Theres More to Trauma than PTSD
They. Welcome to the psych central show. Where each episode presents an in depth look at issues from the field of psychology and mental health with host gave Howard and co host Vincent m Wales. Hello everyone. And welcome to this week's episode of psych central show podcast. My name is Gabe Howard. And I'm here with my fellow host, Vincent, m Wales and our guest today is Dr Robert t Mueller, and he is the author of the psychotherapy book trauma and the struggle to open up from voidance to recovery and growth, which focuses on healing from trauma. Robert, welcome to the show. Very glad. Here. We are glad to have you. So the word trauma is thrown around a lot these days. What do we really mean by that? Well, so there are different kinds of traumatic experiences. But they all are base in the fact that something clear has happened to the person in the external world, something that overwhelms their normal helping Bility's and this can be a natural disaster. Of course. But it can also be an event that occurs in the home. It could be something like physical or sexual abuse from a caregiver various kinds of assault. And these are experiences that are overwhelming and most people who go through these overwhelming experiences don't end up with close to Matic stress disorder or various kinds of consequences, but number of do and when they do they're left with these feelings of great distress. And that's what we refer to as trauma that the feelings that are left in the person that affect them that affect their choices. But in fact, they relation. Ships and affect way, they engage in friendships soloing an overwhelming experience, and it's hard. It's they're very tough for people to deal with you know, outside of people who work in this field. The only really thing that they understand about trauma is post traumatic stress disorder. That's like the closest that the general public gets when you're talking about trauma where does where does PTSD fit in. Can you kinda help people understand that so return PTSD we see in the psychiatric literature, and by PTSD Renes that the person has a disorder after traumatic even post traumatic stress disorder. So that means that they are continuing to suffer. And by disorderly mean that their mental health is suffering, and they're experiencing symptoms of re experiencing the than flashbacks they made remember memory intrusions memories of the vans. And that's very severe. They also have startled responses where they're stressed very very usually on by stress. It can be very overwhelming stress. They also have a problems with mood because they often feel depressed because these traumatic experiences, and then finally they try to stay away from the things that the mind about whatever happened. So we see post traumatic stress disorder in the end vets and Gulf war that that's come back from us ghanistan for sure that we can also see these symptoms in victims of domestic violence and people who have been to experiences knees in who haven't gone to war. So PTSD Thurs to the the psychiatric language that's used to describe the symptoms that many people have traumatic events. So that's really by PTSD. Thank you so much for that. And just to clarify, you can be traumatized and not develop PTSD. Is that correct? Will you can be through? Yeah. So here we get into. Little bit of like different words can come times similar things. But when we talk about someone who is traumatized, they have all kinds of symptoms. They may not have exactly that cluster of things that mentioned that that we call PTSD, but they're gonna have very similar experiences. There's something called complex PTSD, and that's a little bit different complex -pedia. The refers to people very often have had from that happen in childhood. And in relationships, they feel betrayed by people. Who who they thought were going to care for them most? And when people have complex PTSD, very often what they have are huge problems in relationships. So they've been hurt by somebody. They may feel tremendously abandoned by summer who they trust it and then in life and in relationships, they know struggled to trust. And they often really question. Other people. They question whether they really trust them. And then a hard time with those relationships because they feel scared there. Many feelings of fear that come over them. Shame feelings of shame common and complex ATS's so complex PTSD can take longer to heal than than PG. Treatment for PTSD tends to be something more. Like, let's say smokes to a year treatment of complex PTSD can be two three years. Maybe even four years something like that pretty common. So those are some distinctions thank you gave them are both very familiar with abandonment disorder, and that sort of thing attachment disorders, and there seems to be a very clear relation there with with complex PTSD for sure there's there often is, but for sure their feelings of abandonment, very often people with complex PTSD, and there are attachment problems. So by attachment that means that in times of distress. They have difficulty turning to others who if you had a secure what's called a secure attachment. You might have an easier time turning to the people who feel shooting or should care about you, you you might do that more easily like turn to them and ask for help and feel comfortable with that. But when. People have with called an insecure attachment, and this is very common complex PTSD. They have a greater difficulty turning to those people who really think that they could turn to their husband friends had a hard time turning to them. They feel very very frightened very often. People are gonna are just gonna let them down. It's very very challenging disorder to treat. But it's important for therapist who works with people like this be what's called trauma informed, where they know about the effects of trauma that they can help people like this managing spine their way through the trauma, informed care, something again, coming up, more and more and mental health circles. Can you explain what trauma informed care means? So there are many conditions that are related to