How to Help Clients Tolerate Dysregulation and Come Back From Hypoarousal
with Bessel van der Kolk, MD;
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with Bessel van der Kolk, MD; Pat Ogden, PhD; Ruth Lanius, MD; PhD Dan Siegel, MD; and Ruth Buczynski, PhD
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with Bessel van der Kolk, MD;
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Hazel Da Silva, Occupational Therapy, CA says
In listening to the experts discussing how to teach trauma clients to tolerate distress (Internal & external) & to come back from hyperarousal or hypoarousal, I had an experience with watching Michael Moore’s new movie, Fahrenheit 11/9 that was highly informative, but also totally overwhelming. My son & I are working through trauma from domestic violence (as I mentioned below), which is being triggered internally by various external events. The horrors that Michael depicted by showing the current reality of the political situation in U.S. and also the impact of corruption from the top down & abuse of authority, by key political figures in the world (current & past) in the name of capitalistic greed, also power over the poorest on the planet (genocides of various kinds), and including severe neglect of the issue of climate change etc, left us reeling. At the end of the movie, I felt more devoid of HOPE than ever, & wondered what is the use of working so hard to overcome past traumas on an internal level, when externally, no-one can in power be trusted, & it seems that there is no future, as the planet seems to be on a one way trip down into the abyss of darkness. The powers that be are NOT interested in taking positive action for the higher good of all who reside on Mother Earth. Interested in any comments from other attendees.
Kim, Other, NZ says
Hazel Da Silva
Interesting. I too am very aware of how the state of the world impacts my “window of tolerance”. I often times have to refrain from watching things that do not help me to build myself up, and this changes depending on what I am dealing with at the time.
I find when my window is small I need to honour that and let the world pass me by and this may include my own thoughts if they are not helpful to my health and wellbeing.
Remember, this world was always this way, if you look at history, not much has changed, it was pretty ugly. We, the people, need to build our personal selves up so we can make a difference. With so much dysfunction in the world, we have to take care of ourselves and each other, bottom up, grass roots. If I think too much about the state of the world, it overwhelms me and I am in no condition to be part of the solution.
Healing from trauma is a big job and I believe our most important job so we can offer a hand to others. We are all struggling on different levels. I need to trust that my small part of healing will make an impact and play the game of life on my level not theirs.
Kim ?
Lorelee, Teacher, CA says
You can also check out “Optimistic facts and charts that show the world is getting much, much better” on Vox, and “Jesse Ausubel; Nature is Rebounding” for other, more optimistic information. The term “politico” means “gathering of the citizens”, not “election of officials”. There is a phrase, “The new saviour is the sangha”. Sangha means community. The new saviour is the community. New political structures are being created by citizen groups. Many new movements are in place. Because what they are creating is ‘good’ news, it doesn’t find it’s way into news programming that filters information through search engines focused on fear-based words.
Emily, Other, GB says
Hello Hazel, I too get very upset and overwhelmed by what is going on in the world – especially climate change. I can see the parallels between my own trauma and that of climate change – and how both cause me a lot of distress and overwhelm. Not being able to handle the emotions in relation to CC has meant that I’ve not engaged in positive action as much as I would have liked to. And also my personal stuff coming up big time the last couple years has distracted my ability to engage with it as most of my energy has been directed inward. Firstly you have to look after yourself and deal with your personal stuff. And rest assured there are people doing lots positive stuff to create a better world out there (just not as visible in the mainstream media) It is distressing to see the bad stuff happening. How I see it is that the more I am able to deal with my own personal traumas the better equipped I will be for dealing with stuff happening on a global level. Also, in terms of hope – I like the book ‘Active Hope ‘ by Joanna Macy and Chris Johnstone…. now might not be the right time for you to engage with these issues, but I like their definition of hope…. Also,a film called the Economics of Happiness (helena norburg-hodge) whilst going into the problems also goes into the solutions and positive changes that people are making.. Also check out the Transition Towns network….
Rosemary LaNore Bailey, Another Field, Seattle, WA, USA says
Just wanted to say, Thank You! Every time I have heard this segment I have been grateful for the recognition of how absence and neglect affect our processing. The talks help my understanding and reassures me that I am on the right track with my own efforts,and working with Mind-body medicine. The talks also help the person I take care of. Thank you all for the tools.
