Hey everybody thanks for checking back
I have Dr. Alexa Altman here with me and
we're doing a series of videos about
trauma, trauma therapy, all the things that
entails. So if you haven't subscribed
make sure that you do and if you haven't
watched our other videos together
please do that first because we're kind
of building on them as we work through it.
*music*
And today's topic is: can we do trauma therapy
if we struggle with dissociation?
And I know that a lot of you have told me that
you struggle with dissociation, and you
wonder if you can even participate at
all
are there different types?
- yup
- and.. I don't know.
so, Alexa is going to share her expertise!
I love this question because the answer
is a big yes and specifically I will be
on the lookout for a therapist who
specializes in trauma, because
dissociation, if you're prone to dissociative
symptoms, traditional talk therapy might
not be the best strategy for you
- Okay
- and here's why:
you can participate if you dissociate.
Primarily the beginning phase of trauma
therapy is precisely to help your
nervous system feel safe in the present
moment. And that's phase one.
So it's almost like you get to bring your dissociative symptoms
into a room and get help and support and
just being able to be more present,
to feel safe in your body, before you even move
into the trauma work. That is phase one
of trauma therapy.
So the reason I think it's
really useful is sometimes just talking
about your dissociative symptoms don't
bring nervous system change, and that
can be really frustrating for people
because they can talk about their symptoms,
they can talk about what happened
but it's almost like they're talking about somebody else.
- I find it really interesting because I
do talk therapy and this is actually why I refer
out to people like Alexa. When my
clients really struggle with
dissociation, is that
if they can't really be present, and
there's nothing that
I can talk them through, - that's right
and if they're not even able to connect because
it feels like somebody else
- yes - we honestly, just, our, like progress
is stopped and we're at a standstill and
so I find the reason I do refer out is if I
find myself with the client kind of
stuck in a cycle like that like a
hamster in a wheel like okay we can only
get this far, because you aren't able
to participate and I can't do anything
to help me because I'm not trained in that.
- Its a really good point, because, I
think what Kati is saying is, when we're
in that dissociative state,
the way we talked about in other videos was like
that freeze, right, that fight flight
and then there's that freeze state, so it's like part of our
system is off line. And so, the part that's
offline is often verbal part.
Even if we're talking, right?
- But I've had whole sessions where
they either won't remember what we talked about,
or there will be bouts where they
can't speak it all.
- Yeah, god, it's so frustrating the client too,
right? So I'm like 'god, that is so frustrating,"
and you're thinking 'Is. Therapy. Helping?'
- Yes. And what am I doing here? And if I can't talk...
- How and I going to get better? And so, I would say
like "Okay, bring your dissociation into session,"
and what you can look for, to know that things are moving in the right direction,
And it's not going to happen instantly.
- No. It takes times like everything, right?
- and, I wish l could give you a timeline
" oh it's this number," every person is
unique but what you can start to look
for, is
"Wow, I was aware of, maybe the colors in
the office," or "I saw that plant for the first time"
or "I actually know, you know,
what the therapist was wearing" so more
things come into awareness or, like,
" Hey, Alexa, when I left your office I actually
greeted somebody on the street."
So you start to notice your surroundings
a little bit more.
You maybe, throughout the day, maybe even
get a sense of, noticing your own bodily state,
like I worked with somebody who was like, "Wait, I noticed
feeling hungry, I haven't felt hungry in a long time."
- Interesting, yeah.
- So you might become more aware of your bodily states,
maybe when you're going around your day, you
have more thoughts about your day
because you feel like you're in it more
So, I think, looking for cues, or
signals in the session or outside of
your sessions, that you're in your
surroundings a little bit more some of
the indicators, that you're coming back.
Can I give a few more examples? - Of course.
Like what working with dissociation looks like,
In an office? So it might look like
Orienting. And orienting is moving your neck,
and your head, and your eyes, right? Like
and sometimes I'll have people do it really exaggerated,
like can you actually move
your neck as you look around the room
like this. So that activates that attachment,
social engagement system that we talked
about that in our earlier video, right?
And look with your eyes, and really helping a
person coming into focus about, in the
office so we're really working to
establish safety in the office and
safety with the therapist.
- Yeah. And I think that's why it's so important
that if you are struggling with trauma
and dissociation, to make sure you see a
specialist and see someone like Alexa
because you can start out with someone
like me but there's going to become a,
we're going to come to a place where we can't,
maybe we can't move forward, there's
limitations to that and I think having people
who understand how to bring you back
what are signs of you coming back, and
how to best manage it.
- Yeah. And if you're working with a therapist you
really like that, maybe they don't have
this training, you might want to share
with them some of the skills that you're
learning through these videos or we're going to
give you a site to log on to
if you want to know more about trauma therapy,
so you can get some of those books,
bring that also to your therapist maybe
there's some skills some very easy
skills to help you come back into the
present moment that you can integrate
into the therapy that you're doing.
- Yeah because all therapists usually
they're worth their salt at all
it's like, they will try to learn it
they'll try to work with you in session,
and try to better help you,
because that's our whole goal!
In a nut shell, then, I guess
the answer is: yes, we can participate in
therapy even if we struggle with dissociation.
- yeah
- but the main point being that, it'd really be in your best interest to see a
trauma specialist, and I think that
that's an important factor to take into
consideration when you're looking for
a therapist. I know not all of you have
the choice. I know many of you are just
given a therapist, in a lot of countries force
like CBT, as the only treatment. But just
recognizing that there are differences
and we do have limitations. We're humans too.
We only have specific trainings, and
things that we treat and don't treat
Another thing to remember is that you
actually can ask a therapist for their
resume, you can ask them for their
trainings and specialization and the funny thing,
Alexa and I were just talking, and no one's ever really asked us that.
- Never. Never asked.
And I think that it's really important
because you're going to look for someone
who specialize in the certain thing that
you're wanting to work on don't just go
from offline where it says what they
specialize in. People will list a whole
bunch of things but I would try to find
someone who actually has proper training
and current training, because we have to do our CEUs,
continuing education units,
where we continue to be educated about all things
therapy related. We have to do those every, every year.
Essentially, every two years, we have 36 we're
accountable for.
- Yep
- and so ask it's best to be informed
to find the right person for you.
Thank you so much for sitting down with us and sharing your
expertise and like I said, if you haven't
subscribed, click over here turn on your
notifications because we've done a bunch of
videos together and each one's building
on the next, and you don't want to miss them!
And we will see you next time, bye!