No one heals alone: Finding a therapist

One of the biggest roadblocks in healing from trauma is this idea, “I don’t need help, I can do it myself.” Here is the common refrain: “I don’t need a therapist or a group—I have my friend (wife, husband, children…)”

Why? Seems like they could, right? They love us. We feel good with them, safe with them. In fact, it feels like they should be the ones to heal us. They can listen to our problems, and often do. They often listen non-judgmentally as we recount our stories. They often have advice for us, and certainly tell us they love us. They can hold us tightly and kiss us good night. Why isn’t it enough?

We expect our friends and our spouses to be on ‘our’ side. When we feel bad, we want them to help us feel better, not hold us accountable to change. We want them to say the right thing, not the ‘growth promoting’ thing, or worst of all, nothing, and let us sit there with our thoughts. It’s funny, people automatically understand the need for a couple’s therapist when a couple is having a problem. Friends know that they can’t say what they need to both parties and still be ‘loyal’ to their friend, or not be seen as ‘taking sides.’ They know that there are truths to both sides and that they are in over their heads to try and help. Most often you hear, “I’m not going to get in the middle of that.”

A healing relationship is like a couple’s therapist for both sides of the self: the self that wants to change, grow or heal—and the part of the self that wants to stay the same, the part that is afraid of, or unable to change. A therapist’s role is to hold both of these realities—to not take sides, but rather to support both sides by creating an environment in which both sides can grow and integrate.

Healing from trauma is perhaps the most complicated form of therapy. As I mentioned earlier, most trauma is really three interrelated traumas: the experience of repeated trauma, the defensive structure built to survive the trauma, and the loss of healthy growth and development during the period of trauma. While your friends and loved ones may be able to listen and help you with your experiences of trauma, often, it feels impossible to talk with them about it: often these experiences are described as unspeakable. And, often, we don’t want anyone to see us at our worst moments of helplessness. There is simply too much shame. Even if you could share this with them, and you could tell your loved ones how much you are hurting, in some fundamental way they really can’t hear or take in how broken you feel. Not because they aren’t listening, or because they are bad, or they don’t love you—but because they either can’t truly understand, because their experience is too far away from yours, or because it would simply be too hard for them if they did. They need you. They need the relationship with you. You are important for them and they know on some level they can’t fix it and they don’t know how to hold this piece of information with all of the other aspects of you.

How do I find help? What kind of help is best? This is an important question with a lot of answers. There is no ‘perfect’ guide or therapist. When friends and family ask me what to look for, I give a pretty basic answer—what you want in a good therapist or guide or consultant is what you would look for in a good parent. You want someone who can be consistent, patient, hopeful, and who knows that this journey is about you and your growth, not their needs or success. You want someone who knows about trauma or is willing to learn. You want someone who can laugh at herself and who can tolerate her emotions and yours. You want someone who is willing to let both of you make mistakes and who can have a conversation about it when it happens. You want someone you can respect. You want someone whose basic premise is: whatever it is, we can talk about it. And, you want someone who is a good match for you—where you feel safe, and where you feel like you will be understood and heard.

Finding the right person or group is mostly a matter of trial and error. You have to ‘try them on for size.’ You have to see if they are a good match and the only real way to know that is to meet with them and talk with them. That being said, sometimes you don’t get a lot of choice. Depending upon your healthcare coverage, and where you can obtain help—sometimes there are limited options.

But limited options doesn’t necessarily mean poor care. I, and lmost all therapists I know have spent part of our careers in system where we were the only option for people getting help. And this situation is not much different than other aspects of your healthcare. If you go to the emergency room, you don’t generally get to interview doctors.

All therapists are trained to work with a wide range of clients and a wide range of issues. The most important thing you can do is have a conversation about what you want and need—to the best of your ability. What you need to do is to see if the person or group you seek out will be a good match for your healing journey. Can I work with this person? If I have differences of opinions or have doubts about their capacity—can I ask about them?

Here are some questions for you to consider:

• What do you hope to get out of treatment?

• What symptoms are bothering you the most right now?

• What is the most difficult thing about going to see a therapist or being in a group?

• What would help you to talk?

• What gets in the way of talking?

• What gets in the way of taking care of yourself?

And here are some questions for you to ask your potential therapist, guide or consultant:

• How long have you been working in this field?

• What do you enjoy about it?

•  How do you typically work with clients?

• What happens if we disagree?

• What are your expectations of clients?

• Have you worked with clients who have a trauma history before?

• These questions are just a start, and you are free to ask them anything that would help you feel more comfortable working with them. Some people find help on the first try and some on the second. I found it on the sixth. Remember that it is the combination of you and your therapist or your group that is the ‘healing relationship.’   You each hold an end of the rope. Contrary to rumors, your therapist cannot read your mind. The healing relationship relies on both of you—so you need to trust yourself and your experience, and you need to communicate what you want and need so that the relationship can support your work.

If you are in the US and looking for a therapist I recommend Psychology Today’s Find a Therapist link. You can put in parameters you are looking for: insurance, gender, social identity, specialty, location etc. It’s widely used by a range of therapists with many licenses and specialties.