trauma. It's not just trauma, therapists, who come across people who have trauma histories family, doctors, very often will come across people who come in complaining of. My grains, five or my own show on T, irritable bowel syndrome mean system kind of disorders stress related disorders, all in goes are rarely exacerbated in people who have trauma histories, so it's very important for family. Doctors are important for teachers actually to be trauma informed because you may see a kidney or craft who appears to have ADHD. They can't sit still there boulder, and that we also be a reaction to trauma, and I'm not saying that every person has all these disorders has a trauma history. I'm not saying most of the time with people migraine is not because of trauma, but if you do have a trauma history, all of those conditions can be greatly exacerbated. And so it's very important for professionals who work interpersonal with people family doctors chiropractors, dentists temperamental or joint function can be a symptom of trauma. Teachers, nurses, very important for them to be trauma informed for them to understand about the different manifestations of trauma, and there are many very often than the us system because of the stress of trauma in use of has been affected, and that makes you more susceptible to allied different disorders dots. Why you need to be trauma informed now for someone who has a preexisting mental illness, whether it's BI polar or depression, or what have you how are they affected by trauma is at any differently than than someone without those those issues. Yeah. Yeah. So trauma, exacerbates other kinds of conditions of people. Have let's say a family history of depression or family is bipolar illness. And then very traumatic thing happens to them die can answer bait other problems that they have. So it's it's very difficult to disentangle this symptom caused by this is caused by. And it's imp-. Possible really to disentangle west caused by what? But what you do want to do is you wanna work with people? If you're doing therapy in individuals than through this. You wanna work with him in a way where if somebody has by polio where you get them seeing good sokaiya trysts who can describe away medication. But then if trauma history that doesn't mean that that fit with medications all of the treatment. No, somebody has trauma to St.. He's gotta find a way to talk about what's happened to them. And that's very difficult me from hard to talk about. And so good trauman from therapist will work with the person in a measured paste way, something slowly feel comfortable with starting talk about what happened and that can be challenging it's interesting as someone who lives with bipolar disorder. I know the importance of being able to tell my medical team, whether it's, you know, psychiatrist a social worker psychologist, you know, what's going on inside my head. What my challenges are what I need help with it. Sounds like you're saying somebody who just has trauma background really needs to respond the same way they have to be able to explain that to their medical team in order to get the right care. Well, the thing was trauma is that people. A lot of professionals are not trauma informed. And so what ends up happening is that you get people going in for symptoms. So somebody would've trauma history typical kind of presentation. I'll just give name Susan was waived, let's say in university. She experiences, all kinds of difficulty and crosses. She then goes and sees her her doctor gets put on antidepressant is okay for a year or two on this anti-depressant. And then she starts to date again. And then whoa, all these symptoms. Start to come back. She starts experience confusion, chic experiences other symptoms. Like headaches goes back. Get sent to. Specialist then she says she has difficulty with eating then the question wake shit and eating disorder. And so what you end up with is this schmo of sport of different professionals. This person's specializing repression that person specially when being so this person specializing in in my grains, in whatever trying to treat this person. And you don't have a coherent treatment plan. And it's because none of these professionals actually sat down with her and said, tell me a little bit about what what happened in your life of the last five years walk me who it what's happened anything important. So me about it. And if you do that were people you can eat for this sort of thing that you can see okay. Yes. This person's had these depression symptoms in these the eating disorder seem to really gotten a lot worse when dot dot. And then you could start to put the pieces of the puzzle together. And so you're not just treating for this disorder that disorder. We other disorder. But you do coherent plan to help the person find ways start to deal with the underlying trauma that much of variety of different. So that's where it's really important to be trauman where we right back. After these words from our sponsor this episode is sponsored by better health dot com. Secure convenient and affordable online counseling. All counsellors are licensed accredited professionals anything you share is confidential schedule secure video or phone sessions plus chat and text with your therapist. Whenever you feel. It's needed a month of online therapy often cost less than a single traditional face to face session. Go to better health dot com forward slash psych, central and experienced seven days of free therapy to see if online counseling is right for you better. Help dot com forward slash psych central. Welcome back. We're here with Dr Robert t Mueller discussing trauma. There's a therapy relationship. What? So Morten about that. Well, yeah, it's really really important too syrupy relationship and in trauma, work touched -absolutely true. It's it's even true and other kinds of psychiatry or psychological problems research on outcomes of of mental health, problems and treatment strategies, what we find is that regardless of school of thought that the clinician uses let's say people, go to cognitive behavioral hair or the person goes sear Agnes or the person goes to see gestalt