Wednesday, October 22, 2014

Facebook, Friends, Family, and Trauma; Navigating Social Media as a Survivor

Social media has become so interwoven into the details of our lives, turning our private (and occasionally mundane) thoughts into public domain.  In order to remain connected not only socially, but professionally, Facebook and other forms of social media are less optional than subtly compulsory.  Not surprisingly, Facebook is a topic of conversation in therapy for many clients.  Navigating the cultural expectations for continuous connection and unbridled access to each other is a challenge for everyone; trauma survivors are confronted with another layer of consequences for communication (or a lack of communication) on social media.

Posts from "friends" can at times be insensitive, passive-aggressive, attention-seeking, or offensive. They can also pull a community together, offer inspirational quotes or commentary on what's important in life. Politics and religion are handled far less delicately than in the past (perhaps because the discussion isn't between people but rather Facebook can be a platform for expression).  Handling polarized world views in a public forum gracefully is a skill that is currently under construction; we are building the foundation for this form of connection from the ground up.

Challenges that arise in therapy (or outside of it for that matter) include how to ignore or decline a friend request from someone, what the consequences may be in accepting it (i.e. bosses, colleagues, friends of enemies, family members, former romantic partners).  Posting something on Facebook or Twitter has occasionally landed people in hot water with friends, family or partners; sometimes with intention and other times inadvertent.  Navigating social media does require some degree of thought and attention for all of us; at least those of us concerned with minimizing strife.

Survivors of trauma are confronted with nuanced challenges under the social media umbrella.  Filial relationships (particularly if the family of origin had members who were the source of trauma or failed to protect) are challenging outside of the Facebook context as well as within it.  Questions surrounding which relationships to maintain, which to let go of, how to let go, and how to remain connected to some family members but not others is a topic of regular conversation (something to be discussed in Integrative Trauma Treatment Center's "Surviving Survival; Picking up the Pieces after Trauma" support group!).  For those whose perpetrator was not a family member but was someone they new (this is more common than random crimes),  should one "unfriend" all of those who surround the perpetrator? Does this empower the perpetrator and disempower the survivor? One of the quandaries here is that every time a friend "likes" or "comments" on a post of the perpetrator, this can be visible to the survivor.  Facebook can be a source of trauma triggers while simultaneously being a source of social support and connection; a classic PTSD Catch 22.  How does one remain connected and protected simultaneously?

A lot of the work we do in the recovery process surrounds boundaries.  Sometimes I tell my clients that if this part of the work is done well, a sense of safety increases to the extent that symptoms decrease.  The problem with social media is that it, almost by definition, makes it extremely difficult to have any boundaries. There is a sense that in setting limits or choosing not to engage social media, requires an explanation is and yet trauma is often so private.  So....what to do?  There obviously is not a clear answer.  However, the skill of being less permeable without apology or explanation could be a potential focus.  It is okay to say no to "friend" requests, to "unfriend" those who are not healthy connections, to "block" those who are not safe in the inner circle.

It could be argued that while social media is a connective tissue that threads through the fabric of our culture, some of it's concepts are great for setting limits around who has permission to be in our lives. Imagine if "unfriending" someone was as easy as clicking a button? Or, if someone wanted to connect with us who wasn't safe, that we "ignore" or "hide the request" from our awareness? What if we could just "block" those who have caused us harm or are connected to those who have caused us harm?  These are actually fairly solid strategies for maintaining boundaries.  Our vision can get clouded by people. If we can listen to our gut, be clear on who is safe and who isn't, who has something to contribute to our lives and who should have permission to witness the details of our days, social media could potentially offer a bit of clarity around boundaries.  "Unfriending," "blocking," and "hiding requests" for friendship are strategies we could perhaps apply to relationships in "real life."  If someone who wants access to us or has access that is not safe, has broken our trust, caused damage or is a conduit for others who cause harm, Facebook boundaries may be a viable protective strategy; the challenge is giving ourselves permission to say "no" and to say "good-bye."

Sunday, August 10, 2014

Healing through Experience and the Limitations of Talk Therapy

Clearly I am in invested in psychotherapy as an avenue towards healing.  I enjoy providing a safe, open space for people to recover from trauma, address mood related concerns, or dissociative symptoms (for example). We can offer skills, help increase mindfulness around unwelcome patterns of thought or behavior, process traumatic memories, and help navigate internal narratives about self and the world.  I have often felt that it can be a struggle to facilitate a connection between the reasons clients have sought therapy (depression, anxiety, PTSD, dissociation, stress) and the experiences that may have fostered what may characterize their struggle.  When exposed to a traumatic event, we don't often have the conscious thought "I am helpless" or "It's my fault."  Those struggling with depression may believe they are not good enough or feel worthless, while those with anxiety may feel pulled towards perfectionism in order to feel in control. These are typically subconscious, unarticulated beliefs that therapy can help pull from the back of the brain to the front, increasing the opportunity to renegotiate such narratives.  Without minimizing the value of this, sometimes it doesn't seem to be enough.

Adding homework assignments to someone who is depressed or telling an anxious person not to avoid something they fear is easier said than done and can cause people to feel badly about themselves because they just didn't have the strength to do it on their own.  What I want to do is to stop talking about it with my clients and offer opportunities for a different kind of experience.  Our thoughts are a reflection of our experiences, so why not start there?  There does seem to be some nods towards utilizing experience as a healing tool (such as with somatic therapies or psychodrama). In my group practice, we have started to play with various approaches to inviting the body to be part of the healing process.  The more I think about this concept, the more I play with it, the more I realize the body could be a missing link.  I know I am not the first one to think about this (Peter Levine, Pat Ogden).  I guess the difference is that I would like to offer experiential healing in a lot of different ways.  These are some of the things we are doing now:

1. Acupuncture, Massage, & Reiki in adjunct with Psychotherapy:  All of these are intended to calm the central nervous system for those who are fearful, anxious, or hypervigilant. They can also help to invigorate those struggling with depression or to offer the experience of nurturance and safe touch.

2. Equine Therapy in adjunct with Psychotherapy: This has been such a profound and beautiful experience for me as a therapist.  Watching my clients who have specific phobias (being up high, being in a group) or who are very protective of themselves find comfort through working with an animal has been a gift.  There are moments I will never forget in this work, and those moments were those where the experience underneath of a negative belief (i.e. "I am not safe) is challenged through doing (versus thinking).

3. Yoga: We aren't there yet, but I'm working on finding a trauma sensitive yoga practitioner.  This would provide an opportunity to do something physical in a safe environment.  An active body and meditation have so many mental health benefits that I can't list them all here.

There are so many other concrete ways one can begin to challenge negative beliefs or expectations of others/the world around us.  I hope to continue to expand opportunities to address mental health concerns outside of the therapy office.

Athena H Phillips, LCSW
Integrative Trauma Treatment Center