Category Archives for "Anxiety and Trauma"

Oct 25

What is Play Therapy?

By Cisais | Anxiety and Trauma

As psychotherapists, our focus is in child development and play therapy. We use a playful and individualized approach to empower children to cooperate, self-regulate and effectively communicate their needs.

Play therapy is most often used with children ages 3-12 and usually occurs in weekly sessions.  Some children’s behaviors may improve very quickly with play therapy (averaging 15-20 sessions), while others may have more serious or ongoing problems that may take longer to resolve. Play therapy works best when a parent, family member, or caretaker is supportive and actively involved in the treatment process.

Why Play Therapy?

Developmentally, even the brightest children have not developed the capacity to use the insight-based verbal reasoning– which is needed to be successful in one-on-one talk therapy. What works in the world of play therapy is that it play can be used as a language by the child,  overcoming the challenge of more traditional language-based communication while still allowing the therapist to assess and respond to the underlying needs of the child-client. Also, because therapy sessions are child-centered, there is less resistance and often more rapid change than with talk therapy.

Play therapy is different from regular “playdates” because in these specialized sessions, therapeutic space is created to allow the child-client to express, address, and resolve the challenges they have faced. Play provides a psychological distancing from a child’s issues and allows expression of thoughts and feelings– which is the process work of therapy. Through play, therapists can help children learn more adaptive behaviors when there are emotional or social skills deficits. Children learn to communicate with others, express feelings, modify behavior, develop problem-solving skills, and learn a variety of ways of relating to others. Even the most troubling problems can be confronted in play therapy and lasting resilience can be discovered, rehearsed, mastered, and adapted into lifelong strategies.

Play therapy is effective with children experiencing life stressors, such as relocation, hospitalization, chronic illness, abuse, domestic violence, and natural disasters. Therapeutic play and can be used with children dealing with:

  • anger management
  • grief and loss
  • divorce, family dissolution, and abandonment
  • crises and trauma
  • anxiety
  • depression
  • ADHD
  • Autism or pervasive developmental disorder
  • academic and social problems
  • learning disabilities
  • conduct disorders
Nov 16

What is PTSD?

By Lee Ockenden, LMFT | Anxiety and Trauma

PTSD is the acronym for Post Traumatic Stress Disorder and refers to a cluster of symptoms that result from a past trauma. But what’s a trauma?. Trauma refers to a psychological or emotional imprint that occurs when an event or series events threatens our sense of safety or well-being to the extent that our minds react to protect us from any further exposure.

In order to protect ourselves until we are either healthy enough or supported well enough to address issues from the past, sometimes, our experience or memory of a traumatizing event can be compartmentalized or stored away. PTSD can be diagnosed as soon as 30 days after an event or as long as 30 years or more after an event. The good news is that the healing process can begin at any time.

Nov 10

EMDR Therapy and Trauma

By Cisais | Anxiety and Trauma

Trauma survivors often complain of recurring nightmares, sudden tearfulness, flashbacks, aversions to places or people and even somatic/physical discomforts. Eye Movement Desensitization and Reprocessing (EMDR), is a technology created about 20 years ago by Francine Shapiro, PhD. EMDR involves systematically bringing highly charged images/experiences to the conscious self without hypnosis where they can be rationally dealt with and resolved into normal memory. This process is rapid and is noted in psychology journals as the most effective treatment available for PTSD.

Sep 02

A Soldier’s Unseen Wounds

By Cisais | Anxiety and Trauma

A gun, a tank, a rocket launcher all make sense if you are a member of any of our armed services on a tour in the Middle East. They are necessary for the tasks that these men and women have been trained and, for better or worse, fit into the context of war.

Just as a rifle is a tool with a specific design; the sight to hone in on a target, materials that resist wear and damage, a magazine to hold rounds to defend or attack, a trigger to engage the sole purpose of the tool. So too, can a mind be conditioned to serve a specific purpose to suite an environment and a context that can be imagined, practiced and realized in mission after mission.

The difference is that the rifle is not expected to change purpose at the end of a tour. Whether in ‘that’ environment or another it maintains it’s function and form. We expect our servicemen and women to suddenly, and with little preparation or explanation to change context, change purpose, dial back intensity, leave the thousands of hours of training in the camps.

If you are one of them. It may be one of the most difficult experiences you have ever had or will have. Feelings of detachment and isolation even when around familiar people, not feeling purposeful or needed, having a loss of direction and confusion about the future. These are all common to the returning soldier.

Aside from the personal effects, behavioral issues compound the problem. Poor sleep patterns, rapid mood changes, aggression and irritability, depression and even panic attacks can all be an unfortunate result of a rapid transition into what many soldiers had hoped for upon their return.
These symptoms are all part of a syndrome related to Acute Stress Disorder. This is the diagnosis that precludes Post Traumatic Stress Disorder. In later years the military has done a much better job of acknowledging wars effect on soldiers. However, the treatment modalities used such as Systematic Desensitization and Group therapies often offer little help.

The good news is that the prognosis for Acute Stress Disorder, PTSD and other trauma-related issues is very good in that symptoms can be managed in a relatively short time and a healthier experience of themselves can begin immediately.

