I have just turned in my second book to my publisher titled: Wisdom, Attachment and Love in Trauma Therapy: Beyond Evidence-Based Practice. It is a book written for therapists who work with people with trauma and PTSD. It blends attachment theory, neuroscience, transference analysis, trauma theory, Eastern wisdom practices and supervision wisdom with case examples to provide a comprehensive guide for how to be a great therapist, not just what to do. Look for it in 2018!
Blessings,
Susan Pease Banitt, LCSW
Showing posts with label trauma. Show all posts
Showing posts with label trauma. Show all posts
Wednesday, January 24, 2018
Wednesday, February 27, 2013
Mindy McCready's Death: Did Mental Health Treatment Fail?
My husband is an interventional cardiologist. Most of the people he sees are in manageable stages of cardiac disease. Some of his patients are quite sick and come in with advanced stages of illness. A few are dead and dying when they reach his cath lab. Miraculously, he can bring a few back to life, or ease their suffering greatly with stents and medications, saving them the trauma of open heart surgery.
Nobody is surprised when some of these people die. Sad. But not surprised. And certainly not outraged.
I’m a psychotherapist, as is Dr. Drew Pinsky. In the media Dr. Drew has been blamed for the recent death of country singer Mindy McCready, who appeared on his show Rehab a few seasons ago. Like my husband, we both see people in various stages of illness. We’ve held people’s lives in our hands in our offices as surely as my husband has in his cath lab.
Dr. Drew, on his show Rehab, treats the sickest of the sick. He admits people to his hospital who have a terrible prognosis, many of whom have been told they are going to die if they don’t get treatment. They are in the end stages of addiction, a disease just as surely fatal as heart disease.
Yet, for some reason, when these patients die, the good doctor is blamed. Why? He is treating those who need intensive intervention and treatment in a psychiatric facility, just as my husband treats people in his hospital. These patients can get well with interventions for a period of time and then fail, just as cardiac patients can.
I can only chalk this reaction up to the ignorance and wishful thinking of the American people. Here is what I, as a lifelong mental health practitioner, would like the general public to know:
1) Addiction is a deadly disease, no less of a threat than cancer, heart disease, or a terrible accident.
2) It takes a highly skilled practitioner, one with hundreds if not thousands of hours of training, practice and supervision to help these people get better, and, yet, like other physicians, we still may lose our patients.
3) When we do lose our patients, we feel terrible. We work so much more intimately with our patients than, say, my husband does with his. We know their secrets, their character. We have laughed with them and possibly cried with them. It is impossible to be a good therapist without attaching to our clients and they to us.
4) Clinicians don’t just ever treat addictions. Addictions are always a symptom of a much bigger problem, and, frankly, that problem almost always involves boatloads of psychological trauma.
5) Working with traumatic stress is incredibly taxing for patient and practitioner. Frankly, not that many people want to do it. If you don’t believe me ask yourself when the last time is that you asked someone to tell you about their history of abuse and neglect and then listened all the way to the end of their story. Never? I rest my case.
6) Mental health clinicians are the pariahs of the medical community in the same way our patients are pariahs in the public’s eye. We treat “losers” so we must be losers is how so many of us are seen (if you wish you can substitute the word “crazy” for “loser”). Most of us are undervalued, underpaid and disempowered, but we soldier on because we believe in our work and enjoy helping people end their suffering.
7) My husband never lacks for the tools to do his work. His patients have the best equipment, the best care, and only leave the hospital when they are well enough to go home. Often they go home with assistance of some kind or another. This is rarely true in mental health work. Our patients do not have long enough stays to get better, have trouble accessing clinicians who know how to treat them, and are often discharged without enough support at home.
Even with the best support money can buy, some patients, like the country singer Mindy McCready, fail. Some people do well until they are put under undo stress and then they collapse. This was the case, as far as I can tell, with Ms. McCready. She’d already had several suicide attempts until the completed suicide of her boyfriend. She snapped.
