Treating Trauma in a “Zoom” World: Is it even possible?

You might wonder if it is possible to treat post-traumatic stress disorder (PTSD) during a COVID-19 pandemic crisis, but this is the situation that therapists and clients find themselves. Can we find a way to maintain effective treatment through the use of modern technology? Is it possible to treat trauma with this “new world” approach to mental health?

Since the beginning of this year (2020), countries worldwide have worked to protect vulnerable populations from the virus COVID-19. The primary strategies used to prevent the spread of the virus is social distancing and self-imposed quarantine. While this has been effective in reducing the pandemic’s physical effects, it hasn’t protected us from the psychological effects of this unprecedented life-situation. We see an increase in fear, anger, anxiety, panic, helplessness, and burnout in both children and adults. As a therapist working remotely with people dealing with stress and trauma, I have seen several extreme reactions of hallucinations and delusions due to the isolation and continual digestion of negative news media. 

A Healthline.com survey of what COVID-19 is doing to our mental health gives a somber picture: increased worry and insecurity over finances, higher than normal depression and anxiety, prevalent feelings of sadness, and being “on edge,” and an alarming rise in suicides. In America, Federal dollars are being released to increase mental health services nationwide to stem this rising tide of trauma without fully knowing the long-term effects of trauma. 

Therapists, just like the general population, use social distancing and remote work to keep themselves, their families, and their clients safe. Therapists are “front-line responders” and considered “essential workers,” but not all therapists choose to be exposed to 30-40 people a week who might have the COVID virus. Many of them, like myself, have family members who have compromised immune systems and considered to be at-risk. Working from an office and seeing individuals, face-to-face is not an option. Therefore, therapists and clients have to seek alternatives that can be equally beneficial to both. 

The European Journal of Psychotraumatology studied the Telehealth models for post-traumatic stress disorder using cognitive therapy and found that clients rated it as very successful in managing their symptoms. High patient satisfaction ratings were given for both video conferencing and phone call sessions. In the later technology, the only nonverbal communication was the tone of voice, and yet it still benefited clients. 

The journal defines Post-traumatic stress disorder by “a sense of serious current threat, which has two sources: the nature of the trauma memory and excessive negative appraisals.” Traumatized individuals frequently have intrusive, negative thoughts about traumatic experiences and continue to see the world with a negative lens. They have a feeling of hopelessness about their future and easily triggered by daily events. 

Professional organizations are rising to the challenge and providing education and support to remote mental health workers on the unique delivery of mental health through technology. Guidelines have been created by the American Psychological Society, International Society of Traumatic Stress Studies, and the National Institute of Health and Clinical Excellence, specifically targeting PTSD. Governing boards for various mental health professionals are also outlining specific legal and ethical requirements for safe, trustworthy online therapy. 

According to the Psychotraumatology journal article, Telehealth’s use led to “improvements in PTSD symptoms, disability, depression, anxiety, and quality of life, and over 70% of patients recovered from PTSD (meaning they no longer met diagnostic criteria). The Journal of Family Process has reported several articles on the effectiveness of Telehealth with children, adults, couples, and families.

Therapists, offline and online, can provide education and support to (1) reduce negative reactivity in thoughts and emotions, (2) build more effective coping skills, and (3) deepen the quality of life and relationships.

These three areas are healing strategies outlined in my trauma-informed training and therapy. 

The foundation for PTSD work, in face-to-face or video conferencing, is to establish a sense of safety from which to utilize these healing strategies. The client has to trust the therapist, believing he can offer some hope, create an atmosphere of security, and witness the traumatic hurt for PTSD individuals. Empathy isn’t confined to the physical space of the therapist’s office. It can exist in the relational space online as well. Facial expressions on video, tone of voice, empathic responses, and supportive comments assist the connection despite distances.

Finding a private place to have a conversation is one real-world challenge of online work. Privacy can be increased by changing locations (some of my clients go inside cars, relocating to other rooms in the house, or going outside), using headphones, and letting family members know that they can’t be disturbed hour or so. Additionally, therapists can also learn about resources in the client’s living area if referrals are needed. Homework assignments can also be used between sessions and discussed online for adolescents and adults. Parents can participate online with young children, and family members can “zoom” in from different locations at an agreed-upon time. And lastly, follow up with secure emails and text messaging can further increase the outcome of this digital therapeutic medium for PTSD. 

If you are looking for a trauma therapist or someone to help you or a family member with anxiety, contact Ron Huxley today at RonHuxley.com

Be sure to take advantage of our free online resources for families during the COVID-19 Pandemic at FamilyHealer.tv

References: https://www.healthline.com/health-news/what-covid-19-is-doing-to-our-mental-health

https://www.tandfonline.com/doi/full/10.1080/20008198.2020.1785818

https://www.apa.org/practice/guidelines/telepsychology

https://www.ptsd.va.gov/professional/treat/txessentials/telemental_health.asp

How do dad’s emotions affect their children?

