Goals

Yesterday was a big day.  I didn’t do my Friday Counseling post, just wasn’t in the mood for it.  However,  may this post will take its place.

Two things.  Yesterday I did 30 laps in the pool.  Three more, and I’ll be doing a mile.  That’s a very big deal for his not-so-young non-athlete!

(This isn’t me 🙂  She’s got my by almost 20 years, and she’s still swimming. Awesome!)

The second goal I’m happy about is that I’ve now gone over 100,000 hits on this blog!  I’m amazed, thankful, very happy.  I’d continue writing even if there were no hits, because it’s important to me and I believe it honors God.  But it’s very gratifying to know that others are reading and, I hope, being blessed.

So while I was swimming yesterday (it took me 75 minutes!)  I had a lot of time to think. I thought about how wonderful water is.  We would die without it. Our bodies are largely water. We need it to drink, to cook, to clean ourselves and our possessions; we need it to grow food and flowers, and often we use it for transport and sports and just for fun.

I thought about the therapy I use for trauma.  EMDR is something I’ve written about before. One of the things we do is to establish a “safe place” in the client’s mind.  He can use his safe place any time, but in session we use it as a place for him to calm down, relax, and regather himself when the therapy becomes too difficult.  The safe place is anywhere that, when you go there, you feel calm, safe, at peace.  People choose a variety of places, but the most popular by far is the ocean.  The rhythm of the surf, the beauty, the water.  Water is in almost everyone’s safe place, whether it is a lake, river, stream, pond, or waterfall.  Water is relaxing.

Jesus gave living water to the woman at the well.  He told her that if she would drink of the water He gave her, she would never thirst again.  He is the Living Water.  In Him there is peace, safety, calm, and healing for the soul.

Water of Life.  And those are some of the things I was thinking about as I swam yesterday.

EMDR and Sexual Assault, continued

One of the saddest things to me, especially when it happens in Christian circles, is that victims of sexual assault are told to just be quiet, not say anything, especially don’t get the police involved because that would hurt the testimony of the church, and bring shame to the name of Christ.  Where is the concern and compassion for the victim? In my opinion, the real shame here is hiding the truth until it is found, often many years later, and paints ALL of Christianity with a very black brush.

Sexual assault is, in my mind, the most personal crime there is.  It is invasive at every level:  Physically, emotionally, mentally, and spiritually.  The victim is made to feel like the criminal (“What were you wearing?  Was it short/tight/revealing? Were you flirting? Why were you in a situation that could lead to rape? Did you scream?  Did you fight back?  We don’t see any marks or bruises, no buttons ripped off your blouse. Are you sure you’re not just trying to pay him back for dumping you?”) and sometimes the police interrogation and legal process are excruciatingly painful for the victim, while the perpetrator is seen as something of a hero.  Go figure.  I’ll surely never understand it.

So. Our miserable rape or other sexual assault victim has trauma at every level, and has very little help from friends, family, church, or society.  I’m working with a woman who was first molested as a little girl, by her sister’s husband. She was not helped in any way. The attitude was pretty much “just suck it up now and get on with your life. Don’t talk about it any more and eventually you’ll forget it.”

Wrong, so wrong. Her greatest need was to tell what happened over and over; to tell it to someone who was not judging her or accusing her.  So we’re doing that now, using EMDR, and she’s amazed at how much  of what happened is coming up as she retells the story.

One of the reasons EMDR is useful is that the client is in a very relaxed mode while “seeing” the incident mentally. My favorite tool is not the traditional moving back and forth of my hand while the client watches my hand without moving her head.  I find that people can develop migraines, if they are plagued with that horrible tendency.  Some become dizzy and uncomfortable.  Instead, I use a cool little device I call my tappers. The client holds a small disk in each hand. The disks are connected by wires to a small box that I control.  It sends a vibration alternately to each disk and establishes a very calming rhythm.  When I turn the tappers on, the client’s eyes are closed and she is “seeing” the event as if she were watching a movie.  When I turn the tappers off, my client relates what was just seen.  This process continues until the event has been completely relived.

We use a couple of scales to measure emotional and cognitive response to the process.  We don’t stop repeating the story until no more new information comes up, and both scales reach a final number. By that time, the client is typically so relieved and free of all the misery  that she is more than willing to tackle a different situation on her way to putting PTSD behind her.

