Art therapy is a newer form of therapy. It is an integrative mental health practice that is designed to improve the lives of individuals, families, and communities through the process of art-making, creative process, applied psychological theory, and human experience within a therapeutic relationship.
Art therapy should be done by a trained professional of art therapy. This will improve the effectiveness as art therapists are trained to create art therapy exercises that are designed to not only support you but also to help move deeper into your therapeutic goal. Art therapists are trained to use their knowledge to support your personal and therapeutic treatment goals throughout treatment. Art therapy has been used to improve cognitive and sensorimotor functions, help support a better relationship with self-esteem and self-awareness, produce emotional resilience, promote insight, enhance social skills, reduce and resolve conflicts and distress.
Art therapy is a wonderful tool therapists use to help patients interpret, express, and resolve their emotions and thoughts. This is a newer type of therapy and was first established in the 1940s however the practice did not become more widespread till the 1970s. Like other expressive arts therapy, such as dance therapy or music therapy, it draws on creativity.
Often people mistake “Art therapy” for things that are not necessarily due to a lack of knowledge about the profession. However these situations provide an opportunity to offer accurate information and educate the public. This modality must be done by a trained art therapist or it is technically not art therapy. Some products that are mistaken for art therapy are adult coloring books and paint by numbers. Art therapists are not art teachers, their goal is not to make you a better artist but to help you improve your mental state through the use of art.
Many people ask "What is art therapy and how does it work?" It is all about expression. The process of creating is the most important thing, not the end product which is why anyone can do it. Often many people shy away due to a fear of not being an artist but this type of therapy is for anyone. It is designed to use the expressive arts as a way for people to understand and respond to their emotions and thoughts with a valuable new perspective, not only that artistic expression is good for mental health as it is often related to relaxation.
During a session, an art therapist works with clients to understand what is causing them distress. Then the therapist guides the client to create art with an art directive that addresses the cause of their issue or explores it further. During a session, art therapists may:
Through different mediums and art techniques art therapy engages the mind, body, and spirit in ways that are not dependent on verbal articulation alone. Due to the way it engages the body and mind it causes various symbols to be created through the art process, this process also invites modes of receptive and expressive communication, which can benefit those who have limitations of language.
Art therapists are clinicians who are trained both in traditional clinical therapy and art therapy. Art therapists work with people of all ages and various populations. All art therapists are required to follow an ethical code. All art therapists are also required to have a master’s level education, as well as engage in supervision hours under a trained professional in order to obtain their license. This prepares them for various populations and gives them the ability to perfect their work.
Art therapists work with individuals, couples, families, and groups in diverse settings. Some examples include:
There is growing evidence that art therapy helps conditions such as anxiety and depression, trauma, low self-esteem, PTSD, Bipolar and similar disorders. It has also been used with those facing terminal illnesses such as cancer and those hospitalized experiencing pain, as well as it has been used with people working to develop effective coping skills, including prison inmates
Many clients are reluctant to explore art therapy because they think that they have to have artistic talent for it to work or see it as "arts and crafts" rather than see it as an effective tool. This mindset can be very limiting and can hinder the effectiveness for these clients. It is important to go in with an open mind.
There's no way to tell for certain whether art therapy is a good fit for any given person. Therapy is not one-size-fits-all, and a client and therapist may need to use multiple different approaches and techniques in order to find what works best for you. However, if a patient is drawn to art or has had trouble expressing with traditional therapy, art therapy may be a wonderful fit for you.
When choosing a therapist it is good to consider the following. As a potential client, ask about:
Often you should be able to tell in 1-3 sessions if this works for you.
If you feel like art may be a good avenue for you to work through your mental health concerns please call our office and ask for Jillian Martino. Jill is our art therapist on staff and would be more than happy to help you work through your concerns through art. Jill specializes in LGBT issues, trauma, children and couples. Contact our office today to set up a free 15 minute consultation.
Mindfulness is the ability to be fully present and aware of where we are and what we’re doing. One important aspect of mindfulness is to not be overly reactive or overwhelmed by what’s going on around us or in our mind. It is important to just observe without judgment. Mindfulness is a quality that we can all tap into, we simply just need to learn to access it. The following prompts are designed to help you begin becoming more mindful in just 15 days!!

This is one of my favorite personal practices. Write this letter as if you are writing it to a friend. Write everything you are grateful for as well as everything you are grateful to be working towards. After you do this, read it aloud. I like to do this practice daily.

Meditation is a difficult one and can be difficult for people, often we believe that the brain should turn off during meditation. However it is quite the opposite, often our mind will start racing, the buddhist call this monkey brain. It is important during this practice to notice whatever may be coming up for you without engaging or giving the thought energy. After bringing your attention back to your breathing. If this practice is hard for you start small. Start with five minutes and then slowly increase the more you practice. There are also a ton of videos online and apps that can help support you through your meditation.

Take this time to really connect with yourself and your garden. Notice the smells, what you feel in your body. Maybe how your skin feels in the sun etc. Mindfulness is all about giving ourselves a moment to pause and appreciate everything, the good, bad and everything in between. Allow yourself to express without judgment.(If you don’t have a yard pick somewhere in nature)

Really make your food an experience here. Just like meditation, focus on every sensation. How does it taste, how does it feel etc. Be present. Thank yourself for the nutrition!

Here is a simple Practice, set your intentions. Setting goals will help us be more mindful of actually making them happen. If you want to add an artistic flare to this exercise, turn this list into a vision board. This is a super fun activity for date night, girls night or just a little self care for you!

When decluttering the mind it can be helpful to have our living spaces match this energy. Get rid of all the things making energy shifts in your space, I promise you don’t need those pants that are too small on you that you keep as motivation. Focus on the now.

Good and bad, this is about bringing attention to our critical voice. Be honest with yourself. Remember NO JUDGMENT.

