Rethinking Trauma: The Third Wave of Trauma Treatment

As someone who’s been practicing for a while, I’ve seen our view on the treatment of trauma go through substantial development. Our research, theory and treatments have all advanced considerably in the last 40 years.

And as I reflect upon this, I’m seeing 3 waves in the evolution of our outlook.

Looking back at when I first began to practice (in the late 70’s) our understanding of trauma was really quite limited. Of course we recognized the fight / flight response ever since Hans Selye introduced the notion back in the 50’s.

Our Prevailing Treatment Option for Trauma Was Talk Therapy

But our prevailing treatment option was talk therapy.

The thinking at the time was that by getting clients to talk about their traumatic event, we could “get to the bottom of” their issues and help them heal.

We were aware of the body and knew it held some power. But few practitioners used it in treatment (except the relatively few who worked with Bioenergetics, Rolfing, Feldenkrais, Rubenfeld, and to some extent Gestalt therapy).

But we were very limited in our ability to explain how body work, or for that matter, a talking treatment, affected the brain (and we had very little evidence-based research for it either). We just didn’t have much of a roadmap to guide us where we wanted to go.

That was the first wave.

Over time, researchers and clinicians started to recognize the limits of talk therapy. We realized that talking about a traumatic event held certain risks. At times, we inadvertently re-traumatized patients, especially if interventions were introduced too soon, before the patient was ready.

We also saw the memory of trauma as more often held in the right brain, the part that doesn’t really think in words.

So we began to use interventions that weren’t as dependent upon talking, interventions like guided imagery, hypnosis, EMDR, and the various forms of tapping.

We began to use interventions that weren't dependent upon talking
And as the science surrounding the brain’s reactions to trauma became more sophisticated, clinicians grew to understand more about what was going on.

We began to realize that not everyone who experiences a traumatic event gets PTSD. In fact, most people who experience a traumatic event don’t get PTSD.

And so researchers started to develop studies to determine who did and who didn’t get PTSD. We looked for what factors might predict greater sensitivity to trauma.

And we modified our thinking to add freeze (later known as feigned death) to the fight/flight reaction.

Just adding that piece clarified our thinking about what triggers PTSD.

It also began to expand our treatment options to include sensory motor approaches.

And we started to see how more vastly intricate and multifaceted multiple trauma was compared to single incident trauma.

But I believe a third wave of trauma research and treatment innovations has just begun to crest.

And it’s only come recently.

We continue to see advances in the field of trauma therapy that are opening up more effective methods for working with trauma patients.

Because of all the research that’s been done, we are much better able to predict who gets PTSD and who doesn’t. Not only that but we’ve got a good handle on why certain people get PTSD.

And as brain science has revealed how different areas of the brain and nervous system respond to traumatic events, we don’t think so often about whether trauma is stored in the left vs right brain.

We think in terms of three parts of the brain, the pre-frontal cortex, the limbic brain and the lower, more primitive brain. And we’re much more sophisticated in thinking about which part needs our intervention.

Brain Science is Changing What We Know about Trauma

We understand that the lower brain can command the shutdown response, totally bypassing the prefrontal cortex, totally bypassing any sense of “choice” for the patient.

And we see more clearly the part that the vagal system plays in this shutdown response.

We understand more of the role neuroception plays in feeling safe.

Knowing how the body and brain react to trauma opens the door for the third wave.

We are now beginning to use techniques like neurofeedback (based upon but a long way from the biofeedback we used years ago,) limbic system therapy, and other brain and body-oriented approaches that include a polyvagal perspective.

These are techniques I couldn’t have dreamed of when I began clinical practice.

But these are powerful tools that can offer hope to those who have been stuck in cycles of reactivity, shame, and hopelessness.

And now I’d like to hear from you:

What changes have you seen in your work with the treatment of trauma? Please leave a comment below.

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163 Comments

  1. Billy T says:

    Hi,
    Billy here and I enjoyed your article,
    I work in the field of mental health with people who are DTO/DTS, unknown to my colleagues, I am the victim of a kidnap and near death experience in late Sept 2015, naturally I have severe ptsd, and unfortunately sometimes I am even triggered at work.
    I am excited to find any new ideas on the subject, and would like any additional information as to where I may get procedures/support as my struggle has been a difficult one, even therapy doesn’t seem to help much.
    I am pro med and have always have been.
    I wish there were more effort to develop a medication that would really help those of us suffering from trama/ptsd, sometimes I just want to be ok and feel safe.
    Could it at least suppress the fight or flight response?
    I have tried medical marijuana, which seemed to help some (moderate at best), but I am not allowed to test positive for any substances while working in the field (which I understand and respect).
    What I experience, even in therapy, is people really don’t know what a life or death experience is truly like, in relating to the client they are trying to support.
    Every time I speak those words of that horrible event, it not only recreates the trauma, but it sets off thoughts and emotions of distrust and once again feeling unsafe, which can and does lead to all types of desperate behaviors (Including fight or flight), until once again I can try to forget and push it down in my being.
    So in summery I guess what it is really like is that I am left with the feeling that I just have to get through this just by myself, true time does heal all things and I cannot say that I have not improved greatly from where I started, and by God’s Grace am I alive.
    Hopefully, and at times I think to really be able to relate, and help another trauma/ptsd victim.

    • Joe Casey says:

      I think what some of the panelists are getting at is that in most cases, a therapist does well to focus attention on present time manifestations of what we call trauma, foremost as they appear right now in the body. Once that realizations sets in, a number of therapies are useful. EFT, Rebirthing, Metaphor work (as in Metaphors in Mind), and Rolfing come to mind. If you have a reservation that only someone who has had the same experience can help, you place an unnecessary block square in the path of healing. The question must arise whether you want healing or sympathy. The relevant question is: What do you want?
      BTW, my sister has a wonderful reframe for trauma: what if we think of it as “my dangerous beautiful assignment”?

      • Billy T says:

        Hmmm,

        First and foremost let me simply state that I desire no ones sympathy.
        I not only reached out for suggestions and support, instead I received judgment.
        Its obvious once again when someone does not know what a true life or death experience is about, evident by your posted comment.
        I also stated that I am in therapy, have tried different types, as well as current medications with little to no benefit.
        Let someone swing a 16lb sledgehammer over your head, threatening to bash your head in, or dodge bullets as your running away for your life, then maybe then you will have a clue about what you are saying, and what you think the solution is.
        If your not part of the solution, you are obviously part of the problem.
        Besides that, some comments should be left unsaid.

  2. JUDITH THORNE says:

    I have been both therapist and client. Having ME in 1987 gave me much time for reflection in which I felt that the many of us who were afflicted were “the pit canaries of the Earth” living in social conditions and environments creating seriously disturbed vibrational damage. Two months ago my legs collapsed and I was an inpatient for two weeks when no diagnosis could be found. So no treatment given. Once home I was helped by homoeopathy, herbal remedies and sprays which work with the aura and using Bach Flower Remedies both orally and topically. This topical treatment is explored and explained by the German naturopath Dieter Kramer and has been a major turning point in my life. All the zones of weakness in my left leg, ankle and foot totally correspond to the degrees of emotional damage created throughout my life. I am now very much healed using these gifts of nature.

  3. Jane says:

    Where can I get some help/therapy for my child hood trauma and CPTSD in Brighton, UK please?

  4. Joe Casey says:

    Practitioners of Rebirthing have realized since 1975 that this method is useful for resolving trauma. Intended at first to help resolve birth trauma, it soon became evident that all traumas can be aided. What is strange to me, having been practicing Rebirthing for 42 years, is the seemingly deliberate ignorance about its usefulness among psychologists and others who say they want to know how to help those in trauma. Whatever the excuse, it is harmful to sufferers to omit, dismiss, or degrade such a useful practice.

  5. Srishti. Nigam says:

    Brain based therapy help understand the neurobiology , physiology at molecular level and thus lead to resolution of traumatic experience
    Multiple therapies now have a good rationale
    Thank you

  6. Hala Buck says:

    I’ve been integrating the body with art therapy and mindfulness to unlock traumatic memories that are stored in the body and I still believe in the right hemisphere as well. Integrative and creative approaches are what helps clients recall and heal trauma without re-traumatizaiton.
    Energy Psychology has also been a tremendous help.

    I also find that many times we have to also address intergenerational and collective trauma inspired by Bert Hellinger.

  7. an article about robert grant, that i mentioned previously……http://www.ptsdsupport.net/gazette.html

  8. I did an all day workshop yesterday with Robt Grant, phd entitled “The Spiritual Impact of Trauma”. he talks about how complicated it is to treat, that it’s really about an opportunity to develop spiritually with the right kind of therapy and how reticent so many are to entertain that possibility including institutions as well as care givers…he also mentions how unpopular folks can become when proposing it. you can google him to see more about his approach and the books he has written…..

    I had heard much of this before thru michail harner and stan grof…..and was reminded again.

    it brings up for me my annoyance of how i practiced mindfullness under the radar from 1980 after i was swept out to sea and did several Conscious Living Conscious Dying workshops with the levine’s. then, FINALLY, psychology decided to validate what the ancients had known forever and now it’s all of a sudden valid and mainstream. it just takes too long for institutions to move forward.

    • Sally Ramsey says:

      Trauma as an opportunity to develop spiritually….. As we change our focus on trauma treatment and integrate the organic spiritual intelligence of each individual person we create the ground for potentially rapid and enlightened healing.

    • Sally Ramsey says:

      Trauma as an opportunity to develop spiritually….. this is so true! As we change our focus on trauma treatment and integrate the organic spiritual intelligence of each individual person we create the ground for potentially rapid and enlightened healing.

  9. Mike Stapleton, M.S. says:

    Hi, It appears that trauma is a very complex dx to treat and it is working some part of the problem that little by little one could act upon the deep issue. I have found CBT and stress techniques can at first hand help very much to relieve it. I have been once told to learn more about neuro biofeedback. And recently I have found that they are selling a watch that you can wear daily to observe your mood changing. It relatively costs less than the sessions that usually aren’t paid by the insurance. Thank you for these updates that are very informative to most of us.

    • Mike,

      While the “one size fits all” products such as the watch you mention can be useful, they are in no way a substitute for neurofeedback (neurobiofeedback). Neurofeedback is tailored to the individual and uses medical grade equipment. It is also accompanied by a qualified professional who can provide the proper support throughout the process.

      • Mike says:

        Thanks. I’ve just wondered if anyone has heard about it.

  10. Amanda says:

    I’m not a therapist but a ‘client’ and have to say I am so relieved that after 14 years of psychotherapy at last my condition makes sens to me in the context of complex PTSD. Everything I have read about it fits and that iin itself makes me feel nirmal. I’m starting a new treatment and look forward to making some improvements.

  11. Roby Abeles says:

    Like you, I began as a trauma therapist a long time ago – ( the mid a1980’s)

    We now have Brainspotting (BSP), developed by Dr David Grand. BSP is a brain and body based relational therapy, leaning heavily into relational attunement at its core, = interpersonal neurobiology, as researched by (Dan Siegel). which uses the brains own capacity to heal itself within a highly attuned relationship with the therapists moment by moment.
    Ive developed ways of using this amazing therapy to help addicts prevent relapses.

