Tag Archives: Developmental Trauma

Neurofeedback works: Van der Kolk

Bessel website pix vanderKolkportrait1Psychiatrist and trauma expert Dr. Bessel van der Kolk, MD posted a neurofeedback webinar August 9 that changes the map on trauma healing: http://neurofeedback2015.kajabi.com/fe/79711-rewiring-the-brain-free-ce-seminar . [Or try this link to a 5 min intro. His  72-min seminar is below at “Click Here to Begin Your Free One Hour:” http://neurofeedback2015.kajabi.com/fe/80095-support-neurofeedback-research-2015]

Please forward this to your lists of therapists, colleagues, anyone interested in healing. Dr. van der Kolk has promoted EMDR, yoga, and body work for decades.  Now folks with early trauma can check out neurofeedback.

I’ve so far done 10 months of neurofeedback and the healing is enormous. But it’s not known enough or funded. Getting word out could stop suffering.

At minute 20, van der Kolk shows graphics on how Sebern Fisher introduced him to neurofeedback. “She showed me drawings that traumatized kids did of their families (stick figures), then how they developed after 20 weeks of neurofeedback (real people), after 40 weeks (an attached group), and I was blown away by their development,” he said.

“There’s nothing I know that can do that,” he said. “When you see something like that, you pay attention. Can my psychoanalysis do that?  Can my acceptance and commitment therapy do that?  Can my friends who do EMDR or Somatic Experiencing do that?  No.  Nothing I know of can do THAT.  Time to learn new things.”

Don’t hire just any provider. A neurofeedback practitioner with 1. Five-ten years’ neurofeedback; 2. A certificate from EEGSpectrum.com or EEGInfo.com; and 3. Familiarity with attachment issues, is a good place to start.  A good neurofeedback therapist won’t do “one size fits all.”  Ask to be sure that they carefully adjust it to each individual and keep re-adjusting.

My blog on neurofeedback with links to Sebern Fisher interviews is here: http://attachmentdisorderhealing.com/neurofeedback/

Find a Neurofeedback Practitioner Online Directories are here:
1. EEG Spectrum International: http://www.esiaffiliatesforum.com/providers  2. EEG Institute Directory: http://directory.eeginfo.com/
Sebern Fisher says both are fine. Only #2 had a provider near me; he’s great. He’s got all 3 features above.  My insurance covers it for a $35 copay.

Am I In Tune — Or Not?

Neurofeedback Before & After mirasol.netAs for me, I feel calmer, more centered, less frightened, and less easily triggered every day. It works on long-term issues.

Still, I felt shocked as van der Kolk described “ways of being” which I have in spades, but never knew are symptoms of brain disorganization. This knocked me for a loop:

“Our brain is shaped by human interactions, by the way that people respond to us, to rhythms, voices, touch, sounds, how we make music together,” he said. “We are rhythmic machines; I talk to you and move my hands, my face, and I image you responding in kind.

“But if you talk to your partner and they freeze their face, your mind goes blank — because we need feedback… If the world does not respond to you, if people do not smile at you, if as a little kid  when you come home people say, “Oh, you again”?  You miss the experience of being in tune with people. It goes to the very core of our central nervous system.”

At this point (6 minutes in) I had to lay down and sob for 10 minutes. Feeling what he said totaled me.  I had no attunement experiences until I was 4  1/2 and my sister was born. No responses, no rhythm.

“If you have many attunement experiences,” he said, ” when you get scared, someone’s there so the feeling gets repaired; someone gets mad but soon they repair it, then you get a sense of flow with other people. You know we can do things together, we can work things out. You know I can have a voice because my voice has an impact on you. You can have a voice because your voice has an impact on me.”

Again I was sobbing.  What is he talking about?  Have a voice, what’s that?  I never had an impact. Work things out?  Unheard of.  I’m terrified at mis-attunement.  I have no experience that what I feel matters.

In abuse or neglect, he said, “these neural rhythms get broken. The most important parts of the brain to grow in first years of life get you in tune with people, tell you what to be scared of, when to feel safe, how to connect, how to be in synch.”  I was never in synch.

At minute 15:30 he shows astonishing brain scans (click on graphic above). When normal people hear a strange sound (“eeek”), he says, they need to figure out what it means, “so all the different parts of the brain synchronize to focus on that. They’ve developed an N-200 filtering wave that says ‘ignore your phone, your hunger… just pay attention to this sound.’

“But traumatized people have enormous problems filtering out irrelevant information. They are hyper-stimulated by sounds, sights, images, body sensation, have a terrible time filtering them out. As you see here, traumatized people have very different wave forms. Different parts of the brain are not in synch… which explains why they have such a hard time learning from new experiences… taking new information into the brain, paying attention, taking in life as it comes, learning from it.”

That’s me. I’m hyper-stimulated by sounds, sights, images, body sensation. Half the time I can’t filter them out.  This last point really concerns me.  I had no idea that most people can filter out these things.

I just called my neurofeedback therapist and told him that I need a lot more help. “I’m afraid both of us under-estimate how disorganized my brain is,” I said. “You may want to try other areas of my brain for your sensors and/or other procedures” during neurofeedback.

Thank Heaven for neurofeedback and fighters like Dr. van der Kolk.

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Kathy’s news blogs expand on her book “DON’T TRY THIS AT HOME: The Silent Epidemic of Attachment Disorder—How I accidentally regressed myself back to infancy and healed it all.” Watch for the continuing series each Friday, as she explores her journey of recovery by learning the hard way about Attachment Disorder in adults, adult Attachment Theory, and the Adult Attachment Interview.

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Comments are encouraged, with the usual exceptions; rants, political speeches, off-color language, etc. are unlikely to post.  Starting 8-22-16, software will limit comments to 1030 characters (2 long paragraphs) a while, until we get new software to take longer comments again.

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How EMDR Helped My Early Trauma

Guest Blog by Amelia
[Amelia is the pen name of an EMDR therapy client of Dr. Sandra Paulsen, pioneer of new EMDR protocols for developmental trauma/early trauma (ET). [FN] Amelia is now with Paulsen colleague D. Michael Coy, MA, LCSW.  She graciously provided this blog to inspire others to seek healing. –kb]

Sandra Paulsen BookIn 2013 I began working with Sandra Paulsen, PhD. I am very grateful for the early childhood trauma (ET) work we did.   It was a stunning process that gave me understanding and resolution of significant traumas.  I learned to understand “ego states” and gained a view of the numerous parts of me that acted as protectors throughout my life.   The use of “the conference room” was difficult and surprising at first, but with Dr. Paulsen’s encouragement and compassion for “the little one” inside me, it quickly became easier for me to imagine a conference room in which I could see “parts of my self” sitting around a table.

We worked intensively in long sessions often using EMDR therapy.   The tappers were scary sometimes, but became easier for me to tolerate; they create a mild, alternating bilateral vibration and can be held.  [EMDR therapy for ET may tap on alternate feet or other areas away from the face, rather than moving a finger before the eyes as in Francine Shapiro’s original EMDR therapy. -kb]

Initially, I learned to ground myself in the present where I felt safe.   Within a short time, I was able recognize parts of self in the conference room, an imaginal place in my mind’s eye where different aspects, or parts, of myself could come to help us understand and access trauma memories.   The process revealed difficult memories that enabled me to understand “the why” of my lifelong struggle with confusing fear, along with the “why” I felt a need to isolate myself from family and friends.

At the end of each session. the content of our work was consciously set aside in an imaginal “vault” in the conference room until next time.  I envisioned my memories and feelings floating down a stream into a large container that held them tightly (the vault).  After most sessions, despite my recall of terrifying memories, anger, and tears, I felt relief.  Thinking of those sessions now, I’m amazed by the sense of safety I felt with Dr. Paulsen.

Developing Confidence, Deep Body Memories

Paulsen Sandra PhotoI developed confidence in the process and believed that one day my “whole self” would be healed.  I realized too that I was becoming valuable to myself for the first time. [Sandra Paulsen, right]

I remembered more than I could have imagined.  Often my body felt memories first.  These somatic memories led me through a long trail of abuse and abandonment by family members.  Remembering specific parts of the abuse was a surprise at times.  I attribute the lack of memory to my amnesia barrier and am grateful that my brain was able to develop the barrier.  I sometimes recall those surprising memories and marvel at the function of our brains.

I’m also grateful that Dr. Paulsen took time to help me build boundaries that I could use then and later to further process my memories.  My new boundaries were a great help in painful relationships, which could have destroyed my fragile but growing sense of self.

When visualizing my childhood “parts of self” with Dr. Paulsen, I began to appreciate each part and welcomed the knowledge we recovered together.  My parts worked together to accept the reality I could not manage to be aware of in childhood.  I love knowing that my unconscious mind protected the conscious me and built a complex support system.  My understanding and knowledge of my parts is pivotal to release, resolution and healing of my fragmented self.

I am learning to accept all of me rather than just “the parts” my family wanted.  The good and bad parts held me together in the midst of chaos.  I’ve decided the difference between some of the “good and bad” parts of self were those behaviors or beliefs that were acceptable or not.

My experience taught me that I was never safe in my family because attitudes could change in a moment.  I lived in fear of the unexpected changes and surprise attacks.  Sometimes it’s difficult to like certain parts because I viewed them as causing the pain of disapproval and abandonment.  In reality, my unacceptable parts were protecting me.

After working with Dr. Paulsen, I understand the functions each had in helping me stay alive.  For instance, I have a split sense of God.  I’ve hated the bad God part (judgment) and love the good God part (compassion).  I understand now that  “bad God” part protected me from my family because “bad God” taught me to act the “right” way.  To understand it now is valuable, but the judgment led to self-loathing.  It’s amazing that hating myself made me safer within my family.  All I could expect was abandonment and a family that used me rather than caring for me.

My feelings about my family are still confusing, but I’m learning to view them from a distance.  My mother and father are not bad.  There were reasons for their behavior.  I am aware that I see them as the bad parts who inflicted pain.  I expect that resolution can be reached in time.

I developed the ability to talk with my parts.  We have safe spaces to talk, reflect and empathize with ourselves.  I’ve found this essential.  The spaces are in nature…a forest, the beach or a quiet space for meditation.   Walking in a peaceful place is important to clearly see our existence together and care about our efforts toward wellness.

Anger, Move to Chicago

D. Michael CoyOn the opposite side of the peaceful place is the angry place.  It’s very difficult for me to acknowledge anger at others because it is dangerous to do so.  Working with Dr. Paulsen, I could acknowledge the anger.  My acknowledgment of angry feelings was hard because I was not able to express it in childhood or even in adulthood.  For me anger is the most dangerous feeling.  Others could be angry with me, but I could not express anger toward them.  Our work helped release some of my angry feelings, but it’s still difficult to feel safe enough to express angry feelings appropriately.  I recognize the angry parts of self.  I think we’re still waiting to feel safe and valuable enough to own those feelings.  I continue to work in my messy angry part of self.

In April 2014, I met D. Michael Coy, MA, LCSW [above], to whom I was referred by Dr. Paulsen before I returned to live in the Chicago area.   As it was with Dr. Paulsen, our work together has focused on my dissociated “parts of self,” but now using EMDR and other therapies to focus on the later memories of traumatic experience that I continue to struggle to get past.

Looking back over my time since I began working with Dr. Paulsen, then with Michael Coy, I’ve watched myself grow. I care for the many dissociated “parts of self.”  Visualizing my “parts of self,” I understand how each developed and the job each part did to prevent damage throughout my life.   I love knowing that my unconscious mind always protected me.  My understanding and knowledge of my parts is pivotal to release of trauma on every level.  I expect to function in the months ahead as the “whole person” I am.

