Tuesday, December 4, 2012

Trauma Resolution and The Brain

By Melinda Paige, Ed.S, LMHC, LPC, NCC, Master Certified Practitioner, Rapid Resolution Therapy 

Trauma clinicians are increasingly being asked by clients and fellow clinicians alike, "Is Rapid Resolution Therapy evidence-based?" The answer is a resounding "Yes!"

In fact, Dr. Connelly's approach and clinical hypnosis are supported in the trauma literature. A list of references is provided below for your professional development and to strengthen your ability to advocate for RRT and trauma-informed treatment. In summary, the literature suggests the following:

Painful exposure techniques are not required to clear traumatic memory. All that is required is keeping the client "emotionally present" as she describes the details of the event. This concept was introduced by trauma clinician and founder of Rapid Resolution Therapy, Dr. Jon Connelly, Ph.D, LCSW. Current neuroscience and trauma research by Bessel van der Kolk, MD and Dan Siegel, MD have also reached similar conclusions.

When we keep the client emotionally present, we are preventing the amygdala from activating the fight/flight response; amygdala activation inhibits the functioning of the hippocampus and parts of the pre-frontal cortex. The hippocampus and certain aspects of the pre-frontal cortex are responsible for integrating memory and tempering emotional responses. If these parts of the brain are inhibited, then the memory remains in the more primitive part of the brain as a non-verbal, implicit or felt memory. When a memory stays in this implicit form, associated sensory details like smells, times of year, sounds, and visual images can trigger the same feelings of terror as the original event; however, these triggers are often unconscious.

One goal of any trauma therapy is to integrate the traumatic memory into conscious, explicit memory. To accomplish this in session, trauma clinicians utilizing Rapid Resolution Therapy keep the hippocampus and pre-frontal cortex functioning rather than encouraging the client to emotionally relive the event which activates the fight/flight response and causes abreaction thereby inhibiting reprocessing and reintegration of the traumatic memory. According to Connelly (2011), in order to facilitate client recall of a traumatic event without abreaction, effective trauma therapists ground clients in the present by providing experiences in session that require clients to respond emotionally to the present situation or "what is happening." 

Connelly also suggests providing opportunities for clients to be in a "power position" while retelling the trauma narrative so that the client has a resolution experience which is the antithesis of the often disempowering traumatic event. This process allows the client's central nervous system to remain within the window of tolerance for optimal reintegration of the previously traumatic memory within normal memory.

Melinda Paige, Ed.S, LMHC, LPC, NCC is the Executive Director for the Institute for Rapid Resolution Therapy and is currently an RRT Master Certified Practitioner after training with Dr. Connelly for the last six years. She has been treating survivors of trauma for the last fifteen years as well as providing counseling training at universities and conferences throughout the nation.
Melinda holds a masters degree in mental health counseling and an educational specialist degree in professional counseling.  She is currently completing her doctoral degree in counselor education and practice at Georgia State University. Melinda's treatment outcome research involves establishing Rapid Resolution Therapy in the trauma literature as an evidence-based treatment for survivors of trauma.  She is a licensed mental health counselor (Florida), a licensed professional counselor (Georgia), and a national certified counselor (NCC) in private practice in Atlanta, Georgia.

  • Connelly, J. (2011). Rapid Resolution Therapy. Jupiter: Institute for Rapid Resolution Therapy.
  • Cozolino, L. (2010). The Neuroscience of Psychotherapy: Healing the Social Brain. New York: W. W. Norton & Co.
  • Damasio, A. (1999). The Feeling of What Happens: Body and Emotion in the Making of Consciousness. Orlando: Harcourt, Inc.
  • Foa, Keane, Friedman & Cohen (2009). Effective Treatments for PTSD: Practice Guidelines from the International Society for Traumatic Stress Studies. New York: Guilford Press.
  • LeDoux, J. (1996). The Emotional Brain: The Mysterious Underpinnings of Emotional Life. New York: Touchstone
  • Levine, P.A. (1997). Waking the Tiger. Berkley: North Atlantic Books.
  • Mockus, S., Mars, L. C., Ovard, D. G., Mazelis, R., Bjelac, P., Grady, J., et al. (2005). Developing consumer/survivor/recovering voice and its impact on services and research: Our experience with the SAMHSA women, co-occurring disorders and violence study. Journal of Community Counseling, 33(4), 513-525.
  • Ogden, P. (2006). Trauma and the Body: A Sensorimotor Approach to Psychotherapy. New York: W.W. Norton & Company.
  • Siegel, D. (2010). Mindsight: The New Science of Personal Transformation. New York: Random House.
  • Spinazzola, J., Blaustein, M., van der Kolk, B.A. (2005). Posttraumatic Stress Disorder Treatment Outcome Research: The Study of Unrepresented Samples? Journal of Traumatic Stress, 18(5), 425-436.
  • van der Kolk, B. McFarlane, A., and Weisaeth, L. (Eds.) (2007) Traumatic Stress: The Effect ofOverwhelming Experience on Mind, Body, and Society. New York: Guilford Press

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