How is this Dr. Drew’s fault? Now, I know there is some controversy about publicly airing shows on mental health treatment, and the questions are valid. Yet, as a professional whose work is always done in complete opacity, I’m happy that the general public gets to see some of what I and thousands of my colleagues give to our clients on a daily basis. I can’t participate in Take Your Daughter to Work Day, but we can sit down and watch an episode of Rehab.
I am sorry that Mindy lost her battle with depression and addiction. I am sad that Dr. Drew is getting blamed for losing a patient in the end stages of a terrible disease process. I hope we can all use this event to deepen our understanding of the terrible costs and demands of mental health and addictions instead of using it as a way to take a cheap shot at a profession that works in areas that no one else will touch.
Nobody is surprised when some of these people die. Sad. But not surprised. And certainly not outraged.
I’m a psychotherapist, as is Dr. Drew Pinsky. In the media Dr. Drew has been blamed for the recent death of country singer Mindy McCready, who appeared on his show Rehab a few seasons ago. Like my husband, we both see people in various stages of illness. We’ve held people’s lives in our hands in our offices as surely as my husband has in his cath lab.
Dr. Drew, on his show Rehab, treats the sickest of the sick. He admits people to his hospital who have a terrible prognosis, many of whom have been told they are going to die if they don’t get treatment. They are in the end stages of addiction, a disease just as surely fatal as heart disease.
Yet, for some reason, when these patients die, the good doctor is blamed. Why? He is treating those who need intensive intervention and treatment in a psychiatric facility, just as my husband treats people in his hospital. These patients can get well with interventions for a period of time and then fail, just as cardiac patients can.
I can only chalk this reaction up to the ignorance and wishful thinking of the American people. Here is what I, as a lifelong mental health practitioner, would like the general public to know:
1) Addiction is a deadly disease, no less of a threat than cancer, heart disease, or a terrible accident.
2) It takes a highly skilled practitioner, one with hundreds if not thousands of hours of training, practice and supervision to help these people get better, and, yet, like other physicians, we still may lose our patients.
3) When we do lose our patients, we feel terrible. We work so much more intimately with our patients than, say, my husband does with his. We know their secrets, their character. We have laughed with them and possibly cried with them. It is impossible to be a good therapist without attaching to our clients and they to us.
4) Clinicians don’t just ever treat addictions. Addictions are always a symptom of a much bigger problem, and, frankly, that problem almost always involves boatloads of psychological trauma.
5) Working with traumatic stress is incredibly taxing for patient and practitioner. Frankly, not that many people want to do it. If you don’t believe me ask yourself when the last time is that you asked someone to tell you about their history of abuse and neglect and then listened all the way to the end of their story. Never? I rest my case.
6) Mental health clinicians are the pariahs of the medical community in the same way our patients are pariahs in the public’s eye. We treat “losers” so we must be losers is how so many of us are seen (if you wish you can substitute the word “crazy” for “loser”). Most of us are undervalued, underpaid and disempowered, but we soldier on because we believe in our work and enjoy helping people end their suffering.
7) My husband never lacks for the tools to do his work. His patients have the best equipment, the best care, and only leave the hospital when they are well enough to go home. Often they go home with assistance of some kind or another. This is rarely true in mental health work. Our patients do not have long enough stays to get better, have trouble accessing clinicians who know how to treat them, and are often discharged without enough support at home.
Even with the best support money can buy, some patients, like the country singer Mindy McCready, fail. Some people do well until they are put under undo stress and then they collapse. This was the case, as far as I can tell, with Ms. McCready. She’d already had several suicide attempts until the completed suicide of her boyfriend. She snapped.
How is this Dr. Drew’s fault? Now, I know there is some controversy about publicly airing shows on mental health treatment, and the questions are valid. Yet, as a professional whose work is always done in complete opacity, I’m happy that the general public gets to see some of what I and thousands of my colleagues give to our clients on a daily basis. I can’t participate in Take Your Daughter to Work Day, but we can sit down and watch an episode of Rehab.
I am sorry that Mindy lost her battle with depression and addiction. I am sad that Dr. Drew is getting blamed for losing a patient in the end stages of a terrible disease process. I hope we can all use this event to deepen our understanding of the terrible costs and demands of mental health and addictions instead of using it as a way to take a cheap shot at a profession that works in areas that no one else will touch.
