People enter therapy for a number of reasons. Sometimes it’s because of a relationship and other times it has to do with feeling like they aren’t functioning as well as they would like. This can be the result of anxiety, depression, irritability, sleeplessness, etc. Therapists work with clients to treat these symptoms and hopefully help the client live a more fulfilling life. However, oftentimes finding the root cause and treating that can in turn alleviate pain caused from other symptoms. Imagine taking a painkiller to assuage the pain of a nail in the foot. The painkiller might provide some relief, but the pain might always be there, or at least return, unless the root cause is treated. In this case, the nail needs to be taken out! This is often the case with assessing for and treating trauma in therapy. Treating past trauma gets to the root cause of the pain and can provide relief.
The most common response I get to assessing for trauma in the first couple of sessions is, “But wait! I don’t have any trauma! I’ve had a good life!” Or, “My parents did the best they could. They would be devastated if they knew I thought they could have done better.” Or perhaps, “Sure, some terrible things happened but I’m pretty much over them now.” Sound familiar? The thing with trauma is that those statements can be true and yet you can still be affected by trauma. You might have a good life, but still be affected in some ways by trauma. Your parents might have done the very best they knew how, but it still could have been hurtful for you as a kid—and that might still impact you in adulthood. And yes, you might be largely over pain from the past, but that doesn’t mean you don’t experience any remaining symptoms. For example, here is a list of some symptoms associated with trauma: Anxiety, depression, irritability, insomnia, guilt, shame, withdrawing from others, feeling disconnected or numb, difficulty concentrating, mood swings, fatigue, being startled easily, muscle tension, aches and pains, edginess and agitation, etc. The list goes on and on. This is why I personally always assess for trauma. It doesn’t mean it’s there, it just helps create a more thorough and pertinent treatment plan.
In discussing trauma, there are two types: A traumatic event that fits the DSM-5 criteria for PTSD (post-traumatic stress disorder) and complex trauma, which refers to simultaneous, sequential, and chronic experiences often beginning in childhood. I think it’s important that some examples be given of each.
Some examples of PTSD as defined in the current DSM-5 (the manual for mental disorders that clinicians use when diagnosing and submitting claims to insurances) include extreme events that can be violent or accidental. These events may include feelings of helplessness, horror, fear for one’s own life or the lives of others. A few examples of this type of trauma include rape, war, natural disasters, etc.
However, most of the clients I see don’t fit the criteria for PTSD per say, but they are absolutely experiencing effects of complex trauma. Although Complex Post-Traumatic Stress Disorder has not yet been added to the DSM, there is plenty of literature backing its validity. Complex trauma can include emotional abuse and neglect, sexual abuse, physical abuse, and even being involved or witnessing domestic violence. Complex trauma is what I see the most of in my practice. For example, an only child with two working parents who puts herself to bed each night and wakes herself up each morning may suffer as an adult from the pain of being neglected in childhood, even if her parents were doing all they could to put food on the table. Another example might be a young boy repeatedly molested by a family member as a child. Although he might be a grown adult now with those events long behind him, he might come to therapy presenting to be “terrible” in relationships. Only later would we discover that his fear of intimacy would stem from his childhood experiences of being abused. In both of those examples, assessing for and treating traumas that happened long ago can have a big impact on the effectiveness of therapy.
Do you think you still experience the impacts of a painful past event? Then trauma therapy might be beneficial for you. Clients benefit from a therapist that is empathetic, sensitive, patient, and knowledgeable to properly diagnose and treat it. The last criteria is a must—many therapists don’t receive extensive training on treating trauma. Don’t be afraid to “therapist shop” and ask about their training in dealing with trauma.
Working through trauma is a very personal, emotional journey. Although working through trauma can be painful, it can have a big payoff. It can be liberating and restore hope. It can restore confidence. Perhaps most importantly, it can help us be an advocate for others. Robert Bly once said, “Where a man’s wound is, that is where his genius will be.” Call or email to schedule an appointment today and finally work to put the past, well, in the past.
Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition
The Body Keeps the Score by Bessel Van Der Kolk, M.D.
Kayla is a therapist specializing in trauma. She is trained in EMDR (Eye Movement Desensitization Reprocessing) and uses its practices in conjunction with emotionally focused and narrative therapy techniques to help clients resolve painful past memories and experiences.
It’s a natural desire for us to want to present our best selves to others. In most of our interactions with others, there seems to be a performance aspect to what we do. We want to prove to be competent in our jobs, to leave a good first impression with those we come in contact with. We want our houses to be neat and tidy when guests come over. We want to post the best and most exciting photos of us on social media.
