How to Help Clients Tolerate Dysregulation and Come Back From Hypoarousal
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with Stephen Porges, PhD;
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with Stephen Porges, PhD; Bessel van der Kolk, MD; Pat Ogden, PhD; Ruth Lanius, MD, PhD; and Ruth Buczynski, PhD
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Many many thanks for offering these excellent sessions for free. I learned about new tools and gained more understanding for healing my CPTSD.from childhood abuse. Mindfulnessness and meditation have been key for me. And now I find I am also able to support my students in emotional regulation. What you said is so true and powerful. This work to heal trauma is so important impacting individuals, families, communities and the world.
The “bottom up” approach described by Ruth is something that I have found particularly helpful to avoid trauma imprints. Processing potentially traumatic experiences soon after they happened, in a safe and “resourced” environment, helped me to avoid holding on to pain from threatening experiences.
I am a Licensed Clinical Social Worker, currently not practicing ,however, I am planning to do volunteer work, your program has inspired me to put this learning into practice. Thank you very much.
Acceptance is important and how I can help one particular client to understand where she is with her not liking her physical being. An example, she does not like to have her video on during our telehealth sessions. It seems she is fearful of having me (the therapist) see her and/or seeing her reflection on the screen.
Thank you!
I look to the hills from where comets my help.
So beautiful to be…in nature…to be one….with nature.
Thank you!
Thank you so much! I am a foster parent raising three children with trauma disorders and one in particular has a lot of somatic responses. The tools I learned with be helpful to me in helping her! I am also back in school to hopefully become a LCSW and trauma-informed practitioner. Thanks again.
What about reactive attachment disorder?
The literature says this is rare but I don’t think so.
Thank you so much for providing this information. As I was watching and note taking, I was thinking of ways I can better help my clients. I even thought of specific clients that would benefit from the information you have provided.
The importance of being there in the moment with the client, to be able to loose our heads and come to our senses is so important for us as therapists – which helps our clients to do the same and supports their self healing systems. Thank you.
I am a graduate student in clinic mental health counseling. I appreciate that I have access to these educational videos for free as a student. I look forward to becoming a member when I become a practicing mental health professional. Thank you.
I am a non clinical peer support provider. thank you for making this accessible to all. Trauma informed care is an area that I wanted to have more than what I learned from my local Dept of Drug and Alcohol classes.take aways:” trauma is not a death sentence.” I will pay more attention to body language with the individuals I see. Thank you for putting these presentations together.
Hi, Can any of you please comment on the work of Dr. David Bercelli, founder of TRE (Tension Releasing Exercises), meant to recover from PTSD symptoms? Have any of you used his technique, and how did your clients benefit from its short and/or long-term application? Did it help with chronic trauma?
I’m glad marriage/family therapists are paying attention to trauma. I suspect that many of the cases they see have trauma as an underlying element.
Yes that’s certainly true for my practice John. Either one or both have levels of past unresolved trauma and this usually needs to be worked through first before effective couples counselling can commence
Very interesting. I’m a lay person; not a therapist, but learned some useful tools to use when I become deregulated in my emotions, as well as how to bring myself out of that paralyzing dissociative state, when I am simply too fearful to risk anything. Thank you very much.
Thank you all so much
I will start to use the idea of naming what I see in my clients. ‘you are shivering, tell me about that’……what are you feeling. I will be using breath work more, deep breathing. Also, the idea of bringing the client back to the room, back to the relationship, allow them to see you or move about to bring them out of disassociation
Emotional regulation in balance.
Guided exploration for internal and external grounding that allows for processing.
I attend up to three times per session when possible, take notes, and still find new information during each broadcasting.
Excellent info. as always.
Hello, and thanks so much for this series. My question is regarding the diagnosis of ADHD and how its symptoms can be very similar of a highly traumatized patient. I have a client who freezes during sessions when his partner begins to share some distressful emotions about their relationship, and he was previously diagnosed with ADHD. He is unable to sequence the facts spoken, doesn’t know how to describe his emotions clearly, and, after the fact, states that he can’t remember what just happened. Still, I wonder if his symptoms and defensive dissociation are more related to pre-verbal trauma than to his ADHD. How to clearly distinguish between both? Can you please give a clear example, like the bipolar differentiation you gave us?
Gabor Mate M D feels preverbal trauma is a primary cause of ADHD. I saw something recently where Dr Van der Kolk suggested it could be either and the importance differentiating. I know of a client who had a TBI as kid and was thought to be ok because he functioned well in many respects. Much later in life a functional MRI showed the ventricles on the side of the impact were not visible.