Of course, what I’ve shared with you here is a very simplified description of a rather complex process

You can find certified providers of EMDR at http://www.emdria.org and following the search options. One of the things I like best about this process is that there are no pills.  The pain of the event is resolved not with psychopharm, but with facing the situation and repeating it over and over in a relaxed and safe setting.

I was looking at a video several days ago about treatment for soldiers who suffer from PTSD. It wasn’t EMDR, but the process was very similar.  Group sessions were held in which each veteran was asked to tell his story in as much detail as he could recall.  Painful, frightening?  Yes, at first. But with the repeated retelling, a measure of peace was found.

It takes a lot of courage to talk about what happened. In sexual assault cases, it takes a special kind of courage because the victim has been revictimized so often by our tendency to minimize the crime and maximize the blame onto the victim.

Next week, because of  some feedback I’ve received, I want to do a post on male victims of sexual assault and how it affects them both differently and the same as it does for women.

EMDR: How it Works

One of the primary keys to relieving the anxiety that comes with trauma is for the victim to talk about it.  The person needs to repeat what happened over and over again, and with the retelling, the emotions become more manageable.

Here’s a rather clinical video talking about why EMDR works.  You may find it a bit dull, but it really does a good job of describing the theory behind EMDR:

Here’s another one that talks about the way the brain reacts to trauma by creating habits of “fight or flight” that result in anxiety, depression, and PTSD.  I found it very interesting, if a bit long.

And with both these videos, I think I’ve given  you enough to think about today 🙂  We’ll continue the topic next Friday.

PTSD and Sexual Assault

Another hard post to write.

I spend many of my work hours talking with survivors of sexual assault of some type.  It’s not always rape, but it is always traumatic.

Whenever  you have  a dangerous, harmful, threatening or just frightening experience, coupled with a lot of negative emotion, you have trauma.  There are “small t” traumas that we recover from pretty quickly.  These can be things like taking a sudden fall, or losing a wallet or credit card.  They’re troublesome, but not overwhelming.

Then you have “Big T” trauma, which can mean different things to different people. As I’ve said before, these can include  being caught in hurricanes, tsunamis, flooding and other natural disasters;  mass shootings, bombings, wars, persecutions, torture, and so on. A key factor in this type of trauma is that the victim either feels or actually is helpless to escape or prevent what is happening.

Sexual assault is always traumatic. Sometimes the victims become angry at being considered victims. That’s normal and actually pretty healthy.  They are angry that they were in a situation in which they were violated on the most personal level possible, and could do nothing to stop it.

Worse, victims of sexual assault are often made to feel as if they are to blame for what has happened to them. Not only do they feel terrified, vulnerable and frightened; they also feel guilty and defiled. They are sure that everyone knows what happened, and that everyone is now looking at them with disgust.

The symptoms a victim experiences following sexual assault can include the full range of PTSD symptoms, but some are more marked than others.   Depression, lots of crying–uncontrollable, and often coming out of the blue.  Anxiety. A desire to isolate, to hide inside the house or bedroom; hypervigilance; a strong startle reflex; sometimes a tendency to dress in uncharacteristically “frumpy” or unattractive clothing; flashbacks of the assault, nightmares; and a strong aversion to being touched sexually or any other way.

Anyone who has experienced sexual assault could probably add to that list.  Everyone’s experience and reaction is unique to the person and to the incident.  If there was a weapon involved, that increases the fear factor.

I know someone who was raped after the guy put something in her drink–her non-alcohol drink, by the way. She wasn’t at a bar or in a club.  She should have been completely safe, but she wasn’t.  When she woke up and realized what had happened, she  was horrified.  In my mind, this is a completely despicable act on the man’s part.  To resort to such tactics is beneath contempt.  She is pursuing him legally, partly because a friend of hers pointed out to her that she probably wasn’t his first victim, and if no one stops him, she won’t be the last.

She is struggling with some PTSD symptoms, and it’s no surprise to me. The problem is, she’s trying to convince herself that it wasn’t really a trauma, that it didn’t rise to that level. She’s wrong, and I’m doing my best to convince her of that.

For a victim of sexual assault, I think perhaps the strongest reaction is the one of degradation, defilement, and guilt.  It’s not just in our society that the woman is the one on trial when she is raped (I know, men are also victims of rape and everything I’m saying here in the female pronoun applies exactly the same for them).  There are places in the world in which, if a woman is raped, her male relatives feel called upon to kill her because she has shamed the family.