Notice your value: if this is hard examine that. Start small if you can only think of two things that’s okay. Continue to revisit this exercise as you move through the practice. I like to make positivity jars for myself where I put little notes of wins I had over a whole year and read them at the end of the year. Sometimes we let the good we do go unnoticed, this time is for you.

Mandala’s have been known for their meditative properties, they have been recognized by psychologists like Carl Jung for their therapeutic benefits. While creating your mandala again notice what maybe coming up for you.

Again, full transparency here. Want to go even deeper with this exercise? Follow this question up with why do I have these fears? Where did they start?

SELF CARE!!! Do I even need to explain? Not only should you write what you can do for yourself here but also examine what you can do in order to start integrating these things into your day to day.

Spirituality states that our hips hold a ton of our trauma. Moving these parts of yourself will help you release some of those big feelings. Pay attention to whatever comes up for you. You may feel awkward or may even feel uncomfortable with seeing your body moving through the mirror. Pay attention to this, bring awareness to it. Meet it with the question why as well as some compassion.

Everything needs rest, even you! It is scientifically proven that we are more productive when we rest, this helps us avoid burnout. There is an awesome book called “How to Do Nothing” by Jenny Odell that further explains this.

Yoga is a wonderful practice for mindfulness, if its not your thing though do something else to get that blood pumping.This can be walking around your neighborhood or HIIT, whatever makes you feel good! Examine how your body feels before and after your workout.

Cultivating happiness. Abraham Hicks has a ton of videos speaking of the importance of following our happiness. Happiness is our driving force so lets bring our awareness to it.
Long Island is celebrated for its iconic white sandy beaches. But did you know we also have some excellent places for a day walk or hike?
As a Nassau resident who grew up on a brook near conservation land in northern New England, I must admit, I had my doubts about falling in love with the scenery across Long Island. But I’ll admit it – Long Island is spectacular in the summertime (I still think New Hampshire is unbeatable for autumn foliage, though, and yes you can debate with me about that one!). As time has passed, I have been happily surprised to find some great day trips across Suffolk and Nassau.
If you are willing to bundle up, consider even doing a beach stroll in the winter! Bring your binoculars. You will be rewarded with waterfowl which have come thousands of miles south from the tundra, including my personal favorite, the exquisite long-tailed duck. You may also see grey and harbor seals!
Here is a list of some of my favorite places to go hiking or walking on Long Island – as well as a few other things, such as horseback-riding!

A familiar favorite located on the Long Island Sound, Sunken Meadow is one of the more accessible parks for people with limited mobility thanks to its long, sturdy boardwalk. It features three miles of beaches, along with six miles of hiking trails. Want to horseback ride? There are bridal paths, too. There is also a golf course.
Sunken Meadow also has softball and soccer fields, along with playgrounds, making it an excellent choice for families who may want to do more than spend their entire day solely on the beach.
Are you curious about foraging? This is one of the locations where the famous forager “Wildman” Steve Brill offers classes. He will show you which plants are edible, which to avoid, and what to do if you contact with poison ivy. I have taken a Wildman class at Sunken Meadow, and it was quite informative!
I will admit it – I have not done the Greenbelt in its entirety. But there is no way I could skip mentioning the ultimate of the Long Island hikes.
The Greenbelt is an impressive 32 miles long, running parallel to the Connetquot and Nissequogue Rivers. The trail varies in terrain, at times being a boardwalk and then changing over to sand. It also has numerous trails with break away from the main one, allowing for this to be a hike or walk that can be experienced many times.
Blydenburgh is another popular, family and dog-friendly destination. In addition to scenic views for walks, Blydenburg offers birding, fishing, and horseback riding. Rowboat rentals are available from mid-May to Labor Day. Finally, tent and RV sites are available for campers from April 1st through November 11th.
The six-mile walk around New Mill Pond is easy for families, and is beautiful in the autumn during peak foliage.
Blydenberg is $7.00 for Suffolk residents and $15 for non-residents.
West Hills is a historical park which reaches Jayne’s Hill, a beloved spot by Walt Whitman and near his birthplace. At 400 feet elevation, this is the highest point on Long Island; it is a 2.4 mile loop considered easy and possible to complete in about 55 minutes. Ideally, this hike is most suitable in the autumn.
Caumsett is a large park with various activities. It features an impressive stable and dairy complex, excellent trails for biking, paved trails to walk with a stroller, and even snowshoeing and cross-country skiing trails.
This is also a beautiful park for a walk or hiking, as the wooded areas gradually elevate to be the tops of sand dunes that then look down into the water. As you continue along the trail, you will descend at a seashell-bountiful beach.
Wertheim is one of the few protected, undeveloped estuaries on Long Island. It offers rich biodiversity, perfect for those most interested in seeing wildlife.
Unlike most of the parks and preserves here, Wertheim is not best in the summer or early fall, but rather in late October through early April. This is the time for the most ideal wildlife-viewing, with migratory waterfowl who winter here. Come the early springtime, there will be migratory warblers and other such songbirds. However, all year, you may encounter red fox, white-tailed deer or wild turkey.
Personally, I find Wertheim to be most precious on the water. The placid waters of the Carmans River meander through cattails and reeds, offering a smooth and almost effortless paddle. You are guaranteed to see great wildlife, such as the green heron. Additionally, you may choose to stop at Indian Landing, a small beach where you can take a swim to cool down, or you can continue onto the Great South Bay.
This is my favorite place on all Long Island to launch my paddleboard or kayak. Thanks to being in a refuge, I do not have to deal with wakes or noise. It is also beautiful from the start since to get to the refuge you must go under two bridges, the first being a nesting site for tree swallows.
You can either launch from the free boat launch (although I warn you, the path is muddy and completely unmaintained) or you can use spend $10 to use the dock at Carmans River Canoe & Kayak II. I recommend the later as it is much easier.
Bayard Cutting may be the most famous of all the locations I have mentioned, thus, I will not get into detail. Simply put, Bayard Cutting is the place to go if you want to walk and see gorgeous flora – along with Planting Fields in in Oyster Bay.
While I do love Bayard Cutting (who doesn’t?), what draws me there more is not so much the arboretum itself, but rather the picturesque Connetquot River which runs alongside it. In fact, after the Carmans River, this is my other favorite waterway for kayaking and paddleboarding on Long Island.
To paddle -- Drive down to Timer Point Park in Oakdale to launch your water vessel, which you can then paddle toward Bayard Cutting if going left. You can continue beyond Bayard to the many different canals which meander through town. Once you get to around Paradise Island, I recommend you cut straight through the river toward the canal on the other side, rather than continue straight, as this will offer a much longer, quieter, and more interesting experience. Going this way, you will eventually cut through marshland which will eventually lead you out at the canal next to the Snapper Inn. From there, cut straight across the river (be cautious of boats) and you will get right back to the launch.
As an alternative route, you may also go right which will take you to the bay. There is an island where you can relax. However, I do not recommend this route unless you are experienced due to the rapid changes in water conditions and because you will be dealing with wakes caused by jet skis and powerboats.

