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Staged Trauma Treatment

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I generally subscribe to a staged approach to trauma treatment, given my frequent work with survivors of long-term childhood abuse, which interrupts key developmental periods. Such experiences broadly impact personality development, attachment styles, and emotional regulation capacities.  They also often produce symptoms of dissociation, which can profoundly interfere with memory and the ability to be present to one’s life.  Given this array of difficulties (Complex PTSD), it can be important to focus on containment and skills building in the initial phases of treatment, working towards safety and stability and basic self-care before delving into detailed traumatic recollections.  Later, when safety and stability are established, people may be able to work towards making meaning of their experiences and thus may draw more directly on sharing narratives of their traumatic histories. 

 

While attending to these early stages of recovery, models such as DBT may be useful.  Additionally, mindfulness approaches can be quite helpful, both to provide respite from traumatic memory intrusion and to help ground people in the present moment. 

 

I have expertise in treating severe dissociative disorders that can result from trauma. I work to teach clients grounding skills and to build internal communication and collaboration to help create more calm and coherence inside.  

 

Psychodynamic Therapy

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Psychodynamic approaches share in common an emphasis on paying close attention to words and meanings, understanding how the past informs the present, and gaining insight into one’s experience, including potential unconscious feelings and motives that may drive behavior.  As part of my psychodynamic training, I also think deeply about the therapeutic relationship as an agent of information and change and make use of feelings and experiences that emerge in the therapy relationship.

 

Dialectical Behavior Therapy (DBT)

 

DBT is a highly effective treatment for emotional dysregulation, impulsivity, self-harm, and interpersonal problems.  Initially developed to treat Borderline Personality Disorder, this treatment has also been shown to be effective for multiple other disorders.  It incorporates cognitive behavioral strategies (noticing and changing maladaptive thought patterns, modifying behavioral reinforcers to effect behavioral change, building coping skills).  DBT also uses mindfulness practices and dialectical thinking, a way of breaking through rigid, black and white thinking.  I am not currently available for additional after-hours skills coaching but do regularly incorporate DBT into my work. 

 

Mindfulness

 

Mindfulness practices originated in Buddhist meditation but have been applied to many psychotherapy approaches with great success.  Mindfulness is essentially learning to pay attention to one’s mind’s attention, using this capacity to focus on one thing at a time, being fully present in the current moment, and practicing letting go of judgments.  These tools can be applied and practiced in a multitude of ways including and outside of formal meditation.  Mindfulness can provide relief from unproductive anxieties/worries about the future as well as regrets and preoccupation with unchangeable events from the past.