How long does trauma therapy take?

This is a very difficult question to answer, because everyone is different, everyone’s story is different, and everyone’s trauma is “stuck” in a unique way. 

But clients have a right to know how long things might take. So to show I’m not avoiding the question altogether, I’ll talk about it a little bit.

First of all, many people have spent many years suffering.  It’s natural to want a quick fix, and our society specializes in quick.  Unfortunately, it’s more difficult to do that with therapy than with other things.  That said, trauma therapy used to take many years, and with more modern and powerful therapies, it usually doesn’t.  Trauma therapy length depends on a number of factors, so let’s start there.

What influences how long it takes?

What are the factors?

There are many factors that go into determining this; before our first session, I don’t know any of them, and some of them we’ll never know, or at least not until afterwards.  The good news is that there is an afterwards.  Some things that influence how long it takes to get there:


Your goals

Some people want a deep healing of their symptoms, others are satisfied with some significant changes that help them in their everyday life; sometimes people just want to be well enough to function in a job or a relationship.  This part depends on you.


The type and severity of the trauma

If we’re just working on a single event that happened when you were an adult, then it could be fairly short—possibly between 1-3 months.  The research on childhood trauma recommends 15-30 months, but I’ve had clients who were satisfied with what they accomplished sooner, sometimes much sooner.  But no matter what, we can’t know how it will go until we get started.

How “stuck” is the trauma?

If you’ve read my pages on PTSD, you know that the symptoms we see are natural and reasonable responses to threat.  However, the threat is now over.  So the body seems stuck in a place where it responds as if the trauma is still going on.  We don’t know why.  We just know that there are some things that might help get it unstuck.  If we can do that, the healing process will proceed naturally, although that takes some time.  We can’t know exactly how much time, but we do know that it seems to continue even after therapy is completed, if the therapy was effective.

Resources

There are other factors that make a difference.  We don’t know what they all are, by any means.  We know that having one trauma often makes it more difficult to recover from a second one.  Also, we know that having social resources (good relationships with some family and friends) helps.  There are other things that make a difference, too.  (see my blog on Resources)

How soon will we know?

Not right away.  Sometimes we’ll know a little bit after a few sessions, sometimes it will take longer to determine.  It takes what it takes.  But I’m not interested in dragging things out unnecessarily—the suffering has lasted long enough. 

Here’s my suggestion.  Let’s give it a chance.  Let’s have a few sessions together.  The first thing that should happen is that you should start feeling more comfortable in our session.  If that doesn’t happen by the third session, we’re probably not a good fit.  By then we will have started the first phase of trauma treatment—what I call resourcing.  We’ll work on that for a while, finding and using the tools that seem to work best for you.  When that’s finished and we start into the middle part of treatment, then we will begin to know more about how your system is responding to the things we do.  Then, of course, we’ll keep adjusting as we go along, based on what we find out and what your goals are.

Here’s my promise to you: I’ll always be open about my opinion and my reasons for it.  I’ll also try not to speculate when I don’t know.  That’s my professional commitment to being open with my clients about what we’re doing.  You’re always in charge.

If you’re in or near Colorado Springs, you can contact me using the form below or by calling 970-377-4577.

What is a Somatic Approach to Therapy?

(Need to contact me or get information about therapy right now? Scroll to the bottom of the page.)

Somatic approaches to counseling and therapy pay attention explicitly to the physical reactions that accompany psychological issues or symptoms. They take into account current information about the autonomic nervous system (ANS) and how it works. (The ANS is the part of your nervous system that controls things like heart rate, blood pressure and other non-conscious functions.) Traumatic experiences overwhelm the body’s natural defenses. Sometimes people heal from this on their own; sometimes we don’t. When that happens, we develop some form of PTSD (or something similar to it).