Please read more regarding EMDR and Neurobehavioral Medicine or call me to see if you or someone you know may be a good candidate for treatment. And, Thank you for your service.

Aug 16

Anxiety Snapshot

By Cisais | Anxiety and Trauma

One of my many reasons for working with individuals with Anxiety, Panic Attacks and PTSD is that they all carry a very good prognosis. Meaning that, when treated properly, we can expect positive results and we can expect them to last.

When I hear of someone or meet someone who has suffered from long-term generalized anxiety or Panic Attacks I feel a sense of urgency to make changes early on. There is simply no reason why a person should suffer with either of these debilitating clusters of symptoms.

Anxiety and Panic are expressions of a problem at a deeper level. Much like pain in the body, anxiety is a signal that something needs to change. Part of the work is discovering what change needs to occur, part of the work is finding behaviors to manage, reduce or eliminate the attacks/anxiety and part of the work is trusting the change that occurs over the long run.

That being said, treatment approaches can involve emotional, behavioral, environmental, familial and spiritual aspects of a person’s life. While the work to minimize the suffering is primary, the secondary changes that occur in this exploration enrich every aspect a persons’ life.

I work with individuals with problems with anxiety, PTSD, trauma as well as with couples and adolescents.

Sep 22

Decisions, Decisions… How to Stop Fearing and Start Deciding

By Cisais | Anxiety and Trauma , Motivation and Choice

The last time I checked the DSM-IV (and I try not to check it too often), the treatment of Decidophobia, the fear of making decisions, included everything from “cognitive re-mapping” to anti-depressants. Pretty serious stuff for a common problem.

But, if it’s so common, what’s the fuss all about? That is the real damage to indecision?

Often, people who fear making decisions tend to vacillate and procrastinate in an effort to avoid the choices they must make. When the fear of making decisions begins to harm the psyche and affect daily life, it can become a serious problem. Even on a lesser level, individuals who vacillate , are ambiguous or procrastinate can hurt others and their relationships with this indecision. Consistent lack of follow through breeds resentment and distrust.

Making decisions requires confidence. It requires a degree of certainty. When tough decisions with serious consequences are called for, it can be difficult for some people to know what is best. The fear of making the wrong decision can cause a sort of mental paralysis. Individuals who are unable to be decisive may feel angry and agitated when faced with choices, because they are unsure of themselves.

Decisions sign in the skyIn the business world and in personal life, the choices we make can define us. The decisions we make can be wrong, and if they are, they can be very costly. In our busy world, every day brings a barrage of new decisions to be made. But what if decision making could be as easy and instinctual as  dealing with all those small choices, such as what to order at a restaurant?

Effortless Decision Making

I’ve been learning (but haven’t mastered) the principles of Effortless Decision-Making. It’s a way of making decisions where you can flow through the constant stream of decisions we must make every day of our lives, without getting stuck, without being paralyzed by fear. We choose, and flow, and we let go of worry.

What follows is a very brief guide to making effortless decisions.

Let go of perfection.

 We’ll never make perfect decisions, and wanting to make the perfect choice keeps us paralyzed.

Get more information.

Don’t let this hold you up, but if you’re stuck it’s often because you don’t have the necessary info. What info do you need? Can you easily get it? Get it now if you can, but don’t be held up by the lack of info.

Try and err.

If you don’t have enough info — and that’s usually the case — just choose. It doesn’t really matter what you choose, just make a choice and let go of the idea of making the right choice. Now live with that choice for a bit, and see what happens. This is called trial and error, and it’s often the best way to get information. We try something, and see how it works out — and then we have more information to make better decisions in the future. When you look at it this way, decisions are just a series of trial and error experiments, and it doesn’t matter what the outcomes are, because any outcome is good information.

Try intuition.

If you’re stuck and don’t have enough info, let go of worry and just make a choice. How do you make a choice? You could flip a coin, but you could also just go with your gut reaction. What does your intuition say? Start listening to it — often it’s an unconscious decision based on lots of factors that we can’t consciously process, so a part of our unconscious brain processes it and comes up with a split-second decision. Intuition can be wrong, but that’s still OK: we’re going to learn from the results no matter what. So just learn to hear your intuition, and go with it.

Let go of worry.

If you learn the above principles, it’s easy to see that there’s nothing to worry about. You don’t need to be perfect, and a decision is very rarely the end of the world (at least, no decision has led to the end of the world yet). Sure, history is littered with the corpses of those who made bad decisions, but there are a million times more decisions that were made without any really bad consequences. You won’t die, you’ll just learn. So don’t worry — just choose.

Practice, and flow.

You’ll get better at this with practice, as you learn to let go of perfection and worry and see decisions as experiments. You’ll learn to do it better, faster, with more intuition. Soon you’ll flow through your daily decisions with ease. Do it consciously at first, keeping in mind all of the above principles, but it gets easier as you go.

Making decisions is something we do all day long, and it doesn’t have to be difficult. We build certain decisions up in our minds because we think they’re incredibly important, but in truth they’re rarely that big a deal. This isn’t the Cuban Missile Crisis — we’re not deciding the fate of a nation. See choice as an opportunity to learn, and you’ll be happy for every single effortless decision that comes your way.

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