    We also have Somatic Experiencing developed by Dr Peter Levine. We know we have to include the physical body in the recovery and now we know exactly how to do that

    BSP + SE are powerful tools for full trauma recovery.

  12. Waki says:

    Obviously, the attachment theory is the great framework today for therapies, in particular the Developmental PTSD which is epidemic and which we did not know how to treat well and is still the part that we don’t handle so successfully currently. I love the blog of dr. effery Smith, howtherapyworks, because it’s right on the spot: relational therapy. Neurofeedback is far too expensive, sorry, and we need to stay grounded in basic common sense. Therapy works when the therapeutic relationship is healthy, supportive, dynamic, etc. The only thing is that hands-on work needs to be added in many cases, otherwise, that basic key is quite simple. All the research leads to that point. For shock PTSD, Somatic experiencing, TRE etc are doing wonders. All is said now in this matter, I mean, far enough to help clients heal effeciently and rather quickly.

    • Carolyn says:

      I agree that touch is often useful. And, I also have certain exercise equipment in my therapy room for mobilization and transformation of the trauma. (Such as Bosu, balance bars, Pilates rings, rollers, and physio balls.) It expands the energy of a client so they resource and not collapse into the trauma and its negative sense of self. I think “processing” is old school, I teach transformation from an integrative approach. Bridging the worlds of mindfulness practitioners, somatic trauma specialists and hands on energy healing is quite a powerful support for clients. I find they heal quicker and deeper. Is it the next evolution of trauma work? Maybe, for me it is. Thx for all the work you do Ruth/NICABM!!!! It is nice to have platforms to discuss the outer edges of where I think things are evolving toward.

  13. yes that is the reason I studied Sensorimotor Psychotherapy and became a certified advanced practitioner.

  14. Larisa Kompelmakher says:

    Love all sharing about healing trauma….found that just words is not effective in my cause any way…..looking for
    different approaches and want to try TMS THERAPY….Please keep sharing,you are doing great in shaking old approaches…..I was healed and delivered from arrested development by accepting JESUS CHRIST as a savior in my 55years old….Interesting, but true.

    • You might also look into a Christian approach Immanuel Lifestyle. See kclehman.com.

  15. Moreen Halmo says:

    Ruth. This is very helpful. I’m thinking in terms of an “eclipse” of the prefrontal cortex and am working on an article about this. Also, I am seeing that there needs to be a “We” in the relationship that helps the patient feel less shame and reactivity that maintains healthy boundaries yet allows for an experiencing of the relationship as a true partnership in the journey. This focus stays away from transference and requires the therapist to have “extraordinary presence” as referred to in Castonguay and Hill’s edited book recently released. Another piece that I hope to discuss in an article focused on what makes a good trauma therapist.
    Thank you
    Moreen Halmo Ph.D.

  16. M. Hayden says:

    Very Enlightening

  17. Elaine Dolan says:

    Granted, I should be researching and writing it and have pursued it only to a point,
    but the wave of the future is in pre and perinatal psychology–which creates the most long term and
    debilitating traumas–they took place EARLY (when the brain was not fully developed) and
    were life-threatening. Thereafter the body recapitulates (repeats over and over) the events
    that happened early, until the body makes sense of them.

  18. Malcolm Stanislaus says:

    Having practiced for over 30yrs,I, too, have seen tremendous progress in understanding and approacges. The primary change has been from a top-down approach to a bottom-up appriach. And it more clarity regarding preventing re-traumatization.

    However, I’m still surprised that even the so-called “experts” know relatively little about working with shame and how it is one of the most important facets of trauma recovery.

    • Carolyn says:

      I agree. Tell me more abut your shame work. I would love to hear your take on it. For me, I find shame and victim consciousness are the two tough challenges for clients to transform. I find when I work with clients on this topic, the shame covers up the deeper wound around being imperfect or being responsible for the “shameful” thing that happened to them. It zaps their sense of self. Yes, I find as I help clients own their imperfect parts and/or past – yet not let imperfection or their past be a litmus test on their inner value…shame transforms because they drop deeper to the pivitol ego issue involved. Differentiating their sense of self/value from mistakes, miss steps or the past has really helped my clients move forward in healing trauma. Shame can be like a shell covering the meat of the real issue. Unless we can help a client deepen into the deeper sense of self issues that keeps shame in place, it can loop and recycle. I wish we can all accept and love our imperfect human parts. For the imperfect past and our imperfect aspects need love and acceptance and WISDOM that the brokenness or imperfections do not define the client’s (or our) inner value. Thanks for discussing this topic! So very important.

  19. Donna says:

    Talk therapy, immersion may be effective for some; for others, the brain is altered by the traumatic events. Learning meditation, relaxation, etc. may help some calm; however, there are some people whose brains have been hijacked and rewired which makes self soothing pretty much impossible. When people are so seriously impacted, many are blindsided by their symptoms coming out of left field and are not equipped to manage to turn reaction to response. Despite no research on the use of marijuana in treatment of PTSD symptoms, there has been some anecdotal information presented that it offers to alleviate some of the impact. Doubtful any reputable MH practitioner would present that option to a client under their care for fear of losing their license; still, I would be curious of there is any experience or feedback re this issue. I am retired, no longer practicing, but my interest in this concern hasn’t waned and have no opinion on the use of pot for therapeutic purposes.

  20. I am excited to see that neurofeedback is becoming known as helpful for trauma. I have been practicing neurofeedback for almost 9 years. Things are constantly changing in both the technology and protocols. The results I see in my office are often nothing short of amazing. So many clients have suffered for so long before even hearing about neurofeedback. Their success often comes with anger that they were not informed about this option sooner. Thank you for spreading the word!

  21. Tanda Ainsworth says:

    I wrote about Robert Grant’s book, but neglected to mention that the last two trauma brain workshops I have conducted I used the concepts he discusses in his book, and people there were deeply grateful. We did meditation, and they were able to go deep within. I then invited them to share their true self with those in the group. We had a very loving community. I wove them all prayer shawls, and after our discussions I said that our community closeness reminded me of weaving different yarns together into a prayer shawl. They all smiled and wrapped themselves in their prayer shawls. Several have told me over the years that when they wear a prayer shawl they feel held by God. I loved making them and giving them to trauma victims.

  22. Tanda Ainsworth says:

    I love Robert Grant’s book “The Way of the Wound, The Spirituality of Trauma and Transformation”. In this book he outlines how one who has experienced any kind of trauma is invited by the Holy Spirit to go deep within and discover one’s true self.

  23. EA Helwick says:

    My associate and I focus on Emotional Trauma from a research perspective in the neuroscience field. The challenge was to piece together a working template for how the subconscious mind stores and accesses negative emotions / emotional traumas, which our research found was quite different than what conventional wisdom teaches. There is an interesting science article that came out a few months ago where scientists discovered that the brain operates on up to 11 different dimensions, creating multiverse-like structures!

    Our preliminary research indicates that negative emotions basically stick or freeze to memory events that create something akin to a Window’s operating software application that continues to run behind our conscious thoughts 24 /7. The subconscious mind utilizes various coping mechanisms such as drugs and alcohol that are normally referred to as addictions to distance and distract the conscious mind from the pain associated with the repressed / suppressed trauma.

    Dr Gabor Mate Psychiatrist in Canada spent over a decade working with drug addicts on the streets in Vancouver and found that 100% of the women addicted to drugs were sexually molested growing up. You can catch some of his lectures on youtube. He research concurs with our findings that addictions are merely coping mechanisms rather than occupy some kind of brain chemical / genetic basis. We also find conditions such as OCD and ADHD can function as coping mechanisms.

    Our research also coincides with Dr Mate’s belief that early childhood traumas from birth to about age 7 set the stage for how the subconscious mind will connect future negative emotions with the past.

    Our research shows that when an emotional trauma is cleared the subconscious mind will release the established coping mechanism as no longer being necessary.

    The third wave barely scratches the surface of what will unveil over the next few years.

  24. Mary says:

    Thanks for providing an overview of a history of views and treatments for trauma.
    I would like to hear more on neurofeedback, limbic system therapy, and other brain and body-oriented approaches that include a polyvagal perspective.
    I am interested for myself who had multiple early infancy, childhood and adult traumas, including physical abuse at ages 1-6 months old. As well I was exposed to D.E.S. (diethylstilbestrol) in utero, which has proven through recent studies to have had an 83% effect of psychological disturbances in those exposed. ( it was the next ” wonder drug” after thelydamide). I have spent a lifetime searching for proper suppport and have found some therapies to be most useful, too many to name.
    Thanks kindly
    ML

  25. Gil Shepard says:

    This “Third Wave” has been long used by those involved in the creation of alters through ritual abuse and calculated mind control. True we use it thru things like EFT, EMDR and NFL – but “they” also use these methods.

  26. Sarah says:

    Working with the vagus nerve through a breathing exercise given to me by an enlightened physical therapist has been helpful. I take a breath, hold the breath, then shift between pushing my abdomen out and the push my chest out. Thank you for your work.

  27. Abbie says:

    I am interested in working with therapists as a massage therapist and bodyworker.

    I want to explore the impact of safe, soothing touch integrated before (after, or both) the therapist session.
    I have found a little time gently softening the body allows more spontaneous release of stress and tension than can be achieved without, regardless of technique.

    As a person living a life of trauma recovery for decades, i know first hand the physical pain of mental illness. We have tools to relieve some of those pains. Let’s use them!

    Abbie Yandle, LMBT
    NC #2796

  28. I am a LMHCA in WA state and use Lifespan Integration treatment for trauma. I have also been a client of this mind body therapy and it has changed my life. I am grateful for all of the research and practice that has brought trauma treatment to this point. However, I am also in agreement with Bessel Van der Kolk that PTSD and trauma from long term abuse need to be handled differently. Any thoughts about this?

  29. I have worked for several years ( and written my dissertation on it ) with the way somatic bodywork such as the Rosen Method is a way to release trauma in a safe and profound way that truly shifts the client’s experience and outlook on life and allows for profound post traumatic growth experiences. The term relational Somatic Presence that I coined in this work stands for a certain way the therapist relates to the client and brings her own authentic presence into the process.
    I would be happy to share more about my research, and this powerful method !

  30. Dear Ruth Buczynski,
    Thank you for this synopsis. I too have lived through these developments and for me the significant treatment addition has been using EMDR with complex trauma. I have just finished a spasmodic treatment series with a highly intelligent man which ran across three years, and spanned a development from PTSD to emotional freedom and great career success.

    Briefly, his very young parents had not expected a child so soon in their marriage, and found him very difficult because of his high level intelligence, curiosity and, I belief, mild ASD tendencies. Every day from three years old his mother would tell his father on evening arrival home about the little boy’s daily behavioural “sins”, and the father then whipped him with a cat-and-ninetails. The little boy rarely knew what he had done “wrong”, and developed a body based retreat from fear and pain by “pulling the curtain” across his consciousness. At the age of 16 he bashed his father, who ceased the daily whipping. The young man then began to find escape by drinking alcohol until he passed out, a pattern which when we met clearly required deep and urgent change. Initially terrified, prevaricating and denying, he agreed that we used EMDR, which gave him the “best week of his life”. The fear however was enormous and he frequently refused EMDR, until recently he has requested it, learning to read his bodily sensations, abandoning alcohol as salvation and establishing a pattern of limited social drinking only. His relationship and career futures are now very promising.