Somatic Therapy: What it Isn’t

When I say that a somatic approach to therapy works with the body, I’m not talking about massage or touch; these things can be helpful, but that’s not what I provide. A somatic approach does involve talking. But we don’t just talk about problems, issues, ideas, solutions, relationships and the other things that more traditional “talk therapy” involves. Instead, we actually work with your ANS to jump-start your natural healing process and move it forward. While this involves talking, we’re talking about you as a whole person–with emotions and physical reactions–not just about your thoughts.

Paying Attention

Everything starts with paying attention. In modern culture, we are used to using (or abusing) our bodies. We feed them, exercise them, allow them to rest–sort of like we do our pets. We think of ourselves as brains that own bodies. But this is a flawed perspective. We are bodies. Our brains are just a part of us, even if they are a very important part.

So the first aspect of a somatic approach is to learn to simply pay attention to our physical selves. When you’re angry,
for example, what does it actually feel like? What do you feel in your chest, in your arms or legs, on your skin? To work with anger, we don’t just work with the thoughts that go with it, we work with the ANS reactions, the physical reactions that we don’t consciously control. Paying attention is the beginning of this.

Taking it Further

Of course, there is more to a somatic approach than just paying attention. If we are going to change, the physical reactions we have will need to change. This is particularly the case with PTSD. The symptoms of PTSD (whether due to adult trauma or childhood trauma) are mostly not conscious reactions. They are not things we choose. They are things that happen even though we don’t want them to. To change them, we have to involve the system that manages those reactions, the ANS.

There are a number of ways to accomplish this. If you’ve heard of EMDR or Trauma Dynamics, you’ve heard of approaches to therapy that work with the body to heal the effects from past events that still linger with us. There are other approaches, and there are new ones being created all the time, along with modifications of the “old” ones (almost all somatic approaches are new, based on a modern understanding of how the ANS works).

If you live in Colorado Springs and have physical reactions that you don’t like (the agitation of anxiety, the listlessness and muscle pain of depression, flashbacks or uncontrolled anger), then you may benefit from some of the somatic approaches I can provide. Please contact me (below) to see if we’re a good fit.

The sexual abuse of boys

[Looking for support in Colorado Springs now? Fill out the contact form below or call 719-377-4577 for an appointment.]

We hear a fair amount about sexual abuse of girls.  It happens more than most people think, and it does terrible damage.  But we don’t hear much about the sexual abuse of boys.  Let’s hear a little bit.

First of all, it happens a lot.  In fact, it seems to happen to boys almost as often as it happens to girls.  And it’s quite possible that even our most up-to-date estimates are underestimates, due to the wall of silence that surrounds this issue.

The Wall

There are reasons for that wall.  Men are supposed to be stoic and silent and take care of their own problems.  Also, boys are often blamed for what happens to them. Because boys are often aroused at some point during the abuse, people may mistakenly believe they are cooperating (they themselves are often confused by this and can feel that it’s their own fault).  Also, there are forms of abuse that are not acknowledged as abuse.  And then, because no one talks about it, men can sometimes think that they are alone and that it hasn’t happened to anyone else.  Or, they may think that it happens to everyone, that it’s normal, and that they are just supposed to “deal with it,” to “get over it.”  That strengthens the wall.

Another reason for silence about the sexual abuse of boys is that the perpetrators are almost always known to the boys who are violated.  They are either trusted members of the community (teachers, coaches, religious leaders) or, very often, relatives.  Fathers or mothers (yes, mothers), uncles, aunts, cousins or siblings (of both genders).  This means that the abuse is tinged with a sense of betrayal.  And there are consequences for telling.  Not good ones, usually.

Shutting down

So boys learn to shut up.  And when they become men, they stay shut up.  They disconnect from their feelings, they disconnect from the reality of what happened to them. This is a protective response.  But what helps us survive as children often becomes dysfunctional when we become adults.  Even though it’s kept inside, it manifests itself in other ways.  When boys act out constantly, run away from home, are always angry, or are depressed, we are seeing some of the ways that it is manifest.  These things can continue into adulthood.  In addition, it can cause physical problems.  It can also cause a lack of trust (of men, or women, or people in general) and a general sense of emptiness.  It can cause suicidal thoughts and actions (and men complete attempted suicides at a much higher rate than women do).  But still, it may be manageable, for a while.

