How to Ease the Pain of Trauma-Induced Shame
 |
with Bessel van der Kolk, MD;
|
 |
with Bessel van der Kolk, MD; Ruth Lanius, MD, PhD; Peter Levine, PhD; Thema Bryant-Davis, PhD; Richard Schwartz, PhD; Pat Ogden, PhD; Janina Fisher, PhD; Kathy Steele, MN, CS; Stephen Porges, PhD; Martha Sweezy, PhD, LICSW; Deb Dana, LCSW; Ruth Buczynski, PhD
Sign up for a Gold Membership
This is a learning community for practitioners. We can’t wait to hear what you’re going to use with your clients
But please do NOT:
- seek advice for personal problems
- ask for referrals
- post links or advertise a product
- post about technical problems
my big takeaway from today’s session was the importance of doing good things to achieve a feeling of competence and my own goodness. I can’t undo what happened but I can create good/positive memories and experiences that can counter those traumatic experiences. this can build my ability to experience positive emotions and feel safe.
I am glad as an IFS therapist that you invited Dr Schwartz and Martha Sweezy to introduce this wonderfully efficient approach on the delicate issue on how to process shame with a client. All body centered therapies are extremely relevant in my experience. I just wanted to share this and thank you for this very interesting program on trauma.
Cheers from Switzerland
Grateful that I handled it exactly right when my daughter turned to self-harm and was able to nip it in the bud before it became an addiction or went beyond small scratches.
It is very boosting to my self-esteem because figuring out how to help her has been the most difficult and frustrating task of my life.
Also finding new ways to think about my own shame from childhood traumas and thinking about her shame. She feels so much shame from her actions caused by her mental health difficulties when she was younger.
One learns something every day. I learned a lot about shame and the two areas of the brain that are involved in shame and that it’s treatment of this survival response is complex.It was interesting to learn about creating “distance “between the client’s self and their inner critic that holds the shame. Also that different parts of the personality are involved, whereby the those critical parts can be explored safely when those somatic responses by the client are carefully picked up upon., even when that pain is manifested physically in the body. I really found that approach showing how to alleviate that distress in the client very useful. Thank you for such great insights and teaching.
Very helpful with some useful practical ideas – especially seeing the gentleness, sensitivity and patience of the therapists in the way they’ve worked with different parts of clients, valued their adaptive behaviours and patterns and respected the client’s pace for growth.
Jania Fisher’s use of voice to help pace the discomfort of feeling pleasant emotion really helped me learn how to use this skill.
Thank you so much for this valuable, great knowledge!
By any chance can someone please tell me what the other 2C’s are from the discussion on Structural Dissociation in Week2: Cooperative
?, Cohesive and ?. I would appreciate it!
COOPERATIVE
COORDINATED
COHESIVE
COHERENT
I am most interested in exploring different ways of working with shame. I had heard a speaker before speak of the dignity of shame but was unable to grasp that idea and therefore work with it. To see its role as protector doing its best feels like a good way forward. As a movement psychotherapist as well as SE practitioner I also was glad to be reminded of what I am really interested in as I struggle at the moment working on zoom, to focus as much on what I observe in the body. Thank you, Amanda
I found the discussion of the one two punch a really good way to describe what’s going on to patients. The question to ask to make self harm less appealing was also a useful tip to practice and the repetitive flashbacks as a way of self harm an interesting theory. Many thanks for the sessions, very thought provoking.
This week’s presentation covered so many things that can be used with my current clients. The discussion of how best to deal with moral injury was especially helpful because it validated how difficult it has been for me to simply be present with someone who is in so much pain because of something traumatic and life-ending that occurred in his or her presence…the school-aged child whose father died of a heart attack while his mother frantically gave CPR as he watched for the ambulance…or the driver of the motor vehicle involved in a fatal accident that killed a family member or close friend. The most difficult situation involved a client who didn’t speak up when she knew about severe bullying that led to an episode of school violence that severely injured a number of students. It was helpful to know that we can simply be present to help clients contain the pain of moral injury, as opposed to trying to help them reduce the emotional pain and shame they feel. After decades of direct practice work, I think that I intuitively knew this, but have always felt so helpless and inadequate as a therapist when I couldn’t do much else. Although I could think of ways clients in these types of situations could use that shame-energy for something positive and constructive in the future, I knew that this is something that they had to get to on their own and that it would take some time on their part. Some degree of grieving and working through the pain has to come first. There was so much more that I plan to use, but the concept of containment was so helpful in dealing with the “moral injury” that we can sometimes feel, as providers, when we feel unable to do more to help a client who is suffering so much.