In summary… there is so much more to know and say about living with (and healing from) complex trauma.  It’s a relief to know that my symptoms are real and not made up.  I cannot express my relief in light of my work in the therapeutic process called the EMDR early trauma approach, which Dr. Paulsen has so skillfully developed further to work with people like me, who struggle with complex traumatic experience.  I can honestly say that I’ve never been more hopeful in my life.

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Kathy’s blogs expand on her book “DON’T TRY THIS AT HOME: The Silent Epidemic of Attachment Disorder—How I accidentally regressed myself back to infancy and healed it all.” Watch for the continuing series each Friday, as she explores her journey of recovery by learning the hard way about Attachment Disorder in adults, adult Attachment Theory, and the Adult Attachment Interview.

Footnotes

FN1, “Neurobiology and Treatment of Traumatic Dissociation: Toward an Embodied Self,” by Lanius, Paulsen, and Corrigan, 2014, http://www.amazon.com/Neurobiology-Treatment-Traumatic-Dissociation-Embodied/dp/0826106315
See also especially Dr. Paulsen’s website: http://www.bainbridgepsychology.com/EarlyTraumaOShea.html

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New EMDR Therapy for Developmental Trauma

Paulsen Sandra PhotoGuest blog by Dr. Sandra Paulsen (left) & D. Michael Coy, MA, LCSW

[First I discovered it deep within myself and called it “trauma since the sperm hit the egg.”  Then I read that Bessel van der Kolk calls it “developmental trauma,” in his drive to have it finally recognized by the psychiatric profession. Dr. Allan Schore calls it “trauma in the first 1000 days, conception to age two.”  Earlier it was “complex PTSD” or C-PTSD.  In EMDR therapy, Dr. Sandra Paulsen, therapist Katie O’Shea, LCPC (who began this work), and D. Michael Coy, MA, LCSW, use “Early Trauma” (ET).  The science is in Chaps. 16 & 20 of Paulsen’s 2014 book. [FN1]
[Well: “ET, phone home!” Dr. Paulsen & friends have good news: they’ve created new EMDR therapy
protocols to heal developmental trauma. -kb ]

Eye Movement Desensitization and Reprocessing (EMDR) therapy “enables people to heal from the symptoms and emotional distress that result from disturbing life experiences,” says Dr. Francine Shapiro’s EMDR Institute website. Standard EMDR therapy has been shown to heal traumatic memories with a conscious, visual component, also called “explicit” memory. As EMDR clinicians, we have seen frankly astounding changes in our clients, both in how they see themselves and in how they experience and take initiative in the world.

But with in utero and infant Early Trauma (ET) occurring from conception to age three, also called developmental trauma, there is no conscious, explicit narrative memory — infants have not developed the parts of the brain which can think.  These traumas precede the existence of consciousness, so they’re called pre-conscious or “implicit” memories. Such memories are “somatic,” that is, held purely in the body — so healing is far more challenging.

How can we listen to the unspoken experience when, so early on, there were no words to tell it? How can we help the body tell its silent—or silenced—story?

Limitations of EMDR Therapy Standard Protocols

OShea Katie PhotoSandra Paulsen and colleague Katie O’Shea  (right) observe the limitations of standard EMDR as applied to early trauma, specifically:

1) There is no explicit memory in the first years of life, only implicit memory, so the standard EMDR procedure of targeting a memory of trauma could not apply;
2) If a client were able to access early experience in EMDR therapy, it could easily be overwhelming, without adequate preparation;
3) Early experience, when accessed, also accesses the client’s “felt sense” from that early time, with all the limits of self and inner structure that went along with pre-natal, infant, and early childhood developmental stages; [FN1]
4) Because of the paramount importance of relationship and caregiver attachment in infancy, the processing of early experience via EMDR therapy required modification to ensure the client had the felt sense of the therapist’s compassionate and attentive presence; and,
5) Because very early experience is ephemeral and does not consciously register as pictures or videos (as later memories may), the new EMDR therapy needed to explicitly accommodate the subtlety of infant early processing.

For these reasons a four step protocol was developed, starting with the work of therapist Katie O’Shea, who later brought it to the attention of Sandra Paulsen. They then worked to make these new ideas coherent with the latest neurobiology research by Jack Panksepp, Allan Schore, Daniel J. Siegel, et. al.

Four Steps of the Early Trauma (ET) Approach to EMDR Therapy

Early Trauma reprocessing includes the following steps to provide remedies to the limitations of standard EMDR therapy approaches above.  NB: There is substantially more to the treatment than described in this brief summary.

1) Cultivating structured containment of all experience yet to be “learned from or sorted through,” to leave a clear “emotional desktop” for work to occur;

2) Developing a felt sense of safety as a starting point for the work, which is achieved by tapping into and strengthening a naturally occurring (but sometimes hidden) “safe state” in the body. Both steps 1 and 2 may require client practice outside of therapy sessions;

3) The most mysterious step—resetting the affective circuits—involves clearing the emotional pathways that develop in each of us early on during our development in the womb, but which may be congested from maladaptive early learning and inhibitions about whether emotions are okay and safe. Once the circuits are clear, they can function as they were intended, to conduct emotional information between the brain and the body. This step may work directly on subcortical affective circuits, according to Jaak Panksepp in his groundbreaking book, Affective Neuroscience. For individuals with complex trauma histories and/or emotional dysregulation and imbalance, there may need to be additional preparation, most commonly ego state work; further education about healthy emotion, brain functioning and/or trauma; sometimes somatic work; and,

4) Clearing the early trauma, which happens by processing small time periods, beginning with a time before conception (owing to what is theorized to be generational, cellular memory), then moving on to conception, gestation in the womb, birth, and on through the first few years of life. These time periods are variable with the client, depending how “gnarled” the roots of the tree have become by growing around early obstacles. The clearing may be of somatic/implicit memory or of explicit memory, or mental constructs related to the time periods. For each time period, if it doesn’t resolve spontaneously, there is an imaginal good outcome of “what you needed, the way you needed it to be.”
As noted, there is much more to it, but for many the careful application of these steps produces a critical emotional shift with subsequent increase in emotional stability, comfort, and peaceful relation to one’s emotions and the self.

The Mechanics of the Early Trauma Approach

Sandra Paulsen BookThe experience of the infant is almost entirely a “felt sense,” as there is not much cognition at the beginning. So when therapy taps into those early felt senses, it often occurs without as the access to the more conscious and cognitively informed resources usually available to adults. Because of its central role in early life, this felt sense is an ideal entry point for attending to early, emotionally overwhelming experience so that it can be reprocessed and cleared.

As we are relying upon the most primitive information available to reprocess early experience, the standard EMDR therapy modality of eye movements or taps conducted with equipment may be too scary, too technical, and too alienating for some. Therefore, the reprocessing is facilitated by tapping on the client’s ankles, while the client is sitting back in a comfortable, reclining chair.

Because processing may occur over a period of hours, people often want to take off their shoes. This certainly makes it easier to tap on the ankles, and is mentioned here because people sometimes wish they’d worn different socks!
Early trauma reprocessing is designed to come in from the beginning, ‘under the floor-boards’, so to speak, so it is typically quite gentle and tolerable in comparison to consciously-focused EMDR therapy. Grounding is needed much less than in standard EMDR therapy procedures. People learn a lot about their own story in this lovely and very powerful procedure.

Highly-dissociative people are only appropriate for this method if they have already established considerable groundwork in therapy and there is a self-system to allow the work. The early trauma therapist ideally is experienced in working with dissociative clients and addressing concerns protective parts may have, as this piece is critical to ensuring positive outcomes in early trauma resolution work. If a potential client is dissociative and, after the initial evaluation, the early trauma therapist agrees to work with the client using the EMDR early trauma approach, it is necessary that the client have an ongoing therapeutic relationship to receive them after leaving the intensive work, assuming that the client is not working with the early trauma therapist in an ongoing treatment relationship. When the client has a primary therapist, it is typically necessary for the client to grant written permission for the early trauma therapist to collaborate with the primary therapist before and/or after the early trauma work takes place.

Intensive or Week by Week Treatments?

D. Michael CoyAlthough early trauma reprocessing can occur piecemeal, from week to week, hour by hour, this can be both terribly inefficient and not particularly cost-effective. The ideal way to experience this type of reprocessing is in extended, face-to-face sessions. Because the work is subtle, deep, and more felt than thought about in a conscious way, extended sessions allow the work to unfold viscerally and deeply. It’s akin to being on a commercial flight from Chicago to Minneapolis versus a flight from Chicago to Tokyo: yes, you get somewhere in both cases, but if you’re on the long-haul flight, you’re up in the air longer, you move more quickly, and your fuel efficiency is significantly better.

Notably, the Dr. Paulsen uses the intensive approach exclusively. In some instances where there is an ongoing therapy relationship, and insurance coverage is involved, the early trauma therapist and client may resolve that week-by-week treatment is the only way to go. This is the only option for a number of the clients who see Michael (above left), either because the client is not able to do the intensive work immediately (owing to extended preparation being needed), wishes to use their insurance in order to afford it, or they’d like to do the work in the context of longer-term therapy work.

However, the client should expect that it will take a number of months to complete the process of clearing early trauma. Michael does both intensive and week-to-week early trauma resolution work, as appropriate and necessary. Other therapists experienced in the EMDR early trauma approach likely structure the work in a way that fits the needs of their own practice and clients.

It is not easy to predict whether a client will need one, two, or more days of intensive work to clear the entirety of early disturbances and replace it with a felt sense of well-being. This goal is typically possible, but not necessarily easy to schedule or predict. Most people who have participated in intensives require two to three days, or more, to clear the first few years. The time required is variable, based upon how many traumatic experiences there were, how much neglect there was, and how maladaptive the learning outcomes were from those experiences. (Note that it’s not you as an adult who consciously assesses all of what was traumatic in those early times. Your brain did that for you before you were even consciously aware that any kind of wounding was taking place.)

Is This Treatment Right for You?

As different EMDR early trauma therapists may handle assessment, differently, we will speak here to how we approach it. Diagnostic assessment involves looking with the client at the following factors: 1) the client’s present safety and stability; 2) the client’s capacity for experiencing emotion and body sensation; 3) any internal conflicts that may complicate or block trauma resolution; 3) medical concerns; 4) substance use; 5) any evidence of structural dissociation, which would require additional assessment and preparation prior to embarking on trauma resolution work of any kind.

Biographical assessment is also an important piece of assessment. The biographical assessment covers areas of the client’s history such as work, education, military service, nutrition and self-care, basic family history, spiritual and cultural experience, and so on. Biographical assessment can provide both a helpful ‘fly over’ of the client’s experience, as well as point out the ‘smoke trails’ emanating from the client’s early, unresolved experience.

During and After Early Trauma Intensive/Reprocessing

On the first day of the intensive, the therapist and client ensure that all the necessary preparatory steps have either already been undertaken, or they will begin there in the work together.

It is not unusual for a client to feel ‘drained’ after early trauma reprocessing has taken place. Most people don’t want to do much in the evenings after an intensive session. The work is profound and will take some time set aside for introspection just plain rest.

Self-care is key in this work, so plan on drinking plenty of water, getting plenty of sleep, inviting oneself to dream, eat good food, maybe take some anti-oxidants because the client will be releasing energetic holdings. Fruits and vegetables will be put to good work in reconfiguring a ‘new you’. If the client is traveling from a different time zone, it is recommended that they are taking Melatonin or some other supplement (as approved by their primary care physician, as appropriate) to manage the effects of jet lag.

