Thursday, January 16, 2014

GROUNDING in the present moment

     

     Right now is a great time of the year to talk about grounding. Some of us are still riding the high of the New Year Resolutions hoping that finally we will be able to catch our dream by the tail. Others are already in the state of hopelessness, feeling defeated and incapable of changing their lives for the best. Both sides need some reality check. Using grounding skills is one of the best ways I know of to provide reality check for yourself and come to the truth of the present moment.    
     Grounding is a group of skills that are very helpful to human beings coping with stressful situations, as well as many trauma survivors. They can be used to deal with flashbacks, anxiety, dissociation, and any intense overwhelming feelings. As the name of this group suggests, grounding skills help a person utilizing them connect with the physicality of the present moment.  
     For someone, who survived traumas in the past, it is often a difficult thing to do, as the traumatic memories and experiences intrude on the present moment. Trauma survivors often feel, think, and act as if trauma is not over and continuing to happen in the now. It is very understandable given the overwhelming nature of the past experiences. Using grounding skills can help leave the trauma in the past and focus on the present, first for a moment, but with consistent and frequent use for a lifetime. 
     For those, who have not experienced many traumatic things in the past, grounding may be a helpful tool, when dealing with ongoing stressors and difficulties. Believe it or not most of the time our anxiety and fear are about the future that may or may not happen. When we can truly find ourselves in here and now, we can notice that we are OK in the moment, and this is often enough to change the state from highly stressed, edgy, irritable to more calm and relaxed.
     Below a variety of different practices is described. You can pick the ones that seem beneficial to you or test all of them. Each practice can be used on its own or in combination with the other ones in this group.

     1. Using your body to ground

1.1.  focus on your breathing for a few moments; notice how you breathe air in and how you breathe it out, notice the temperature of the air entering your nostrils, notice how your chest and stomach are rising and falling with every breath, notice the rhythm of your breathing; after a few moments of doing it, check in with yourself again to see how you are feeling.
1.2.  Another option is to use your feet. Put both of your feet on the ground. Notice how firm is the ground and how well it supports your feet, notice which parts of your feet are in direct contact with the ground.
1.3. Also, you can use slow and steady movement to ground yourself. For example, start walking slowly in your current space. You can even walk in one spot. Pay attention to the dynamic contact between your foot and the ground. Breathe deeply. If you have more space or time available, do a few yoga stretches. For example, do a downward facing dog pose and walk your feet in this pose.

    2. Using a physical object to ground     

Pick a river pebble or a small stuffed animal or a pendant or a piece of cloth. Any small object that is pleasant to touch and can be carried around easily will do. When you start feeling anxious, overwhelmed, or disconnected, grab the object and focus on exploring it. What does it smell like now? What is it like to touch it now? What color is it now? What texture does it have now? If you can find a place where you are alone, you can describe the object and answer these and other questions out loud. If not, do it silently in your mind. This practice can be done anywhere anytime without anyone around you knowing what you are doing.      

 3. Using your environment to ground (AKA 5-4-3-2-1)

One of my clients shared this technique with me a couple of years ago. Since then I used it with multiple people, who found it helpful and easy to perform. Here is an easy way to remember it:
Five things to see, four objects to touch, three sounds to hear, two things to smell, and one positive affirmation to repeat.
When anxiety or a flashback hits, look around you and find five  different things that are of a certain same color (e.g., green).  For example, as I am looking around my room right now, I see a green bottle, a green mug, a bag that has green in it, green picture frame, and green palm tree on the picture. Next,  find four different surfaces or objects you can touch (e.g., top of the table, your own hand, your pants, a pen or a notebook, etc.) As you touch each object, use one or two words to describe the feel or the texture of it. Next, listen to the sounds around you and identify three different ones. As I am writing this post, I can hear clicking of the keys on my keyboard, running water in the kitchen, and a wooshy sound outside. Next, find two different things to smell. Anything that smells relatively pleasant to you will do the trick. Some examples maybe hand lotion, soap, a cup of coffee, perfume, a flower. Finally, use a positive affirmation. Say it out loud or silently. Repeat several times. The last two steps can be used as the stand-alone grounding techniques. See below for more details.