Although we look nice and clean when we present our “best selves”, sometimes we may feel messy on the inside. Everyone sees the life we live when we are on stage, but very rarely do they get to see the life behind the curtain. The sad thing is that everyone has their hidden messes, and I mean EVERYONE. Just as with the great Wizard of Oz, when you take away the filters and magic tricks, we are all just people trying to do our best.
I believe that a great deal of our depression, anxiety, and low self-esteem comes from trying to hide our life behind the curtain. We tend to say things to ourselves such as, “If people knew who I really am, they wouldn’t love me”, or “I’m not as good as people think I am”. “I act like I’m happy all the time, but on the inside I feel broken”.
At times I wish that I could have known the truth about people’s lives behind the curtain when I was growing up. I would have seen my shortcomings and weaknesses with a lot more acceptance and compassion. My first experience with sharing my life behind the curtain was in therapy. Therapy is a safe and sacred place to start unveiling your authentic self because your vulnerability and openness will be held with no judgment. As you start to open yourself, something crazy will happen, you will begin to find value in the mess that you think you’ve made, you may even begin to love that mess. There is a saying in the world of recovery: “turn your mess into a message”.
We all want to be loved, seen, and heard; but how can someone truly love you if they have only seen a part of you. The parts of you that others can’t see are the parts that need the most attention because they are the parts that need the most healing. As you engage in the healing process you will able to find that every part of you is worth loving. Your healed heart can become a gift that you can share with the world.
EMDR (Eye Movement Desensitization and Reprocessing) is a type of therapy that enables people to heal from the distress and ongoing symptoms that can result after experiencing trauma. Repeated studies show that by using EMDR clients can streamline the therapy process; EMDR therapy enables individuals to experience the benefits of years of psychotherapy in a much shorter amount of time.
One study*, focused on sexual assault victims, found that 90% of PTSD sufferers exhibited eliminated symptoms after only 3 sessions of EMDR.
The American Psychiatric Association, the World Health Organization, the Department of Veteran Affairs, and the Department of Defense all recognize EMDR as one of the most effective treatment for trauma and other disturbing events.
Read more about EMDR Psychotherapy: What is EMDR?
Kayla Burningham, AMFT is an EMDR certified therapist, and specializes in helping clients overcome the trauma from their past.
Contact our office to speak with Kayla and learn more.
*Rothbaum, B. (1997). A controlled study of eye movement desensitization and reprocessing in the treatment of post-traumatic stress disordered sexual assault victims. Bulletin of the Menninger Clinic, 61, 317-334.
Marriage therapy is a complicated dynamic. One in which we have to manage what each individual partner may want from the experience as well as what will be truly beneficial to helping the relationship which when done correctly, really becomes the patient that the three of us (yourself, your spouse and the therapist) are trying to heal.
One of the misnomers about marriage therapy is that we are here to help a couple to stop fighting. However, much like a virus or a bacterial infection, the fights that a couple engage in are most often a response to a foreign idea or experience that needs to be understood and addressed, not just ignored.
Humans are passionate and dynamic. When you put two of them together in close quarters and invite them to work together, there are bound to be arguments. What makes a marriage successful is each partner’s ability to repair.
Marriage therapy is not about teaching you to ignore the problem, but it is about getting into the middle of it and learning not how to be right but how to get it right. At Connections Counseling Services, our therapists have specialized training to help you and your partner to learn how to repair hurts, listen, receive and understand one another. As you do, you will notice that although the fights may still happen, they will resolve more quickly and you will feel closer to your partner not farther apart. There is hope and healing ahead. We can help you to find it.
Premarital Couples Counseling — Is that really a thing???
Marriage is the biggest decision a person will make in life. We all enter marriage with high hopes that the relationship will be fulfilling, rewarding, and long lasting. Additionally, we hope the marriage will be of benefit to future children—protecting them from mental, physical, emotional, educational, and social problems. However, despite the best intentions, according to the American Psychological Association a whopping 40-50% of marriages end in divorce, severely impacting all parties involved, especially children. What if there was a way to help prevent becoming included in this grim statistic?
Premarital couples counseling is quickly becoming a popular new trend—and according to research it is proving to be effective. One particular study published in the Journal of Family Psychology found that premarital education decreased the odds of divorce by 31%!!! Additionally, couples in the study reported higher marital satisfaction, less destructive conflicts, and more commitment to their partner. Another study published in the Journal of Marital and Family Therapy, the most renown journal in the field of marital and family therapy, found that premarital couples counseling helped increased confidence in their ability to discuss important topics and helped clients better understand their partner. Who wouldn’t want those dynamics in their marriage? Premarital couples counseling is a great tool to prevent divorce and increase a stable foundation in the relationship.