After the work, the nervous system will be “knitting and purling” for a time, and this is usually gentle and comfortable. Occasionally, if the work was paused in a gnarly hurtful baby spot, the client may feel stuck there. In those instances, the client may need help in person or by phone to move through such a spot.

It is also really important to keep in mind that any unusual experiences during the work or in the time right after the work may be related to the work. One can think of these as ‘vapors leaking up from King Tut’s tomb’. So, for example, if the client’s spouse, partner, or a good friend seems, for whatever reason, suddenly to resemble demon spawn, they are encouraged to consider the possibility that something about the early work has a theme of demon spawn in it somewhere.

Similarly, if it seems to the client that the early trauma therapist is suddenly just like the meanest parent ever, they are encouraged to mention this, because, although it may have a basis in present time (and, for Michael, his dogs might agree, depending on which chew-thing he’s rescued from them that day), we’ll consider that, often those kinds of feelings and perceptions are part of the client’s story, telling itself without words. The therapist and client use
information in the room and about what is happening between them, moment to moment, as clues to that story. Client and therapist become detectives together, hearing the client’s story together, however it seems to want to be heard. The most common unsettling experience after early trauma work is to feel oddly inert or flaccid. This seems to be part of a baby state, as if baby is just sitting, waiting, not mobilized for much action.

Closing Thoughts

We feel honored to do this important early trauma work with their clients. Michael was fortunate to have been trained in the EMDR early trauma approach both by its originator Katie O’Shea and by Sandra Paulsen, PhD, with whom Katie has collaborated to bring it to public consciousness and develop it into a replicable, systematic process for healing early wounding that can be used safely and effectively even in the most complex situations. (Notably, a cartoon book for therapists and clients on the EMDR early trauma is currently in press.)

We consider this work a sacred trust. It is such a privilege to hear the story of the baby within that may never have been told or heard before, except in symptoms or reenactments. The EMDR early trauma therapist’s intention is to help the client review, release and repair very early experience in a way that provides a felt sense of well-being. We encourage our clients to spend a little time before we meet identifying, if they don’t already know, what their highest resource is, and what their relationship is to the spiritual realm. Then we are more able to support the client’s process in a way that makes sense to them, on their own terms. This is the most helpful way we know to repair very early injuries, hurts, betrayals and disappointment.

See also the EMDR therapist finder directory of the EMDR International Association: http://www.emdria.org/search/custom.asp?id=2337

Sandra Paulsen, PhD, is the founder of the Bainbridge Institute for Integrative Psychology and a leading edge practitioner who has integrated her knowledge of Ego State Therapy, somatic therapies, and EMDR therapy to effectively treat clients struggling with complex trauma and dissociation safely and effectively. Dr. Paulsen accept clients for early trauma treatment in the intensive format but only via therapist referrals at this time. See: http://www.bainbridgepsychology.com/ET-Referring-Clinicians.html

D. Michael Coy, LCSW, LICSW, is a Master’s level therapist in independent practice in Chicago, IL, certified in EMDR therapy and also trained in clinical hypnosis, Ego State Therapy, and essential somatic methods for enhancing trauma resolution work. Michael’s primary focus is with clients who struggle with complex PTSD and/or dissociative disorders. Michael is also a clinical associate of the Bainbridge Institute for Integrative Psychology. For more information about Michael, see https://www.dmcoy.com.

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Kathy’s blogs expand on her book “DON’T TRY THIS AT HOME: The Silent Epidemic of Attachment Disorder—How I accidentally regressed myself back to infancy and healed it all.” Watch for the continuing series each Friday, as she explores her journey of recovery by learning the hard way about Attachment Disorder in adults, adult Attachment Theory, and the Adult Attachment Interview.

Footnotes

FN1, “Neurobiology and Treatment of Traumatic Dissociation: Toward an Embodied Self,” by Lanius, Paulsen, and Corrigan, 2014, http://www.amazon.com/Neurobiology-Treatment-Traumatic-Dissociation-Embodied/dp/0826106315
See also especially Dr. Paulsen’s website: http://www.bainbridgepsychology.com/EarlyTraumaOShea.html.

FN2  For Eugene Gendlin’s foundational work on the “felt sense,” a term he developed, see Gendlin, Eugene T (1978), Befindlichkeit: Heidegger and the philosophy of psychology. Review of Existential Psychology and Psychiatry 16 (1–3): 43–71. 
Dr. Peter A. Levine uses Gendlin’s “felt sense” work strongly in his “somatic experiencing” trauma healing:  Levine, Peter A., PhD, “Healing Trauma: A Pioneering Program for Restoring the Wisdom of Your Body,” ‘Sounds True, Inc.,’ Boulder CO, 2005; ISBN 1-159179-247-9

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My Neurofeedback Journey, 2

Tina Hahn ACEs Too High photoMy Neurofeedback Journey, 2 of 2
by Tina Marie Hahn
— as told to Kathy Brous

Tina added on July 11: I am experiencing major changes in my brain functioning so fast with neurofeedback, although as of this writing, I have only been doing it for three months. But in six months I seriously don’t think I will recognize myself anymore, and I say that after decades of struggle.  I truly recommend checking out neurofeedback, for anyone who has failed all the traditional approaches to trauma. Now back to my journey…

Major Trauma Release

On April 27, it had been about three weeks that I’d been working with the BrainPaint® desktop home neurofeedback machine.  I’ve been doing about 1.5 hours of neurofeedback a day. That turned out to be a little too much for me as a beginner, so I gave myself a break the last two days.

After my second “Alpha-Theta” training April 19, I could not stop sobbing during the session, or after — for 4 hours straight. It was cathartic. During the session my body was shaking — like really shaking. It reminded me of Peter Levine’s discussions and the video he has of the polar bear shaking after it was attacked and then later it came out of the trauma. It was incredible. I wasn’t just thinking this poison was coming out of my body — I was feeling it. I was shaking worse than if I had been locked for several hours in a deep freezer…

It really was amazing… I let go of a lot of stuff. I saw that my mother did the best she could. I could see myself letting go of the residual anger.

Then, the anger was replaced with a tremendous well of grief and loss. I realized that I was full of so much grief over what could have been and how my life might have been different if this had not happened to me — how my mother’s life would have been different if she had been able to feel love from her children instead of being so stressed that she allowed the most horrific things to happen to her kids.

I thought about how my brother wouldn’t be psychotic if he hadn’t been hurt so much…. How he could know happiness instead of his constant fear…..

And please know: it might not be good for most people to do this alone, as the title of your book says, “Don’t Try This at Home.”  For me, I’ve been working on confronting my childhood for decades, so I have an ability to tolerate this intense experience.  But for most people, unless you are willing to take chances and you’re pretty strong, a person might get really shaken up. It would probably be good to have a therapist to discuss what is happening and to process those deeply brain stem based emotions — or a group of healing friends. To have someone with you to support you would be helpful.

I might be doing better if I had a therapist too, but like Kathy I’ve had bad experiences with therapy so my confidence in it is low and anyway I’m in a rural area without much available.  But I think many people with severe childhood trauma like me who are considering neurofeedback might want to use it with formal support such as therapy or a support group.

For me, I wasn’t re-traumatized. That is all I want to say for now except I think this is a powerful tool!

Getting More Relaxed

By May 6, I found that we need to give the neurofeedback some time to settle into our brain, let the brain settle into new patterns. That’s why I’m not posting as much: I just don’t feel the need to reflectively respond to everything, and that means everything in general.  For someone with trauma, that’s progress.

I have been able to work through my anxiety and though it seems strange, send the emails and make the telephone calls that I need to make but generally procrastinate on. I have been cleaning and organizing. Usually I am so disorganized I am not good at this.

Now I am less reactive. I am certain of it.  When talking to others and they say something that would generally trigger me – I might still become triggered but there is more of a second or two to contemplate first.

I stopped doing several hours of neurofeedback per day. I think so much was making it very confusing for me to determine what was going on in my brain.  While I think generally it has all been effective, I like the general stabilizing non-linear protocol I began with.  I have done several more sessions of the “Alpha-Theta.” That is the type that has the capability to take us into the deep meditative state.

I haven’t had anymore of those really emotional spells during the “Alpha-Theta,” but my dreams have been more colorful. Actually last night I had the first dream in color and it was sad, but more positive.  Usually my dreams have always about big mean things trying to kill me.  So that is great, too.

I feel like I am better able to sit back, take in others point of view, back off from feeling like I have to do everything myself. I really feel this is great.  I also attribute it to the neurofeedback.  I feel like I could talk to people much easier now and have a great interactive conversation without feeling strange and out of place inside.  This is all awesome to me.

And I am feeling like moving into other areas of healing like meditation which I am not good at because of a “way too busy mind that is always quadruple tasking”.  I actually sat down and did about 15 minutes of sitting meditation yesterday and that was good.  So I think all in all this has been a very positive process for me.

I have also been taking others suggestions or at least listening and then making I think more informed decisions based on information from others. To me this is the start of trying to connect.

Also, though I don’t use Facebook much, I have been posting on Facebook more recently and will see people I know. Before, I would be afraid to send a friend request — I would be too afraid because I’m a bad person, that person wouldn’t want to be my friend.  But now, I have been taking chances, sending friend requests and guess what – people have been accepting.  I just find this totally weird for me.  I don’t look out of control outside but now, I am starting to feel more competent instead of “out of control inside.”  By that I mean that strange anxiety when you feel like you don’t belong, like you are an alien to a foreign species.  But now I’m starting to feel I do belong more, I’m feeling more human.

A Breakthrough or Epiphany?

On June 8, I wrote that I haven’t posted on my use of the BrainPaint® neurofeedback system for a month for a few reasons.

Good reasons: I felt so much better due to neurofeedback that I got too busy!  I’ve been out a lot, creating and attending meetings about the ACE Study and regional trauma-informed schools, and I’m writing several articles.  I’ve begun working on key things I used to procrastinate on, that’s also getting better with neurofeedback…  I can feel a real improvement in my impulse control and affect regulation (my ability to regulate my emotions is growing nicely.)

I still feel neurofeedback benefiting me in daily activities, for example if I want to write something that makes a point, I do it so that it’s not impulsive, and is worth reading.  My new ability to do that is part of the neurofeedback.

But I also missed a lot of BrainPaint® sessions. On the one hand, we do need time for the neurofeedback changes to settle into our brain. But I got 2-3 weeks behind so let me note: For anyone who decides to do home neurofeedback, it is important to follow the BrainPaint® policy to rate your goals and answer the assessment questions before each session, and also be careful to keep up with the updates they issue to their computer system.

I got behind on that because my cursor wasn’t working properly, I was blaming myself, so I missed a lot of sessions. Finally I called my BrainPaint® home neurofeedback coach and we learned it wasn’t my fault — the program needed an update, so it was updated June 5.

Then we reviewed and updated the BrainPaint® assessment together that calculated new protocols and she told me to stop trying to do everything on my own, to please call for help. I promised to follow the directions and did so over the weekend and — wow, did my brain move with the new protocols the system created!

In fact, as I was doing my session with the directed protocols, I came to what I have to call an epiphany.  Something has happened to me which feels weird, in fact it feels absolutely crazy (compared to how I used to feel).

I want to report it because it must be the neurofeedback which is really helping me. OK:

I’m often scared to take my dogs to the vet because the office is on a main highway, and the dogs jump out of the car as soon as a door is opened. I’ve been afraid one would jump out and get hit by a car. I have to put them in the back of the RAV4 when driving or I get a 60 or 45 pound dog in my lap, but I couldn’t get them out the back door due to trouble with the auto-lift gate.