I have been teaching therapists to work with traumatised clients and working in this field for many years but listening to the experts and Ruth’s summaries have reminded me of aspects If have neglected or undervalued their importance.
Thankyou so much
This series has helped me tremendously in the comfort of my own home. Thank you very much.
How does the role of conventional exercise (walking, biking, strength training) play a role in trauma recovery.?
Hard to get program tride for days very hard to get
I’m really appreciating the wonderful combination of intellectual with practical information in all of this series from such an experienced & generous group of experts! You are deepening my understandings of both my own healing & wellbeing journey & my clients. I particularly liked hearing Bessel today differentiate Trauma events from Childhood emotional dysregulation (neglect, abuse, attachment problems & emotionally unavailable parent/s). As an Advanced Practitioner of EFT Tapping, I’m finding everything being said is reassuring me that EFT includes many of these aspects already (sensori-motor, bottom/top, processing past in present, acceptance, etc), and what you’re saying is helping me understand them in new or deeper ways. So that my challenge now is to reflect & apply your wisdom to further refine my ability to serve my clients really well. (Also loved Bill OHanlon’s reminder at the end that despite all the theory, in a session Watch The Client! as they have all the information about themselves). Thank you from Australia!
Thank you for todays session … I am an Integrative Psychotherapist and I work as a senior training and development officer for the Social and Health Education project n Cork Ireland. Every year we run a129 hour experiential group work personal development course with over 100 participants. Groups are facilitated by 2 psychotherapists. At evaluation we hear how the course has impacted on participants lives .. how their self confidence and self awareness has improved … how their relationships with themselves and others has improved and often how participating in the course has changed their lives . Sometimes people comment on what we call our getting here at the start of each session. This could be a mindfulness practice, body scan, visualisation .. listening to poetry etc Some participants have said they have found these practices distressing … just having to sit still for 10 mins never mind expecting them to engage with a body scan. After todays session I understand why this is and Will with my colleague orgainise a session with the facilitators before they start working with the groups in the autumn to discuss this issue and see how we can listen in a different way to the participants feedback , help to resource them and be sensitive to their distress and not continue to expect them to sit through a what we might consider to be a benign exercise that possibly is traumatising for them.
Also I had taken a 3 year break from my own small private practice after my husbands death … listening to the webinar today has set a spark to my love for the work and has motivated me to start back with my client work .
I am deeply grateful to you all for your generosity and care in offering these webinars to help us learn how to work with our own trauma as well as with our clients
Deirdre O Sullivan Killarney Co Kerry Ireland
Thanks for sharing Deidre, that’s helpful to know re your group feedback on the sitting still impacts. Like you, it now makes sense to me, after what we heard today. And actually thanks too because it reminds me that I did hear or read once that getting schoolkids to do mindfulness or relaxation in class (eg to calm after lunch) can be triggering for refugee kids & I wondered why. This explains it.
Hi Deirdre, I’ve heard various trauma-informed meditation teachers address this. They’ve said that walking meditation works well. I imagine one can do a body scan while walking–mindfulness–which is essentially what a walking meditation is. Hope that’s helpful. 🙂
I’m intellectually curious about this topic, and myself have experienced trauma, without ever being in psychotherapy. I think being in sync and acceptance were mentioned as helpful practices, and this resonates with me. As hobbies I’ve practiced yoga, dancing, singing and improv. And believe improv (also martial arts) is especially helpful in practicing acceptance on whole different level. Improv is based on the “Yes, and” pillar and connection, and I’ve found this to be very useful in life and work.
I’ve work with many not so smart people in IT, and learning to accept the reality has helped me so much to calm down, do what I can, but not to expect too much can be changed and be as efficient as I’d like it to be.
And playing improv games with good improvisers is an unforgettable experience of creativity = imagination having fun.
Thank you. I’m not a therapist but have been considering a career change and have had some severe childhood trauma. I see myself in both hypo & hyperarousal descriptions, depending on the circumstances & environment. I will try using the terms and examples here to talk to my mom about our relationship and why I respond—or don’t—the way that I do. Hoping that this will help push me to make the financial investment in a master or PhD program to help some of the people around the world who have experienced and continue to experience traumas from families, religion, culture, wars, poverty, and more.
I am a Neurologic Music Therapist who works at a mental health clinic that uses Neurofeedback therapy. We work mostly with trauma. Although Neuromusic therapy is a bottom up approach we are continually working on integrating top down and bottom up approach. This training just confirms that we are working on the right direction. Thank you for providing a wonderful resource to so many of us working with Trauma. I hope to see more research specifically with Neurofeedback therapy and Neurologic Music Therapy!
