https://theconversation.com/7-science-based-strategies-to-cope-with-coronavirus-anxiety-133207
Category Archives: Trauma
Understanding and Quieting Intrusive Thoughts: Why Do We Have Thoughts We Just Don’t Want?
Intrusive thoughts are unwanted thoughts, images or urges that pop into your mind out of nowhere. These thoughts can take on any number of unwanted ideas, including fears of contamination or illness, fear of hurting others, or fears of hurting the self. These thoughts can be directed toward loved ones, people who are close by, or the self.
Some common intrusive thoughts include:
1. The sudden image of harming your child, other children, or other loved ones, despite having no intention or desire to do so.
2. The thought of performing a sexual act with someone, despite it being inappropriate and/or lacking attraction toward that person.
3 A fleeting, unexpected urge to jump when standing on a bridge.
The unwanted, upsetting, and unexpected nature of intrusive thoughts separates them from other types of thoughts, such as wishes or worries. In fact, intrusive thoughts are often so contrary to one’s character and wishes that they cause significant distress or disgust.
Intermittent intrusive thoughts are common and expected, found in up to 50 percent of people with no history of diagnosed mental illness. However, people who are more sensitive to anxiety are more likely to experience intrusive thoughts and they also are more common in certain disorders, including anxiety, major depression and bi-polar disorders.
So why does a normal brain produce seemingly abnormal, persistent, and unwanted thoughts? Some researchers, including Stephen Porges, hypothesize that these thoughts are a sort of misinterpreted warning signal. For example, when a mother checks her car’s emergency break repeatedly due to intrusive fears that her car will roll and hurt a child, her brain is likely over-attending to and misinterpreting danger cues, and excluding evidence of safe and social cues. Reassuringly, intrusive thoughts do not seem to predict actual behavior; fears of hurting others do not actually result in an individuals causing another harm.
When intrusive thoughts become severe, recurrent, and anxiety-provoking, we call them obsessions. Obsessions are perhaps best known in the context of obsessive-compulsive disorder (OCD). People with OCD often suffer from compulsions as well—behaviors or mental rituals that aim to decrease the anxiety associated with the intrusive thoughts or obsessions, successful in the short term at best. This results in a person repeating the compulsions to try, over and over again, to relieve the discomfort caused by the intrusive thoughts.
It is important to realize that over-pathologizing intrusive thoughts can create unnecessary anxiety, and there is no room for that in our work together. Instead, think of these thoughts as brain hiccups. As frightening as they may initially seem, intrusive thoughts may dissipate if you accept them and allow them to pass without giving them too much attention or analysis, or by trying to ignore them or push them away.
If intrusive thoughts reach the level of obsessions, and cause you significant distress and interruption of your family, personal or professional life, know there is meaningful assistance. As many psychologists do, I integrate cognitive behavioral therapy (CBT) and have found it very helpful, especially when it includes exposure and response prevention (ERP) and anxiety management strategies. However, as a holistic psychologist, I feel the need to discuss one additional component….Brainspotting (BSP). AS its creator David Grand has said,”Where you look affects how you feel.”
In working with people as they heal so many challenges, I am repeatedly struck by the fact that there is always a significant piece of an experience or trauma that language fails. In fact, almost 80 percent of a challenging experience is housed in our brains and body through non verbal means. This is where Brainspotting (BSP) is critical. In working with people distressed by intrusive thoughts, BSP assists them in accessing their inner, physiological resources (area of calm, peace and strength) in ways that CBT and ERP cannot alone. I have found it to be a wonderful combination allowing people to quiet these thoughts, access other means of feeling calm and peaceful, and move forward in their lives. The combination is transformational; my clients report a prolonged quieting of intrusive thoughts, a related ending of behaviors or rituals, and an inner, physical sense of quiet, calm and well-being that had, for many, eluded them for a long time. Does it sound wonderful? I must say, as one who has both provided and received BSP, it is!