Now yesterday while I was doing neurofeedback, for the first time in my life it hit me: Hey, I could go inside the vet’s office and simply ask a front desk person to help me so my dogs don’t jump out and get hurt. This sounds so stupid but it isn’t — it means for the first time in my life I considered asking another person for reasonable help!

That means believing people are supposed to help each other and that some people can be approached for help.

That’s a first step in trust. Amazing.
So I began to weep, really weep.
Let me explain why this feels so weird and crazy and amazing to me.

As many of us with a high Adverse Childhood Experiences (ACE) score, people have horribly hurt me. I’ve come to feel, I want no part of mammalian attachment to people (you call that “fur”) — even if it is the only way to heal. Trusting people is horribly scary for me for reasons like this:

When I was 7 or 8, I was with my dad in the car about an hour away from our trailer.  I never asked my dad for anything because he was incredibly mean. My dad smoked in the car with us kids inside.  But on this winter day, I had a cold, and as he is smoking, I suddenly couldn’t breath.  I am scared to death because I cannot breath. I timidly ask him “Dad could you please stop smoking? I cannot breathe.”  His response was “If you don’t like it, I can drop you off here right now and you can walk home!”  A very typical response. I don’t know how I managed to escape with my life in that small car for an hour as he puffed away while I was close to respiratory arrest… but I never forgot the incident or the horrible insensitivity.

From that time forward, I could not ask for anything reasonable – I could not ask for something reasonable to save my life.

To others, asking for assistance may seem like a no-brainer. But for me, tremendously hurt by my parents for years starting at a young age — to consider in the middle of today’s neurofeedback session that I could ask the vet for reasonable help — it made me weep.

And I’m going to try to no longer react immediately, even to such epiphanies, as I want to be more reflective going forward — another amazing plus of neurofeedback.  But wow, I have experienced an amazing movement of my brain that I don’t think could have occurred any other way.

I may even be able to move to where attaching to people becomes okay.
Oh and as I had this epiphany – my dogs ate my dinner and I didn’t get mad!

———————————

Kathy’s blogs and Guest Blogs explore the journey of recovery from childhood trauma by learning about Adult Attachment Disorder in teens and adults, Adult Attachment Theory, and the Adverse Childhood Experiences (ACE) Study.

2,270 total views, 4 views today

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My Neurofeedback Journey, 1

Tina Hahn, 30 monthsMy Neurofeedback Journey, 1 of 2
by Tina Marie Hahn
— as told to Kathy Brous

I am Dr. Tina Marie Hahn, MD, advocate for Trauma-Informed Care and Communities, and survivor of actually ten Adverse Childhood Experiences (ACEs). As a pediatrician, I screen parents and children alike for childhood trauma. That’s me at 30 months old and my background story is here: http://acestoohigh.com/2014/05…-her-ace-score-is-9/

I’ve been excited for some time to try neurofeedback, after listening to a talk given by Dr. Bessel van der Kolk and Sebern Fisher and reading Dr. van der Kolk’s latest book “The Body Keeps the Score” and a blog on Sebern Fisher’s work with neurofeedback here at http://attachmentdisorderhealing.com/neurofeedback/   I then read three books on neurofeedback, including Dr. Fisher’s book “Neurofeedback in the Treatment of Developmental Trauma: Calming the Fear-Driven Brain” and decided to research several electronic neurofeedback systems for home use.

I report as a user/patient, not as a doctor or expert, because my experience so far has been fairly stormy — I’m just starting out, so I don’t know where this will go and I am not an expert. I feel I should warn readers: if you have experienced severe infant and childhood developmental trauma as I did, neurofeedback seems like a very rewarding method for healing — but it has intense risks if not done with care.

Please if possible, as Kathy’s book says: “Don’t Try This at Home.” Neurofeedback is designed to be done in a trained practitioner’s office. So for most people with trauma, probably it’s best not to do neurofeedback alone at home. Please try to do it with access to formal support, hopefully a good attachment therapist who is very compassionate, so you can discuss what is happening and process these deeply brain stem based emotions with another human. If therapy is really impossible, maybe you could create a group of healing friends or at least have a friend come regularly to be with you while you do it or afterward. Some type of support would be key.

I had to opt for a home-use neurofeedback system because I am in a rural backwater where everyone knows everyone so I don’t feel comfortable sharing incredibly strong emotions. I’ve also had prior bad experiences with psychiatry plus right now there aren’t good practitioners anywhere near where I live. In fact, I might be doing better if I had a well-trained therapist possessing extensive knowledge of developmental trauma.

As to the level of pain in my healing with neurofeedback so far: I have been working on this level of emotional pain for decades, so (thus far) it seems I have an ability to tolerate this intense experience. (I won’t know how much I can tolerate until I go further, who knows.) But I did want to note that unless a person is willing to take chances and is pretty strong, they might get really shaken up.

The Fear-Driven Amygdala

I wanted to specifically treat my fear-driven amygdala that I have from being terrorized as an infant and child. I found one home system, which looked good, but it did not allow one to use different protocols to specifically calm down an overactive amygdala.

So I chose BrainPaint®, which did, and I was excited to get my BrainPaint® home neurofeedback system in the mail April 6. BrainPaint® sent an excellent 47 minute video tutorial showing me how to set up the system and before the first session, I had an 1.5-hour phone tutorial. The system is very easy to set up and use. Also we get 45 minutes of assistance by phone every month we rent the system, and we can pay extra for more telephone help if we need it. I will be texting or calling my BrainPaint® “assistant” to help me as I become ready to change protocols based on symptom improvement.

BrainPaint® is not cheap but mental health and well-being? Priceless. The BrainPaint® set I got has a minimum two months rental at $675 per month for shipping and a deposit; I initially paid $1,875. The deposit comes back when you send the rental back. Here is an introductory YouTube video: https://www.youtube.com/watch?v=7s0AFjRVfmk

I did my first session April 7; it starts with a symptom checklist. I had lots of symptoms checked. The protocol chosen initially was to calm my right amygdala— but because it looked like so many areas were out of whack, I did something called “non-linear on T3 and T4″ (right and left temporal) to get the brain hemispheres in synch.

My first session was 7 minutes….. It was interesting.. Looking at a screen with fractal patterns and auditory inputs. After the first 7 minutes, I fell asleep for 2 hours. For me that is amazing because I don’t take naps and don’t sleep well… I feel relatively calm and just completed a second session for 14 minutes. I am now pretty tired.

I don’t know the outcome of this process, but I have a strong feeling that neurofeedback is going to help rid me of my low self esteem, my rough edges and though I am really tired, I think this is going to really make some good changes. It already did something, as normally looking at a computer screen would never make me take a nap.

More Good Results

On April 8, I had more good results:  I did a few more BrainPaint® sessions throughout the day. Then last night I slept the best I have in months!

On April 20, I did an “Alpha-Theta” session on BrainPaint® and had a rather weird experience so here’s what happened:

I am stuck inside an ostrich shell. I am really stuck. I am little but grown. I am pushing on the shell. It doesn’t move and all around me is space …. lots of space.. me in a shell… then I flash into the basement…. it is dark but there is a window a small window that is in the basement and I look outside trying to see the outside where it is light and bright and trees and leaves and I am stuck…

I don’t fight, I just flash back into the eggshell… then I think I cannot push this open… I will try to melt it away into infinity ..the infinity of equanimity ….. then it was done….

I suppose this is what we experience in the early sessions.

Coming July 24: Part 2 of Tina’s amazing report

———————————

Kathy’s blogs and Guest Blogs explore the journey of recovery from childhood trauma by learning about Adult Attachment Disorder in teens and adults, Adult Attachment Theory, and the Adverse Childhood Experiences (ACE) Study.

2,675 total views, 4 views today

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My Neurofeedback Journey – Dr. Tina Hahn

Tina Hahn, 30 monthsMy Neurofeedback Journey
by Tina Marie Hahn
as told to Kathy Brous

[Tina added on July 11:  I am experiencing major changes in my brain functioning so fast with neurofeedback, although as of this writing, I have only been doing it for three months. But in six months I seriously don’t think I will recognize myself anymore, and I say that after decades of struggle.  I truly recommend checking out neurofeedback, for anyone who has failed all the traditional approaches to trauma.]

I am Dr. Tina Marie Hahn, MD, advocate for Trauma-Informed Care and Communities, and survivor of actually ten Adverse Childhood Experiences (ACEs). As a pediatrician, I screen parents and children alike for childhood trauma. That’s me above at 30 months old and my background story is here: http://acestoohigh.com/2014/05…-her-ace-score-is-9/

I’ve been excited for some time to try neurofeedback, which I began on April 6, after listening to a talk given by Dr. Bessel van der Kolk and Sebern Fisher and reading Dr. van der Kolk’s latest book “The Body Keeps the Score” and a blog on Sebern Fisher’s work with neurofeedback here at http://attachmentdisorderhealing.com/neurofeedback/   I then read three books on neurofeedback, including Dr. Fisher’s book “Neurofeedback in the Treatment of Developmental Trauma: Calming the Fear-Driven Brain” and decided to research several electronic neurofeedback systems for home use.

I report as a user/patient, not as a doctor or expert, because my experience so far has been fairly stormy — I’m just starting out, so I don’t know where this will go and I am not an expert.  I feel I should warn readers: if you have experienced severe infant and childhood developmental trauma as I did, neurofeedback seems like a very rewarding method for healing — but it has intense risks if not done with care.

Please if possible, as Kathy’s book says: “Don’t Try This at Home.”  Neurofeedback is designed to be done in a trained practitioner’s office.  So for most people with trauma, probably it’s best not to do neurofeedback alone at home. Please try to do it with access to formal support, hopefully a good attachment therapist who is very compassionate, so you can discuss what is happening and process these deeply brain stem based emotions with another human. If therapy is really impossible, maybe you could create a group of healing friends or at least have a friend come regularly to be with you while you do it or afterward. Some type of support would be key.

I had to opt for a home-use neurofeedback system because I am in a rural backwater where everyone knows everyone so I don’t feel comfortable sharing incredibly strong emotions. I’ve also had prior bad experiences with psychiatry plus right now there aren’t good practitioners anywhere near where I live. In fact, I might be doing better if I had a well-trained therapist possessing extensive knowledge of developmental trauma.

As to the level of pain in my healing with neurofeedback so far: I have been working on this level of emotional pain for decades, so (thus far) it seems I have an ability to tolerate this intense experience. (I won’t know how much I can tolerate until I go further, who knows.)  But I did want to note that unless a person is willing to take chances and is pretty strong, they might get really shaken up.

The Fear-Driven Amygdala

I wanted to specifically treat my fear-driven amygdala that I have from being terrorized as an infant and child. I found one home system, which looked good, but it did not allow one to use different protocols to specifically calm down an overactive amygdala.

So I chose BrainPaint®, which did, and I was excited to get my BrainPaint® home neurofeedback system in the mail April 6.  BrainPaint® sent an excellent 47 minute video tutorial showing me how to set up the system and before the first session, I had an 1.5-hour phone tutorial. The system is very easy to set up and use. Also we get 45 minutes of assistance by phone every month we rent the system, and we can pay extra for more telephone help if we need it. I will be texting or calling my BrainPaint® “assistant” to help me as I become ready to change protocols based on symptom improvement.

