What Is A Trauma Therapist?

[Sunrise]

Anthony,
re your post of Nov 17, I agree with some and disagree with other but because I strongly support you and the overall intention of this forum, I would rather not to and fro on stuff.

happy 2012 to all,
with love!
cuppla things to share:
Could be a more focussed place to do sharing(?)

 

[mamachick]

sunshine-you can be a psychiatrist, psychologist, social worker , or counselor, and have little knowledge in ptsd. Each of those professions require little specialty. The first four years of education are basic psychological training, yet everyone need those first four years because they teach life span, basics of mental illness, even such basic things such as differentiating so the clinician can see the whole picture-outside the box. Part of that is cultural differences. Then again in grad school is cultural differences on an upper level.

IMHO, you need seven to eight years of education before attempting to specialize in ptsd.
DBT for example, works well for borderline personality traits in therapy-ptsd or not,
Exposure therapy will not work so well with someone who's trauma is more shame/abandonment based, better for avoidant.

In your second example on nov 17 related to cbt-
CBT is geared at changing your core thoughts so the example given is not really relative, as it is an example of a surface thought.CBT is about changing unhealthy beliefs. The beliefs are very basic, learned early, there are only a few, and other dysfunctional belifs spring from them. You must change the core belief-the surface is irrelevant, or more like a sympton. As in the example you gave, a possiblity might be-your misinterpretation would lead back to -inability to be wrong- back to not feeling worthy. The misinterpretation you listed is only a symptom of something greater-there is a pattern there (rarely an isolated incident), . There is a core belief that is being stimulated in the example that you gave. So even if it were settled in this manner, it woould continue to repeatedly surface again with others-which is why all those years of education are necessary.

 

[Sunrise]

Thank you brat17.
I agree that "you can be a psychiatrist, psychologist, social worker , or counselor, and have little knowledge in PTSD." And even many who have knowledge and experience in dealing with PTSD will confess that they can only offer limited help. You are intimating that one cannot help PTSD sufferers without first having a degree and I do respectfully accept this as your belief.

In my "second example...", I simply use this to illustrate that a belief about an incident once exposed and seen by it's owner as erroneous is no longer a belief so therefore can no longer have an effect, there is no longer anything there to trigger. With nothing there to be triggered there is nothing to rise to the surface.

I cannot say that what you said is wrong.
I need to accept that we are interpreting through different paradigms.
If symptoms resolve via the different approaches we all win.
In my take, the genesis of the problem in a traumatic event that causes it to have after effects is that decisions made about it at the time can be hidden in the incident. As we walk around and even when triggered (especially when triggered) we are not aware of this. This is locked into place at the time of the incident when the person is in physical/emotional pain and the effect may be that when I see you I am triggered by the painful memory that has you/the incident in it. But I am not aware at that level, especially when I am re stimulated by the trigger. I just know that I am now uncomfortable in your presence. I may blame what I think is the problem and come up with all sorts of things in an effort to "rationally" explain it. Only when the incident is examined closely and I am able to see it clearly do I discover that that my decision/belief was invalid. Once that happens the thing loses it's power, the "charge" dissipates and the the post incident effect(s) cease.

I could go for a much more real example but I don't want to trigger anyone.
Sorry if I have not explained it well.
How I understand it or badly explain it perhaps matters little because at the end of the day what happens in the therapy room is what counts.
Just one (non triggering) example: when a long standing and upsetting phobia that reoccurs on cue in the presence of certain triggers, does not appear after a session in the presence of the former triggers and months later has still not appeared, then the theory, or my inability to explain it clearly becomes less significant.
You can imagine the reaction by such a client to this outcome.
All that you say may be solid theory in your experience.
I humbly offer what I have said in the hope that some may find it helpful.
Love to all,

 

[Tinyflame]

I understand this- or I believe I relate- 'at the time (+/or) hidden in the incident' (or shortly thereafter), that is the problem, I agree. My experience to the extent I can understand myself.

Similarly speaking, I think if one is able to speak about, or get help, etc, shortly after a trauma, that may contribute to preventing the formation of ptsd.
JMHO of course.

I can only imagine all 'T's', specifically, are different, but someone would need to be at least familiar with trauma, and ptsd, I suppose to be able to grasp it effectively.

 

[Sunrise]

Dealing with PTSD is certainly not childs play. Without proper training it would be guesswork at the expense of the sufferer and could make things worse. There will be debate though as to what constitutes proper training.

What a blessing if PTSD can be prevented by quick action Junebug!
As you know PTSD often manifests years and even decades after traumatic events.
You deal with it when it happens and it may be waiting up the road for many unsuspecting folk who never thought that their events were sufficiently traumatic to cause them a problem.

[It must be really sobering for those who, after coming though events 'unscathed' label others as soft or fakers for claiming PTSD after the same event, only to find years later they themselves are triggered into full on PTSD.]
Love to all...

 

[mamachick]

Sunshine-after reading and considering a more real example, I think I understand better what you are saying. You were referring more to an incident that would cause a trauma trigger I think, and I was thinking more general communication and interpretation that might be self destructive. I see more clearly what you mean.

