Action Trauma, 16 trauma experts sat in my living room in June 2020
Recently I attended Action Trauma 2020 (22&23 June) that is usually held in Belfast but due to the pandemic was virtual. The clinicians gave their talks from homes and places local to them rather than on stage with an audience and some distance. As I sat in my living room with cups of tea it felt like I was having screen tuition from those I explored in my journey to become a trauma psychotherapist. Clive Corry who founded Action Trauma introduced each of the guests to my home which included Stephen Porges, Robin Shapiro, Dan Siegal, Laurence Heller, Bessel Van der Kolk, Janina Fisher, Peter Levine, Gabor Maté; there were additional talks from Sue Carter, Richard Brown and Patricia Gerbarg, Richard Shwartz, Sue Saunders, Jeffrey Mitchell, and Deb Dana. Those also watching were able to ask text questions and we voted for ones that sparked a lot of interest. This meant additional learning from the responses the clinicians gave to us after speaking for one and a half hours with another half hour for questions. The additional talks were presented slightly differently.
Trauma conferences can be a small world thinking back to those that I attended and presented to in the past. It gets smaller when you specialise in a specific area even though that can be connected to many of the topics discussed at this conference. My area was sort of missed which makes sense as vicarious trauma can happen at times with some material discussed; I presented last year on captivity within a micro-cult in reference to those with systems within systems or polyfragmented DID. Dissociation was spoken about in quite a few talks so perhaps my specialty was spoken about but in a slightly different light. I did finish each talk with a feeling that what was said would be beneficial to add to the work I do. My bookshelf has become heavier as I ordered books presented to explore more.
Stephen Porges who wrote The Polyvagal Theory and presented Understanding Trauma Through the Lens of Polyvagal Theory. He spoke about how we are all in a sort of trauma with Covid19 as time progressed. The acute trauma will be felt quickly by those that lost people they knew or staff caring for these patients. The effects on the body were mention and noted that people could come down with MUS or Medically Unexplained Symptoms in health clinics. Polyvagal Theory was discussed in connection to how we might feel or react. It made me wonder whether clinicians should all have training in Anatomy and Physiology as it’s not just the mind in distress but the body as well. Social connections were brought up and why it may take longer for some clients to trust.
Robin Shapiro who wrote Doing Psychotherapy: A Trauma and Attachment-Informed Approach, presented on an Introduction to EMDR with the history and what it can assist in the present such as complex trauma and dissociation. During the questions the EMDR flash technique was explained and how it assisted various trauma conditions. As many of us went online there was some curiosity whether EMDR and similar technique could be used virtually. On the EMDR solutions website there is a free guide to doing this work online. I was pleased to hear EMDR is not a single step process and for those with dissociation they may need time before EMDR is used.
Dan Siegal who wrote Mind, Consciousness, and Well-Being being published Sept 2020, spoke on The Healing Power of Emotions. He gave us insight on how we came to be and the connectiveness within the body. What fear does to the body and how we might react sounded familiar. I found the explanations of the body and mind helpful thinking again I need to do an anatomy class as the one I did at 18 is too distant to remember. It brought to mind clients who had both trauma and health concerns. The integrated mind was mentioned alongside wellbeing which intrigued my interest wondering whether anyone had a completely integrated mind as varied events occur in life.
Laurence Heller who wrote Healing Developmental Trauma and is founder of NeuroAffective Relational Model™ (NARM) spoke on the Healing Developmental Trauma and what happens after for that individual. If a trauma situation isn’t supported in some way then this can have additional consequences for the child or adult. I see this in my work when harm occurs and there isn’t someone who can show kindness or be supportive. During the pandemic stats have shown a rise in domestic violence and no one is there to step in. What developmental traumas have occurred in families without harmony as we were all told to stay home? Developmental traumas are relational and can lead to social isolation, collapse, dissociation, toxic shame just to name a few. These symptoms can be healed so they are not permanent.
Bessel van der Kolk who wrote The Body Keeps the Score spoke on Coronavirus and trauma treatment in his talk The Pathway to Recovery. Many perceive covid19 as a threat because the primitive part of the brain has been activated. This has led to some reactions that are affecting both our physical and mental health. Those who already carried trauma have found an increase in their symptoms or have dissociated or gone numb in a way to protect them from threat. Many examples were given on how to both assist our clients and ourselves because being a clinician doesn’t make you immune from world events. An amazing piece of work was shown with psychodrama, which I did once in the past, showing how unmet needs from the past could be met in the group.