BrainPaint® is not cheap but mental health and well-being? Priceless. The BrainPaint® set I got has a minimum two months rental at $675 per month for shipping and a deposit; I initially paid $1,875. The deposit comes back when you send the rental back.  Here is an introductory YouTube video: https://www.youtube.com/watch?v=7s0AFjRVfmk

I did my first session April 7; it starts with a symptom checklist. I had lots of symptoms checked. The protocol chosen initially was to calm my right amygdala— but because it looked like so many areas were out of whack, I did something called “non-linear on T3 and T4″ (right and left temporal) to get the brain hemispheres in synch.

My first session was 7 minutes….. It was interesting.. Looking at a screen with fractal patterns and auditory inputs. After the first 7 minutes, I fell asleep for 2 hours. For me that is amazing because I don’t take naps and don’t sleep well… I feel relatively calm and just completed a second session for 14 minutes. I am now pretty tired.

I don’t know the outcome of this process, but I have a strong feeling that neurofeedback is going to help rid me of my low self esteem, my rough edges and though I am really tired, I think this is going to really make some good changes. It already did something, as normally looking at a computer screen would never make me take a nap.

More Good Results

On April 8, I had more good results:  I did a few more BrainPaint® sessions throughout the day. Then last night I slept the best I have in months!

On April 20, I did an “Alpha-Theta” session on BrainPaint® and had a rather weird experience so here’s what happened:

I am stuck inside an ostrich shell. I am really stuck. I am little but grown. I am pushing on the shell. It doesn’t move and all around me is space …. lots of space.. me in a shell…
then I flash into the basement…. it is dark but there is a window a small window that is in the basement and I look outside trying to see the outside where it is light and bright and trees and leaves and I am stuck…

I don’t fight, I just flash back into the eggshell… then I think I cannot push this open… I will try to melt it away into infinity ..the infinity of equanimity ….. then it was done….

I suppose this is what we experience in the early sessions.

Major Trauma Release

On April 27, it had been about three weeks that I’ve been working with the BrainPaint® desktop home neurofeedback machine.  I’ve been doing about 1.5 hours of neurofeedback a day. That turned out to be a little too much for me as a beginner, so I gave myself a break the last two days.

After my second “Alpha-Theta” training April 19, I could not stop sobbing during the session, or after — for 4 hours straight. It was cathartic. During the session my body was shaking — like really shaking. It reminded me of Peter Levine’s discussions and the video he has of the polar bear shaking after he was attacked and then later came out of the trauma. It was incredible. I wasn’t just thinking this poison was coming out of my body — I was feeling it. I was shaking worse than if I had been locked for several hours in a deep freezer…..

It really was amazing…. I let go of a lot of stuff. I saw that my mother did the best she could. I could see myself letting go of the residual anger.

Then, the anger was replaced with a tremendous well of grief and loss. I realized that I was full of so much grief over what could have been and how my life might have been different if this had not happened to me — how my mother’s life would have been different if she had been able to feel love from her children instead of being so stressed that she allowed the most horrific things to happen to her kids.

I thought about how my brother wouldn’t be psychotic if he hadn’t been hurt so much…. How he could know happiness instead of his constant fear…..

And please know: it might not be good for most people to do this alone, as the title of your book says, “Don’t Try This at Home.”  For me, I’ve been working on confronting my childhood for decades, so I have an ability to tolerate this intense experience.  But for most people, unless you are willing to take chances and you’re pretty strong, a person might get really shaken up. It would probably be good to have a therapist to discuss what is happening and to process those deeply brain stem based emotions — or a group of healing friends. To have someone with you to support you would be helpful.

I might be doing better if I had a therapist too, but like Kathy I’ve had bad experiences with therapy so my confidence in it is low and anyway I’m in a rural area without much available.  But I think many people with severe childhood trauma like me who are considering neurofeedback might want to use it with formal support such as therapy or a support group.

For me, I wasn’t re-traumatized. That is all I want to say for now except I think this is a powerful tool!

Getting More Relaxed

By May 6, I found that we need to give the neurofeedback some time to settle into our brain, let the brain settle into new patterns. That’s why I’m not posting as much: I just don’t feel the need to reflectively respond to everything, and that means everything in general.  For someone with trauma, that’s progress.

I have been able to work through my anxiety and though it seems strange, send the emails and make the telephone calls that I need to make but generally procrastinate on. I have been cleaning and organizing. Usually I am so disorganized I am not good at this.

Now I am less reactive. I am certain of it.  When talking to others and they say something that would generally trigger me – I might still become triggered but there is more of a second or two to contemplate first.

I stopped doing several hours of neurofeedback per day. I think so much was making it very confusing for me to determine what was going on in my brain.  While I think generally it has all been effective, I like the general stabilizing non-linear protocol I began with.  I have done several more sessions of the “Alpha-Theta.” That is the type that has the capability to take us into the deep meditative state.

I haven’t had anymore of those really emotional spells during the “Alpha-Theta,” but my dreams have been more colorful. Actually last night I had the first dream in color and it was sad, but more positive.  Usually my dreams have always about big mean things trying to kill me.  So that is great, too.

I feel like I am better able to sit back, take in others point of view, back off from feeling like I have to do everything myself. I really feel this is great.  I also attribute it to the neurofeedback.  I feel like I could talk to people much easier now and have a great interactive conversation without feeling strange and out of place inside.  This is all awesome to me.

And I am feeling like moving into other areas of healing like meditation which I am not good at because of a “way too busy mind that is always quadruple tasking”.  I actually sat down and did about 15 minutes of sitting meditation yesterday and that was good.  So I think all in all this has been a very positive process for me.

I have also been taking others suggestions or at least listening and then making I think more informed decisions based on information from others. To me this is the start of trying to connect.

Also, though I don’t use Facebook much, I have been posting on Facebook more recently and will see people I know. Before, I would be afraid to send a friend request — I would be too afraid because I’m a bad person, that person wouldn’t want to be my friend.  But now, I have been taking chances, sending friend requests and guess what – people have been accepting.  I just find this totally weird for me.  I don’t look out of control outside but now, I am starting to feel more competent instead of “out of control inside.”  By that I mean that strange anxiety when you feel like you don’t belong, like you are an alien to a foreign species.  But now I’m starting to feel I do belong more, I’m feeling more human.

A Breakthrough or Epiphany?

On June 8, I wrote that I haven’t posted on my use of the BrainPaint® neurofeedback system for a month for a few reasons.

Good reasons: I felt so much better due to neurofeedback that I got too busy!  I’ve been out a lot, creating and attending meetings about the ACE Study and regional trauma-informed schools, and I’m writing several articles.  I’ve begun working on key things I used to procrastinate on, that’s also getting better with neurofeedback…  I can feel a real improvement in my impulse control and affect regulation (my ability to regulate my emotions is growing nicely.)

I still feel neurofeedback benefiting me in daily activities, for example if I want to write something that makes a point, I do it so that it’s not impulsive, and is worth reading.  My new ability to do that is part of the neurofeedback.

But I also missed a lot of BrainPaint® sessions. On the one hand, we do need time for the neurofeedback changes to settle into our brain. But I got 2-3 weeks behind so let me note: For anyone who decides to do home neurofeedback, it is important to follow the BrainPaint® policy to rate your goals and answer the assessment questions before each session, and also be careful to keep up with the updates they issue to their computer system.

I got behind on that because my cursor wasn’t working properly, I was blaming myself, so I missed a lot of sessions. Finally I called my BrainPaint® home neurofeedback coach and we learned it wasn’t my fault — the program needed an update, so it was updated on Friday [June 5].

Then we reviewed and updated the BrainPaint® assessment together that calculated new protocols and she told me to stop trying to do everything on my own, to please call for help. I promised to follow the directions and did so over the weekend and — wow, did my brain move with the new protocols the system created!

In fact, as I was doing my session with the directed protocols, I came to what I have to call an epiphany.  Something has happened to me which feels weird, in fact it feels absolutely crazy (compared to how I used to feel).

I want to report it because it must be the neurofeedback which is really helping me. OK:

I’m often scared to take my dogs to the vet because the office is on a main highway, and the dogs jump out of the car as soon as a door is opened. I’ve been afraid one would jump out and get hit by a car. I have to put them in the back of the RAV4 when driving or I get a 60 or 45 pound dog in my lap, but I couldn’t get them out the back door due to trouble with the auto-lift gate.

Now yesterday while I was doing neurofeedback, for the first time in my life it hit me: Hey, I could go inside the vet’s office and simply ask a front desk person to help me so my dogs don’t jump out and get hurt. This sounds so stupid but it isn’t — it means for the first time in my life I considered asking another person for reasonable help!

That means believing people are supposed to help each other and that some people can be approached for help.

That’s a first step in trust. Amazing.
So I began to weep, really weep.
Let me explain why this feels so weird and crazy and amazing to me.

As many of us with a high Adverse Childhood Experiences (ACE) score, people have horribly hurt me. I’ve come to feel, I want no part of mammalian attachment to people (you call that “fur”) — even if it is the only way to heal. Trusting people is horribly scary for me for reasons like this:
When I was 7 or 8, I was with my dad in the car about an hour away from our trailer.  I never asked my dad for anything because he was incredibly mean. My dad smoked in the car with us kids inside.  But on this winter day, I had a cold, and as he is smoking, I suddenly couldn’t breath.  I am scared to death because I cannot breath. I timidly ask him “Dad could you please stop smoking? I cannot breathe.”  His response was “If you don’t like it, I can drop you off here right now and you can walk home!”  A very typical response. I don’t know how I managed to escape with my life in that small car for an hour as he puffed away while I was close to respiratory arrest… but I never forgot the incident or the horrible insensitivity.

From that time forward, I could not ask for anything reasonable – I could not ask for something reasonable to save my life.

To others, asking for assistance may seem like a no-brainer. But for me, tremendously hurt by my parents for years starting at a young age — to consider in the middle of today’s neurofeedback session that I could ask the vet for reasonable help — it made me weep.

And I’m going to try to no longer react immediately, even to such epiphanies, as I want to be more reflective going forward — another amazing plus of neurofeedback.  But wow, I have experienced an amazing movement of my brain that I don’t think could have occurred any other way.

I may even be able to move to where attaching to people becomes okay.
Oh and as I had this epiphany – my dogs ate my dinner and I didn’t get mad!

———————————

Kathy’s blogs and Guest Blogs explore the journey of recovery from childhood trauma by learning about Adult Attachment Disorder in teens and adults, Adult Attachment Theory, and the Adverse Childhood Experiences (ACE) Study.

3,988 total views, 10 views today

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What is EMDR – and Why is it So Effective?

Francine ShapiroDuring REM sleep, the brain is attempting to process survival information until it’s resolved.

Eye Motion Desensitization and Reprocessing (EMDR) is a potent trauma treatment developed by Dr. Francine Shapiro (left), a literature professor who was diagnosed with cancer.  The shock of suddenly finding her survival was under threat, affected her so strongly that Dr. Shapiro mindfully paid attention to how her body was reacting.

She discovered by accident that when the survival fear got intense, her eyes would sometimes move back and forth diagonally or from side to side, as if in dreaming – following which she felt less upset, much to her surprise.

So Dr. Shapiro began to study mind-body programs for trauma and PTSD – and went back to school for a PhD in trauma psychology.  EMDR, the treatment she developed,  is now used by the Departments of Defense and Veteran’s Affairs, the World Health Organization, and many others.  Dr. Vincent Felitti, co-director of the Adverse Childhood Experiences (ACE) Study, recommends EMDR as “highly effective” for the healing of trauma.