The Stillwell Woods Loop, located at Trail View State Park, is a 7-mile loop considered to be of moderate difficulty. It can be completed in around 3 hours. However, what truly sets Trail View apart from other Long Island hiking trails is that it has more range in intensity and elevation – giving it a different feel than the typical flat trails. For the avid hiker, this is one of the few trails where they can truly say “this is a hike, not a walk” and feel challenged.
The park itself skirts Bethpage State Park and Cold Spring Harbor State Park. Thus, you can spend a day (or even two!) hiking and doing other nature-based activities.
Sands Point is one of the lovelier parks in Nassau County. The Loop is a 2-mile walk that is popular for birders. There are also cliffs overlooking the water, which offers a great opportunity for photographers.
Sands Point also hosts special events, such as yoga.
The price is $4 per person or $10 per car.
Cedar Creek is a 259-acre park best for families and sporting.
Cedar Creek has an excellent playground. It has been voted the best playground across all Long Island in both Long Press and on News 12. Also, a fun activity for the children includes a roller-skating rink.
There are eight handball courts, three basketball courts, and various athletic fields (please note the fields must be reserved and include a Leisure Pass, insurance and permit, and fee). Also of particular interest, there is an archery range open to the public but note you must bring your own equipment.
Additionally, there are paths suitable for walking, jogging, and biking. There are entrances from Cedar Creek to both Tobay Beach and Jones Beach. If you want to get a challenging work-out followed by crisp, relaxing water, consider doing this bike ride!
Massapequa Preserve spans across an impressive 423 acres. Some parts of the park are frequented by bikers, so do exercise caution if you want to be here for a leisurely walk. However, should you go onto one of the quieter trails, you will quickly be rewarded by various species of deciduous trees as well as some endemic birds. I myself have spotted many different birds here, ranging from various species of warblers to the occasional northern flicker, a unique-looking woodpecker. There is also a popular residential wood duck drake.
Massapequa Preserve is where I offer the majority of my forest therapy sessions. You may read more about that on this blog post: https://liemdr.com/forest-therapy/
At 550 acres, Muttontown Preserve is by far the largest nature preserve on Long Island. It offers many different ecosystems ranging from upland forests to woodlands to waterways, offering a spectacular opportunity to see different birds, including characteristic species such as the chestnut-sided warbler, indigo bunting, Baltimore oriole, and American woodcock. If you are lucky, you may also spot a great-horned owl or screech owl.
Personally, I do not think you will need top-notch gear for almost any Long Island trail… or even gear at all. Disclaimer - I am quite a hiker – I have summited Black Elk Peak in South Dakota, scrambled waterfalls in the Rocky Mountains, traversed the rock fields of Mount Washington, and even backpacked the Alaskan tundra. That said, I do have some impressive gear which has been needed.
But here on Long Island? To be honest, I leave most of my gear at home! For my adventures here, I am fine with a water bottle with a shoulder strap, along with an ultralight daypack. I also pack the following essentials: sunscreen, bug spray, first aid kit, a protein-packed snack, birding binoculars, and my homemade jewelweed salve (for contact with poison ivy). Sometimes I will bring a plant or bird ID guide.
I do recommend appropriate footwear, but hiking boots are overkill unless you need the ankle support. I have a pair of Teva’s which I wore for many years before eventually retiring them. I then bought a pair from LLBean which cost considerably less but seem to be just as durable.
In addition, dress in layers and make sure you have a light raincoat available just in case. Do not wear cotton.
Camping in Suffolk County
https://www.suffolkcountyny.gov/Departments/Parks/Things-To-Do/Camping/Annual-Group-Lottery
Kayaking, Paddleboarding, and Canoeing in Suffolk County
https://www.suffolkcountyny.gov/Departments/Parks/Things-To-Do/Canoeing-and-Kayaking
Horseback-Riding Sites in Suffolk with a Suffolk Green Card and Riding Permit
https://www.suffolkcountyny.gov/Departments/Parks/Things-To-Do/Horseback-Riding
Valerie Smith, LMSW, CFTG, is a therapist, social worker, and certified forest therapy guide at Long Island EMDR under the supervision of our clinical director, Jamie Vollmoeller, LCSW. Valerie possesses a bachelor and master's degree in social work from Adelphi University and Fordham University, both from which she graduated summa cum laude. Valerie is also a certified forest therapy guide through the Association of Nature and Forest Therapy (ANFT), where she trained in the Rocky Mountains to master sensory-based, mindful activities through a biophilic perspective. Valerie is passionate about the health benefits of a plant-based diet as well as holistic wellness. Valerie is trained in EMDR and TF-CBT, with experience in DBT-informed skills. She focuses her treatment on adolescent girls and young women with C-PTSD and PTSD. Additionally, she helps people with life-threatening disease and their caregivers. Finally, she works alongside those experiencing grief and bereavement, especially young adults who lost one or both of their parents/guardians.
Throughout Western societies, we buy into the prevalent sociocultural belief of the stage theory of grief. As if to bring comfort and understanding of our loss, we are told we should progress through a series of five stages: denial, anger, bargaining, depression, and acceptance.
Even while I was in graduate school for social work, I can vividly recall some professors ascribing to this model, never once questioning if their claims were accurate since it seems to be a universal statement as true as 2+2=4.
