Coming Soon: Spoil Your Survivor & Healing The Healer Gift Certificates for Acupuncture, Massage, or Reiki (or a combination)

In celebration of both those who have endured and those who support them, Integrative Trauma Treatment Center will be offering gift certificates for survivors (of trauma, of physical injury or chronic illness, of child birth, or of just living) and healers (partners who have supported the healing process, medical professionals, mental health workers, first responders, international aid workers).

These will be available for single massage, acupuncture or reiki (or a blend).  Packages will be offered at a discounted rate.  Keep an out for more info on our Facebook page and we will be featured in the Willamette Weekly Gift Guide.

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."

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
Owner/Therapist
Integrative Trauma Treatment Center
www.traumacenternw.com

Survey: What would you want your physician to know (or not know) about your mental health?

In preparation for a presentation to a group of physicians in August on the topic of mental health in a primary care setting, the wheels have started turning on what the "patient" perspective might be.  There is a significant push towards coordination of care between disciplines, which clearly is beneficial in many ways. From my perspective, coordination of care can mean advocating for sensitivity and communication during medical appointments.  Clients reflect a reluctance to go to the doctor because of mental health concerns.  One might feel judged because of a struggle with addiction, because depression makes it difficult to get to the doctor or even make an appointment, or trauma makes doctor or dental visits frightening, for example.  I realized that as I prepare, I too may be making assumptions about how medicine is experienced by those who are struggling with mental health. So....

I propose a question: What are some things you would like to share with your physician but don't out of fear or in effort of showing respect (or something else)? What are things you hide from your physician? What would help you be more transparent in a medical setting?

If you respond, please leave out identifying information.

If you don't respond, it's okay!

Horses & Happiness; Equine Therapy and Recovery

Our last equine event was one of my most memorable professional experiences.  Witnessing the courage of working through trauma, anxiety, and self-criticism or judgement in such a safe way was a great gift (and by that I mean a gift for me!).  It made me realize some of the limitations of regular talk therapy because the experiential component is missing.  Building trust between human and horse while simultaneously building a sense of agency was different to watch out there in the world versus working through it in session.  This is not to say that psychotherapy is ineffective,  because it isn't.  There is a relationship there that is quite unique and facilitates growth in it's own way; this was just different.  So, that being said, I hope to offer this group monthly (more if there is enough demand).  Right now our next group is on July 30th at 10am.  Our website is www.traumacenternw.com.  Contact us if you are interested :)

"Noone can make you feel inferior without your consent." ~Eleanor Roosevelt

Eleanor Roosevelt was a rockstar....

This quote made me think about when I do feel inferior and how I may have aligned myself with whomever instigated that response in me.

That's all...

A thought...

Failure is nothing to concern ourselves with. Rather, opportunities lost to fear are treasures that slip through our fingers that may not present themselves a second time. Take a chance. Dance with optimism and let go of attachment to outcome. .... ~Athena

Massage, Acupuncture, & Mental Health

After watching the relationship between the mental health and the body be conceived as somehow distinctive from each other and thus the assumption is to treat them as separate entities, I thought it might be interesting to offer adjunctive treatments to folks.  When I opened Integrative Trauma Treatment Center, that was a large factor in what drove the design of our model.  We have massage therapy, acupuncture, medication management and psychotherapy available in one location.  These services can be utilized together or a la carte.  The goal is to provide a safe place for folks to get body work done, where they know their practitioners will tune in to them and have a nurturing but empowering presence.  I also wanted to acknowledge the despair, suffering, and isolation that can go with trauma, depression, anxiety, or other mental heath concerns and to create a community that was open, welcoming, playful, and safe.  A place for people to spoil themselves.  I suspected that clients would appreciate it.  I knew I liked the concept.  What I didn't expect is how I feel comforted by the fact that there is a team working with me and my clients in their process.  I am not only surrounded by other like-minded therapists, but other practitioners who can approach the same challenges from different angles.  This provides me with a safety net that I appreciate so much and did not expect that I would feel comforted by them.  I feel less isolated as well.  Hopefully, the gift to me as equally meaningful to those who visit ITTC.