    I know I could not have achieved this outcome in any other way.

    I appreciate your offer to partake in your course on the third wave in treating trauma. I’d appreciate the possibility of confirming on Sunday (in Australia) when I will better know my commitments.

    Kind regards,
    Loris

  31. Jane Strong says:

    I work with horses for the benefit of veterans, treatment center residents and others who are willing to experiment with new ways to get ‘unstuck’. We fall under the umbrella of ‘Equine Therapy’ but I’m not sure we belong under that umbrella that has always smacked of pathology and ‘broken vs. fixed’.

    My partner David & I studied at the Somatic Experiencing Trainibg Institute and have embraced Bessel van der Kilk’s work as well as that of Stephen Porges.

    What we find, is that without playing games, or setting clients up to experience frustration, anger, sadness, etc. (as do some forms of equine therapy. We offer vets and others the chance to titrate their experiences and reactions and down and really understand what’s happening to them. We help them discover the somatic markers linked to fear, vulnerability, anger, etc. and empower them with an education along with the experience of working with our horses.

    They get bilateral stimulation, the benefits of oxytocin, trust, joy, innocence and all if what Peter Levine calls….restoring goodness to one’s body.

    Our approach is unique and powerful and offers participants the chance to gain agency over their bodies, their emotions and their minds. We believe it’s time to make some distinctions within the category of Equine Therapy….and we at The Equus Effect are most certainly a ‘horse of a different color.’.

    • Steve says:

      Just surprised that Peter Levine isn’t shown in the same sentence as Dr’s Bessel van der Kilk’s Stephen Porges?

    • Debbie Reichard says:

      Where are you based?

  32. I tried talk therapy, which was less than satisfactory. I received training in Traumatic Incident Reduction, an in vivo exposure technique, which seemed almost too violent for some people. Now I am practicing with sensorimotor techniques, which seem to hold promise. Most people are very receptive, able to use the tools, and find so e measure of relief.

  33. Diane J. Strickland says:

    I work with wives and partners of compulsive-abusive sexual-relational disordered men (often mis-diagnosed as sex addicts). When Dr. Steffens’ research showed that wives and partners were more correctly diagnosed with post traumatic stress symptoms (nearly 70% with PTSD) instead of codependence, the world of healing opened up. Women started to get better. Even if I can only get then to do breathing at first, symptoms are diminished and managed more effectively. Their ability to concentrate and process information returns, and they make better decisions for themselves and their children. Sometimes these women have come from other treatment streams that use the word trauma but don’t actually treat it. I am struck be how many of these women were constantly shamed and berated for “not getting over” what happened. It became clear to me that the counsellor’s trust in the woman’s capacity to get better and affirmation for each step in healing process was critical for recovery.

  34. Carolyn says:

    I love reading these comments and the latest advancements that are more integrative. This motivated me to comment about the powerful healing I see clients do in our integrative work together. I teach an integrative form of trauma work. It bridges the worlds of mindfulness practitioners, energy healers and somatic body-centered trauma specialists. I discovered that when you include subtle energy awareness into the mix, the work goes deeper so healing happens quicker. I do believe the next evolution of trauma work will include a more integrative, all in one approach. I have a free trauma series training that talks about this if anyone is interested, let me know. I think the topic of healing trauma is bigger than just helping people one at a time. I think ultimately, it is about healing deeper world conflict too. Thanks NICABM for doing the work you do!

    • nazeer sultan says:

      can you send me the link please..N-j0y…nAz

    • Julia says:

      Could you please send me the link to your webinar!
      Thanks so much,
      Julia

    • Sandy Lillie says:

      I’m interested in your course too!

    • Ieleen Taylor says:

      I’d appreciate more information on your course please.

    • Debbie Reichard says:

      Interested in your training series and fully agree with your concept of integrated healing being a deeper more
      effective way.

    • Linda Hughan says:

      I am in agreement with this approach and am quite interested in your approach. Would you please send me your information on your trauma series? Thank you.

      • Carolyn says:

        Here is a link to a webinar I just did on the topic. At the bottom of this blog page is the sign up for the Trauma Myth series. Stay in touch! I really think the next evolution of psychotherapy is a more integrative approach that includes subtle energy. As a clinician, I feel as if I had to do a “coming out” party and really speak about the power of working all three mind, energy and body systems into one organized trauma healing modality! Best to you, Carolyn

  35. David oz says:

    Loving all this. I have been on a mission all my life to deal with my childhood trauma and I have tried many of the therapies that u talk about above and more. After many years you tend to give up hope because although you are very knowledgeable, the trauma and the symptoms remain. Phase 3 has very much given me renewed hope. Thank you

  36. Bern says:

    It is very exciting times. I also feel that there is a fourth area of the brain to to be explored – the role of the cerebellum in relation to freeze in relation to the importance of mindful movement as a healing approach. Also the importance of the voice/ hearing is rarely mentioned and is so important in ventral vagus healing. So often PTSD involves long periods of silence in freeze because there are no words to describe what is being experienced. Just sounding on the out breath can be very healing.

  37. s a psychologist working with people who are working through trauma and as a woman healing herself I can see that a one size fits all approach does not work. Our understanding of how trauma works and the fact that our traumatic experiences our lived in our body naturally will inform us to create tools and processes that can facilitate wholeness. However, it seems that each person’s journey will be different and what that person needs to heal will also be different. Personally, I have sought many body based therapies and sometimes dance and journalling will be all I need to work through whatever I am experiencing. At other times I have wanted to talk or be supported from a therapist who can create a safe space. Ultimately though what I have found that works the best is for me to create a safe place inside of me. Inviting, holding, accepting, softening into numbness, pain, frozen parts of ourselves can go a long way to ease us back into the flow of life.

    Thank you, Ruth, for inviting us all into this conversation. Your work is much appreciated!!

  38. Michelle Kelley says:

    Hello from Iowa! I’ve worked primarily with complex trauma throughout my career and I agree it is an exciting time but I think we have far to go. I use E.M.D.R, E.F.T, art and play therapies, and guided meditation to access that right brain toward integration of trauma into the client’s narrative. I wish i was taught these techniques right out of school years ago. But thanks to the work by many wonderful pioneers and researchers in the field of trauma, I’ve learned much over the last decade. When treatment works for someone who believed they would suffer for the rest of their lives, it feels like a miracle. We have to keep exploring new treatments and training the next generation of young therapists. I really appreciate your trainings and articles and share insights with my colleagues. Your work and the work of the practitioners is important! Thank You!

  39. As a psychologist working with people who are working through trauma and as a woman healing herself I can see that a one size fits all approach does not work. Our understanding of how trauma works and the fact that our traumatic experiences our lived in our body naturally will inform us to create tools and processes that can facilitate wholeness. However it seems that each person’s journey will be different and what that person needs to heal will also be different. Personally I have sought many body based therapies and sometimes dance and journalling will be all I need to work through whatever I am experiencing. . At other times I have wanted to talk or be supported from a therapist who can create a safe space. Ultimately though what I have found that works the best is for me to create a safe place inside of me. Inviting, holding, accepting, sofening into numbness, pain, frozen parts of ourselves can go along way to ease us back into the the flow of life.

    Thank you Ruth for inviting us all into this conversation. Your work is much appreciated!!

  40. Hello, Ruth,
    I know of two therapists who use a very complicated feedback therapy where music is an essential component. Today I am sending you a brief summary of my discoveries that began in 1997 with my first personal encounter with the Tomatis Method of music therapy. When our son’s relapse from his treatment resulted in schizophrenia, it took me 10 years to discover that a very simple music therapy in use by millions of people could cure his schizophrenia. But not his addictions. When he relapsed two years later, I set about to learn how and why music could alter brain function and succeeded in making some groundbreaking discoveries that include the right ear’s control of the vagal networks. I think you will be happily surprised!

  41. Valerie Feeeley says:

    Also, EMDR is a combination of light, tolerable exposure and cognitive interventions – the bi-lateral stimulation works with the way the brain works to properly store memories and end re-experiencing. I would not list it with guided imagery and hypnosis though I understand why one might.

  42. Valerie Feeeley says:

    Neurofeedback is an exciting avenue of research – and quite possibly the future or the route of futre trauma treatment. However, the training and equipment can cost over $20,000. I work with trauma everyday, mostly complex trauma and having trained in CE, CPT and EMDR, I find EMDR to be the best tool available to me NOW, it is gentle and heals on a deep level.

  43. Laurie Teal says:

    great article! Thank you!

  44. Tobias Schreiber says:

    Over the past decade the expansion of useful knowledge has been enormous. We now are developing assessments and treatment that encompasses the whole being and the connected environment. Thank you for your insight and encouragement.

  45. A helpful, concise update and summary! Thanks

  46. A helpful, concise uodate and susmmary! Thanks

  47. Kim O'Donnell says:

    I loved this article, thank you so much!! Although CBT is still the only “accepted” recognised therapy in Australia, EFT is starting to gain traction. I love working with the body-centred therapies and also incorporate heart opening exercises and visualisations as I see a lot of progress when using processes that integrate the mind, body and spirit.

  48. Rachel says:

    I’m new to this and fascinated. My own therapy is from a paychoanalytic perspective and I’m very interested in how this approach overlaps – concurs and disagrees. Any suggestion for reading welcome!

  49. Margie Strosser says:

    The disciplined practice of meditation in the Tibetan tradition has “cured” my PTSD over the course of several years. The teachings of being present, self compassion, compassion for others and the path toward waking up are time honored wisdom for human beings managing trauma. The practice is the syntheses of body/mind/ spirit which continues to support new discoveries in neuroscience.

  50. Judi Barwick says:

    Since training in Brainspotting I feel I am able to assist clients much more effectively. I love working at this somatic level. I can’t recommend this method enough…I love David Grand’s explanations and you tubes.

    Brisbane Australia

  51. This is a great summary of the waves of change in our understanding that is leading us to be more aware of the psychobiological processes involved in working relationally with people who carry trauma. The polyvagal work by Porges has helped me regulate myself more readily in situations where I can be triggered emotionally and lose touch with clients, and teach clients simple steps to open their window of tolerance that will enable us to work together with what is arising. Thanks so much for all you bring to us, your work continues to be major platform for my learning, personally and professionally.

  52. Simone Maree Rae says:

    The fear of actually being successfully successful in life and what new works out for me!!
    Far from too emotionally to explain any further.
    Other than ….
    No vocabulary discribes that energy field.
    I surrender tho. I need to let go of my past. It dies not serve me anymore
    Which I could believe 24/7 until I’m fully there.
    Back to presently now namaste

  53. Danielle says:

    TRE by Dr. David Bercelli is phenomenal

  54. Fi says:

    I totally agree with Isabella, the main problem being the division between mind,body and spirit and not recognising the person as a whole individual! Whils I think it is brilliant that new waves of therapy and breakthroughs are being explored,I also think that sometimes “back to the future” old therapies need to be revisited and reconsidered,as a neurodevelopmental psychologist(among other things) I am surprised that basic techniques such as NDD(reflex therapy) are not taken into account,still this is a very healthy and exciting forum and I am so glad to be part of it!

