Our Trauma-Informed Care Program is designed to address the psychological and physiological symptoms that can emerge from both acute and developmental trauma. The program combines body-based practices, such as Sensorimotor Psychotherapy, Somatic Experiencing, and EMDR with our foundational treatment services including DBT, ACT, Mentalization, family therapy, neurofeedback, psychiatry, and experiential activities (trauma-informed yoga and Qigong.)
What is Trauma?
Psychological trauma is defined as a deeply disturbing experience that impacts a person’s physical or psychological safety and well-being to the degree that it impedes their ability to function in the world. It involves an overwhelming level of stress that exceeds one’s internal resources, and thus, one is unable to cope or integrate the intense emotions that emerge from that experience. Examples of acute trauma include physical and sexual assaults, experiences associated with military combat, accidents, certain medical procedures, natural disasters, and violent crime. Developmental trauma can include child abuse (both physical and emotional), neglect, deprivation, unsafe living conditions, or repetitive bullying. Developmental trauma can manifest in ongoing negative relational interactions occurring within families or among childhood peers. The experience of trauma differs among people and is determined by the subjective experience of the individual rather than by the objective facts. This is because people react to experiences differently based on a number of factors that determine whether a particular experience is traumatic. These factors are both internal, meaning each person’s unique psychology, as well as external. External factors that are particularly important include the relational context of the individual at the time of the traumatic events and afterward. For example, two children could experience bullying, but one might be blamed for what is happening by teachers or parents while the other is supported and understood. This can lead to two very different outcomes as it pertains to the level of trauma.
What is Trauma-Informed Care?
At CW we believe that the treatment of trauma is best conceptualized in stepwise fashion with three distinct phases. We utilize various body-based models that invite the client to access the trauma through a bottom-up, rather than top-down, approach. Current research shows that symptoms are best targeted through approaches sensitive to the interplay of the body and the mind’s response to trauma. We utilize various body-based models that invite the client to access the trauma through a bottom-up, rather than top-down, approach. If past experience is embodied in a person’s physiological state and action tendencies, then an integrative treatment is indicated.
Phase One: Symptom Stabilization and Trauma Orientation
This phase may also be considered the “container phase.” The goal of this early stage of treatment is to develop a sense of trust and safety in the treatment. In turn, symptoms are stabilized through a range of skill building approaches. A common experience of those who have been traumatized is for others around them to be confused, in denial, or to blame the traumatized individual for what has happened. As a result, it may be difficult for clients to expect things to go differently with their therapists. Trust is developed as the client experiences the clinician’s capacity to tolerate and hold traumatic material as they manifest in the therapeutic relationship. Symptom stabilization involves goals such as developing affect regulation skills, self-reflection or mentalization skills, and increasing one’s “window of tolerance”–the range of emotional activation within which self-reflection is still possible. This is particularly challenging with clients who dissociate, a common trauma symptom. In this phase of treatment the client identifies internal and external resources through an increased awareness of internal sensation. When clients develop the capacity to resource and reflect in the face of dissociation, then they may be ready to think more fully about their experience.
Phase Two: Trauma Processing
Once the client’s symptoms have stabilized and the foundation has been laid for increased self-reflection and emotional regulation, we move into trauma processing. This involves directly exploring past traumatic experiences with the goal of shifting the nervous system from chronic dysregulation to emotional regulation, even in the context of exploring traumatic material and memories. It also involves the completion of defensive responses that were originally blocked at the time of the original trauma. By doing so, we help the client to decrease fight or flight responses and other less effective coping mechanisms such as self-harm, suicidal ideation, substance abuse, or other forms of self-attack. With developmental trauma, processing may include exploration of child states, deep emotion, and reworking negative thinking and beliefs through a body-based approach.
Phase Three: Trauma Integration
The final phase of trauma-informed care at CW involves integration of dissociated or split-off memories and self-states with the goal of reducing state-dependent thinking and behavior. This includes making meaning of past experiences and their impact on the development of the person’s sense of self and others. Clients integrate their body sensations, movements, and five sense perception with emotion and cognition to develop a new experience of understanding the trauma and understanding one’s self. Phase three also includes further consolidation of emotional regulation skills and other adaptive functions that help to move one closer to long-term goals and higher overall functioning. Deeper family work may be indicated in phase three, including processing within the family system the memories and feelings associated with past traumas.
What is Sensorimotor Psychotherapy and Somatic Experiencing?
Sensorimotor psychotherapy, developed by Pat Ogden, Ph.D., www.sensorimotorpsychotherapy.org and somatic experiencing, developed by Peter Levine, Ph.D., www.traumahealing.org are body-based approaches that emphasize the effects of the trauma more than the trauma narrative. They are both based in research related to the way the brain responds to both acute and repetitive trauma and utilizing this information to target treatment. They draw on the wisdom of the body including posture, movement and the nervous system to help the client heal traumatic injuries and develop new coping abilities. Research has shown that these therapies lead to both symptom reduction (decreased anxiety, depression, PTSD, and relational problems) as well as improvement in work and social functioning, body awareness, and overall health.
What is EMDR?
Eye Movement Desensitization and Reprocessing, or EMDR, was developed by Francine Shapiro, Ph.D. It is a psychotherapeutic approach that helps to unlock the nervous system and allow the brain to process traumatic experiences and visualize disturbing events in less distressing ways. The therapist utilizes an external stimulus such as lateral eye movements, hand-tapping, or audio stimulation that are delivered as the client discusses traumatic experiences. This serves to both lower the severity of disturbing memories and to facilitate information processing in which new associations can be made between traumatic memories and more adaptive thinking.
Why Choose the Trauma Program at Community West?
CW offers trauma-informed care utilizing treatment modalities such as EMDR, Sensorimotor Psychotherapy, and Somatic Experiencing within the context of a comprehensive psychological treatment that includes a range of group and individual therapies. When combined, these modalities can effectively treat both trauma and the psychological symptoms and conditions that often co-exist with trauma such as depression, anxiety, and relational problems. We find that trauma treatment is most effective when clients are also engaging in adjunctive therapies such as DBT, ACT, Mentalization, Art Therapy, and Neurofeedback, as well as family therapy and psychiatry when indicated. All of these approaches, and more, are available at CW and can be combined in a tailored fashion to meet the unique needs of each client.