Transcript Overcoming Past Trauma - Breaking Free with Laurie Forbes

Overcoming Past Trauma
11 March 2010
Laurie M. Forbes, MSW, CSW
www.forbes-breakingfree.com
What is Trauma?
The Social Work Dictionary: “An injury to the body or
psyche by some type of shock, violence, or
unanticipated situation.”
 Traumatic events overwhelm the ordinary human
adaptations to life, they generally involve threats to
life or bodily injury, or a close personal encounter
with violence and death.
 Traumatic reactions occur when a person feels
action is impossible, when neither resistance nor
escape is possible.
PTSD-W
Examples of traumatic events:
 Adults and teens
– Accidents involving vehicles, people, animals, natural
disasters
– Major illness, surgery, terminal illnesses
– Rape, sexual assault, etc. (in men or women), domestic
violence, other crimes against the family or person,
terrorism, war/combat, kidnapping, prisoner of war, etc.
 Children (pre-teen)
– Accidents, illnesses (self or loved ones)
– Crimes against the family or person (bullying, terrorism)
– Separations from loved ones (hospital stay, trips, foster
care)
– Changes in family structure (new baby, divorce, death)
– Abuse (emotional, physical, sexual, verbal, domestic
violence)
Some Effects of Trauma:
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Anger
Fear
Confusion
Depression
Inability to concentrate
Anxiety
Social withdrawal
Panic attacks
Obsessions and/or
compulsions
 Sleep problems (too much,
too little)
 Eating problems (too
much, too little)
 Addictions
 Nightmares, flashbacks,
intrusive memory
fragments
 Problems with
interpersonal relationships
 Problems trusting
 Loss of faith in and/or
anger at a higher power
 To rigid or lack of personal
boundaries
 Problems with sexual
boundaries, intimacy or
promiscuity
 False beliefs and thinking
errors, feeling like a failure
 Emotional numbness
General Rules to Overcome Past Trauma:
 Admit that there is a problem or need for change
 Don’t expect to be “cured” overnight, unless you
are willing to forgive right now
 Include prayer and seek spiritual guidance
 Have a plan (Goals)
 Choose one or two things to work on at a time –
don’t overwhelm yourself with too much
 Go at your own pace, not what others believe you
should be doing
 Use all the resources at your disposal
 Involve others you trust
 Don’t be embarrassed or afraid to seek help
A Comparison
Hierarchy of Needs
Effects of trauma
 To satisfy hunger, thirst, sleep,
etc.
 Eating & sleeping problems,
nightmares
 Need to be secure, safe, have
stability, and shelter
 Need to belong, to love and be
loved
 Anxiety, Fear, Panic attacks,
flashbacks, intrusive memories
 Social withdrawal, trust and
interpersonal relationship
problems, personal or sexual
boundary problems, emotional
numbness
 Obsessions, Compulsions,
Addictions, Depression, Anger
 Confusion, inability to concentrate,
loss of faith in and/or anger with a
higher power
 False beliefs and thinking errors,
feeling like a failure
 Need to achieve and to be
recognized
 Need to know, to explore, to
understand
 Need for self actualization
Loss
 Loss is what is missing or has
been removed from your life due
to wanted or unwanted changes
 Things that can cause loss:
– Death, divorce, moving, illness,
accidents, abuse, addictions,
unemployment, change, having
a baby, marriage, healing,
natural disasters, unnatural
disasters, terrorism, etc.
 Things that can be lost:
– Childhood, joy, peace, parents,
love, limbs, property, health,
siblings, grandparents, other
relatives, opportunity, future,
confidence, esteem, children,
companions, etc.
 If you don’t already know your
losses, discovering what you
have lost as a result of trauma
can be emotionally painful
 The pain is due to having a loss
that has not been mourned
 Allow yourself to grieve your
losses as you discover them
 Allow yourself to understand
that loss is real, that you have a
right to grieve
 Grieving provides a release from
emotional pain, allowing healing
to take place
 Grieving brings freedom from
emotional suppression or
oppression
Grief and Mourning
 5 Aspects of Grief:
– Denial
 having trouble accepting the
reality, the shock is too
much, time is needed to
“take it all in”
– Anger
 Has many faces, directed at
many people
 Is not logical or valid, may
be unreasonable
 Should not be denied,
should be acknowledged
and worked through
– Bargaining
 There is a human tendency
to bargain for what we want
– extended life, escape
from pain, a distraction from
reality.
