Transforming Trauma: Empowering People with CBT

Hey there, everybody, and welcome to this video on empowering people with trauma. I'm your host, Dr. Donnelly Snipes. I had initially thought about calling this Empowering Patients with Trauma, but then I thought, you know what? Most people who experience trauma never become patients. Most people who experience trauma don't go on to develop PTSD or cptsd, but it's important to in the aftermath of a trauma, whether it's a sudden death or an accident or a natural disaster or whatever the trauma is, it's important in that immediate aftermath to help people regain a sense of empowerment. These tools can be effective in that immediate aftermath period as well as years later, working with people with PTSD or CPTSD and helping them reestablish a sense of safety and personal power. So let's start at the beginning. What is trauma? Trauma is any event that causes a person to feel unsafe and powerless and overwhelms their ability to cope. Now you can think of times in your life that something happened that was just completely overwhelming and it made you feel powerless. Which when we feel powerless, it kind of goes hand in hand with feeling unsafe. Many trauma survivors develop behaviors like inattentiveness, irritability, or social withdrawal in the immediate aftermath. Their stress response system is still on overdrive. They're hypervigilant. They're trying to regain a sense of safety. If it persists, then they may even develop more problematic behaviors like addiction or stress related physical or mental health disorders. When symptoms are caused by feeling unsafe and powerless, which is kind of the core feature of trauma, then a core feature of recovery is safety and empowerment. And I've created this mnemonic to help you remember the things that we need to do to help people unpack their trauma and start feeling safe and empowered. So obviously, the trauma the the mnemonic is unpacks U stands for understand symptoms might be caused by trauma. As a clinician, as a loved one, or even as a trauma survivor, it's important to look at your symptoms and say, all right, in what way is this behavior or this feeling maybe keeping me safe because I feel unsafe? In what way is this situation maybe reminding me of the past, that trauma, and triggering me to feel unsafe in the present? We want to help normalize people's experience of trauma. Everybody experiences trauma in their life. Not everybody develops ptsd, but everybody experiences trauma. And people's reactions can be very, very varied. For children, for example, they may become much clingier. They may regress in age if they are 8 years old. Chronolog logically they may start acting like a three or four year old again. They may become very clingy, or they may become very disengaged. We don't, we can't predict how people are necessarily going to respond, but we want to remember that behavior is communication and what that person is doing is representing their best way to stay safe from being victimized, from feeling vulnerable, from feeling overstimulated. Whatever the case is. P stands for pace is set by the client or the person. I should have said person here. When processing a trauma, even in the immediate aftermath, it's important to get support immediately, within the first 24 hours, ideally in order to help have the best resolution. But that doesn't mean necessarily processing the trauma during that point in time. During those first few hours, the person needs to regain a sense of safety, but they need to set the pace about how, how quickly and how in depth they process the trauma. Our neighbor a few months ago lost their house in a very terrifying fire. And I can only imagine what was going through her mind. But sitting down and saying, okay, this happened, let's talk about it, you know, that wasn't for me to do. That wasn't for anybody to do. That was for her to decide when it was appropriate, when she was ready to start processing exactly what happened and figure out, okay, how can I feel safe ever again? Becoming aware of the triggers and tools to cope with those triggers is also important for a lot of trauma survivors. They may smell something, hear something, feel something, and it reminds them of that trauma. But it's not a clear memory. It's just they're triggered. They encounter that stimulus and they start having this feeling of panic or terror or desire to just withdraw and leave the situation. Or they get angry, for example, and they may not know where it's coming from. They're like, I don't know where this is coming from. I'm just being so short tempered and impatient lately. Okay, let's look at that and figure out what's triggering that. And as people start to become aware that their behaviors, their responses, the changes that occurred after that trauma make sense, and their responses in the present do have a trigger which may be related to that trauma that's helpful. Then people, once people have can diagnose what's going on, they're like, okay, I know when I hear this sound in my car, it means that the brake pads need to be changed. Okay, I feel safe. Same thing with our emotions. I know when I start having this feeling, it may be because I was triggered. So this Is what I need to do to stay safe. Control is identified, and that's your c. We help people who've experienced trauma identify what they do have control over. If it's after a tornado, for example, they don't have control over how quickly stuff gets rebuilt. They don't have control over a lot of stuff, but what do they have control over and helping them identify, no matter how small it is, the things that they can control in the present, the ways that they can keep themselves and their loved ones safe in the present. K stands for kindness towards self. We want to encourage that. A lot of people who've experienced trauma are very hard on themselves. They may carry shame with them and, and feel like they're not worthy of love. They may feel like they don't measure up. They may fear rejection, or they may fear that, okay, this is my fault, this happened, so I need to fix it. And they wear themselves into the ground. There's a lot of reasons people who've experienced trauma may not be kind or compassionate to themselves. But it's important that we try to encourage them to be willing to do that, to be willing to allow themselves to heal, to be willing to allow themselves to not have a good day and say, you know what? Today is not a good day. And I'm gonna get up and show up. I'm gonna do as much as I can to the best of my ability today, but it's not gonna be my best work. Being kind to one another or. And being kind to themselves and sometimes even saying, you know what? I just can't, I just can't today. I need to take a day for me to heal. And finally, S stands for safety. Safety is defined and developed by the individual, for the individual they need to identify. In what ways did this trauma make me feel unsafe? Physically, emotionally, mentally, in my relationships, in my environment? In what ways did it make me feel unsafe? And how can I feel safe again? What do need to do? And that, along with feeling safe, means addressing some of those triggers. It may mean removing certain pictures or I. I don't know. But figuring out what is it that helping them figure out what is it that I can do to feel safe and empowered in my skin, in my home, in my car, and then eventually branching out to at work and maybe even you wherever the trauma occurred, if they have to go back there with regularity, how can I feel safe going into a store again after this or going into the bank again after this? So the person defines safety and figures out what they need to do in order to feel safe, undertake undertaking the tasks that are important in their rich and meaningful life. Trauma survivors did not anticipate the traumatic event. This may leave them feeling anxious about when is the next shoe going to drop? I didn't expect that. So you know who went, who am I to say that something else bad isn't going to happen right now or 10 minutes from now? And I didn't expect the last thing. So I didn't have the power to stay safe. So how do I know that I can stay safe in the future? So that contributes to that feeling of persistent unsafeness and powerlessness, which is why it's so important in the immediate aftermath, if possible, to help people re establish a sense of equilibrium, of safety. Okay, tornado destroyed the house. That's awful. What can I do? Where can I stay safe? What resources do I have that I can call on and order to have a roof over my head? Empowerment begins by helping people understand the logic behind some of their symptoms, feel in control of their treatment or their progress, develop a sense of safety in the present, and kindness towards themselves. All of this unpacks their baggage.