In EMDR a therapist moves a finger or two from side to side (or diagonally) before the patient’s eyes.  This guides the eyes to move as they do during the Rapid Eye Movement (REM) phase of sleep in which we do most active dreaming. Dreaming can “process” a lot of trauma, move it from short-term memory banks where it feels like a terrifying flash happening “right now,” to long-term memory banks where we feel it’s past and we’re “over it.”

I use EMDR to calm myself at home, sitting with eyes closed and moving my eyes back and forth while focusing on the upsetting thought until it dissipates.  This works with upsetting incidents in the present, such as arguments.  I also use EMDR to heal grief over specific past incidents such as hurtful acts by others. But long-term healing needs a therapist.

It had been thought that EMDR is best for “incident trauma” due to one or any finite number of incidents, such as battlefield traumas, car accidents, rape, threats such as Dr. Shapiro’s cancer, or incidents like mine above.

EMDR  had been considered iffy for developmental trauma which starts with fetal stress and continues while the infant brain is developing. As Dr. Bessel van der Kolk notes, it’s a continuum of panic until we become a “frightened organism.” Drs. Shapiro and van der Kolk have said that in developmental trauma, EMDR may bring up infant feelings so overwhelming as to be re-traumatizing. [FN1]

More recently, however, Dr. Sandra Paulsen and colleague Katie O’Shea  have had success using new EMDR methods they’ve created specifically to address developmental trauma, documented in  “Neurobiology and Treatment of Traumatic Dissociation.” [FN2] Here’s a summary: http://attachmentdisorderhealing.com/emdr-sandra-paulsen-developmental-trauma/

“EMDR is effective and well-supported by research evidence for treating children with symptoms accompanying post-traumatic stress (PTSD), attachment issues, dissociation, and self-regulation,” GoodTherapy.org also recently reported: http://www.goodtherapy.org/blog/emdr-for-children-how-safe-and-effective-is-it-0430155

Dr. Paulsen’s collaborator Dr. D. Michael Coy details how he keeps patients safe while going deep into infancy with EMDR on his website:  https://www.dmcoy.com/main/my_practice/emdr-therapy/emdr-pre-verbal-trauma/.  See also Dr. Coy’s comments below, including a link to the EMDR International Association’s EMDR therapist finder directory: http://www.emdria.org/search/custom.asp?id=2337

I still say, as in my book title, “Don’t Try This at Home.”  Please do not “do it yourself.”  Get a highly-trained attachment therapist and/or EMDR specialist with a lot of specific training in your type of trauma.

When Nightmares are Real

Until you’ve been beside a man/ You don’t know what he wants
You don’t know if he cries at night/ You don’t know if he don’t
When nothin’ comes easy/ Old nightmares are real
Until you’ve been beside a man/ You don’t know how he feels
Bob Seeger

Francine Shapiro Getting_Past_Your_Past_smallDr. Shapiro gave a terrific webinar on EMDR which even explained what nightmares are, how they work in trauma, and how we can leverage this to heal traumatic feelings.  It was Dr. Ruth Buczynski’s April 17, 2013 interview for the National Institute for the Clinical Application of Behavioral Medicine (NICABM) “Trauma 2013” series.  [FN3]  Her book is seen above (please click on the graphic to see it best; my software’s not behaving well…)

“Disrupted REM (Rapid Eye Movement ) sleep is often a marker of PTSD,” Shapiro said. “The earlier memory in PTSD, the trauma, is being held unprocessed with the emotions as physical sensations.  The brain continues to try to process it; sleep researchers say that during REM sleep, the brain is attempting to process survival information until it’s resolved.  That’s why we’ve all had the experience of being disturbed at something, going to sleep, and feeling better about it, with a better understanding of what to do next.

“The brain has done what it’s supposed to do: it’s processed the information, and now it’s guiding us appropriately into the future.  But if a trauma has disrupted that process, although the brain may be again trying to process this (survival information) in dreams, the person continues to wake up in the middle of a nightmare (ie., stop the processing prematurely), because it’s too disturbing.”

“When people are jarred from sleep because of a nightmare, the disturbing images can be difficult to shake,” Dr. Buczynski said on her blog April 12, 2013.  “Even though they’re ‘just dreams,’ nightmares can be very upsetting and can sometimes haunt us long after we’ve awoken. But believe it or not, there may be a good reason for them. Nightmares are part of the brain’s attempt to help us resolve traumatic experiences. But when they wake us up too soon, a key process for healing gets interrupted. So how can we finish what the brain is trying to start?”

“In EMDR,” Dr. Shapiro then explained, “we look for what are the nightmare images that a person can recall. One person would continually wake up from a nightmare of being chased by a monster through a cave.  So (in the EMDR session) we target that dream image, so she’s holding in mind being chased through a cave by the monster.  Then we start the EMDR processing – and it’s like a veil gets peeled back, and the individual sees what the actual experience was, and she reports, ‘OMG, that’s the person who molested me, chasing me through my childhood home!’

“The EMDR processing moves the past memory to resolution, and now the person no longer has that dream, because once it’s processed, it’s integrated with larger memory networks and arrives at adaptive resolution, so that dream image does not come back. So with EMDR you don’t have to try to change their mind about it or talk about it. It’s simply identifying the image and their thoughts that go with it, and then processing it (by EMDR) to complete resolution.”  Check out her video: http://www.nicabm.com/nicabmblog/the-brains-attempt-to-help-us-heal-from-trauma/

Dr. Shapiro reports fantastic results especially with rape victims and war veterans.  “These past traumatic experiences get locked into the brain until they can get processed… We try to process how the earlier traumatic memories created the problem, then we process their current situations that are disturbing, and then what might disturb them in time in future.  If they can’t identify the past memories, we talk about what is currently disturbing them.  That often automatically takes them back to the past experience — and in those instances where it (the past traumatic experience) hasn’t fully be stored (in  long-term memory,) we can see that it shifts (from short-term to long-term memory) and ultimately they’re no longer disturbed…

“My PhD dissertation on rape victims was published in the Journal of Traumatic Stress back when PTSD was viewed as intractable, but I was getting results in a single session,” Shapiro said. “So the controversy was: ‘how could anything be that rapid, and how could eye movements have any effect?’  There were 20 randomized controlled trials introducing EMDR. One done with rape victims was by a very experienced cognitive behavioral researcher viewed as extremely credible; she reported that 90% of the rape victims no longer had PTSD after three EMDR sessions.

“That corresponded to another study at the time published in the Journal of Clinical Psychology which showed the same with a mixed trauma group, that after three EMDR sessions, 84% no longer had PTSD.  We’ve continued to see that… a rule of thumb is, a single trauma can be processed by three 90-minute EMDR sessions.  A study by Kaiser Permanente that used 50-minute sessions found… that an average of 6 EMDR sessions, found 100% of single-trauma victims no longer had PTSD and 76% of multiple trauma victims no longer had PTSD.”

Here’s an ABC News clip by the CalSouthern School of Behavioral Sciences featuring Dr. Shapiro. Again it notes that EMDR is best done with a therapist, which is why they don’t post “How To” on the internet.  It also notes that in Shapiro’s original discovery, her eyes “flickered,” and therapists continue to have patients move eyes fast, “like watching tennis,” as one rape victim (who got huge relief) reports: https://www.youtube.com/watch?v=GTLLfdcJE0Q

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Kathy’s blogs expand on her book “DON’T TRY THIS AT HOME: The Silent Epidemic of Attachment Disorder—How I accidentally regressed myself back to infancy and healed it all.” Watch for the continuing series each Friday, as she explores her journey of recovery by learning the hard way about Attachment Disorder in adults, adult Attachment Theory, and the Adult Attachment Interview.

Footnotes

FN1  Francine Shapiro, PhD, “The Power of EMDR to Treat Trauma,” April 17, 2013 and Bessel van der Kolk, MD, “Expanding the Perspective on Trauma,” April 24, 2013, webinars by the National Institute for Clinical Application of Behavioral Medicine (NICABM): http://www.nicabm.com/trauma2013/trauma2013-post/

FN2  “Neurobiology and Treatment of Traumatic Dissociation: Toward an Embodied Self,” by Lanius, Paulsen, and Corrigan, 2014, http://www.amazon.com/Neurobiology-Treatment-Traumatic-Dissociation-Embodied/dp/0826106315

FN3  Transcripts and recordings of this and five related webinars again at  http://www.nicabm.com/trauma2013/trauma2013-post/

More reading:

Shapiro, Francine, PhD, “Getting Past Your Past: Take Control of Your Life with EMDR Therapy.”

Shapiro, Francine, PhD, “The Role of Eye Movement Desensitization and Reprocessing (EMDR) Therapy in Medicine: Addressing the Psychological and Physical Symptoms Stemming from Adverse Life Experiences,” Permanente Journal, Perm J. 2014 Winter; 18(1): 71–77   A substantial body of research shows that adverse life experiences contribute to both psychological and biomedical pathology. Eye movement desensitization and reprocessing (EMDR) therapy is an empirically validated treatment for trauma, including such negative life experiences as commonly present in medical practice. The positive therapeutic outcomes rapidly achieved without homework or detailed description of the disturbing event offer the medical community an efficient treatment approach with a wide range of applications. Methods: All randomized studies and significant clinical reports related to EMDR therapy for treating the experiential basis of both psychological and somatic disorders are reviewed. Also reviewed are the recent studies evaluating the eye movement component of the therapy, which has been posited to contribute to the rapid improvement attributable to EMDR treatment.  Results:  Twenty-four randomized controlled trials support the positive effects of EMDR therapy in the treatment of emotional trauma and other adverse life experiences relevant to clinical practice. Seven of 10 studies reported EMDR therapy to be more rapid and/or more effective than trauma-focused cognitive behavioral therapy. Twelve randomized studies of the eye movement component noted rapid decreases in negative emotions and/or vividness of disturbing images, with an additional 8 reporting a variety of other memory effects. Numerous other evaluations document that EMDR therapy provides relief from a variety of somatic complaints: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3951033/

van der Kolk, Bessel A, MD, “Restoring the Body: Yoga, EMDR, and Treating Trauma , July 11, 2013 interview by  Krista Tippett of OnBeing.Org.  Human memory is a sensory experience says psychiatrist Bessel van der Kolk. Through long research and innovation in trauma treatment, he’s learning how bodywork like yoga or eye movement therapy can restore a sense of goodness and safety: http://www.onbeing.org/program/restoring-the-body-bessel-van-der-kolk-on-yoga-emdr-and-treating-trauma/5801

van der Kolk Bessel A, MD, Spinazzola J, Blaustein ME, Hopper JW, Hopper EK, Korn DL, Simpson WB,  “A randomized clinical trial of eye movement desensitization and reprocessing (EMDR), fluoxetine, and pill placebo in the treatment of posttraumatic stress disorder: treatment effects and long-term maintenance, J Clin Psychiatry. 2007 Jan; 68(1):37-46. Abstract: The relative short-term efficacy and long-term benefits of pharmacologic versus psychotherapeutic interventions have not been studied for posttraumatic stress disorder (PTSD). This study compared the efficacy of a selective serotonin reup-take inhibitor (SSRI), fluoxetine, with a psychotherapeutic treatment, eye movement desensitization and reprocessing (EMDR), and pill placebo and measured maintenance of treatment gains at 6-month follow-up. METHOD: Eighty-eight PTSD subjects diagnosed according to DSM-IV criteria were randomly assigned to EMDR, fluoxetine, or pill placebo. They received 8 weeks of treatment and were assessed by blind raters posttreatment and at 6-month follow-up. The primary outcome measure was the Clinician-Administered PTSD Scale, DSM-IV version, and the secondary outcome measure was the Beck Depression Inventory-II. The study ran from July 2000 through July 2003.RESULTS: The psychotherapy intervention was more successful than pharmacotherapy in achieving sustained reductions in PTSD and depression symptoms, but this benefit accrued primarily for adult-onset trauma survivors. At 6-month follow-up, 75.0% of adult-onset versus 33.3% of child-onset trauma subjects receiving EMDR achieved asymptomatic end-state functioning compared with none in the fluoxetine group. For most childhood-onset trauma patients, neither treatment produced complete symptom remission. CONCLUSIONS: This study supports the efficacy of brief EMDR treatment to produce substantial and sustained reduction of PTSD and depression in most victims of adult-onset trauma. It suggests a role for SSRIs as a reliable first-line intervention to achieve moderate symptom relief for adult victims of childhood-onset trauma. Future research should assess the impact of lengthier intervention, combination treatments, and treatment sequencing on the resolution of PTSD in adults with childhood-onset trauma: http://www.ncbi.nlm.nih.gov/pubmed/17284128

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Neurofeedback: Healing the Fear-Driven Brain

Sebern FisherPsychotherapist Sebern Fisher gave a great webcast on October 22, 2014 in the NICABM series, about neurofeedback (biofeedback to the brain), which gives us access to our brain function frequencies.