     4. Using your sense of smell to ground         

     Aromas and smells are the only type of the sensory information that
bypasses cerebral cortex; olfactory nerves through the olfactory bulb send information directly to the amygdala (a part of our emotional brain) and therefore smells have much quicker effects on our mood and mental state than sights or sounds.  I advise my clients, who tend to get easily anxious
or overwhelmed,  to always carry with them something that has a pleasant smell. Good candidates are essential oils, such as lavender or peppermint or sweet orange. These oils can be bought in a health food store or online. Put several drops of your favorite oil on a piece of cloth or carry the whole bottle with you and put a drop on your wrist, when needed. Please, note that essential oils are very potent and need to be handled with care. You only need a drop or two for the grounding technique.
     When you get anxious, smell the oil on the cloth or your wrist. Really, focus on the smell. What is it like? How does it make you feel? This is a very quick “pick me up” technique that maybe effectively used in critical circumstances.

   5. Using affirmations to ground

I suggest combining this particular skill with any one of the above. Create your own phrase that helps you connect to the present moment or use from the list below. Once you have a phrase, repeat it out loud or in your mind many times.
- “I am OK here now”
- “Present moment is all I have”
- “All is well in my world”
- “I am safe here and now”
- “I am present”
- “Everything is well now”
-“I am in tune with the flow of life”
-“I am centered and grounded”
- “I am connected to myself and the present moment”

 
   I often use grounding techniques in my regular life. Whether I am stuck at the airport, have too much on my plate, dealing with physical pain, or with a new situation, I put two feet on the ground, keep my spine straight, raise my head high, breathe in deeply and tell myself: “I am OK here now”. Sometimes after that I walk in place or take a very brief walk. Every time I am surprised how such a small trivial thing as putting my  feet on the ground, breathing in, and telling myself I am ok brings me back from the painful past or scary future to a pretty tolerable here and now. I then remind myself to focus on one step at a time or one day at a time or one breath at a time, whatever the situation warrants. I am hoping that you can find a grounding practice that works for you and integrate it into your daily life.
 Happy grounding :)

As always, I am interested in your feedback. Have you tried any of the aforementioned techniques? How did it work? Do you have any other grounding techniques that you would like to share? 

Monday, December 23, 2013

Surviving holidays with dysfunctional family - 101



     This post is my gift to those, who tend to suffer through the holidays. If you are from a lucky bunch, who enjoys very much spending time with their immediate and extended families during the holiday season, I wish you the most festive celebrations and you can stop reading now. However, if you are a one, who was born into or adopted by a dysfunctional family, keep reading. You may have a laugh or possibly find a useful point or two below.



     Holiday time, especially Christmas time, is a season, when dysfunctional families blossom. They prepare for that time throughout the whole year with passion and enjoy every moment of it with the grimaces of suffering on the family members’ faces. Don’t ask me why. I am not a psychic. Just sharing my observations. So, if you would like to join in with your dysfunctional family and have fun being ridiculed, guilted, put down, and made feel like you are the worst human being that ever walked the face of earth, it is OK. It is a conscious choice, and I do not have any judgment there. You can stop reading now and go do your normal routine. If, however, you are tired of suffering and spending months putting yourself back together after holiday fun with your family, I have some suggestions that I summarized below in the form of steps.
Step 1. Adjust your goals and expectations.
     Somehow many of us have a goal to enjoy holiday time with our families. Crazy, huh? Even though we have never been able to reach this goal in the past, we keep pursuing it and hoping that this year things will turn out differently.  Others come to their homeland with the goal of finally showing them, making them understand, apologize, change, etc. When our goal is not being met, we tend to criticize and blame ourselves for that.  
     Well, maybe it’s a time to consider a different goal? For example, getting through the visit with the family in one piece with minimal emotional wounding with the follow up goal of spending just two weeks instead of four months healing from the experience.  What do you think? Framework is everything J
Step 2.  Give yourself compassion
     After all, you did not choose what kind of family you were born into, adopted by, or married into.  You cannot control other people’s choices or decisions. You are not responsible for the mess they create. But… you are affected by all that shit. It is extremely painful to hear for one hundredth time that unlike you, your brother has impeccable taste in women or is capable of providing for his aging parents. It is difficult to not feel responsible or guilty for your father’s asthma or drug abuse that he acquired working hard to provide for you. So, give yourself a hug and pour some unconditional love on yourself. You are lovable and worthy no matter what your family members say, think, or do. Here is the tape by Kristin Neff that you can download on your favorite digital device and listen to over and over again on your trip, before you go to bed, first thing after waking up in the morning, when you step outside for a breath and so forth: http://www.self-compassion.org/LKM.self-compassion.MP3.  After many repetitions it may brainwash you into believing that you are OK in spite of your mother’s or father’s insistence to the contrary.
Step 3. Predict
     From the previous years of experience with your family, you can predict a lot of what is going to happen. You may foresee that your uncle Henry will get drunk and start inappropriately touching you or make sexual advances towards your girlfriend or wife. You can be pretty confident that your grandma will ask you in front of the rest of the family, why you still have not lost any weight or are not married or don’t have kids or lost your job again. You may even anticipate that your mother will bluntly or subtly let you know that you are not good enough son or daughter, because you don’t visit enough, forgot her cat’s birthday, or obviously didn’t care about her health enough to visit her during the hospital stay you didn’t know anything about or because Shelly’s girl bought her a trip to Europe for Christmas and Pete’s boy got another promotion and is now the CEO of the World’s bank. As long as you step into the time with your family with your eyes open and your memory intact, you can take step 4.    
Step 4. Plan and Modify your responses to the predictable assaults
   
