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.

What Not to Say to a Person with Trauma

“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. 

What Can You Say Instead?

“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.

Why Stay in Therapy

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.

Why Low Stress Times is When Real Work Happens in Therapy

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.

When Do I Not Need Therapy

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.

Looking For A Therapist?

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.

-Jamie K Vollmoeller, LCSW

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.

Symptoms of 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.

What is Complex Post-Traumatic Stress Disorder?

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.

Symptoms of C-PTSD

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. 

Treatment for C-PTSD

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:

• Eye Movement Desensitization and Reprocessing (EMDR) Therapy. In EMDR, the individual reflects on a trauma while following a bilateral stimulus that results in the eyes moving back-and-forth. EMDR is considered a “hallmark treatment” for PTSD and C-PTSD.
• Trauma processing therapies.
• Exposure therapy, in which individuals re-experience their traumas in a safe, controlled environment.
• Cognitive Behavior Therapy (CBT), which focuses on the relationship between cognitions (thoughts), emotions, physiological sensations, thereby changing the resulting behaviors.
• Dialectical Behavior Therapy (DBT), an off-set from CBT which also includes interpersonal effectiveness (relationship skills), emotional regulation, distress tolerance, and mindfulness.
• Cognitive Processing Therapy (CPT), a behavioral therapy that challenges and changes unhelpful beliefs associated with the traumatic events

There is hope for healing from complex post-traumatic stress disorder!

Looking For a Therapist?

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.

Citations/further information:

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

https://www.healingfromcomplextraumaandptsd.com

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

-Valerie Smith, LMSW

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.

Some Signs That Your Inner Child May Be Impacting You:

• Having feelings of shame, guilt, inner restlessness
• Having feelings of worthlessness, never feeling satisfied with self
• Negative self-talk
• Having the need to be a perfectionist with responsibilities or tasks
• Self-sabotage, self-destructive behaviors
• Excessive work ethic
• A pattern of unhealthy/unstable relationships
• Chronic overworking and overachievement (to knowingly or unknowingly gain approval, praise or belonging)
• Not being able to be in the here and now (present moment)

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. 

Some Inner Child Mindfulness Practice:

Heal Your Inner Child Meditation

-Conor Ohland, MHC-LP

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.

1. Evaluate Your Values

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.

2. Set Some Boundaries

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.

3. Let Go of the Guilt

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.

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.

Need Help?

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,

Jamie Vollmoeller, LCSW

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:

1. American Foundation for Suicide Prevention
2. Strong Minds- Mental Health Africa
3. The Trevor Project
4. Born this Way Foundation
5. National Alliance on Mental Illness

But what about you?

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:

1. Identify: What exactly are you uncomfortable with feeling? Do you think it’s generalized or do you think that it’s situational? Asking yourself some questions about what you are feeling, experiencing, thinking is a great way to put a label to some of the emotions that are running through your head. But, once you identify the emotion, what do you do with it?
2. Self-compassion- The term compassion is defined as, “sympathetic pity and concern for the sufferings or misfortunes of others.” If we are able to have this sense of compassion towards others, why can’t we treat ourselves the same? Because it’s hard to!! Being nice to ourselves is more than just giving ourselves a pat on the back, acknowledge the pain or even acknowledge the happiness.
3. Self-awareness- Having a good sense of self-awareness can continue to help you practice self-compassion, mindfulness, coping skills, etc. You can practice self-awareness through journaling, meditating, breathing exercises, anything that allows you to focus on yourself.
4. Talk- Sometimes being alone with your own thoughts, feelings, and/or emotions can be overwhelming and intimidating. Which is normal, and why talking to others is so heavily encouraged. Being able to talk with a friend or family member may seem awkward or uncomfortable, but you may be opening a door that needs to be opened. Talking with a therapist is another great way to explore your mental health. 

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.

-Conor Ohland, MHC-LP

A traumatic event is an occurrence that overwhelms our stress response system. When we endure trauma from someone close to us we can develop a trauma bond, especially when we experience trauma repeatedly by an attachment figure. A trauma bond occurs when the abused develops sympathy or affection towards their abuser. This can happen over any time period and rarely, if ever, develops into a healthy relationship. A trauma bond can cause the abused to experience guilt, confusion and self-judgment when analyzing their feelings towards their abuser, however this type of bond, while unhealthy, can originate from a protective place in the abused person.