Shutting up and shutting down and disconnecting works until it doesn’t.  This can happen at any time.  Sometimes there is a trigger, some highly stressful life situation, or hearing about someone else’s abuse.  Sometimes it happens when their own children get to the age they were when it happened.

Letting it out

The first reaction, when the dissociation stops working and things start going badly, is surprise.  “Why is this happening now?  I thought I put this aside, I thought I was over it.  I haven’t thought about it in years. I was OK last year; why am I so depressed (or anxious, or angry) now?”  The answer is simple:  It’s time for this to come out.  Your body, your mind, your nervous system needs to heal from it.

Then it’s time for action.  It’s time to tell your story to someone.  Someone you trust:  a therapist, a spouse, a support group, someone.  There are many ways that people recover. Reading a book about others’ experiences, or joining a support group can help—it’s important to know you’re not alone.  One support group is called “1 in 6”, and they have a number of resources available.

This is, of course, also a time that therapy can help.  Seeing a therapist who uses powerful somatic therapies (such as EMDR) can support you to move forward in your healing process.  Childhood trauma, if not addressed, can continue to do damage over one’s lifetime.

There is a lot to say here, far more than I can touch on in this blog. If you live in Colorado Springs, and you’ve survived sexual abuse, please feel free to call me to discuss what options might be available. (719-377-4577) or fill out the contact form below.  If you live somewhere else, click on the link to 1 in 6 above.  You’ve suffered long enough—it’s time to start healing.

The impact of childhood trauma

I’ve worked with a lot of people with addiction (and I’ve struggled with addiction myself).   At some point I realized that among the people I knew well with addiction, the only ones who hadn’t told me about awful things that happened to them as children were the ones who hadn’t told me anything about their childhood.  That thought got me interested in childhood trauma, and I began reading and trying to learn more, as well as listening (which I’d already been doing).  I then ran across the ACE Study.

ACE Study

ACE stands for adverse childhood experiences.  This study took the medical records of over 17,000 people and correlated them with the results of a survey.  The survey asked them questions about negative things that may have happened to them as children.  The negative things were actually categories of things.  They involved physical, verbal or sexual abuse, neglect, divorce, having a parent die, seeing your mother struck, living with a person who had a mental illness or substance abuse problem or who became incarcerated.  They counted how many categories (of the 10) that each person had experienced.  Then they looked at the medical records.

The results were a bit stunning.  The main finding was that the higher the person’s ACE score, the more at risk they were for developing a host of physical and psychological problems as adults.   That’s right, physical problems.  Not only were the folks with higher scores more likely to fall into addiction, anxiety or depression, they were also more likely to develop heart disease cancer and obesity.  Now, this data has been looked at very closely and many research papers have been written about it.  Problem after problem, condition after condition, including antisocial behavior–all are more likely to befall people who had painful and awful things happen to them as children.  It’s pretty shocking.

It’s also terribly unfair.  Unfortunately, we all often participate in making it more unfair.  Every time we think that addiction or overeating is about willpower, every time that we assume heart disease is all about diet, we are neglecting one major thing that (for many people) can cause or worsen all of them:  adverse childhood experiences.  Trauma and loss.  Bad stuff.

What to do?

We go to doctors to get better, to feel better, and they often give us pills.  Not just pills for heart disease, but pills for anxiety and depression and many other things.  But there’s often a missing piece–the unacknowledged and untreated pain and damage created a long time ago by overly stressful and traumatic experiences.  If there was ever an argument for the need for trauma treatment, this study is it.   (I’m not at all putting down the good work doctors do–and I should note that the principle investigator on the ACE study–the one who first studied this connection–is a medical doctor.  Many of us get significant help through medical treatment.  But many of us also need more than that.)