Neurofeedback, she said, is a computer program therapists use in their office, training clients on it to get them in touch with their own brain waves, learn what’s good for the brain, and calm their thoughts.

The brain is organized from the womb in oscillatory patterns, Ms. Fisher says, so we with developmental trauma, early neglect and abuse, have disorganized and dysregulated brains.  Our fear circuits dominate.  Neurofeedback can calm these erupting circuits and even grow neural connectivity, which helps us create a more coherent sense of self, so we feel safer and more centered. [FN1]

Folks with difficult parents often grow up with a “fear-driven brain” as I did — and it’s a huge relief to find out we’re not freaks — we’re a chunk of the mainstream.  In fact, maybe 50% of Americans have some degree of this “attachment disorder” due to parents who were too scary to attach to. Of course it’s not their fault either; odds are, our grandparents were too scary for our parents to attach to, and so on back, inter-generationally.

I was particularly struck watching Ms. Fisher’s NICABM video as she repeated again and again how many people are walking around with a “fear-driven brain.”  Her 2010 radio interview “Attachment Disorder, Developmental Trauma and Neurofeedback” says she spent decades trying to heal kids with early attachment wounds, but found we can’t talk to the parts of the brain formed from conception to 36 months; those parts have no speech. So she made no progress until she tried neurofeedback in 1996. It can talk to those parts: http://www.futurehealth.org/Podcast/Sebern-Fisher-Attachment-by-Rob-Kall-100516-497.html

I’d bet maybe 20% of us have “developmental trauma” like that, as I do, which means that life was one continuous trauma “since the sperm hit the egg.” For what it looks like when Mom is too scary for her child to attach, check http://attachmentdisorderhealing.com/developmental-trauma-2/

I was moved to tears by Ms. Fisher’s more recent interview “Neurofeedback in the Treatment of Developmental Trauma,” as she described how deeply necessary love and attachment are to the creation of a human brain. It’s because we crave the regulation of our nervous system which love can bring, that our brains respond to neurofeedback signals which feel calmer and even loved: http://shrinkrapradio.com/452-neurofeedback-in-the-treatment-of-developmental-trauma-with-sebern-fisher-m-a/

And: here’s an amazing blog by Dr. Tina Hahn MD, “My Neurofeedback Journey,” on the BrainPaint® home neurofeedback system she’s using.

Find a Neurofeedback Practitioner: Online Directories:
1. EEG Spectrum International [Ms. Fisher’s husband John Fisher was president of this co.] Directory: http://www.esiaffiliatesforum.com/providers
2. EEG Institute Provider Directory: http://directory.eeginfo.com/

Trauma, Up Front and Personal

Ms. Fisher got into therapy and attachment work in the first place because she herself had developmental trauma.  She also had a lot of head injury and traumatic brain injury.  One of the first things to be healed when Ms Fisher began neurofeedback herself were her terrible migraines, which have never returned.  She still uses neurofeedback because, she says, “I have had a lot of head injuries so I am at a greater risk of Alzheimer’s than other people, but all of the signs of head injury and traumatic brain injury that I had are all gone.”

Here are some salient quotes from Ms. Fisher’s  NICABM interview:

“Neurofeedback is biofeedback to the neuronal activity of the brain. It is a computer interface where you pick up the firing of the brain in the EEG (electro-encephalogram) in real-time, scrolling for a therapist and client to look at together. By challenging their brain through feedback, we can see that the EEG is changing,” she starts.

“And obviously the change that I am most concerned about is change in levels of fear. Mostly what I am concerned about is quieting fear, so let’s take that situation. We know that the fear circuits are in the temporal lobe and that survival’s fear circuit, the survival amygdala, is in the right hemisphere. We’re trying to say to the brain – not to the person– “Stop practicing that fear-driven over-arousal. Chill. Get quiet!”

“Now, if people could do this on their own, they wouldn’t need the game or the neurofeedback. [So she’s never harsh on the person; she just re-trains their brain.] We have to find the frequency that works for that particular individual – it’s going to be different for everyone. They tell me two or three days later that, on the whole, they have been calm, they have been sleeping, they are less reactive, and/or they are making easier eye contact. That is what I mean by works….

“I had a young woman, who had been adopted from a third-world country. She had been in an orphanage after having been delivered in a shoebox from a police station. They fed her with an eyedropper, not ever expecting that she was going to live. She had every possible level of disorganization: she couldn’t read; she bumped into doorjambs; she had a very difficult time negotiating through life.

“I was now meeting her out of a mental hospital, and she was in her twenties. [After neurofeedback training] she comes in and tells me this story. She was always the last one chosen for any sports team, as you can imagine, when she was a kid, and now she’s stabilized enough to be dating. She is out with a guy, they are waiting to go to a movie, and they go to a batting cage – she hits 90% of the balls. Therapy could never get somebody from bumping into walls to being able to hit 90% of the balls! Her boyfriend was very impressed…

“Neurofeedback is deeply organizing to the nervous system. This goes deep into the nervous system; neurofeedback is healing deep into the CNS, the central nervous system, and through the brain.

“I had one patient who was given the diagnosis of Borderline Personality Disorder and had been hospitalized multiple times. She very much wanted to do neurofeedback training because she felt like she had gone as far as she could with psychotherapy, and she still wanted to drive off a bridge every day!  We used two different protocols: the eyes-open protocol – it doesn’t matter what the specifics were for her – but she got stabilized in 20 sessions, and then we did the alpha-theta protocol. She did 30 or 40 sessions. All together, she had about 60 sessions, then it was over. She did not meet any criteria for Borderline Personality and she no longer wanted to jump off a bridge.

“She actually got married and had a baby, and went on to advance her career. I saw her once after that ending, and it was when a pet that had been her primary object of attachment, was killed in a freak accident. She came back in and she was very distressed. An additional trauma can also throw the brain back into its known pattern of firing. So we trained about four times, to address the state she was in, and she very quickly reorganized and was off again.

Repair of Attachment with Neurofeedback

(Interviewer Dr. Buczynski): “How do you think of attachment and repairing of attachment in regard to neurofeedback?

Fisher: “Oh, that’s a wonderful question, and it is somewhat amazing that this happens. In my experience, what I have seen is that people always seem to want relational connection.

“Things can get in the way – if you are having something akin to a seizure and you’re constantly living in fear; it is very difficult to imagine relationship as a primary part of your life. But we are social creatures; we are meant to relate to one another. That is our safety; that is our harbor, as my patient said, and when you find a way to quiet the fear-driven brain, what emerges quite spontaneously are the attachment circuits.

“I had one patient who was self-abusing and dissociative when she came into sessions. She had not seen her mother nor talked about her mother – so this wasn’t a result of conversation – but her mother had not behaved ideally. She came in one day [after neurofeedback treatment] and said, “I think you might be interested in this: I called my mother last night.” It was spontaneous, and now we could talk about the reality of her mother’s trauma.

“Now, this had been presented to her multiple times, and it even occurred to her, but the dysregulation and high arousal of her nervous system made it pretty meaningless. I see that happening a lot. I see spontaneous family reunion that I have nothing to do with orchestrating, and often, without even talking about it, I see it happen with people who train their brains.”

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Kathy’s blogs expand on her book “DON’T TRY THIS AT HOME: The Silent Epidemic of Attachment Disorder—How I accidentally regressed myself back to infancy and healed it all.” Watch for the continuing series each Friday, as she explores her journey of recovery by learning the hard way about Attachment Disorder in adults, adult Attachment Theory, and the Adult Attachment Interview.

Footnotes

FN1 “Neurofeedback: Soothe the Fear of a Traumatized Brain: How a New Intervention Is Changing Trauma Treatment,” Sebern Fisher, MA, BCN, Psychotherapist and Neurofeedback practitioner, Private Practice, Northampton, MA;  10-22-14 Webinar interview by Dr. Ruth Buczynski, National Institute for the Clinical Application of Behavioral Medicine (NICABM), http://www.nicabm.com/treatingtrauma2014/post-info/

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The Body Keeps the Score – Bessel van der Kolk

Bessel Book bodykeepsscore “The Body Keeps the Score” by Bessel van der Kolk, MD, will “permanently change how psychologists and psychiatrists think about trauma and recovery,” as trauma scholar Dr. Ruth Lanius writes.  She was the first to call developmental trauma a “hidden epidemic,” source of my book’s subtitle “Silent Epidemic.” Dr. van der Kolk repeats this in his new book.  [FN1]

And it is about the body. “Infants are psycho-biological beings, as much of the body as of the brain,” writes Prof. Ed Tronick, author of the Still Face Experiment. “Without language or symbols, infants use every one of their biological systems to make meaning of their self in relation to the world.  Van der Kolk shows that those same systems continue to operate at every age, and that traumatic experiences, especially chronic toxic experience during early development, produce psychic devastation.”

I reported van der Kolk’s work on developmental trauma and on getting the military to recognize PTSD in March 2014.  When the New York Times damned van der Kolk’s insistence on body work in June 2014, I roasted them.  In this book, van der Kolk makes his case much better than anyone else could.

I’m having trouble reading the book; I keep starting to sob. That started on page 3 where Dr. van der Kolk describes his heart-breaking childhood experience in bombed-out post-war Holland, with his father prone to violent rages, and his mother acting out her childhood trauma on him. I could feel that little boy, what he’s been going through all these years, and see the depths of what he has accomplished by giving his life so passionately to heal himself and all the rest of us.

These are “good sobs;” they feel good, because once again van der Kolk has told the truth about reality where few dare. Half the human race has had significant childhood trauma, and most of them are in complete denial and live in a state of dissociation, aka freeze or numbness. People in trauma, he writes, feel “numb” to most of life. One patient felt “emotionally distant from everybody, as though his heart were frozen and he was living behind a glass wall. He could not feel anything except his momentary rages, and his shame.”

Dr. Stephen Porges calls van der Kolk’s book a “courageous journey into the parallel dissociative worlds of trauma victims and the medical and psychological disciplines.” As van der Kolk and Porges have said before, medical and psychological experts have been just as much in denial and dissociated regarding the serious nature of trauma as are the traumatees.  “As our minds desperately try to leave trauma behind, our bodies keep us trapped in the past with wordless emotions and feelings,” Porges says. “Van der Kolk offers hope by describing treatments and strategies that have.. helped his patients reconnect their thoughts with their bodies.”

