc. then was assigned a coach who decided to single him out. The coach began to make fun of him and was overly critical of his every move. This person quit playing and never picked up a baseball bat again, truly believing he had failed the game. Even though this wasn’t an obvious sign of abuse, it did have a lifelong impact on the person. EMDR and cognitive restructuring helps people challenge irrational thoughts and beliefs, to redefine who they are!
Traumatic or abusive events that resurface take over the emotional hemisphere of the brain and shut down the rational or intellectual part of the brain. By following the therapist’s fingers the eyes move back in forth as in REM sleep. During REM sleep the eyes also move back and forth bringing up images or at times unresolved issues from the past. Images or pictures from the past do come up! This becomes complex with abused or long term trauma folks, especially those who may have a tendency to disassociate.
With EMDR both the emotional and the rational hemispheres of the brain are engaged. This is a huge component of its efficacy to help the patient resolve childhood and traumatic issues. This is where the baseball player resolved what the coach had to say and began to play baseball again. This was an easy one. The case below was a little more difficult.
With this person’s permission, I am sharing what recently happened during a session with me. This person is a successful salesperson who is currently going through a divorce after 20 plus years of marriage. The person felt betrayed because their spouse was cheating and was flaunting that it is not against the law to cheat on a spouse. This person works and has always taken great care of the children. Their background included a lot of childhood neglect. Many years ago they evolved irrational beliefs: “Nobody loves me. Everyone else is happy except me. I’m not valued. I’ll never be happy.” I began to see this person for anger control issues. I’ve used hypnotherapy and Brief Cognitive Therapy addressing their belief system trying to build up their level of confidence, and relaxation exercises to reduce their anger.
Recently, this person presented for a scheduled session almost in a rage and was unable to focus or concentrate on work. An agreement to use EMDR was facilitated. Following the protocol and from earlier sessions an imagined safe place evolved. EMDR therapy began after the person calmed down utilizing some hypnosis techniques focusing on the five different senses of smell, touch, hearing, sight and taste. They were relaxed and experienced a childhood scene with feelings of safety and security. Having the person imagine their own personal safe place is key, as shown below.
Focusing on the scene from their past, EMDR began. After about 5 minutes feelings of anger began to evolve and the therapist redirected the person to their safe place. A few moments later the tears began and painful images of their childhood surfaced. An image of a forgotten childhood birthday emerged. At this point, the person’s heart rate began to escalate and the EMDR was stopped. The person was led back into hypnotherapy using breathing and progressive muscle relaxation. Through hypnosis the safe place was imagined, heart rate returned to normal, and the person had the feeling of exhaustion. The process of restructuring beliefs into positives such as “My kids value me!” was processed with more EMDR. The disturbing feelings were contained while building on the person’s resources to handle any stress that might come up during the week. This person left my office feeling emotionally drained, with no signs of anger and an irrational belief partially resolved.
The person later that afternoon returned to work and was able to complete all their tasks. Two days later, the person is experiencing a continued state of calmness with no signs of distress. We have an agreement that if stress is experienced, they are to call my office at once.
EMDR is not magic. There is a lot of work left to do. Recovering from childhood issues is like peeling an onion, one layer at a time. That afternoon we chipped at just a piece of that layer. EMDR is a gradual safe process that has a proven track record when done according to protocol and with the right therapist who is properly trained in this therapeutic technique. It is not for the novice nor to be tried on oneself! Whenever any traumatic or childhood memory is explored it needs to happen in a safe place, in a safe way, and with a skilled therapist.
John Lee LMHC owns the copy rights on the above article
Veterans Suicide Prevention Hotline 1-800-273-TALK, Veterans Press 1 The Department of Veterans Affairs’ (VA) has founded a national suicide prevention hotline to ensure veterans in emotional crisis have free, 24/7 access to trained counselors. To operate the Veterans Hotline, the VA partnered with the Substance Abuse and Mental Health Services Administration (SAMHSA) and the National Suicide Prevention Lifeline. Veterans can call the Lifeline number, 1-800-273-TALK (8255), and press “1” to be routed to the Veterans Suicide Prevention Hotline.