Hazel Da Silva, Occupational Therapy, CA says
Pat Ogden described dealing with hypoarousal, using movement and also asking the client to describe sensations in the body during hypoarousal. I have an Occupational Therapy background, and I have been training in trauma to help myself and my adult son (who has been affected since “in utero”) to work through past traumas from severe domestic violence of many years. It is a daunting task to wear 2 hats, one as parent and one as therapist. However that is all that we have in terms of financial resources & also having been violated emotionally by therapists in conventional medicine and also in integrative medicine. In the case of conventional medicine, they are often not trauma-informed and are mostly NOT doing their own healing work. In integrative medicine, it was NOT doing their own healing and their baggage was unravelling in our (individual & family) therapy sessions. So we have to make do with me doing therapy for myself and also with my son (self-regulation & co-regulation), as this is a relatively safe environment, compared to therapy sessions with outside therapists. Admittedly this becomes somewhat more complex when IGT (Intergenerational Trauma) is stirred up, so I have to get myself back online to help my son.
My question: how do I deal with my son (who often goes into extreme freeze mode) and is unable to talk to describe his body sensations? Even at the best of times, he has “selective speechless terror,” mostly with authority figures (peers, management at work, even me) & is able to communicate verbally only with kids, as they often are non-judgmental & non-critical. Do I simply work with getting him to move & asking him to look at me, walk with me etc, in order to get his frontal lobes back online? We have done some neurofeedback, which helped him a lot with bringing his frontal lobes back online. However with recent harassment at work by a manager and loss of his job (working with kids) when he lodged a formal complaint, he has gone back to minimal verbal communication again (reliving trauma & abuse from his dad). Would appreciate any suggestions from other attendees.
Katherine, Other, Portland, OR, USA says
I am not a therapist. I don’t think a therapist would address your question, for legal and ethical reasons. I am watching this series to increase my personal awareness. I am glad you have a good job that allows you to help others, that is a very empowering task! You have so much going for you, in a very difficult situation. In regards to your child, regular exercise in nature will really help. Getting into a safe nature setting can be incredibly settling. Just opening a window and looking at the sky can help. Some people do not process touch as expected, so rubbing the upper shoulders or ear lobes might not feel good for one person, but its very helpful for others. One young person I know is very self regulated but cannot tolerate soft fabrics, blankets, foot rubs etc. Another is quite grounded by feeling soft, clean cotton. Your son will tell you/show you what he needs.
I understand the emotional flooding you are experiencing with the out of control pathological state of world leadership. Stepping back out of the swirl of rotting lies and terror is a good step. “Getting out of your mind and coming to your senses” is a pretty good way to step back from the sensation of helplessness and abuse from the outer world. Michael Moore is a good documentarian but he can’t say how its going to turn out in ten years, civilization is being stimulated at a mighty level to change our ways. The tools we are learning here will help us do the best we can in our current world. This is the life we have to live, we can do what we can to be there for ourselves and others. I also worry for the next generation and lift them up in prayer. We can still have a meaningful life, sharing beauty and serving. Thank you for sharing your experience in life.
Evonne M Kundert, CPS, M Div, Other, LaCrosse , WI, USA says
I have been meeting with a mindfulness coach. Have am excited at how every one brought out and made connection with the sences and being so totaly in the present. “Get out of your (head) mind and into your sences” Is great. I can’t wait to share this info with my mindfulness coach, especially how and why mindfulness works with the brain and traumatic experiences. through out the webinar I was thinking up all kinds of mindfulness activities and exercises that I can use in my work. Thank you ever so much again!
Ekata, Nursing, AU says
I learned about hyperarousal vs hypoarousal, and the window of tolerance. I learned how skills like mindfulness, sensory deregulation and CBT can be used to up or downregulate during hypo or hyperaroused state. I learned that the distinguishing factor between manic Bipolar disorder and trauma related emotional dysregulation to be low need of sleep vs cannot sleep or get restful sleep respectively.
Tips for practice: Pay attention to client’s behaviour, posture, habits and level of engagement.
Be there in the present moment with client.
Centre yourself as a clinician to prevent vicarious trauma.
Use your 5 senses.
Find out what resources client uses to cope in the other times and build on it.
Bobbe Nunes, Social Work, South Acworth, NH, USA says
The comments are pure gems for anyone engaged in both practice and research. The comments clearly demonstrates the splendid resource for teasing out how this work knows no boundaries. As a retired clinical social worker, a full-time caregiver, and an avid lover of literature . . . this has been tremendously rewarding on all fronts.
Elaine Dolan, Other, Holiday, FL, USA says
Always always, thank you for sharing these methodologies and talk-back discussions.
