Keep Pain in the Past. Dr. Chris Cortman

opposed to medication that prevents the root cause of emotional trauma from being addressed. The psychological community appears to be equally culpable in Jim’s forty-five years of misery. Let me illustrate: At a recent professional psychology conference, I listened to a capable presenter discuss the two “leading treatments for PTSD.” She shared that Eye Movement Desensitization and Reprocessing (EMDR) and Prolonged Exposure (PE) were the best treatments we had at this time.

      I sat there stewing, knowing she was wrong. But how could she have been so unaware of the much more effective alternatives to treating emotional trauma? Here’s how. Various psychological schools and practitioners, past and present, offer an abundance of training, research, and theories on everything from psychological development to personality theory to effective treatments for psychological disorders. There is no one paradigm or model from which to draw. Psychologists emerge from their training with the theories and styles that best fit each practitioner. That only makes sense, but it also guarantees that if you enter six psychologists’ offices, you are likely to receive six different (albeit potentially similar) therapeutic styles and treatment plans to address the very same presenting issues.

      One therapist, for instance, may operate from the belief that you the client have suffered enough trauma already, so the last thing you need to do is revisit the scene of the crime. What the client needs instead are coping tools. This well-intentioned approach, though, may help you cope but not thrive. You may be able to maintain a relationship and a job but probably never be able to enjoy either. Until you make peace with the pain in your past, you will never do much more than cope.

      Other therapists try to help you to rethink the traumatic event. These therapists might have tried to convince Jim that he’d had about three minutes to locate his two sons, rescue them from the icy water, and revive them, and that given the impossibility of doing so within this time frame, he should free himself from his guilt. They would provide him with other types of useful and realistic information to alter his beliefs about the trauma. This might help Jim to some extent, but it wouldn’t allow him to release the intrusive attacks of the undigested trauma.

      Some psychologists believe in using highly specialized approaches, such as eye movement desensitization and reprocessing techniques (EMDR), which requires clients to visualize the trauma while watching an object such as a pencil move back and forth. While the visualization of the trauma is necessary for healing to occur, the eye movement is extraneous and completely unnecessary. What is paramount, however, is the need to release the traumatic event permanently, which in my opinion, EMDR does not accomplish effectively.

      And there are therapists who base their treatment on a behavioral principle called “flooding”, which employs a technique called prolonged exposure (PE) where clients are asked to revisualize and re-experience the trauma continuously until they are habituated (i.e., stop responding emotionally) to it. While remembering the traumatic event fully is important (as you will see, it’s step one of the Fritz), simply remembering it over and over again is unnecessarily torturous, forcing people to relive the biggest horror of their lives repeatedly. This is cruel and unusual punishment, especially given that a single return to the trauma is all that is required to find peace with the intrusive recollections and stop the nightmares.

      Assess Your Own Treatment

      As you read about these various treatment types, at least one of them may have struck a chord with you because of your own journey. It’s worth assessing that particular form of therapy (or those therapies) and what went wrong; or what failed to go sufficiently right so that you could now be living a life free of the effects of your trauma.

      Take a look at the following questions and think about your answers:

      •What type of therapy did you use? What method did your therapist employ (assuming he or she disclosed this method), or from what therapeutic school of thought did your therapist develop his or her method?

      •How long were you in therapy? Did you stop for a particular reason?

      •Are you a serial therapy-seeker? How many different therapists or types of therapy have you had?

      •Have you been prescribed any medications to help you deal with the problems stemming from your trauma? What are the medications, and how effective have they been, both in addressing the short-term symptoms as well as in helping you heal and lead a fulfilling, successful life?

      •How much work on your issues have you done on your own? Did your therapist suggest you should be working on healing outside of his/her office? Did your therapist give you any tools or techniques to use on your own?

      •How has the emotional trauma you suffered affected your life negatively? Has it negatively affected you in terms of your careers, relationships, moods, or ability to enjoy life? Has therapy helped you deal successfully with any of these problems, especially in the long term?

      Analysis: Putting Your Therapy on the Couch

      •What type of therapy did you use? What method did your therapist employ (assuming he or she disclosed this method), or from what “school” of therapy did your therapist develop his or her method?

      If you don’t know what type of therapy or school of thought your therapist uses, you’re not alone. Your therapist may not have divulged this information to you for a variety of reasons—he or she may not have found it therapeutically beneficial, for instance. It’s also possible that your therapist does not endorse a particular approach or theoretical construct to treat trauma. In either case, as a client, you’re in the dark, and you shouldn’t be.

      •How long were you in therapy? Did you stop for a particular reason?

      You may have been in therapy for many years and continued to wait for it to work. You may have also tried therapy for a short period of time and quit because you weren’t seeing any results. In either case, the lesson learned is that time is not a predictor of effectiveness. Every client is different, and it takes longer to heal some emotional traumas than others. That said, the right therapy should work relatively quickly.

      •Are you a serial therapy-seeker? How many different therapists or types of therapy have you had?

      Bouncing around from one therapist to another is incredibly frustrating, and if this has been your experience, I apologize on behalf of our profession. The odds are that if you’ve seen multiple therapists without much success, then you probably didn’t feel safe or heard when you were in therapy. With Jim, I assured him that effective trauma treatment existed for his particular issues and that healing was possible, and I did this in our very first session. Without believing a therapist “gets” what you’ve been through and that (s)he can help you, you won’t feel safe or heard and will leave, usually sooner rather than later. Maybe therapies you’ve experienced have been focused on coping instead of healing. Remember, many therapists focus on coping rather than healing, as such therapists don’t believe that you can really heal from emotional trauma.

      •Have you been prescribed any medications to help you deal with the problems stemming from your trauma? What are the medications, and how effective have they been, both in addressing the short-term symptoms as well as in helping you to heal and lead a fulfilling, successful life?

      If you have tried medications, I hope that they helped at least somewhat. Zoloft, Prozac, Wellbutrin, Abilify, Seroquel, Effexor, Trazodone, Ambien, and others are all typically prescribed for a diagnosis of PTSD. Again, I think medications can assist in trauma treatment, but as you may have experienced, medications may work, but only until you stop taking them, either because you don’t like the side effects, hate being dependent on them, or even become frustrated with the whole process. Medications may help with some trauma symptoms, but as soon as you stop the medications, your symptoms will return. As previously referenced,3 most medications will help some, however, without the addition of effective psychotherapy, all medications are prone to a relapse in symptomology when the medication is stopped.

      •How much work