VA: VA Benefits: 1-800-827-1000:
Beneficiaries in receipt of Pension Benefits: 1-877-294-6380
Education (GI Bill): 1-888-442-4551
Health Care Benefits: 1-877-222-8387
Income Verification and Means Testing: 1-800-929-8387
Life Insurance: 1-800-669-8477
Mammography Helpline: 1-888-492-7844
Special Issues – Gulf War/Agent Orange/Project Shad/Mustard Agents and Lewisite/Ionizing Radiation: 1-800-749-8387
DCoE Outreach Center (Defense Center of Excellence)
What we do: • Provide an authoritative source of information and resources on psychological health (PH) & traumatic brain injury (TBI) issues• Help service members, veterans, and their families by connecting them with the resources they need to promote their resilience, recovery, and reintegration• Compile in-depth information and tools related to a PH or TBI inquiry
• Assist service members, veterans, families, leaders, healthcare providers navigate the
system of care• Respond to information requests about the DCoE• Support the Real Warriors Campaign.
Who we serve: • Service Members• Veterans• Families• Military Leaders• Clinicians• Researchers• Educators• Support personnel• Chaplains.
Benefits of our Center:• Specializes in providing in-depth information and resources related to the spectrum of psychological health matters and traumatic brain injury, not available elsewhere• Brings in-depth PH & TBI information/tools to warriors, families, clinicians, leaders• Collaborative in approach, facilitates networking and partnerships among DoD, VA, federal agencies and community organizations• Augments existing military and federal contact center and services. Our Capability: • 24/7 availability of our Health Resource Consultants (most have masters or doctoral level degrees and healthcare experience)• Respond by phone, email, instant messaging, chat, fax• Respond to specific research requests
VETS RESOURCE CENTER
7305 N. MILITARY TRAIL, BLDG. 6, WPB; 422-8262
Provides information and referral to shelters, halfway houses, case management programs, substance abuse programs, food and clothing pantries and showers..
Center of Hope
1577 N. Military Trail, West Palm Beach, FL 33409; (561) 682-1118
*** MALES ONLY *** This is not a homeless shelter, it is a comprehensive program and shelter is only one component. Homeless clients must be willing to make a commitment to end their homelessness. As such, only appropriate clients will be accepted into the program via Social Services. The Center of Hope offers transitional housing with support services: comprehensive substance abuse treatment services; mental health screening and services; anger management classes; GED prep and testing; Adult basic education; budget management; interviewing skills; life skills, employability classes and job search; case management; reintegration services; on-site NA/AA; off-site NA/AA; transportation (when appropriate); on-site spiritual activities (by client choice); transportation to Salvation Army faith-based programs (by client choice); client newsletter; other long and short term activities for client skill-building, relaxation, and socialization.
First Stop Veterans’ Resource Center
3175 S. Congress Avenue, Suite 304, Palm Springs, FL 33461; (561) 968-1612 Ext 13
Provides community reintegrating services to veterans. Services include: job readiness skills and assessment; job training/educational referral; VA/SSA benefit information; peer support group meetings; outreach and family counseling.
Hire A Hero
5245 College Avenue, Suite 408, Oakland, CA 94618; (866) 447-3243 or 866-HIRE A HERO
Internet Site: http://www.hireahero.com
Hire a Hero is an Internet networking website helping returning military personnel get a meaningful civilian job. Hire a Hero brings together military job seekers, military friendly employers and local people who want to help our returning military personnel get started with the rest of their lives as civilians.