I find someone sitting doing ‘nothing’ compassionately, just giving presence, to be more healing than any technique which as you say can come in handy later. I recently noticed an example of this kind of doing nothing in the book of Job, of all unlikely places! His friends saw the depth of his suffering and sat with him in silence ‘for 7 days and 7 nights, because they saw how great was his grief.’. Ancient cultures seem to have this intuitively too and it seems to me were better in some ways at naturally offering consolation in community. Silent presence is such a healing thing. Animals like monkeys and elephants also do it when there is grief.
Wow. I so appreciate the opportunity to listen to this series. So many great thoughts to ponder and so helpful.
Reflecting on the last section, Positive Emotion, as a take away, I think many people with trauma struggle with how to feel good. It reminded me of how difficult it was for me to hear such a mundane positive comment such as “Good Morning” directed at me when I would come into work, early in my career. It was so foreign to me since I had grown up in a family where I had felt unacknowledged, invisible, unloved and rejected. I had no memories of anyone ever saying good morning to me before. It felt so strange and discombobulating. I really struggled to say: “Good Morning” back, in return. It took some time for me to feel comfortable but I forced myself to say it and with practice it gradually began to feel normal. Although I was acutely aware at the time of how ridiculous this was and that it had to do with my family upbringing, I still struggled with feeling foolish and anxious. This was due to my lack of understanding that my nervous system was being acutely triggered by two positive, kind, simple words: Good Morning. I understand better now the window of tolerance my nervous system had with taking in positive words and actions from others when my life experiences and lack of connection up to that point was so much the opposite.
In the work setting, I also knew that I struggled to accept and take in compliments. It was again a very foreign experience when you are raised in a negative and critical household. It was difficult for my nervous system to tolerate the kindness of compliments from others to the point where I would immediately reject what was being said and try to find something negative to say in its place. This seemed to be my nervous system/mind trying to feel “normal.” I was not aware that I had an inability to feel good, from a compliment, because I didn’t feel safe as a result of my window of tolerance being so limited. I seemed to be protecting myself from foreign feelings that did not feel good. I did not understand that compliments are a way to positively connect to another human being and I was missing out on this interaction. Negativity creates separation from others, which was what I was use to, and connecting to another being in a positive way did not feel safe or desirable due to past conditioning. It took time for me to consciously titrate these feelings, break the pattern and arrive at a more balanced state (re-establish a “new normal) and be able to give positive reinforcements or comments. Unfortunately the “old programming” is always playing in the background and it takes great effort to maintain the right balance.
Shame: an entrenched sense of unworthiness with a powerful impulse to not be seen; and may present in surprising ways.
I was VERY interested in the idea that the nervous system can become unregulated by exposure to positive experiences, perceptions, emotions. Also the idea of titration of exposure within the window of tolerance and with careful framing as a survival response.
Moral injury was an important inclusion in this session on shame too.
Thank you again for a rich offering.
I love the concept of working with clients nervous system. I will utilize the different parts concept of IFS with clients who self harm. Thank you
As all of your sessions, I learned so much. I really appreciated the concrete examples of how to isolate the critic and talk to a client’s parts. I would have loved to hear more about what a plan that meets the needs of a suicidal/self-harming client would look like as opposed to the ones we often use in agencies and private practice.
Thank you!
Nasim
Several things resonated with me today with the talk about Shame.
The saying “we teach people how to treat us” I have subscribed to that for many years, little realizing I am shaming myself in believing it is my responsibility if someone doesn’t treat me well.
Shame cannot be managed away. Toxic recovery is complex. It’s not a place you get to where everything is wonderful, everything is fabulous.
I was getting one aha moment after another in today’s webinar.
In general this course is wonderful. So many wonderful teachers and teachings. What is most valuable for me is formalising ideas that I have sensed in myself, eg Trauma response is a survival strategy. Very grounding and then the possibility of working with these ideas.