Sebern Fisher who wrote and presented on Neurofeedback in the Treatment of Developmental Trauma, Calming the Developmental Brain. Brains wired for survival find it hard to relax to do living life without these reactions. Neurofeedback was discussed and showed in a video of a young child who was very reactive and after neurofeedback was much more contained. The results were amazing but I did wonder how this can be used in private practice since equipment is needed and how it would work on adults. It seemed a clinical setting was needed however how a traumatised brain is wired seemed similar to other clinicians who spoke on the body and brain.
Janina Fisher who wrote Healing the Fragmented Selves of Trauma Survivors spoke on the developments in trauma work and how to work with complex trauma in The Principles of Sensorimotor Psychotherapy. Trauma gets stored in the body and mind with triggers like covid19 reawakening material from the past. It might be working online is hard because of the phone or laptop camera (some abuse with children involved taking pictures) has opened up fragile material. The change of not being in your therapist’s office may have also rattled some new material free. Some clients may love online therapy as they don’t need to go outside where they feel danger lurks. Hyperarousal and hypo arousal were also spoken about with helping clients to try and get in between those in the window of tolerance. The ‘living legacy of trauma is in the present moment despite being from the past’ which summed up the work explained well. There was a helpful list presented of trauma reactions and the resources that can help which I have used at times in my own practice.
Peter Levine who wrote Waking the Tiger which was an early book on trauma, spoke about Trauma and Memory, Brain and Body in a Search for the Living Past. Trauma and Memory is also the title of his more recent book. He talked about explicit (conscious) and implicit (subconscious) memory and how these may look in everyday life. ‘Making coherent narratives helps us make sense of the world’ showed the progression that takes place in therapeutic work. The most moving part if his talk was a video of him working with a mum and young baby; due to a difficult life-threatening birth the child was really struggling. Mum tried her best to help her new son but it wasn’t going to plan. Levine worked with mostly the baby with mum holding him and he was able to release some of the prebirth trauma with his cries. He was snuggling against mum at the end and the follow up showed him leaping through his developmental stages with no problem. It helped in a way to see trauma that was medical because that can get missed at times in talks. Later he spoke on dreams and how helpful they are to healing. Some trauma clients have bad dreams so he suggested focusing on just a small part as the whole dream could overwhelm the work for the client.
Dr Gabor Maté wrote When the Body Says No and spoke in an interview with Clive Corry on Coronavirus, Trauma, Addiction and the Future. It has been noted in a number of countries already that addiction rates have increased. People have found it very challenging so some have turned back to old ways of coping. It’s important to remember addictions isn’t just drugs, alcohol and gambling but also shopping, gaming, snacking and even meditation. The rates of domestic violence have also gone up and those in need of support can’t get online therapy with threat in the home. If something is being done out of balance then it may need reviewing, I know I had to pull back from watching the news constantly because it got out of hand so instead of morning news it turned to all day scary news which was affecting my sense of wellbeing. It was suggested addiction training should start with pregnant mum and throughout rather than the teen years when addictive behaviour have already started. One may feel their teen is fine because they don’t drink but how often are, they on their phone, what else were they checking out as they were doing online school work? Resources and selfcare can help stop going towards behaviours to numb out the feelings. Trauma is behind all addictions and was interested to learn that the adverse childhood experiences ACE Scale was started in an obesity clinic where they found everyone had a high number of past traumas. When trauma is resolved, addiction levels go down as they no longer need it. Working with compassion and without judgement really helps those struggling to cope when we see them. 12 step programmes can be helpful especially if they are trauma informed.
Sue Carter, PhD was executive director of the Kinsey Institute and wrote numerous peer reviews plus Attachment and Bonding; she is spoke on Oxytocin and Traumas, The Healing Power of Love. Oxytocin and Vasopressin are hormones that are adaptive and connected to early life experiences. Social connection is needed for survival and if unavailable others are found like drugs, alcohol, mental destruction and for some death. Pathways form in the brain which are shaped by early experiences and help in reproduction, social bonds, resilience and survival. Oxytocin can be seen as a stress coping hormone and in therapy with newer resources clients can find better ways to deal with stress. It also plays a role in healing from coronavirus as it can assist but may backfire if the person has had lots of past distress. I use to hear people say in the hospital that it seems happy patients heal faster which may be tied to oxytocin working properly.