Body-Based Therapies in Talk Therapy
I came across this piece in Medium that is very timely. Always develop, always continue to grow! This is exactly why I continue to train in body-based therapies, such as Brainspotting and Sensorimotor Psychotherapy. Our experiences leave imprints on our bodies, not just our minds. In fact, research shows that almost 80 percent of experiences leave their mark in our bodies and the nonverbal parts of our brains, leaving us feeling stuck. Tapping into the body in talk therapy sessions helps to get “unstuck” and enhances growth and healing.
BRAINSPOTTING
Over the years, I have dedicated myself to the practice of holistic psychology. This way of being and working honors the reality that the mind affects the body and the emotions and the body affects the emotions and the mind. This focus led me to stumble on an effective set of tools called Brainspotting (BSP). Brainspotting can be defined as a powerful approach to healing and wellness that meaningfully combines what we know about the mind/brain into therapy, particularly in resolving old wounds or traumas.
As we journey through life, it is inevitable that we experience trauma, whether a national crisis, chronic illness or pain, the loss of a loved one, or a physical, sexual or emotional attack. When we experience trauma, the brain protects us by encapsulating the event in the areas of the brain where language is not (in the mid-brain or back of the brain). This allows us to take the immediate steps needed to respond or protect ourselves as best as possible, while protecting us from the longer term emotional, physical and social pain caused by the trauma. As time goes by, people do all sorts of things with this, denying the impact of the event, avoiding triggers that remind us of the trauma, or forgetting about the event. But nonetheless, the trauma remains encapsulated in our brain. As we continue moving through life, inevitably another trauma occurs, causing the first trauma to reopen or erupt and creating a significant nervous system reaction to the second trauma.
Over many years in practice, I have witnessed this painful cycle over and over again. I also have witnessed brave individuals “doing their work” to heal past traumas. Here is what I have learned to be true; many people move forward, heal and lead successful, peaceful, and fulfilling lives. Trauma informed interventions are helpful for many individuals and I continue to use those approaches in my work everyday. BUT, there is always a piece of the trauma that cannot be accessed and healed through language or body-based work completely separated from the brain; there is a piece where language fails….always. This is where Brainpostting comes in, allowing the psychologist to work gently and collaboratively with the client to access, reorganize and heal the trauma encapsulated in the brain.
You may be wondering “What does this mean and how does this Brainspotting work?” Well, I moved beyond reading, video watching and podcast listening to experiencing Phase 1 and 2 Brainspotting training for myself. One of the first concepts I learned was a process in which a psychologist focuses on the interpersonal, therapeutic relationship between professional and client, while simultaneously attending to the person’s brain-body response to the area of focus. To me, this was a critical first step toward “buy in,” as effective therapeutic intervention hinges both on the quality of the relationship between the therapist and those with whom they work, as well as on the quality and meaningfulness of training in integrating approaches.
As training went on, I came to understand that Brainspotting accesses the brain-body’s innate self-scanning and self-healing capacities. In Brainspotting, a person’s brain-body activation around a trauma, which can include blinking, staring, facial twitches, racing heart, tightening in the chest, or fluttering in the stomach, is paired with a relevant eye orienting position, called a Brainspot. What this really means is that working through difficult areas in life involves more than language, but incorporates opening “memory files” that allow the brain-body to regulate and reorient in a positive or adaptive way. When this happens the prior activation, felt possibly as anxiety, depression, inattention, lessens and the person feels and functions better.
Healing the Trauma Within
As a holistic, integrative psychologist, I have seen the impact that trauma has across all areas of life. In working to help others heal trauma, I have come to realize that only a few of the healing components focus on the physical, while others, such as releasing suppressed emotions or identifying the reasons or purposes of living, are harder to identify and cannot be attained by merely “writing a prescription.” They are, however, equally important to the sustained healing of trauma. When trauma is left unidentified or unattended to, it can spiral into several types of physical and psychological iemsymptoms that lead to needless suffering. Within the social and physical sciences, there is now a discussion of what is termed ‘Big T’ and ‘Little T’ traumas that build up in a person’s system overtime. The more trauma a person experiences, the greater the risk of disease, particularly as we age. Fortunately, more recent scientific findings suggest that trauma is completely treatable. The science is now available to apply to emotionally-based interventions, which truly solidifies the connection between mind-body approaches. In reality, the mind (brain) and body are one interconnected system.