I do plan to sign up for the gold course ultimately however already studying the Mindfulness course in depth so will come back to this after Christmas. I am appreciating the crossover between the two courses.
Ann, If you are interested in the Gold Course you might need to check if it will still be available later? If it is, will the price go up?
I hope you can get access okay.
At the very end, I (early sexual abuse survivor) wrote this question: When is it ever safe for me to SAVOR something, or ENJOY myself? I’m hit with simultaneous guilt and shame. It’s so much easier for me to just sacrifice my self for the needs of someone else…ie. to be “use-ful” which may just be a reiteration(shadow) of being immorally “used”. A different kind of self-denial, and even self-harm. Thank you for this teaching.
“
Susan,
Thank you for sharing your insightful self-observation. I relate to it, and I’m sure quite a few others can as well.
Wishing you well on your path.
Julie
Thank you for a very important presentation on working with clients who experience shame. With a client who has a strong inner critic that causes him shame, I’m going to explain parts theory to him and assist him in looking inside himself and working with his inner critic with curiosity, and try to develop a positive relationship between his inner critic and his Self. I now feel that I have a better idea of how to help another of my clients to be able to begin to tolerate having more positive emotions within herself.
As the presenters speak, I find myself in almost a hypnotic state. My notes are jottings of key interactive bits and phrases that my deeper brain seems to be connecting with clients past and present. I expect that using some of what I am absorbing in these trainings will simply be automatic responses from me to my client(s) as we progress.
Wow. This was a powerful week for me. Very personal. The clarification on guilt vs shame and the somatic experience of adrenaline and endorphins.. so clearly and simply explained. It has helped me in my healing and I look forward to sharing it with my family and coaching clients. Blessings to all our teachers here and those listening in. ?
I really appreciated the piece on moral injury, that you can’t ever make it ok, that you can only help them hold it so that they are not holding it alone, and then to also help them hold the dialectic so that they can go out in the world and create goodness too. Next week I am piloting a new group on trauma in first responders and I am going to weave this in, as much for prevention as for intervention.
Thank you.
I really appreciated using the window of tolerance with intolerance to positive feelings, that was extremely helpful. the session overall was a great reminder of the ways a therapist could unintentionally re-traumatize a client through rushing to the positive.
Very grateful for the stories about healing and helping others get their life back.
So when do i start with the official “lessons”? Bonny
As someone that has gone through Trauma after Trauma since i was 2 (fleeing country in political disarray, being left with strangers at 3 as my mother went to save and pick up my other siblings from other parts of the countries, and just unraveling it this year thanks to covid, i find these workshops very helpful in identifying challenging triggers that seem to halt me in the process of shaking, dealing, processing the shame that i have of having gone through so much trauma and having had a life so different than many of my colleagues, friends and family, specially since I’ve kept most of my experiences to myself due to constant and unintentional shaming that still exists in the patterns of generational trauma that i seem to be breaking slowly.. one step at a time… thank you for this one. i will always take all the teachings i can that are offered free when it comes to dealing with trauma. tears and insights guide towards a path of brighter blessings to come. thank you
What a wonderfully informative masterclass! …. again …. so many insights around self harm as I used to cut for several years. I found the cross benefits to cutting, eye opening to say the least, and understanding the addictive power in the stress hormones totally enlightening !! Also understanding the reasons behind the discomfort in positive feelings was a fantastic insight that will serve me well into the future ! Thank you so much !
I missed that particular part of the lecture around the epinephrine and the addiction to the hormones. Can someone clarify pls?
Increase of adrenaline replaces numbness or emotional overwhelm with “calm, cool, and collected” –
then an endorphin release ensues.
Thank you for this week’s information. It is so powerful. As a Certified Grief Recovery Specialist, I facilitate 8-week sessions using a particular method to assist adults in working through their grief about a particular loss that they choose (not during Covid!). It is an educational program.
I consider myself emotionally intelligent but did not understand the veteran attendees’ responses to some of our small group meeting discussions. Your description of feeling unsafe and of the resistance to positive emotions is what I think I sensed in them. Now I have a better grasp of what was taking place and why. This will help me to be more sensitive to those types of trauma responses in the future.