© Gretchen L. Schmelzer, PhD 2023/2014

the healing power of the ordinary

A traumatic experience is by very definition extraordinary—it is defined as an experience or event that overwhelms your capacities to depend upon or protect yourself—something that you experience as totally out of the ordinary. But repeated trauma is different. With repeated trauma, long term trauma, intergenerational trauma—the extraordinary becomes utterly and completely routine—trauma becomes what is expected.  When you are healing from trauma there can be such a wish for something extraordinary to happen—some big shift the way things happen in the movies. In the movies, people change their whole lives in an hour and half. You want to believe in the one conversation that will change things, the one cathartic meltdown. The scene in Good Will Hunting where Robin Williams’s character tells Will “It’s not your fault.” and Will is healed.

But I have found that some of the best healing is not the extraordinary—it is the utterly and completely ordinary. It is the daily dog walk, it is the morning coffee, it is the routine of food shopping or doing laundry. It is the smile that the cashier at the store gives you, and the one you give the woman walking in the door of your office. For many of my clients the daily-ness of caring for grandchildren was immensely healing. For others it is ordinariness of planning for life’s typical events—birthdays, Halloween, staff parties. The chance to live out the normal events of their week—and to know that they were part of the fray.

When I am having a bad day one of my favorite people to talk to is my brother-in-law. He loves sports, and he loves to sail. I could listen to any of these conversations for hours—and it’s not because I share his interests—I don’t love hockey and I don’t know much about sailing—but I love listening to him talk about them because his joy is simply contagious. They are easy, flowing conversations that aren’t trying to get anywhere in particular. They are about the ordinary—and they allow for something extraordinary. My other favorite healing conversations are listening my in-laws and friends talk about their kids—they love their kids and listening to people talk about their kids can be one of the most healing conversations of all, because kids, regardless of age, are the gurus of ordinary. This is, of course, why children drive most parents nuts—the relentless ordinary that goes with them. When people like my in-laws or my best friend tell stories about their kids they are mostly tales of a peaceful ordinary.  The ordinary frustrations, the ordinary school bake sales, the ordinary struggles of growing up and moving. There is nothing quite as soothing as the peaceful ordinary. A peaceful ordinary is the necessary and healing antidote to the violent ordinary. So never underestimate your ordinary days, or your ordinary support of others. It is what helps the healing happen.

© Gretchen L. Schmelzer, PhD 2014/2016/2023

When the Wall Comes Down

I first went to the Berlin Wall as an exchange student in Germany in 1982. The Berlin Wall was an immense concrete wall that was covered with graffiti on the West side because the residents could get close to it. On the East side, it was no where near where someone could get close to—in front of it lay a no-man’s land strip of raked ground, razor wire and guard towers between even good sections of the city and the wall.

West or East, the wall made sure that there was no contact between lives on one side and lives on the other. This is what walls do.  They create a no-contact zone between sides of a country or sides of a self that can’t know about the other.

Trauma fragments and breaks things into pieces-- and the protections created to survive trauma keep that fragmentation in place. If I experienced something awful, or witnessed something awful, or perpetrated something awful and I was undone by it, I erect inner Berlin Walls between the self that lived through the trauma and the self that is trying to get by in the world. The wall allows me to keep on going, but I lose access to parts of myself. I lose access to prior learning, to my feelings, to flexibility. On my bad days, I am behind the wall living in my trauma and I can completely forget that the healthier side exists. And on my good days I do everything in my power to stay away from the dark side of the wall.

Healing from trauma is the gradual taking down of the wall. Of integration. of bringing the sides of yourself together again to become whole.

In 1989 when the Berlin Wall came down it was a scene of liberation and celebration. And when inner walls come down, there can be immense feelings of relief. But there can also be immense feelings of grief—for the years that the walls were up. Immense grief because you finally see and feel the experiences that you hid behind the wall.  And it can come as a bit of a shock—the wall helped you stay numb and away from feelings. When the wall comes down, feelings can flood in and knock you down. You think you should feel good, and instead you are wondering how to put the wall back up.

We think of the wall “falling” 25 years ago today, but the Berlin wall was dismantled slowly—it didn’t actually start coming down until 1990 and wasn’t fully dismantled until 1992, a nearly three year process. Healing from trauma, from whatever war erected your wall, means allowing each piece of the wall to come down, letting each side greet each other. Letting each side share some time together at a pace that allows you to digest your history and take it in—and heal the reasons that the walls were erected in the first place. 

© Gretchen L. Schmelzer, PhD 2014

Cultivating Mindfulness for Healing: Start Very Slowly

Mindfulness isn’t easy for everyone. This can be especially true for people who have experienced trauma. But one of the most important skills for healing is the skill of awareness.  What do I mean by awareness? It is the ability to pay attention. To observe, to feel, to notice. Awareness is the first requirement for learning or change of any kind. You need to know first what is there, to know what is working and what isn’t. The first awareness in healing needs to be some form of self-awareness. You need to have the ability to pay attention and report what is going on inside you and outside you.