 Your past responses might have been to suffer through it all in silence or defiance or fight the injustice or something else. If you are reading this, it most likely means that whatever you did in the past has stopped working. So, may be it is a time to try something new? With the help from many of my clients and other people I have created a list of different types of responses. It is not an exhaustive list, feel free to create your own options. Just pick/create one or two new strategies to try this season. Write it down on a note card and carry with you as a reminder.
Different kinds of responses to predictable family assaults.
Preventing assaults from happening
·         Shorten your visit
·         Structure the time you spend with the family by playing board games, watching movies, going on hikes, etc.
·         Associate with people, who are supportive of you, and avoid those, who are hurtful
·         Be prepared to leave earlier than planned if things start escalating
Responding to the violation of physical boundaries, AKA unwanted touching
·         Prevent it from happening by maintaining physical distance between you and a family member, who tends to be inappropriate or unwelcome with touching
·         “You might not know this yet, but I have a personal bubble (use your hand to delineate it) and it is not OK for you to go inside it”
·         “I am not in a touchy feely mood”
·         “Stop it. I don’t like being touched”
·         Gently take a person’s hand or other part of the body that is used to violate your space and place or move it back on/towards their body
·         Walk away
·         Say very loudly: “I am sure you meant to touch my shoulder not my breast/ butt/ crotch/thigh. It happens”
·         “I am sure your wife/girlfriend/partner would love a touch like that. But I am your niece/daughter/son/sister, etc.”
Responding to the unwanted questions, jokes, comments AKA emotional fucking
·         INTERRUPT: “I am sorry. I need to go to the bathroom”
·         DISTRACT: “Oh my God, your earrings/necklace/outfit/hair are stunning”
·         DISARM: “I agree. I’m a total fuck-up. After all, the apple doesn’t fall far away from the tree”
·         STOP: “No comments”
·         USE HUMOR: Make a joke
·         IGNORE: pretend you didn’t hear comment or question
Step 6. Plan for crisis
     Depending on how dysfunctional your family is and how volatile and hurtful things have been in the past, you may want to have a safety/escape plan ready before you even leave your house. Make sure that you can exit the gathering place at any moment, give yourself permission to leave, have plan B ready with clear ideas of how to leave, where to go, and how to take care of yourself before you can get back home.
     Be on the lookout for the red flags that signal to you it is time to leave. For example, if you know that every time your uncle gets drunk, the physical fight between him and one or two other family members is coming, then leave when he is on the way to getting drunk and before he is already drunk.
Step 7. Take good care of yourself
     Focusing on yourself during a gathering of a dysfunctional family, is not selfish. It is responsible. What do you need to survive this stressful time with minimal harm to yourself? Answer this question and commit to doing those needed things. I know for myself that during stressful meetings, I need my full 8 hours or more of sleep, meditation, and at least a brief yoga practice. I commit to doing those things for myself. In the past, when I was capable of fitting all three things into my daily routine, I found that jerks I was surrounded by, somehow were more pleasant and easier to deal with.  J
Step 8. Focus on healing when you are back home