Even if I was not doing grief recovery work, much of this series has been very helpful in understanding my own PTSD treatment.
From Daniel Chang Li, Registered Psychotherapist, Toronto
Hi, Dear Dr. Ruth Buczynski and Other Leading-Edge Doctors/Professionals:
Thank you for your very important series of workshops, on neuroscience and neurobiologically-based understanding of trauma, and today’s topic is on how to understand trauma-induced shame.
Thank you for your insight and wisdom.
However, as a mental health professional in Canada, while originally I came from another culture/country, I experienced and know trauma in a very different level that most people in the west even could never imagine or dream of.
From my own experiences, I know shame could be one of the products of trauma, but I feel guilt is another big issue after trauma happened (self-blaming even by imagination).
For most of the mental health issues, I think and agree that they either fall in or fall out of Window of Tolerance, thus people become functional or dysfunctional.
However, as for shame, guilt, and moral injury, I think they could also be falling in or falling out of the Window of Value Systems, or of Different Cultural Systems.
People from different values and cultural systems may or may not feel the same as regarding to shame, guilt, and moral injury.
Also guilt could be intra psycho-related; and shame could be more interpersonally related.
Regards
Daniel/Chang
I am extremely appreciative for access to this training, as another said from the people who authored some of the books on my shelf.
There are many aspects of this episode and previous I found interesting. Particularly the reminder that positive emotions can also be overwhelming and triggering to clients. Pat’s offer to hold the hand of her client really showed how we can actually ‘hold’ our clients traumatic experience – very permission giving for me as a therapist.
I already use a lot of the techniques/theories with my clients as I work with clients who have a history of childhood sexual abuse., so fragmented parts / dissociation and shame are a major part of my work. I do a lot of work to help clients heal the inner child/children that were/are traumatized. Great to have the work we do validated by great names in the field of trauma work. Thank you so much
I am an artist and a writer who has been researching and creating a schools resource called ‘The Culture of the Heart’. The resource supports staff in building healthy relational learning communities. Working alongside a psychiatrist, councillors and EQ experts, I am interested in how our physical bodies are part of the process of healing emotional trauma. After reading ‘The Body Holds The Score’ and other books, I was interested to see your advert.
I love the physicality of reminding your patients of how their body feels when experiencing shame and then slowly changing posture.
The gentleness and care with which you have created this resource is beautiful. Also the option to hear your content without paying is such a gift. As yet, the schools work is done pro- bono – so this opportunity is greatly appreciated. Thank you.
Changing up immediately regarding the regulation, asssessment and use of positive emotion in sessions. The moral injury tips were insightful; and I am integrating all the training immeidately into practice with myself and clients. Great topic and insightful, relevant, timely information!
It is important for me to keep in mind that my “plan” for another’s regulation might be best for me, but not those around me. It is important that I remind myself to check in with the other’s nervous system.
Very helpful to emphasize the different disguises shame may take in clients…to be aware of this aspect.
Normalizing and reframing to recognize other options in seeing shame as a protective part, especially in early childhood occurrences..
Ways to dialogue with the shame part or inner critic so client sees it as a part, not the whole of them.
The cautions about not getting lost in details in the early process of treating shame.
Hello, I’m Suzette Misrachi from Melbourne, Australia author of: “Lives unseen: unacknowledged trauma of non-disordered, competent Adult Children Of Parents with a Severe Mental Illness” and various articles. I will most definitely be using the ideas presented here. The notion of “moral injury” in relation to shame was particularly poignant as many of my clients experience this type of (greatly unknown) injury. The do’s and don’t’s segment for therapists was particular useful as without knowing it, we could instinctively think we are helping when we are not. Therefore, points raised were critical.
Thank you so much!
Good reminders around the nuance needed around safety plans; the description and label of “moral injury”, which is so important to name and is often harder to recover from than any physical or emotional injuries as it generally gets equated with a negative character assessment.
