Wednesday, February 29, 2012

When More is Not Better

For the past two decades, science has been uncovering some important features of traumatized patients. There is mounting evidence that traumatized individuals vary widely in their ability to adapt to trauma, in part due to underlying physical factors. For instance, some see the presence of chronic emotional trauma as having the potential to cause permanent physical damage in the hippocampus (Sapolsky, in Why Zebras Don't Get Ulcers (1994). This might mean that some individuals who have gone through multiple traumas or what in the DSM V will likely come to be called Disorders of Extreme Stress NOS, because of a changed hippocampus, will have diminished abilities to perceive or recover from subsequent stressors.

Other studies have shown that certain traumatized populations (traumatized women and combat veterans) share similar characteristics of neurological dysregulation. Susan Johnson noted (Emotionally Focused Couple Therapy with Trauma Survivors, 2002) that one implication is that such individuals may be unable to use their emotions as an appropriate danger signal to prompt adaptive action. The chronic activation in their brain systems seems to result in overreactions to non-emergencies and freezing responses in the presence of real danger.

All the above ought to be enough to caution the use of any kind of therapy that exposes the client to more of the emotional impact of their trauma and instead turn our attention to therapies that emphasize the client's ability to build an emotionally neutral or regulated response to what has happened, as well as to foster an adaptive recognition and response to new dangers. Helping the client stay emotionally connected in the here and now, rather than being re-traumatized by the tendency to focus on the there and then, in other words, seems key.

One therapy that goes about it in precisely this way is Rapid Resolution Therapy, as developed by Jon Connelly. The therapist uses a strong interpersonal connection built from the first moments of the session and collaboratively builds a model for calm, centered, and enlightened functioning with the client. This is reinforced artfully in a variety of ways, such that when client and clinician finally deal with the trauma story, the most important thing going on in the room is the ongoing present connection between them. Clients find, to their amazement, that their stories can be told, neither in a dissociated way nor an overreactive way, but calmly and straightforwardly, as so much historical data about an episode in their lives, and in the same tone as one might read out of an outdated phone book. This produces an emotional freedom occurring from what seems like a shift in the brain's processing mechanism. Outcome studies are currently underway with regard to Rapid Resolution Therapy and more light will no doubt be shed on this interesting method which works quickly as well as painlessly for clients.

Mark A. Chidley, LMHC, Certified Rapid Resolution Therapist, CAP, a fully licensed mental health counselor and certified addictions professional, offers counseling services at his office Kelly San Carlos Executive Center in Fort Myers, Florida.He has been in private practice since 1997. He holds certifications in Rapid Trauma Resolution (2010), Imago Relationship therapy (2001), and now specializes in the treatment of couples as well as individual trauma recovery and anxiety issues. He brings rich experience from a combined 26 years of hospital work and mental health counseling.

No comments:

Post a Comment