1. Overcoming Past Trauma 11 March 2010 Laurie M. Forbes, MSW, CSW www.forbes-breakingfree.com

2. What is Trauma? The Social Work Dictionary: “An injury to the body or psyche by some type of shock, violence, or unanticipated situation.”  Traumatic events overwhelm the ordinary human adaptations to life, they generally involve threats to life or bodily injury, or a close personal encounter with violence and death.  Traumatic reactions occur when a person feels action is impossible, when neither resistance nor escape is possible. PTSD-W

3. Examples of traumatic events:  Adults and teens –Accidents involving vehicles, people, animals, natural disasters –Major illness, surgery, terminal illnesses –Rape, sexual assault, etc. (in men or women), domestic violence, other crimes against the family or person, terrorism, war/combat, kidnapping, prisoner of war, etc.  Children (pre-teen) –Accidents, illnesses (self or loved ones) –Crimes against the family or person (bullying, terrorism) –Separations from loved ones (hospital stay, trips, foster care) –Changes in family structure (new baby, divorce, death) –Abuse (emotional, physical, sexual, verbal, domestic violence)

4. Some Effects of Trauma:  Anger  Fear  Confusion  Depression  Inability to concentrate  Anxiety  Social withdrawal  Panic attacks  Obsessions and/or compulsions  Sleep problems (too much, too little)  Eating problems (too much, too little)  Addictions  Nightmares, flashbacks, intrusive memory fragments  Problems with interpersonal relationships  Problems trusting  Loss of faith in and/or anger at a higher power  To rigid or lack of personal boundaries  Problems with sexual boundaries, intimacy or promiscuity  False beliefs and thinking errors, feeling like a failure  Emotional numbness

5. General Rules to Overcome Past Trauma:  Admit that there is a problem or need for change  Don’t expect to be “cured” overnight, unless you are willing to forgive right now  Include prayer and seek spiritual guidance  Have a plan (Goals)  Choose one or two things to work on at a time – don’t overwhelm yourself with too much  Go at your own pace, not what others believe you should be doing  Use all the resources at your disposal  Involve others you trust  Don’t be embarrassed or afraid to seek help

6. A Comparison Hierarchy of Needs Effects of trauma  To satisfy hunger, thirst, sleep, etc.  Need to be secure, safe, have stability, and shelter  Need to belong, to love and be loved  Need to achieve and to be recognized  Need to know, to explore, to understand  Need for self actualization  Eating & sleeping problems, nightmares  Anxiety, Fear, Panic attacks, flashbacks, intrusive memories  Social withdrawal, trust and interpersonal relationship problems, personal or sexual boundary problems, emotional numbness  Obsessions, Compulsions, Addictions, Depression, Anger  Confusion, inability to concentrate, loss of faith in and/or anger with a higher power  False beliefs and thinking errors, feeling like a failure

7. Loss  Loss is what is missing or has been removed from your life due to wanted or unwanted changes  Things that can cause loss: –Death, divorce, moving, illness, accidents, abuse, addictions, unemployment, change, having a baby, marriage, healing, natural disasters, unnatural disasters, terrorism, etc.  Things that can be lost: –Childhood, joy, peace, parents, love, limbs, property, health, siblings, grandparents, other relatives, opportunity, future, confidence, esteem, children, companions, etc.  If you don’t already know your losses, discovering what you have lost as a result of trauma can be emotionally painful  The pain is due to having a loss that has not been mourned  Allow yourself to grieve your losses as you discover them  Allow yourself to understand that loss is real, that you have a right to grieve  Grieving provides a release from emotional pain, allowing healing to take place  Grieving brings freedom from emotional suppression or oppression

8. Grief and Mourning  5 Aspects of Grief: –Denial  having trouble accepting the reality, the shock is too much, time is needed to “take it all in” –Anger  Has many faces, directed at many people  Is not logical or valid, may be unreasonable  Should not be denied, should be acknowledged and worked through –Bargaining  There is a human tendency to bargain for what we want – extended life, escape from pain, a distraction from reality. –Depression  A healthy response to loss and its overwhelming sadness  Comes and goes, changing with each stage or aspect a person is in  Usually clears on its own –Acceptance  Accepting the reality of the loss, and the new reality resulting from the loss  Acceptance does not equate with liking the change or being “alright” or “okay” with the change. “On Death and Dying”

9. Anger  “___ made me mad.”  Anger is bad – true or false?  FALSE  Anger is a choice  Anger is based on two emotions – fear and/or hurt  Anger is not bad, it is misunderstood  Anger has a useful and righteous purpose  Anger is used to bring about change within ourselves or our community/world  Anger focused on self is usually focused on revenge.  Anger focused on violation of another’s needs is usually focused on change

10. Anxiety/Panic “Triggers” Why it happens: TTTTraumatic events can leave a person with fear of “it” happening again. RRRReminders of the traumatic event often ‘trigger’ similar panic or anxiety felt during the event. How to figure out what your triggers are: PPPPay attention to what your thoughts are. OOOObserve what is going on around you. OOOObserve who is around you and what they are doing. CCCCompare the above to what you experienced LLLLook for similarities

11. Boundaries  Unhealthy –Can’t say “no” –Everyone is given “intimate” status, including strangers –Decisions are based on emotions –Love and sex are the same thing –It is okay to tell everyone about private matters –Needs and wants are the same thing –Helplessness instead of autonomy –Touching or being touched without permission is okay  Healthy –Knows limitations and can say “no” when needed –Understand safe limits with strangers –Decisions are based on rational thought, facts, and emotion –Love is based on mutual respect and friendship –Private matters are only shared with a few trusted persons –Needs and wants are different –Ability to help self or decide who can help if needed –Who touches and when touching happens is a choice

