Tuesday, April 21, 2015

What Does Trauma Recovery Actually Look Like?


Recovery looks different for everyone. It is simplistic to reduce anything as complex as how people heal or change to stages, steps or phases. However, I have noticed a flow or pattern of how people go through their recovery process. Sometimes they repeat stages, stay for long periods in certain stages or even jump stages. Here is the framework that I often see.

1. Denial. Most people start their recovery with some degree of denial. In order to live life, be successful, and move forward denial is an important coping skill. Sometimes a traumatic memory needs to be hidden in the psyche if a person wants to survive. When the time is right to heal; meaning that there is enough safety, enough support, and/or the weight of the trauma memory becomes too big to carry, then the work to unfold the trauma capsule or memory can begin. Other parts of the self work hard to protect the traumatized part with denial. Consequently, the parts of the psyche or self that have been denying the trauma need to emerge and agree that they have been doing just that and it is no longer beneficial to continue. This part of the work can go on for a long time depending on how much the person wants to move on in their healing. I hear phrases like:
“I can’t believe this really happened to me.”
“This couldn’t been true.”
“Did I make this up?’
When there is no longer any part of us invested in denying the reality and scope of the trauma, then we feel like we are seeing the truth of what happened for the first time, even though we have lived with it for years. The pain now fully emerges due to not having the numbing device of dissociation to cover it. We wake up into numbing disbelief, which turns into pain and suffering. At this stage we need a lot of support, nurturing and care to not turn to addictions to escape the feelings.

2. Anger. The second step after we fully accept our trauma is anger. We are angry at the past, people in the present, and ourselves. We are angry that the world can be so cruel, that we were not protected, that people can act so horrid, and that we had to live through what we did. We can be angry with our therapist for leading us into this awakening. During this stage I hear phrases like:
“How come my mother did not protect me?”
“I wish he was dead.”
“There is no God.”
“The world is cruel.”
“Why me?’
When we learn ways to move through anger, how to release it safely, how to hold it without being overwhelmed by it, and how to calm it, then we can move into a more reflective expanded awareness of our self and the world. We need to pace this step because we could be dealing with years of bottled up anger. Remorse, self-blame, and fear can emerge and different parts of self will have different agendas and stories that we will need to listen to and resolve.

3. Bargaining. The third step is bargaining with the past and the future. In this stage people feel that they have lost too much time, wasted the best years or their lives or made bad choices because of their traumatic childhood. Sometimes they wish they had never started their recovery process because it is too painful. Sometimes they wish they could just check out. This is a time when clients stop therapy and think they need a break, when really, what they need to do is feel all the feelings that are emerging and realize that they can bear it, even though it is difficult and painful. During this stage I hear phrases like:
“I will never use again if things just get better.”
“ Why me, I don’t deserve this.”
“ If I read this book, do this workshop, see this healer I will be healed and the pain will be over.”
“Why can’t I just move on?”
 Railing against fate can turn into having a deeper ability to reflect, understand and be with the chaos of the universe. We can move away from blame and fear and find new ground after we get a new philosophy, spiritual belief or understanding of the world that fits.

4. Depression. The fourth step is depression. This stage is usually flooded with sadness for yourself, others and the state of the world. Sometimes you are reflecting in a healthy way on your past and other times you feel overwhelmed by the magnitude of your loss. You may isolate yourself and pull back from the world. It is the beginning of the mourning process and you need to be gentle, and soft with the new you that is emerging.
During this stage I hear:
“The world is too evil.”
“Maybe I need to travel, retreat, and/or move.”
“ What is the meaning of life?”
This retreat stage is a time to heal wounds, talk to family members and start the process of meaning making. It really is a time to embrace “not knowing” although every inch of you wants to know why. It is a time to deeply listen to all the different parts of you and be with yourself in a kind compassionate way. You are getting to know yourself freshly.

5. Acceptance. In this stage of the work you learn to accept yourself and others. You return to the surface work of being yourself in the world. Practical matters are easier to work with and you don’t feel as lonely. You want to reconstruct yourself and find a new way of being in the world. The pain and turmoil are still with you but you have skills in releasing, being and working with it. You find that you can stand in the reality of your situation without the past hijacking you. You don’t feel the urge to deny the past. It has found a different way to live openly in your body. You are starting to feel hopeful. During this stage I hear:
“I am feeling more integrated and whole.”
“I am amazed about how strong I really am.”
“I want a more meaningful life.”
“I am less afraid and more peaceful.”
This awaking stage can be scary and exciting. It is another birth stage in your life. You don’t turn your back on your weakness or wounded parts but use your strength to integrate and include them in yourself. Accepting your own weaknesses enables you to accept other people’s weaknesses and creates an expansiveness in your field of awareness.
Clients art work.

Wednesday, April 8, 2015

How Wanting to Help Can Be Harmful


I worry when I hear people in the “helping professions” say that they want to help. Why? Because that attitude can be harmful.
I work with children and youth who have been marginalized and discriminated against. They have often been abused in their homes, treated badly in their foster homes and labeled by teachers, foster families, therapists and social workers as problem children. When one of us in the helping profession gets involved to “help” these children we may do further damage. How?

There can be something wrong in the wanting to help when there is something in it for the helper. Why do we want to help? So we feel that we are doing something worthwhile with our lives, that we are “making a difference”. What does this have to do with the needs of the child? Sometimes nothing. Sometimes this “helping” attitude gets in the way of seeing and being with the child. It is an agenda. The child needs to change in the way the helper wants in order to make the helper feel successful and useful.