MHA Veterans Programs
2695 N. Military Trail, #10, West Palm Beach, FL 33409; (561) 712-0584 or (866) 832-3755
MHA is part of the BrAIVe Coalition, a coalition working alongside the VA to to build network of agencies helping Veterans and their families. Services include the following: Veterans support groups are held weekly at Peer Place–A drop-in center. Peer place provides a safe and comfortable place for consumers of mental health services to learn essential wellness and recovery skills. This peer mentoring program employs nationally recognized strategies for helping people with chronic mental illness help each other achieve the best outcomes possible in their lives. Peer Place also offers supported employment, peer mentoring, a computer lab, wellness planning and support, hosts 6 and 12 step recovery meetings including: a Schizophrenics Anonymous Group, Other supports include art and relaxation activities, and group counseling support and assistance creating a wellness and recovery plan. MHA’s Mental Health Resources Database: Contains a list of agencies and support groups that offer help about mental health and wellness in the community for veterans. www.mhapbc.org
Local Veteran’s Facilities/Centers
West Palm Beach VMAC 7305 N. Military Trail, West Palm Beach, FL 33410-6400; (561) 422-8262 Provides primary and secondary level health care to eligible veterans in a seven-county area along Florida’s Treasure Coast. Comprehensive services include medical, surgical and psychiatric inpatient care and outpatient services in each specialty. In addition, extended care services offer community residential care, adult day health care, respite and hospice in addition to nursing home care.
Delray Beach Community Based Outpatient Program: 4800 Linton Blvd., Building E, Suite 300, Delray Beach, FL 33445; (561) 495-1973 Services Available: Primary care / internal medicine services; Care and management of chronic illnesses; Preventive healthcare screenings and evaluations; Nutritional consultation and evaluations; Outpatient nursing care and health education; Mental health assessments, screening, and therapies for a limited number of Mental Health diagnoses; Social Services assessments and referrals.
Stuart Community Based Outpatient Clinic 3501 S E Willoughby Boulevard, Stuart, FL 34997; (772) 288-0304 Services Available: Primary care / internal medicine services; Care and management of chronic illnesses; Preventive healthcare screenings and evaluations; Nutritional consultation and evaluations; Outpatient nursing care and health education; Mental health assessments, screening, and therapies for a limited number of Mental Health diagnoses; Social Services assessments and referrals
Vetsville Cease Fire House 291 N.E. 19th Avenue, Boynton Beach, FL 33435-2291; (561) 736-4325
To help disabled/homeless and hungry veterans by providing emergency residential lodging for $100 per week. No food nor transportation provided.
My counseling career began 20 plus years ago in a substance abuse treatment facility. I will never forget my first day! A drink was smuggled in to a person. The person had a “Slug”! He later left and died! How tragic! Addiction is cunning , baffling and powerful. I’ve seen many deaths both by accidents and suicides because of taking that first slug.
There is a part deep in the unconscious part of the brain that automatically makes the heart beat and drives other automatic behaviors such as addiction! This part of the unconscious stores feelings. Especially, euphoric experiences and how one reached that state of euphoria. That memory is carved into the brain and never goes away.
One little taste or one little innocent hit can remind the brain just how great it felt. The good feelings outweigh the bad so the brain does not automatically bring up the memories of puking in the gutter at 4am. Or, countless days of looking at oneself in the mirror asking why do I keep doing what I don’t want to do.
Yes! Just a slug does hurt! A Slug or a hit can lead a person to a relapse where there may be no return! I have never met an addict who could honestly predict behavior once the decision was made to use! If you are in need of counseling for addictions please give me a call! Also please visit my Facebook fan page
jack lee psychotherapist
Letting Go of the Grip of PTSD
Training the Brain to Respond rather than React
in recovery from PTSD
PTSD is a reaction based disorder. Survivors and people with untreated PTSD have anchors of horror that could come up with a familiar smell in the air, a tome of someones voice, something they see, hear taste or touch. During 4th of July fireworks combat veterans could have flashbacks as the sounds are similar to the battlefield. Just the sound of a firecracker could lead to a PTSD reaction. Core Mindfulness is just one way of many that can be used to retrain the brain to respond. Core mindfulness comes from Buddha’s Philosophy and means totally experiencing the moment, utilizing the body’s 5 sensory pathways. These sensory pathways are sight, smell, hearing, touch and taste. Utilizing these pathways to totally experience the moment the moment helps lower anxiety and helps one train the brain to respond rather than react. People go all out to exercise their bodies but how many really make it a point to exercise their minds?