In short, this belief pushes the idea that bereaved individuals must undergo a specific sequence of reactions over time as the result of the death of someone who was significant to them. Not only is this inaccurate since individuals may not experience all the stages in their set order, but it also is stigmatizing to those who never experience the stages at all as they may think there is something “wrong” with them. Thus, I argue that the stage theory should be abandoned, for there are newer, different models that are more accurate for illustrating the grief journey.
In 1969, psychiatrist Elisabeth Kübler-Ross introduced the model in her groundbreaking book On Death and Dying. At the time, there was a severe deficit in medical schools on the topics of death and dying, which motivated Elisabeth Kübler-Ross to do the research herself by observing the reactions of her patients with terminal diseases. She was also influenced by some researchers with stage models from decades earlier.
Quickly, the Kübler-Ross Five Stages of Grief model was branded as universal knowledge among the medical community, scholars, and the public at large.
Later, Kübler-Ross clarified she never intended for the stages to be viewed as a linear progression, and that she wrote them in a way that was misunderstood. She added she meant for the stages to reveal how people with terminal illness cope with learning they are close to death, not as a reflection of how people grieve once that person has died.
In a later book Kübler-Ross coauthored, she lengthened her model to consist of all forms of loss, such as bereavement (the specific term designated for the death of someone who was significant), the end of a relationship, unemployment or loss of income, substance abuse, incarceration, infertility, and the diagnosis of disease. Thus, at best, the model is helpful for understanding grief across multiple contexts.
Unfortunately, there are significant problems with the Kübler-Ross model. They include the following:
Please note: For a detailed report on the problems resulting from the Kübler-Ross model from an academic perspective, please visit the citations at the bottom.
In an effort to replace the Kübler-Ross model with a more practical, forgiving model to help people navigate through their bereavement, therapists and other professionals have adopted the TEAR model. This is also known as the Four Tasks of Mourning and is explored in-depth by researcher J. William Worden.
T: To accept the reality of the loss.
E: To experience the pain of the loss.
A: To adjust to the new environment without the lost object.
R: To reinvest in the new reality.
Notice the paramount difference between the two models. In the 5 Stages of Grief, acceptance is at the end of the sequence which assumes the work has been completed. Conversely, in the TEAR model, acceptance is at the start of the journey. In other words, grief work can only begin once the mourning period has ended. It must come after the sympathy cards, texts and phone calls have stopped. It approaches when the bereaved individual is expected back at work or school, operating as if things are “normal” like nothing happened.
This comes after the mourning period, after when the sympathy cards, texts and phone calls stop coming. This is when the bereaved individual is expected back at work, operating as “normal” like nothing happened.
It is time we discard the widespread belief that grief is a set of prescriptive stages. We should embrace grief as an ongoing set of work, ready to be approached only once the public mourning has ceased. Acceptance is the prerequisite to face true, raw grief, and from it come recognition and resolution.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5375020/
https://web.archive.org/web/20100322212850/http://home.windstream.net/overbeck/grfbrf13.html
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5375020/
About the Author, Valerie Smith, LMSW:
Valerie Smith, LMSW, CFTG, is a therapist, social worker, and certified forest therapy guide at Long Island EMDR under the supervision of our clinical director, Jamie Vollmoeller, LCSW. Valerie possesses a bachelor and master's degree in social work from Adelphi University and Fordham University, both from which she graduated summa cum laude. Valerie is also a certified forest therapy guide through the Association of Nature and Forest Therapy (ANFT), where she trained in the Rocky Mountains to master sensory-based, mindful activities through a biophilic perspective. Valerie is passionate about the health benefits of a plant-based diet as well as holistic wellness. Valerie is trained in EMDR and TF-CBT, with experience in DBT-informed skills. She focuses her treatment on adolescent girls and young women with C-PTSD and PTSD. Additionally, she helps people with life-threatening disease and their caregivers. Finally, she works alongside those experiencing grief and bereavement, especially young adults who lost one or both of their parents/guardians.
When someone survives a traumatic event, it can be beneficial to have both personal and professional support through recovery. Leaning on personal supports can be just as important as speaking with a therapist, but as a friend or family member looking to provide support, it can be difficult to find the right words to say. These conversations can be uncomfortable and difficult to navigate, but it’s important to choose your words wisely as to not further harm or re-traumatize the survivor.
In this blog post, I list a number of phrases you should avoid when speaking with trauma survivors, as well as a few things you can say in order to best support your loved one. Let’s start with the former.
“Why didn’t you say anything at that time?”
It’s incredibly common for survivors of trauma not to disclose what they’ve been through right away. Sometimes it takes years to work up the courage and speak with someone about it. Sometimes people don’t have any memories of their trauma, and sometimes these memories come back way later on in life.
It can also be very painful to talk about past trauma, especially when it feels like no one else can possibly understand what you’re going through. If a loved one has opened up about past trauma, don’t question why it took them as long as it did to speak up. Simply be grateful they feel comfortable enough to talk to you now, and try to support them as best as you can.
“I know what you’re going through”