I think of the story in the gospels in which some Pharisees self-righteously threw a woman “caught in the very act” of adultery at Jesus’ feet, demanding judgment on her.  I’ve always wondered what happened to the man she was with.  I guess he got away, or he would have been in trouble too, right?   And I love it that Jesus calmly stooped down and wrote something in the dust of the ground, and then told them that whoever was without sin among them could cast the first stone.

They turned and walked away, with their tails tucked between their legs. God does not look on a person who has been sexually assaulted as if she is no longer worthy.  She is not the one who is defiled.  The perpetrator is the one who is defiled.

I had a young couple several years ago who came for counseling help because the woman had not told her husband that she had been molested as a child until after they were married. When he knew, he wanted to divorce.  When I asked him, “But why?  She did nothing wrong!” his response was, “I wouldn’t have married her if I had known she wasn’t pure.”

She was not the one who was made impure. The molester was the one who was impure. So I asked him, “Well, if she’s impure, and now you’ve had sex with her, then I guess that makes you impure, right?”

“No, of course not.  I was deceived, and didn’t know!”

There’s a perfect example of that double standard we hear so much about. Good grief.  They didn’t come back, and I don’t suppose they’re still married.  So why didn’t she tell him before she married him?  Well, I asked her that, and her answer was no surprise to me. She said, “I was afraid. I’ve never told anyone, because the molester always told me no one would believe me, and they would know it was my fault.  I guess he was right.”

I want to emphasize the words in the picture at the top of this post. You are not to blame. You are not alone.  Help is available.  You do NOT need to spend the rest of your life suffering over what happened to you. The rapist is the one to blame.  There is absolutely no excuse at all; I don’t care how you were dressed, and I don’t care if he told you he loved you and then betrayed your trust. None of that matters.  Rape is as much a crime of power and control as it is a crime of lust.

One of my sons said something really important on this subject.  I don’t think he’ll mind if I use his words.  He said that he has seen hundreds of girls and women who were not particularly modest, some who were flagrantly immodest, and he’s never raped a single one of them.

What a predator does, he does of his own volition, his own decision, and his own will. Sexual assault is a crime. Period. Those who are assaulted are not to blame. They are to be shown compassion and help, not judgment.

Addenda: This is by way of a postscript, I guess.  I want to reaffirm that I am fully aware that boys and men are also victims of sexual assault. You can look up the stats yourself and see that by age 18, one out of every three girls has been molested in some way; one out of every 6 or 7 boys, the last time I checked.  Neither of these numbers is acceptable. I do not mean to denigrate in any way that men who have been assaulted are just as traumatized. I am not ignoring you. Everything I’ve said in any post related to these topics is true for both sexes.

Symptoms of Post- Traumatic Stress Disorder

There’s a lengthy list of sypmtoms.  I’ll try to condense it down to a practical picture for you.

Here is a condensed list. You can read more about it at a website I’ll give you toward the end of this post.

• Recurrent re-experiencing of the trauma ( troublesome memories, flashbacks, recurring nightmares, and/or dissociative reliving of the trauma)
• Avoidance that results in agoraphobic behavior and/or shutting down of all emotion
• Hyperarousal, including sleep problems, trouble concentrating, irritability, anger, poor concentration, blackouts or difficulty remembering things, increased tendency and reaction to being startled, and hypervigilance (excessive watchfulness) to threat

Emotional deadness can result in distancing oneself from people, and/or a sense of a foreshortened future (for example, not being able to think about the future or make future plans, not believing one will live much longer). At least one re-experiencing symptom, three avoidance/numbing symptoms, and two hyperarousal symptoms must be present for at least one month and must cause significant distress or functional impairment in order for the diagnosis of PTSD to be assigned. PTSD is considered of chronic duration if it persists for three months or more.

Symptoms of PTSD that tend to be associated with (Chronic)-PTSD include problems regulating feelings, which can result in suicidal thoughts, explosive anger, or passive aggressive behaviors; a tendency to forget the trauma or feel detached from one’s life (dissociation) or body (depersonalization); persistent feelings of helplessness, shame, guilt, or being completely different from others; feeling the perpetrator of trauma is all-powerful and preoccupation with either revenge against or allegiance with the perpetrator; and severe change in those things that give the sufferer meaning, like a loss of spiritual faith or an ongoing sense of helplessness, hopelessness, or despair.