For many years while treating people with schizophrenia I taught core mindfulness as part of my group therapy. Surprisingly, many who practiced learned to tune out the voices they were hearing. The first step is, What leads up to the reaction of hearing voices? One popular technique many began to practice was utilizing the self talk: “Stop!” “This isn’t me!” This is my illness.” For a few this began to really work. Then those who really applied it were ready to take it a step further. What I taught them next was how the brain receives its information through their five senses. What one saw, felt, heard, or smelled sometimes could trigger a reaction. Interestingly, this small group really got into this as they were realizing and experiencing how their positive self-talk seemed to help. I then would take them for a walk to get into the moment. By totally focusing on the experience of what the rose smelled like, what the trees looked like, what the chirping of the birds sounded like, and what the lemonade tasted like, people with schizophrenia began to experience the voices quieting down. By focusing on the experience of the moment they were also slowly training their minds to new habits which could lead to tuning down the volume of the voices. They continued to practice focusing on the wind against their chin and hearing the birds. Then they slowly began to experience how, when they would even talk to another person, the voices they heard in their heads would become softer and not as noticeable. By learning to turn down the voices, by practicing in the moment techniques, many began to stay out of the inpatient unit.
I had one case of a person who was on the list to go to the state hospital because of multiple inpatient episodes in one year. After time spent building a relationship, establishing trust and teaching the person to experience what happens to the voices while practicing positive self-talk and experiencing the moment, the person began to realize the voices weren’t as loud. Today this person is no longer at risk for more intensive treatment. In fact, they have gone years now without an inpatient episode.
Practicing core mindfulness works! If practicing core mindfulness can work with the voices of schizophrenia, it can certainly work with the reactions of PTSD. In fact, often the intrusive thoughts and intrusive images related to trauma are often misdiagnosed as psychosis. The difference is that the intrusive thoughts of PTSD are more focused and related to trauma. Psychotic voices are part of a disorganized thought process and are more outside of the body like one would hear sounds through a set of headphones. Intrusive thoughts are inside one’s head.
PTSD is a reactive disorder. The brain uses the same senses to send and receive information as in core mindfulness training. In the transmission of information to the perception part of the brain, traumatic thoughts and memories emerge from the amygdala, the part of the brain where they are permanently stored. This process is also connected to one’s fight or flight response and one’s sense of perception. When a dog sees fire, the dog runs away. The dog smelled the smoke long before it saw or felt the heat of the fire. The same is true with humans. The transmission of information from the sensory system is about self protection. That self protection is heightened in a person with PTSD.
One of the things I may do with a client is go for a walk in a safe secure place While walking I request the client to focus on the feeling of one’s feet while taking each step. Total focus was in the moment, being aware of where one was walking, and emphasizing safety. I then asked the client, while walking, to inhale counting up to four steps, then hold their breath for four steps, then exhale slowly for the next 8 steps and do this for a cycle of ten. I would then ask the client to sit and feel the warm sun, feel the breeze flow against their face, or hear any noises as there are often birds. I would I then ask them to focus on the moment by experiencing what the wooden bench felt like, to smell the smell of the air, and to look at the trees. I asked them to focus on the experience of the moment and to maintain this for 3 minutes. Even three minutes for a person with PTSD could be very difficult to accomplish. The goal would be to find a starting point. If one could completely focus for 2 or 3 minutes then with practice the next week the person may be able to focus for 4-5 minutes. By practicing core mindfulness skills, one is exercising the mind’s ability to focus and training the mind to respond. Often with PTSD one habitually reacts to similar events. By practicing, the reactions decrease and the ability to respond increases.