So how do we do this work and keep ourselves and our agenda out of our work? I think the first and most important step we can take is to be as present and as awake as possible when we are with clients so we can be authentic and genuine. Russell Delman talks about returning to grounded presence. This means that I am not getting lost in feelings or thoughts. It means that I stay aware of the “I” that is with the children that I work with.
A clients artwork to help remind herself to dream big about the future.
I might think that I know what needs to happen in a session, but I need to be aware that the part of me that thinks I know, needs to be mindful and aware that it is a small part of the rest of me that is resting in being awake, aware and available to what arises fresh in the moment. What arises freshly is what I need to be ready to hold, be with and facilitate, not what my imagined “agenda” thought was needed.
When I start wanting something to happen in a therapy session, I know that “I” am leaning in way too far. The session is becoming what I want and that means there is less room for the client’s needs.


Saturday, March 7, 2015

New Publication: There Is No Need to Talk about This: Poetic Inquiry from the Art Therapy Studio

 
In the book, There Is No Need to Talk about This readers are given a glimpse into my therapy practice. The poems embrace the painful aspects of my clients' lives, the breakthroughs and struggles my clients experience. The text explores mental illness, trauma, abuse, autism, and depression  and how art and play therapy can help clients move into wholeness. My hope is that this book will resonate with anyone who works with children and youth and that it may inform practice as well. 
The book is published by Sense Publishers and may be ordered online at: Sense Publishers.
 


Thursday, February 26, 2015

Grand Theft Brain Development and Art Therapy


It has long been known that whatever we focus on, repeat day after day and habitually do creates more of the same thoughts, beliefs and patterns in the brain. The brain wraps itself around whatever our strongest focus is. Norman Doidge in How the Brain Heals Itself, writes about competitive plasticity and the brains ability to rewire itself.
The good news in this is that we can change our brain by exposing it to what we need or want it to believe or perceive in the process healing. It also confirms that doing activities like showing up to meditate and doing the practice, even when it seems hopeless and unfruitful, still helps rewire the brain and deepen and strengthen the networks in the brain that will allow better and more focused meditation in the future. So practice does pay off.
I work with children who habitually wrap their brain around video games such as “Call of Duty” and “Grand Theft Auto.” That is the realty that is being reinforced and absorbed by their brains. These types of games normalize the violence and abuse that some of these children have lived through and help program the children to display behaviours that support violence.
I have also witnessed children who have come from abusive homes and foster homes who have been moved to nurturing and safe foster homes whom have changed so dramatically that I can hardly believe it. Their brains rewire to the new environment and as a result the child looks cared for, act like they matter, develop empathy, and start to like themselves.
 I also feel that in coming to Art Therapy and being exposed to the arts, they get another healthy piece of reality in learning that they are creative and they can create. I do therapy with my clients, but if I only did art, that alone would expand and heal the children whom I work with brain networks. It opens out a whole new world to explore for some of my clients who have never picked up a paint brush, touched clay or made a toy from scratch.
Brain research is fascinating and confirms for me that I picked the right profession.

Saturday, January 17, 2015

Some Surprises are not Good



A child's drawing of how she feels when she is surprised. 
I do Art and Play Therapy with children who have moved many, many times to new foster homes. With each move there are new setbacks, new fears, new traumas, and new issues for child to struggle with. Sometimes the move to a new environment happens as a complete surprise to the child and sometimes what a Social Worker describes as going for drive ends up being arriving at a new home for a very startled and shocked child.
So, it is any wonder that small and large surprises, moves or changes would trigger traumatic memories or fears?
Even those of us who have not moved seven or eight times in our lifetime, find moving traumatic or at least tough. Having your own space, room, or home helps create the environment within a sense of grounding and belonging can take root and grow. Always moving, means that space has to be nurtured inside oneself. It is hard to trust others or the world if it cannot also be grown outside oneself. And it cannot be grown at all if the body is constant flight-or-fight response.
When any unexpected event happens, we all experience levels varying levels of fear, surprise, or shock. The children I work with have had their fight-or-flight response activated so many times that it becomes a habitual state to live in one or the other. A startle response which is a brief mental and physiological state of surprise or not knowing in response to a small surprise or change, moves quickly into high end flight reaction (dissociation) or fight (aggression). Moving to a new classroom, new bedroom, having a new eating place at the dinner table, etc. all trigger the trauma response without the child knowing why. But it is our responsibility as adults to know why and to create the safety and containment that child in our care needs.
When the rules of reality dictating everyday life are always changing, as where you live, who you call Mom, and what the day to day rules are, how can a child achieve self-regulation?  
So if a foster child is in your classroom, home, or therapy room understand why surprises are not always good for this child. Routine is important, change is frightening and needs to be clearly explained. Being consistent with your child makes them feel safe and wanted. Watch your child for signs of activation; raised eyebrows, wrinkles in forehead, dilated pupils, dropped jaw, darting eyes, shallow breathing, tightening in the upper body, or a darting or running response. These involuntary bodily responses often displayed for a fraction of a second may be followed by confusion, fear, or anger.
Explain to them what is happening and why. Offer them ways to de-escalate as, to do some deep breathing, drink a glass of water, do some movement or release the energy in a way that works for the child. Later doing art expressing feelings would be a good idea. When children regain control and body awareness, then they are not triggered by small changes that remind them unconsciously or consciously if the big life changes that they have experienced. The fear, anger and frustration that the child now feels transforms into grounded awareness and self-regulation. The flight or fight response decreases and the child can move safety and confidently through the world.


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