12. Shame/Guilt  Shame –Based on false beliefs and embarrassment about yourself as a person –Is unhealthy –Has no useful purpose –Is oppressive –A sign of having been powerless or helpless  Guilt –Stems from having taken an action that is not correct or a lack of action when needed –Is healthy –Produces change –Is not permanent –Is about your actions not you as a person

13. Perseverance: the Truth About Failure  Failure doesn’t mean you are a failure – it does mean you haven’t succeeded yet.  Failure doesn’t mean you have accomplished nothing – it does mean you have learned something.  Failure doesn’t mean you don’t have it – it does mean you have to do something in a different way.  Failure doesn’t mean you have been a fool – it does mean you were willing to try.  Failure doesn’t mean you are inferior – it does mean you are not perfect. Failure doesn’t mean you’ve wasted your life – it does mean you’ve a reason to start afresh.  Failure doesn’t mean you should give up – it does mean you should try harder.  Failure doesn’t mean you’ll never make it – it does mean it will take a little longer.  Failure doesn’t mean god has abandoned you – it does mean God has a better idea. Author unknown

14. Addiction  Illegal drugs  Alcohol  Tobacco  Caffeine  Prescribed medicine  Sex / pornography  Food / junk food  Chocolate / candy  Anger / strong emotions  Foul language  Violence  Adrenaline rush / danger  Power / control  Helplessness  Out of control hobbies  Seeking Attention  Anorexia / Bulimia Definition of Addiction: “The giving up of one’s self habitually.” or “Slavery to (name your addiction)”

15. A Different Way of Thinking  As children we have a certain set of experiences that shape how we see the world  This set of experiences is only a small part of the experiences that occur in the world  As we grow, we learn how to respond to these experiences and design a story or “script” in our head  This script allows us to describe and make sense of our experiences, and our responses to these experiences  Schemas are the set of beliefs & responses that form our scripts  Our schemas (beliefs & responses) become set at a fairly young age  Even if we have new experiences that challenge these beliefs & responses, we tend to try to understand these experiences using the schemas we already have, to keep our script from changing

16.  While these ways of understanding and responding often help us to survive when we are young, they can interfere with our ability to adapt to new, challenging situations as adults (remember, we only have limited experiences when we are young)  We design ways of thinking to make sure that our beliefs and response don’t change, so we can keep our script safe  These ways of protective thinking are called “thinking errors” because they do not allow us to change our responses so that we can adapt to new situations  Instead they cause us to deal with new experiences with old beliefs and responses  The problem is that these old beliefs and responses are now maladaptive and cause us and those around us to have problems  In order to responses to new experiences in a way that does not cause harm to others and ourselves we need to understand our scritps, schemas, and thinking errors  We need to challenge them, and change our response to them, and ultimately to adjust our view of the world A Different Way of Thinking Thinking Errors Handout – Valley Mental Health - Forensics

17. Thinking Errors TTTThought distortions that are not reality, how our thinking distorts reality. TTTThoughts that encourage the continuation of irresponsible behavior. EEEEveryone uses thinking errors. TTTThinking errors affect how we see, hear, feel or internalize the world around us. TTTThinking errors impact jobs, self-esteem, and relationships. CCCCommon thinking errors: –A–Abusive labeling –A–All or nothing thinking –A–Assuming –B–Blaming –C–Catastrophizing –D–Dismissing the positive –E–Emotional reasoning / making feelings fact –F–Flaw fixation –O–Over generalizing –P–Personalizing –R–Regrets –S–Shoulds –U–Unfavorable comparisons PTSD-S

18. 7 Principles of Healing 1)H ealing starts by applying skills to manage PTSD symptoms. 2)H ealing occurs when traumatic memory is processed or integrated. 3)H ealing occurs when confronting replaces avoidance. 4)H ealing occurs in a climate of safety and pacing. 5)H ealing occurs when boundaries are intact. 6)K ind awareness and acceptance of feelings aid the healing. 7)B alance in our lives is necessary to heal. PTSD_S

19. Faith  Common beliefs: –“God allowed this to happen.” –“God didn’t protect me.” –“God doesn’t love me or this would not have happened.” –“I am angry with God but can’t admit it because he will punish me.”  Truth: –The gift of Agency was involved –God does not take away anyone’s agency –God uses our actions to judge us – good or bad –God loves all of his children equally –God understands our feelings (anger), he is patient and will wait for us to learn the truth

20. Questions? www.forbes-breakingfree.com

21. Resources  Allen, Jon G., Ph.D., 1995. Coping with Trauma: a Guide to self- understanding. American Psychiatric Press, Washington DC.  American Psychiatric Association: Diagnostic and Statistical Manual of Mental disorders, Fourth Edition, Text Revision. Washington, DC, American Psychiatric Association, 2000.  Barker, Robert L.,1999. The Social Work Dictionary, NASW Press, Washington, DC.  Herman, Judith, M.D., 1997. Trauma and Recovery, The aftermath of violence - from domestic abuse to political terror, Basic Books, New York.  Ingraham, Linda, 1991. Life Without a Crutch: an Introduction to Recovery from Addiction, OPEN Inc., Garland, TX.  Kubany, Edwards S., Ph.D., 2004. Healing the Trauma of Domestic Violence: a Workbook for Women. New harbinger Publications, Oakland CA.  Schiraldi, Glenn R. Ph.D., 2009. The Post-Traumatic Stress Disorder Sourcebook, 2 nd Ed., McGraw Hill, New York.  Williams, Mary Beth, Ph.D., 2002. The PTSD Workbook, New Harbinger Publications, Oakland, CA