there. You name it, regardless of the school of thought the one thing that seems to run through out Sarabi is the benefits of having good strong psychotherapy relationship. And so this means that if you're cognitive behavioral therapist might be that the person got better impart because you're helping look they're underlining thoughts and feelings and how you help them change their behaviors they'll improve their feeling maybe maybe the piece of it. But it also is the case. Some research what we know is that if you do that in the context where the two of you are really working together and feel drugs saying page and therapy will be much more effective. So so this is true for all schools up there, psychoanalysis and everything else. And so this therapy relationship research shows is really important. So what does that mean carapace and called are working to get on the same page working toward similar goals the same roles really you have to have similarity of around the goals, and there's a sense of warmth. There's a sense that the client feels that they're therapist gives a dart that they really do actually care. And and they're this gets it the client how to feel that the therapist gets it and listening as paying attention. These are really important skills, and you know, call. Rogers and the eighteen fifties really honed in on this. And since then we've come up with all kinds of therapies, and I'm not saying these other therapies are not helpful. I'm just saying that going back to basics is really important that the skills that Rodgers Tom around embassy turns out to be in fact, what research shoes, they're important, and this is really the case with trauma therapy when you've been traumatized, and you've been traumatized most often when people feel in relationships that they've been hurt then they might work with comparison. See my therapist like me, or my therapist is being abandoned the right there. This is judging and it's understandable that you'd feel this way as a client. If you've been hurt and your trust is violated. You're going to be very cautious for good reason in relationships, and you're even gonna be cautious around your relationship with your best. You don't know whether you're just trying to manipulate you in all in all. Fairness you don't know. And so it's very important for the therapist to be tinted to these kinds of relational issues and trauma were climbing ions say page, and that sort of thing who should go to trauma therapy. I mean, who is I know that the answer might be anybody who's traumatized but more specifically like who is trauma therapy for exactly. So very often. If you're holding in something that feels like it's a huge burden dot something to notice Sapir tension to this question, ask yourself and my carrying around a deep burden from years ago. Am I holding onto a secret a secret that of other people knew I would feel judged? I would feel that they would hate me. I would feel ashamed of those sorts of things, and I being loyal to people who harm to me. Those are all questions that you can ask yourself. I talk a little bit about this. In trauman struggle open up idea of how people how many trauma symptoms develop in. These themes are really really big teams of secrecy things of betrayal. Things of loyalty to those who maybe you shouldn't be so loyal to those kinds of questions to ask yourself. That is the thought of some memory about something 'cause it make you feel sick. The make you feel like this feeling of on a bad person. You know, when I think about X Y Z that happened to me, I feel terrible guilt. How could I how can I done that? If you're asking yourself questions, like why me or if you're asking your questions of yourself, like why not me why did XYZ happen to my brother and got me, those sorts of questions are very important questions. That candy dressed in trauma therapy and very often. People have those questions in association. With symptoms with you know, when you think about XYZ that I just mentioned maybe feel depressed or maybe you feel south load or disappointed in yourself. Why did I do that? Why didn't I help my sister? When such and such when dad did what you know such dad was drinking the way he was was why didn't I ask yourself those two questions and your pained by it that might be a sign that getting helped talking to therapist around your histories is important because you've been trying to deal with this on your own for so long, and I feel very lonely to feel very burdensome. And you don't have to be alone in dealing with these. Housing therapy. We also have what we call post traumatic growth is that just a fancy word for recovery or well, no, no, it's related to recovery. I mean, people you you hope that too from therapy. People will get back to the way they were before, you know, they started really deteriorating. But it doesn't exactly work that way recovery is a bit unpredictable, and what happens is as people start to talk about their problems and start to talk about their history. They start to deal with things in a way that they never dealt with before. And so they start asking them questions. Like, I mentioned why me why not make those kinds of questions. What's my place in the world? After what happened to me? I thought my identity would be such and such. But now, I just don't know. So when you start addressing questions like that, those kinds of questions lead to. Revaluate of yourself, and so along with recovery along with yielding better along with removing or removing recovering from these psychiatric symptoms that you really want to to recover from along with that house, and you understanding as you start to delve into issues tasks, and so that's where there's an opportunity for what's called post traumatic growth that through the process of talking about and questioning and dealing with. There's a reckoning and that reckoning can help you grow in ways. You may not have imagined. You may realize things about yourself that you that you haven't really thought of before, you know, like, you may realize things like previously when I thought about such and such I just don't guilt about what I did as I think about