Why all the denial?  “We don’t really want to know what soldiers go through in combat,” writes van der Kolk. “We do not really want to know howe many children are being molested and abused in our own society and how many couples – almost a third –engage in violence at some point…. We want to think… of our own country as enlightened civilized people. We prefer to believe that cruelty occurs only in faraway places like Dafur…”

Solutions for Recovery

Bessel van der KolkLet’s get right to what everyone wants to know.  Here are Dr. van der Kolk’s “Paths to Recovery,” which I think of as  “body solutions” :

— Healing starts with owning our “self,” 100% total acceptance of our self, exactly as we are today, no guilt, no self condemnation. It means developing pride in who we are; only by accepting ourselves as we are now, do we become free to change. We must respect our body for putting us into trauma freeze; it was the only way to defend us, as Stephen Porges says at the end of my blog last week.

– Recognize that language is a “miracle and tyranny,” van der Kolk says. “Telling the story doesn’t necessarily alter the automatic physical and hormonal responses of bodies that remain hypervigilant, prepared to be assaulted, or violated at any time. For real change, the body needs to learn that the danger has passed.” At some point we must let go of all the verbiage as yackety-yack largely in the conscious frontal cortex and logical left brain.

Instead, we must grasp that there is something more fundamental underneath all that, lead by our body sensations, non-verbal subconscious, and non-logical right brain. The body literally needs to have many, often thousands, of new, good physical experiences, such as being taught to physically move or defend itself, just where it could not during the original trauma. Only these can create a “visceral” certainty of safety, to race the old experiences of danger.

EMDR (Eye Movement Desensitization and Reprocessing) is van der Kolk’s next step, to integrate the right and left sides of the brain. In trauma often neural pathways between them have been frozen; in developmental trauma from infancy, these pathways may not have developed well and must be developed now.  By moving the eyes back and forth, we simulate Rapid Eye Motion (REM) sleep, which the brain uses to take events of “now” (today) out of short-term memory, where feelings like fight-flight and trauma reside, and put them into long-term memory.  Instead of feeling as if our trauma is happening again now, it begins to feel like an old story that loses its sting.

Yoga then teaches us how to inhabit our bodies right here, right now; that’s why it’s been used as a path to enlightenment for thousands of years.  Easy to say, but the challenge is to actually practice it rigorously and regularly; only then comes the benefit.

Neurofeedback programs done by trained neurofeedback specialists really help.  Dr. van der Kolk also recommends the computer (and smart phone) -based electronic feedback system EmWave by HeartMath, which trains users to synchronize breathing and heart rates, known as heart rate variability (HRV). In good HRV, heartrate speeds up when we breathe in and slows when we breathe out.  But in trauma we lose HRV coherence; breathing is very rapid and shallow, and heart rate de-synchronizes from the breath, also hazardous to physical health.

Finding Your Voice:  As Bruce Perry says, “Patterned, repeated rhythmic activity”  can re-tune a traumatized brain stem.   Dr. van der Kolk likes  “communal rhythms” such as drum circles and dance.  He particularly likes theater work because it gives the players a substantial voice and a character they can use to express all their feelings in a way everyone can accept.

Trauma Experts Praise “Body Keeps the Score”

“This is an absolutely fascinating and clearly written book by one of the nation’s most experienced physicians in the field of emotional trauma. Equally suitable for primary care doctors and psychotherapists wishing to broaden their range of helpfulness, or for those trapped in their memories, ‘The Body Keeps the Score’  helps us understand how life experiences play out in the function and the malfunction of our bodies, years later.
– Vincent J. Felitti, MD
Chief of Preventative Medicine Emeritus, Kaiser Permanente San Diego;  Co-Principal Investigator, ACE study

“Breathtaking in its scope and breadth, ‘The Body Keeps the Score’ is a seminal work by one of the preeminent pioneers in trauma research and treatment. This essential book unites the evolving neuroscience of trauma research with an emergent wave of body-oriented therapies and traditional mind/body practices. These new approaches and ancient disciplines build resilience and enhance the capacity to have new empowered bodily (interoceptive) experiences that contradict the previous traumatic ones of fear, overwhelm and helplessness. They go beyond symptom relief, and connect us with our vital energy and here-and-now presence. A must read for all therapists and for those interested in a scholarly, thoughtful, tome about the powerful forces that affect us as human beings in meeting the many challenges of life including accidents, loss and abuse.
– Peter A. Levine, PhD, Author, In an Unspoken Voice: How the Body Releases Trauma and Restores Goodness.

“This book is a tour de force. Its deeply empathic, insightful, and compassionate perspective promises to further humanize the treatment of trauma victims, dramatically expand their repertoire of self-regulatory healing practices and therapeutic options, and also stimulate greater creative thinking and research on trauma and its effective treatment. The body does keep the score, and Van der Kolk’s ability to demonstrate this through compelling descriptions of the work of others, his own pioneering trajectory and experience as the field evolved and him along with it, and above all, his discovery of ways to work skillfully with people by bringing mindfulness to the body (as well as to their thoughts and emotions) through yoga, movement, and theater are a wonderful and welcome breath of fresh air and possibility in the therapy world.”
– Jon Kabat-Zinn, Professor of Medicine emeritus, UMass Medical School, Author of “Full Catastrophe Living.”

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Kathy’s news blogs expand on her book “DON’T TRY THIS AT HOME: The Silent Epidemic of Attachment Disorder—How I accidentally regressed myself back to infancy and healed it all.” Watch for the continuing series each Friday, as she explores her journey of recovery by learning the hard way about Attachment Disorder in adults, adult Attachment Theory, and the Adult Attachment Interview.

Footnotes

FN  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  http://www.amazon.com/The-Body-Keeps-Score-Healing/dp/0670785938#reader_0670785938

Bessel van der Kolk, M.D. is the founder and medical director of the Trauma Center in Brookline, Massachusetts. He is also Professor of Psychiatry at Boston University School of Medicine and Director of the National Complex Trauma Treatment Network. When he is not teaching around the world, Dr. van der Kolk works and lives Boston, Massachusetts.

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Pediatricians Screen for Child Trauma

To prevent childhood trauma, pediatricians screen children and their parents…and sometimes, just parents…for childhood trauma”
guest blog by Jane Ellen Stevens, Editor, ACEsTooHigh.com and ACEsConnection.com

Tabitha Lawson & kidsWhen parents bring their four-month-olds to a well-baby checkup at the Children’s Clinic in Portland, OR, Drs. Teri Petersen, R.J. Gillespie and their 15 other partners ask the parents about their adverse childhood experiences (ACEs).  [Tabitha Lawson of Portland, OR with her two children, who greatly benefited from the new program; more below]

When parents bring a child who’s bouncing off the walls and having nightmares to the Bayview Child Health Center in San Francisco, Dr. Nadine Burke Harris doesn’t ask: “What’s wrong with this child?” Instead, she asks, “What happened to this child?” and calculates the child’s ACE score.

In rural northern Michigan, a teacher tells a parent that her “problem” child has ADHD and needs drugs. The parent brings the child to see Dr. Tina Marie Hahn, who experienced more childhood trauma than most people. Instead of writing a prescription, Hahn has a heart-to-heart conversation with the parent and the child about what’s happening in their lives that might be leading to the behavior, and figures out the child’s ACE score.

What’s an ACE score? Think of it as a cholesterol score for childhood trauma.

Why is it important? Because childhood trauma can cause the adult onset of chronic disease (including cancer, heart disease and diabetes), mental illness, violence, becoming a victim of violence, divorce, broken bones, obesity, teen and unwanted pregnancies, and work absences.

The CDC’s Adverse Childhood Experiences Study (ACE Study) measured 10 types of childhood adversity: sexual, physical and verbal abuse, and physical and emotional neglect; and five types of family dysfunction – witnessing a mother being abused, a household member who’s an alcoholic or drug user, who’s been imprisoned, or diagnosed with mental illness, or loss of a parent through separation or divorce.  (There are, of course, other types of trauma, but those were not measured in this study. Other ACE surveys are beginning to include other types of trauma.)

Each type of trauma — not the number of incidents of each trauma — was given an ACE score of 1. So, a person who has been emotionally abused, physically neglected and grew up with an alcoholic father who beat up his wife would have an ACE score of 4.

The ACE Study found that childhood trauma was very common — two-thirds of the 17,000 mostly white, middle-class, college-educated participants (all had jobs and great health care because they were members of Kaiser Permanene) experienced at least one type of severe childhood trauma. Most had suffered two or more.

The more types of childhood trauma a person has, the higher the risk of medical, mental and social problems as an adult (Got Your ACE Score?). Compared with people who have zero ACEs, people with an ACEs score of 4 are twice as likely to be smokers, 12 times more likely to attempt suicide, seven times more likely to be alcoholic, and 10 times more likely to inject street drugs. Compared to people with zero ACEs, people with an ACE score of 6 have a shorter lifespan – by 20 years.

Twenty-two states and Washington, D.C., have done their own ACE surveys, with similar results.

The ACE Study is part of a perfect storm of research emerging over the last 20 years that is revolutionizing our understanding of human development. Brain research shows how the toxic stress of trauma damages the structure and function of children’s brains, which can explain their hyperactivity, inattentiveness, angry outbursts and other behavior. This affects their ability to learn in school, and leads them to use drugs, alcohol, thrill sports, food and/or work as coping mechanisms.

Biomedical researchers discovered that toxic stress experienced as a child can linger in the body to cause chronic inflammation as an adult, resulting in heart and auto-immune diseases, such as arthritis. And epigenetic research shows that the social and emotional environment can turn genes on and off, and childhood trauma can be passed from parent to child to grandchild.

Let’s put this another way: A huge chunk of the billions upon billions of dollars that Americans spend on health care, emergency services, social services and criminal justice boils down to what happens – or doesn’t happen — to children in their families and communities.

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The pediatricians mentioned in this article know that, and they also know that if they intervene early enough to stop or prevent childhood trauma by building resilience factors in children and families, children won’t suffer, and they’ll have happier, healthier lives as adults.

Pediatricians aren’t just about sore throats and ear infections anymore, says Gillespie. “This is a culture shift. We’re here to support families.”

The profession is moving away from looking solely at healing a child, to healing a family and a community. For the last several years, the American Academy of Pediatrics has been helping pediatricians create medical homes where all needs of children and their families are met, including “specialty care, educational services, out-of-home care, family support, and other public and private community services that are important for the overall health of the child and family.”

Two years ago, the AAP encouraged pediatricians to also address adverse childhood experiences and toxic stress in early childhood. Last month, AAP President Dr. James Perrin launched a new initiative, the Center on Healthy Resilient Children, to “coordinate the academy’s response to the issue of adverse childhood experiences, the promotion of healthy development, and the prevention of toxic stress.”

Feeling overwhelmed…and someone to turn to

When Tabitha Lawson brought her four-month-old son in to the Children’s Clinic in Portland, OR, they both were having a hard time. Unlike her 6-year-old daughter, he wasn’t an easy baby. He had colic, and Tabitha and her husband were under stress from his long bouts of crying.

“I was feeling overwhelmed,” she recalls. “I had no breaks. I work full time. From my job to my house is five minutes, where I’d go into my other life mode, and every evening, the scream-outs.”

She filled out a survey with 10 questions about her adverse childhood experiences (ACEs)…  click here to READ MORE…

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