It is common for me to feel bad when good things happen to me. A lot of good things happen to me. A lot of bad things happen to me. When bad things happen to me I have an explanation, and I have an action plan. When good things happen, I feel undeserving and unlovable. Good things are the doors to bad things. My therapists have been unable to understand this. I cannot believe everyone else does not feel the same way. But a lot of good things happen to me, and I am learning I do deserve them, but in my thankfulness I am still a bit ashamed and afraid of being unloved because of it.
Thanks for talking about this.
Ana Maria Menendez
Working with a client whose positive emotional state is overwhelmed by association with hateful words and actions by her father when she was a child. Am very much looking forward to companioning her as she advances just over her level of tolerance, and to spend a likely short, but meaningful time there before she, possibly with empowerment, moves back.
Another great presentation. Thank you.
Thank you this has been very enlightening. I have watched a number of your sessions and they have all been fantastic. I will take with me the idea that shame can be a protective defence – what an eye opener for clients who are so very ashamed of their shame! I have also previously tried parts work as well as somatic approaches and your training has given me some additional valuable ideas to put into practice. Issues around moral injury have been particularly pertinent for some of my clients in the past and I now have an additional perspective to work with around moral injury induced shame. Thank you all.
Again, a beautiful gathering of great minds! Thank you.
In my practice, the use of movement which brings about newness, curiosity, and ease in the body, is a nice way to introduce how positive sensations can be safe to feel.
We are all in this together! Thank you all for being part of the evolution of the species.
Thank you for this wonderful work. I do not practice anymore but am interested in new developments and use this awareness in all my interactions as I go about each day.
This was great, I did not realize that so many behaviors were so entwined with self harm, shame and now i can work with this micro nuances… Also the concept of moral injury! I think is worth it to go deeper into this, I’m sure there are more ways than a client suffers it.. not only war but even marriage; family systems
Understanding why shame is heroic and being invisible (feeling shameful) helped them to stay safe.
I appreciate the focus on the client’s nervous system status and the slow predictable pacing of affect with attunement. Thank you for sharing this material!
Why its so hard to enjoy For some, and that it can trigger negative feelings, memories in the body.
increase positive affect in a slow pace…monitor my own affect or at least notice if my affect affects their regulatory system..Denise
Huge take away in how threatening positive emotions can be and the value of checking in and asking how positive attention, comments make them feel and then using that as a guide to go at their pace.
Very helpful and insightful
As an MSW who has not practiced for the 16 years since having kids, I am grateful to currently be in training for intiatic sensorimotor therapy for healing trauma, The timing of this NICBM offering was perfect (even despite finding it late and missing the first 2). To see and hear these profoundly dedicated and compassionate practitioners who have previously only resided in the pile of books on my table, brings the immensely rich content to life and to hear the humanity inherent in being a guide with those in trauma. It is fascinating to feel the polyvagal theory at work as I am viewing each therapist sharing and pages of notes for my own inner work are now filled. I am amazed at the depth of content in a matter of hours!
Today’s topic of shame was extremely helpful— the moral injury and toxic recoveryism aspects, especially so. I hope this access is offered again, as I know many who would benefit greatly from the conglomeration of expertise and gentle encouragement that widens understanding our own trauma and that of those with whom we live, work, and meet, daily. I will work on saving up funding so that eventually, I may be able to purchase the package. The comments are all insightful and deepen the content, as well. Tremendous gratitude to you, all, for the decades of work that went into creating and sharing this life-changing work. You are spreading healing in profound ways that will continue to ripple out and change how we heal….
Ah Ha!
Found this special golden key which unlocks my quandary of how to get a client past negative, unsafe association to positive feelings.
-The subtle concepts of growing a traumatized client’s tolerance of feeling good in micro-moments especially approaching through somatic experiences of ‘noticing’ of both discomfort and warmth, creating safety in the moment and being careful to avoid the therapist impulse to enrich or ramp-up client’s ‘savoring’ prematurely to avoid triggering established autonomic patterns to allow growth of new associations. Thanks!
Being a cerebrally-weighted person by nature, I was often frustrated in my early years of providing therapy as I was unaware of the near-magical abilities of the body to help and inform the mind.
I am glad for your clients. As a client, I did not trust my therapist additional positive reinforcement. I am bathing day by day with the good that is around me, I forget the trepidation sometimes and have started to believe it ay not be a flunk, that some of the good around me is because of me!