it. Now, actually, I was pretty strong the way I stood up to so. And so the way I did session such and I feel actually feel proud of myself for that that may not sound like a big deal. But it can really feel like a big deal if you felt ashamed of yourself for so long. Do do you think there's a lot of people who are suffering from trauma who just don't realize it? And how do we reach those people because you can't exactly has for help. If you don't know that you are in need of help. Right. Will this is why Trump education is so important. There's getting to be more and more education about this. I have an online pre mental health magazine called the trauma. And then they'll help report where my students, and I we publish articles will very very straightforward articles written for general consumption, like they're not Akkad damage, heavy kinds of articles. And we're trying to teach people about you know, what happens in trauma, and we have a lot of stories, you know, for example, one of my favorite stories is corporal speaks ten questions for soldier who served in Afghanistan. And he tells his story this corporal who came back I happen to be Canadian he served alongside Americans and many of the stories. Late actually to American soldiers. He worked sir with. And it's just a really interesting story is is always. And and so we're trying to teach about how people struggle with things things in a way that in general public construction. Learn it's not just, you know, people in mental health or whatever or Akkad demo about this stuff. But that that people in general population can can start to learn about this. And I think there's greater interest. There's more interest lately noticed in the topic of dissociation people who have been trauma, many of them dissociate. So they check out they sort of go absent at times, you know. And why do they do this because sometimes emotional trauma can be so well-made that they lose focus and attention to that and start thinking about some totally different things, and that allows them to to feel okay? But you know, that can be very challenging when we say a lot in every lines. So there's a little bit more knowledge about that. And the Jenner. Public military, increasingly. So I think it's I think it's really about education. And I think what you guys are doing here with this part and other people other mental health park chassar becoming much more commonplace and people are asking these questions. There's more stuff there. I think I think is the way to people to learn about this stuff, we agree with everything you just said except other mental health podcasts were were completely unaware of any other podcast other than this one. Don't search for them. No, just kidding. I just have a couple of more questions because we're about out of time. But one please talk about your book for a moment. And where folks can find it. I'm assuming you're gonna say Amazon, and what got you interested in researching and writing about trauma in the first place. I imagine they go kind of hand in hand for sure. So of the thing about the book for so it's called from and struggled to open up from voidance to recovery gross. Available on Amazon and mental health bookstores as well, it's a there's a hard hard copy kindle show. What would gun the interest in traumas? Not a short answer to originally interested is a little bit different than when I realize, you know, years later when I been working field for a long time, originally, I just thought it was interesting research topic, and my supervisor was interested in graduate school. But what I realized in my forties was that. There was a much deeper unconscious reason, I think that I really got drawn into it. And I also realize this much more. So as I did my own psychotherapy. And that is that my parents were children during the holocaust and both of them actually were separated from their families, and I believe to to some extent traumatized by the holocaust to some extent. I would say that childhoods were shaped in ways that you can never imagine. My father's father was was actually killed. My mother's. Parents were not killed. They're okay. But they were they my mom was separated from them. She was only six years old. She separated parents for months, and so terrifying for six had no idea where her parents were. And they left her in the care of Jewish woman. Again, this saved my mom's life, but this is a terrifying experience for her. And so I grew up with stories about the holocaust and with sores about what it was like to be a child during the holocaust what it means lose easier. Innocence of the child what it means to lose your child that child and so those kinds of experiences, I think to shape shaped me, I believe that ultimately why went into this? Why went into this field, and why can connect with trauma survivors. You know? I think that's fair. Yeah. Yes. Thank you so much while will thank you for sharing that story with us at so prob that's really heavy and thank you so much for for being here and for informing us on on trauma. So that we can. Recognize it and deal with it when we have. Okay. Okay. My pleasure. I remember you can get one week of free convenient affordable private online counseling anytime anywhere by visiting better. Help dot com slash psych central. Thanks. See you next week. Thank you for listening to the sunk central show, please rate review and subscribe on. I choose a wherever you found this phone cost. We encourage you to Xiao show on social media and with friends and family previous episodes can be found at psych central dot com slash show. Psych central dot com is the internet's oldest and launches independent mental health website. Psych central is overseen by up to Joan grow a mental health expert and one of the pioneering leaders in online mental health. Our host gate Howard is an award-winning writer and speaker who travels nationally you can find more information on gave at gave Howard don't come. I'll co-host Vinton damn Wales is a trained suicide prevention crisis counselor and all of several award winning speculative fiction novels. 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