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Trauma Recovery Interventions Conventional talk therapy can best be
described as an extended conversation between two people, focused on and
for the benefit of one of them. Together, client and therapist:
Solution-focused
counseling is often helpful with specific issues such as acute depression
or anxiety resulting from a situational crisis, such as a geographic move,
and can be successful in as few as three to five sessions. Psychotherapy
which is meant to resolve deep-seated emotional trauma, on the other hand,
has long been thought to require much more time. Within the past
twenty years, however, there has been increased interest in specialized
clinical interventions which are designed to resolve moderate-to-severe
trauma within as few as ten or fifteen sessions. In this article, we will
highlight three specialized interventions which are available at
CounselingWorks, and which may be helpful as you work through particular
psychological challenges. Clinical Hypnosis is a technique which uses the client's
ability to achieve deep relaxation and intent focus (called a trance-state) in order to resolve, understand and change behaviors or
symptoms. It is primarily used for three essential purposes: To encourage the use of mental imagination or imagery To present ideas or suggestions To
facilitate unconscious exploration. Mental
imagination is useful because the mind seems capable of using symbolic
imagery to help bring about what we imagine. For example, one hypnotic
technique, called "age progression," encourages the client, while in a
trance-state, to visualize his life at some future point when all current
difficulties have been resolved, and then challenges the client to
identify and work toward the specific goals which must occur in order for
that future to be realized. Hypnotic
suggestions are used when the client wishes to work on a particular
behavior, such as smoking cessation or weight control. Hypnotic
suggestions are also useful for pain control, insomnia, addiction, and
many other physical complaints. Unconscious
exploration may be used to better understand underlying motivations,
to recall that which has been forgotten, or to identify how past events or
experiences are associated with current life problems. In
hypnosis, the client is not under the control of the hypnotist. It is a
common myth that, while in a trance-state, an individual can be made to do
things against her will, or that what happens in a trance will not be
remembered upon return to full consciousness. Most trance-states last
about twenty minutes, and are experienced by the client as pleasant,
peaceful and relaxing. Eye Movement Desensitization and Reprocessing
(EMDR) is
a technique designed to reprocess memories associated with disturbing
events in order to reduce symptoms of trauma. It involves the use of rapid-eye movements-
similar to those which occur during the dream-stage
of sleep- as well as cognitive restructuring (changing negative thoughts
you might have about yourself). It has successfully helped over a million
individuals who have survived sexual abuse, domestic violence, combat, and
crime. It has also been found to be an effective treatment for other
problems, including phobias, depression, panic attacks, poor self-image,
and performance anxiety. In one study financed by Kaiser-Permanente, EMDR
was noted to be twice as effective in treating trauma in half the amount
of time as standard talk-therapy. It does not require narrative memory, the ability to
remember and discuss an event in ordered sequence. However, EMDR is not
indicated for clients who have used mind-altering substances in the past
six months, or who have any history of seizure disorder. It should also
not be used by those who are not in good contact with reality or those who
are very fragile emotionally. The ideal EMDR candidate can withstand
increased levels of affect and emotional discomfort; has the ability to
self-soothe; is present and stable in her daily life; and has strong
emotional connections with others. EMDR sessions last about 90 minutes. Traumatic Incident Reduction
(TIR) is
a technique which was developed in 1984, and has been in use since that
time as a highly successful strategy designed to eliminate the negative
effects of past traumatic incidents. If it can be said that we all have "buttons," those issues or memories which provoke in us strong and
often unpleasant reactions, TIR is a technique designed to "flatten the
button," so that the issue or memory no longer holds a potent and
unpleasant emotional charge. In this technique, traumatic memories are
treated like videotapes, and the client is directed by the facilitator to
view the memory tape and describe it in as much detail as possible. Then
the facilitator directs the client to rewind the tape and describe the
incident repeatedly, until strong negative emotions about the incident
diminish and, eventually, resolve. This end-point is reached when the
client can recollect, discuss and verbalize insight about the incident
without any disturbing or upsetting emotion. TIR shares some similarity
with therapeutic interventions such as repetitive exposure and flooding,
in which the client is confronted with a feared experience until she gains
control of her anxiety and dread. TIR is different from those, however, in
that the therapist does not examine or interpret the client's
recollections, but instead functions as a guide or facilitator through a
highly structured and scripted process. TIR works best with narrative
memories, which can be described in detail from beginning to end. A
typical TIR session lasts about 90 minutes, although longer interventions
are possible depending upon the complexity of the traumatic incident. In
summary, standard "talk therapy" is the best choice for some clients
coming to counseling. For others, one or more of the targeted techniques
described above may be very useful. Please talk to your therapist if you
want more information or think you'd be a good candidate for any of
these specialized interventions. |