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Interviewing a New Trauma Therapist – Questions For Dissociative Survivors to Keep in Mind

Are you looking for a new trauma therapist? Do you need to find a therapist that specializes in trauma disorders?

When you are interviewing new therapists, in addition to clarifying that they have the skills and training it takes to provide proper treatment for your trauma issues, it is also important to ask about their approach to trauma work. Make sure their views match or blend with your own views, otherwise there will be conflicts ahead. There are a number of different approaches to trauma work — just as there are tons of different recipes for how to make a loaf of bread. It isn’t that one way is “THE” right way. You and/or the therapist may have very strong opinions for what works best, but the point that matters is if you agree with how your therapist approaches the issues with you.

For example, if a survivor with DID / MPD said to me, “Help me get rid of all these pesky little parts that are irritating me. I want them totally gone and removed from my head.” Oh, well, you see… there are some therapists that would gladly approach therapy work with that goal in mind. I, on the other hand, would have a cow. A really big cow. If someone wanted me to help rid them of their insiders, I couldn’t do it. I wouldn’t do it. I don’t agree with that approach, and just couldn’t be convinced to go there. In that case, this person and I would be a therapeutic mismatch. We would not be aiming for the same goal, so it would not be a good idea for us to work together.

Before you share very much of your personal system information, please take the time to interview the therapist very closely. You must be VERY sure of the safety of the therapist before you disclose about yourself on those deep levels. There are lots of great therapists out there. There are also lots of clowns claiming they are trauma specialists. They may not be dangerous people, but they can do a lot of harm by not actually knowing how to treat trauma-related issues. Please be aware, there are also “double agents” out there — people who claim to be a helping person, but are actually working to support the dark side. Interview all therapists very very closely to make sure you find someone who is both safe and qualified.

When interviewing new therapists, some of the important areas to consider are:

Direct Experience:

  • How many years of experience do you have in working with trauma disorders?
  • How many dissociative survivors have you met?
  • How many survivors with dissociative identity disorder have you treated (as the primary clinician)?
  • What percentage of your practice has been filled by clients with trauma-related issues?
  • Do you have a web-site, any books, articles, or outside referral sources that can confirm your experience?

Education:

  • Where did you first learn about trauma and dissociation?
  • Who have you studied with, and/or who mentored or supervised your early years of trauma work?
  • What conferences and training programs have you attended?
  • What have you done to build and develop your expertise in the trauma field?
  • Where do you go for help if you have a clinical question?
  • Do you have a valid mental health license, and can you verify that your license is in good standing?

Approach:

  • In your opinion, what are the most important aspects of trauma work?
  • In your opinion, what do people need to do to process their trauma?
  • In your opinion, how long does it take to work through trauma-related issues?
  • What do you do if someone is stuck on a particular trauma-related issue?
  • How do you manage issues related to self-injury?
  • What are your office policies for emergency situations?
  • What are your policies and guidelines for regular therapy sessions?
  • If I need additional support between therapy sessions, what do you recommend?
  • What do you think of “so and so’s” approach to therapy? (insert the names of your favorite trauma therapists or authors)
  • What are your thoughts about ritualized abuse, cult abuse, and organized abuse?

Dissociative Specialty Questions:

  • How do you define Dissociative Identity Disorder?
  • In your words, what is involved in the treatment process for Dissociative Disorders?
  • When do you approach trauma / memory work?
  • In your opinion, when is a client not ready to do memory work?
  • What are your beliefs / perspectives about who the alters are?
  • Do you speak directly to insiders? Why, or why not?
  • Do you prefer all communication to go directly through the host / adult / front part? Why, or why not?
  • What kinds of homework will you expect my system to do outside of the therapy sessions?
  • What are your beliefs and approaches to integration?
  • How do you define “success” in terms of treatment goals for DID / MPD?
  • Have you ever worked with mind control issues? If so, what do you do?

Of course, as you go through the interview process, be sure to ask clarifying questions about the answers you are being given. Any therapist that understands trauma disorders is going to understand why you need to check them out thoroughly. Needing time to build trust is obvious, and having the same theoretical foundation is critical.

These are not personal questions. Keep your questions focused on the type of work that will happen in the therapeutic environment, and not on the therapist as a person.

Before you get emotionally attached to a therapist, please make sure that their approach fits with how you want to proceed with your own therapy.

Your healing journey belongs to you. You get to decide how it will look, and what paths you will take. Working with a therapist that fits with what you want is critically important. Otherwise, you will waste a lot of precious healing time struggling with opposite or conflicting goals. The journey will go much smoother if you and your trusted therapist approach your healing process from the same wavelength.

Trauma Stigma – We Are Only As Sick As Our Secrets

I had a reminder recently of the stigma facing those dealing with trauma related to childhood abuse.  I have encountered this before of course, perhaps vicariously, during my 20 plus years in the trauma treatment trenches.  As a psychologist specializing in treating trauma I am well aware that many people do not want to be reminded of the less than pleasant aspects of life.  Even mentioning what I do for a living can get me interesting responses, or sometimes just shut down the conversation altogether.

Someone unfollowed me on Twitter, and wrote to inform me,  because I was not a “positive psychologist”. This took me aback  and I tried to understand what led to that impression.  I looked through my most recent Twitter postings to try to see what they saw.  I had been posting, as I always do, about the impact of trauma and had recently written an article about how childhood experiences are linked to adult problems: Childhood Wounds: Understanding Yourself in Context.

“You are only as sick as your secrets”.  If the oft repeated 12 step slogan is true then our culture is indeed sick.  The refusal to acknowledge the link between childhood trauma (big T and little t) and mental health issues of all sorts in adulthood seems to me to be a kind of cultural dissociation.  We would rather blame the victim, or in family systems terms set up the “sick” one as an identified patient, who has bad brain chemistry or has come by their mental “illness” in any way other than as a result of their childhood experiences.