I like the awareness around top down vs. bottom up – calming (top) and safety and connection (bottom).
Thank you a lot for sharing. I can’t afford these sessions.
I have patients who have trauma (rapes mostly); I think I can help them more effectively.
Thank you again
That was so very interesting and informative. I found the description of inviting the client to go into the ‘felt sense’ in the present when dissociation occurs particularly helpful.Thank you so much!
The series so far has been very informative.
I wonder why EMDR Therapy has not been mentioned yet among the treatments suggested since it would seem to be highly relevant to much that has been presented.
I think it will come up. what surprises me is how Tapping is rarely mentioned. I use EFT and it works extremely well with trauma and reprocessing.
I am not a mental health professional. I’m trained as a volunteer facilitator for grief & loss support groups and am currently a volunteer for the American Red Cross (ARC). With ARC, we meet typically people immediately after they’ve experienced a traumatic event – hurricanes, wildfires, and one of our current ARC response events in Uvalde to assist the families & the community. The segment that resonated most for me today: ‘Observe the client’ and will have this on repeat in the brain as I’m meeting people when deployed. Thank you NICABM – this Treating Trauma series has been invaluable for my continued learning and understanding about trauma. With so much gratitude to your organization for making it available for free and for non-mental health professionals, and thank you to the practitioners for offering your experience and expertise. Now I’m off to buy some of your books to continue learning and understanding. Thank you again!
Thank You for the excellent integrative ideas.. I really enjoy your presentation as I process or revise my own experiences or thoughts. Trauma is one of the most challenging subjects and so IT is trying to help those in need!
As a dance movement psychotherapist (DMP) I feel very much confirmed and encouraged through your teachings. In my area of expertise I can tap into an amazing pool of resources that is helpful for trauma clients; to mention just a few: The combination of bottom up and top down approaches, processing emotions instead of just reliving them, creating rhythm, interaction, for regulation and being in sync with others, music, relaxation and breathing techniques, creativity and imagination (vision for a better future), movement observation (!), somatic counter transference…and so on…
Thank you!
This has been so great for what we do with MoCrazy Strong llc! We give educated guidance through peer to peer support for TBI survivors and family caregivers! TBI is “Traumatic” Brain Injury. This series of seminars is giving us great ideas on recovery and understanding for the Trauma portion on TBI! I also love all the comments on mindfulness! That is a huge aspect we focus on in recovery from TBI. The most miraculous healing for lived experiences come from mindfulness and Person Centered Practice, which was touched on today I think by Stephen Porges, PhD to “observe the client do not fall back to statistics or stereotypes”.
If anyone would like to contact me about our TBI work or has individuals or families they think would benefit from MoCrazyStrong.com feel free to email us! mocrazystrong@gmail.com
MoCrazy Strong has two employees listening and we have become a Gold Member!
Again, thanks so much for your work of investing in your traumatized clients, like me. My husband is a therapist too. I’m a Trauma-Informed Coach and a survivor of childhood trauma with a diagnosis of CPTSD. I sign up for your Free sessions when I am able because the information allows more understanding to what happened to me during the trauma which took place as a child and how I carried it for so many years. Also, it brings more detail to my healing journey. Thanks so much for the SAFE SPACE you’ve all created, the huge hearts you’ve grown into, and the obvious LOVE for helping people, their families, communities and the world.
My take away from this webinar: I will cultivate presence in my own life and in each session with each client. I will be curious, observe, note what is happening inside of my body, and support my clients in doing the same. Thank-you.
Eloquently Expressed by all and esp. by Ruth. Wish to hear again all videos. Very useful ideas shared. Congratulations and Stay Blessed!
Thank you for your wonderful presentation and combined knowledge and wisdom of how to help those with Trauma.
Very much appreciated.
Its so helpful to learn that disorganized attachment is alongside the trauma memories of a particular client who is unable to narrate her internal experience, or remember much of the trauma altho naming it – starting sessions with mindful breathing, working to help the upper and lower parts of the brain connect more – and encouraging her with some activities that will help her sync with people (dancing, tai kwon do or Qi gong) are good ideas. Mostly however i believe i need to do my own mindful meditation practice before this client to tend to my therapeutic presence first.
Thank you- I will use the nature walk and bottom up top down approaches. Really connected with the “make contact” and importance of observation. Loose your mind and find your senses is gardening for me! Thanks so much for these free sessions ~ they make me a better counsellor!