How Trauma Bonding Occurs from Our Fight, Flight Or Freeze Response

Our brains have a survival response system, often referred to as the “Fight, Flight or Freeze” response. The body can activate this response system if our brains detect danger and turn on different pathways to get us out of the dangerous situation safely. This is the same response system that is responsible for the increase in adrenaline we experience after we hear an unexpected loud noise or are startled. It is our “Fight, Flight or Freeze” response system has allowed our species to survive for as long as we have and it is this system that becomes activated when we experience trauma. 

Survivors who endure abuse from their loved ones, especially their parents as children or their partners as adults, go through an extremely complicated process to try to make sense of their relationship with the abuser. In an effort to allow the survivor to be able to function with their abuser the brain may turn on protective defense mechanisms in the form of dissociation, forgetting or minimizing abuse or even to take responsibility if the abuse with an attachment figure. For example, it would be extremely difficult for a child to function with the knowledge that they have to rely on the same person who is mistreating them so the brain may “try to make sense” of the abuse by using one of the above tactics to allow the child to still function with their abuser day to day. This is not the say that abuse is therefore alright. It is not and no one deserves to be mistreated or abused. 

What This Does Not Say About The Survivor

1. That the abuse did not happen.
2. That they want the abuse to happen.
3. That they deserve abuse.
4. That there is something “wrong” with them.

What This Means

Forming a trauma bond with an abuser does not mean there is something wrong with the survivor but rather speaks to the survivor’s ability to survive in a dangerous, unpredictable environment. No one deserves to be in a dangerous, unstable relationship or environment. If you feel you may have this type of attachment to a person who has made you feel unsafe, please call our office to work through your emotions related to trauma bonding to enhance self-compassion and secure safety for current and future relationships. 

By Marissa Ahern, LMSW

Flashbacks are our brain’s way of processing traumatic events that we’ve experienced. Our subconscious taps into those important memories but they are not contained- meaning they tend to spill out everything related to the traumatic event. For many individuals, this experience can be just as terrifying as the initial event.

Flashbacks usually happen without warning. Most result from a “triggering” that occurs by an external experience. Triggers are typically sensory-based experiences that manifest via smells, sounds, tastes, textures that remind the person of the traumatic event. The sound of fireworks or a car backfiring can remind a soldier of gunfire. I once had a patient who would have flashbacks around flower shops, as the overwhelming smell of flowers would bring him back to his sister’s funeral.  

Living with flashbacks is very difficult, but with practice there are some ways you can work through these disturbing events:

1. Remember

Remind yourself that you are in a safe place and having a flashback. Use that self-talk and tell yourself, as many times as necessary, that these are only memories until you can feel yourself begin to calm.

2. Empower Yourself

Sometimes using your five senses can help you to be in the present moment. If one sense is causing the flashback use your other senses to place yourself in the actual current environment. The tactile experience of stamping your feet on the ground can remind yourself that you are free to get away from any situation that has become uncomfortable for you. See more here on mindfulness tips.

3. Breathe

Fear and panic causes our breathing to become shallow and erratic. Shallow our erratic breathing exacerbates the stress we feel in that moment because our body is literally panicking from a lack of oxygen. In these fearful moments, when we slow our breathing and take deeper and deeper breaths, we actually signal to our brain and body that everything is okay. One of my favorite breathing tricks is to trace one hand with the opposite. When you go up a finger breathe in, then breathe out as you trace back to the palm of you hand. Repeat till you are calm and your breathing is regular. 

4. Honor the Experience

No one wants to remember their trauma, let’s face it it’s not an easy experience and I understand you want to move on and forget it NOW. However, our bodies and our minds need time to process what has happened. It’s normal, expected, and honestly needed to experience a full range of emotions. Honor your experience and yourself for making it through and surviving.

5. Find Support

Going through trauma alone is not really advisable. I understand there may be feelings of shame, guilt, fear that are preventing you from feeling comfortable opening up. However, it is important for you to have supports 

It’s important that you let loved ones know about your to help you through this process. Opening up to trusted loved ones can allow for them to help you work through flashbacks and process what has happened. You may also want to open up to a mental health professional to gain a deeper understanding of what is happening to you, how to cope with flashbacks and triggers and work through those difficult memories and emotions. 