Depression is a part of PTSD.  So is disturbed sleep, a tendency toward self-medicating with alcohol, drugs, or other harmful behaviors such as sexual promiscuity. The worst part of PTSD for a lot of sufferers is the belief that no one else has ever gone through what they are experiencing; that they are “crazy” and different, and that there is no help.

Marriages are destroyed.  Jobs are lost.  Connection with friends and relatives are severed. It’s a terrible place.

It’s not just soldiers or victims of sexual assault who experience PTSD.  Any event that involves harm and death, generating great fear and a sense of helplessness, can cause PTSD.  Since 9-11, many of the first responders have struggled with it.  They are the ones who saw and heard the bodies of those who jumped rather than being burned.  They heard the cries for help from underneath tons of rubble, and couldn’t get there fast enough to save people.  They are the ones who climbed up the stairs as hundreds rushed down.  They marched into the “valley of death,” and those who managed to return have suffered with survivor guilt along with all the other horrors they saw.

Hurricanes, tsunamis, earth quakes, mass shootings, bombings and more all create the perfect setting for survivors to experience PTSD.

Next week, I’ll write specifically about PTSD and sexual assault.  In the meantime, if you’re interested, here’s just one of many good websites:

http://www.webmd.com/anxiety-panic/guide/post-traumatic-stress-disorder

Trauma Therapy/EMDR

It’s Friday Counseling Issues time, and I’m going to a new topic.  Had more than enough of pornography!

I am a fully trained and certified EMDR provider.  I think tody I’ll tell you briefly what that’s about, and then we’ll talk about different kinds of trauma and PTSD (Post-Traumatic Stress Disorder).

When I was first introduced to EMDR, I thought it sounded like voodoo.  However, as I looked into it I became more interested and finally decided to get the training, which is intense and not inexpensive.  I have not regretted a minute of time or a cent of the money I spent to get the training.  It has changed my practice to having a more specific focus.  I still do other kinds of counseling, but trauma therapy has become my first love.

EMDR stand for Eye Movement Desensitization and Reprocessing.  That’s a lot of psychobabble for a relatively simple concept  The process itself is based on the knowledge gained from sleep studies, particularly with soldiers returning from Viet Nam who were deeply traumatized.  The best thing we had to offer them, really, was lots of medication.  Some of those soldiers are still in VA hospitals, never having regained their ability to function in “normal” life.

During sleep studies with these soldiers, the observation was made over and over that when they were in deep sleep (rapid eye movement, REM)  they were NOT experiencing flashbacks, night terrors, hallucinations or other symptom of anxiety. Rather, as long as their eyes were moving rapidly under their eyelids they were completely relaxed.  It was when they began to come up out of REM sleep that the symptoms began to reappear.

Francine Shapiro, who first developed EMDR, was a doctoral student at the time. She was working on a PhD in human behavioral psychology. She read about the studies in the VA hospitals, and wondered if it would be possible to put someone in that state of relaxation while they were awake, and asking them to relive their trauma while they were relaxed, then relating what they were “seeing” to the therapist.  Here’s a video that will help you get a better idea of the basic process:

This combination of relaxation and talk therapy has become very important in the treatment of trauma victims in all different kinds of situations, ranging from mass shootings to hurricanes and tsunamis, and including the attacks in 9/11.  There are EMDR providers who have agreed to be on call for emergency situations.  I would love to be able to do that, but I find my energy level and endurance just aren’t what they used to be.

My primary use of EMDR is in treating those who have been victims of childhood sexual abuse; adult sexual trauma including rape  or attempted rape; or victims of accident injuries and related trauma.  It’s pretty normal, when working with victims of sexual assault or childhood molestation, to find that there is either ongoing assault over a period of months or years, or multiple counts of assault by more than one perpetrator.  You can read more about this here: https://lindasbiblestudy.wordpress.com/category/counseling-issues/childhood-sexual-abuse-counseling-issues/.  You’ll need to scroll all the down to the bottom of the topic to get the whole picture.

The point of EMDR is to separate the negative emotional response from the event.  When you have an event happen that you do not want, did not invite, and cannot stop, then you also have a lot of negative emotion including fear, shame, dread, worthlessness and anger.  To separate the emotions from the event is to put the event into proper perspective so you can go on with your life minus the anxiety, hypervigilance, night terrors, and depression.

Okay, that’s enough for now.  Next week, we’ll do an overlook on trauma and its effects.