I wanted to share another MINDFULNESS practice which helped me somewhere in my late
30’s to get a grip, if you will. I was guided to eat a very careful and cleansing diet, but
beyond the food–I was told to 1) Prepare my food myself, fresh 2) Be seated as I eat, no acceptions
(because I had always eaten in almost frenetic motion) 3) Chew every bite thoroughly before swallowing
4)Eat SILENTLY–no conversation, no radio, no TV (no texting today or reading emails).
Suzette Misrachi, Another Field, AU says
Among many ideas, e.g., the window of tolerance, tolerating dysregulation and coming back from hypoarousal or being aware when hyperarousal occurs is critical to my work with adults who grew up with mentaly unwell parents which is based on my research at The University of Melbourne entitled: “Lives unseen: unacknowledged trauma of non-disordered, competent Adult Children Of Parents with a Severe Mental Illness”. It’s free to download. Just Google my name: Suzette Misrachi and you’ll get that + free e-publication updates aimed at busy doctors and mental health practitioners, which I then put on medium.com for anyone to access along with a resource website.
Thanks Ruth and colleagues for such an important series!
Lorelee, Teacher, CA says
I read the first chapter of your thesis with interest. You mention agencies putting the needs of parents ahead of children. Another example is putting the needs of teachers ahead of children. In the Canadian Government’s Document “Psychological Abuse: A Discussion Paper”, by Doherty and Berglund, several Australian studies are quoted re: abuse by teachers. In Canada, School Boards will not fire tenured “bully teachers” because they would need to use monies for other budgetary items to mount a defence against Lawyers hired by the Teacher’s Union and paid for by Teacher’s Union Fees. As Ruth mentioned at the end of the talk, healing trauma impacts our entire society. So does preventing it.
Barbara Kampa, Social Work, South Bend , IN, USA says
Hearing that the key to knowing how to tell the difference between PTSD and Bipolar makes perfect sense. That is very helpful.
thomas purcell, Counseling, Edgewood, IA, USA says
I would like to lettering that think this is excellent presentation. Quite a bit of what I heard tonight. I have been doing, but I have been doing reservation lacking the accreditation that these Presenters process.I have been reading Bonnie’s anguish for quite a lot of time, At presentI haven’t used it. To the extent that the good Dr. brought me to believe in. I will future that I can see now that this is extremely important specially at the beginning when they walk into my office. I worked with several people online using either Skype , or Zoom, and I find it for me. As for filling as face-to-face. This window, we spoke of tonight I have to do some more work on it. I can say it I understand it quite a bit and I think it’s 1 of the keys that I’ve been looking for. When things seem to be hyper or below, particularly when I’m working with bipolar. The recap at the end. I really enjoyed because it pulled it all together for me and if I can I will rewatch this presentation due to the fact that I had to stop and reload page again. I myself have probably experienced. I don’t know how many of the scenario, along with being diagnosed as profoundly dyslexic. As you can see I’m using a voice to text and unless and I do extensive editing which I should do. This is what we get. I have had to have myself a lot of work with other counselors prior to my expanding my practice but has given me the most priceless piece of education that any practitioner may possess. That is, experience and empathy. One man that I worked with for quite a while and brought me around possess the same aptitudes as I do at this time. I have over 35 years as a lay counselor and I am at present working to acquire my own masters degree in counseling and become accredited. Therefore, gleaning all the information in becomes paramount. Thank you, Thomas Purcell
Liz, Psychology, GB says
Thank you for inspiring me – I’ll remember the importance of breathing, movement and encouraging clients to distinguish between their trauma reacting minds and their thinking minds. I loved the description of “Shut up, be still and know what goes on inside” as an explanation of mindfulness … I plan to discuss this with my clients who are a little resistant to mindfulness and worried it’s a cult thing. Great advice on bringing clients back on line – I immediately thought of some of my patients who would benefit from this. In the end sections, great but simple advice about “observe your patient”, how they come into your room, how they are etc.
Georgie, Psychotherapy, GB says
My clients comment on worsening nightmares and waking up tired …. please give some help on how to work with this, thanks
Lorinda Cooper, Counseling, St. Charles, MO, USA says
I’m grateful for these webinars, if I were still practicing I would definitely become a gold member. Retirement is good, and I do miss active engagement with our community. It is a good thing to watch it grow – it’s a great pleasure to see the growing integration of neurological and psychological bodies of knowledge and to see new insights coalesce into more effective treatment.