If you or a loved one is suffering from flashbacks and would like to explore treatment options, please be in touch, we would be happy to discuss how we may be able to help.

Stay Shining,

Jamie Vollmoeller, LCSW

Unfortunately, being a survivor of trauma or abuse is exceedingly common. According to the National Sexual Violence Resource Center,one in four girls and one in six boys will be sexually abused before they turn 18 years old. Additionally, they also found that one in five women and one in 71 men will be raped at some point in their lives.

Being a survivor of abuse can be challenging, thankfully with some self-care in place you can begin your healing journey to a healthier you.  That journey from feeling scared, afraid, angry and/or alone to a place of peace and acceptance can be an empowering one. Regardless of whether your trauma was recent or happened years ago, a daily self-care regimen will help you cope with the trauma that still affects you today.

1. Quality Sleep

An essential component of maintaining optimum physical, mental, and emotional health is ensuring you get adequate sleep each night. According to The Sleep Foundation,  “while sleep issues after a traumatic experience can be distressing, they may also be an important opportunity for treating and healing from trauma. Research suggests that being able to sleep after a traumatic event can reduce intrusive trauma-related memories and make them less distressing.” Additionally, getting adequate sleep helps to improve memory, increase positive mood and decrease stress.

2. Meditate

Meditating for just five to ten minutes can have some really positive benefits including: boosting immune response, regulating stress levels, increasing focus and elevating mood. Headspace (the App) now has a program on Netflix that not only guides you through meditations but also explains why and how a particular exercise can help you.  I’ve also always been a big fan of the App Insight Timer. I find guided meditations are often easier for people to start off with and you can then work your way into solely music, nature sounds or silent meditations. For anxious folx, guided meditation can help to give you a focus point so it is not so overwhelming in the beginning. 

3. Exercise

Exercise is beneficial for just about everyone, but for trauma survivors it can also be a way to release pent-up emotions you have relating to what has happened to you. The type of exercise is not really as important, as engaging in a daily practice of release. If you like to dance, do some Zumba, if you are more of a yoga lover, go with that. For some, taking kickboxing or jiu-jitsu can help them feel more in control after an assault and better able to defend themselves. No matter what you choose remember that exercise should be an act of self-care, meaning it should be something you enjoy- not a punishment. 

4. Positive Affirmations

For many survivors there is a good-deal of shame and guilt that comes with what has happened to them. For those reasons, it is all the more important to really focus on programing yourself with positive thoughts and beliefs. For example: “I am loved,” “I am worthy,” “I am valued,” “I am strong,” “I am enough.” I often tell client’s to pick an opposite thought to their negative self-talk, so if your inner “Karen” is saying: “I am disposable”, you say to yourself: “I am worthy and deserving of love, respect and affection”. There is a really amazing App that spams your phone, however often you set it, to give you positive affirmations called “I Am”. If its a struggle for you at first to come up with your own affirmations, I really recommend it.

This process of changing that inner voice takes time and truly is a practice so be gentle with yourself. You will have days where it works great and other days where you cannot seem to get “Karen” to stop talking. It’s okay, just take it one step, one moment at a time. 

5. Support

Support is critical need for healing, surround yourself with people who build you up, cheer you on and pick you up when you are down. If you have a solid support system don’t be afraid to engage them, by calling a friend or family member, attending a support group and/or finding a therapist. If your support system is lacking, use a smartphone app or the Meetup website to find a local, like-minded group and make some new friends.

Often times survivors feel alone and like no one can or will understand how they feel, or that they will be judged for what happened to them. However, as said in the beginning abuse is more common than we would like to believe in this country. Sharing your struggles with people who understand and care about you and your well-being is an important aspect of your healing journey. If you are a sexual abuse survivor and need some words of advise from others who have been through it but are not ready to take that step of opening up just yet, I highly recommend Dear Sister by Lisa Factora-Borchers and Aishah Shahidah Simmons - a book of letters from survivors of sexual abuse to other survivors. 

Are you a survivor of trauma or abuse? A licensed mental health professional can help you so you don’t have to go through this alone. Give our office a call today so we can set up a time to talk.

Keep Shining,

Jamie Vollmoeller, LCSW 

Have you ever wondered how childhood trauma impacts adolescents or adults? Do you find yourself asking yourself how much your childhood has a impact on your relationships today? Childhood experiences, both positive and negative, have major impact on our emotional development and how we continue to interact in the relationships around us. 