Teaching people to practice a combination of breathing exercises and core mindfulness helps people practice a new behavior of being more in control of the way their brain habitually reacts to similar events. The more core mindfulness is practiced, the more the brain will be trained to cope with what was once a debilitating reaction. Core mindfulness helps teache the brain how to respond to information received by the sensory system of touch, vision, hearing, taste and smell.
Some describe PTSD as a time bomb encased with bricks! A similar smell or similar sound can set it off. People with PTSD often don’t understand the “Why” behind the time bomb! By practicing breathing exercises, self hypnosis and core mindfulness behaviors, the brain is learning more positive habits to deal with stressors. A person can actually teach himself or herself to form a new habits of responding to familiar stressors. The more these new behaviors are practiced the more reprogrammed the brain becomes to respond rather than to react.
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Loosening the Grip of PTSD: Normal Human Reactions in Response to a Horrific Event
My heart goes out to the people in Haiti and to their loved ones here in America. I practice in South Florida and have been called upon to provide critical incident stress debriefing to people who have been affected by the earthquake. I’ve spoken with people who were there and now back here, people who do not know the status of their loved ones, and people who have lost multiple family members.
Just like I remember what I was doing when President Kennedy was assassinated or what I was doing when other disasters hit, I will always remember what I was doing when I received my first call last Wednesday afternoon. The terror in people’s eyes! Not wanting to believe what just happened! Not knowing if…..! Not being able to call…! Calling cell phones and not hearing the ring or voice mail! Terror! Absolute Terror!
I am sharing this experience because I need to provide more information on what to expect when trauma strikes! It is normal to have a reaction to tragedy or trauma. Trauma can happen to anyone. Normal everyday people have normal reactions to trauma! Accepting that it is OK to experience this kind of shock is very, very hard. It is very important for people to have an understanding of some of the normal reactions to really bad events which normal people experience.
Sometimes these reactions happen right away and sometimes they might happen a few days later. Less than 24 hours after the earthquake, what I saw from victims was shock, desperation, wanting answers and wishing we could wake up from a really bad nightmare. Not only do people have reactions to the event but also events like this can bring up other memories of “Trauma” from years ago. For example, someone can have a nightmare two days later of another horrible event.
People try their best to deal with the emotional part of trauma on their own. However, sometimes the “Normal reactions” are just too much to bear. It doesn’t mean you are going crazy or becoming mentally ill! It just means there is help out there to assist with the normal recovery process. It is especially important to seek help to prevent later issues like Post traumatic stress disorder or severe depression.
The following are normal reactions to Traumatic Events.
Many people experience Physical, Cognitive or Thinking, Emotional, Behavioral and Spiritual reactions. Physical reactions may include extreme tiredness, nausea, fainting, vomiting, chest pain, high blood pressure, difficulty breathing and heart attacks.
Cognitive or thinking reactions include not being able to think, not being able to make a decision, nightmares, memory loss, becoming fearful, feeling lost, forgetfulness. Many confuse some reactions to psychosis. Some people may experience seeing things or loud intrusive thoughts. Seeing things and voices are part of psychosis. However, when the thoughts or hallucinations are trauma related it becomes a very treatable issue. This is why it is so important to know this is a reaction. If you experience these frightening reactions say to yourself, “Stop!” This is a reaction!” I can get help and I will be OK! “This will pass!” Again, there is a big difference between psychotic voices and hallucinations and intrusive thoughts or images that are trauma related.
Emotional reactions include guilt, depression, anger, NS fear. Don’t feel bad if you need to scream out or cry! It is OK. Express your feelings. If you feel you will lose control, talk to a friend or reach out to a professional. Constantly remember, “What I am experiencing are normal reactions to a horrible event.”
