On Trauma Therapy

I'm a licensed clinical social worker who specializes in complex trauma. I am currently taking therapy clients in Washington, DC, at the Viva Center, which is in Dupont Circle. I'm also happy to provide consultations on how to become a trauma therapist, graduate school, whether to get therapy or most anything else related to trauma, send me an email at sara.staggs.lcsw [at] gmail. I'd love to hear from you!

[traumatherapist]

Aren't we all?

[humansofnewyork]

(¾) “Sometimes my anxiety would get so bad that I’d turn completely white. I’d shoot out of bed some nights, and my heart would be racing, and I’d start running around the room trying to find stuff. My wife would have to physically put me back to bed. Then one day I was taking a train out of Hoboken, and we were passing through these wetlands, and there were all these reeds, and it reminded me of Afghanistan. And I looked down at my phone and there was a Facebook post commemorating the anniversary of the death of a guy in my company. And I got dizzy and couldn’t talk. I thought I was having a heart attack. I just couldn’t take it anymore. I had to get help. I went to the emergency room at the VA and was diagnosed with PTSD. Eventually I found my way to Headstrong Project. At first I dreaded going to therapy. I went through a treatment called EMDR. My therapist would take me back to every point of trauma and have me describe it in detail. It was like literally going back in time. I could touch the faces of all the guys I’d lost. I could talk to them. We could talk about what happened. And how we all knew the risks. And how sometimes people died. And it was nobody’s fault. And I could apologize to them. And when it was over I’d be completely exhausted. And I’d feel like a bitch because I’d just cried for an hour. But it worked. The symptoms started to go away. After a few sessions, I remember walking into my therapist’s office and saying: ‘This stuff actually works!’ And he said: ‘Yeah. It does.’”

[mollyostertag-deactivated202310]

personal comic about being sad

[eventidetempleguardian]

Sylvie: What lies ahead for us, I wonder?

Athos: It really doesn’t matter.

Sylvie: Doesn’t matter?

Athos: Not if we face every challenge the way we always have. With great passion; hearts that stay true to all we hold dear; courage, no matter how many enemies lie in wait for us; faith that daylight will always follow the dark.

Sylvie: And love?

Athos: Above all else.

[traumatherapist]

Triggers are portkeys

How did I not see this before? They transport you to a different time and place. It's disorienting and while obvious, the way back is sometimes really difficult.

[traumatherapist]

[epiccsocialwork]

Things I never learned in graduate school but found out real fast on the job:

·       1 in 3 women is sexually assaulted, but it seems more like 2.9 out of 3. In my work setting, there are weeks when every single one of my female clients is living with some form of sexual assault. I was floored and my spirit bruised.

·       Sometimes clients will ask you about yourself and it does not mean they want to blur/destroy boundaries. Sometimes they just want to know that you’re a real person who also has to go out and face life on evenings and weekends.

·       This work will change you. Being changed is different from being burned-out. The change should be named. It brings with it some important gifts (strength, courage, depth, gratitude). The burn-out should be avoided: one seasoned clinician said, “Most of the time when someone truly burns out, they will never come back the same.” This has motivated me to pace myself and pay closer attention to my own health and work/life balance.

·       The more you work with real human beings with real stories, the less you understand the DSM.  And that feels okay—the DSM is a guide, not a legal document. 

-  Jennifer Andrashko, MSW, LICSW, is an ACSWA member and Behavioral Health Coordinator for a regional health center in rural Minnesota.

[traumatherapist]

ISTSS was surprised to learn how say much clients want in their treatment. Most clinicians probably aren't. It’s sad that researchers are out of touch with a client-centered approach so this is an important wake up call. Clients want to be informed and have choices in their PTSD treatment!

[traumatherapist]

[humansofnewyork]

“Some of my colleagues tell me they can’t imagine working in pediatrics. Millions of years of evolution have conditioned us to respond to the cries of a child. We can’t bear to see a child in pain. And once we have children of our own, it makes the work even more difficult. We all handle it differently, but everyone cries at some point. Not in front of the patient, but everyone cries. Every few months we have a ceremony where we mourn all the children who have passed away. We have a slideshow. We make cards. We talk about them and remember them together. We acknowledge that we all feel the loss. And even though our grief is not as significant as the family’s, it’s not trivial either. And we must take time to acknowledge that. Or all of us will burn out.”

[traumatherapist]

When I was in school, books with a gazillion editions were my nemesis. I mean, is the latest edition 97 times better than the previous edition? ‘Cause that’s the price difference.

Now I LOVE ‘em. I can buy a previous edition for 1 lousy cent for my personal use. These came in this week. Actually, The Skilled Helper is an update for me, since I just gave away the 7th edition.

Occasionally I’ll find a new edition with tons of updates that do make it a much better book, and then I may wait for an end of term to see if some used copies come out. But usually the penny edition means that I’m going to read a book that I otherwise would not have read. Just a thought for those of you eager to get a jump on your psychology education, or post-graduates looking to expand your knowledge.

[traumatherapist]

Update

Hey followers!

I know posts have been sporadic, and that’s probably optimistic.  I am currently working on the transition from living in Ghana to moving back to Washington DC now that my partner’s 2 year post is up.  It is, of course, a time of great euphoria and deep sadness with lots of goodbyes and exciting plans.

 So, basically this blog will continue to be pretty quiet until August, when I am somewhat settled in DC. Why am I so confident that I will be blogging regularly again?  Well, I already know where I will be working—at a private practice near Dupont Circle working once again with adults with trauma histories. Also, the obstacles that are part of living in West Africa—lack of internet access, feeling out of touch with America/Western culture and concerns—will dissipate. Then I’ll just have the same-old obstacles—busy schedule, writer’s block, navigating ethical issues—and I already know those are no match for my desire to connect with you.

 So thanks for hanging in there these last 2 years.  I know that it hasn’t been that exciting for this Tumblr, but it has been a time of intense emotional, spiritual, intellectual and professional growth for me and I know that I will be a better clinician and writer for it.

-Sara

[traumatherapist]

[incidentalcomics]

Interior Life

[traumatherapist]

I don’t know much about David Bowie, but I know he didn’t become an icon because of his ability to fall in sync with those around him.  We can’t all live like rock stars and we can’t all be icons, but maybe it’s still true that when we’re our authentic misfit selves, we are our most fabulous.

[traumatherapist]

What is Trauma, Part 6: Dysregulation

Someone with a healthy regulation system follows the yellow activation pattern:

A) starts with a calm baseline B) gets activated without being out of control C) does not remain at peak very long D) starts calming relatively quickly E) is back at baseline after establishing she is no longer in danger

Someone whose sympathetic response has been dysregulated by trauma will follow the red:

A) starts with a higher baseline due to being hypervigilant—her brain is looking for anything that might even RESEMBLE danger B) will spike extremely high and will leave her window of tolerance, resulting in either a panic attack or numbing/disassociation C) will remain at peak a lot longer than necessary D) when starting to calm, it will take her much longer to return to baseline E) may not even be able to return to her initial starting baseline, continuing the cycle of dysregulation

Another response is numbing, which can occur at any stage of the response and would be represented by a plunge toward the bottom axis of the graph.

[mentalhealthresource]