Richard Brown and Patricia Gerbarg wrote the Healing Power of the Breath dedicating their lives in aiding those who struggle and presented on an Introduction to Breath, Body and Mind. They showed in various clips how breathing technique can aid healing quickly such as helping kids fall asleep to aiding traumatised groups who have just left dangerous situations while fleeing. One group had just arrived to the camp looking very distressed and by slowing their breathing down and activities this adjusted their mind to a more regulated state. Some of the children were laughing by the end of a very short intervention. Breathing work has been used in disaster relief, the 911 tragedy, Boko Haram, Haiti earthquake, slavery in Sudan etc. Breathing techniques can be useful when working with clients who may only take shallow breaths or hold their breath when recalling past trauma.
Richard Shwartz wrote and founded Internal Family Systems Therapy which identifies various parts of the self; his presentation was Evolution of the Internal Family Systems Model IFS. These parts may seem to be helpful and unhelpful however the parts that have been carrying stressful events are able to release them during this therapy. One that is seen as critical may also be the hero in keeping that person safe. They can sometimes let go of old behaviours and take some of the burden off of themselves. A video was shown from a workshop where the person had suffered with a lot of backpain. The parts helped tell what happened in the past trauma and could express feelings changing the internal balance. The person involved later reported no backpain since the workshop. The body was taking the pain and once heard could release it. As I work with those with ways of being on the dissociative spectrum, I related to a lot of what was being spoken about so it felt new to me for individuals who have other trauma conditions with less or minimal dissociation. The goal of IFS (Internal family systems) is to liberate parts of the self while having compassion for each one of them. The actual self is trauma free but may need help in recovery parts that are traumatised.
Sue Saunders wrote Negotiating the Teenage Years and is a practitioner at the Human Givens presenting on Trauma Healing with Human Givens. There is a move towards healing without getting into the deeply traumatic experiences with the use of guided imagery, rewind technique and hypnosis. They use the APET model which is Activating agent, Pattern match, Emotional arousal and Thought understanding. Work is done via resources which can apply to the physical and emotional needs then once needs are met good health is restored. Their training is both online and when covid19 restrictions have lifted then in person.
Jeffrey Mitchell wrote Critical Incident Stress Management (CISM) and was founder of the International Critical Incident Stress Foundation which helps before, during and after a critical incident like 911 or hurricanes. He presented on Critical Incident Stress Management, a comprehensive staff support programme. The before training could be given to workers on what to do if an incident connected to their work happens so there is less panic when a situation occurs. The during is about assisting those helping a crisis so they can return to their field such as the hospital in the middle of the pandemic, the after is debriefing which combined help workers return to their jobs. Those that do need therapy can then move on to that if the trauma is staying which may happen if trauma occurred in childhood. There was also a background and personal history given which gave a fuller understanding in his work. Did make me think about my own incidences that led me to my career and why other clinicians chose the work they accomplish.
Deb Dana wrote Polyvagal Exercises for Safety and Connection which was just published and runs courses on polyvagal theory in therapy now virtually on her site Rhythm of Regulation. On her website she wrote ‘Polyvagal Theory…the science of feeling safe enough to fall in love with life and take the risks of living…’ which was explored further in her discussion for this conference. Varies exercises were shared for those watching to try out on themselves and she mentioned resources on her website which could be looked up. Polyvagal theory was explained in detail which really helped me with a limited scope of the internal body. The polyvagal has three states which are needed for survival and each one can cause a differing reaction which was explored using the polyvagal ladder. Some people did polyvagal art to express how these states looked to them which was thought-provoking.
I would like to thank those who spoke at this conference and for sharing their expertise online to those watching. The last quote given was from writings by Stephen Porges which I felt would be ideal to end this piece of writing.
Trauma is a chronic disruption of connectedness. Regulation is a goal point and really helps our being so body and inner experience are more balanced.