– Depression
 A healthy response to loss
and its overwhelming
sadness
 Comes and goes, changing
with each stage or aspect a
person is in
 Usually clears on its own
– Acceptance
 Accepting the reality of the
loss, and the new reality
resulting from the loss
 Acceptance does not
equate with liking the
change or being “alright” or
“okay” with the change.
“On Death and Dying”
Anger
 “___ made me mad.”
 Anger is bad – true or
false?
 FALSE
 Anger is a choice
 Anger is based on two
emotions – fear and/or hurt
 Anger is not bad, it is
misunderstood
 Anger has a useful and
righteous purpose
 Anger is used to bring
about change within
ourselves or our
community/world
 Anger focused on self is
usually focused on
revenge.
 Anger focused on violation
of another’s needs is
usually focused on change
Anxiety/Panic “Triggers”
Why it happens:
How to figure out what
your triggers are:
 Pay attention to what
 Traumatic events can
your thoughts are.
leave a person with
fear of “it” happening
 Observe what is going
again.
on around you.
 Reminders of the
 Observe who is around
traumatic event often
you and what they are
‘trigger’ similar panic or
doing.
anxiety felt during the
 Compare the above to
event.
what you experienced
 Look for similarities
Boundaries
 Unhealthy
– Can’t say “no”
– Everyone is given “intimate”
status, including strangers
– Decisions are based on
emotions
– Love and sex are the same
thing
– It is okay to tell everyone
about private matters
– Needs and wants are the
same thing
– Helplessness instead of
autonomy
– Touching or being touched
without permission is okay
 Healthy
– Knows limitations and can
say “no” when needed
– Understand safe limits with
strangers
– Decisions are based on
rational thought, facts, and
emotion
– Love is based on mutual
respect and friendship
– Private matters are only
shared with a few trusted
persons
– Needs and wants are
different
– Ability to help self or decide
who can help if needed
– Who touches and when
touching happens is a
choice
Shame/Guilt
 Shame
– Based on false beliefs
and embarrassment
about yourself as a
person
– Is unhealthy
– Has no useful purpose
– Is oppressive
– A sign of having been
powerless or helpless
 Guilt
– Stems from having
taken an action that is
not correct or a lack of
action when needed
– Is healthy
– Produces change
– Is not permanent
– Is about your actions
not you as a person
Perseverance:
the Truth About Failure
 Failure doesn’t mean you are a
failure – it does mean you
haven’t succeeded yet.
 Failure doesn’t mean you have
accomplished nothing – it does
mean you have learned
something.
 Failure doesn’t mean you don’t
have it – it does mean you have
to do something in a different
way.
 Failure doesn’t mean you have
been a fool – it does mean you
were willing to try.
 Failure doesn’t mean you are
inferior – it does mean you are
not perfect. Failure doesn’t
mean you’ve wasted your life –
it does mean you’ve a reason to
start afresh.
 Failure doesn’t mean you
should give up – it does mean
you should try harder.
 Failure doesn’t mean you’ll
never make it – it does mean it
will take a little longer.
 Failure doesn’t mean god has
abandoned you – it does mean
God has a better idea.
