Last month, I was in Cape Cod, Massachusetts, learning from the experts of The Trauma Center, founded by Bessel Van der Kolk, and home to some of today's foremost research on trauma and the brain. I attended seminars on the complexity of adaptation to trauma, how to work with dissociation through component based psychotherapy, and trauma sensitive yoga. Here are a few takeaways:

From Joseph Spinazzola's talks on Complex Trauma:

• The seat of consciousness is in the brain stem, not the frontal lobe.
• Instead of "I think therefore I am", it's "I feel my body, therefore I am."
• Psychological maltreatment happens more than any other type of abuse and leads to a 93% higher risk of addiction.
• "We can become addicted to pain, when it is inseparable from love."

From David Emerson's talk on Trauma Sensitive Yoga:

• Our yogic third eye is called the medial prefrontal cortex in brain language, and its purpose is to locate where our physical body is oriented in space.
• Interoception is the ability to sense the body, and is dramatically decreased in trauma survivors.
• Building the ability to sense the body helps us re-learn the body is a reasonably safe place.
• Goals of trauma sensitive yoga are
  • Empowerment
  • Making Choices
  • Present Moment Awareness 

From Fran Grossman's talk on dissociation:

• Everyone has parts of themselves that are sometimes at odds.
• The degree of the separation between the parts reflects the degree of trauma.
• The goal is to get the parts cooperating and healing, not to eliminate them.
• Creating meaning in the story of one's life is a key component of therapy.

Part of what we do in therapy  with any client, whether trauma has been present in their lives or not, is help them gain coping skills to manage stress, moods, circumstances, and the unhelpful reactions and thought processes that come along. Meditation and mindfulness are the cornerstone of this practice at Flourish, and I am always looking for ways to share it with clients. On breaks from this summer training, I enjoyed lots of time at the beach. The video below was taken at the Nauset Lighthouse (pictured above, yes it's the one on the Cape Cod chip bags!). I found myself lost in the sound and the beauty of water moving over rocks and sound, and for a moment found a peaceful and contented place within. I captured the moment to share here on the blog and with clients in session. Sensory tools like this video may help to cultivate clarity, focus, and to filter out the mental chatter that doesn't serve us. 

Watch this 1 minute video and be sure to turn on your speakers. Notice:
1. What do you find beautiful?
2. What do you find distracting?
3. What judgments do you make? Is the clip too long, too short, too loud, too boring?
4. What past experiences does it bring up for you?
5. What hopes for the future does it bring up for you?

Here is an introduction to Solution Focused Brief Therapy written by Flourish' new therapist, Megan Kennedy, LMSW. 

When things in our lives arise that we see as problems, it can be more natural for us to focus on why the problem exists, how it emerged, and what we are doing that’s allowing the problem to remain present. As a counselor, I believe that searching for the cause of people’s problems is not nearly as useful as exploring what has been different when the problems are less severe or non-existent. Counseling from this approach is formally called Solution Focused Brief Therapy or SFBT for short. Developed by American social workers, Steve de Shazer and Insoo Kim Berg, this counseling approach is very much strengths- based, future focused and heavily dependent on a collaborative relationship between the counselor and client.   

As noted by Wayne McCashen in The Strengths Approach, SFBT emphasizes solution talk over problem talk in counseling sessions and is more concerned with how solutions work than how problems work. This is not to say problems are ignored, but rather than focusing on problems, counselors look for exceptions to problem. This means solution-focused counselors ask people questions that seek out times when the intensity of the problem was lessened or absent all together (i.e. exceptions). Exceptions to problems often highlight our strengths and resources, which can help foster change. 

From a solution-focused perspective, it is more valuable to concentrate on what people are doing when the problem is nonexistent or less severe than to focus on what people are doing when the problem is greater or more frequent. But what does this really look like in practice? Counselors may begin by asking the client to describe what things would look like if the problem was not present. We call this the “Miracle Question.” While there are various forms of the Miracle Question, it essentially asks, “If you woke up tomorrow and all of your problems were to magically disappear, what would be different?” The client’s answer to this question paints a picture of their preferred future.

Here is a very basic example of beginning stages of SFBT in action:

If a client answered the Miracle Question along the lines of, “I would not argue with my child every day,” the counselor might reply by asking the client to describe a specific time or times when arguing with the child did not occur or occurred less frequently. Once the person has answered, the counselor may ask for elaboration through questions such as: “What was occurring instead? What circumstances were present that allowed a more peaceful environment?” and so on. Within the client’s answers to these very purposeful questions, we find exceptions, which aid in providing a direction as to where to start for change to occur.

When clients begin to recognize that exceptions are always present and can be used as catalysts for positive change, hope and confidence emerge. From here, plans can be made and actions can be taken towards a preferred picture and transformation can begin take place. The solution-focused approach offers a context that underscores and respects people’s capacity to be their own agents of change, shifts away from pathology and emphasizes people’s strengths and abilities to be their own experts in times of hardship and adversity.   

References

McCashen, W. (2010). The strengths approach: A strength-based resource for sharing power and creating change. Victoria, Australia: Innovative Resources.