  55. Marianne, psychotherapist and trauma therapist says:

    I miss here Somatic Experiencing by Peter Levine working with the trauma underlying and trauma feeding physiology, including the Poly Vagal Theory. Absolutely great therapy. I did not meet anything better in the field.

  56. I concur! completely with what you said. Good stuff. Keep going, guys..

  57. David Dressler says:

    Are you familiar with NeuroKinetics? (Important to spell it that way exactly or you get an equipment company in the US or somebody doing some kind of bodywork in Australia.) NeuroKinetics is a traumatology clinic in Vancouver, British Columbia, Canada. I worked there for awhile. I was the communications person who described this cutting-edge trauma technique to the public, physicians, insurers, and media. I will attempt that here.

    NeuroKinetics was developed by Dr. Philippe Souvestre, an MD licensed in France. The technique was used in the French Aerospace Agency on astronauts! Did you know astronauts are traumatized–not when they go into space or through a rough landing back on Earth–but by their safe return to their home planet? Astronauts show all the symptoms of physical and emotional trauma: dizziness, imbalance, depression, anxiety, emotional instability, acting-out…. And for no apparent reason.

    But there is a reason. In space, the brain begins to mutate. It starts to change in ways it has never done in millions of years…in response to the absence of gravity and an horizon. These are two of the most fundamental ways in which the human brain orients in the world: vertically by sensing gravity, horizontally, which means three-dimensionally being able to move in all directions on the world (walking, turning, etc.). Babies have to do this orienting when they learn to stand up and walk. It is fundamental to brain development.

    Gone! in a few weeks living in space.

    Shocked–traumatized–on return to the gravitational field of Earth. In a word: disoriented in the central nervous system.

    The definition of trauma at NeuroKinetics is the inability of the CNS to adequately process incoming stimuli from the peripheral nervous system. What does this mean for therapy?

    It means that massage therapy for the tense muscles coming from stress does not relieve the source of trauma because the messages from the PNS (musculoskeletal system sensory nerves during massage) are not being integrated by the brain in the usual (pre-trauma) way.

    It means that verbal psychotherapy doesn’t work because the words heard by the traumatized person’s hearing apparatus are not being received and interpreted by the brain in the way the speaker intends or the way they would be interpreted pre-trauma. So, the astronaut-patient may not be helped or may act out in response.

    What does work? What does affect the CNS? Drugs. But they have side-effects that add to the trauma, so in the end they don’t work.

    Here is the unique NeuroKinetics treatment for trauma that is both physical or mental, sudden or slow developing….

    We know that information travels by two essential means from PNS to CNS: via nerve pathways and by hormonal signalling. The fight/flight/freeze reaction is one typical example of neuro-chemical transmission. But in trauma, these pathways are compromised so that signals do not get through accurately and are not properly processed by the brain.

    But did you know there is another pathway?

    Russian research as well as European has discovered that cells communicate by what is called “bio-photonic light.” Cells emit light. They “talk” to each other by way of this bio-photonic light. As long as a person is alive, these cells are still communicating, uninterrupted by the trauma or any other means. Think what this means….

    In the NeuroKinetics treatment chamber, a patient with (say) traumatic backpain steps onto a platform. Her feet are standing on two detector plates connected to a computer. This person has chronic scoliosis and is in pain due to a motor-vehicle accident perhaps years ago that did not resolve with various physical therapies, chiropractic, massage therapy, etc., and no amount of counseling has helped much. The plates are now warming up, ready to….

    …emit biophotonic light into the soles of her feet. There is a pleasant sensation in her feet… In less than thirty seconds, she lurches slightly and is standing up straight for the first time in perhaps years. She steps off the platform, dazed, amazed, saying “What happened? I feel so much lighter! The pain is gone!” I witnessed this. It happened.

    I tried the treatment myself. I could feel my feet warm, and then a second later I felt my heart “open” the way it does when having a revelation or emotional insight, and I began to cry. But no thought content. I asked Dr. Souvestre what had happened. I said it felt like I “got” some insight but there was no cognitive content. He said “You ‘got got'”. He later elaborated a bit and said that the light had been transmitted cell-to-cell from my feet to my brain, and my brain “got” the message clearly, completely, re-orienting its processes. I gather this happens during an insight that changes one’s understanding during effective therapy. In my case, I wasn’t in need of therapy so there was no content change, just what felt like a white light going through me.

    The point here is that there needs to be a direct, uninterrupted connection between the outside world and the inside world of the brain in order for the brain to re-orient after any kind of trauma. When the neuro-chemical pathways are compromised–as they are in any serious trauma–this reorientation cannot take place and peripheral therapies (those affecting the CNS via the PNS which is compromised) don’t work adequately. The good news is that the biophotonic pathway remains unaffected and messages from the external world to the brain can be transmitted cell-to-cell-to-brain via this light.

    NeuroKinetics had an 85% success rate at the time a few years ago when I worked there. This figure was supported by research in the literature as well. Part of the reason for its success is the two-hour assessment that went on for every potential patient. No one was admitted who did not show a strong likelihood of being cured by this approach.

    The clinic also used other therapies–acupuncture, EFT, homeopathy, but biophotonic light was the key to success.

    • Marcia says:

      Wow! This is a wealth of information. I so appreciate the sharing of your work and everyone else here. This article helped me begin to understand in some fashion more about the nervous system. I had a stroke over 10 years ago and was paralyzed on the left side suddenly. Once you experience this you never take the nervous system for granted. It took over a month for the motor planning center to start to reconnect what I had learned as that child learning to walk. I would be perfect today if I had not got too cocky after I finally could get out of the wheel chair and off the cane, then broke my tibia and fibula so badly had to have surgery. There the connection stopped and for the past years have not only had to heal with metal and screws in my left leg but fell six more times and broke 8 bones. If I had known about this neurokinetics perhaps I might have not been so damaged as I am today, still having tremendous fear of falling. Still just cannot maneuver my motor planning center to navigate sufficiently after I had to have a hip replaced after so many falls. Once that was repaired the motor planning center was again at a loss as to how to change that system again. That stroke and all those falls ruined my body mechanics once again. It has also inhibited prevented healing of childhood traumas as that fear of falling keeps me in the FFF response. Working with vets you can easily understand what causes their slow healing. It is gratifying to work with them to help them overcome their many fears, but still feel like a charlatan my self as I am not as efficient as they become in their own healing process. We are getting there slowly but surely. The marvel of the mind and human body gives me hope. When clinicians get together like this, it brings us all closer to ultimate answers. Thanks for sharing. I will look further into neurokinetics for myself. I long to ride a bike again, or walk the ocean knowing I can get over the fallen trees that block the coast line. I use what was given to me by a neurologist a book called SuperBetter that disusses how games can repair traumas, to a point that they used virtual reality to drop burn victims pain down to 25%. I also encourage truma victims to use certain games to help with flashbacks and find they have helped me in many ways. It was always clear to me over the years that ADHD children were getting a benefit from hand held games that did help their focus in ways that were hard to realize by parents. They have done 30 years of research regarding video games for determining what can help certain areas and what is harmful.
      So many questions and so many answers. It is time we do more collaboration to share these ideas instead of keeping them to ourselves.

    • Jenny Berry says:

      This is really interesting. Would it be possible to have references for the literature you mentioned?
      Thanks.

  58. MrSportPsych says:

    The Psychophysiology Lab and Biofeedback Clinic at ECU uses biofeedback and psychophysiology to help Americas wounded warriors heal the emotional wounds of war.
    http://www.youtube.com/watch?v=kDlKRA_vURk&feature=player_embedded

    Carmen Russoniello, PhD, LRT, LPC, BCIAC was the President of the Association for Applied Psychophysiology and Biofeedback. He is currently Associate Professor and Director of the Psychophysiology Lab and Biofeedback Clinic at East Carolina University. Dr. Russoniello teaches undergraduate and graduate biofeedback courses through a first of its kind global classroom initiative and directs a biofeedback program for Wounded Warrior Marines at Camp Lejeune. The novel biofeedback intervention involves EEG and heart rate variability feedback and includes the use of virtual reality. Dr. Russoniello is himself a former Marine machine gunner and decorated Vietnam combat veteran.

  59. Deb Schneider-Murphy says:

    We’ve gone through many waves of learning about trauma, and we’ve developed many paths and many approaches to healing as we continue to learn more and more.

    I have found the work of Ruella Frank, PhD to be a fascinating, effective, RELATIONAL and EMBODIED approach to mental health treatment, and specifically, trauma treatment. Dr. Frank has studied early non-verbal communication and how these earliest of relational patterns can determine things like susceptibility and resilience later in life. She looks at movement patterns between child and adult that get reenacted between therapist and client. These patterns communicate need, create contact or misattunements, and make up the process of repair.

    It is the RELATIONSHIP that becomes the medicine, the means of rewiring the brain, the means of restoring health, and learning to trust in Benevolence.

  60. Aub, Allied Health Professional, Canada says:

    In 2012, traumacentre.org had a note on their web page about neurofeedback. something to the effect that while some practitioners had seen ‘amazing results’ there was still little in the way of research based evidence to back this up. Today, the same site promotes its neurofeedback services. What has changed? Did anyone make new discoveries or is this third wave the precursor to the 4th, 5th, and 9000th waves that will crest and crash?

  61. Debbie Bohnet Los Gatos CA says:

    I need referrals to local practitioner’s in Santa Clara County doing this kind of work who are also skilled and experienced with multiple personality or whatever it is called.

    My brother was severely and repeatedly traumatized for at least 6 years starting as a 10 year old and has what looks like to me different personalities that helped him out at the times.

    Now he is so complex but I see him as someone quite extraordinary to have survived so far.

    All they want to do is drug him but what about helping him resolve his issues which he has expressed a great deal of anguish about?

    • Anna Kohn says:

      Adam Crabtree, a registered psychotherapist in Toronto and a faculty member at the Centre for Training in Psychotherapy, has worked extensively with multiple personalities.

  62. MichaL Curry,HealingTouchP,SantaFe, NM says:

    I have been practicing trauma healing since Hurricane Katrina. I learned an energy technique that is called Head to Heart Reconnection. It begins to reset the amygdala in the brain. It literally follows the fight-or-flight in the body. The other great aspect about this technique is that you can teach it to clients to do on themselves. Dr. Harvey Zarren & I have been using this technique for years. I have many stories about this & would love to share them with you.
    thanks for all you do–MichaL Curry

    • Debbie Reichard says:

      A link would be great pls

    • Sherry Belman says:

      Mivhal Curry, Please send a link, thanks

      • Marcia says:

        Yes, a link, please.

  63. elena says:

    Nice wrap-up, Ruth.