With that in mind, I would like to outline some of the mental, emotional and spiritual practices currently being utilized to heal trauma, and briefly discuss the extent of scientifically based research in support of their use:
1. Advanced Integrative Therapy (AIT)
This form of energy therapy is similar to tapping (EFT) but is grounded in a more complex psychotherapeutic foundation. It is now used to help cancer patients who have either opted out of conventional treatment or choose to use it as adjunctive treatment. AIT identifies and permanently clears traumatic blocks in the energy systems that are believed to predispose an individual to mental and physical health challenges. A goal is to move these stuck energies through the chakra system and to facilitate the “three step transformation” to interrupt and heal traumatic patterns. At this time, there is anecdotal support for AIT. Given scientific advances in brain mapping and the identification of changes on a cellular level, it seems reasonable to hope that scientific evidence will be forthcoming in support of this approach.
2. Internal Family Systems (IFS)
IFS is a less known healing modality created by family therapist, Richard Schwartz. The approach speaks to the many different sides of every individual, such as the inner child, parent, or caregiver, referred to as “discrete minds.” It looks at how all sides of an individual play an invaluable part in the complete self. Importantly, there is the beginnings of scientific evidence in support of this approach in the treatment of physical disease and trauma.
3.. Eye Movement Desensitization and Reprocessing (EMDR)
This psychotherapeutic technique, in which therapists guide patients through guided eye movements, may be particularly beneficial for people who do not completely remember their traumas. Examples of this include those who have a phobia they cannot explain the cause of, or those who recall pieces of traumatic experiences but cannot stop their impact on current attachments. Scientific research has shown that EMDR significantly decreases activity in the amygdala and hippocampus. The result is that EMDR takes the stress response, which due to trauma has remained consistently active and heightened, and quiets it down. Once this occurs, the individual recalls the trauma in a more complete way, but is no longer impacted by the fight, flight or freeze response in day to day life.
4. Emotional Freedom Technique (EFT)
EFT, also know as tapping, is a traditional Chinese medicine technique that involves tapping on key energy centers of the body to release pain and stagnation. These energy centers coincide with acupuncture and acupressure points used by professionals trained in eastern modalities. Currently, there is anecdotal evidence in support of this approach. More scientific research is needed in order to bring this approach to the level of being an evidenced based approach.
5 Brainspotting (BSP)
Brainspotting locates points in a client’s visual field that help to access trauma in the subcortical areas of the brain-stem, amygdala and hippocampus (non-verbal) areas of the brain. BSP helps to identify and heal the underlying trauma that contributes to depression, anxiety and other behavioral conditions. It can also be used effectively to enhance performance and creativity. BSP provides the therapist with access to both brain and body processes, as it bypasses conscious, neo-cortical thinking. Instead, it accesses the deeper emotional and body-based parts of the brain. Scientific research has shown that BSP significantly decreases activity in the amygdala and hippocampus. The result is that BSP takes the stress response, which due to trauma has remained consistently active and heightened, and quiets it down. Clinical research is showing that BSP seems to accomplish this in a gentler way than other body based approaches, such as EMDR.
At this time, more scientific research is needed to determine the efficacy of several trauma healing techniques. As the scientific research into these techniques continues to evolve, it is vital to work with a well trained, licensed professional. Specifically, one who keeps up with recent research developments and can discern the difference between evidence based approaches, scientifically promising approaches, and techniques with no merit or research behind them, as well one able to discern the suitability of each approach for specific situations.
Holistic Psychology: What Is It Anyway?