Behavioral reactions include: not being able to sleep, inability to sit still, getting into “If I woulda, coulda, shoulda things would have been different,” giving up or neglecting personal hygiene, not wanting to go to work, avoiding people, places and things. Often there is a huge tendency to drink alcohol or use street drugs to kill the pain or get some relief. However, drinking takes away judgment and often people take out their loss on others. Many domestic cases of violence are related to reactions from trauma and alcohol and drug use. You might find yourself taking out your anger on an innocent bystander. Again, if you are experiencing loss of control or uncontrollable anger, get help!d
Often people could feel suicidal or homicidal. Feeling “I wish I could just die” is a normal symptom of depression and sometimes a normal reaction to trauma! Are you experiencing these kinds of thoughts? Then stop what you are doing and get help. Right now!
Other less severe behavioral reactions include feeling paralyzed like you can’t move! Often there is a big tendency to stay away from people! This is the time when people need to be around others. Helping others is a great way to distract yourself from the tragedy. This is the time to be a friend for somebody who needs a friend.
Spiritual reactions include anger at God, asking yourself “If there is a God, how could this happen!” Another spiritual reaction is stopping your normal religious practice.
It is important not to suppress your feelings. This is not the time to pretend everything is OK. Don’t say things like “I am OK!” “I can handle it!” Trauma is huge! Please give yourself permission to get the emotional help you need to recover!
If you don’t feel eating, make yourself eat! Drink plenty of water! Take vitamins! Force yourself to eat a nutritious balanced diet, even if you don’t want to. Not wanting to eat is a normal reaction!
Go for a long walk. While walking, don’t go over the trauma in your head. During the first 4 steps, take in a slow deep breath. The next 4 steps hold your breath, and the next 8 steps exhale pulling your navel towards your spine. Do this cycle of breathing for 8 times. And, practice it at least 8 times per day. If traumatic thoughts come into your mind, refocus on your breathing.
Many people find getting back to work is helpful. While working, if your thoughts become distracted on the trauma, refocus on your work. Ever see the movie “Karate Kid?” “Wax on. Wax off.” The character concentrated on applying the wax and removing the wax. He became totally focused.
Some people find journaling or writing is good to stop recurring thoughts. If you can’t get to sleep because you keep going over and over the trauma, write it down and tell yourself, “I have it written down; I can go back to it in the morning. I don’t have to do it now.”
One thing I feel is the most important thing to do for yourself. If you love someone, call them up right now and tell them you love them!
Remember, everything I wrote about is a possible normal reaction to trauma. It is important to experience the reactions and not to suppress them. Stuffing the feelings is what could later turn into problems like PTSD. Give yourself permission to seek help. Work through the different stages of grief. What do you tell someone who lost many family members? What do you tell someone who actually saw the devastation? Answer? Listen to them and provide an open ear and an open heart. What happened in Haiti could happen anywhere, which is why I wrote, “If there is someone you love, Call them up Right Now and tell them you Love Them!
PTSD can be treated! The once powerful reactions can become an issue of the past! People with untreated PTSD often manifest into a hyper aroused state, become startled easily, can’t sleep, become hyper sensitive to sounds and sometimes even to darkness. Often when someone experiences a similar sounding event there can be an over reaction.
One Patient described her PTSD as a Time Bomb encased in Brick and she never knew when it would go off. What a person hears, sees, smellls, tastes and touches can often trigger the reaction.
If you find yourself with insomnia, thoughts of the past, over reacting, avoiding places, or having nightmares about trauma call for help today! I am a PTSD survivor and a Licensed Mental Health Counselor. I am a member of the Florida Society of Clinical Hypnosis and have learned how to have more control over my mind. I had to develop more positive habits using core mindfulness, breathing techniques, and self hypnosis on a daily basis to calm down the hyper arousal! I have helped many simply teaching people what not only worked for me but what has worked on so many others. If you are suffering from PTSD, call me or email me today! I provide phone hypnotherapy and specialize in the treatment of Postraumatic Stress Disorder! I have had many sucessful outcomes with those who practice the skills they learn! So call me today for the help that you need!