Trauma therapy

Trauma is a normal reaction to an abnormal event. An event becomes a trauma when it exceeds an individual's psychological coping skills and causes a feeling of being overwhelmed and helpless. In a trauma, a person's mental and physical balance is shaken by an external event, the central mental and physical processing is overwhelmed, The basic trust in caregivers or the environment is damaged or destroyed. The person is unable to separate themselves physically and emotionally, and anxiety and agitation rise sharply.

Our therapeutic approaches are based on the realization that the fundamental events in trauma are physical, organic and unconscious and are based on a learning experience.

At WIENER COUCH, we specialize in trauma therapy and offer 3 scientifically sound and demonstrably effective methods:

• EMDR
• BRAINSPOTTING
• SOMATIC EXPERIENCING

 

EMDR

EMDR (=Eye Movement Desensitization and Reprocessing) means that stressful, traumatic events are processed through specially guided eye movements, which are similar to dream processing. This method was developed by Francine Shapiro at the end of the 1980s.

The AIP (Adaptive Information Processing) is the basis of EMDR's mode of action. The approach assumes that an autonomous neurophysiological system is active in every person, which filters all incoming information in order to maintain a mental-emotional-physiological balance. In the event of trauma, stress and external threats, this system can be overwhelmed and information processing can be disrupted. This happens when the experiences are too strong, too bad or too unexpected. The impaired processing of events can be the cause of a variety of disorders. Post-traumatic stress disorders (PTSD) are particularly well-known in this context.

This is where EMDR comes in and brings the processing of information back to a healthy level. The stressful experiences are activated in the safe environment of the therapy , re-evaluated and then stored in the past.

The aim of EMDR therapy is therefore to store the memory of the trauma in the memory like a normal memory. Those affected should no longer feel at the mercy of the situation, but should be able to perceive and endure the memories neutrally after EMDR treatment.

Brainspotting

Brainspotting as a trauma therapy method was developed in 2003 by David Grand, an American psychotherapist with psychoanalytical training. He postulates a neurological connection between the direction of gaze and psychological content.

Brainspotting (BS) assumes that memory contents that are not accessible to conscious recall and trigger disorders can be specifically activated and influenced by the direction of gaze. BS is therefore a further development of EMDR. Within a trusting therapeutic relationship, BS can be used to treat experiences and symptoms that lie beyond conscious verbal access.

As with EMDR, brainspotting is based on remembering stressful events that need to be reprocessed. With BS, however, physical sensations also play an important role in the therapy alongside memories.

SOMATIC EXPERIENCING

Somatic Experiencing (SE) is a body-oriented approach to understanding, coping with or preventing stress caused by shock and trauma. The basis of SE is described as non-verbal communication with the body's memory, which needs to be improved. The aim of SE is to (re)establish natural self-regulation in the nervous system and thereby reduce symptoms. Among the trauma therapy methods, Somatic Experiencing is the method that focuses most strongly on body reactions.

This type of trauma therapy works with the psychophysiological consequences of an event, not with the event itself. It attempts to resolve the disturbance of the nervous system caused by the event.

In a threatening situation, an emergency program runs automatically: fight, flight, freeze or cooperate. Only when one of these reactions has been completed is the danger over for the body. Otherwise, the body remains on alert, the energy is stored in the nervous system in an unpleasant way and trauma occurs. The nervous system continually tries to discharge the energy blocked during the trauma. This results in states of agitation and ultimately disorders. SE works to release the so-called "frozen situation" from the past, which has a negative effect on the nervous system, to dissolve it and experience it anew. SE was developed by Peter Levine on the basis of neuroscience and psychotraumatology research.

The theory behind our trauma therapy methods

The polyvagal theory (Stephen Porges) serves as the basis for the therapeutic approach. It explains how the human nervous system reacts to safe, dangerous and life-threatening situations: According to this theory, there are three hierarchically organized subsystems of the autonomic nervous system that influence our neurobiological responses to stimulation from the environment. With "neuroception", the nervous system has a perception channel that is rarely processed consciously, but with the help of which the environment is constantly "scanned".

1. the ventral parasympathetic branch of the vagus nerve: for the social engagement system (safety)
2. the sympathetic system: mobilization (fight-flight behaviour - in case of danger)
3. the dorsal parasympathetic branch of the vagus: immobilization (freezing - in life-threatening situations)

SAFETY:

This system determines how conscious or awake a person is at any given moment.
The social engagement action system is already available to the newborn and is expressed when the baby cries or smiles in order to interact with the caregiver. Through repeated experiences of harmonious dyadic interaction with the mother or father, the child develops experiences of security.
Neuroconception explains why a baby enjoys a gentle parental hug, for example, but experiences the same gesture with a stranger as an attack.

The "social engagement" system, which is activated in safe situations, influences the following systems:

• Opening of the eyelids - vision
• The facial muscles - emotional expression
• The muscles of the middle ear - filter voices from background noise
• The chewing muscle - food intake, digestion
• Laryngeal and pharyngeal muscles
• Tilting the head to the side and turning through the neck muscles - social gestures and orientation reaction.

The "social commitment" system...

• enables a rapid response to the environment and relationships (orientation) as well as a rapid withdrawal from them by regulating the heart rate, without the need to mobilize the sympathetic nervous system.
• promotes the switch to calmer, more flexible and therefore more adaptive general states. This enables us to read facial expressions, listen or vocalize
• regulates the sympathetic nervous system in non-threatening contexts, it helps us to engage with the environment and it helps us to develop positive attachments and social relationships.

Even if there is an acute threat, a person with good adaptability can use their "social engagement" system, for example by trying to engage in conversation with a potential attacker (communicative flexibility).

DANGER:

The sympathetic system, mobilization. The activation of the sympathetic nervous system, more primitive and less flexible than the social engagement system, increases arousal (the general level of activation of the central nervous system) in the event of a threat and activates survival mechanisms. Acute danger: The sympathetic nervous system switches on, releasing neurochemicals that increase arousal. Breathing is accelerated, the muscles are supplied with blood and the blood supply to the cortex is reduced.

Hyperarousal enables us to carry out fight-or-flight activities that require a lot of energy and strength. In a chronic state, however, it impairs the ability to make adaptive decisions and behavior becomes reflexive and impulsive. If neither the "social engagement" system nor fight-or-flight reactions (sympathetic nervous system) guarantee safety, the dorso-vagal complex comes into action as the next line of defense:

LIFE THREAT: The immobilization system

The dorsal branch of the vagus nerve activates the most primitive of these systems. It is activated by hypoxia (reduced supply) and causes immobilization (ensuring survival) in the form of deadness, motionlessness and/or fainting. Chronic immobilization often results in somatoform dissociative symptoms such as motor weakness, signs of paralysis and disturbances in the perception of internal bodily sensations such as amnesia, confusion and attention deficits.
Many bodily functions are restricted, which leads to a relative drop in heart and respiratory rate and is reflected in the mind in a feeling of numbness and closure and a dissociation from the sense of self or in panic.