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

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!

Building Family Resiliency (Video)

Parent Connection Coach and Educator Ron Huxley, L.M.F.T., is here to help you and your family build resiliency during these stressful times.
Watch the video and learn how to:
1. Gain new perspectives.
2. Teach your children to be problem solversHelp parents become resiliency coaches and avoid power struggles.
3. Eliminate negative game playing to develop loving and cooperative relationships.

Ron Huxley has over 30 years experience helping families heal and serves as a parent coach and educator with Parent Connection of San Luis Obispo County. In his capacity as a parent coach, Ron specializes in working with families who’ve experienced trauma. He believes in taking a strength-based approach that builds on solutions and he creates strategies that fit each family situation in the shortest time necessary.  


Ron Huxley is a licensed Marriage and Family Therapist providing trauma-informed therapy for individuals and families. Currently practicing on the Central Coast of California, Ron travels internationally educating parents and professionals on trauma-informed care.

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!

Humility Allows Opportunity for Family Healing

Humility is a great opportunity for healing. It creates an ideal mental state that allows you to connect deeply with another human being. When you are in a humble space, I see our relationship as it is, not as I think it is… It restructures the nervous system to “fire and wire” with new neural networks that prepare us for change. This is why pain can bring breakthrough in our life and relationships. It is why loss can develop into growth. It’s not that you want to go through the pain and loss but it can be transformed into some new and precious.

Humility will break-through emotional programs of trauma from the past. In others words, you can get unstuck!

“The reward of humility and the fear of the Lord are riches, honor and life.” Proverbs 22:4

Trauma + Faith = Resilience

According to the National Opinion Research Center’s General, Social Survey over 90% of Americans believes in God or a higher power. Sixty percent belong to a local religious group. Another 60% think that religious matter is important or very important in how they conduct their lives, and 80% are interested in “growing spiritually”.

Even when people do not belong to a specific religious group or identity with a particular spiritual orientation, 30% of adults state they pray daily and 80% pray when faced with a serious problem or crisis.

Trauma is defined as any event, small or large, that overwhelms the mind and bodies ability to cope. Some people appear more resilient or able to “bounce back” in the face of trauma. Studies proof that faith is one-way children and adults can cope with traumatic events and suffering.

The question remains “how does faith make us more resilient?” It may be that faith reduces the negative, victimized thinking that results from trauma. For example, victimized people understandable “feel” as if they are damaged, dirty, worthless, stupid, vulnerable, ashamed, or unlovable. The type of trauma might be small or large but this is a common emotional reaction to the hurt someone suffers.

This reaction results in a lower ability to mentally plan and adaptively cope with situations create more possibility that fear, hurt, and worthlessness will result. You can see the vicious cycle that trauma can create…

Our minds are meaning-seeking devices. We like to find things to validate our thoughts and experiences so we can better navigate future circumstances. The upside of this is that we can be more efficient problem-solvers and survive. The downside is we can unrealistic or simply untrue beliefs.

Faith counters this downward cycle of believing, acting, and reacting by shifting the story from the negative plot lines to the bigger themes that “I am loved, valued, and cared for…even when things are bad!” Faith can override negative views of oneself with the belief that you are loved just as you are, normalize the internal spiritual struggles, encourage opening up and being vulnerable again, renewing a sense of control or mastery in life, and fostering social connections.

Being part of a larger group of people contributes to our collective connectedness that detours isolation and loneliness and encourages greater personal healing. Research demonstrates that socially connected people are more likely to meet the demands of everyday loss and stress.

Spirituality and religious affiliation can also benefit traumatized people from the toxic memories of the trauma event. This occurs with the individual feels they can share their grief with a greater community. Traumatic memories cannot be forgotten but they can be contained and/or unburdened when shared with fellow sufferers and with God or your higher power. This is a move toward memory instead of moving beyond memory. As one author described it: “One must have the courage of memory, because through it, one can seek God.”

Finally, religious groups have the best inspirational self-help scripts available in the form of the Bible, Torah, Koran, other holy scriptures, liturgy, and worship. They offers a framework for dealing with trauma and copes with stress.

Rabbi Harold Kushner, in his popular book on “When Bad Things Happen to Good People” writes:

“In the final analysis, the question of why bad things happen to good people translates itself into some very different questions, no longer asking why something happened, but asking how we will respond, what we intend to do now that it has happened.” (p. 147) .

Faith provides us with the HOW of living resiliently!

REFERENCES:

Meichenbaum, D. (2016) TRAUMA, SPIRITUALITY AND RECOVERY: TOWARD A SPIRITUALLY-INTEGRATED PSYCHOTHERAPY :

Click to access SPIRITUALITY_PSYCHOTHERAPY.pdf

SAMHA Website on Faith-based Communities : http://www.samhsa.gov/fbci/fbci_pubs.aspx

Pargament, K. I., Kennell, J. et al. (1988). Religion and the problem-solving process: Three styles of coping. Journal of the Scientific Study of Religion, 29, 90-104.

Microsoft Word – MeichSPIRITUALITY INTEGRATED PSYCHOTHERAPY1 final edits.doc

Jay, J. (1994). Walls of wailing. Common Boundary, May/June, 30-35.

Harold S. Kushner’s “When Bad Things Happen To Good People” New York: Schocken Books, 1981.