    I’m looking forward to the next layer coming forward, to unlock Attachment-Bonding traumas in the mother-baby dyad and family circle (our first relationships)- in the womb, birth experience, neonate, infant and toddler. I think these earliest experiences will open our eyes to CORE INJURIES and EMOTIONS,to how we PROJECT and mirror these in a reciprocal direction, and how to repair relationship–what might be most easily described as broken-heartedness.

    • Marcia says:

      If any of your ever have a chance to do research observing mother and infant dyads, you will learn so much about those first months of bonding and how the personalities are affecting mother and infant. I worked as a researcher for my Ph.D at the children’s psychiatric clinic for a year and that benefited me in attachement understanding observing these dyads. We all have a gold mine of learning in this research forums if one can get you foot in the door. I am semi retired but want to do more and more research pursuing answers and reforming truths as new information is gained in the process. Learning for our sake and for the client is truly a gift.

  64. Rokhsareh S. Shoaee, LPC, LMFT/PhD, Annandale, VA says:

    I enjoyed reading your piece on “The Three Waves of Treatment of Trauma.” I have been using new neuroscience research, tools and techniques in my practice with individuals, families and couples. I certainly see the great impact on treatment of my clients, especially professionals who may not believe in therapy at all. Thank you.

  65. Robert Kinstler, Software Engineer, Townsend, Massachusetts says:

    If the understanding of trauma and treatment has increased so dramatically in recent years, why are the distinctions between single-event trauma (e.g. rape, natural disaster, violent attack and other traumatic events), repeated traumatic stress (e.g. combatant, hostage, refugee, prisoner, ghetto dweller) and chronic childhood traumatic stress not being elucidated? Could it be that the fear of losing professional standing by contradicting the DSM 5 is causing self-censorship? A quick search of the NICABM web site confirms that c-PTSD and DTD are forbidden terminology. It’s a sad state of affairs when van der Kolk is gaining so much attention, but his work to have these disorders recognized is ignored.

  66. B. Savage, Canada says:

    A gentle correction: “Freeze” and “Feigned death” are different responses. “Freeze” is a very alert, very aroused, very tense, state of immobility – a sympathetic nervous system response. “Feigned death” is a state of collapse rather than arousal, with an absence of muscle tension – a parasympathetic response.
    Thanks for all your postings, Ruth!

    • Sylvie T, Canada says:

      B. Savage, thank you for this precision. An important one. They are indeed two different responses. I’ve experienced both. They sure feel different­.

      And thanks to everyone for your comments. I’ve learned so much from the webinars and the postings on trauma in the last two years !
      Sylvie

  67. Barbara Belton, M.S., M.S., Colorado says:

    Read this post with some tears in my eyes….as I travelled this path on, as they used to say, “the other side of the desk”. Am amazed at 66yrs of age how much I’ve learned, how far I’ve come, and how deeply I’ve healed. Not sayin’ I’m done yet, but…well you understand. So often along the way I met just the right person or persons who held gifts of knowledge, insights for me and offered them with open, compassionate hearts always affirming my ability to find my way….like you, Ruth and NICABM. Thankyou seems faint praise in light of the bigness of the gift! I offer you and all those who walk this path professionally my own deepest gratitude for your persistence, your insistence on believing there are and finding answers…your sisterhood and brotherhood call us home!

    • Net says:

      September 25, 2012I wish I didn’t have the fraadgrance senadsiadtivadity. It really limadits where I can go and who I can be aruond. The chronic pain is bad enough.Today, I have a lot of pain, which is typadiadcal. Can’t take drugs, so movading aruond is very slow. I have numeradous tools for the emoadtions, but as you well know, they can still be very difadfiadcult. I’m getadting betadter at using them, though.Right now, as I am catchading up on blogs, I’m draped in a few heatading pads for the more painful areas, breath deep, and sip hot green tea. I look out the winaddow and enjoy the vibrant autumn coladors along the mounadtainadside, and the birds freadquentading the feedaders. It’s imporadtant to try and find ways to self soothe like this whenadever the chance arises.Thank you so much for asking.

  68. Jill, Healing , CA says:

    checking to see how the posting process works

  69. Jill, says:

    Checking to see if my entry was posted

  70. Jill, 12 Step attedee says:

    I am wondering why no one ever mentions the positive contribution that 12 Step programs have made . I look for therapists who are oriented towards the combing therapies of all kinds with all that 12 Step offers. Also , it is my experience that the sex addiction field of therapy offers rigorous treatments for both the traumatized addict and co-addict.
    I am appreciating the webinars , last years series as well. I take what I like and leave the rest . I have gained much in the way of healing and am encouraged so much that I can heal . Without 12 Step meetings I don’t think I would even be here. It has been and continues to be the cornerstone of my healing.

    • Barbara, Psychotherapist Western Australia says:

      Yes Jill you are correct. The many benefits of 12-step groups are often overlooked. They can provide a great sense of belonging and acceptance for some which can slowly work toward healing attachment/developmental trauma through members “loving you until you can love yourself” and the sense of “shared experience”.
      There are many other useful benefits in 12-step groups….someday I may endeavor to illustrate these many ways in writing. Cheers from down under

  71. George Patrin, MD, MHA says:

    Esta Rose – I recommend you look at the ACES website for the most inclusive definition of “trauma.” Adverse Childhood Events” (ACEs). It’s definitely not all about Traumatic Brain Injury (TBI) although the lay public might think so. The emotional traumas are perhaps, the most debilitating and long-lasting.

  72. Esta Rose psychoanalyst/psychotherapist NYC USA says:

    I have enjoyed the audio webinars. They both refresh and teach.
    Can someone define “TRAUMA” for me? I am not sure what a “significant incident” or a chronic “significant condition” as opposed to a trauma. It must be subjective on the one hand
    or is there another way to define it.
    Thank you,
    Esta Rose

  73. Carl Robbins, LCPC, Baltimore, MD says:

    I am disappointed that your essay does not discuss the robust evidence base for treatment of PTSD that includes a number of studies demonstrating the efficacy of Prolonged Exposure, Cognitive Process Therapy, and EMDR (which you do cite). According to the National Center for PTSD – reviewing meta-analyses of trauma treatment research:

    “Evidence-based treatments for PTSD work. All of the treatments we discuss—CPT, EMDR, PE, and SSRIs—help people with PTSD more than no treatment at all and more than alternative treatments that are available in the community. For people with PTSD, the best bet for recovery is evidence-based treatment.”

    The difference between the 4 interventions mentioned and alternative treatments is profound in terms of effect size.

    Ruth, I appreciated the regard and reference to the evidence base (on treatment outcomes, not just neuroscience) in your seminars on mindfulness. I don’t understand why you wouldn’t bring the same rigor to this discussion of PTSD.

    Where do you see the effective (in fact, superior) Cognitive Behavioral interventions in your 3 waves? Certainly, CPT and PE should not be regarded as traditional “talk therapy.”

    To include tapping and guided imagery but not PE is a puzzling choice.

    • Julie, Nurse and Psychology student, Penna says:

      I spent quite a bit of time on the National Center for PTSD website, and found it very helpful. However, in their analysis they more or less dismiss hypnosis as an alternative therapy with scant evidence base. I looked at their references, and they were basing that on one article from the Netherlands with a tiny sample size, and half the subjects actually in bereavement. There is a substantial body of research related to hypnosis in PTSD, whether as the primary therapy or an adjunct. So I began to think the authors decided what the important therapies were beforehand and didn’t make much effort to include anything else. It made me view the website more critically.

  74. Gertrude, healthadviser, traumasurvivor says:

    Thanks for this Ruth. Being in those therapïes earlier were just subsequent traumas or edged them even more into the groves of my brain. Some therapists really caused harm, brought me close to suicide. But this new wave, Bessel van der Kolk speaking in a lecture, not yours, got my hopes up again. I went to the wrong kind of Neurofeedback first. The Zengarmethod. Which claims to influence the brainwaves unconsciously. Since your lecture of Bessel, i did some further googling and had a trialsession with the right kind of NeuroFeedback. To be able to come even close to the 300-400 sessions Sebern Fisher mentioned, i will have to learn the method myself, as i did many other methods, and go into a process of occasionally a practicing with a therapist, a measuring of QEEG and having the discipline to practice myself at least twice a week or more. For many traumapatients, a career, an healthy income never happened. We are living of low sensitive budgets and still have to continue living, often for others. Like i have for my children, grandchildren, even when contact has broken with 2 sons, 3 grandchildren, next monday 4. You once talked about secondary trauma for therapists. You have no idea how it is for children growing up with a mother like that or trying to stay when that mother goes deeper into the process of healing without any therapy. I can just listen to your lectures, read books, do an online workshop and/or buy the equipment myself. i guess in a way with an inability to allow anyone in, possibly being my own therapist is the only safe way for me. Wish the professional field would dive into that more as well into realizing it is like Russian Roulette to have the luck to find a good or even adequate therapist, capable of real help. In an earlier webinar by Pat Ogden i got the impression she also did not know how to treat prenatal trauma. Seems in between lectures she found out how to approach it. Not talking the best suggestion i heard in a long time. I doubt if many therapists would dare that approach. I also loved the approach of a belgian psychiatrist, which i did some 20 years ago, Karel Ringoet, who made his clients/patients go back into the womb, a construction hanging in the deep end of a swimmingpool, which one entered with divinggear. There i was lucky of the psychologist taking a special interest in me. I could connect with her being a mother herself, and through that make a connection with my own imprisonment inutero. The man was ridiculed when giving a lecture at some congress in London at that time. Maybe something for you to look into. Maybe these times are ready for his therapy. I never heard of limbic therapy, but will look into that. Another bodytherapy is Kahunamassage. I had one session, and it reached me, then my therapist fell down the stairs and tore a sinew, and for 4 years she did not heal, after which i had to end the not working talktherapy she replaced it with.

  75. Letha Marchetti, Occupational Therapist; San Rafael, Ca. says:

    Having survived a nasty auto accident, and begun Somatic Experiencing treatment, I soon realized the symptoms I saw in the children I treated were my own.

    It was a major help as I provided OT to recognize that, indeed, these young children had been overwhelmed. A difficult birth, being adopted & other attachment ruptures are typical for my clients. Using body based, sensory informed treatment (combined with parental education) has been my most effective approach. Of course, I must avoid the word “trauma,” lest a parent become traumatized.

  76. Elsa, writer, thinker, poet, Canada says:

    The changes are fascinating – and make so much sense. Thank you, Ruth, for being so central in bringing this out much more into the world. Elsa

  77. Brigit Viksnins, SEP, RCST, Silver Spring, MD says:

    Looking forward to the wave when practitioners are trained in detailed tissue and fluid hands-on work (limbic therapy), mindful presence, embodiment, advanced energetic and autonomic awareness, self- and co-regulation (+IPNB), secure attachment, verbal trauma-related skills, completion of unfinished motor patterns, thawing of frozen parts (physical, emotional, mental, spiritual, etc), cultivation of health after transformation of dysfunction…. When not only healthcare practitioners but also teachers, parents and more of society would have a clue about what is possible in healing. Yes, the healing field is moving in a positive direction. Thank you, Ruth, for what you have created to help spread the word of what is possible now!