Sheila West, Nursing, Champaign, IL, USA says
Thank you for the opportunity to understand helping people who are traumatized. I am the retired person that you mention in your video. I retired at age 59. I am a retired registered nurse having 40 years of practice caring for people at their bed side. I also have bipolar one disorder which I have been able to take better very good care of myself through counseling, my psychiatrist, family support, depression bipolar support groups in America. Your Free online teachings have added tools for self-care and helping a
Others heal as well. I appreciate the education which you all have shared with me today. Thank you much!
Joyce, Exercise Physiology, Denver, CO, USA says
This research and practice is extremely valuable! Given there is a large population with ADHD, that is predisposed to trauma thru their neurovariant stimulation apparatus and behavioral patterns, how can this work be fine tuned for them?
Amy Elizabeth Gordon, Coach, UM says
Trust importantance of connection to aide the healing journey. Deeply exhaling, walking in the natural great beauty and remembering the role of acceptance in growing tolerance. Thank you all. Ruth, I’ve watched you for years. This production is top quality. Very well done!
Carolyn Hartness, Another Field, Indianola, WA, USA says
I work with people who have fetal alcohol spectrum disorder, many of them are traumatized. Observation and repetition work best as talk therapy doesn’t stick. I look forward to next week. Thank you
Georgie, Other, GB says
What a fantastic session. I am a mindfulness teacher for trauma survivors and I’m so grateful that you shared this vital information about connecting with the body and the breath and using the body and nature to come back into the WOTolerence! We have had these resources all along, there is far more right with us than wrong with us ! Keep up the good work and I eagerly await the next session .
Jacalyn Brecher, Coach, New York, NY, USA says
Thank you to Ruth Lanius for beginning to talk about Comprehensive Resource Model/CRM. More depth on this approach would be greatly appreciated in future programs!
Deirdre McConnell, Psychotherapy, GB says
Many thanks, for such a clear description of the ‘Window of tolerance’ and how to help folk self-regulate when they are at the edges or further away.
Ruth Lanius’ explanation of working with sensory experience and stepping into emotion, in order to deal with affect at root, then gently engaging the thinking brain in a top down way is very useful and powerful. I will be using this and also Bessel’s references to the huge challenge our clients face, in focusing so as to be able to learn and grow from new information.
I work in a team of arts psychotherapists, with children and young people whose self-regulation challenges resulting from trauma can lead them to exclusion from schools if untreated. Some of those without support have eventually found themselves on a relentless trajectory into the youth justice system.
Through working with the arts therapies we have constant opportunity to offer new and exciting sensory experience, combined with relationality or ‘contact’, in imaginative, creative ways in a safe physical space. CBT is not successful with most of our clients who have need for a much more sensory ‘bottom up approach’, involving creative non-verbal means as well as verbal, to help them find their own personal ‘resources’ to recover from trauma as suggested.
We have difficulty in communicating why and how we often successfully enable our young clients to change – ‘to notice, be present, and increase tolerance of distress’. We attempt to explain to school leaders who tend to see ‘bad behaviour’ and not the adverse experiences which are powering the ‘behaviour’. Sometimes people conclude that what we do must be a mystery, magic or simply unbelievable. But the changes in our clients are based on psychotherapy – and the processes you all so eloquently describe. The master class gives me new language to communicate what we do. I can’t thank you enough for this.
I will be using all this information with – most importantly – my clients, but also with my therapist colleagues and when communicating with senior managers and people in our systems (headteachers, teachers, social workers and others) who seek to understand better how to support the traumatised children they are concerned about, they refer or might refer to our team of therapists.
Thanks again.
I’m looking forward to next week!
Dr. Adelle Gascoyne, Clergy, ZA says
I’ve learned about the training late (and joined the series for 1st time tonight) as I was in rural Uganda giving training, including to children regarding Emotional Action Planning (EAP) and healthy coping skills. My key take away today is the importance of a combination approach to dealing with trauma. I will add the information learned today to the workshops I give at prison on Emotional Action Planning by adding a segment on the effects of trauma and how to widen the window of tolerance when dealing with trauma. The Pastors of East Africa deal with many people who struggle to cope after decades of war in the region and so I’m sure my colleagues there will benefit from the information. I’ll be glad to share it with them. Thank you so much for this training.
Mariel, Medicine, Lexington, KY, USA says
That was an informative session. Thank you! One of the experts commented on gestures of care – her example was of giving a “shivering” patient a sweater during the session. What do you do with a patient whose dissociative trigger is, in fact, the therapeutic relationship itself? When consciously experiencing feelings of increasing trust, safety, and the stability of the therapeutic relationship the patient reacts by shutting down?