Chances are, no you don’t! Unless you went through the exact same trauma, and have the same physical and emotional responses to trauma as your loved one, you do not know what they’re going through. Everyone responds to trauma differently, and comments like this tend to come across as minimizing the effects of the trauma. For the survivor, this trauma is theirs, and while it may not be something they are proud of, they are most likely working on owning their experience and their emotions. It’s important not to take that away from them.
“Let it go” or “Get over it”
Unfortunately, these are words that many survivors have heard from someone they’re close with. It is common for survivors of trauma to be diagnosed with Post Traumatic Stress Disorder, or PTSD, and because PTSD is an invisible wound, it is often misunderstood as something that is being exaggerated. Just because you cannot see it, doesn’t mean it isn’t there.
There is no ‘just get over it’ with trauma. Survivors do not choose to have these symptoms, and symptoms can be intrusive and incredibly debilitating. By saying things like ‘let it go’ or ‘get over it,’ you’re telling them that their feelings are too much, too dramatic, and taking too long to resolve. Each healing journey is unique, and you have no way of knowing how much work someone has already put in to get to where they are now.
“Did that really happen?”
It is common for survivors of trauma to experience shame and guilt throughout the healing process. Many people blame themselves for what happened even if it may seem clear to you who is actually to blame in the situation. By questioning if it really happened, you’re validating and reinforcing any self-doubts the survivor has experienced over the years. This will ultimately slow the healing process, and maybe even cause your loved one to regress on their healing journey.
“It could have been worse”
This is another comment that minimizes the effects of the trauma and sends the message that the person is overreacting. What is traumatizing for one person may not be for someone else, and that is okay. Each person responds to trauma differently, but there’s absolutely no sense in comparing one trauma to another. Any survivor is hurting and trying to heal. It does not matter whose trauma was ‘worse.’ It can trigger feelings like shame and guilt, and really hinder the survivors healing journey.
“You should do/try _______”
As a loved one, the most important role you can play is being there for support, not giving advice on how to heal. Even if you’ve gone through something similar and feel like you understand, there’s no guarantee that what worked for you will work for them. And if they end up taking the advice you give but it doesn’t work out as they hoped, this can really hinder the healing process, and may even impact your relationship with your loved one.
“Do you want to talk about it?”
Oftentimes with trauma, survivors lose a sense of being in control when they went through that situation. If they feel forced to talk about it with loved ones, it can be triggering and bring up all of those old feelings of not being in control. Asking this question gives the survivor a chance to decide what they would like to do. Maybe they’re not feeling up to talking about it right now, and that’s okay. Giving them a sense of control in regards to this topic can be really helpful for their healing process.
“I hear you”
One of the most difficult parts of the healing journey is feeling like you’re going through this alone. Sometimes being there with a listening ear is the best support you can provide your loved ones. Try practicing Active Listening. Active Listening means making a conscious effort to hear, understand, and retain the information being relayed to you. It does not always mean you have a response or advice to give. Instead, pay attention, show that you’re listening with feedback, and ask questions if there’s something you don’t fully understand. Simply saying, “I hear you” can mean the world.
Are you a trauma survivor, or looking to better support a loved one struggling through their recovery? We can help. Give our office a call at (631) 503-1539.
About the Author, Jennifer Tietjen, LMSW
Jennifer Tietjen is a Licensed Master Social Worker (LMSW) at Long Island EMDR and is currently receiving supervision towards her clinical license under Kristy Casper, LCSW. She helps clients by providing the support, acceptance, and empathy they need as they face challenging life experiences. Jenn is passionate about helping clients overcome past trauma and make positive change in their lives. She is trained in EMDR therapy and is currently focusing her future training and experience on women’s issues. This includes maternal health concerns such as antepartum and postpartum depression and anxiety, and reproductive health issues including infertility.
In general people see a therapist when there is a problem. This is true. Most people need some sort of problem that’s uncomfortable enough that they will take the step to begin therapy. It’s of course not comfortable opening up with a stranger and telling them all your deep darkest secrets. It takes a lot of courage and internal motivation to take that step.
Most people also think when they are starting to feel better that therapy has worked and they can now stop coming. For some people this can be true. But with most of our trauma folks, “better” simply signifies not being in constant crisis mode. Yeah, that is an awesome feeling. But because you were in constant crisis mode your therapist likely was helping you develop coping skills and maybe change your behavior a bit so you could stop the cycle.
The truth is that deep work cannot be done when you are not stable. I cannot start EMDR with a client that is chronically suicidal, self-harming and self-sabotaging. I cannot do deep work with client’s coming in with a new fire to put out every week. I can help them learn to manage the moment and self-regulate better. I can help them set boundaries so they are less overwhelmed. I can help them build up their social support so they feel less alone. All of that is still gold. It’s great life changing stuff that ends the roller coaster.
But the deeper stuff that triggers them jumping back on that roller coaster. The inner voice that feels “not good enough”, “alone”, “unlovable”, “responsible”, “guilty” etc. will end up creeping in again and those great behavior changes will likely fade away again and you're back in crisis mode.