·              After you make it back home in one piece, no matter how distraught you are, congratulate yourself. You survived another family holiday gathering, you tried something different, and it is a big accomplishment no matter what the result is.
·         Do something soothing but not destructive. Here are some ideas: wrap yourself in a warm blanket and read your favorite book, have a cup of your favorite tea, take a nap, go for a walk, take a bath with aroma oils, or work out.
·         Process and debrief. Talk to a supportive friend or family member about the gathering, write a funny story about it, make a piece of art, or just journal.
·         Take it easy for a few days. Be gentle with yourself. Recognize that stressful and difficult events need to be followed by restful and restorative ones.
     Please, remember that even though you are not responsible for other family members’ choices and cannot control their actions, you are in full control of yourself. You have the right to protect yourself from being hurt. You have the responsibility to heal yourself after being hurt. If all members of your family did just that, you would not have a dysfunctional family to begin with J
     Have some compassion for your dysfunctional family members. After all, if it was not for you and other targets, they will have to focus on themselves and deal with their own issues. And you know how scary, hard, and plain painful that is. How can you expect someone you love to go through such a torture?
     I hope that this article made you smile at times and gave you some ideas to try. I trust that you were able to distinguish jokes and sarcasm from serious points and suggestions. J
HAPPY HOLIDAYS TO YOU AND YOUR FAMILY!
With much  love and compassion,

Irina

 



Wednesday, October 23, 2013

Dealing with negative self perception

     Disliking oneself is a very common consequence of the traumatic experiences. This often does not make sense to either trauma survivors or those who live with them. What happened was not their fault, why so much self-hatred? Let’s think about it together. Any violence towards a person carries within it a very powerful message. When violence is directed at me, it says to me “You are worthless and therefore deserving of this kind of treatment” The more intense and/or prolonged violence is, the more energy this message carries.  It often penetrates all kinds of self-defenses and touches the depth of our being. After violence is over, we start repeating this message to ourselves until we completely believe in it. What makes this situation very challenging is the fact that both transmission of the message and its repetition happen on an unconscious level, in the back of our minds.
     Good news is that since self-dislike is a learned response, it can be unlearned and a different positive response may be acquired. If you would like to learn to treat yourself better and have a more positive perspective on yourself, try one or more of the following practices.

1.       Positive affirmations
Those are the brief and precise sentences that describe how you would like to see yourself in a more positive way. The trick is that they are formulated in a present tense. For example, “I am wonderful just the way I am” or “I love and accept myself” or “I am worthy” or “I deserve to be taken care of” and so forth.  Develop three to four sentences. Write them on the notecards, sticky notes, your mirror, your phone. Repeat them as often as possible throughout the day.
At first, you probably would not believe any of those words. It may feel strange, awkward, even fake to say those things to yourself. But the more consistent you are in using those positive affirmations the more you will eventually believe in them.