As a side note, the commoness of Fitbits and smart watches has made it interesting to see what happens during dissociation. A patient may internally feel overwhelmed or panicked, while they are physically hypoaroused and experiencing bradycardia.
Kristyn Snedden, Psychotherapy, Demorest, GA, USA says
The client situation you describe is really tough. I work hard to stay attuned and present – period. When the client is well regulated we talk about the impact of trauma, triggers and our relationship acting as a trigger and I continually ask the client for guidance on what is helpful. I’ve also noticed what you describe with fitbit feedback and sometimes work “in the moment” to get curious about how to pendulate between hyper and hypoarousal – working to give client an experience of self efficacy. Hope that makes sense. Tough challenge.
M J Shipley, Nursing, Salt Lake City, UT, USA says
I like learning about brain organization. As a Vietnam veteran with years of PTSD this knowledge meshes well with my personal experiences, With new learning, I both understand myself better and sit more comfortably with others.
Shayla, Psychotherapy, IE says
I find that it really helps me to hear this information over and over again, from the many courses I have done with NICABM over the years. Each time I listen, it brings it into a sharper focus as to how it relates to different clients I work with. I found today very helpful on the topic of dissociation/hypoarousal, which I find much more challenging to work with that hyperarousal.
Thank you for offering us this for free, it is a great gift! I hope that I can afford to purchase the series by next week, when it finishes!
michelle massaro, Stress Management, wooster, OH, USA says
This video lesson has been an elegant reminder of all that encompasses the being who is coming to me for massage therapy. So much of the medical massage that I have provided feels like I am relying on unspoken and unvoiced cues. I am more than aware of my lack of training in the area of trauma, and over the years have stood in amazement of what dignified and responsive touch can accomplish where no roadmap was provided. These human instruments we have been given are astounding in their ability to heal. Thank you for the window to the soul you are providing us!
Marcos Baumann, Osteopathy, CL says
Hi Ruth
Today I was able to see the video for the first time. This was possible thanks to my Osteopathy teacher Alain Gehin ( Barcelona )
who gave me the link to this Trauma Program.
I do like a lot the comprehensive style of the program, the variety of topics related to the occurrence, development , work and resolution of trauma.
This body of work that you give resonates in my practice , specially by being centered, present and zero in the sessions.
The ideas presented in Breathing exercise and gently guiding the client to reconnect in the conversation/connection with gentle attitudes, is helpful.
Just want to comment that the audio in the interview with Dr Pat Ogden was difficult to catch, there is a distortion in the voice.
I am thinking of getting the gold subscription , just want to know how practical it would be to apply it in my osteopathy practice ,which is a hands on work.
Much thanks to you, and congrats for your beautiful work.
Marcos Baumann , PT, DC , Osteopath
Santiago – Chile
Ruth Rieckmann, Nutrition, DE says
I give counseling for nutrition and self-care for severely ill patients and their relatives. I often find traumatic response either to recent or childhood situations. I already offer choices and let the patient lead and choose in the counseling process, but after this session I will more closely watch their breathing and intervene actively when they approach the edge of their window of tolerance. This often happens when they want to tell me details about a traumatic situation during the first session. I already use tapping, acupressure, body and breathing exercises and will suggest them earlier and more actively. Up to now I only worked with the body, breathing or tapping after the first session.
Eileen Donahoe, Psychology, CA says
Liked the point about sleep to differentiate bipolar vs trauma. Appreciate the discussion about helping people to accept the present. The discussion about helping people come out of hypoarousal as well as identifying the precursors to entering hypoarousal added some ideas for me.
Garth, Other, CA says
Thanks Ruth! Lots of interesting ideas and approaches to healing trauma as usual. I was reassured by the welcome you extended to laypeople like myself. I was also inspired by the reminder that “Trauma isn’t a life sentence. It can be healed” and that healing trauma is important beyond the well-being of the individual. Thanks for your support of our healing process.
