Archive of ‘Mental Health’ category

Trauma and The Brain

I believe when helping individuals recover from traumatic events they have experienced the first step is to help them understand just how trauma affects the body. And it does indeed affect your whole body, specifically your brain. Today I’m going to talk about trauma and the brain and give a brief overview of what happens in your brain during and after a traumatic event. First I’d like to point out that the definition of trauma lies on a broad spectrum and that the experience of trauma is subjective. I think of trauma as a high level of emotional or mental distress, and what qualifies as a “high level” varies from person to person. Here is a simple definition of trauma by researchers Duros and Crowley (2014): Too much too fast, too much too long, or not enough for too long.

By: Susanna Wetherington, LPC-Intern Supervised by Lora Ferguson, LPC-S

By: Susanna Wetherington, LPC-Intern
Supervised by Lora Ferguson, LPC-S

When trauma is experienced, the body becomes dysregulated because some systems go “offline” in order to attend to the emergency at hand. This dysregulation of the nervous system results in distortion and fragmentation of memory, perception, beliefs and emotions (Van der Kolk). Lets get a closer look at how this happens. It is important to note that what I am going to explain happens reflexively, meaning we have no control of how the process unfolds. When information comes into the brain through the senses, that information is directed to the amygdala. The amygdala can be thought of as the brain’s “smoke detector,” constantly scanning (5 times a second, to be precise) for danger. It determines if any stimulus in the environment is dangerous. If danger is perceived, then the amygdala gets the nervous system going. The thalamus signals the brain stem to release norepinephrine, a stimulant, throughout the entire brain. The hypothalamus sends a signal to prompt the pituitary gland, which then signals the adrenal glands to release adrenaline and coritsol so the body can jump into action. When cortisol floods the brain, the hippocampus shuts down. This is important because the hippocampus is responsible for processing explicit memory – the parts of memory that can be explained with words, such as the where and when of an experience, visuals, sounds, and smells. The problem is that since this part of the brain shuts down these parts of the experience do not get processed along with implicit memory – the parts of memory that contain body sensations and emotions. Since these two parts of memory of the event are not processed together and thus stored separately, the experience of the traumatic event gets fragmented. So, when something in the environment triggers the physical sensations or emotions that were present during the trauma, there is no activation of the part of the memory (explicit) that indicates time and place. As far as the body and brain are concerned, there is currently a real and present danger and the body reacts accordingly. As you can imagine, this can be very difficult for the individual having this experience. You could be going through your day as you usually would, and then for no obvious reason you are experiencing panic, fear, anger or sadness. Some wonder if they are losing their mind because they don’t understand why this is happening! My hope is that in explaining what happens in the brain when a distressing event occurs, that relief can settle in because there is now an understanding that this is not “crazy” but a biological result of distress. Once you understand what is happening, you are much more able to address it with helpful techniques to calm down the nervous system.

References:

Duros, P., & Crowley, D. (2014). The body comes to therapy too. Clinical Social Work Journal. doi:10.1007/s10615-014-0486-1

Van der Kolk, Bessel, MD., “The Body keeps the Score: Brain, Mind, and Body in the Healing of Trauma,” Peguin Press Viking, New York, 2014


Shame: The Insidious Defeater

It wasn’t until after I was out of graduate school and well into my professional career that I really learned about shame. While many of my clients seemed to receive help and work through tough problems and even trauma, there seemed to be a few areas where we would sometimes get stuck. After training with Dr. Brené Brown and her team on shame resiliency, I began to notice huge progress both within myself and in my clients.

Jennifer Alley, LPC

By: Jennifer Alley, LPC

Most of us don’t talk about shame. By definition, shame is that which feels unspeakable; the things that keep us awake at night or nag us throughout our daily tasks. They are the messages we hear in our head when we want to be vulnerable or make a connection with another person; the voice that discourages us when we think of taking a risk or doing something brave. For many of the clients I work with, the voice shows up as something like, “not ____________ enough” (fill the blank with words like good, smart, pretty, skinny, sexy, funny, etc). It also dresses up in messages like, I’m unloveable, flawed, disgusting, broken, worthless, a phony, or a fraud. When we have a fight with someone we love, shame is often the feeling that causes us to curl up in the corner feeling completely defeated and “bad” or lash out and blame the other person, perhaps even shaming them.

For many people, these messages and statements are so insidious, so ingrained that they are perhaps not even really consciously noticed. Instead, they may just be internalized as “truth,” minimizing the chance that the person feeling shame might take that risk, share something vulnerable, or succeed at something hard. It often keeps people from having the close relationships that they would like to have because they fear that if people only knew the “truth” about them, they wouldn’t be liked or considered worthy of connection.

