Thursday, October 27, 2011

From Little “T’s” to Big “T’s”; Alleviating Stressors Using Trauma Focused Therapy Approaches

by Kathleen Krol, LCSW, RPT 
Life is stressful! No one is immune from experiencing stress, whether it is the day to day little “T’s” or the bigger life changing “T’s”. Little “T’s” are the fender-bender accidents, dissatisfaction with a critical boss, fear of giving a presentation or navigating through your child’s terrible two’s. Big “T’s” are the events that have a lasting impact; loss of a loved one, involvement in major accident, experiencing or witnessing violence or abuse. Little “T’s” are the situations that cause some sleepless nights, muscle tension, worry, intestinal problems, poor concentration, anxious or sad mood. Big “T’s” may include the same disturbances as the smaller “T’s” but may occur with more intensity or for longer duration of time. Big “T” symptoms also may include recurrent dreams or flashbacks of the event, detachment from others, irritability or angry outbursts, psychological distress and physiological reactivity to internal or external stimuli that remind one of the trauma.
In this article, I’d like to highlight three modalities; Sand Tray, Trauma Art Narrative Therapy and EMDR, that can be used in alleviating symptoms from little or big “T’s”.  All three approaches can be used with children, teens and adults.
Sand Tray provides choice of using either wet or dry trays of sand along with selected “miniatures”, objects which provide the medium for emotional expression and communicating one’s experience. Trauma is sensory based in that traumatic memories are encoded in both the body as well as the brain. The modality of sand has a kinesthetic quality that addresses the sensory component of trauma, the deeper emotional experience that is retained in the body itself. For children, sand tray provides a safe, natural way for them to express themselves without re-experiencing the traumatization of the original event. Adolescents and adults may experience emotional release through the use of symbolism and projection of feelings until the sand tray and miniatures.
Trauma Art Narrative Therapy (TANT) is a structured cognitively oriented technique which uses art as a modality for healing from trauma. With trauma, memories are often disconnected and fragmented. Trauma art pieces together these memories by guiding one to narrate the traumatic experience through a series of sequential drawings. As one draws “snapshots” of the event, integration of the emotional and cognitive components of the brain takes place and promotes healing. Preparation for this trauma work always includes establishing a safe point before and after the trauma. TANT is effective with both minor single incidents to major events that have had significant impact. Artistic ability is not needed to benefit from this modality and more spontaneous drawing is most effective.  
Eye Movement Desensitization Reprocessing (EMDR) uses bilateral stimulation techniques such as eye movements, tapping or audio which stimulate both sides of the brain. When a traumatic event occurs, pieces of the trauma can remain stuck or frozen in the brain and nervous system. Bilateral stimulation helps “unlock stuck material” thereby allowing the mind and body to process the traumatic event. EMDR is often used with big “T” traumas but equally can be beneficial in alleviating symptoms of general anxiety and phobias or working through little “T’s” that can impact daily functioning, assist one in better managing stressors related to job, family, relationships and overcoming roadblocks to growth and development. Preparation includes developing resources in stress management and relaxation.
Kathleen Krol, LCSW, RPT is a independent practitioner at the Resiliency Center and also a Licensed Clinical Social Worker and Registered Play Therapist, who uses these three modalities along with Family and Play Therapy and Parent Education.  She works with children, teens and adults experiencing anxiety, depression, trauma, grief and loss, abuse and behavior issues. To learn more about any of these specialties’ or discuss how she might help you and your family, email or call 215-289-3101, mailbox #1.

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