There is some interesting research on the link between depressed dads and its effects on their children. This supports much of the posts I have written on the importance of father/child bond. The research is summarized by Child-Psych.org at http://bit.ly/mvo6nu: “The current study used a nationally representative sample of fathers of one year-olds, 1,746 dads in total.

The men answered questions in four different areas: interactive play (e.g., peek-a-boo), speech and language interactions, reading to the child, and spanking. Whether or not the fathers had talked with their child’s pediatrician during the past year was also assessed. Seven percent of the fathers in the study reported being depressed during the past year. Seventy-seven percent of these dads also had spoken with the pediatrician over the past year… there were no differences between fathers that were not depressed and those that were in their reports of playing interactive games and singing songs/nursery rhymes with their children. Depressed dads were less likely to read to their one year-olds and much more likely to spank them.”

Conclusions of this study focused on the relationship between a fathers well-being and the child emotional and academic abilities later in life. As you might expect, the higher the depression in dad, the lower the functioning of the child. In addition, there is a connection between how aggressive dads were in their discipline. A higher percentage of dads spanked or acted out of anger with their children. Why do I keep harping on this topic? I want dads to be aware of and accept how vital there role is in the life of their children. I want others (moms and society in general) to be more mindful of the need to educate and support dads in this role. As men, we don’t get the same amount of formal or informal training to be parents as moms. More focus is needed for men to rise to the challenge of parenting.

Telehealth for Trauma: An effective treatment strategy

According to the National Center for Post-traumatic Stress Disorder, Telehealth or TeleMental Health services are an effective treatment strategy for trauma. Telehealth uses information technology, such as email, phone calls, FaceTime video, and Secure Online Video to conduct therapy services. This technology allows a therapist and a client to engage in real-time two-way interaction. Services that can be provided via Telehealth include assessments, individual and group therapy, psychoeducational interventions, and general therapeutic interactions.

Traditionally, mental health services are engaged in face-to-face, office visits. Just because this is traditional, doesn’t mean that is is more effective. There are times when face-to-face visits are preferred due to lack of adequate technology, challenges with privacy at home, or personal limitations of the client in using technology. In all other situations, TeleHealth is a unique service that provides several benefits, including:

  1. Savings in time and money,
  2. Overcome geographic distance for rural populations,
  3. Increased access to care for individuals with mobility issues (lack of transportation),
  4. Flexibility of appointment times (e.g., out of town for work, babysitting concerns, or other restriction on clients availability like a lunch hour, etc.),
  5. Promotion of physical health by avoiding spreading a contagious illness (COVID-19 or general sickness, like a cold).

Telehealth is not new. It has been used for six decades, in the medical field, and is now being adopted by TeleMental Health as a flexible option for individuals. It is not a “lesser” alternative to mental health care. Outcome research has proven it to be very effective in many areas of mental health issues, like anxiety, depression, and trauma. It also offers convenient support for many general concerns, such as parenting education, life transitions, spiritual direction, and more.

A recent article from the Washington Post points out how global pandemics, like the COVID-19 virus, have shifted the landscape of mental health services through the use of technology allowing more people to attend to their mental health needs. Therapists and individuals may be just blocks away from one another geographically, but medical issues isolate and create an insurmountable “distance” between them. The use of Telehealth or TeleMental Health eliminates geographic and social distance.

The reality is that people around the world are suffering and in need of mental health treatment, education, and support. Children and adults who have experienced trauma cannot wait for medical cures or be punished for lack of mental health access. Telehealth/TeleMental Health is a powerful tool to bring immediate hope and healing.

Learn how to use TeleHealth with Ron Huxley by clicking here!

Read about our security measures and informed consent for Telehealth services here!

SOURCES:

https://www.ptsd.va.gov/professional/treat/txessentials/telemental_health.asp https://www.apa.org/pubs/journals/releases/ser-a0034963.pdf https://www.washingtonpost.com/opinions/2020/03/23/coronavirus-is-mental-health-emergency-too-we-must-remove-barriers-care/?fbclid=IwAR3JK9PIihf_5_nbwbPtgtC1coPpflzmWnAPEDE5FL5kgjsvCnUix_N74aY

What is Anxiety and How to Manage Pandemic Uncertainty

In this first video of five total video series on Building Family Resiliency we talk about how to manage anxiety in a time of uncertainty. Learn powerful tools that will help you and your children find freedom from anxious thoughts. Discover bodily-based strategies that don’t require lecture, rationalization, or complex ideas to bring peace to your life.

Get more free tools at FamilyHealer.tv or schedule a time to talk to Ron today!

Finding comfort and joy, moment by moment.

