Overcoming Past TraumaOvercoming Past Trauma

11 March 2010

Laurie M. Forbes, MSW, CSWLaurie M. Forbes, MSW, CSWwww.forbes-breakingfree.comwww.forbes-breakingfree.com

What is Trauma?What is Trauma?The Social Work Dictionary: “An injury to the body or The Social Work Dictionary: “An injury to the body or

psyche by some type of shock, violence, or psyche by some type of shock, violence, or unanticipated situation.”unanticipated situation.”

Traumatic events overwhelm the ordinary human Traumatic events overwhelm the ordinary human adaptations to life, they generally involve threats to adaptations to life, they generally involve threats to life or bodily injury, or a close personal encounter life or bodily injury, or a close personal encounter with violence and death.with violence and death.

Traumatic reactions occur when a person feels Traumatic reactions occur when a person feels action is impossible, when neither resistance nor action is impossible, when neither resistance nor escape is possible.escape is possible.

PTSD-W

Examples of traumatic events:Examples of traumatic events: Adults and teensAdults and teens

– Accidents involving vehicles, people, animals, natural Accidents involving vehicles, people, animals, natural disastersdisasters

– Major illness, surgery, terminal illnessesMajor illness, surgery, terminal illnesses– Rape, sexual assault, etc. (in men or women), domestic Rape, sexual assault, etc. (in men or women), domestic

violence, other crimes against the family or person, violence, other crimes against the family or person, terrorism, war/combat, kidnapping, prisoner of war, etc.terrorism, war/combat, kidnapping, prisoner of war, etc.

Children (pre-teen)Children (pre-teen)– Accidents, illnesses (self or loved ones)Accidents, illnesses (self or loved ones)– Crimes against the family or person (bullying, terrorism)Crimes against the family or person (bullying, terrorism)– Separations from loved ones (hospital stay, trips, foster Separations from loved ones (hospital stay, trips, foster

care)care)– Changes in family structure (new baby, divorce, death)Changes in family structure (new baby, divorce, death)– Abuse (emotional, physical, sexual, verbal, domestic Abuse (emotional, physical, sexual, verbal, domestic

violence)violence)

Some Effects of Trauma:Some Effects of Trauma: AngerAnger FearFear Confusion Confusion DepressionDepression Inability to concentrateInability to concentrate AnxietyAnxiety Social withdrawal Social withdrawal Panic attacksPanic attacks Obsessions and/or Obsessions and/or

compulsionscompulsions Sleep problems (too much, Sleep problems (too much,

too little)too little) Eating problems (too Eating problems (too

much, too little)much, too little) AddictionsAddictions

Nightmares, flashbacks, Nightmares, flashbacks, intrusive memory intrusive memory fragmentsfragments

Problems with Problems with interpersonal relationships interpersonal relationships

Problems trustingProblems trusting Loss of faith in and/or Loss of faith in and/or

anger at a higher poweranger at a higher power To rigid or lack of personal To rigid or lack of personal

boundariesboundaries Problems with sexual Problems with sexual

boundaries, intimacy or boundaries, intimacy or promiscuitypromiscuity

False beliefs and thinking False beliefs and thinking errors, feeling like a failure errors, feeling like a failure

Emotional numbnessEmotional numbness

General Rules to Overcome Past Trauma:General Rules to Overcome Past Trauma: Admit that there is a problem or need for changeAdmit that there is a problem or need for change Don’t expect to be “cured” overnight, unless you Don’t expect to be “cured” overnight, unless you

are willing to forgive right noware willing to forgive right now Include prayer and seek spiritual guidanceInclude prayer and seek spiritual guidance Have a plan (Goals)Have a plan (Goals) Choose one or two things to work on at a time – Choose one or two things to work on at a time –

don’t overwhelm yourself with too much don’t overwhelm yourself with too much Go at your own pace, not what others believe you Go at your own pace, not what others believe you

should be doingshould be doing Use all the resources at your disposalUse all the resources at your disposal Involve others you trustInvolve others you trust Don’t be embarrassed or afraid to seek helpDon’t be embarrassed or afraid to seek help

A ComparisonA ComparisonHierarchy of NeedsHierarchy of Needs Effects of traumaEffects of trauma To satisfy hunger, thirst, sleep, To satisfy hunger, thirst, sleep,

etc.etc.