Premarital couples counseling can be brief, comprising of approximately 10 sessions or less. First, the therapist will work with the clients to conduct a relationship assessment—identifying strengths and weaknesses in the relationship. Following the assessment the therapist will then work with the couple to set goals to help overcome challenges. Then the therapist will teach the clients skills that will help them establish a solid foundation in their relationship. These skills can include:
- Learning to communicate more effectively.
- Avoiding toxic resentments.
- Setting realistic expectations.
- Conflict resolution techniques.
Premarital couples counseling is one of the best investments a couple can make for their marriage. At Connections Counseling Services, our licensed therapists are skilled in helping couples prepare for challenges in their relationship, thereby decreasing the likelihood of divorce and increasing marital satisfaction. Enter your marriage prepared and confident by giving your relationship the gift of premarital couples counseling.
American Psychological Association
Larson, J. H., Vatter, R. S., Galbraith, R. C., Holman, T. B., & Stahmann, R. F. (2007). The RELATionship Evaluation (RELATE) With Therapist-Assisted Interpretation: Short-Term Effects on Premarital Relationships. Journal of Marital and Family Therapy, 33(3), 364–374.
The Mayo Clinic
Naylor, S. (2014). Everything you need to know about premarital counseling. The Huffington Post.
Stanley, S. M., Amato, P. R., Johnson, C. A., & Markman, H. J. (2006). Premarital education, marital quality, and marital stability: Findings from a large, random household survey. Journal of Family Psychology, 20(1), 117–126.
Mindfulness has become a popular term lately. It is also a very common intervention used in therapy for a variety of presenting problems. In 2010 an analysis of all previous studies of the effects mindfulness on anxiety, depression, and other mood disorders was conducted. The results? Mindfulness significantly decreased symptoms of anxiety, depression, and other mood disorders. While that is great news, what clients really want is an intervention that will help them in the long run–that will help create lasting change and lead to healing. With that in mind, what else did this analysis find? At follow-up appointments clients still reported significant decreases in symptoms! Mindfulness can be a powerful intervention in the treatment of mood disorders. Here are some other great benefits studies have attributed to mindfulness:
- Improve well-being
- Strengthen relationships
- Increase focus and attention
- Boost immune systems
Wow! Three cheers for mindfulness!
So, what is mindfulness? Psychology Today defines mindfulness as:
“A state of active, open attention on the present. When you’re mindful, you observe your thoughts and feelings from a distance, without judging them good or bad. Instead of letting your life pass you by, mindfulness means living in the moment and awakening to experience.”
In therapy, your therapist will guide you in becoming aware of your thoughts and encourage you to stay in the present moment. When thoughts drift, the therapist will gently pull you back to the present to an observable state. For example, focusing on your thoughts as if they are clouds slowly moving by in the sky. Eventually mindfulness allows a client to observe their thoughts without reacting to them or judging themselves. This ability to be aware of what we are thinking without reacting puts us back in the driver seat in our own lives and allows us to make more educated decisions about what actions to take, what behaviors to change, and, perhaps most importantly, what to let go.
Mindfulness can be incorporated in couple or family therapy as well. I have oftentimes used it in my own practice to help family members take a deep breath, reach a state of calm, observe their thoughts, and mindfully practice what they want to say. This helps clients to then communicate with their loved ones more effectively.
All this goes to say that mindfulness has broad applications. A skilled therapist can utilize mindfulness in a variety of ways to assist clients in understanding their thoughts, emotions, and the physical sensations associated with those emotions. When mindfulness is regularly used and practiced, it has the potential to create lasting change, boost the healing process, and help a client lead a proactive life.
Hofman, S.G., Sawyer, A.T., Witt, A.A., & Oh, D.The effect of mindfulness-based therapy on anxiety and depression: A meta-analytic review. 2010. Journal of Consulting and Clinical Psychology. 78(2).
Kayla is a Licensed Therapist
working with individuals,
families, couples, as well as groups.
Choosing the best therapist for you can be difficult. This is the person you hope to share your deepest darkest secrets with!!! You might ask, “How can I know if I will be able to trust him or her!” “How do I know if this person is right for me?” “How can I know they can help me?” or “Can they really understand what I am going through?”
It’s important to ask yourself these questions and find someone that you feel understands your needs and that you can trust to help you. Many people seeking help can go through several therapists until they find the one they are comfortable with. A good therapist understands this and will respect your choice to find safety. As a practicing therapist, I have functioned in both the capacity of someone’s first therapist as well as someone’s last.
Research has shown that the best outcomes in therapy come from two very general dynamics (Cooper & Lesser, 2011, p.33; (Teyber & McClure, 2011):
- The client’s comfort and connection with the therapist and
- The therapists sense of hope in the client’s progress.