Daniel Barcus, Other, Boynton Beach, FL, USA says
I am a therapeutic parent with a handful of severely traumatized boys ranging in age from 11 to 27. I just want to thank you for allowing lay-folk to participate, and to reinforce how very helpful and informative these sessions are. Most of the healing I focus on as a dad deals with attachment, and today, for example, hearing ideas about how to help my 25 year old who frequently suffers from hypoarousal in his studies at University of Wisconsin. Even among clinicians, I have found that so FEW practicioners really grasp developmental trauma AND the hope for progress. Your teams’ work is a welcome breath of fresh thinking. Thank you! DanB
Bahar Farhi, Psychotherapy, GB says
I will try to help them get out of thier mind and getting into thier senses, by being present in the room and observing whats happens, maybe taking a walk in the nature and being minfull of the smells, temprature and all living organisms around them.
Esther Battle says
I thought you did an excellent job of integrating and explaining the segments from the separate presentations, Ruth. Thank you,
Clare Fuller, Psychotherapy, CA says
Thank you so much. I cannot afford gold subscription as I just started up my practice in a new city, but I have read books by most of your authors, and do EMDR with trauma clients, and I love that you are bringing all the important relevant details to me in a summary. From these texts. Thanks again! I will use this with clients most certainly.
Lynne Euinton, Counseling says
“Lose your mind and come to your senses” was most helpful today. Observing clients.
Thank you.
Sandra Kampczyk-Januschko, Teacher, DE says
One specific point: this session gave me more scientific background for the efficacy of finger-raking the midline of the head, an exercise I heard first by Donna Eden and that has always had also a grounding effect on me. This is something that can easily be done by students themselves on themselves, by also expanding the rib rage and impacting breathing (which you again pointed out here). It looks harmless enough to go under the radar of resistance, and can be a simple exercise for continuous processing of classroom reality for better performance and realizing more of one´s potential. Even remembering it as one more act of self-care in recess can help me be a calmer, more confident, collected and compassionate and even a more feminine leader, as it also increases my receptivity, flexibility and responsiveness. Much gratitude, with a smile on my face: Gracias!
terri rucker, Exercise Physiology, san diego, CA, USA says
Hello,
Took so many notes during this last video, Tolerating Dysregulation and Coming Back From Hypoarousal. I have been teaching yoga for 15 years and recently been certified to teach mindful meditation. I am using these videos and my mindful meditation training to work with trafficked women in a Trauma Sensitive Yoga (TSY) class setting in a recovery home. These past 2 videos have given me so many tools and confirmation that I am doing the right thing in helping these women. Yoga teachers like me who teach TSY and/or any other style of yoga, also use these tools when a yogi has a deep emotion arise during class or meditation. Different breathing practices, grounding the body techniques, connecting the emotion to a body part and staying with it, and paying attention to what’s happening in a nonjudgmental way are all strategies used on a daily basis in my yoga classes. :0)
I am so thrilled that these videos are available to me at this time in my career, so thank you!
Mindfully,
Terri Rucker
Sandra Kampczyk-Januschko, Teacher, DE says
The ideas from this session will be very useful in the classroom. It´s also a bit scary for me to move back into working with many individuals in a sometimes rather rigid and constricted context with diverse stimuli. I feel more confident about it now that I´ve seen and experienced myself the depth of recovery and flexibility that can be achieved by applying what you teach, combined with individual coaching and physical therapy. I´ve used both free access and paid programs from your institute. During this particular session, this thought came to me with a feeling of gratitude and confidence and softness: I will not be able to be there for everybody or know what is going on with everybody. What I can do and aim for is to be an example how we can get to know ourselves more and thus becoming more kind and present and resourceful and fullfilled and confident towards others and with each other. Thank you so much!
Ruth Rieckmann, Nutrition, DE says
Hi Sandra, we definitely need more teachers with awareness of trauma and skillful means to offer to children who suffer from trauma or with disorganized attachment. So much harm is done when teachers feel helpless and react harmfully because they don’t understand those children.
Laura, Another Field, Bellingham, WA, USA says
I am primarily bodyworker but I move into the mental integration by encouraging presence and awareness while I attend to the body of the client.I felt affirmed by the assertion that it is crucial to be able to articulate something of what the one is noticing as one touches into the edges of dysregulation. The ideas of Focusing infused with bodywork seems to correlate with this. I like the idea of connecting the dorsal vagal state of deep relaxation with tapping back into social engagement. I use the bottom up approach of stimulating facial nerves with gentle touch and a bit of coaching (sometimes). I also love the affirmation of the importance of our own mindfulness skills and our own development of interception that can assist our work with clients in guiding them into these awareness states.
Patty Everitt, Psychotherapy, GB says
Using the excellent content from today’s session I want to improve my observation and calibration skills. I also want to pay more attention to helping clients describe what’s happening in their body in the present moment to help them soothe, re-engage their cortex and notice that they are in the here-and-now not the there-and-then.