Denying the past dooms us to repeat it. Denying the link between childhood trauma and mental health disorders of many kinds leads to inadequate treatment of the put a band-aid on it sort, no treatment at all, and/or adults who are ill prepared to themselves provide good enough parenting (or protect their children from outside perpetrators).  And thus the cycle continues.

The pervasiveness of childhood trauma and its long lasting impact is the big secret and survivors who try to talk about their experiences are shamed and stigmatized.  We want to view you as other, an anomaly, not the understandable consequence of a sick society.

My Twitter experience felt very much like a reaction to my telling the truth about these issues our culture wants to disavow. If I as a professional am impacted, imagine how much more so this stigma impacts survivors, I was reminded.  The silencing, minimizing and blaming that can occur when a survivor tries to tell their story is a whole other level of traumatization.

This experience reminded me that visibility and conversation about trauma-related topics is crucial.  It is why I see blogging and using social media to be an important part of my work as a trauma therapist.  By speaking out about trauma and its impact I hope to support those who must live with it and to educate those who do not yet understand.

What else can we do to combat trauma-related stigma?

-Stop blaming the victim.  Speak up as an ally when you hear victim blaming conversations.  Those who have been abused and need to get help for it are not the problem. Abuse and the systems that allow it to continue are.

-Understand that avoidance, denial, not talking about childhood trauma and abuse does not make it better. If a survivor could just think it away, they would have long ago.

- Realize that nature vs. nurture is a false dichotomy. Our environment (how we are nurtured) effects our brain chemistry. “Chemical imbalances” as the cause of psychological problems rarely exist in a vacuum.

Please do share your experiences with stigma related to trauma issues, or mental health in general,  and how you combat and cope with this.

How to Deal With a Trauma: 7 Steps to Take After a Car Accident

Minor car accidents are one of the many little traumas we encounter in life. What may seem minor at the time, however, can become something major if the effects of the trauma are ignored. We can deal with these traumas with a very easy technique that will stop them from becoming big traumas that stay in the body and wreak havoc later in life.

In the act of living, we constantly encounter events in our lives that are challenging. In trauma, a challenge is any event that is perceived as a threat and causes us to “rise to the occasion” to deal with it. That is, we summon all our strength, focus our attention, and direct our actions to bring the challenge to a satisfactory conclusion. When we meet the challenge successfully, we feel strong. It was a little trauma. If we don’t, it can impact our well-being for years to come–a big trauma.

So let’s say on the way to the supermarket, you round a corner and find the traffic has come to a sudden stop-too sudden for you to stop. You rear-end the car in front of you. Yikes! What now?

Before you can even blink, the body has already launched a survival response. The first response? How can I get away or flee? Which is usually not an option if it is your car. Since you can’t run, the second response follows in a split second-the urge to fight. But who are you going to fight? The driver of the car you hit? That could create more trauma.

So what is left? Since you couldn’t respond with the first two survival urges, your body will temporarily shut down. You freeze after impact and sit there stunned.

But then the neocortex kicks in. You jump out of the car and quickly start planning the next course of action. You confront the driver you hit, drop to your knees and apologize, exchange contact information, drop to you knees again and beg the other driver not to report it to the insurance companies, etc.

Later, you go home. You feel extremely tired. You just want to sleep, or check out by watching TV, or drink a case of beer. For days afterwards you feel tired. That little trauma has become a big one. And it links up with all the other impact traumas you had before this accident and will anchor itself to the ones that follow.

What could you have done to completely bypass the effects of the trauma? You could travel back in time and avoid the accident. But that isn’t a very good option at this time.

Here is the secret to preventing a trauma: Do nothing. And do it by yourself.

1. If at all possible, you should slip out of the car and sit on the curb-by yourself.

· If people come up to you, you can shoo them away by saying something like, “I have rabies and feel like biting.” Or perhaps, “I need a few moments to myself.”

2. As you sit there, turn your awareness away from the chaos around you, focus it on your body, and find a place in your body that grabs your attention. Then describe the sensation to yourself.

· What do you feel in your body? Where do you feel it? What is the exact sensation? Tightness? Pressure? Pulling? All sensate words.

3. After you have located one sensation, find a place in your body that feels the opposite of that feeling and place your full attention there.

· If you feel tension in your chest, look for a place somewhere else that either feels relaxed or at least tension-free. Focus on it.

4. Then bring your awareness back to the original site in your body that had a negative feeling.

· So you feel tension in your chest. You observe it. Then you find that your toes feel fine. So you focus on them for a few moments. Then you go back to your chest.

5. You continue to swing your attention between the two areas. This is called Pendulation.

6. You will probably feel either a soft trembling or shaking throughout your body. This is the nervous energy from the trauma discharging. The discharge is what rids the body of the trauma. Don’t try to stop it or control it. Let it happen. It is good.

· You may also feel a series of deep breaths and yawning instead of the shaking. These are also signs of discharge.

7. After you go through the cycle of pendulation with one set of feelings, go to another set and repeat the process. The more you can do, the better.

But at some point you will have to stand up and head back into the fray. Not only will you be surprised by how well you handle the situation now, you will also be free from the reactivation of the trauma in the future. Instead of becoming upset when you recount the story to your spouse or friends, you will just tell it with the same emotions as relating what you had for breakfast that morning.

If you can’t sit down and handle it at the site of the trauma, you can do it later when you’re alone. Just recall the accident from the moment of impact and follow the above steps. Since the trauma has lodged itself in your body, it will be there waiting either to discharge its energy now or grow into a problem later.