In practical terms, this means to attend one or two initial sessions and trust your instincts on whether there is a good connection. You may need to explore different therapists – but it is worth it.
Here are some other thoughts to consider:
- We Don’t Sell!
- Be aware that a good therapist will be inviting, but will not try to sell you on their treatment….you may feel motivated to continue with a therapist after the first session(s), but you won’t feel pressure.
- We are All Unique!
- Every therapist has a different personality and a different style of practice. For example some may be skilled at listening and letting you come up with solutions, some are more directive. Choose the person that you feel will suit your needs and personality. Ask your therapist what his/her process of change looks like in dealing with your issues. Understand your treatment plan.
- We Don’t Give You Fish….We Teach You to Fish!
- Both the therapist and the client need to be working together towards the issues that the client feel are important towards him and her. A therapist doesn’t force the client to change or make a habit of telling the client a specific course of action to resolve a dilemma. They should however, help you develop skills and perspectives that allow you to own and solve your own issues effectively. In this way you continue to grow long after therapy is over. Assignments and opening your heart and mind to new perspectives are important in this regard, not necessarily advice giving. Over time, you will learn to both trust yourself and work with others in getting answers.
- There is No “Right” Way!
- There are many different theories of practice out there (e.g. cognitive-behavioral therapy, emotional focused therapy, etc.) and many different types of therapists (LMFT, LCSW, CMHC or LPC, Psychologists, Psychiatrists). Ask your therapist what theories they practice and how they view change and progress with individuals and families. Ask them to give you a basic outline of these theories.
- Be Committed to the Process!
- Most therapists will do a 15-30 minute consultation for free to find out all of these questions and get to know them more; here at Connections, we offer a 30 minute consultation. Don’t be afraid to shop around. But when you do choose a therapist, spend more than a few sessions with them. Therapy can take time. If you find yourself not progressing or feeling uneasy in your session, or if you are concerned with how your therapist is handling certain issues, talk to them about it! A good therapist will be open and helpful with this information. They will be respectful of your issues and seek to come to an understanding of your needs if you feel they don’t already.
- We Don’t Need our Ego Brushed. Be Honest with Your Feelings!
- There have been many times clients have been concerned with how I say something or do a certain therapeutic process, but will be afraid to speak up. If I don’t catch it right away, the client will not receive the amazing benefits that come from working through relationship concerns with someone skilled in this process. When a client opens up about some of his/her concerns, these can be some of the most uplifting, growth inducing processes in a session. It is necessary to have a safe and open dialogue with your therapist. If you feel that you can’t, you need to be direct and honest with them.
- If you feel that you aren’t understood or heard when this happens, be honest and seek to find a therapist you feel that you can be honest with and that you feel will validate your concerns. Often times this isn’t about the therapist or you as the client nearly as much as it is about the therapeutic style, personality compatibility, and your current motivations for change and growth. Don’t be afraid to be honest with your feelings towards your therapist. A good therapist will be able to emotionally handle any feedback they are given. You are paying them to help you. They understand this. Don’t waste your money on unsaid and unspoken language.
- Not all Therapists Are Trained the Same!
- There are different types of therapists that are best suited for specific issues. Ask your counselor what they are trained in. Therapists have been trained on most client issues but their training and approach is particularly suited to some issues more than others. Ask your therapist about their experience in the areas that are of interest to you. As an MFT (marriage and family therapist), people will often assume that I only specialize in family and couple counseling but not individual counseling. This is a mistaken assumption. Most MFTs work mostly with individuals with a variety of issues. They are just trained to view many problems in the context of the relationship and family system. Psychiatrists and psychologists are often misunderstood as well. Psychiatrists attend medical school and most of their work consist of diagnosing and prescribing medication. Psychologists don’t prescribe medication but can diagnose and test. Most therapists have the training to diagnose, but might send you to a psychiatrist or psychologist for further testing or medication.
A Few Final Points…
Recognize your expectations with the therapy process and open up to your therapist about them. Clients will often expect their therapists to lead the counseling sessions. Meier and Davis discuss a few important factors to consider when starting counseling:
- The pain can get worse before it gets better, so consider with your therapist if the pain you are experiencing in therapy is legitimate pain of growth, or if it is making things worse.
- Therapists take confidentiality very seriously but you should talk to your counselor about the exceptions to confidentiality.
- People who go to counseling are those with the courage and capacity to seek and consider input in helping them function more happily and effectively in their every day lives. Getting help is not a weakness….
Kyle is a Marriage and Family
Therapist, specializing in individual,
relationship, and family work.