  78. Camilla Mowbray, Equine therapist, psychology undergraduate, Sydney, Australia says:

    I am very new to this field, but have been drawn to trauma recovery through my work with horses. The opportunities for opening up new treatments are phenomenal, and I hope to be able to be involved in delivering some really good, evidence-based programs over the coming years.

  79. Mario says:

    All very interesting. Whatever the method, it has to become safe to fully occupy one’s body. And many of us don’t, whether we’ve been traumatised or not; so what’s going on there? I believe that the shame aspect and the sense of victimisation is a very important element to work with. Our existential dilemmas and the body’s vulnerability can often produce a sense of shame. This may be why Peter Levine speaks of trauma having the potential to open to spiritual awakening; that aspect of our being that is invulnerable – providing we can remain grounded. Donald Kalsched describes trauma as any experience that is overwheliming to the psyche. How much of the psyche’s content is displaced onto the body, who knows? Is this why the body becomes hated? Then the task to have the perfect body or at least a better body becomes the goal – commonly seen in eating disorders. So we not only need to feel safe in the body; but safe in the mind too. How do we fully occupy our mind – the psyche, the soul, our grounded conscious being? All very interesting to me.

  80. Tracey Rowe, Social Worker, Australia says:

    Working in the field of out of home care, (foster care and residential care)I have studied through the Australian Childhood Foundation, they have great resources on their website. I have working in the field of social care for over thirty years both with adults and children. What strikes me is some of the early learning links into the recent research, we did not always know back then why working within Rogerian principles worked but now we know about the importance of relationships and establishing safety upon the brain. Also, Intendive Interaction (Dave Hewitt) had some amazing results working with people with learning disabilities and autism. My training and subsequent study on neurobiology explains why this was so successful. More research should be done in this area, we need not to work in silo’s but incorporate this knowledge about the brain across other fields.

  81. Lili Hudson, hypnotist, Nashville, TN says:

    Not receiving the confirmation email. Your series are of such high value, I don’t want to miss. Please resend.
    Thank you

    • NICABM Staff says:

      Hello Lili,
      I am sorry that you didn’t receive the email from us that contains the link to watch the broadcast. I have just emailed that access link to you so that you have it for the remainder of the Rethinking Trauma program. Please let us know if you have any other questions.
      NICABM Staff

  82. Robert Royeton, Pre-school teacher and Parent Coach, Walnut Creek, CA says:

    I haven’t worked specifically with trauma…at least with adults. I worked as a child therapist in the 70’s and 80’s. I did work with children who had experienced trauma. I used play therapy and worked with the parents helping them to re-bond with their child. I was in London and was aware of the work John Bowlby was doing. I was working blind. In fact one 3 and a half year old had been kidnapped and wasn’t found and rescued for over a year. I did see the little girl in play therapy, but mostly I worked with the parents. The father was actually blind and I used his blindness as a metaphor the work we were doing. I knew that we had to try to re-build attachment. Well, the story goes on, of course. I just wanted to share a little.

  83. Don St John says:

    Love your synthesis of third wave approaches. I predict a fourth wave. In my forth coming book i argue against the model of trauma/no trauma. (Based on my forty five years of personal healing–near death at birth, extreme abuse, violence, serious beatings, constant verbal assaults, etc throughout childhood; and upon my professional experience as a psychotherapist, movement teacher and structural integrator). I argue for a model and ideal of coherence–based on the biochemistry/quantum physics of Dr Mae-Wan Ho, I believe we all have a great deal of room to grow in the direction of coherence. Simply defined, coherence is a state in which both individual autonomy and global cohesion are maximized. I argue this applies to the body-its tissues, structure and movement. It applies to our psyche, identities, beliefs and emotions. And it applies to our relationships. Hurray for the right brain, body oriented treatments coming in; but let’s go further. We’re all on the same bus.

  84. Sandi Wilson, Clinical Psychology says:

    My first PTSD case was in the mid-70s. I used talk therapy, visualization, the two chair technique, and some body work to treat her. Since she did not have clear memories of some of her experiences but was having nightmares giving information, I helped her to reframe the nightmares to her mind’s attempt to give her information and help her understand what happened to her. I definitely was flying by the seat of my pants on this one, believe me. Back then, I don’t think anyone in my sphere of practice had ever heard of working the way I was working, even my supervisor. My work was more intuitive than learned skills but she and I learned together and she improved significantly during her treatment.

    A few years ago I became certified in Trauma-Focused Cognitive Behavior Therapy, and have used it with traumatized children, and adapted it for adults to some extent, but I find a combination of treatment approaches to be most helpful when working with people who have developed PTSD subsequent to trauma.

    • Marcia says:

      I , too, enjoyed TFCBT until I discovered the SNS and how one can get stuck and still function quite affectively until the crash into the PSNS. That understanding knowing more about Porges work, helped open up a whole new base of information to augment the trauma work. I knew so well about my own traumas but ther connection was not connected to the body. the TFCBT connected it well to amygdala and hippocampus but the nervous system was the other part of the puzzle. the nervous system, the TFCBT and hypnosis with that connection to our subconscious seems to aim to more affective comprehensive healing.

  85. Connie, Psychotherapist, C) says:

    What exciting time it is for working with trauma. It has changed my appoach to working with trauma to a more body centered approach.

  86. Laura Plumb Ayurvedic Medicine says:

    Truly with all due respect, you are not the pioneers. The sages who first taught Yoga understood all this. That is why Dr. Bessel van der Kolk repeatedly cites Yoga as the prime tool for trauma recovery. With respect and gratitude.

  87. Corina Vanana Valcan says:

    Many persons observed that now a lot of their colleges and people they know have this traumas but a lot of them can forget about the traumas. The answer how, it is to have a good education, without lies and also be connected to a spiritual, religious side. Yoga, Reiki and natural medicines are also a very good side for them and in case some of such trauma persons can collaborate between them is a more happier possibility. Most of all to concentrate on their mind and stay equilibrated.

  88. Martha Woods, support group for trauma says:

    In the post below our group has predicted more workplace violence on the horizon. If you can acknowledge what we are saying we would love to hear from you.

    please post a comment or call me at 25 three, 32 six, 4 four 85.

    thanks.

  89. Martha Woods, support group for trauma says:

    The main changes we see in Stop The Bullies is that workplace bullies are getting sicker, sneakier, and more malicious. It is a sport to these people, and the Targets are getting more injured. Most have to stay in the abusive environment to survive.

    We are also seeing more and more people who have been bullied out of their jobs and have NO financial resources whatsoever. Most find themselves with a diagnosis of PTSD, whether or not there was some physical abuse by their bully. This group of people is SINGULARLY unable to pay for treatment. Mostly, bullying happens not to the inept (who simply get fired) but to the conscientious employee who has years and years of civil service with excellent performance record.

    Please note: It is not the fired employee who is in this position – it is the employee who is tortured then fired some years later. These are the kinds of situations where people return to the workplace with a gun or knife.

    We predict more work violence as long as America does not care about these victims. This is not to condone the violence, but when someone’s ENTIRE LIFE is masticated (i e they lose their job, career, health, health insurance, retirement, home and family) that person is left bewildered and unable to pay for even the simplest mental health care.

    While I applaud Ruth and her colleagues for disseminating this information, I hope they spare a thought for our folks – people who were maliciously bullied out of their jobs – They need mental health care as much as the combat vet. Our group members who have been in hand to hand combat and have also experienced one of these bullies tell us that the constant and merciless abuse for 8 hrs a day at the hands of a malicious bully and over a number of months or years – they tell us the workplace bullying is worse – WORSE. WORSE than for 9-11 rescuers – WORSE than being a train driver and have someone throw themselves in front of your train .

    Who should pay for their mental health care? If employers had to pay, then they would rehabilitate their bullies or fire them. We have one bully who was not removed until she bullied 24 people out of their jobs. This woman grabbed her subordinates IN BETWEEN THE BREASTS !!

    Please could someone respond to this post? Thanks. You can also call me at 2 five 3, 32 six, four 485. Thanks.

    • Stop The Bullies - support group for Targets says:

      We are here for you!

    • Lois Psychiatric Nurse practitioner, Atlanta, GA says:

      I agree with the incredible increase in workplace bullying and victimization. From an anecdotal standpoint, I was the victim of workplace bullying and ended up having what we term as “a nervous breakdown”…I think it more a breaking point in the stress/diasthesis model-the point that tipped things over (I also have significant childhood trauma) and I think that the bullies so to speak are targeting folks who already have baggage. This work is instrumental in so many ways, which is why I went back to school to become a psychiatric nurse practitioner, focusing on trauma. Odgen’s work is critical to being able to move past and incorporate trauma from any situation and release the energy that trauma holds.

      • Stop The Bullies - support group for Targets says:

        Lois, our group members concur with what you are saying.

  90. Margaret Jones Callahan, MA, RCC BCATR, MBAT teacher says:

    I appreciate your series a lot as you keep refining your “up-dates” of our field and I try to stay connected to your work.
    I have worked with the freeze response with clients for many years using MBAT, mindfulness based art therapy approach, with specific techniques for generating new resources, and releasing old patterns of response to trauma. I notice that you do not include art therapy in your series. Is there reason why?
    Thanks for all you do.
    Margaret

  91. Roro, psychotherapist, Ca says:

    Mindfulness plus meditation have been very helpful.
    Roro

  92. Eileen Balint says:

    I am not a therapist. I am someone who tries to understand PTSD from the inside out as well as from the outside in. I sincerely hope that this third wave moves us closer towards realizing that as long as a division exists between the analyzer and the analyzed … it will be business as usual. The Mindfulness Movement comes closest to understanding that a psychological dualist approach between client and therapist only perpetuates the past and therefore inhibits moment to moment awareness and insight.

    • Marcia says:

      That seems to be why Rogerian therapy is so affective as part of the answer, but it is just not that simple if one does not understand mental health from a holistic standpoint, i.e. mind, body , spirit. thersapy is as complicated as our body yet using a computer term it is good to sync all these many ideas from so many specialists. Quantum psychology also plays a role in healing if one believes in this theory by Wollensky, as I see this more and more begin brought into my office by any numer of clients. I use the Tonglund method to help in the healing process, while another toolbox tool is to use a CBT tool of thought stopping. Ken Wilbur says we need to meet the client where they are and wrok from thers and that is why it im imperative to have a way into what the client needs. I have rarely met two with the same distinct needs. What is good for the goose is not always good for the gander.

    • Fanny says:

      Home run! Great slingugg with that answer!