Of course, not everyone has a high ACE score.  But a lot of us have a few, and a few of us have a lot.  The impact of childhood trauma is something we should acknowledge, something we should look at.  It’s something we should try to address.

A Personal Story

How to do that?  Well, we can start by not blaming children for what happens to them.  Years ago, I was teaching high school, and I had a student who “gave me a lot of trouble.”  I sent him to the office a lot.  Over and over.  Then one day I was talking with the assistant principal about him, and I found out what had happened.  My student, 16, and his 15 year old brother had been abandoned by their parents.  Just left by themselves.  They were living with their 19-year old brother who was working and trying to keep it all together so his brothers could stay in school.  How’s that for an adverse childhood experience?  After I learned that, I had a bit of a different attitude about my student.  I started trying to connect with him a little more.  I was young and didn’t know a lot about how to do that, but it was something.  So things went a bit better after that.  I didn’t stop enforcing rules, and he didn’t completely stop breaking them, but things got better.

If you want to find your ACE score and read about the study, there’s a great website here.

We’ll keep talking about this problem.  And about what can be done to address it.

Childhood Trauma

What is complex childhood trauma?

Childhood usually involves a few traumatic events: accidents or injuries, unintended separations, grief over minor losses, etc. Events such as these can have some long-term impacts, but often they don’t. However, some children experience things that are usually more serious: divorce, death of a parent, ongoing abuse or neglect, a parent with addiction or mental health problems, etc. These usually involve a disruption or difficulty with an important relationship. In these cases, we talk about complex childhood trauma (or developmental trauma). [Look forward to my talking about this regularly in later posts.]

Impacts

It turns out that these kinds of events or situations can have very damaging long-term impacts on a person’s health. They can increase your chances of developing things like heart disease, obesity and other physical problems as well as mental health issues like depression, anxiety or addiction. [More about the research on this.] In other words, some childhood events can create many different ongoing difficulties. Many people are unaware of this connection, including some in the health fields.

Why is this connection important? For a simple reason: treating the wrong health condition doesn’t always help. If you go to the doctor for a broken arm and she gives you antibiotics, well, your arm won’t get infected, but it also won’t heal correctly. This can happen in therapy. A person will try to get help for depression or anxiety, and they may get medication for it (which can be helpful) and may get some therapy or counseling to gain some coping strategies (which is also helpful). But if the underlying cause is childhood trauma, and that doesn’t get treated, problems often persist.

Treatment

Some people say, “well, you can’t change the past, so you might as well figure out how to live with it.” In my view, that’s both true and false. It’s true that we can’t change past events, and we can’t change the way we reacted at the time, or the effects it has had up to now. But there is a lot more that can be done than just “learning to live with it.” It turns out that we can actually change what has happened in our bodies as a result of trauma.

Our bodies? That sounds weird. But let’s think about it carefully. Heart disease happens in the body. Depression affects the brain and the chemistry of the blood. Anxiety is mostly physical—heart and thoughts racing, tightness in the chest, shaking, sweating.   And most PTSD symptoms are things we can’t consciously control—flashbacks, feelings of unreality, fear, hopelessness, intrusive thoughts about the situation, etc.

Working with the body

For this reason, many of the modern, cutting-edge approaches to trauma treatment are based in the body (we say they are “somatic”).   Things such as EMDR, Yoga, acupuncture and massage all have been found to be helpful. I work with a somatic trauma therapy called Trauma Dynamics. It targets the effects that events and situations have had on our nervous systems, particularly the parts we can’t control. This somatic PTSD therapy is only a few decades old, and is still developing. But there is evidence that it’s extremely powerful, even in cases of complex childhood trauma.

So it turns out that healing is possible. We can’t change the past, but we can change the effects it has had on us. That’s good, good news for everyone.