Over the coming weeks, I’ll be sharing lots and lots of information about and answering questions about the effects of childhood trauma on adults. I’ll be talking about the physical, neurological, psychological, spiritual and cultural effects (yes, it’s a culture, for better and worse). But since I’ve just done five posts about “the problem,” it’s time to say a little bit about solutions. I’m going to tell you about a handful of treatments that other people have found helpful, and then I’m going to introduce you for the first time to the technique that saved my life when I was throttled by PTSD.(If you want, you can cut to the chase and see the video here).
My opinions and descriptions are my own. As you may have already noticed, I’m personally wary of a lot of professional opinions, only because in the past, the help people tried to offer me was usually off base and unhelpful, if not outright harmful. But different people respond to different things. And many, many medical and mental health professionals are actively enagaged with new research and revising standard approaches to care. There is so much hope, so it is well worth summarizing some things others have found helpful. I was convinced to be open minded by the excellent book on trauma, Bessel Van Der Kolk’s The Body Keeps the Score. They’ll be a whole post on this later.
Some Popular Treatments for PTSD and Complex Trauma
EMDR (eye movement desensitization and reprocessing). This is a technique, endorsed by the Veterans Administration, that helps to integrate the haunting, traumatic memories typical PTSD. In PTSD, the activation of certain memories produces an intense psychological and physiological distress (nightmares, pounding heart, outbursts of rage) as though the event is happening in this very moment. These reactions occur again and again, and don’t tend to diminish over time.
EMDR involves the use of controlled side-to-side eye movements, vibrating paddles, or other tools that alternately stimulate the left and right brain as the practitioner helps you to visit traumatic memories, and then “reprocess” them. The goal is to make a traumatic memory more like a normal memory — remembered, but not so intensely charged. According to van der Kolk, the effects are long-lasting; occasionally those who have benefitted from it will opt to come back for EMDR sessions months or years later. The technique is effective at treating adult onset trauma. (For example, I was going to weekly talk therapy to try to “process” a shocking episode where I had found a friend dead, a suicide. Anything that reminded me of the incident would put me in full fight-or-flight response, 10 or 20 times a day — for like eighteen months. One session of EMDR put that ugly memory in the normal memory bucket and now I can remember what happened, but don’t get overwhelmed with feeling, and I seldom think of it.)
EMDR has not been shown to be as effective for treating trauma that had its origins in childhood (this was also my experience).
Depression and anxiety are extremely common in people with complex trauma, and these days it is highly likely that those who seek help for these problems will be prescribed antidepressants and/or anti-anxiety medication. With complex trauma, they can be somewhat helpful to calm intense symptoms, though in many cases it can delay recovery by dulling awareness, or producing a “brain-fog.” There can be serious side effects, including suicidal and homicidal ideation, sexual difficulties and a sense of numbness when trying to make decisions or connect with others — all very important to recovery. They do not offer a cure; side effects as well as benefits subside as soon as medication is discontinued.
One of the things going on in PTSD is disregulation of the brain. When we’re calm, brain activity is even and it’s driving body responses and emotions in an even and predictable way. With disregulation, our thinking and behavior can become erratic, and our brains produce distinctive signals at these times. Neurofeedback uses electrodes to monitor these signals, and make them visible to you so that you can notice when disregulation is happening and learn to re-egulate them yourself. Some neurofeedback setups involve watching a television that goes dark during “bad” brain activity, and becomes bright and visible again when you re-regulate. Practicing regulation in this way, over several sessions, helps you to (unconsciously) learn to stay regulated. I tried neurofeedback four times and it just made me feel sleepy and spaced out; the practitioner told me that this was a sign it would soon be effective for me, but I didn’t like the feeling and didn’t stick with it.
I’m making a broad category here, that yoga, dance and martial arts as well as touch, massage and movement therapies such as somatic body work, reiki, feldenkrais, etc. It completely makes sense that traumatic memory is stored “in the body” and can be accessed, triggered and/or soothed through physial means. When a person is suffering from trauma — either recent or through long-term effects — vigorous excercise is one of THE most effect treatments. When I was drowning in my 18-month episode? My doctor and therapist were pushing medication (because for real, adrenal overload like this breaks down the immune system and opens the door to more serious illness, so any intervention might be better than none). But I did a little online research at the time that suggested I go running 45 minutes a day and stop eating sugar. My symptoms were reduced by about 60% the first week!
I can also vouch for yoga. Some gifted professionals have developed yoga practices specifically designed for treating trauma (there is sensitivity re: feelings and memories that could be triggered by certain poses, and an emphasis on being conscious and gentle with whatever may be triggered.
Traditional psychotherapy, including cognitive behavioral therapy (CBT, which attempts to replace negative associations with positive ones), are THE standard of our times for anything trauma related, but this may be changing. Research has produced conflicting findings about their effectiveness for trauma. After many attempts and therapists in my earlier years, I have personally had some very caring, smart therapists in the past but have not found it particularly helpful (and sometimes it’s just plain upsetting). I have many friends, however, who have felt it was very helpful.
Mindfulness and Meditation
There are very promising results using meditation. Personally, I think everyone should meditate, especially people with emotional difficulty or attention problems. I’ll have a lot to say about this later.
Once popular, this is falling out of favor. You try to make yourself immune to a bad memory by reliving it in a safe environment, until it loses its power. Evaluation of its effectiveness has not been as hopeful as other approaches mentioned above.
A lot of people swear by the tapping technique for calming anxiety and harsh emotions. There are terrific videos on YouTube that show you how to do it, tapping with your fingertips along acupressure points, or meridians of the body. Some say the benefits are just a placebo effect but I say, if it’s free, easy and works for you, it’s awesome.
Just Get Over It
Some things really do heal with time. Just getting over a trauma is an excellent first line of defense. If you can’t get over it, then it’s time to try something new.
Aha! Here is where it gets interesting (for me). Writing is free, easy to do any time, and for some of us is WAY more effective than talking about feelings. I’ll go into great detail next week about the neurological reasons for this and the research that demonstrates effectiveness. I have personally been writing daily for more than 22 years — a special technique a friend showed me. She was and is a sober alcoholic in AA, and learned this technique from someone there, and today I know of hundreds of alcohlics who have become and remained sober using this technique, along with a simple form of meditation. I am not an alcoholic, but I’ve found the same technique works wonders on my PTSD. As an alcoholic is never NOT an alcoholic, even when they have long time sobriety, I am never totally free of PTSD, even though I have long periods of neurological peace.
Here is the technique, called “Taking a Personal Inventory.” You might find it helpful to relax around all the election brouhaha out there. We’ll talk more next week.