Childhood is where our attachment styles are developed and our parents are our primary attachment figures. The way they respond to us in childhood shapes our worldview, or perception of the world, and how we expect others to respond, relate and interact with us. This is the foundation of whether or not a child will feel the world is safe and whether or not those around them will accept them.

Erikson called this our view of “trust or mistrust”. Is it a safe place to venture out and take emotional risks? Are all people generally good or are they out to hurt us and therefore untrustworthy? Can we trust others to support us in times of emotional need or crisis or do I need to rely on myself?

Complex trauma refers to the prolonged exposure to a stressful event, or repeated traumatic events layered on top of another. This would include children, who have grown up in physically, sexually, and/or emotionally absent or abusive households, as well as children who grew up in unsafe communities, an incarnated parent or a parent with mental health or substance use concerns.

How Childhood Trauma Continues to Effect us into Adulthood

The following are the four basic attachment styles. Please keep in mind that these descriptions are very general; not everyone will have all these characteristics. Attachment styles are relatively fluid and can be ever-changing depending on your partner’s own attachment style and the adaptations you make as you grow and learn.

Secure Attachment in Adults

These individuals usually grew up in a supportive environment where parents consistently responded to their needs. Securely attached individuals feel comfortable in their own skin, easily share feelings with partners and friends and seek out social support. These individuals have a generally positive outlook on life and seek physical and/or emotional intimacy with minimal fear of being rejected or overwhelmed.

Securely attached individuals, much like their parents were to them, are generally consistent and reliable in their behaviors toward their partner. They also tend to include their partner in decisions that could affect their relationship or life goals. 

Dismissive-Avoidant Attachment in Adults

Children develop this attachment style when their primary caregivers are not emotionally responsive or are rejecting of their needs.

Children learn to pull away emotionally and be overly self-reliant, as means to avoid feelings of rejection. As adults, they become uncomfortable with emotional openness and downplay the importance of relationships.

These adults tend to place a high priority on their own independence from others and tend to be extremely self-reliant. They develop techniques to reduce feelings of being overwhelmed and defend themselves from perceived threats to their “independence.”

These techniques include, shutting down, sending mixed messages, and avoiding. These coping techniques end up becoming detrimental to their adult relationships.

Fearful-Avoidant Attachment in Adults

Children who have developed this style of attachment may have been exposed to prolonged abuse and/or neglect. Their primary caregivers are a source of hurt, rather than fulfilling their vital role of providing support and comfort. 

As adults they see the value in having close relationships but due to the abuse they received have a difficult time trusting others. Due to this distrust, they avoid being emotionally vulnerable with others and have difficulty clearly expressing their wants and needs, as they fear it will lead to more hurt and rejection.

Anxious-Preoccupied Attachment in Adults:

Children with anxious-preoccupied attachment had caregivers who did not consistently meet their needs, as in their responses to the child were not consistent or predictable. Their parents were nurturing, caring and attentive at times but this was alternated with cold, rejecting or emotionally detached behaviors. 

This alternation between love and rejection makes it difficult for a child to know what to expect from day to day. These children then grow up to be adults who require a lot of connection, closeness and attention within their relationships, sometimes to the point of being “clingy.”

Individuals who have this attachment style may need more validation and approval from loved ones than the other attachment styles.

Neurobiology of Attachment and Childhood Trauma

As products of our own environments, adults will often find themselves repeating the same behaviors witnessed and experienced in childhood. This is because the neural pathways developed from childhood traumatic experiences shape keep us stuck in these unhealthy patterns and ways of relating.

To say all of this is not meant to place blame on caregivers for the types of relationships formed in your adult life. However, increasing awareness of your own attachment style can help you take those first steps towards recognizing patterns and improving your relationships as an adult. With newfound awareness you can move to form securely attached relationships with your partner and with your own children. 

Processing those difficult childhood memories of abuse and neglect can help you to make new neural connections with more adaptive experiences in your life and thus alter that inner-voice that keeps your stuck in poor patterns of behavior. 

Where to go From Here?

At Long Island EMDR, we understand how complex childhood trauma affects you as an adult, which is why we specialize in EMDR and trauma-focused therapies. We are here to help guide and support you through your journey of processing past hurts and forming healthier connections.

Keep Shining,

Jamie Vollmoeller, LCSW