subject: Varied Effects of Trauma: An Integrative Approach [print this page] Varied Effects of Trauma: An Integrative Approach
Any psychotherapist or counselor who has worked with people who've experienced psychological or emotionaltrauma -- no matter what the origin; childhood abuse, rape, domestic violence, war, sudden loss or other trauma -- knows that the list of possible effects is a very long one. Organizing these effects into categories, called "disorders," has little bearing on how the individual can effectively recover.In my practice, Itake this into account by providing therapy methods that match the symptoms, rather than a disorder title.
Looking atthe range of related DSM IV-Rdisorders provides a hint as to the range of its potential effects; somatization, dissociation, PTSD, acute stress, borderline personality disorder and more. Symptoms can vary in severity and duration too. As examples, here is a list of just a few of theissues that can result from psychological or emotional trauma. There are many more.
Nightmares
Trouble relating to others
Distrust of others
Cognitive distortions
Aggression
Hostility
Out-of-body experiences
Sleep issues
Commitment problems
Exaggerated startle responses
Automatic rage
Sexual intimacy issues
Physical symptoms without physical causation
Self loathing
Feelings of powerlessness
Mood swings
Defensiveness
Paranoia
Panic attacks
Undiagnosed physical ailments
Fear
Rage
Most counselors and psychotherapistssee the effects oftrauma along a spectrum. Many toonow consider that ithardly matters what grouping of the effects of a trauma, or disorder,appear, since therapy is largelyfocused on therapist-client rapport and safety, attention to specific effects of the trauma, processing the traumatic event or events, development of resilience, mental health education,learning new thought patterns, practicing new relationship skills,processing the trauma, decision-making, problem-solving,self-careand developing emotional regulation.
In my work with clients who are suffering effects of trauma, I'm likely to use all or some of these approaches, depending on the individual's needs, preferences and readiness. Again, the needs are most likely toinvolve symptom reduction andalleviation. Preferences of therapy methods are very individual and may overlap with readiness; for instance, a person who has a high degree of fear probably won't prefer to process the traumatic event or events too early in therapy and therefore, won't be ready to do so. Some people who are suffering from trauma won't want to close their eyes for meditation, relaxation exercises or visualization, at least at first.
Readiness can oftenbe evaluated according toan individual's level of fear about using a certain method, but also entails ensuring a strong rapport and sense of safety with the counselor/psychotherapist in a certain setting and may require a gradual increase in type, intensity and duration. This allows the individual to build confiendence in his or her self in the process, as well as in the psychotherapist/counselor, and calm the fight or flight reponses enough to proceed on to more intensive psychotherapy. Some other factors that must be considered when selecting therapy methodsat certain intervals in the processare the origin of the trauma, demographic, cognitive and verbalcapacity fit with therapy methods.
I've had strong success with using this integrative approach in my practice, "Jolyn Wells-Moran, PhD, MSW Counseling."Like much of psychotherapy and counseling, effectiveness is also partly dependent on the work that the individual does outside the therapy setting -- in other words, practice of the skills in everyday life. Again too, success is partly a result of how comfortable the individual is with the psychotherapist/counselor.