So that deep stuff. That inner child that still gets “pinged” when you get a critic at work, or your husband says “did you change the diaper genie?”, or your friend cancels plans. That work is best done when you are stable. It’s hard work. But changing that inner voice and those automated thoughts and responses is what truly puts you in the driver's seat of your life. It is also what ends the intergenerational trauma from continuing forward with your children.
That inner voice comes out so often and so unconsciously that it perpetuates us in the cycle. The woman that struggles with self-esteem, ends up criticizing her daughter’s weight and making food comments- that cause her daughter to feel the same as her “unlovable” or that love is conditional or that my value is based on my appearance. It’s surely unintentional and likely not in any way what that mom wants for her kid. But when we don’t have full operational control of our inner voice we end up sending mixed messages to our children, our loved ones and our colleagues.

When it is smooth sailing it’s the perfect time to dive deep. There are less stressors from school, work, life problems which is why you now feel “there’s no stress. I don’t need therapy”. The lack of stress allows for you to now really dive into some deeper issues that are going to bring up some uncomfortable thoughts, memories and emotions. It is the best time to do that work because now that your daily stressors are gone you have the emotional bandwidth to add the work- and healing yourself is work.

So now you're probably like, “Okay, Jamie. If even when I am not stressed I need therapy, when do I not need therapy?” Valid question.
My answer is when you can easily silence that inner voice that pops up. Whether that be the voice that makes you feel responsible for others, not good enough, unlovable, damaged, guilty, or that you cannot trust your judgment. When you can easily stop playing whack-a-mole and that voice doesn’t pester you- end therapy. When you have worked through and healed that inner child- end therapy. When life is stressful and you don’t want to rip out your hair, or feel your skin is crawling- end therapy. Don’t end when there is no stress. End when you can manage your stress without being in crisis mode.
But if you are a constant crisis mode client that is finally off the rollercoaster. Please talk to your therapist about doing some deeper work. About exploring those core beliefs and truly processing the memories associated with them. We want you to feel better. Truly better and in control of your life.
If you are looking for a therapist our counselors at Long Island EMDR would love to help you. What sets us apart from most therapists is that we are authentic humans. Imperfectly perfect I like to say. We are real, down to earth people. We love what we do and who we work with. We do evidenced-based work and are not afraid to challenge you when needed. Because we are down-to-earth genuine humans we truly care about our clients. Even though we will push you, we are probably some of the most compassionate, empathetic, and empowering people you will meet. Give our office a call today to be matched with a therapist who truly understands your concerns. And sleep a little better tonight knowing you took that first step.
What is C-PTSD? How is it Similar and Different from Post-Traumatic Stress Disorder (PTSD)?
Post-traumatic stress disorder (PTSD) and complex post-traumatic stress disorder (C-PTSD) are both neurobiological disorders that occur when someone experiences or witnesses a traumatic event. Examples include, but are not limited to, war or combat, natural disasters, physical or sexual assaults, and life-threatening accidents.
Almost all of us associate PTSD with veterans. We understand combat is gruesome on the body and devastating to the psyche. We realize war is hell, if only we look at the faces of our veterans when they return. We know, even without words, that they went through something far beyond the scope of normal human experience. In fact, generations before the term “post-traumatic stress disorder” became public knowledge, and added by the American Psychiatric Association to the Diagnostic and Statistical Manuel of Mental Disorders in the 1980s, PTSD was known by other names: war neurosis, shell shock, soldier’s heart, or combat fatigue. Furthermore, much of the research, advocacy, awareness, and treatment options for PTSD have been through means such as the U.S. Department of Veterans Affairs. Thus, it makes sense we as a collective society to visualize a soldier in battle when we think of PTSD.
However, across the general population and in terms of numbers, PTSD is most prevalent in people who have experienced dangerous, life-altering events. It seems to be most frequent in survivors of sexual assault or those who went through or witnessed violent car accidents, both which involve powerlessness, danger, and terror. Furthermore, PTSD can occur in populations that often are forgotten to be traumatic, such as ICU stays.
It is believed most people will experience at least one traumatic event in their lives, and a fourth will develop PTSD. It is not known how many people live with C-PTSD.
People who suffer from trauma may feel its impact for days; this is called acute trauma. If the symptoms continue for weeks or longer, and if they are disruptive to daily living, that is suggestive of PTSD.
There are three types of PTSD symptoms:
Hyperarousal symptoms. People with PTSD may have sense-of-threat symptoms, as if they are on edge and hypervigilant of their environment. They can have a startled response such as jumpiness.
Re-experiencing symptoms. Nightmares and flashbacks are the hallmark symptoms of PTSD. The individual may “go through” the trauma again via memories, via sensory experiences and emotions. The individual may feel the same smells, sights, sounds of the trauma.
Avoidance symptoms. Those living with PTSD will participate in avoidance symptoms, as in avoiding triggers associated with the trauma. This is broad, and can include places, situations, people, or events (i.e., holidays). They may also attempt to drown the symptoms through self-medicating with alcohol or other substances.
C-PTSD is a messier, multilayered version of PTSD which involves prolonged or chronic attacks on an individual’s sense of safety, self-worth, and integrity. This is dissimilar to PTSD, which is the result of one traumatic event. The ongoing maltreatment causes a multitude of additional symptoms, which shape neuropsychological development such as personality.
C-PTSD results from situations of chronic powerlessness and a lack of control, such as long-standing domestic violence (whether experienced or witnessed), sex trafficking, or child maltreatment. However, it is most common in those who were subjected to child abuse or neglect beginning in the earliest formative years, especially if the harm is by a caregiver or other significant adult, and there is a lack of hope for escape or that the situation can otherwise improve. Also, multiple traumas increase the risk of developing C-PTSD too.
People with C-PTSD have compounded symptoms of both PTSD and those from other mental health disorders. These may include the following:
Psychosomatic issues: Psychosomatic issues are physical issues without a medical explanation, caused or worsened by a psychological reason such as stress. It is common for people with C-PTSD to have vague physical symptoms such as dizziness, chest pains, abdominal aches, and headaches.
Emotional flashbacks: A flashback is a vivid, intense experience in which a person will relive some parts of a trauma or feel as if it is happening in the present. Stereotypically, people tend to think of the war veteran who is having a “movie-like” flashback in which the event unfolds again in its entirety. However, a flashback does not need to be so extreme – and usually they are not.