  93. Dawn Matejka RN Trimont, MN says:

    I am adding this because it is important part of the healing modalities to know.
    Healing can be very complicated… For me, EMDR brought emotions I had never before experienced and realizations that brought me to my knees. With this came a long process of acceptance, forgiveness and then grieving the loss of what I once believed was my truth.
    It has been a lonely process, for what is discussed in the privacy of the counseling hour has not been something I could ever share with anyone, including the wonderful friends and family members of my life.
    My goal, from the moment I first met my therapist was to leave counseling whole, grateful and without a feeling of dependency on him. As I heal, I now start the process of leaving the only person who knows everything I wish had never happened. The dependency I tried to avoid has been un-avoidable, the gratefulness that I feel is profound for this man, who with integrity and professionalism, provided a safe haven for this ‘journey out’. After 6 years of intentionally entering (and sometimes forcing myself to enter) that room, I am finally at peace. I am slowly telling close friends (who do not pry) some of my journey, but only if it also helps them or someone else. Details are never important, but how one faces adversity in a proactive way is important to all of us.
    I have never seen a book that provides a roadmap out of counseling. Maybe one of you can write one? My goal is to leave counseling permanently, without this being another loss and with the knowledge that I am indeed capable of living the rest of my life finding my own answers and knowing that I am finally ‘done’.
    He has told me that he will help me with this too. And I believe that he is right… :-)

    • Letha Marchetti, Occupational Therapist; San Rafael, Ca. says:

      _Waking the Tiger_ by Peter A. Levine is my recommendation for you.

  94. Dr. Robert Blundo, Professor, Wilmington, NC says:

    As a teacher and as a Vietnam PTSD client, I have seen them all. I have not found EMDR or talking helpful. My experience was so constant and consistent and over a very long time that it is different than a particular event. I was also as a medic in a field hospital that I was faced with constant traumatic injuries, day and night. Relationships and feeling understood and recognizing what I was experiencing made sense given my experiences was very helpful initially. Also, the neuroscience has opened me up to mindfulness work. I still rely heavily on Medication. Things can get very strange and come at moments you are not expecting them.

  95. Caryll Cram psychotherapist Fort Collins, CO says:

    Thank you for this concise depiction of the evolution of PTSD. The biggest change for me has been in recognizing how the body can identify what the true issue is for each event and each individual. Understanding the Polyvagal theory has certainly helped clarify some thoughts but for my practice more refined muscle testing (using indicators from the mind-body to identify specific focus areas and determine most appropriate modality or process) has made all the difference.

  96. estrid, psychotherapist, los angeles, california, usa says:

    I work in a setting where unfortunately, the clinician in charge, is not keeping up to date on newer research. This is frustrating. It is limiting. I want to stay on top of new approaches, I appreciate your efforts.

  97. Rupa Cousins, The Connected Self says:

    Hello Ruth,
    I am so happy you listed Rubenfeld, when relating to some “exceptions,” in your article above, using genle hands on and verbal exchange, it has been helpful for over 30 some years. I have been a Rubenfeld Practitioner for many years, and it is so true that how the body contracted or compressed has stories to tell and when investigated reveals a reflection of a life lived, trauma included. I am also an Alexander Technique Teacher which has for over one hundred years focused on the juncture of head, neck and spine and how habitual compression along with stress and trauma relates to “flight, fight or freeze.” It seems it is all coming together now with new research and I am excited to participate in your series.

  98. Art Blank Jr. M.D., psychiatrist and psychoanalyst. Chevy Chase MD USA says:

    New understanding of the role of the body in reactions to psychological trauma, and body -based treatment, are a welcome development. However, some current conventional wisdom about”talk therapy” is mistaken, and without some important clarifications, we run the risk of losing the mind. Both aspects of the person–mind and body– are wounded by Trauma. The failures or even harmful effects of “talk therapy” are due to a fundamental misunderstanding of the nature of psychological trauma and PTSD. What occurs with a traumatic wound is an inability to process, digest, incorporate effectively, the events which have occurred. Since the person cannot integrate the experience, it is indeed counterproductive to promote simply repeating the traumatic event in words. The kind of “talk therapy” which IS helpful, and sometimes vital, is talking in a kind of relationship, and with an understanding of how the mind works, where the traumatized person can grow and develop the new structures and processes of mind with which they can harmoniously integrate and understand what they have experienced. The interactions of two subjectivities in psychodynamic therapy focused on growth, not repetitive trauma-viewing,
    make this possible. EMDR, yoga, meditation, and one or another of the somatic experiencing therapies, in concert with psychodynamic therapy, offer many persons the healing they need. . The role of psychodynamic therapy has been extensively documented in the psychoanalytic literature by such authors as Mardi Horowitz, Krystal, Judith Herman, D. Laub, Nanette Auerhahn, and many others.

    Art Blank Jr. M.D.

    • Theresa, Retired Psychologist, USA says:

      Dr. Blank —

      You are so right! I experienced severe, ongoing trauma throughout my childhood and adolescence, and I was dysfunctional in many areas of my life. I had a total of about 20 years of talk therapy with various licensed practitioners. Much of it was probably more harmful than helpful. One of my therapists, however, was internationally known, and I admired and envied her. In therapy, she sometimes spoke of her own problems and issues as examples. She made the talk therapy into a kind of conversation between equals, and sometimes asked my opinion about things as if she really cared what I thought and believed. As I look back on these sessions, I see that they changed me by giving me self-confidence and a feeling of adequacy for the tasks of life, whatever they might be. Other traumatized patients may have benefited from talk-therapy in other ways, but this is how it helped me. I would not say that it totally relieved me of the effects of my trauma, but it cleared away some of the cobwebs and paved the way for further healing. I was not ready to hear directives or recommendations from anyone until I had repeatedly engaged with a respectable, successful person who elicited my comments and opinions and listened to them respectfully and attentively, bestowing upon me the dignity that I was silently craving.

      • Fanni says:

        Наташа & Katya, now I am really cfoeusnd about the language to use when talking to both of you. A nice discussion! I am glad Katya raised one issue I was going to raise too, viz. “where did all these girls who were great at mathematics in school [and let me add, in their undergrad and graduate studies] disappear to?” Well, I am not sure I am totally convinced by Natasha’s reply to this. Here at MSRI they worry about this issue, and here is the statistics that bothers them: among math Ph.D’s in the US, women constitute about 30%. At the same time, the fraction of female applicants to practically every program at MSRI is about 10%. Why is this happening? There is probably a combination of several factors at play here, and actually I am not even sure this is such a bad thing. After all, pure math is not a prestigious subject in this country, it is not very well paid (although I am not complaining :) ), it can be quite frustrating at times, etc. Maybe women are just too smart and too practical to go there (this is definitely my explanation of why women are not as good in chess as men).But MSRI does not see things this way, so does everything possible to stretch 10% of female applicants into as close as possible to 30% of participants. Frankly sometimes it’s not pretty.Returning to the issue of “connections for women” meetings, let me also reiterate that an absolute majority of young female participants are enthusiastically supporting this idea and insisting on continuing this tradition. In this country you don’t ignore things like this. To summarize my attitude, I find Natasha’s negative view a little oversimplified. I think it is a complicated issue, and I don’t have a clear-cut answer in my head.

      • Reno says:
      • Migz says:

        there is nothading that can be done and that I would just have to avoid fraadgrances where posadsiadble. There are more and more fraadgranced prodaducts comading out, which makes it more limaditading for me. Our home is what hubby and I decided we would conadtrol, since I need a safe place. I seek out fraadgrance free prodaducts, which is actuadally halethadier in genaderal. I’ve learned there can be many toxadins and irriadtants in fraadgrances. My mother’s home is fraadgrance free so it is a safe place for me. I try to do more outaddoor activadiadties, which is theradaadpeuadtic in itself. It’s helped me appreadciadate nature more. I love social gathaderadings and havading peoadple over, but when we have a get together at our house, we ask peoadple to be fraadgrance free when they come. When we are invited someadplace, I have to ask if they use any fraadgrances on themadselves or in their home. The answer deteradmines whether or not I’m able to attend. When we go shopadping I avoid fraadgranced stores, or walk out quickly if I notice it when I enter a shop. I have two best friends who are fraadgrance free when they know they will be around me.It’s amazading I was able to have a good career for 18 years in an office enviadronadment (and with lots of travel), but there didn’t seem to be as many fraadgranced peoadple and areas until more recently.

  99. Joanie Lane specializing in PTSD Therapy says:

    Thank you for this series Ruth. I am getting so much out of this and it is a wonderful tool for trauma therapy.

  100. Theresa, Retired Psychologist, USA says:

    Over the years I have watched “alternative” practices, like EFT and TFT, become accepted in the mainstream and substantiated by science. I remember the days when I was frowned upon for using Heartmath and EFT in schools with disruptive and learning disabled students. We have come a long way. The future of psychology looks brighter to me now than it did 20 years ago.

  101. Dr. Viviane Carson, California says:

    Yes, you’re right, Ruth. Developing new ways of working with trauma have been absolutely necessary to help patients to heal, especially for severe cases. I had to help myself first before I could help others. I have been working with a method I developed over the past 35 years that I call “Psychobiophysical Healing”TM which works on seven levels through the brain and the heart and which has helped all patients with PTSD, and most psychological as well as physiological conditions to heal from the root cause. I treat people from anywhere in the world on Skype in addition to my private practice in California. I have enjoyed listening to you and watching you and your series with all those illustrious teachers and therapists and am looking forward to more! Thank you for all your work, Ruth. Please go to my website for more information at:
    http://www.drvcarson.com

  102. Harry, Physician Psychotherapist, Certified in Sensorimotor Psychotherapy, Toronto, Canada says:

    Yes, trauma treatment has changed, and continues to change.
    It breaks my heart to see survivors of trauma still re-traumatized over and over again through insurance assessments that force them to re-tell their stories in words.
    If only the rest of the world would keep pace with these advances, our approach to education, to social justice and even to how we approach collectively dealing with endemic stress would change.

    From a sensorimotor psychotherapy viewpoint, we make a clear and profound distinction between freeze (tonic immobility with high sympathetic outflow) and feigned death (collapse and loss of sympathetic outflow) – there are many different reasons why this distinction is important and it will make a good question for Pat Ogden during your interview with her.

  103. Joseph Maizlish, MFT, Los Angeles CA USA says:

    Each wave’s success, know it or not, included the gradual and usually unconscious learning to apply self-regulation, learning to recapture the body by moderating the alarming arousal or freezing responses which are adaptive during traumatic events but which can be ignited by recollections and associations long afterwards. If the arousal/freezing responses do not overwhelm the individual’s capacity for self-regulation but do challenge it, verbal recounting MAY be accompanied by release from the alarming internal states, as may the desensitization encounters with the place and the situation. For everyone, including those who are too reactive to benefit from the earlier “waves,” direct training and practice such as yoga, forms of relaxation, or even simply (!) consciously monitoring of the body can use that basic but often unrealized factor in what has made any of the “waves.”
    Twenty-five years ago I wouldn’t have understood what I wrote just now! But we were using it nonetheless — just less consciously and less effectively.