Need to be secure, safe, have Need to be secure, safe, have stability, and shelterstability, and shelter

Need to belong, to love and be Need to belong, to love and be lovedloved

Need to achieve and to be Need to achieve and to be recognizedrecognized

Need to know, to explore, to Need to know, to explore, to understandunderstand

Need for self actualizationNeed for self actualization

Eating & sleeping problems, Eating & sleeping problems, nightmaresnightmares

Anxiety, Fear, Panic attacks, Anxiety, Fear, Panic attacks, flashbacks, intrusive memoriesflashbacks, intrusive memories

Social withdrawal, trust and Social withdrawal, trust and interpersonal relationship interpersonal relationship problems, personal or sexual problems, personal or sexual boundary problems, emotional boundary problems, emotional numbnessnumbness

Obsessions, Compulsions, Obsessions, Compulsions, Addictions, Depression, AngerAddictions, Depression, Anger

Confusion, inability to concentrate, Confusion, inability to concentrate, loss of faith in and/or anger with a loss of faith in and/or anger with a higher powerhigher power

False beliefs and thinking errors, False beliefs and thinking errors, feeling like a failure feeling like a failure

LossLoss Loss is what is missing or has Loss is what is missing or has

been removed from your life due been removed from your life due to wanted or unwanted changesto wanted or unwanted changes

Things that can cause loss:Things that can cause loss:– Death, divorce, moving, illness, Death, divorce, moving, illness,

accidents, abuse, addictions, accidents, abuse, addictions, unemployment, change, having unemployment, change, having a baby, marriage, healing, a baby, marriage, healing, natural disasters, unnatural natural disasters, unnatural disasters, terrorism, etc.disasters, terrorism, etc.

Things that can be lost:Things that can be lost:– Childhood, joy, peace, parents, Childhood, joy, peace, parents,

love, limbs, property, health, love, limbs, property, health, siblings, grandparents, other siblings, grandparents, other relatives, opportunity, future, relatives, opportunity, future, confidence, esteem, children, confidence, esteem, children, companions, etc.companions, etc.

If you don’t already know your If you don’t already know your losses, discovering what you losses, discovering what you have lost as a result of trauma have lost as a result of trauma can be emotionally painfulcan be emotionally painful

The pain is due to having a loss The pain is due to having a loss that has not been mournedthat has not been mourned

Allow yourself to grieve your Allow yourself to grieve your losses as you discover themlosses as you discover them

Allow yourself to understand Allow yourself to understand that loss is real, that you have a that loss is real, that you have a right to grieveright to grieve

Grieving provides a release Grieving provides a release from emotional pain, allowing from emotional pain, allowing healing to take placehealing to take place

Grieving brings freedom from Grieving brings freedom from emotional suppression or emotional suppression or oppressionoppression

Grief and MourningGrief and Mourning 5 Aspects of Grief:5 Aspects of Grief:

– Denial Denial having trouble accepting the having trouble accepting the

reality, the shock is too reality, the shock is too much, time is needed to much, time is needed to “take it all in”“take it all in”

– AngerAnger Has many faces, directed at Has many faces, directed at

many peoplemany people Is not logical or valid, may Is not logical or valid, may

be unreasonablebe unreasonable Should not be denied, Should not be denied,

should be acknowledged should be acknowledged and worked throughand worked through

– BargainingBargaining There is a human tendency There is a human tendency

to bargain for what we want to bargain for what we want – extended life, escape from – extended life, escape from pain, a distraction from pain, a distraction from reality.reality.

– DepressionDepression A healthy response to loss A healthy response to loss

and its overwhelming and its overwhelming sadnesssadness

Comes and goes, changing Comes and goes, changing with each stage or aspect a with each stage or aspect a person is inperson is in

Usually clears on its ownUsually clears on its own– AcceptanceAcceptance

Accepting the reality of the Accepting the reality of the loss, and the new reality loss, and the new reality resulting from the lossresulting from the loss

Acceptance does not Acceptance does not equate with liking the equate with liking the change or being “alright” or change or being “alright” or “okay” with the change.“okay” with the change.