During this season we hear a lot about comfort and joy but many people feel only pain and loss. Comfort and joy are the perfect antidotes to this suffering. It is what a broken world needs most. It may be that we can’t find comfort and joy because we believe that when we do we will stop feeling hurt. This is not always true. Our heart is to create more space not to eliminate hurt. That would be a nice result but isn’t reality. We strive to allow comfort and joy to coexist with our pain and loss. This inner act expands our heart of compassion. We now have a greater capacity for feeling both comfort and pain, joy and loss. It is a spiritual paradox but it is a direction for our own healing. 

Science confirms this idea. Our hearts literally do expand when we entertain compassion and allow more space for comfort and joy. Choosing compassion releases neurotransmitters in the brain and hormones in the body and calm down the hyperaroused nervous system, reducing fear, anger, anxiety, and depression. 

Studies on the practice of compassion reveal improved autoimmune functioning, decreased inflammation, improved digestion, increase mental focus, motivation, and even sleep. Dr. Caroline Leaf, a noted cognitive neuroscientist, and researcher on the mind-body connection report that compassion increases the grey matter in the brain, allowing improved thinking and sensory processing. 

So how does compassion start? How do we allow comfort and joy into our lives when we feel stuck emotionally? The answer is where we put our focus. 

Right now, at this moment, you have a choice. Whoops, there it went but don’t worry, here comes another. Missed that one. Just wait…

We have thousands of opportunities to choose comfort and joy. Every moment is a chance to change the directions of our lives. It will not remove pain and suffering but it will allow us to build a mindset that allows comfort and joy too. Take a deep breath and make one statement of comfort and joy. Maybe it is gratitude for that cup of coffee or tea in front of you. Is it warm and comforting however brief? Maybe you heard someone laugh and it made you smile? Perhaps, someone opened the door for you when your hands were full? Life is constantly presenting micro-moments of comfort and joy. You just have to notice them. 

The problem is that we allow suffering to be our filter for living. We get angry expecting things to be different than they are. We resent people for not treating us the way we deserve. Just allow those challenges to exist alongside the next moment of gratitude and pleasure. Build those moments up, one after the other, and live a day full of tiny, joyful experiences. Tip the emotional scale in your direction. 

The brain likes to automate our life. It will take any repeated experience, good or bad, and make it a habit. This is how we can do so many tasks and face so many diverse problems. It makes us efficient and skilled. It can also make us miserable if we stop being aware of what is going on around us. A lack of moment to moment awareness makes us a machine, driven to self-protect and insulate from anything that smells dangerous or out of the norm. We don’t want the norm. The norm is hurt. We want the new which is comfort and joy. This will cost you some mental energy until the new norm becomes a happy habit. 

Test these ideas out today. Stop three times today to recognize a moment of comfort or joy. Write them down on a post-it note. Remember, in as much detail as you can muster, throughout the day, what it felt like. Do this for a week and see if your pain, your suffering, starts to lessen and a life of greater compassion takes over. 

Let Ron Huxley, Licensed Marriage and Family Therapist, assist you in finding more comfort and joy. Schedule a session today – Click here!

Begin 2020 with Forgiveness…

When you spend your days encountering pain and suffering, you look for ways to find comfort. It isn’t easy to find if you are looking in the wrong places. True comfort that is…Addictive activities bring some relief from the overwhelming feelings of pain but then you have to engage in the addiction again, to find that comfort once more. It’s an endless, downward spiral.

As a therapist who works with traumatized children and adults, I have found that the most lasting comfort comes from within, not without. It isn’t in things or activities, although they can provide some distraction. It comes from our hearts and minds as we battle the negative interpretations of our lives and relationships in the aftermath of trauma.

True comfort begins by clearing out our own judgements. Hurts result in resentments which turns into isolation and insulation from others. We want to protect ourselves. They is a normal, innate response to pain particularly when it comes from those closest to us. The pain programs behaviors that protect but this also cuts us off from sources of healing. How do you find real comfort in this season of “joy and hope?” Let’s start with forgiveness.

Most people are fearful of forgiveness. Is it because there are common myths about what forgiveness is and why we should do it.

Forgiveness is not staying a victim or allowing further pain to come into our lives from toxic people. Forgiveness is not forgetting what has been done. We need to remember so we have the wisdom to make healthier choices and set boundaries.

Forgiveness releases the angry toxins from our thoughts and emotions. It doesn’t have to benefit others, although it may. It won’t always result in a reconciliation with others but it could. It doesn’t happen in an instant and might even take a lifetime to completely forgive. That’s ok!

Forgiveness sets us on a course of self-directed healing of the hurt. It must become a lifestyle and not a one time answer to all our pain.

Deborah van Deusen Hunsinger, in her book Bearing the Unbearable: Trauma, Gospel, and Pastoral Care states: “The God who alone sees the human heart is the God who alone who may judge.”

