'Trauma does not mean the end'

FINDLAY — Long afterward, trauma can continue to wreak havoc on a person. But trauma can be treated, and the research on how to do so most effectively continues to grow. Nicole Frankart, assistant director of clinical services at Family Resource Center, said that as a trauma therapist, "you can really see those light bulb moments where relief starts to happen." FRC has clinicians who treat trauma using individual therapy and group classes. Some are trained in dialectical behavior therapy, or DBT, which Frankart said helps clients learn to regulate their emotions and improve interpersonal relationships. They work on mindfulness skills and communication skills and begin to "build a distress tolerance level." FRC also offers eye movement desensitization and reprocessing (EMDR) for both youth and adult clients. "Trauma lives in your body," Frankart said. "It lives in your nervous system." EMDR allows trauma to become "unstuck" from the nervous system, Frankart said. The process involves bilateral stimulation, or stimulating both sides of the body, which is believed to activate both sides of the brain. This stimulation may be through eye movements, but can also take other forms. While primarily in an administrative role now, Frankart previously provided EMDR therapy, working closely with occupational therapy students at the University of Findlay. "Our OT students could really focus on the somatic stuff, what was coming up for them in a physical sense," Frankart said. That is, as clients processed their trauma, they might notice a sensation in their stomach, or feel their hands shaking. The occupational therapy students could help them figure out how to respond when experiencing this physical sensation. FRC also has clinicians trained in trauma-focused cognitive behavioral therapy (CBT), a form of talk therapy that helps clients to reframe their thinking and change negative thoughts into positive ones. Frankart said it helps clients to find safe coping strategies. Frankart has worked with law enforcement in the past. Coming from a family of volunteer firefighters, Frankart said "there were things I know my dad and my brother witnessed at accidents that they didn't come home and talk about" but which "weighed heavily on them." She herself experienced birth trauma with the birth of her first daughter, and she said EMDR helped her through that. She has also counseled other mothers who had traumatic experiences while giving birth. She said concentrating on the senses can help. If someone is getting stuck in a flashback, sucking on a Lemonhead candy or breathing in the scent of eucalyptus may help. If Frankart sees someone disassociating or seeming to go numb from a trauma memory coming up, she may encourage them to take a break and suck on a Lemonhead. Peggy Dillon trained in EMBER (Embodied, Mindfulness-Based Emotional Resilience), a trauma-informed yoga program developed in Columbus, after becoming a yoga teacher. The program, developed with the help of experts including neurologists at Ohio State University, was first taught in prisons in the Columbus area, she said. Dillon said EMBER recognizes how trauma affects mental health as well as physical health when it's stored in the body. "Trauma rewires the whole nervous system, not just the brain," she said. At the time, she was volunteering her time teaching yoga to people in recovery from addiction. She began to recognize that everyday yoga practices might look different to this population. For example, as a yoga teacher she would say, "be the witness," encouraging the students to practice witnessing their own breath. But for someone who has been incarcerated, "witness" can have a very different meaning. "And that can feel really triggering," Dillon said. She designed these classes so no one was sitting with their back to anyone else, to help everyone to feel safe. It's a practice Dillon has continued to use in all of her other yoga classes since then. Dillon is now a therapist at Mind Body Health Associates. She said somatic interventions — that is, practices involving the body — can help people going through counseling for trauma or other mental health issues. Yoga is one example of a somatic practice, but somatic work can be as simple as breathing deeply, "stepping into the body and feeling the body breathe," she said. It might also involve noticing other physical sensations. Dillon said it might include, "What does your pinkie feel like?" or "Can you feel the breath right at your nostrils?" "So it's, where can you find a little sip of awareness?" she said. "And some people are so disconnected, and so it's learning, where do we meet our clients or our students where they're at? And acknowledging, it's OK if you don't feel what I'm saying. ... There's no judgment of where you're at." She always encourages clients to view this "through the lens of curiosity". That is, don't judge yourself if you're having trouble with this, and instead