Is Your Client Stuck in the "Low Road"?

Much of what a trauma-informed clinician does is help clients and patients understand the ramifications of the trauma they have experienced. How do you do this? Using a variety of means, including media available online can go a long way to begin this process. 

Often, people who are wounded minimize what has happened to them. This is understandable. Denying that we have experienced "trauma" is one way humans survive it. However, after the events and circumstances have passed and the individual is suffering with depression, anxiety, startle response, nightmares and other effects, acknowledging "trauma" is essential for healing. 

This clever video is one I use to help clients know that they are not "crazy" or hopeless. The brain has been misfiring and setting off a process in the body that can be changed. The "low road" (amygdala) gets triggered and bypasses the "high road" (rational brain). Then it conveys that the person is in danger when in fact, he or she is not.

Understanding this brain process is a first step toward healing. What's next?

Fearless Not Reckless Means Trauma-Informed Thinking

Trauma-related conditions include Post-Traumatic Stress Response, dissociative disorders, depression and anxiety. One related condition that many practitioners may be fearful of treating is Borderline Personality Disorder. It's time for us to apply trauma-informed thinking to this condition. One way we can do this is by challenging the current diagnostic system's labeling of the after-effects of trauma as "personality disorder". Here, Dr. Jay Watts discusses "How Personalities Are Formed". If you'd like assistance to develop your own Trauma-Informed Mind, contact Cathy Harris for consultation or training. Take action now!

 

What Every Trauma-Informed Therapist Needs To Know

Many clients who seek help from counselors and psychotherapists have a history of trauma. Whether Big T or Little t trauma (EMDR: The Breakthrough Therapy for Overcoming Anxiety, Stress, and Trauma, Shapiro and Forres, 1998), this factor, if not addressed, can prolong the client's symptoms and decrease functionality. This has been my experience for over 20 years as a Licensed Clinical Social Worker.

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However, even when we clinicians acknowledge the fact and effect of our clients' traumatic life experience, responding with "It wasn't your fault" is not enough. We need to go further. We need to provide explanation about why the person blames him or herself in the first place.

"What's the purpose" of this defense?

Piaget described "egocentric" thinking in small children (in Dissociative Identity Disorder: Diagnosis, Clinical Features and Treatment of Multiple Personality Disorder, Ross, 1996). The precocious 3 year-old says "It's raining 'cause I'm sad." She thinks she causes all in her world to happen and it happens to her. So, if someone is hurting her, she reasons that "It's my fault." This thought gives her a sense of empowerment, albeit a false one.  Eventually she decides that "maybe I could be good enough and you won't hurt me."

This reasoning gives her something to work on. Maybe she can be pretty enough, smart enough, clean her room 'good' enough, etc.  This coping defense helps children psychologically survive horrendous circumstances and events.

But, how does this play out in the grown-up child's life? Why does the adult cling to this defense after it's no longer needed?  More importantly, how can we therapists assist our adult clients to process through and move past the effects of this coping defense?