As part of the work I do with clients, I ask them to notice the “tapes” that play in the back of their minds. When they feel challenged, when they are trying something new or difficult, when they feel scared or hurt, what messages are they hearing? They often come back surprised by the amount of negative self-talk or shaming messages that are on replay throughout their days.

Particularly in my work with individuals who have a trauma history including family of origin mental illness or dysfunction, domestic violence, assault, or abuse, with clients who have experienced divorce or made the difficult choice to abort or give a baby up for adoption, and with clients who are in recovery from various types of addiction, there is often a great deal of shame happening consciously or unconsciously.

The biggest problem with shame is that it jeopardizes relationships, stunts our growth, keeps us from connecting with others, and makes us feel very alone. The anecdote to shame is owning our story with self-compassion and love in addition to sharing our story and our shame with those that we trust.

To learn more about Dr. Brown’s work on shame, visit http://www.brenebrown.com. If you are interested in joining a group or receiving individual counseling about shame/shame resilience, visit http://www.austincounselors.org.

Upcoming Group Offering:

Daring Recovery– an eight week group for women in recovery based on the work of Dr. Brené Brown. Facilitated by Jennifer Alley, LPC, CDWF-candidate at 5000 Bee Caves Rd. Suite 100.

Mondays 6:15-7:45pm

October 27-December 15

Group objectives:

  • Gain courage to own, share, and live our stories
  • Learn how to live life sober, transforming the way we live and love
  • Choose authenticity over numbing, pretending, and perfecting
  • Increase self-compassion, empathy, and connection
  • Understand our shame triggers and what drives that feeling of not being enough
  • Connect bravely with other women

Contact Jennifer at [email protected] or 512-761-5180 to register or for more information. You can also visit http://www.austincounselors.org.


When Self-Harm Hits Home

As parents, we never want the “scary” things to happen to our kids.   We want our kids to be happy, healthy, confident and caring. We spend so much of our time and energy trying to protect them from baby falls to bullying, but sometimes the “scary” things hit close to home. One such thing is finding out that your child is harming themself.

Christel Gilbreath, LCSW

By: Christel Gilbreath, LCSW

These acts of harm against oneself is what we call self-injury or self-harm. Teens typically do this through cutting or burning their skin. You may notice cuts or burns on their forearms or thighs, which they may try to hide with long-sleeve shirts, pants, or bands or excessive jewelry around their wrists.

According to several studies, self-injury seems to be on the rise. School counselors, college professors, and parents are all noticing what some call a “psychic epidemic.”

So, what should you do if you discover that your child is engaging in self-harm?

Here are a few ideas both from my own work with individuals who self-harm and from several authors I have noted below.

    1. In the words of one adolescent, “Try not to totally freak out.” Your heightened emotional reactivity and/or anger only works to increase your adolescent’s anxiety. You want to show your adolescent that you are willing and able to tolerate their disconcerting emotions and are able to offer assistance.
    2. Avoid threats, yelling, breaches of privacy, and discouraging remarks.
    3. Try things that help calm your child such as making eye contact, letting your adolescent tell their story of what provoked the self-injury, respectfully listening, offering hugs, using an attitude of empathy, being nonjudgmental, and encouraging your child that you can all get through this together.
    4. Matthew Selekman, in his book noted below, suggests asking the following questions:
      1. “Now that I know that you are cutting yourself, can you help me understand what it means to you?”
      2. “How has it been helpful for you to do this?”
      3. “Is there anything really stressing you our in your life right now that I might be able to help you out with?”
      4. “If you don’t wish to talk about it right now, I understand. I just want you to know that I care and am here for you when you are ready to talk about it. Would you like me to check in with you or would you prefer to come to me when you are ready to talk?”
    5. Have the courage to ask your adolescent what you may be doing to contribute to the overwhelming feelings that lead an adolescent to self-harm.
    6. At the same time, recognize that your adolescent’s decision to harm themself is a choice they made and is not your fault.
    7. If school bullying or academic pressures are a leading cause of the self-harm, advocate for your child within their school.
    8. Ask your child if they would like to speak with a professional counselor.   Allow the adolescent to be part of the process of selecting who this professional may be.

mom-comforting-daughter

Sources:

Brumberg, J. (2006). Are we facing an epidemic of self-injury?. Chronicle of Higher Education, 53 (16), B6-B8

Plante, L. (2007). Bleeding to ease the pain: Cutting, self-injury, and the adolescent search for self. Plymouth, UK: Rowman and Littlefield

Selekman, M. (2006). Working with self-harming adolescents: A collaborative strengths-based therapy approach. New York: WW Norton & Company


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