Monday, September 24, 2012
Wednesday, September 19, 2012
Trauma and Attachment
Here’s a little known fact about trauma: an experience of extreme stress or trauma always ruptures a sense of connection and secure attachment in the world.
What do I mean by that?
The world and our sense of safety and connection in it profoundly altered by the sense of disconnection. This makes healing from trauma a doubly hard endeavor.
Here are some examples of common traumas and the ruptured attachment:
Rape: strangers, your own judgment, even a whole gender (men, usually).
War: commanding officers, countries, your own country, people of other races
Child Abuse: authority figures, intimate relationships, justice system, sense of self
Natural Disaster: God, nature, government (if inadequate response)
Car Accidents: other drivers, own judgment, motor vehicles
Major Medical Illness: body, medical system (if inadequate), society (if not able to get insurance or help due to finances)
There are, of course, many other kinds of trauma and endless variations on disrupted attachment and connection depending on the experience involved.
All victims of traumas naturally experience a questioning of and sense of separation from self. Most end up having some sort of spiritual crisis in that their attachment to a higher power is called into question.
Without feeling secure in the world it’s easy to become lost and not know where to turn to for help when you need it the most. Therapists often underestimate the damage done by rupture of secure attachment in the midst of crisis, and patients often end up feeling angry, guilty and paralyzed.
It is important to not pathologize these responses but to see them as a normal conditioned response to trauma and extreme stress.
So, easy does it. When you are ready, sit down and think about areas of mistrust that result directly from your trauma. Be good to yourself today!
Wednesday, July 18, 2012
5 Ways to Manage Post-Disaster PTSD
I just had a lovely interview with Luke Hayes, of MyRecovery Disaster Resilience Radio. We discussed helpful ways to prevent and overcome post traumatic stress around natural disasters, that are increasing in frequency and intensity around the world.
1) Be prepared. Don't think it can't happen to you (denial). Have food and water items stocked. Know what kind of disasters could happen in your area. Make a plan for a quick evacuation. An ounce of preparation is worth a pound of loss later. We don't think and plan well in the midst of crisis. So plan ahead!
2) Know where to find help. Form a community organization. Familiarize yourself with local assistance such as Red Cross, shelters etc. If your community does not have such assistance consider forming a group yourself. People have much less trauma when they feel looked after by their community.
3) Practice control over your mind and emotions now. The first technique I teach my patients about PTSD is a single pointed meditation. Focus on one object for 3-5 minutes at a time. Most of us have flabby mind muscles. This exercise strengthens our ability to focus in a crisis and its aftermath while staying calm. It is easier to keep the mind calm when we have practiced at it ahead of time.
4) If you have severe trauma after a disaster seek help. EMDR (Eye Movement Desensitization Response) is a powerful modality that involves eye movements that dissipates traumatic responses. It seems to work best on those who did not grow up with tremendous amounts of trauma. The results can be surprisingly fast and powerful.
5) Restore yourself and your body after the crisis has resolved. The body is profoundly affected and in some cases permanently altered by trauma. The endocrine system and central nervous systems may take weeks to months to heal fully affecting appetite, weight, autoimmune responses, mood swings, sleep patterns, libido and other aspects of human life. Most people tend to underestimate the results of trauma. Take the time you need to get help and heal yourself. It may take some time.
You are valuable. You are needed. You deserve to heal!
Monday, May 14, 2012
The HPA Axis, Trauma and You pt. 2
Maybe you have seen the discussion in the media lately around whether PTSD is a disorder or an injury. It is an injury.
Psychological trauma affects the entire body through the Hypothalamic-Pituitary-Adrenal (HPA) Axis. As we discussed before, (see The HPA Axis, Trauma and You), this axis governs the body's entire endocrine (hormonal) system. This is not in control of the victim, any more than bleeding and swelling is for the victim of a beating. PTSD always involves injury to the body's mechanisms. Always. This is one of the reasons the disorder is so painful and so hard to describe.
I have come to believe that all symptoms of PTSD are related to these disturbances or attempts to 'heal' the disturbances.