People with C-PTSD are likelier to experience what is called an emotional flashback – that is, the emotions experienced during the trauma, such as shame or fear. Such individuals may react to these events in the present, unaware they are having a flashback.
Difficulty regulating emotions: Those with C-PTSD may experience sharp, vivid emotions which can be inappropriate for the situation. These rapid shifts in mood can be misdiagnosed as bipolar disorder or borderline personality disorder, which can have similar features but are not the same.
Flat affect: People with C-PTSD may also have a flat affect, meaning they appear numb, somber, or emotionless to others. This body language can be misinterpreted by others, making people think the individual is feeling a certain way or is aloof. In truth, the person may have a rich, complex inner world of their emotions and be feeling very differently than how they are expressing themselves.
There are several reasons for a flat affect. One powerful reason is because the individual may not have witnessed emotional expression in their formative years, thus in turn they have been sharpened to be “flat” as an adult. To explain it plainly, imagine a primary caregiver not smiling at their baby. The baby mimics and responds to the caregiver by also not smiling. This is sharpening the baby to respond such a way going forward.
A lack of emotional vocabulary: Finally, individuals with C-PTSD may have difficulty with articulating their emotions or they may not understand what they feel; that is, there is an absence of an emotional vocabulary. They may struggle in therapy when asked “what are you feeling?” and respond with “I don’t know” or they may describe a physiological feeling instead (i.e., tiredness, nausea). This is because in the context of prolonged trauma they had to adapt to shutting down their emotions to survive. For example, they may have been programmed in their earliest years to think “emotions are bad” because they were consistently invalidated or punished for emotional expression by their caregivers.
Dissociation: Dissociation happens to everyone. Dissociation is a sensation of feeling disconnected from oneself and the world through a sensory experience, thought, sense of self, or time. A person who dissociates may feel depersonalization (detached from their body) or derealization (feeling as if their surroundings are unreal). And at one time or another, all of us have dissociated. Getting lost in a daydream, forgetting the details of a car drive, or spacing out during a boring class lecture are all examples of dissociation.
When applied to trauma, dissociation is an innate coping mechanism. It is a protective action taken by the mind to let an individual survive a traumatic experience. At the time of the event, dissociation is beneficial, especially for children as they often lack insight and more sophisticated coping skills. However, the downside of dissociation is that when someone has dissociation and is at risk of developing C-PTSD or another trauma-related disorder, the dissociation does not resolve the trauma. In adulthood, the effects of dissociation can negate the ability to trust, form and maintain healthy relationships, and prioritize self-care. Through the phenomenon of mind-body separation, individuals may develop self-destructive behaviors such as ones that keep them dissociated (“I can’t tell when I’m feeling hungry, so I eat less than I should”) or ones to make them dissociate (“I drink alcohol to numb myself so I don’t have to feel my despair”).
(Dissociation is a complicated phenomenon which cannot be fully explained in a few paragraphs. The article writer will make a detailed blog entry dedicated solely to dissociation in the future.)
Negative core beliefs: Individuals with C-PTSD may have the core belief “I am not safe” or “the world is unsafe.” Alternatively, they may have other core beliefs (“I am unlovable” or “I am not worthy of respect”, for example). These core beliefs are deeply ingrained, at the pool of their identities, which can mean the individual is unaware they even carry such beliefs until they develop more insight.
Relationship difficulties: Individuals with C-PTSD can struggle with developing and maintaining healthy relationships. Such individuals struggle with feeling able to trust others due to their traumatic histories; thus, they may isolate themselves or feel intensely uncomfortable with “opening up” to others. Or they may respond inappropriately in a social situation. Unfortunately, these factors only enhance their risk of disapproval or misunderstanding by others, which makes them more susceptible to social isolation or ridicule.
Additionally, people with C-PTSD are more susceptible to entering and remaining in abusive relationships – especially those who already experienced abuse.
C-PTSD is a treatable condition. However, clients (patients) should be cautious when selecting their therapist. The treatment of complex trauma is a specialty, and not all therapists have the knowledge, skills, or experience to adequately support those who have C-PTSD. Thus, it is encouraged to “screen” the therapist during the consultation session by asking for their background in treating C-PTSD. Much like we may make thoughtful, careful choices about our medical doctors, the same should be done for therapists too!
Ask the therapist about their intervention styles (treatment approaches) as well.
The following treatments are frequently employed for C-PTSD treatment:
There is hope for healing from complex post-traumatic stress disorder!
All of our counselors here at Long Island EMDR specialize in trauma work. We have a variety of sub-specialities within that including sexual assault, domestic violence, infertility, childhood abuse/neglect, loss of a loved one and bullying. Contact our office today to schedule with a therapist who meets your needs and start living the in the present.
Websites:
American Psychological Association (APA) – PTSD Treatments
https://www.apa.org/ptsd-guideline/treatments
CPTSD Foundation: https://cptsdfoundation.org
Healing From Complex Trauma & PTSD/CPTSD
(Complex) Post Traumatic Stress Disorder
Mind – Complex post-traumatic stress disorder (complex PTSD)
https://www.mind.org.uk/information-support/types-of-mental-health-problems/post-traumatic-stress-disorder-ptsd-and-complex-ptsd/complex-ptsd
U.S. Department of Veterans Affairs – National Center for PTSDhttps://www.ptsd.va.gov/index.asp
WebMD – What to Know About Complex PTSD and Its Symptoms
https://www.webmd.com/mental-health/what-to-know-complex-ptsd-symptoms
Books:
Pete Walker – Complex PTSD: From Surviving to Thriving
Arielle Schwartz – The Complex PTSD Workbook
Bessel van der Kolk – The Body Keeps the Score
There are many differences between experiencing trauma as an adult and experiencing trauma as a child. One difference is that experiencing a stressful event as a child can cause an everlasting impact throughout adulthood. This everlasting impact is what affects the ‘inner child’ when those children become adults. The inner child is something that exists within everyone. It is the playful, fun, cheerful, hurt, as well as saddened child we once were. Any traumatic or stressful event that was experienced as a child is remembered by the body, and that is how it continues to affect us into adulthood.
"A child who does not play is not a child, but the man who does not play has lost forever the child who lived in him." - Pablo Neruda
The obstacle to overcome when attempting to heal the inner child is being able to understand, connect with, and accept the child within. Inner child wounds can be because of abuse that was experienced as a child, neglect, distressful events, loss of a loved one at an early age, as well as many more. Tending to the inner child can allow for growth and prosperity for later life.
