Hey everybody thanks for checking back I have Dr. Alexa Altman here with me and we’re doing a series of videos about trauma, trauma therapy, all the things that entails. So if you haven’t subscribed make sure that you do and if you haven’t watched our other videos together please do that first because we’re kind of building on them as we work through it. *music* And today’s topic is: can we do trauma therapy if we struggle with dissociation? And I know that a lot of you have told me that you struggle with dissociation, and you wonder if you can even participate at all are there different types? – yup – and.. I don’t know. so, Alexa is going to share her expertise! I love this question because the answer is a big yes and specifically I will be on the lookout for a therapist who specializes in trauma, because dissociation, if you’re prone to dissociative symptoms, traditional talk therapy might not be the best strategy for you – Okay – and here’s why: you can participate if you dissociate. Primarily the beginning phase of trauma therapy is precisely to help your nervous system feel safe in the present moment. And that’s phase one. So it’s almost like you get to bring your dissociative symptoms into a room and get help and support and just being able to be more present, to feel safe in your body, before you even move into the trauma work. That is phase one of trauma therapy. So the reason I think it’s really useful is sometimes just talking about your dissociative symptoms don’t bring nervous system change, and that can be really frustrating for people because they can talk about their symptoms, they can talk about what happened but it’s almost like they’re talking about somebody else. – I find it really interesting because I do talk therapy and this is actually why I refer out to people like Alexa. When my clients really struggle with dissociation, is that if they can’t really be present, and there’s nothing that I can talk them through, – that’s right and if they’re not even able to connect because it feels like somebody else – yes – we honestly, just, our, like progress is stopped and we’re at a standstill and so I find the reason I do refer out is if I find myself with the client kind of stuck in a cycle like that like a hamster in a wheel like okay we can only get this far, because you aren’t able to participate and I can’t do anything to help me because I’m not trained in that. – Its a really good point, because, I think what Kati is saying is, when we’re in that dissociative state, the way we talked about in other videos was like that freeze, right, that fight flight and then there’s that freeze state, so it’s like part of our system is off line. And so, the part that’s offline is often verbal part. Even if we’re talking, right? – But I’ve had whole sessions where they either won’t remember what we talked about, or there will be bouts where they can’t speak it all. – Yeah, god, it’s so frustrating the client too, right? So I’m like ‘god, that is so frustrating,” and you’re thinking ‘Is. Therapy. Helping?’ – Yes. And what am I doing here? And if I can’t talk… – How and I going to get better? And so, I would say like “Okay, bring your dissociation into session,” and what you can look for, to know that things are moving in the right direction, And it’s not going to happen instantly. – No. It takes times like everything, right? – and, I wish l could give you a timeline ” oh it’s this number,” every person is unique but what you can start to look for, is “Wow, I was aware of, maybe the colors in the office,” or “I saw that plant for the first time” or “I actually know, you know, what the therapist was wearing” so more things come into awareness or, like, ” Hey, Alexa, when I left your office I actually greeted somebody on the street.” So you start to notice your surroundings a little bit more. You maybe, throughout the day, maybe even get a sense of, noticing your own bodily state, like I worked with somebody who was like, “Wait, I noticed feeling hungry, I haven’t felt hungry in a long time.” – Interesting, yeah. – So you might become more aware of your bodily states, maybe when you’re going around your day, you have more thoughts about your day because you feel like you’re in it more So, I think, looking for cues, or signals in the session or outside of your sessions, that you’re in your surroundings a little bit more some of the indicators, that you’re coming back. Can I give a few more examples? – Of course. Like what working with dissociation looks like, In an office? So it might look like Orienting. And orienting is moving your neck, and your head, and your eyes, right? Like and sometimes I’ll have people do it really exaggerated, like can you actually move your neck as you look around the room like this. So that activates that attachment, social engagement system that we talked about that in our earlier video, right? And look with your eyes, and really helping a person coming into focus about, in the office so we’re really working to establish safety in the office and safety with the therapist. – Yeah. And I think that’s why it’s so important that if you are struggling with trauma and dissociation, to make sure you see a specialist and see someone like Alexa because you can start out with someone like me but there’s going to become a, we’re going to come to a place where we can’t, maybe we can’t move forward, there’s limitations to that and I think having people who understand how to bring you back what are signs of you coming back, and how to best manage it. – Yeah. And if you’re working with a therapist you really like that, maybe they don’t have this training, you might want to share with them some of the skills that you’re learning through these videos or we’re going to give you a site to log on to if you want to know more about trauma therapy, so you can get some of those books, bring that also to your therapist maybe there’s some skills some very easy skills to help you come back into the present moment that you can integrate into the therapy that you’re doing. – Yeah because all therapists usually they’re worth their salt at all it’s like, they will try to learn it they’ll try to work with you in session, and try to better help you, because that’s our whole goal! In a nut shell, then, I guess the answer is: yes, we can participate in therapy even if we struggle with dissociation. – yeah – but the main point being that, it’d really be in your best interest to see a trauma specialist, and I think that that’s an important factor to take into consideration when you’re looking for a therapist. I know not all of you have the choice. I know many of you are just given a therapist, in a lot of countries force like CBT, as the only treatment. But just recognizing that there are differences and we do have limitations. We’re humans too. We only have specific trainings, and things that we treat and don’t treat Another thing to remember is that you actually can ask a therapist for their resume, you can ask them for their trainings and specialization and the funny thing, Alexa and I were just talking, and no one’s ever really asked us that. – Never. Never asked. And I think that it’s really important because you’re going to look for someone who specialize in the certain thing that you’re wanting to work on don’t just go from offline where it says what they specialize in. People will list a whole bunch of things but I would try to find someone who actually has proper training and current training, because we have to do our CEUs, continuing education units, where we continue to be educated about all things therapy related. We have to do those every, every year. Essentially, every two years, we have 36 we’re accountable for. – Yep – and so ask it’s best to be informed to find the right person for you. Thank you so much for sitting down with us and sharing your expertise and like I said, if you haven’t subscribed, click over here turn on your notifications because we’ve done a bunch of videos together and each one’s building on the next, and you don’t want to miss them! And we will see you next time, bye!