2.       Loving Kindness Meditation with self- focus
This is a beautiful practice of wishing yourself well and sending to yourself all the healing and support there exists. There are a lot of different versions of it. Multiple tapes are available for you to listen to. I wrote about it in the January 2013 post. Here is an excerpt from it K
1) Choose several phrases that you will be working with (repeating) that start with “May I” and focus on wishing yourself well. Usually, meditation consists of  3-4 phrases repeated over and over again. If you find it difficult to come up with those phrases, here are some suggestions:
- May I be well
- May I love myself no matter what
- May I accept myself just the way I am
- May I be content
2) After you identified and wrote down the phrases you are going to use, find a quiet place, where you will not be disturbed by anyone or anything. Sit in a comfortable position, such as with your legs crossed on a cushion or in the chair or on the sofa. Close your eyes and focus on your breathing for a few moments. Notice how you breathe air in and how you breathe it out. Then visualize yourself surrounded by white or yellow light. Feel the warmth of light on your skin. Enjoy the sensations. Now start saying the phrases that you identified out loud or silently in your mind. Pause after each sentence and connect to the wish it contains. Maintain awareness of your breathing and picture of yourself surrounded by white light. Spend 3-5 minutes repeating the phrases. Repeat this practice daily.
Note that for the first couple of months wishing yourself love and acceptance may feel false or wrong. Some parts of you may think that you don’t deserve all of those things. It’s OK. You don’t have to believe in what you are saying to get positive results. Additionally, the more often you practice this meditation the more you will feel and believe in your worthiness.
3.       Treating self well
     When you take good care of yourself and treat yourself well, you re-wire your mind to believe that you are a good person worthy of love. Even if you don’t feel like it, create a routine of basic care and follow it consistently. For example, every morning when you wake up, take a shower, brush your teeth, put on fresh clothes, and make a breakfast for yourself. Every evening put on fresh pajamas, light candles, and take a few minutes to read something inspiring before you go to bed. This is just an illustration. Listen to yourself and create a routine that feels good for you.
     Take any opportunity to be good to yourself. When you make a mistake and catch yourself in a severe blaming or shaming talk, interrupt it and say something reassuring instead, such as “everyone makes mistakes” or “I can learn from it” or “if God wanted me to be perfect, he would have made me that way”.  When you feel down, bad, lazy, crazy, say something supportive and uplifting, offer self a cup of hot tea or a hug. Treat yourself the way you would treat your dearest friend.
     Remember that learning to treat yourself well is a work in progress. It may be challenging. You may feel like you are failing at it. You may forget and relapse. It is all OK. All of those things are a part of the learning process. You can always try again and you can build on the previous mistakes. That is a beauty of life. Every moment is a new and fresh start J
4.       Abstaining  from self-harm
     Directly related to a previous point, is the idea that self-harm promotes negative self-image and further deepens the belief that you are not good enough. Therefore, to improve your self-perception, it is important to abstain from it. I understand that inflicting pain on self, whether it is cutting, burning, hitting, pinching or something else, is often a way to cope. It helps to suppress more severe emotional pain or on contrary makes you feel something when you are in the state of traumatic numbness. Sometimes it is the quickest way to change a state. Sometimes it is a way to express how much you hate yourself. This behavior is very understandable in those who survived violence, and yet it has to be changed in order for you to start feeling better. Here are a few ideas on how to deal with the urges to self-harm. However, if it is an ongoing issue for you, I recommend that you find a therapist and start working with him/her.
1) when an urge to harm self presents itself, ask yourself a question “who am I angry at other than myself?” Then express your anger towards that person or situation in a non-hurtful way, such as journaling
2) if you cannot identify source of your anger outside of yourself or it feels dangerous, use softer/substitute methods of inflicting pain, such as holding ice-cubes in your hands or immersing your face in ice water for a few seconds; sometimes drawing lines with the red marker at the site where you want to cut or burn, helps to alleviate an urge;         
3) call a trusted friend or a crisis number, such as 1-800-273-TALK to discuss how you are feeling;
4) get out of the current situation: step outside for a few breaths of fresh air, go to the park or to the coffee shop, distract yourself with something positive, such as uplifting book or a movie.
about it, creating a piece of art, going for a run, or screaming/singing in a shower;
     Give yourself time to process the idea that you can change how you feel about yourself. Give yourself time and space to practice the aforementioned techniques. Be patient like you would with a baby, who is just learning how to walk. Remember you will not smack the baby or call it worthless, when it falls down. So, extend the same kind of kindness to yourself. After all, you are just learning or re-discovering how to be good to yourself.
     Some of you may doubt that loving yourself is a goal worthy of pursuit. Isn’t it selfish? Haven’t we all be taught that we need to focus on others before we focus on ourselves? These questions and doubts are very understandable. Here is the way I came to view it based on my years of experience of working with people. Belief that self-love is selfish and therefore bad is a cultural myth. Unfortunately, this myth is wide-spread and has perpetuated a lot of violence and suffering. When a person genuinely loves themselves, they are a joy to be around. They spread positive energy and infect others with love and compassion. They do not have any desire or motive to harm anyone. They value human life. If everyone in this world loved themselves, there would be no war, no hunger, no violence. In my opinion, coming to accept yourself is the best gift you can give this world J

    


