Working with Trauma and PTSD

I am an NLP Master Practitioner and a BACP Accredited counsellor. I work to the ethics of both the BACP and NLPtCA. My training includes trauma resolution and defusing and debriefing.
For the past 8 years, I have run a private practice and also worked with NHS staff.
My experience of working with trauma is fairly broad but includes; Egyptian hotel bombing, dog fight, birth trauma, armed bank robbery, car accidents, abuse, NHS incidents, aeroplane crash and family suicides.

Every case and every person is unique and I start and work from this viewpoint. When two people are involved in the same trauma such as the young couple I worked with who were in a plane crash on their honeymoon, they can both have very different responses and needs.
I frequently use a simple trauma questionnaire early on. It helps me to gauge the range of symptoms and pick up on any earlier experiences which may be relevant. It also helps people to see that the symptoms they are experiencing are a ‘normal response to an abnormal experience’. The symptoms following a trauma can be very scary – sometimes people feel they are going mad so reassurance is essential. I also use the CORE assessment form in the first session, and again at the end.

Many trauma symptoms resolve themselves within 6 weeks. Symptoms may include an exaggerated startle response, disturbed sleep with nightmares, panicky feelings, inability to relax, feeling overwhelmed, feeling disconnected from other people and the future, anger and irritability, reliving the event, and many more.

Frequently, people repeatedly re-traumatise themselves by constantly re-living the experience with all the sights, smells, and feelings as strong as the original experience. These memories can become ‘stuck’ – the brain is just unable to process them. This may be so that we learn from the experience and avoid similar situations in future but PTSD is a ‘stuck’ and debilitating state. Some people live for years with these ‘toxic’ memories.
For stuck trauma images (still pictures) I use the NLP synaesthesia technique. It takes just minutes and can resolve disturbing memories which have been present for years. With any technique I use, I first describe what it is, how it works and then let the client decide whether they would like to do it and when. My approach is solution focused but I go at the client’s pace. It is important for most people to feel in control during therapy and this is especially important after a major life-threatening incident.
With stuck memories of the event that run like a film, I use the NLP Rapid Rewind technique. This is more tricky as the client needs to stay in a relaxed state during the process, and it takes a bit longer. Trauma memories can ‘pattern-match’ with previous memories and these also need resolving.
Frequently, work around trauma will include tools and techniques to deal with feelings and negative or intrusive thoughts. As sleep and nightmares are a common problem, I sometimes use a relaxation and guided journey to help with sleep and feeling safe.

Helping people to make sense of the experience can help to assimilate the experience, resolve the symptoms and prevent PTSD. A major trauma does change people – they become a ‘survivor.’ It changes their identity, self-image and beliefs: the world is no longer a safe place. Therapy sessions can help to integrate the memories and come to a positive self-view.

There are some fascinating facts about how people react in a life-threatening situation. Women of child-bearing age more frequently dissociate and freeze. Nature over millennia has devised ways of helping us to survive, even if when it comes to the crunch, we aren’t the hero we identify with in the films! Understanding these primal responses also helps people to make sense of what happened and their reactions. There are positives to come out of traumas, even if no-one would choose this as a learning method. Interestingly, research shows that those with some sort of a plan for survival stand a much better chance of living through a major event. Learnings may be very practical: sit in the middle of the plane, have a plan for emergencies, have an advocate present at all times during a birth, never confront anyone who is armed, etc.

There may be other work to do. People who experience bereavement often become more aware of their own mortality. After a major trauma, this is also true, but in a more dramatic way. A person’s whole value-system may change which can lead to questioning everything they took for granted. Counselling can help make sense of these re-arranged priorities and help work out what they may mean in practice.

The period after a major incident can leave those who survive feeling isolated. No-one they know is in a similar place or able to really understand what they are experiencing. For example, after a traumatic birth if the baby is well, friends and family do not understand why a mother may still be suffering. Physical injuries are sometimes a result of the trauma. Feelings around loss of independence or mobility may need to be addressed. Physical injury can also prevent a return to ‘normality’ and work. Deaths of others can also be an issue leading to a host of conflicting feelings.

Towards the end of the work together, I test out that in a similar environment in the future, the responses are normal. It is important not to avoid places or situations which ‘pattern-match’ with the trauma as that can lead to agoraphobia. It can also lead to an ‘away from’ approach to life which makes people more susceptible to having unmet needs and depression.

It is a privilege to be able to share these rare experiences with survivors and help prevent PTSD. Therapists working with trauma need to be careful they themselves are not traumatised by the vivid images and unusual experiences which are shared. Self-monitoring is part of keeping both counsellor and client safe while we work together.

I am happy to share the trauma symptom questionnaire if you email me.
Joe Isaac

Submitted by Joe Isaac, Professional Member

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