Im not sure if I think it is possible to be effective in treating ptsd without those credentials, I may have just not seen an example. I think it is the structure of acadamia-must have a bachelor degree before going on to med school or a grad program, yet only a portion of all that education is related to the ultimate goal which is focused on more following a bachelor degree. To become certified in trauma therapy, I believe you must hold a graduate level degree in order to be accepted into trauma program. Yet hypothetically, it seems that one could have all the pre-requisite training without all the other bs classes required for the desired degree. In that case, one could be very competent in treating trauma.

 

[Tinyflame]

I read a thread here once that indicated (I believe) that it was actually was preferential to speak of the trauma after a period of time- initial therapy (of some sort-I can't recall what? :rolleyes:, 'talk therapy', I believe) was best delayed. I can see how that would be so, in so far as dealing with the stress, grief, etc- allowing one's self to process everything and 'feel' it.

However, I think (again, just personally 'looking back' and comparing the difference between several traumatic events- which did not contribute I believe to my ptsd), I think there-in lays the problem: the 'period of time' they indicate, is 'natural' and 'required' and 'healthy' and 'normal' (to grieve, etc). But the problem comes when during that time, (or similarly living 'within' and 'through' years or decades etc of abuse etc, for example) there is no 'talking', no feedback, no other ideas that challenge the thoughts, decisions, conclusions drawn, etc, hidden within the incident, as you said. And especially having to 'hide' it or (and) try to 'tune it out'. Even if one has 'blocked it out' (or so they think, or shut down emotionally- so forget 'feeling'). So there is also bound to be more resulting guilt, shame, survivor's guilt, self-blame etc. And then I believe if PTSD sets in, for lack of a better word, well then worse follows, as one tries to make sense of a whole new set of symptoms and problems they can't understand or explain and cope with that, as well, often in ways of avoidance, physically or through behaviours, substance abuse, etc, none of which works to actually address or 'treat' the ptsd.

I just say this because when something awful has occurred, if I can actually bring it up- or even more fortunately I can recall 3 events at least when I 'heard' something afterwards that helped immensely, relieved a lot of my guilt, and prevented or precluded me from internalizing more self-blame, the guilt etc didn't arise- but I know if I hadn't heard it I would have felt much worse- when I actually had time later to go over the details in my mind. I am positive of that.

This may sound funny, but I think regardless of qualifications, humility goes a long way as does trust and honesty, to me that's massive.
Also, genuinely trying to help (not indifferent/ seeing people as a number).

 

[Tinyflame]

And for children, also- they are not adults when traumas occur- even if they think they are, or are treated as if they are. As a child who internalized everything- and I do mean virtually everything- that's just again my experience.

(And also, secondary wounding and such, if one does try to talk, well I think that even contributes to more 'negatives' and hidden thoughts/ beliefs/ perceptions).

 

[Sunrise]

This may sound funny, but I think regardless of qualifications, humility goes a long way as does trust and honesty, to me that's massive.
Also, genuinely trying to help (not indifferent/ seeing people as a number).

Sounds spot on Junebug
Imagine all the learning in the world and no humility/genuine caring. No wonder wonder people quit therapy.
Sunrise : o )

 

[Tinyflame]

Yes, I think so because it leaves one feeling less judged, but humility also opens the door (I think), to be open to learn, it's always been my experience that the most brilliant Dr's etc were the most humble.
And they are always saying everyone's unique, therefore it seems it would be necessary, or at least 'useful'!
And also, there's no 'cure', so it wouldn't hurt if someone thinks outside the box, I think.

I think anyone who cares about people will always do more good/ less harm, than if not. If nothjing else, even if there is no 'solution' per se, the person has been given the 'solution' that they aren't entirely on their own, as far as someone else actually hoping they get well or manage or make progress, too. (Which might also be a new or unique experience).

I can honestly say after decades- no matter what the problem/ situation, I never have forgotten any truly compassionate person, even if they could 'do' nothing to help the situation. Likely they might have felt they didn't 'help', but I personally won't forget them.
To me sincere intention and effort is almost just as valuable if the outcome were just straight-up favorable, I mean- they tried.

Of course, you'd want 'competency', but ptsd is ~different- it's baffling and multi-layered. I'd still rather have someone honest and humble and hoping I 'could' get well, to tell me what they thought.

 

[Sunrise]

Genuine caring, empathy and the ability to accept what the client says as true for that person in their world
+ competent training and experience to expertly address the job at hand
= your are in with a chance : o )

 

[mamachick]

Junebug I think you are so right. I can think back many decades and recall how someone made me feel by a few encouraging words and humble honesty.

My concern with competency is that I have read posts where others have had a bad experience to treatment, for example, emdr, in which they may not have been using it correctly. I have also known of others to have Ab-reactions that the therapist were unable to help resolve effectively.

I am also in favor of preventative measures. I am stable at the moment but certainly not fully managed or thriving. I have asked myself-If I had an incident today that would be potentially very traumatic, do I have the supports (family, friends, partner, etc) in place to deal with it most effectively? I do not, Im sorry to say.