Trauma Therapy

“The very making of an appointment with a total stranger to deal with the greatest intimacies and vulnerabilities of one’s life is an act of profound faith.”

Diana Fosha (2000, p5)

What to expect from Trauma Therapy

Initially, we offer a 30-minute initial chat (via phone or Zoom) free of charge.

This is an opportunity to ask any questions you may have about trauma, PTSD or the process of therapy. If you would then like to go ahead with therapy, we would then organise a 3-session assessment. This assessment includes background, trauma history and symptoms. This is important in order to determine what type of trauma we are looking at, i.e. whether it is a single incident, or complex in nature, and whether there are any co-occurring disorders, for example, anxiety, depression, addictions or dissociation.

We also determine what strengths, resources and support someone has, as well as eliciting together what your hopes and goals for therapy may be. These could include a reduction of symptoms such as flashbacks and sleep problems, processing the trauma or cognitive restructuring. These elements will help in determining an individually based plan and help us move forward in a safe way.

Following assessment, trauma therapy is comprised of three phases:

• Stabilisation

• Trauma Process

• Integration and Recovery

Stabilisation

This includes Crisis Management, Psychoeducation, Containment and Emotion Regulation strategies. Stabilisation has been shown to have a treatment effect in its own right, and some people, depending on their goals, feel they have improved enough to not need any further therapy. The stabilisation phase equips clients to regulate their emotions more effectively, to manage symptoms such as panic attacks, and can lead to more healthy interpersonal relationships. How long this phase lasts is again very individually determined and depends on the resources someone may have available prior to attending therapy.

Trauma Process

The trauma process itself directly addresses and revisits the trauma or traumas, confronting painful memories and feared situations. Most trauma processes include an element of exposure, that means clients revisit a trauma in detail, which is something they may have avoided for a long time. At Traumaform our therapies include:

Integration and Recovery

The Integration phase serves to imbed behavioural and neurological changes by continuing with cognitive restructuring, preventing relapse and leading to post-traumatic growth. A person whose distressing memories, symptoms of PTSD and unhelpful patterns of behaviour have been reduced, is able to move forward in life more freely from the things that have been holding them back, and more able to reach their potential. It is an ongoing process.

EMDR

EMDR (Eye Movement Desensitisation and Reprocessing) is an information processing therapy for PTSD, Complex Trauma and other disorders, utilising bilateral stimulation through eye movements or tapping that help clients cope with distressing memories.

EMDR was developed by Dr Francine Shapiro in the 1980’s and since its inception research has found strong evidence for its safety, effectivity and efficiency. During therapy the client focuses on a specific thought, image, emotion, or sensation while simultaneously watching the therapist's finger or baton move in front of his or her eyes, or by tapping.

EMDR weakens the impact of negative emotions and distressing memories. See www.emdrassociation.org.uk for further information. I have completed my training in EMDR Levels 1-4 as part of an MSc in EMDR at Worcester University, a course that is accredited by the EMDR Association, and am working towards accreditation.

Getting Past Your Past is a self-help book written by Dr Shapiro that can be a useful read.

Prolonged Exposure Therapy

Prolonged Exposure Therapy (Foa and Kozak, 1985, 1986) is a bottom up trauma process recommended for PTSD 1 and other trauma related reactions such as depression or anxiety following any kind of trauma where the sufferer has sufficient recall of the trauma and can describe it with a beginning, middle and end. The purpose is an emotional processing of traumatic experiences through repeated exposure. Fear is regarded as the primary emotion in PTSD 1 which often leads the sufferer to avoid reminders of the trauma, thereby exacerbating the problem.

Prolonged exposure therapy utilises psychoeducation, breathing retraining as well as both in vivo and imaginal exposure in a systematic way in order for habituation to occur. The fear structure is activated during exposure in order for new information to be incorporated. Prolonged Exposure has a large research and evidence base and its efficacy is well documented (Foa, Hembree & Rothbaum, 2007).