  104. Dawn Matejka says:

    Dear Ruth,
    Thank you for putting together these ‘Trauma Series’. As a RN in a major Medical ICU, I witnessed very traumatic happenings for our patients and their families. I was able to draw on what I have learned through these webinars to be a more affective caregiver.
    I am also a care receiver, having struggled for many years with nightmares, strong and ‘very difficult emotional and physical feelings’ when I least expected them and the frustration of trying to explain what was happening physically to a psychologist only to be told “you just need someone to listen to you” and “why would you want to know what happened? Just live your life!”
    I became very good at coping. I learned how to turn off fear in seconds until the next nightmare or unexpected “trigger”. At times, life inside of me was like living in a nightmare, as the people around me witnessed instead my smile or my children joined me as I attempted to make wonderful childhood memories for them… We camped, hiked through woods and our home was a gathering place for their friends. I ‘went through the motions’ and dreaded alone time because I didn’t have these distractions.
    Six years ago, I found a therapist who has patiently helped me learn how to tolerate the fear I would experience “out of the blue” or in the middle of the night. I have been able to take partial memories and make peace with them. Forgiveness has been a huge piece of my healing.
    He and much of the material on your Webinar, along with the books that many of your speakers have written, are the reason that I am starting to feel like I once felt many years ago. The most important factor has been belief and validation of what ‘I EXPERIENCED’ and a focus on ‘leaning into’ rather than ‘running from’ the strongly negative feelings or fear.
    With new found energy, I am finally starting to wake excited about my day; I feel stronger and very hopeful that this will continue. I am realistic, for I have found that the ‘strong feelings’ have not magically gone away, but when they do come, I am able to acknowledge them, tolerate them, let them pass and refocus on what is present. I keep photos of my grandchildren,beautiful sunsets and good memories handy for these moments. And they do pass :-)

    As I go through this transformation,
    I am humbled…
    …as a dream
    wakes me with the past,
    …as I realize
    that the past 6 years were for naught
    but hushing the response of fear.

    No quick fixes
    to what is unknown,
    to what stays below the surface,
    …or for the woman who quietly
    and finally
    begins to rest.
    I have learned how to live
    with reality
    in it’s totality.

    Again, thank you.
    Dawn

    • Sherry Belman, MA, LMHC, New York says:

      Yay

  105. Mitch Swergold, Coach, LifeStudent, Miami, FL says:

    Awesome. Great description. Thank you.

  106. Annie Combrink Social Worker counsellor South Africa says:

    I am working according the EMDR method and used EFT as well very affectively. This method helps people in a very quick way to process the trauma. It is exciting to experience understanding the way of trauma and the brain.

  107. Carol Brown Training Supervisor Mansfield Ohio says:

    I am fascinated with the ongoing study and understanding of trauma and the brain. It is exciting to see attention paid to a good medical assessment as well as trauma assessment. Team work or other comparisons and collaboration of professionals seems essential and welcome. So much to learn……

  108. Chris Williams, CBT/CFT Therapist,UK says:

    I appreciate your sharing of information on the latest developments arising from the understanding offered by neuropsychology. In reference to PTSD one change being discussed locally to me is intervention time after trauma event. There has been historical criticism of intervening too soon with talking therapies after trauma, and of course diagnostic criteria asks us to identify trauma symptoms still present three months following. So interventions generally recommended to support ‘stabilising’ only. The Berkshire Trauma Service advised on a more idiosyncratic approach, if treatment appears indicated sooner, perhaps following assessment of resilience and psychological mindedness (for CBT interventions) then to go ahead and treat.

    Thanks and all the best Chris.

  109. Patricia Murphy, LCSW, Oceanside, CA says:

    I am still finding EMDR and TFT very effective, and am excited about Dr. Allan Botkin’s discovery of IADC and am taking his training in Illinois later this month. He developed it while doing EMDR at a veteran’s hospital in the Chicago area. It completely clears long-standing grief from loss through death, in one or two sessions. I highly recommend his book, Induced After Death Communication: A Miraculous Therapy for Grief and Loss, by Allan L. Botkin, PsyD and Craig Hogan.

    • Karthik says:

      It sounds to me like the cernurt situation in most math departments is likely to select for women who don’t mind or even prefer to be in the minority – the women who aren’t happy to have so few women in the department would presumably be that much more likely to leave to do other things. And it seems from the comments people made at the panel that events like this can help to keep those women from leaving for reasons that have nothing to do with their abilities in math, and to attract other women who might otherwise be wary of entering such a male-dominated field. That seems to me to be a good enough reason to have events like this, to begin with.But more than that, to me, this event more than proved its usefulness with that first question that was asked, about how being pregnant might affect a woman’s career. Can you imagine such a question being asked at a panel where all or most of the participants were men? Even if there was a woman brave enough to ask such a question, would a panel of men even know what to say? And yet it’s clearly an important question that many women struggle with. (As I can tell even from the comments to this entry alone.) Isn’t it good to have a place where women can discuss such issues and give advice to each other and discuss their experiences, without each woman having to feel like she has to reinvent the wheel alone, stuck as she is as the only woman in a faculty of men, at what has to already be a difficult time in her life?There are clearly questions about what it’s like to be a woman in mathematics that men can’t answer. Is it really so bad to provide a place where such questions can be discussed?

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    • Sang says:

      You dear sweet woman. I am working on week 2 of coinmg out about my oldest 2 siblings. My brother, my senior by 6 years ,sexually abused me (no penetration) from 5 to 13. It’s really my sister ,senior by 5 years, that disturbs me the most. I cannot confirm but I think she has a personality disorder that attributes to her overwhelming sense of power. I am a 55 year old woman and I have an acute sense of right and wrong, and she is wrong! She has gathered up all members of our family ,about 11,and has threatened them that if they believe my accusations against our brother they will no longer be a welcome member of the family. In all your research of your book how often have you heard similar stories? Where do I go to participate in this workshop of yours?

    • Matilda says:

      Hey, that’s the grsaeett! So with ll this brain power AWHFY?

  110. Irene Lyon, SEP, Feldenkrais Practitioner. MSC. says:

    YES YES YES! (did I say YES?) = )

    I’m a Somatic Experiencing practitioner, Feldenkrais Practitioner and assistant at the master level is Peter Levine. This is SO refreshing to see and read.

    For those interested, I did an interview with one of my colleagues, also a high level assistant within the SE world, on the topic of Neuroception, would LOVE to share.

    Here it is:

    https://www.youtube.com/watch?v=I2pZGdIuNKs&list=UUBkXgr0E9ZWUg4iSDEUKqVA

    Irene xo

  111. Deborah Clements Canada says:

    I live in a Canadian city of over one million people, Calgary AB. In my opinion we are in the dark ages here. The go to therapy is still CBT. DBT is staring to make an appearance but the wait lists are very long. I have been constantly traumatized physically and mentally by the psychiatric system here in Calagry and had given up on my healing journey. A friend in the U.S sent me information on current treatments and I finally feel some hope that I can be healed. Many of my questions regarding ineffective treatment have been answered. Thank you for all the information you send it has helped me immensely.

  112. Irene, Hakomi Practitioner, Mexico says:

    Huge! difference, from lost to could be found, from hopeless to you ca do it, from bear it to heal it.
    I am wondering if in the series anyone is talking about working with the limbic system; and talking about the freeze specifically.
    What exactly is best used with freeze?
    How do you determine witch part of the brain is triggered or in unbalance in the client?
    what works best treating each part of the brain?

    Tose are my main concerns… besides many point you mention in the next series,
    wonderful!
    thanks

  113. Paula Susan, Trauma & Relationships , Mt. Laurel, NJ says:

    My practice is totally integrative, with components of the myriad masters with whom I have studied. (I’ve taken some of your webinars.) The process that impresses me the most, is the direct root to deep healing, using EMDR. I facilitated transformation in a man who had repeatedly raped his wife for twenty years. The rage and self-loathing in him from his past fueled his evil. I’ve facilitated people’s healing of seizures (some of them from anxiety), resentments in marital relationships, the shame that is often under layers of justification with affairs, the impact on affairs and the ruminating that often occurs with the wounded partner.
    Acknowledging my “addiction” to learning, I have created some of my own “processes” including aspects of neurolinguistics, journalling, cognitive/behavioral, attachment theory, Imago and the list will never end when I experience something that could enrich my help for people who are suffering – with trauma, with self-esteem issues, with anger, depression….
    Our responsibility, our privilege, our love for our clients can change their brains in ways that open their lives and their ability to love themselves and others. What we do will radiate out into families, workplaces, the world. I am awed by my choice of career. Thirty-two years and still learning. Thanks to people like you who have much to offer. However, whomever we can thank for neuroplasticity and our ability with our own limbic system to engage others and lead them into a whole, healthy way of being! It’s awesome!

  114. Shirley, Psychoanalyst, NYC, NY says:

    Nice overview. And there was also an ancestor of the first stage espoused by misguided followers of Skinner, who thought that mere survival and will power would do the trick. I remember a professor, who proudly described his cure of a shocked and traumatized dog by repeatedly returning the animal to the site of trauma without repeating the shock. While the “cure” was eventually somewhat effective for the dog, presumably because of what we now know to be processes of memory, it was also traumatizing for psych students to hear. Applying this flooding method to humans, especially those with what we would now call dis-regulated attachment, was actually cruel as well as misguided and authoritarian. Survivors of battle shock in WW2 and Vietnam had to endure this “pull up your socks and get on with it” treatment. It is a remarkably visible shift in consciousness in our field that we have sought for more effective and empathically related methods and even found the rationale in neuroscience to support them.

  115. Isabella Mancuso says:

    Please do not discount that the internal injuries can cause seemingly mental health issues (due to the clinicians perspective), when in reality it is the injury, the damaged tissue itself that is causing the bodily responses.
    Vagus nerve can be affected by intestinal blockage pressing on the nerve. Clearly here we would remove the blockage and free the vagus nerve (which by the time the blockage is removed the nerve may be damaged), and NOT treat as so called PTSD or mental illness. CORRECT DIAGNOSIS is imperative, as there are many negligent MD’s all too willing to hand over a mental illness dx when in reality they have missed the correct physical disability, while they pass on from doctor to doctor the mis-Dx and while patient gets “sicker and sicker”. There may be a degree of ptsd at work, yet if the patient is denied the means to heal or attend to the physical body, the “mind” stuff becomes mute.
    As stated above the intestinal blockages need detoxing, proper amounts of stretching and exercise as well as stress management.
    Too many times, also brain injury and brain/vessel abnormalities are overlooked and poo pooed. This is not only detrimental to client but may be deadly when mishandled. For if you call a patient severley depressed due to lethargy and lack of motivation when in fact they have a brain injury with blockage and vessel malformations and slow blood flow through vital conscious areas, ((slowing breathing capacity))of the brain, to treat this as mental illness is wrong, IT IS A PHYSICAL injury needing medical NOT psychological intervention. Once the patient is properly breathing, getting sufficient oxygen to body organs, the brain can “think ” again, and they are oheir way to wellness.
    JUST A NOTE: Bloodwork may look good, chest x-rays ok…..but when arterial blood gas is done the overwhelming lack of oxygen is startling….BE SURE there is a FULL medical evaluation before DX any mental illness, so many are dx with mental illness when there is an organic physical cause easily remedied. This is how (we) you may be putting trauma upon trauma.

  116. AnnaMaria Life Coach The Netherlands says:

    I have also followed the changes and I am amazed at what we knoe at the moment. I am especially interested in brainentrainment and how to combine it with other brain and bodyoriented approaches.

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