As a holistic psychologist, I am quite fortunate to work with children, teens, adults and couples as they work to strengthen various areas of their lives, whether quieting ineffective thoughts and replacing them with positive self statements, learning new behaviors and ending unsuccessful behaviors, accessing and regulating emotions or healing from recent or longstanding trauma. In my work with clients, I do this using comprehensive body based and brain based approaches usually missed by many practitioners. For example, appropriately credentialed health coaches or yoga instructors are taught to help people heal by entering the body, they do not have the required training to integrate cognitive or brain based approaches. Likewise, many mental health practitioners work to help clients resolve the same trauma or negative experiences through cognitive based or talk based therapy. In reality, neither in isolation is enough. There is now definitive research to suggest that the mind (brain) and body are inextricably tied and must both be integrated into meaningful healing. To do so effectively and responsibility takes significant training and experience. With that in mind, I recently found a few articles that, in different ways, begin to speak to this critical point.
In the article, “Can Psychiatry Heal Itself?” John Horgan discusses a Harvard historian’s position that psychiatrists need to focus more on helping people and far less on making money. He focuses on “Mind Fixers: Psychiatry’s Troubled Search for the Biology of Mental Illness” by historian Anne Harrington. What immediately struck me about Horgan’s post was the decision to choose a piece that is in fact very metered in its criticism of psychiatry in comparison to the positions laid out by other authors. As a psychologist, I found Harrigan’s indictment of this arena quite startling and damning for precisely this reason.
The post by Horgan provided a brief meandering through the field of psychiatry, noting that the “psychobable” of Freud was to be replaced by good biological theories of and treatment for the brain. Meaning what? You guessed it…drugs. Thorazine, Valium, Lithium, and Prozac were touted as bringing psychiatry into a truly scientific discipline. However, in her work, Harrington stated that this narrative is clearly false. I do agree with Harrington’s position that the bio-psychiatry of the 1980s and 1990s “over-reached, over-promised, over-diagnosed, over medicated, and compromised its principles.”
In her book, Harrington outlines the history of the development of psychiatry and, through its failures, the opening for psychoanalysis. As a psychologist practicing in the 21st century, I have nothing to say on the later account. In my view, psychoanalysis has long been irrelevant and not worthy of discussion here. I can see, however, why modern bio-psychiatrists are Harrington’s current target. As prescriptions for psychiatric medications have soared over the past few decades, their limitations have become abundantly clear. While appropriate and effective use is, in reality, limited in comparison to the ever rising prescription rate, the adverse side effects, including weight gain, addiction, agitation, and suicide itself , really beg the question, is this worth it? Harrington clearly believes not. And, in many cases, so do I.
It seems that some psychiatry insiders are also saying that the answer to this question may be no. I was heartened to read the transparency that Steven Hyman (Director of the National Institute of Mental Health from 1996-2001) and Thomas Insel (Director of the National Institute of Mental Health from 2002-2015) display by maintaining that psychiatry has not moved the needle in a positive direction to help those millions struggling with mental illness, whether by reducing suicide rates, hospitalization rates, or improving recovery overall.
Harringtons”s book concludes with a number of calls to action, if you will, for modern psychiatry, including:
- to admit its mistakes and its tendency to follow the money instead of the human suffering
- to overcome its reductionist view and meaningfully collaborate with social scientists and scholars in the humanities
- to listen more carefully to self described “survivors,” or those successful in mental health treatment
- to focus on severe mental illness and allow psychologists to treat the “worry well” that does not need medication
I agree with Harrington, who states that this last step requires tremendous professional ethics and courage on the part of psychiatrists. It is asking them to focus on the appropriate patient, thereby slashing their market share and their income. So, where does that leave you, you might ask? Well, as psychiatry works to fix itself, or not, be encouraged that holistic psychologists work to assist you in changing your physical activity, looking at quality and quantity of food intake relevant to quieting symptoms of depression, anxiety, or inattentiveness, and integrating body based approaches to change and healing. While medication is, of course, needed and valuable in some instances, for most the battle cry really must be “Mind Fixers, find an experienced holistic psychologist and fix yourselves!”
https://blogs.scientificamerican.com/cross-check/can-psychiatry-heal-itself/
https://www.wsj.com/articles/the-food-that-helps-battle-depression-1522678367?mod=e2fb