“On Death and Dying”

Anger Anger ““___ made me mad.”___ made me mad.” Anger is bad – true or Anger is bad – true or

false?false? FALSEFALSE Anger is a choiceAnger is a choice Anger is based on two Anger is based on two

emotions – fear and/or hurtemotions – fear and/or hurt

Anger is not bad, it is Anger is not bad, it is misunderstoodmisunderstood

Anger has a useful and Anger has a useful and righteous purposerighteous purpose

Anger is used to bring Anger is used to bring about change within about change within ourselves or our ourselves or our community/worldcommunity/world

Anger focused on self is Anger focused on self is usually focused on usually focused on revenge.revenge.

Anger focused on violation Anger focused on violation of another’s needs is of another’s needs is usually focused on changeusually focused on change

Anxiety/Panic “Triggers”Anxiety/Panic “Triggers”

Why it happens:Why it happens:

Traumatic events can Traumatic events can leave a person with leave a person with fear of “it” happening fear of “it” happening again.again.

Reminders of the Reminders of the traumatic event often traumatic event often ‘trigger’ similar panic or ‘trigger’ similar panic or anxiety felt during the anxiety felt during the event.event.

How to figure out what How to figure out what your triggers are:your triggers are:

Pay attention to what Pay attention to what your thoughts are.your thoughts are.

Observe what is going Observe what is going on around you.on around you.

Observe who is around Observe who is around you and what they are you and what they are doing.doing.

Compare the above to Compare the above to what you experienced what you experienced

Look for similaritiesLook for similarities

BoundariesBoundaries UnhealthyUnhealthy

– Can’t say “no”Can’t say “no”– Everyone is given “intimate” Everyone is given “intimate”

status, including strangersstatus, including strangers– Decisions are based on Decisions are based on

emotions emotions – Love and sex are the same Love and sex are the same

thingthing– It is okay to tell everyone It is okay to tell everyone

about private mattersabout private matters– Needs and wants are the Needs and wants are the

same thingsame thing– Helplessness instead of Helplessness instead of

autonomyautonomy– Touching or being touched Touching or being touched

without permission is okaywithout permission is okay

HealthyHealthy– Knows limitations and can Knows limitations and can

say “no” when neededsay “no” when needed– Understand safe limits with Understand safe limits with

strangersstrangers– Decisions are based on Decisions are based on

rational thought, facts, and rational thought, facts, and emotionemotion

– Love is based on mutual Love is based on mutual respect and friendshiprespect and friendship

– Private matters are only Private matters are only shared with a few trusted shared with a few trusted personspersons

– Needs and wants are Needs and wants are differentdifferent

– Ability to help self or decide Ability to help self or decide who can help if neededwho can help if needed

– Who touches and when Who touches and when touching happens is a touching happens is a choicechoice

Shame/GuiltShame/Guilt

ShameShame– Based on false beliefs Based on false beliefs

and embarrassment and embarrassment about yourself as a about yourself as a personperson

– Is unhealthyIs unhealthy– Has no useful purposeHas no useful purpose– Is oppressiveIs oppressive– A sign of having been A sign of having been

powerless or helplesspowerless or helpless

Guilt Guilt – Stems from having Stems from having

taken an action that is taken an action that is not correct or a lack of not correct or a lack of action when neededaction when needed

– Is healthyIs healthy– Produces changeProduces change– Is not permanentIs not permanent– Is about your actions Is about your actions

not you as a personnot you as a person

Perseverance: Perseverance: the Truth About Failurethe Truth About Failure

Failure doesn’t mean you are a Failure doesn’t mean you are a failure – it does mean you failure – it does mean you haven’t succeeded yet.haven’t succeeded yet.

Failure doesn’t mean you have Failure doesn’t mean you have accomplished nothing – it does accomplished nothing – it does mean you have learned mean you have learned something.something.

Failure doesn’t mean you don’t Failure doesn’t mean you don’t have it – it does mean you have have it – it does mean you have to do something in a different to do something in a different way.way.

Failure doesn’t mean you have Failure doesn’t mean you have been a fool – it does mean you been a fool – it does mean you were willing to try.were willing to try.