Wednesday, August 14, 2013

Dealing with the messiness of life

     Throughout the years I noticed that many trauma survivors, including myself, have desire to avoid messiness of life at all costs. We lock ourselves in the safety of our houses, relationships, jobs, routines, etc. We dread any change. We want to have full control of our lives, which is very understandable given how out-of-control traumatic experience felt. However, as protective and desirable as it is, this state of avoidance is also unrealistic. We do not have full control of our lives and our circumstances. There are too many forces and factors that play on the stages of our lives. The only control we truly have is of how we respond to what happens.
     Practicing yoga on the beach helped me learn about messiness and control in my life. I have always thought about practicing yoga on the beach as a fun and pleasant activity. I have been craving it for a while. Finally, two weeks ago I arrived at the beach on Hilton Head Island with my yoga towel and a bottle of water and an intent to fully immerse myself in the yoga class offered there. It was 8:30 a.m. in the morning on a sunny day with a fresh breeze coming from the ocean. The sound of waves crushing against each other was very soothing. I placed my towel next to another yogi’s towel and stood at the top of it as instructed by the teacher. As we started engaging in Sun Salutations and other standing poses, I realized that my towel does not hold my weight very well. The sand under it got very bumpy. Moreover, sand got on the towel, on my hands, arms, legs, and feet. It was rubbing against my skin. Wind was blowing sand into my face. My eyes were stinging with sweat pouring from my forehead. People walking on the beach were stopping and staring at our small group, some even took pictures. Seagulls were screaming. Kids were running around sprinkling water all around. “What a mess!” I thought to myself. Suddenly I felt uncomfortable, unpleasant, and disappointed. “This is NOT what yoga on the beach is supposed to be like!”
     Then I realized that there is NOT “supposed to be” for any experience, including yoga on the beach. It is what it is. I have a choice of accepting this experience as it is or fighting it. I decided to slow my mind down and focus on my breathing. Soon I noticed that in addition to all the aforementioned discomforts, I also experienced pleasure from moving and stretching my body, from the breeze caressing my sandy arms and legs, and from being able to identify and intensely listen to the sound of waves. “It’s just like any other part of life,” I heard a voice in my head. “In order to feel joy and pleasure, you need to immerse yourself into an experience fully and be willing to take discomfort that comes with it as well”. 
     When the class hit its midpoint, my experience was quite different. I actually stopped minding sweaty sandy mess that covered my body. My focus shifted towards movement, breath, and ocean waves. I felt as One with all of that. I still noticed all the other stuff, like people walking and staring, seagulls screaming and so forth, but all of them became background for my sense of connection with my body and nature.
     Later on, when I reflected on my experience in the class, I thought of messiness as an integral part of living. Nothing good is ever created without a mess, be it a baby being born or a meal being cooked or a piece of art being created or a tomato being grown. I found the quote by Charles Caleb Colton that I really resonated with: “Life isn't like a book. Life isn't logical or sensible or orderly. Life is a mess most of the time”.
     So, why are we so mess-phobic? Why are we trying to keep mess and disorder out of our lives? Somehow we came to equate mess with danger and evil. We get overwhelmed. We think we will not be able to cope if we get ourselves in a mess. We don’t have skills or resources. So, there are different ways to go about the issue. One would be to avoid mess altogether and accept the consequences of avoiding life and joy and learning and growth. Another way is to learn skills and obtain necessary resources to deal with the mess, so that we can experience our lives fully. The choice is ours. And, we can choose every moment and every day J


Wednesday, July 24, 2013

Monsters on a healing journey

The following video explains how trauma happens, how it effects our lives, and how we cope and then heal from it. It is told in a form of story involving pictures of monsters and stick people. I believe it helps understand what trauma does to us on a more emotional level. Please, watch and comment.