To keep it simple, in this type of therapy the trauma memory is revisited in a detailed and prolonged way – this helps the brain to understand that the trauma is only a memory and is not happening now, and any danger has past. Alongside this, therapy also looks to help a person stop avoiding aspects of the trauma in a step by step way.

Cognitive Processing Therapy

CPT is a hybrid therapy that involves a cognitive as well as an exposure element.

CPT is a top down process that keeps the pre-frontal cortex connected whilst processing the emotions through exposure. The goal of CPT is recovery from trauma through a change in the survivor’s belief system in order to gain a balanced and realistic view of the event or events.

This is achieved through encouraging the survivor to stop avoiding. Emotions experienced through recollection of the trauma are helped to be processed in a healthy way.

It works by helping the client to re-interpret the event in light of context and facts of the event. It serves to diminish any difficult emotions that may have been based on misinformation or misinterpretation of the event in connection to view of self, others or the world. It thereby enables the survivor to avoid overgeneralising from a single event/person/disaster to the world at large (Resick et al).

Brainspotting

“Brainspotting is a new psychotherapy approach that hypothesises that the field of vision can be used to locate eye positions that correlate to inner neural and emotional experience. After these eye positions, or Brainspots, are located, they may (by maintaining eye fixation) lead to a healing and resolution of issues that are held deeply in the non-verbal, non-cognitive areas of the neurophysiology. BSP utilises both focused activation and focused mindfulness as its mechanisms of operation.

It aims at full, comprehensive discharge of activation held in the brain and body. BSP is a model that incorporates systemic activation and resources applied based on both diagnostic and developmental consideration. The BSP model is developed as both relational as well as technical, with philosophical and physiological underpinnings. It is an open, inclusive, yet framed model that invites the therapist to make use of their prior study, experience and practice wisdom.” (David Grand)

www.bspuk.co.uk

For list of therapists in Wales and rest of UK please follow link:

http://www.bspuk.co.uk/therapists/list-of-therapists/wales/

Brainspotting has been described as a new revolutionary technique that focuses on mind-body processes and works on the theory that “Where you look affects how you feel”. It allows for deep emotional processing of a trauma where the therapist is attuned to the client and will be with them along the way. Watch the video by David Grand, Brainspotting founder, to find out more.

Image Rescripting and Reprocessing Therapy

Image Rescripting and Reprocessing Therapy (IRRT) is an integrative Cognitive Behavioural approach originally designed as treatment for adult survivors of childhood abuse (Smucker, Dancu, Foa & Niederee, 1995), and is recommended for Type II clients where emotions such as anger, blame, grief, guilt and shame are predominant, rather than fear.

With its elements of imaginal exposure, mastery imagery and cognitive restructuring, IRRT seeks to modify images during rescripting and reprocessing of a trauma, and works at the schema level, thereby tapping into the 7 key areas affected by Complex PTSD. The goals of IRRT include the reduction of physiological arousal, eliminating the re-experiencing of distressing imagery, developing more adaptive schemas and beliefs associated with the trauma or traumas as well as to increase the client’s self-nurturing abilities and coping skills; in this sense IRRT is said to go beyond extinction models to facilitate change at the schema level. Since its conception IRRT has been utilised to treat many other forms of trauma as well as co-occurring disorders and is expanding its evidence base (Brewin et al, 2009).

To keep it simple – in this type of therapy an individual is again helped to revisit a trauma, often this may be a childhood trauma, and with guidance from the therapist in a structured and systematic way, is enabled to confront the perpetrator in their imagination and gain mastery over situation and the memory. This therapy helps to process a trauma emotionally as well as cognitively.

Narrative Exposure Therapy

Narrative Exposure Therapy is a treatment for trauma survivors during which the client constructs a chronological narrative of their life in an attempt to integrate often fragmented memories of traumatic experiences into a coherent life story. In the initial sessions clients will lay their “life-line”, making use of flowers (for positive events) and stones (traumatic events) along a rope or ribbon.