Failure doesn’t mean you are Failure doesn’t mean you are inferior – it does mean you are inferior – it does mean you are not perfect. Failure doesn’t not perfect. Failure doesn’t mean you’ve wasted your life – mean you’ve wasted your life – it does mean you’ve a reason to it does mean you’ve a reason to start afresh.start afresh.

Failure doesn’t mean you Failure doesn’t mean you should give up – it does mean should give up – it does mean you should try harder.you should try harder.

Failure doesn’t mean you’ll Failure doesn’t mean you’ll never make it – it does mean it never make it – it does mean it will take a little longer.will take a little longer.

Failure doesn’t mean god has Failure doesn’t mean god has abandoned you – it does mean abandoned you – it does mean God has a better idea.God has a better idea.

Author unknown

AddictionAddiction

Illegal drugsIllegal drugs AlcoholAlcohol Tobacco Tobacco CaffeineCaffeine Prescribed medicinePrescribed medicine Sex / pornographySex / pornography Food / junk foodFood / junk food

Chocolate / candyChocolate / candy Anger / strong emotionsAnger / strong emotions Foul languageFoul language ViolenceViolence Adrenaline rush / dangerAdrenaline rush / danger Power / controlPower / control HelplessnessHelplessness Out of control hobbiesOut of control hobbies Seeking AttentionSeeking Attention Anorexia / BulimiaAnorexia / Bulimia

Definition of Addiction: “The giving up of one’s self habitually.”or “Slavery to (name your addiction)”

A Different Way of ThinkingA Different Way of Thinking As children we have a certain set of experiences that As children we have a certain set of experiences that

shape how we see the worldshape how we see the world This set of experiences is only a small part of the This set of experiences is only a small part of the

experiences that occur in the worldexperiences that occur in the world As we grow, we learn how to respond to these experiences As we grow, we learn how to respond to these experiences

and design a story or “script” in our headand design a story or “script” in our head This script allows us to describe and make sense of our This script allows us to describe and make sense of our

experiences, and our responses to these experiencesexperiences, and our responses to these experiences Schemas are the set of beliefs & responses that form our Schemas are the set of beliefs & responses that form our

scriptsscripts Our schemas (beliefs & responses) become set at a fairly Our schemas (beliefs & responses) become set at a fairly

young ageyoung age Even if we have new experiences that challenge these Even if we have new experiences that challenge these

beliefs & responses, we tend to try to understand these beliefs & responses, we tend to try to understand these experiences using the schemas we already have, to keep experiences using the schemas we already have, to keep our script from changingour script from changing

While these ways of understanding and responding often help us to While these ways of understanding and responding often help us to survive when we are young, they can interfere with our ability to adapt survive when we are young, they can interfere with our ability to adapt to new, challenging situations as adults (remember, we only have to new, challenging situations as adults (remember, we only have limited experiences when we are young)limited experiences when we are young)

We design ways of thinking to make sure that our beliefs and response We design ways of thinking to make sure that our beliefs and response don’t change, so we can keep our script safedon’t change, so we can keep our script safe

These ways of protective thinking are called “thinking errors” because These ways of protective thinking are called “thinking errors” because they do not allow us to change our responses so that we can adapt to they do not allow us to change our responses so that we can adapt to new situationsnew situations

Instead they cause us to deal with new experiences with old beliefs Instead they cause us to deal with new experiences with old beliefs and responsesand responses

The problem is that these old beliefs and responses are now The problem is that these old beliefs and responses are now maladaptive and cause us and those around us to have problemsmaladaptive and cause us and those around us to have problems

In order to responses to new experiences in a way that does not cause In order to responses to new experiences in a way that does not cause harm to others and ourselves we need to understand our scritps, harm to others and ourselves we need to understand our scritps, schemas, and thinking errorsschemas, and thinking errors

We need to challenge them, and change our response to them, and We need to challenge them, and change our response to them, and ultimately to adjust our view of the worldultimately to adjust our view of the world

A Different Way of ThinkingA Different Way of Thinking

Thinking Errors Handout – Valley Mental Health - Forensics

Thinking ErrorsThinking Errors Thought distortions that Thought distortions that

are not reality, how our are not reality, how our thinking distorts reality.thinking distorts reality.

Thoughts that encourage Thoughts that encourage the continuation of the continuation of irresponsible behavior.irresponsible behavior.