An Art-Based Restorative Workshop for Survivors

Up & Coming: A Saturday Workshop for Women with Athena Phillips, LCSW & Jessica Boldt, LCSW. This is for survivors of trauma and will be an art-based resiliency & restoration workshop that will likely take place towards the end of June. Contact ITTC to add your name to the interest list! Number of participants will be limited to 8.

Equine Facilitated Trust, Safety & Self-Esteem: A small group experience for trauma survivors & horses!

ITTC is partnering with Happy Trails Riding Center to offer two brief classes on Equine Facilitated Trust, Safety, & Self-Esteem. This is a small group experience for Trauma Survivors to build trust in themselves, to regulate emotion through connection, and foster a positive sense of self. Also, it's just fun to hang out with horses! June 7th at 10am and 11am. Please contact ITTC to register. There are only 6 spots available!

DID & Authenticity

Dissociative Identity Disorder

&

The Question of Authenticity

            Many of us find ourselves contemplating the question of “who am I” at some point or another; perhaps we are pursuant of a spiritual connection to our place in the universe or may be hoping to connect with ourselves veritably. Evaluating the supposition of authenticity highlights the fact that fidelity to self is layered and complex.  The foundation is characterized by a knowing; awareness of internal strata and facets of one’s constitution.  Secondary to knowing is acceptance of one’s characteristics; only with knowledge and acceptance of who we are can we begin to navigate our relationship to the world around us. Presenting ourselves genuinely without fear or regret is risky and requires significant ego strength; the venture of rejection of true self is more painful than that of a disingenuous self.  Relating to others in a real way while being accepted simultaneously is a challenge for all of us; individuals with Dissociative Identity Disorder (DID) are faced with a normal question that is complicated by multiplicity (and it’s functions).

            The basal layer of authenticity poses a problem to dissociative individuals; the function of fragmenting can be to hide selves from the self.  Presupposing this is a protective process, how does one connect to who they are if overwhelming information is held in the answer to the question? Parts or “alters” are often hidden from view or are “behind the curtain” of consciousness in order to protect the rest of the system.  Self-awareness can seem commensurate to emotional gambling.

            The second layer of authenticity requires acceptance. Assuming trauma is the etiological base behind DID, acknowledgement of some alters can feel parallel to an acceptance of unacceptable events.  Protective alters who hold anger, self-injure, engage in addictive, or violent behavior are often completely rejected by the rest of the internal system.  Child alters (who often hold the traumatic memories) are sometimes viewed by the rest of the system as pathetic, shameful and weak.  Managerial alters do find external belonging, but become fatigued from their overwhelming task of hiding and pushing for success. Recognition of a fragmented identity may equate to acceptance of the past, acceptance of a controversial diagnosis, and acceptance of an experience that many people will find challenging to connect to.

            A common theme that arises in working with DID reflects this quandary; how can I be myself if my self changes?. Essentially this is a logistical question; how does one establish an authentic connection to the outside world when it feels like one’s demographics are in flux? Age, gender, and race are significant determinants of who we relate with and how relationships develop.  Small children like to play in very different ways than teens or adults do; men develop different relationships with women than they do with men and adolescents think adults are ridiculous. What if you are male sometimes, a five year-old at other times, or an adolescent girl at others?  This is an experiential truth for those with DID and it is very unclear as to how to be real and accepted under the umbrella of fragmentation. 

            When asked the question of how to relate to others in a way that feels real, my response is likely fairly inadequate.  I can only acknowledge the reality that DID is difficult even for some mental health professionals to accept (although research is making this more and more challenging); friends, family members, co-workers, and strangers are even less prepared to navigate such relationships.  There is truth in this experience and I have not discovered the right answer to living authentically in a world that is accustomed to and expects continuity.   It could be argued that we all are multi-faceted and are accustomed to disguising our vulnerability or less acceptable components of personality. Authenticity is a collective challenge, although it is a far more complex aspiration for those whose experience of who they are is relatively fluid.  Someone who lives with alters may say that in order to be genuine, they may require acknowledgement of all parts of self, to accept them, and to interact with the world from varying perspectives.