Lois Bernard, Social Work, Asheville, NC, USA says
Noticing the body and breath first of all and spending time with the person downregulating arousal. Hypo-arousal is still my biggest problem with one certain client. Nothing I do seems to get past the client’s defenses which she is very well aware of having. So that continues to be the area I would like more information on. I also really appreciated the information on sleep and bipolar d.o. vs trauma effects.
Nicole Francis-Cotton, Counseling, SX says
Thank you Dr. Ruth and associates for this great content.
It resonates with my experience with my clients and has added value to me being better equipped to work with clients who are traumatized. Thanks for your clarity in presenting the information also.
Lisa, CA says
I want to thank you for this wonderful trauma series broadcast. I have struggled with PTSD and dissociation over the past few years and have had two very different therapeutic experiences. I was perpetually outside of my window of tolerance with the first therapist and became more and more dysregulated as it progressed. The second therapist is very experienced and trauma-informed. Watching this series has helped me to understand the crucial differences between their approaches and why the second experience has been so much more successful. As a client, I want to let all of the therapists out there know what a difference a deep understanding of trauma can make. Not only has it saved my life, but it has also greatly impacted my husband and four children as a result. Thank you to all of the therapists that practice using these approaches and understandings. It makes all the difference!
Sandra Kampczyk-Januschko, Teacher, DE says
Oh, Lisa, you´re so right… I resonate with your experience. And you really sound like an amazing mom! Your family must be so proud of you and happy to have quality time with you, as you know what it means to be truly present. Appreciating you for just yourself and all your journey, Sandra
RL Jenn, Another Field, AU says
I was really pleased to be able to see this week’s session – it’s the first I’ve seen. There wasn’t a moment of the seminar that wasn’t helpful. Most of the theories, and a number of the techniques, have been introduced to me by a very skilled therapist. Whatever the issue I’m dealing with – medical, surgical, or in therapy – I’ve always tended to seek information. For surgery, it might be to help me make a decision about whether to have it, the technique being used, or questions to ask about the best ways to prepare or rehabilitate. That the information you covered was very consistent with both my therapy experience and the theories my therapist mentions and provides reading material on, is reassuring (though I need little of that with this excellent clinician) and also leaves me with a feeling of contentedness, and trust, as I recognise that apart from the acts of our relationship, my therapist understands and trusts my intellectual interest and ability. For someone who is often trying to escape from the current of emotions dragging me out to sea, the intellectual perspective provides some much needed distance.
srishti nigam,Dr.,edmonton/ ab, Canada, Medicine, CA says
It is good to understand the neuroscience behind the workings of the Window of Tolerance.
the Infographic you provided is excellent
I really like the new way Topics have been organized , especially the way you refocus the take home points after each Expert’s discussion
Much Obliged for your wonderful vision and Presentation
Mahtab, Counseling, CA says
This may sound funny, but I realized today that I am applying both bottom-up and top- down approach with my clients, your program is amazing, thank you for your efforts and passion to make life easier for everyone.
Ella Flemister, MFT, LMFT, Marriage/Family Therapy, Griffin, GA, USA says
This was an awesome presentation! I especially like the “Window of Tolerance” segment. I will use this information in my practice to help clients understand their window and how they can learn to self regulate.
I think the Window of Tolerance (WOT) is something I can utilize in several ways for clients who are not traumatized.
Thanks to all the presenters for this series.
Hilary Jones, Psychotherapy, GB says
I liked what /bessel said, that most of us are patients. I liked, was it
Bill, who emphasised observation- a useful tool for use at any time. But I liked best of all what Ruth said, that when you work with a traumatised client, you change the course of civilisation, because you will reach that person’s whole family and all their contacts- this touches on all the meanness and cruelty in the world, which it’s so desperate to reduce
Jeff Lubin, Marriage/Family Therapy, IL says
Very interesting. I hope there will be more talk about the actual methods of trauma treatment. There has been some and I would like more, in particular in the form of actual therapeutic sessions conducted by your experts. If you are not going to show that in the remaining sessions, is there another offering in which you will show much more of it? Theory is needed but needs to be complemented by extensive observation of practice. It was said, for example, that some people experience a high frequency of traumatic flashbacks due to self-loathing but it was neither explained nor shown what a therapist can do to counter that. I don’t think it is enough to simply ask a client if he is doing that because he hates himself for past crimes.