Everyone uses thinking Everyone uses thinking errors.errors.

Thinking errors affect how Thinking errors affect how we see, hear, feel or we see, hear, feel or internalize the world internalize the world around us.around us.

Thinking errors impact Thinking errors impact jobs, self-esteem, and jobs, self-esteem, and relationships.relationships.

Common thinking errors:Common thinking errors:– Abusive labelingAbusive labeling– All or nothing thinkingAll or nothing thinking– AssumingAssuming– BlamingBlaming– CatastrophizingCatastrophizing– Dismissing the positiveDismissing the positive– Emotional reasoning / Emotional reasoning /

making feelings factmaking feelings fact– Flaw fixationFlaw fixation– Over generalizingOver generalizing– PersonalizingPersonalizing– RegretsRegrets– ShouldsShoulds– Unfavorable comparisonsUnfavorable comparisons

PTSD-S

7 Principles of Healing7 Principles of Healing

1)1) Healing starts by applying skills to manage Healing starts by applying skills to manage PTSD symptoms.PTSD symptoms.

2)2) Healing occurs when traumatic memory is Healing occurs when traumatic memory is processed or integrated.processed or integrated.

3)3) Healing occurs when confronting replaces Healing occurs when confronting replaces avoidance.avoidance.

4)4) Healing occurs in a climate of safety and pacing.Healing occurs in a climate of safety and pacing.5)5) Healing occurs when boundaries are intact.Healing occurs when boundaries are intact.6)6) Kind awareness and acceptance of feelings aid Kind awareness and acceptance of feelings aid

the healing.the healing.7)7) Balance in our lives is necessary to heal.Balance in our lives is necessary to heal.

PTSD_S

FaithFaith Common beliefs:Common beliefs:

– ““God allowed this to God allowed this to happen.”happen.”

– ““God didn’t protect me.”God didn’t protect me.”– ““God doesn’t love me or God doesn’t love me or

this would not have this would not have happened.”happened.”

– ““I am angry with God I am angry with God but can’t admit it but can’t admit it because he will punish because he will punish me.”me.”

Truth:Truth:– The gift of Agency was The gift of Agency was

involvedinvolved– God does not take God does not take

away anyone’s agencyaway anyone’s agency– God uses our actions to God uses our actions to

judge us – good or badjudge us – good or bad– God loves all of his God loves all of his

children equallychildren equally– God understands our God understands our

feelings (anger), he is feelings (anger), he is patient and will wait for patient and will wait for us to learn the truthus to learn the truth

Questions?Questions?

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Mental disordersMental disorders, Fourth Edition, Text Revision. Washington, DC, , Fourth Edition, Text Revision. Washington, DC, American Psychiatric Association, 2000.American Psychiatric Association, 2000.

Barker, Robert L.,1999. Barker, Robert L.,1999. The Social Work DictionaryThe Social Work Dictionary, NASW Press, , NASW Press, Washington, DC.Washington, DC.

Herman, Judith, M.D., 1997. Herman, Judith, M.D., 1997. Trauma and Recovery, The aftermath of Trauma and Recovery, The aftermath of violence - from domestic abuse to political terrorviolence - from domestic abuse to political terror, Basic Books, New , Basic Books, New York.York.

Ingraham, Linda, 1991. Ingraham, Linda, 1991. Life Without a Crutch: an Introduction to Life Without a Crutch: an Introduction to Recovery from Addiction,Recovery from Addiction, OPEN Inc., Garland, TX. OPEN Inc., Garland, TX.

Kubany, Edwards S., Ph.D., 2004. Kubany, Edwards S., Ph.D., 2004. Healing the Trauma of Domestic Healing the Trauma of Domestic Violence: a Workbook for WomenViolence: a Workbook for Women. New harbinger Publications, . New harbinger Publications, Oakland CA.Oakland CA.

Schiraldi, Glenn R. Ph.D., 2009. Schiraldi, Glenn R. Ph.D., 2009. The Post-Traumatic Stress Disorder The Post-Traumatic Stress Disorder Sourcebook,Sourcebook, 2 2ndnd Ed., McGraw Hill, New York. Ed., McGraw Hill, New York.

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