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

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!

Fearful of Forgiveness?

In this healing video, Ron Huxley, explains what forgiveness is and isn’t. Learn the benefits of forgiveness to release angry toxins from your life even if you can’t reconcile or ever be with another person ever again.

Fearful of Forgiveness?

Get more power-full people tools by taking a course at FamilyHealer.tv!

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!

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.

Talking to Children about Violence

This article is a reprint on how to talk to children about violence. Unfortunately, the information is still timely as shootings continue to occur around the globe negatively impacting children and their development. Regardless of the specific incident, this blog will help parent understand the process for safely communicating with children.

Violence in society is a major issue for families today. It’s everywhere we look, it seems, and as a parent it disturbs me deeply. Part of the job of parenting is to protect our children from the ills, if not the evils of the world, but what do you do when it comes looking for you. Recent sniper attacks, school suicide-killings and the outbreak of fighting around the world, makes talking to our children about violence a necessary responsibility.

It would be easy to wait until our children bring up the issue and not take a lead role in discussing violence with them. Unfortunately, too many children take in the information, attempt to process it with their limited experience and understanding, and never say a word to an adult. Just because they don’t initiate, doesn’t mean that parents shouldn’t. For these children, talking about the violence may relieve feelings of anxiety and insecurity they were bottling up inside. Children get their sense of safety from the attitudes and behaviors of adults, primarily parents. How we act and talk will have a direct impact of the emotional well being of children.

The first step to talking to children about violence is to acknowledge their thoughts and feelings about the violence. The best way is the simplest: Ask them what they think or feel. This will give parents a barometer about where the child is at and what concerns need to be addressed. Demonstrate that you are willing to hear it and give your child full attention without judgement. Too many parents are quick to jump into a child’s comments and make them seem invalid. A parent might dismiss their child’s fears as unnecessary: “You shouldn’t feel that way” or “You don’t need to worry about that.” A parent might even reply that the child is being silly, stupid, or overreacting for what they are thinking and feeling. This is a sure method to get a child to shut down emotionally and not communicate with a parent, now and in the future. Get on a child’s level by sitting or kneeling down when talking to them. And get rid of any distractions (i.e., turn off the television or radio). Make the conversation about them not you.

The second step is to clarify and/or reflect back a child’s comments. For example, a parent might say, “Tell me more about your fears of someone killing you” or “What do you mean you think the world is going to end.” This also communicates to a child that what they have to say is important and not trivial. It makes parents more aware of the underlying issues. If a child’s comments are clear then repeat back to the child what you heard them say. Don’t be a parrot; just summarize it, so that you and the child are on the same ground mentally.

The third step is to share your feelings and value about the violence. This means you must be aware of what they are before you ask your child to share. How do you feel about the violence? What is your value-system about killing, death, and violence? Is it a social, moral, or relational issue for you or does it encompass all three. Once you are aware of where you stand, you can communicate this with your child. Share in a direct, simple, and honest manner. How you say something may be more important than what you say. But be sure to say it in a matter of fact way.

What you say will vary depending on your values and the age of your child. Young children have difficulty separating reality from fantasy and it may be important to describe the difference. For example, a parent of a young child might state: “I know that the cartoons you watch sometimes have characters who shoot one another but that is not real. In real life, when someone gets shot they get hurt and they might even die.” Avoid in-depth explanations for younger children. They will lose attention and not be able to process long descriptions. One to two sentences are more than enough. Additionally, parents can use drawings and children’s book about fighting, violence, etc. Always follow up with reassurances that you love them, will do your best to care and protect them, and that they are safe.

Older children may be able to verbalize their thoughts and feelings more distinctly but don’t let that be an excuse not to talk about it. Use the same principles as with younger children but feel free to talk more deeply about the violence. Watch the news report together or read the newspaper article out loud, pausing to discussing thoughts and feelings. Ask them if they know of anyone who has been the victim of violence. The older they are the more likely they will know or have heard of someone. Talk about violence that has occurred towards them or in their daily life, such as school. Guide the older child toward your values without forcing them on them or telling them how they should believe. And look at ways to get involved in your community or through national relief efforts to help victims of violence. Being proactive will give a child a sense of power versus powerlessness.

What we say to children is important and we must say something. Sticking our heads in the sand will not improve the situation. Actually, ignoring or dismissing the topic of violence will increase a child’s anxiety and fears. But even more importantly, how we talk about violence will have profound impact on our child’s sense of self, their understanding of right from wrong, and their relationship with the parent.