Let us let God be God to judge others. That is too big a burden for us to drag around. Let us be free of the weight of past pain and hurt. Let’s allow more love and comfort to enter into our lives. Let us us find comfort this Christmas by giving ourselves an lasting gift.

You can learn more ways to walk in healing with the courses at familyhealer.TV

Start the New Year 2020 with Forgiveness!

The Problem with Labeling Trauma

There is a common problem in social work and mental health today in trying to label people who have experience trauma. The reason for this is that trauma can impact the brain and the body in a way that produces a wide-range of symptoms that can be confusing to understand.

Most professionals are not “trauma-informed” meaning they haven’t received training on how trauma affects every area of human functioning or how to treat the whole person. Trauma, particularly the adverse experiences endured in early childhood, that can result in coping mechanisms that mimic criteria of various clinical diagnoses.

What are some of the labels you have heard placed on traumatized children or adults?

  • Manipulative
  • Oppositional
  • Defiant
  • Hyperactive
  • Temperamental
  • Trouble makers
  • Bipolar
  • Narcissistic
  • Borderline
  • No conscience
  • Destructive
  • Stressed Out
  • and many more…

In addition to a lack of trauma awareness, we are all “meaning-seeking creatures” that want to label everything so that we can feel better about ourselves and our world. Unfortunately, it can do a lot of damage to the people we are labeling. If we label incorrectly, we will treat them incorrectly. This is might also be why so many survivors appear to “sabotage” their success. It isn’t a real desire to ruin their life. They need sensitive professionals and parents who understand how to deal with the root, trauma issues.

Fortunately, there is a national movement to train parents and professionals, who work with traumatized children, to become more “Trauma-Informed.” This movement is reaching out to homes, school, and organizations and explaining “What is trauma?”, “Impact of Trauma on the Brain, Behavior and Health”, “Adverse Childhood Experiences”, “Power of Resilience”, “Regulation Skills”, “Dissociation”, “Mindfulness and Compassion”, “Recognizing Signs and Symptoms of Trauma in Children”, “Attachment Disorders”, “Post-traumatic stress and Post-trauma Growth”, “Trauma in the Community”, “Avoiding Re-traumatization in Survivors”, “Trauma-Sensitive Schools”, “Faith-Based Approaches to Trauma” and more.

The focus of these training efforts is shifting the primary question inherent in treatment plans, screenings, programs and polices from asking “what is wrong with you” to “what has happened to you”. 

This paradigm shift starts the dialogue with survivors, humanizes our practices and helps traumatized children and adults on how to find true healing.

If you would like Ron to train your organization on Trauma-Informed Care, contact him today at 805-709-2023 or email at rehuxley@gmail.com.

Gathering an Audience of Appreciation

Gathering an audience of appreciation

Have you been faced with a stressful situation where it is crucial how you perform, only to choke just when you need to be at your best? We all have! An article, by Scientific American journal, studied this experience and found some interesting insights.

The researchers found that negatively stereotyped social groups are some are at the greatest risk of choking under pressure. For example, if women are told that they are not as good as men at math, right before a math test, then they tend to do poorer on that test then if they were not told this statement.

One reason for the may be that the women are having to fight off the negative thoughts as they are trying to also person a complex task like solve math problems. This is what the researchers called “Increased Cognitive Load”. Others studies suggest that a negative stereotype increases feelings of anxiety and stress which affect performance.

As an artist, I feel the pressure of creating a painting when someone asks me to do one or wants to commission a specific image or scene. I can do great art, when I follow my muse and don’t worry about the outcome. That is because I am not worrying about whether someone will like it or question myself about my artistic abilities.

There is also the element of our identity. How we “see” ourselves or thing that others see us can affect our performances. Another researcher studied how positive stereotypes affect complex activities and found that this actually boosts ability to perform. Why don’t positive intrusive thoughts cause people to choke like negative ones? Because positive thoughts don’t focus on our feelings of worth as a member of a particular social group. As an artist, positive thoughts about my artistic skills increase my worth in this group of people.

Is the answer than to just pump ourselves up before a difficult task or pay others to tell us nice things about we are? Probaly not! As a psychotherapist, I tell my clients to explore their audiences of appreciation. Who values them? Who will be able to notice their efforts to change and will accept them unconditionally? A lot of emotional sufferers just don’t have enough awareness of their audiences of appreciation. Maybe my role as a psychotherapist is to be one of those audience members.

So instead of finding people to be “accountable to” in your efforts to set up a new New Years Resolution, try gathering together an audience of appreciation. Now wouldn’t that feel nice for a change? S

Ready to overcome anxiety, fear, and panic? Take a free ecourse at FamilyHealer.tv today and find “Freedom From Anxiety”.