Therapy then focuses on reliving these events taking account of physiological, emotional and cognitive elements experienced at the time and interweaving these with the “here and now”, thereby acting as constant reminders that these experiences are in the past and only memories. In the presence of the therapist these memories are reprocessed.

After therapy a copy of their autobiographical life story is given to the client, this document may also be used for human rights advocacy.

As NET involves narrating the entire life story, it is particularly suited to treating Complex Trauma. It was developed by Schauer, Neuner and Elbert and is being used in the treatment of refugees and the victims of torture” otherwise it sounds like refugees are the perpetrators! with projects all over the world. See www.vivo.org for further information.

Alpha-stim – microcurrent treatment for anxiety, depression and insomnia

Alpha-stim treatment available at Traumaform. What is Alpha-stim?

The alpha-stim leaflet states:

“Alpha-Stim is a clinically proven medical device that relieves anxiety, insomnia and depression using electromedical technology. Alpha-Stim generates a unique patented waveform no other device can offer. Much like every white pill is not the same, the uniqueness of Alpha-Stim’s waveform produces results vastly different from any other medical device. Unlike medications which are introduced to your body in a chemical form and then broken down to smaller components such as electrons, Alpha-Stim begins at the electron level, allowing your body’s cells to return to their natural functioning state. AlphaStim provides long lasting, cumulative relief without the risk of negative effects such as tolerance and addiction to medications.”

See here for full leaflet

Heartmath Technology – reduce stress – available at Traumaform

According to heartmath research: “Science has now shown us that the rhythm of our heart beat affects how we think and feel.”

“Coherence is an optimal physiological state shown to prevent and reduce stress, increase resilience, and promote emotional wellbeing. Coherence is measured through Heart Rate Variability (HRV) – a unique window into the quality of communication between the heart and brain which directly impacts how we feel and perform.”

www.heartmath.com

Post-traumatic Growth

Post-traumatic Growth refers to the phenomenon that between 30-70% of individuals who have survived trauma, report positive changes as a result of the struggles involved in the trauma. Post-traumatic Growth has been defined as the “experience of individuals whose development, at least in some areas has surpassed what was present before the struggle with crises occurred. The individual has not only survived, but has experienced changes that are viewed as important and that go beyond the status quo” (Tadeshi and Calhoun, 2004). That is not to say that individuals would not prefer that the trauma hadn’t taken place, yet some positives are often taken from it.

Research has found that these changes occur broadly in the areas of emotional growth, closer relationships, altered perspective on life, changes in self-concept, living in the moment, and appreciation (Joseph,S, 2013). Follow the links for further information.

For more information plese click on: Trauma-Recovery or here: Positive-Psychology

What is Creyos?

Creyos is a scientifically-validated online platform for
precise and efficient measurement and monitoring of
cognitive and behavioral health. Backed by 30 years of
research and a robust normative database of 85,000
participants, it combines online, gamified, cognitive
tasks with digital behavioral health questionnaires to
provide an objective and comprehensive assessment
of brain health. Trusted by tens of thousands of
healthcare providers world wide, we’ve added Creyos
to our practice to enhance care delivery and elevate
our clinical decision making – helping you to achieve
better outcomes, faster.

Try it out!

How we use Creyos at Traumaform

Taking a Creyos Health assessment is straightforward and
hassle-free—no need for any fancy gadgets. You can do it
on any device you prefer, like your laptop, desktop, or
tablet, and it works with all the latest web browsers. Here's
a quick run-through of the steps:

- We will send you an email containing a link to your personalised Creyos assessment

- Before you take the assignment, you will be guided on what
to expect, how to tackle the assessment, and how long it'll
probably take.

- After you've got the hang of the tutorial, it's showtime! Complete the task, and once you're done, a report will zip off to your practitioner to check out.