Excellent
This session was so helpful! I’ve been researching Vedic astrology as a predictive tool for healthcare through the nervous system, and your insights are mapping 1-1 and provide so many insights! You’re correct What can seem like “alternative healthcare” from other cultures have mapped solutions that are in alignment 100% with your discoveries thousands of year ago. It’s very beautiful to see these alignments across cultures.
Outstanding integration of body-mind-emotions! I wonder about including the rich spiritual domain?
It is enormously helpful to have Ruth outline what we will learn following up to clarify, emphasize salient points and summarize so succinctly and clearly!
Along with Peter Levine’s physical tools to self-soothe, teaching EFT, “Tapping”, could be another simple tool to aid people in becoming Present & facilitate connection with the therapist. Dr. Pat appeared to naturally be “tapping” her own body into Presence as she recounted experiences with clients…
What of the role of dreams…..? How can we help people access their messages?. What are effective
ways to deal with ongoing night terrors for Veterans and/or other traumatic situations? Dr. Bernie Siegel
used dream work effectively with his cancer patients.
Jonice Webb, Ph.D coined the term Childhood Emotional Neglect (CEN) . She deftly illuminates the effects of what kids did NOT get and how that plays out in their lives. (“Running on Empty: Overcome Your Childhood Emotional Neglect”) Bessel van der Kolk & she would have much to share and compare! I think Ruth B would enjoy a conversation with Jonice to explore common interests; both women would resonate on many levels.
I’ve become a Gold subscriber! This will enable me to further digest ALL your excellent information.
I applaud your heartfelt mission to bring this cutting edge information free to our needy world!
Rose Cook, MSW (Denver University)
B.S. from UCONN
I would love to hear more strategies for helping those with trauma-induced hypoarousal to come out of that state safely and securely.
So grateful for this opportunity to learn more about healing trauma. I am 80 years old and trying to figure out what happened in my family. Bless you all for making it available!!
Very interesting! Thank you. I have one question….does trauma-induced hypoarousal sometimes manifest as lack of libido, or perhaps disinterest in physical activities (such as exercise, dance, walks, etc.) Or as angefonia?
There were lots of take away messages which links in with my research entitled: “Lives unseen: unacknowledged trauma of non-disordered, competent Adult Children Of Parents with a Severe Mental Illness” at The University of Melbourne, Australia. If people google my name Suzette Misrachi that research should come up. Today also touched on the short articles on trauma and grief I’ve been invited to write by a psychiatrist for an e-publication (aimed at psychiatrists and various mental health practitioners) which I then put on medium.com for free for the general public. But I was left with 2 questions:
1) Can one “be stable” in unstable relationships, and if so… why was this not mentioned?
2) Can one’s Window of Tolerance be so big as to have someone fall/crash through it? For example, in the case of parentified individuals. I wrote an article about this entitled: “Parentification: A License to Kill Childhood” free for the general public (you’ll get it also by googling my full name).
Thank so much NICABM for this important topic. I greatly value all of your impressive presenters! Suzette
Ruth and all marvelous NICABM counselors – thank you. I am a journalist and English as an additional language teacher interested in communication in all its forms, including non-verbal communication. In my adult life, I continue to explore the effects of culture on the ways people chose to communicate or hide their individual selves.
Have you some concepts that you “wish” friends and families of your clients would understand?
Are there behaviors, with or without words, that would be helpful?
Are there “dumb” things people say or do that are possibly well-meaning but definitely counter-productive?
I read as many comments as I can from a world-wide community that expresses such appreciation for what you offer freely. I join them, and I also thank your subscribers whose support keep this gift in existence.
Thank you. Very concrete content that help to feel the theory (and not only to stay in the head with it).
Process that is relevant to be able to do as a therapist in order to help the client to do it as well…Keeping our humanity and being connected to oneself as a therapist is essential. Indeed, the therapist is an example or a model for the client.
I can’t thank you enough for providing these webinars for free. I am an abuse survivor and a single mother that fled an abusive husband and is raising traumatized children. I NEED these tools and the information I’m learning just to get through the day and help my children learn to self regulate. I thought we were all ADHD but now I realize, maybe we aren’t. We just don’t know we are dysregulated or how to “fix” it. We are in therapy but some of our therapists are ignorant of polyvagal theory etc. I am passing these concepts on to them in hopes they will explore them further. Thank you, Gold Subscribers many thanks to all you wonderful teachers!
I am a teaching artist with a trauma informed approach and somatic movement, and consider art making to be a movement practice as well as a valuable way to explore our environment, identities and how we make meaning – and i am usually working in under-resourced communities carrying a lot of generational trauma. Since I often have 30 students at a time, the more awareness i can hold about manifestations of trauma/disorganized attachment and how to appropriately respond in the moment, the better.