Deb Jones, Teacher, Fort Worth, TX, USA says
Thank you, Ruth and all of the expert team.
Fabulous and truly life changing!!! I’m recovering from a pharmaceutical brain insult as well as a 30-year multiple sclerosis journey – entangled with parenting a 28-year-old adoptee with Fetal Alcohol Syndrome. To say I’m traumatized and so is the rest of my family is an understatement.
I am working with a counselor and have embarked on a season on healing to hopefully kick MS back into remission for the umpteenth time. I also own a parent training business and work with many adoptive and foster parents training them in the work of the late Dr. Karyn Purvis who was our mentor and teacher for nearly 18 years.
This knowledge will help me help parents who are in the trenches with kids from hard places. It will change generations to come as well as my own family will be starting a new generation at the birth of the new year as we welcome in our first grandchild, a grandson!
I still can’t believe y’all did this for free. This Texas gal with Connecticut roots, Ruth, is so grateful!!!
Blessings,
Deb
Carol D Rogers, CA says
wondering how to incorporate going to beautiful outdoor spaces when our Northern Canadian winter is harsh and long…any ideas ?
Elmira, Counseling, Bloomington, IN, USA says
Sounds so hard! I wonder if you could incorporate using photos of the places that clients like looking at, visualization of favorite vacation places. Also, it made me think of other sensory activities that could be used: being in a hot sauna or having nice warm coco/tea while cuddling up in a warm blanket :), playing with play dough…
Garth, Other, CA says
Laurel Parnel in her “Tapping In” book describes accessing states like this by simply imagining them with as many senses as possible involved and using bilateral tapping to reinforce it.
Angela, Coach, DFW, TX, USA says
Guided, meditation, virtual reality programs, indoor gardens/solariums, collage/vision board creation are things that might be worth trying.
Viv Todd, Another Field, GB says
The ideas come from the client-what they love doing…wasn’t this meant as an example of that..it’s what she liked. Diff clients will be able to ID their own useful activities?
Elizabeth, Psychology, AU says
I have done that with clients in a cold of winter. Just dress up warmly and go outside into the park or the woods. Observe the moss on trees with icicles reflecting the sun-rays, the silence of the snow-clad landscape etc. Another hint: observe the frost patterns on the window panes from the inside of a warm room. I also work with people to acess memories of the past lived moments out-side, when nature made an impact. Most people have one or two memories of beautiful open landscapes they viewed and were impacted positively such as the view from the beach or over a lake or of the mountains or hills with the horizon line, sky and clouds etc. So going back to those memories has a positive effect as well (one of them, which is not an open landscape but a place in nature: was sitting in a green tree, up high on a limb being surrounded by a sea of leaves and feeling safe and having an advantage over those below (“vantage point”) – having control.
Adelle Gascoyne, ZA says
Carol Rogers, sometimes one is unable to get to a beautiful spot in nature, but reliving a memory of such a time can help one calm down/cope. I once suffered involuntary spasms (pulling up into fetal position) and trouble breathing from a medication I was allergic to. I was hospitalized at the time and was freaking out a little bit, because I didn’t understand what was happening and had no control over those frightening effects. My distress made the effects worse. My dive buddy came to visit during one of those episodes. He held my hand and guided me to thinking about a dive we really enjoyed a few days before. I was able to cope with the spasms and breathing difficulties better as I visualized our dive. I could feel the gentle surge of the ocean and see the soft corals in their beautiful colours. I was able to ‘hang in there’ (reliving a relaxing dive), while the nurses scurried around to find out how to reverse the effects of the meds. So perhaps encourage patients to revisit a favourite memory of an activity in nature that relaxed them. One of the speakers mentioned a patient who used walks in (and later drawings/paintings of) her favourite woodlands to calm down.
El, Another Field, CA says
Hi Carol,
I am from BC Canada, am a trauma survivor and retired medical professional. Winter is my favorite season as we embrace winter activities such as cross country skiing, snowshoeing, photography and walking. The winter landscape is phenomenal and ever changing. It is advisable to find a group of mentors to introduce you to, encourage you and accompany you on these winter outings. Look in your community for outdoor groups or someone you know who is experienced. The appropriate outdoor clothing, hydration and food is vital to a successful experience and again mentors can advise. Once you are comfortable with the activity you can begin to observe the incredible beauty of winter. Walking, skiing and snowshoeing in the moonlight and sunshine is unforgettable and uplifting. The benefits of the exercise cannot be understated.