Let's take an extreme symptom, cutting or self-mutilation. We know in neurology that pain in one part of the body cancels out pain in another part of the body. This is a joke with my acupuncturist. Some times a painful needle will be inserted and he'll ask how my symptoms are. I'll answer, "fine, now that all I can feel is your painful needle!".
So, in a strange kind of way, cutting can be "adaptive" for forms of extreme trauma by managing through diversion and re-routing of pain signals, which then gives the victim a feeling of control.
Avoidance is another one of these symptoms. People with PTSD go to great lengths to avoid (or scare off, if it's a person) reminders of their trauma, sometimes resulting in strange "phobias" or behaviors. That saying, "you always hurt the one you love" goes twice for PTSD sufferers when their partners inadvertently trigger them. We need to learn when our PTSD injury is manifesting and make ourselves safe in ways that don't injure our relationships.
When medicine embraces the physiologic basis for PTSD, sufferers will finally gain the help that they need to heal from this profound HPA injury.
Tuesday, April 24, 2012
The Trauma Tool Kit Has Arrived! *GIVEAWAY*
Hi all,
I'm happy to tell you that The Trauma Toolkit: Healing PTSD From the Inside Out is now in bookstores across the United States and is shipping from online booksellers. I had the privilege of finally holding my own copy this week. In celebration I am giving away three copies to the first three readers who link to this blog and comment below. Please be sure to send me your address privately if you see your name in the first three comments! Here's to healing from traumatic stress! Blessings, Sue
I'm happy to tell you that The Trauma Toolkit: Healing PTSD From the Inside Out is now in bookstores across the United States and is shipping from online booksellers. I had the privilege of finally holding my own copy this week. In celebration I am giving away three copies to the first three readers who link to this blog and comment below. Please be sure to send me your address privately if you see your name in the first three comments! Here's to healing from traumatic stress! Blessings, Sue
Monday, April 16, 2012
TTK BREAKING NEWS
Hi all. Today I am pleased to tell you that one month out, the Search Inside function has been activated for The Trauma Tool Kit: Healing PTSD From the Inside Out. Quest Publishing has been quite generous with their sharing so you can begin reading now! Click on the book cover to the right of this post to go to Amazon's site for the book. My greatest desire is that this book help you overcome your traumatic stress and PTSD. Blessings, Sue
Friday, September 16, 2011
The Realization of Dawn
This poem comes courtesy of my ancient 14 year old daughter, Maya. She knows a thing or two about traumatic stress and healing.
The Realization of Dawn
What is this light that I see?
Could it really be what we have all been waiting for?
The warmth from the rays eases my aching brow
It gives me the strength to lift my falling head
To embrace what this impossible answer might mean
I hear the ticking behind me
On the peeling paint wall
The clock knows what time it is
And it's time that knows what we have to do
The time has come to flood our dried out deserts
To calm our overflowing seas
The time has come to embrace this beacon
It is time to understand
We need to fill our cracking despair
With this light and love that is so bright
But yet so dim to our non understanding eyes
The answer is here
Almost in our grasp
It is time for us to wake up
It is time for us to see this glowing dawn
Emerging from this blinding night
The Realization of Dawn
What is this light that I see?
Could it really be what we have all been waiting for?
The warmth from the rays eases my aching brow
It gives me the strength to lift my falling head
To embrace what this impossible answer might mean
I hear the ticking behind me
On the peeling paint wall
The clock knows what time it is
And it's time that knows what we have to do
The time has come to flood our dried out deserts
To calm our overflowing seas
The time has come to embrace this beacon
It is time to understand
We need to fill our cracking despair
With this light and love that is so bright
But yet so dim to our non understanding eyes
The answer is here
Almost in our grasp
It is time for us to wake up
It is time for us to see this glowing dawn
Emerging from this blinding night
Friday, July 8, 2011
Your Brain on PTSD
We all have those days! When your traumatized brain is not quite up to life, take some time for restoration and recuperation. You may not need to announce to your boss you are taking a mental health day, but take one anyway! Anything you can do to calm down your mind and relax your body will help you cope and function better. Stay tuned for more blog posts on how to do just that!
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