just think "maybe next time." "Sometimes we'll do specific activities, like holding a dishrag and pulling it apart…. Sometimes we just shake," she said. "Sometimes we do little pushups, like when people don't feel like they have a voice, and they can put their hands against the wall and say, 'Stop.'" It might also help to write words on a piece of paper and crumple it up, then throw the crumpled ball. Laughing, crying or yawning might help a person process. There's no one way to approach it, "other than I always start with the breath, and body scans," Dillon said. "So let's start inviting curiosity." Dillon recently announced that she would be closing Hot Yoga Findlay at the end of June. The week of the announcement, in particular, people told her, "This feels like a safe space and I feel like I can relax, where I can't even relax at home." As people would come into yoga class, "their body is recognizing this space," she said. "They've trained, right? They keep walking in and we do the same exercise, over and over," she said. "So I say, 'Well, it is this space, but also you can create this space with your breath in your car, or in conversations.' … But you have to keep practicing so you can use it, so then it's a skill to be used throughout your day." Dillon added that many of these practices that can help with trauma can also help with everyday life stresses. "It's important," she said. "Are you breathing? Not just chest breath, but are you breathing into the belly?" Ashley Bush is the owner of Bloom Women's Counseling, Consulting, and Wellness, a Toledo practice which recently opened a Findlay location. She has found that, even if someone first comes to therapy believing it's for some other reason, "oftentimes, the root of the problem has something to do with trauma, whether it's 'big T' or 'small t.' There's just a lot. Trauma changes the brain. That's what the research shows." Maybe someone wants counseling because of a lot of emotions related to being a parent, but they realize it's based in something from their own childhood, for example. Or someone may be seeking counseling for anxiety or obsessive-compulsive disorder. "It's all about safety, right?" Bush said. But as they go back, they may realize "your sense of safety was impacted maybe because there was a childhood fire or a car accident or whatever." Bloom is a women's counseling practice, and Bush said she does notice differences in how men and women process their trauma. "Women are more open to processing trauma verbally… I mean, there's a reason why we have the clichés of 'girl brunch' and 'Let's go to the bathroom together' or 'Sit down, tell me the tea,' right?" Bush said. "It's because women love to process their lives verbally." She said men, however, may process trauma through their bodies. They will go for long runs, or take up boxing. "They're processing their trauma more somatically, through their body, versus through their brain," she said. Several of the therapists working at Bloom provide treatment through EMDR or brainspotting, an offshoot of EMDR. Bush said some clients respond really well to EMDR but others may find it "jolting," especially for particularly rough traumas. Brainspotting is based on the idea that some memories and traumas may be fixed in a certain space within your brain, and encourages clients to sort of hone in their gaze in that direction, she said. "How I like to describe it is, where EMDR is like a shovel in an excavation, brainspotting is like the brush," she said. She added that EMDR is best known as a trauma treatment, but can also help people to reprocess their negative beliefs. "So if you have, let's say, a belief of 'I'm not good enough,' that is something that EMDR can help you reprocess," she said. "Our brain likes pathways of least resistance," Bush said. So once you come up with a belief, like "I'm unlovable," that pathway is there and your brain might seek it out again the next time something happens, establishing the belief even more strongly. Bush said some people, like first responders, experience what is called "vicarious trauma. That is, I am being traumatized simply by witnessing someone else's trauma. It happens in hospitals all the time." When she met her husband, Bush was working in a children's hospital. She recalled telling him early on that she wasn't sure if she wanted children, because all children are born with serious issues. Her husband responded, "Yeah, I don't think that's true," she recalled. "I just think that every day, in your job, you see sick children." (They are now parents.) It's an example, she said, of how what you continually expose yourself to will create neural pathways in the brain. All three clinicians emphasized that, while trauma may feel overwhelming, it is indeed treatable. "Trauma does not mean the end," Dillon said. "It doesn't mean that your life is limited. It doesn't mean that you are broken. There are lots of skills and tools and supports. And you're not alone."