Author unknown
Addiction
Definition of Addiction: “The giving up of one’s self habitually.”
or “Slavery to (name your addiction)”
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Illegal drugs
Alcohol
Tobacco
Caffeine
Prescribed medicine
Sex / pornography
Food / junk food
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Chocolate / candy
Anger / strong emotions
Foul language
Violence
Adrenaline rush / danger
Power / control
Helplessness
Out of control hobbies
Seeking Attention
Anorexia / Bulimia
A Different Way of Thinking
 As children we have a certain set of experiences that
shape how we see the world
 This set of experiences is only a small part of the
experiences that occur in the world
 As we grow, we learn how to respond to these experiences
and design a story or “script” in our head
 This script allows us to describe and make sense of our
experiences, and our responses to these experiences
 Schemas are the set of beliefs & responses that form our
scripts
 Our schemas (beliefs & responses) become set at a fairly
young age
 Even if we have new experiences that challenge these
beliefs & responses, we tend to try to understand these
experiences using the schemas we already have, to keep
our script from changing
A Different Way of Thinking
 While these ways of understanding and responding often help us to
survive when we are young, they can interfere with our ability to adapt
to new, challenging situations as adults (remember, we only have
limited experiences when we are young)
 We design ways of thinking to make sure that our beliefs and response
don’t change, so we can keep our script safe
 These ways of protective thinking are called “thinking errors” because
they do not allow us to change our responses so that we can adapt to
new situations
 Instead they cause us to deal with new experiences with old beliefs
and responses
 The problem is that these old beliefs and responses are now
maladaptive and cause us and those around us to have problems
 In order to responses to new experiences in a way that does not cause
harm to others and ourselves we need to understand our scritps,
schemas, and thinking errors
 We need to challenge them, and change our response to them, and
ultimately to adjust our view of the world
Thinking Errors Handout – Valley Mental Health - Forensics
Thinking Errors
 Thought distortions that
are not reality, how our
thinking distorts reality.
 Thoughts that encourage
the continuation of
irresponsible behavior.
 Everyone uses thinking
errors.
 Thinking errors affect how
we see, hear, feel or
internalize the world
around us.
 Thinking errors impact
jobs, self-esteem, and
relationships.
 Common thinking errors:
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Abusive labeling
All or nothing thinking
Assuming
Blaming
Catastrophizing
Dismissing the positive
Emotional reasoning /
making feelings fact
Flaw fixation
Over generalizing
Personalizing
Regrets
Shoulds
Unfavorable comparisons
PTSD-S
7 Principles of Healing
1) Healing starts by applying skills to manage
PTSD symptoms.
2) Healing occurs when traumatic memory is
processed or integrated.
3) Healing occurs when confronting replaces
avoidance.
4) Healing occurs in a climate of safety and pacing.
5) Healing occurs when boundaries are intact.
6) Kind awareness and acceptance of feelings aid
the healing.
7) Balance in our lives is necessary to heal.
PTSD_S
Faith
 Common beliefs:
– “God allowed this to
happen.”
– “God didn’t protect me.”
– “God doesn’t love me or
this would not have
happened.”
– “I am angry with God
but can’t admit it
because he will punish
me.”
 Truth:
– The gift of Agency was
involved
– God does not take
away anyone’s agency
– God uses our actions to
judge us – good or bad
– God loves all of his
children equally
– God understands our
feelings (anger), he is
patient and will wait for
us to learn the truth
Questions?
www.forbes-breakingfree.com
Resources
 Allen, Jon G., Ph.D., 1995. Coping with Trauma: a Guide to selfunderstanding. American Psychiatric Press, Washington DC.
 American Psychiatric Association: Diagnostic and Statistical Manual of
Mental disorders, Fourth Edition, Text Revision. Washington, DC,
American Psychiatric Association, 2000.
 Barker, Robert L.,1999. The Social Work Dictionary, NASW Press,
Washington, DC.
 Herman, Judith, M.D., 1997. Trauma and Recovery, The aftermath of
violence - from domestic abuse to political terror, Basic Books, New
York.
 Ingraham, Linda, 1991. Life Without a Crutch: an Introduction to
Recovery from Addiction, OPEN Inc., Garland, TX.
 Kubany, Edwards S., Ph.D., 2004. Healing the Trauma of Domestic
Violence: a Workbook for Women. New harbinger Publications,
Oakland CA.
 Schiraldi, Glenn R. Ph.D., 2009. The Post-Traumatic Stress Disorder
Sourcebook, 2nd Ed., McGraw Hill, New York.
 Williams, Mary Beth, Ph.D., 2002 . The PTSD Workbook, New
Harbinger Publications, Oakland, CA