"Monsters in our lives" video






Thursday, June 27, 2013

National PTSD Awareness Month

     June 2013 is a PTSD awareness month. Different events are being held across the nation to improve understanding of experiences and awareness of signs and treatments of PTSD. As I am waiting for the start of the community discussion on PTSD facilitated by Dr. Susan Fuhr (http://www.yourjourneys.net/), I am reflecting on what it means to be diagnosed with PTSD, to live with PTSD. On a daily basis I talk to folks, who survived different kinds of traumas. I hear the stories of survival and struggle. Often there is a lot of hopelessness and despair. Always there is a lot of pain. It is very understandable given what trauma survivors went through. They experience normal reaction to the abnormal situation, even though many of them and their significant others do not think that survivor's response is normal.
     I would like to share some of my thoughts on PTSD. In the past two decades our understanding of this disorder changed a lot due to developing research and clinical practice. We know now that this disorder has neurological underpinnings, and that it changes brain. We know that it affects individuals on all levels: physical, cognitive, emotional, social, and spiritual. We also understand that trauma wounds are not healed by just time and do not go away on their own.
     In spite of all the pain and hardship that PTSD comes with, there is a lot of hope too. In the past decade a number of treatments became available to trauma survivors. Among them are EMDR (http://www.emdria.org/),Internal Family Systems (http://www.selfleadership.org/), Somatic Experiencing (http://www.traumahealing.com/), Sensorimotor therapy (http://www.sensorimotorpsychotherapy.org/), and cognitive processing therapy (http://www.ptsd.va.gov/public/pages/cognitive_processing_therapy.asp). All of these treatment modalities have shown tremendous success in treating the effects of trauma and helping survivors find a way to make sense of what happened to them, assimilate their experiences, and truly move forward with their lives.
     In addition, a number of complimentary approaches were introduced, including yoga (http://www.yogajournal.com/) and mindfulness (http://www.mindful.org/). These practices help survivors re-learn how to be present with their current experiences. They help people stay grounded in the present moment as opposed to the past events. They also have tremendous calming effect on the nervous system and brain.
     If you were to take  away  just one point from this post, let it be the following: PTSD can be treated. Get professional help! The sooner you address it, the better results you will get.
   

Tuesday, May 7, 2013

Packing for a journey: tools and skills


     Healing from trauma is a long process and a substantial journey. As any big trip it requires preparation and right gear. For some journeys we need clothes and a sleeping bag for others we need tools and skills. This post will help you understand a broader picture of what you may need to support your healing journey. The posts that follow will expand on each category and teach you specific skills.
     Very often when trauma is over, we find ourselves behaving in self-destructive ways, such as abusing alcohol or drugs, cutting self, taking unjustified risks, engaging in unsafe sex and so forth. This happens not because we really want to hurt ourselves but because we are reaching for what is available and quick to relieve our emotional pain. A couple of drinks can really take the edge off in this moment. A one night stand can temporarily relieve loneliness and create a moment of pleasure.  
     The truth is we want to cope. We want to feel better. But we don’t know of lasting and effective ways to bring relief. Nobody teaches us in school or college the skills we might need if we get traumatized. Good news is that we can obtain what we need at any age by understanding common emotional needs of trauma survivors and learning specific ways to address them. So, let’s get to the bottom of it. The table below  summarizes common emotional needs and issues of trauma survivors and suggests different tools and skills that can be helpful in dealing with each one of those. 
Common emotional concerns of survivors
Focus of learning
Skills & Techniques
Mood & affect instability
How to tolerate distress and pain without falling apart; How to improve mood
Distraction
Self-soothing
Mind-body techniques Containment
Anxiety, hyperarousal, stress and tension
How to tolerate anxiety; How to reduce anxiety
Mind-body techniques
Imagery techniques, i.e. Safe Place
Relieving past traumatic experiences: flashbacks, obsessive thoughts, sudden intense emotions
How to be in and return to the present moment
Grounding
Mind-body techniques
Containment
Difficulty communicating with or relating to others
How to express self effectively; How to listen to others efficiently
Expressing your thoughts and feelings
Asking for what you need
Effective use of “no”
Non-specific difficulties functioning at the “normal” level
How to take good care of self
Basic  self-care: sleeping, eating, exercising
Negative self-image & shame
How to focus on the core goodness; How to focus on the positive aspects of self
Positive self-talk & affirmations
Discovering anger
Persistent feelings of guilt 

Forgiveness practice

Intense anger
Coping affirmations
Time out
Safe expressions of anger
Suicidal thoughts, impulses to self-harm, homicidal thoughts
Understanding the nature of the thoughts/impulses
Survival kit/box

     In the next several posts I will describe the skills summarized in the table above in detail. Each post will focus on the specific emotional concern (left column of the table) and teach you skills to address or cope with this concern. Some of the skills or concerns have been described in the previous posts. You will find links to those posts in the table.
     As a conclusion, healing from trauma is a long process that takes courage, perseverance, time, and multiple resources. It is a long journey. As any successful journey, it has to be planned and prepared for. Think of learning and practicing coping skills as a very important preparation step.You need those tools in order to cross the "oceans" and "desserts" that you will meet on your way and to reach the oasis of  healed and whole self. So, do not regret time and energy you spend at this step of the process. It will serve you very well once you delve into reprocessing traumatic memories, the most painful part of the .journey.