Taking steps towards healing the inner child can be done with seeking therapy, practicing mindfulness skills, as well as increasing one’s own level of self-awareness. Navigating inner child work with a therapist can allow you to work through that trauma, distressing memories and emotions. Working through these events can be distressing in and of itself, though having someone who is trained to support people with these types of issues can allow for many doors to open. The goal of inner child work within therapy is to explore these past events, with an emphasis on early memories to learn skills on how to regulate the self.
Many of my clients have difficulty living the life they want and need to feel truly happy. They struggle with expectations placed on them by others, feelings of guilt if they put themselves first and most days feel like they cannot catch their breathe. Trauma therapy can help you to end old patterns and put yourself first. Self-care isn't selfish- I know it's a clique but it is true. You need to take care of you to be your best self for your family, friends and career. If this is speaking to you, strap in- I have some Pro-tips for you.
What is most important to you? List 3 things. Could be family, honesty, integrity, compassion, trust etc. Then you need to start seeing if your actions actually align with your values. Those that do keep at them- those that don't make an effort to change them. For example, if you choose "family, compassion and health" and you are offered an additional work shift. Is taking this shift detracting from your family time? Do you need a mental health break or day off to take care of you? If so say no. If it's to help a colleague who is going through a rough time and you feel you have enough time on another day to take care of you and spend time with family and you want to honor that "compassion" value you can also say yes. Seeing how our actions are in align with our values helps us to begin living a life that makes us happy- not a life that is spent trying to appease or please others.
In set with setting those values is setting up some boundaries with those around us. When we have no boundaries- meaning we having difficulty saying no or often do things out of pleasing others even if it's not what we want- we continue to feel exhausted, unhappy and overwhelmed. Boundaries despite what childhood may have taught you are actually healthy. Saying "No I'm sorry I can't go out tonight", "No I won't be able to take on that extra project with my current workload as it stands",or "I would appreciate if you refrained from "xyz" in front of my children" is the first step to reducing our triggers, reducing your stress load and giving yourself the time to focus on you and do what makes YOU happy.
Often times my clients struggle with boundaries because of the guilt they feel in saying no to others. They feel responsible to take on the problems of those around them. They are accustom to the role of "fixer". Those around them, often family members but sometimes even colleagues or bosses sometimes push back on boundaries set and plead or ridicule them if they don't get what they want. I'm not going to say setting boundaries is an easy task when you are accustom to saying "yes" to everything because your role has always been to put others before you. But I will say the more you stick to your boundaries, the less others push back over time. It helps to see if keeping those boundaries is in alignment with your values or the type of person you are aspiring to be. Simple answer my look like "yes, I value helping others". With a closer look though it's easy to see it is hard to be our best self for others when you are running on empty. As I often tell my trauma therapy clients, and as they say on the air plane "put your mask on first" before you help those around you. It also helps to make a list of the short term positive gain of letting others violate your boundary and the long term consequences. For example, lets say you have difficulty saying no at work and are constantly taking on additional tasks asked of you.
| Short Term Positive of Not Holding My Boundary | Long Term Consequences of Not Holding My Boundary |
| -Don't feel guilty | -I am overwhelmed and burning out |
| -My boss is happy | -It's hard to complete additional work assigned in my work hours so I am constantly bringing work home |
| -I get positive praise | -I am working so hard that when I am done I have no energy to engage meaningfully with my husband and kids |
| -I feel taken advantage of and under appreciated | |
| -My workload will never decrease if I do not voice concern with the disproportionate work I get in comparison to colleagues |
After making this list you may decide to have a conversation with your boss and say "I would love to be able to help with that project but I already have 3 other projects I am currently working on. I will need to finish those first before I can take on any more. It's important to me that the quality of my work meets the standard and I am afraid I won't be able to complete all projects to our client's expectations." Starting an honest dialogue can help you feel more in control and will likely make you a better employee. Same with friends and family, when you are happier and more relaxed you can be your best self for your spouse, children, parents and friends. If this seems daunting, trauma therapy can surely help you work through your fears and doubts.
If this sounds daunting, you may need some extra support in navigating beginning to set boundaries and taking back control of your life. This is really common with clients who have trauma, are children of alcoholics, were parentified children (children that functioned more as parents), and those with low self-esteem and attachment difficulties (as they often fear boundaries will push others away). Trauma therapy can help! Just like my clients you can take back your life, begin to feel in control, less overwhelmed, more peaceful and joyful. You deserve happiness too. If you need the extra support in getting there give our office a call. We would love to help you on that journey.
Sending love & light,
It’s okay to be! Feeling emotions can be difficult at first especially if you're used to pushing everything down. Everyone has a unique life, and our mental health plays a big role in how our “unique life” comes to be. Struggling with mental health is completely normal! It is just as normal as not struggling with mental health. Oftentimes, people associate the term “mental health” with derogatory words, stigma, as well as prejudice. Here at Long Island EMDR it is our mission to separate ourselves from what may be so heavily broadcasted.
Throughout the past couple of years, the term “mental health” has been in the spotlight due to the ongoing COVID-19 pandemic and its numerous effects on people’s mental well-being. However, much more is needed than an ongoing movement. In order for the movement to be effective, people must become comfortable with feeling! There are several organizations that have been created in order to support mental health treatment, advocacy, as well as research. Some of the organizations are:
Are you ready to start feeling? If the answer is yes, then let's begin meet with a Suffolk County therapist! If the answer is no, that is completely okay and you are on the right path towards doing so! Here are some steps that will help you start the journey towards an improved mental state of mind:
Now ask yourself again, are you a stranger to learning more about your own mental health and are you ready to explore? If so call our office to meet with a Suffolk County therapist. I’d love to guide you on that Journey.