Let me say at the outset that once again that this is one of those sentences and encouragements that sounds simple: be self-aware. But it is not. Not for a lot of people and especially not for people who have been deeply hurt by trauma for a long time. In an earlier blog post I discuss the difference between acute trauma and repeated trauma: a single terrifying event will create a fire-alarm system in your body. You become hypersensitive to any trigger for a time. But this is an impossible state for you to live in for a long period of time. If you have ever had a faulty alarm system in your house, or car—one that beeps or flashes past its usefulness, you will have like most people, found a way to dismantle it—take out the batteries, pull the wire, cut the fuse. When it stops beeping or flashing there is tremendous relief. Ahhhhh. Peace. Essentially, with repeated trauma your brain does this to your body. It pulls the fuse on awareness. It says: you don’t have to feel this anymore, I’m cutting the connections to the feelings of this you so have some rest from the alarm, so have the energy to pay attention to getting through your day. Surviving trauma requires numbing. And healing from trauma requires waking the numb parts back up. In order to begin the process to wholeness you have to gently come back into your own awareness, your own feelings, your own body.

It also should be said that this numbing is not a perfect system. For many people there can be severe swings between numb and overwhelmed. It is as if the ‘force shield’ of numbing has a short in the system. At times it is there, protecting you, and at times, when triggered by something, it is removed completely forcing you to experience the full weight of your emotions. Either way, awareness and mindfulness is gone. Either your awareness is shut down or it is totally overwhelmed. Mindfulness and self-awareness practice can help you from living in either of these two extremes.

Lots of people try to explain self-awareness, but I think they leave out a crucial element that makes self-awareness actually useful, and it is this: being non-judgmental. I have found in my work, and in my experience of healing that it is one thing to be self-aware: to be able to feel, experience, see what is there—and it is another thing entirely to be able to just stay with it, observe it, sit with it, explore it. Most often you start with the intention to be mindful and self-aware, and then you get a big wave of experience of what is there: emotions that are difficult, thoughts that race, and you start to judge—these feelings, thoughts, sensations are wrong, bad, immature, yukky. “Wasn’t this supposed to make me feel better?” you ask. Then you turn away from the practice. Self-awareness that heads toward judgment and criticism cuts healing off at its knees.

Lucky for us, there are cultures that have been practicing awareness for centuries and have created simple practices that have served people forever. My favorite way to teach self-awareness is through the practice of mindfulness. Mindfulness according the Jon Kabat Zinn is synchronous with awareness.⁠ Mindfulness is the intentional regulation of moment to moment awareness. As Kabat-Zinn notes, Mindfuless is “paying attention in a particular way—on purpose, in the present moment, and non-judgementally.” It is the practice of just paying attention to this moment, observing, not judging. Mindfulness is the building block of any meditation practice and it begins often with the simple instruction to breathe. Yes, breathe. Just take an easy deep breath in and and easy breath out. Pay attention to the breath coming in and the breath moving out.

What do you notice, even in this small act? What do you observe? I notice that when I try to pay attention to my breathing, it often feels awkward. As if it weren’t something that I do all the time, like I was trying some really complicated dance step. With each breath I can stay present with the breath, or expand my awareness. What do I notice about my body? Where is is tight? Where is it relaxed? What are the sensations? What are my feelings? What are the sounds around me? What are the thoughts traveling through my brain?

Mindfulness is powerful medicine and quite often too much mindfulness is prescribed to start. In the field of Mindfulness Based Stress Reduction (MBSR) teachers are warned that MBSR can be very difficult for people with histories of trauma. The way I think about it is about dosage—just like any powerful medication, like chemotherapy. Mindfulness is simply a powerful self-awareness practice of bringing someone in contact with him or herself. You come to really sit inside and observe the country that is yourself. Now, if your country has been at peace for most of your life, and the weather is pretty good, then sitting and visiting that country won’t be too stressful, and being aware of all the aspects won’t require too much help. Like spending an afternoon in Amsterdam in spring appreciating the tulips, the art, the canals. But if your country has been at war the last ten years, if you are going back to sit in truth and reconciliation meetings, if you are walking through inner villages that have been decimated—then awareness is going to require shorter trips and more support. You aren’t visiting Amsterdam, you are visiting Laos. So you need to take it very slowly. One breath, three breaths, twenty breaths, one minute, five minutes, twenty minutes. These are the increments to move in.

And if sitting is difficult see what it is like to stand. If standing is difficult see what it is like to walk. Or lie down on the floor or a couch. See what it is like to be in any comfortable position for one minute. Your task is simply to be aware of what you notice. Not change it. Not judge it. Just breathe with it. Be with it. And simply work from there.

For readings on mindfulness: check out this week’s Editor’s Picks:

3 Must Reads for Mindfulness.

http://www.emotionalgeographic.com/new-blog/2014/11/5/3-must-reads-for-mindfulness

And this article from Mindful.org 

http://www.mindful.org/news/healing-trauma-through-mindfulness

© Gretchen L. Schmelzer, PhD 2014