When a partner or spouse in a relationship learns that the person whom they have trusted has been unfaithful to them, the pain of that discovery can be incredibly intense, leaving the person with an overwhelming sense of betrayal.
Betrayal as an Attachment Trauma
Betrayal in a committed relationship includes the violation of relationship norms. When a partner violates the standards considered to be the norm in the relationship, relational trauma may be experienced. Relational traumas are attachment injuries, which occur when “one individual betrays, abandons, or refuses to provide support for another with whom they have developed an attachment bond” (Steffens & Means, 2010). According to Judith Herman, attachment injuries are a “violation of human connection” and lead to the relationship being perceived as a source of danger rather than a safe haven.
PTSD Symptoms
Many betrayed partners, after learning about the betrayal, exhibit symptoms of Post-Traumatic Stress Disorder (PTSD). PTSD symptoms may include:
Increased anxiety, which may include the following:
Hypervigilance (scanning the environment for any signs of potential danger/threat)
Paranoia
Overwhelming terror
Insomnia
Inability to concentrate
Startling easily
Avoiding reminders or conversations of the event or not being able to remember some or all aspects of the event (blocking/denial)
Re-experiencing the event through invading thoughts or memories that can’t be held back, be it through flashbacks and/or nightmares
The person’s distress can grow so intense that it impacts them in multiple areas of their lives (e.g., their ability to work, take care of day-to-day responsibilities, or participate in relationships).
Carol Juergensen Sheets has created a powerful short video that explains the “brain science” of partner betrayal and how these acute symptoms can manifest in a partner’s life. Please be aware that the video depicts a cisgender female in a heterosexual relationship. It is important to be aware that partner betrayal can occur in any relationship, regardless of sexual orientation and gender identification. https://youtu.be/Sbfkj-T6g0M (The animated video starts at 5:15 minutes.)
Betrayed Partner Needs
Following Discovery of the infidelity, betrayed partners often need the following:
To feel a sense of emotional safety in the relationship
To feel that their partner is willing to change and make a serious commitment to do so (Certified Sex Addiction Therapists – CSATs may be found at: IITAP Community )
To feel the betraying behavior has stopped
To feel that repair of the relationship is the betraying partner’s #1 priority
How Betrayed Partners Can Begin Their Healing Process
Learn and practice grounding/mindfulness techniques to help them stay in the present.
Regular individual therapy sessions with a betrayed partner specialist or a therapist who understands betrayal trauma (partner specialists may be found at: Our Specialist List – APSATS)
Time for practicing your spirituality (e.g., praying, meditating, walking in nature, etc.)
While healing from betrayal trauma can be a long and arduous process, recovery of the partner’s sense of a “Reintegrated Self” is absolutely possible! The right tools and resources can facilitate that process.
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For additional information related to betrayal trauma and healing, the following resources are recommended:
Your Sexually Addicted Spouse: How Partners Can Cope and Heal, by Barbara Steffens, Ph.D., and Marsha Means, MA
Mending a Shattered Heart: A Guide for Partners of Sex Addicts, edited by Stephanie Carnes, Ph.D.
Courageous Love: A Couples Guide to Conquering Betrayal, by Stephanie Carnes, Ph.D.
Help.Them.Heal: Teaching You Both How to Heal Your Relationship After Sexual Betrayal, by Carol Juergensen Sheets, LCSW, CSAT, CCPS-S, CPC-S, PCC
Intimate Deception: Healing the Wounds of Sexual Betrayal, by Dr. Sheri Keffer
Out of the Doghouse: A Step-by-Step Relationship-Saving Guide for Men Caught Cheating, by Robert Weiss, LCSW, CSAT-S
A Man’s Tools for Addressing Betrayal: Keys to Unlocking Freedom & Moving Forward, by Sibylle Georgianna, Ph.D.
“How could she not love that – I put so much thought/time into making her birthday special!”
Many many years ago when I was in the first few years of my 1st marriage I planned what I was sure to be the best birthday party ever for my wife. It was a surprise party! I had invited all her friends and family members and arranged for them to, if possible, all be there when we showed up back to our little apartment after a romantic dinner. I’ll spare you most of the details, but I will say I arranged it for them to decorate the apartment while we were gone and despite this being in the pre-cell phone days, we timed it all perfectly!
After the party was over I was looking forward to hearing how much she loved it, how special the night was, and if I’m honest- also hoped to hear what an amazing, thoughtful husband I was. She was gracious in how she expressed it, but after thanking me for the gesture and the time I put in to it, she expressed that she was anxious and uncomfortable most of the night. She clarified that she was uncomfortable with knowing they were all there and she hadn’t had a chance to clean the apartment the way she would if she knew a bunch of people were coming over. Perhaps more importantly, she shared with me that she had told me on more than one occasion that she didn’t like surprises in general and surprise parties specifically- and clarified some of the reasons why.
Upon hearing all that, I felt both sad and offended in that I had put so much time and effort in to something that was not appreciated. After all, I would have LOVED IT! In fact, several of my favorite birthday parties had elements of surprise in them. Most Christmas morning’s were unexpectedly awesome in part because the days leading up to them included at least 1 comment about how this year’s presents were going to be limited because things were a little bit tighter financially…but the family room was as full of treasures as it ever was!
So what was the problem!?!? To put it simple, I was acting on what I wanted or liked, not on what my wife wanted or liked. With the best of intentions, I was operating from what by many is known as the “golden
DO UNTO OTHERS AS YOU WOULD HAVE DONE UNTO YOU.
Great rule- right! If you’re not sure how to treat somebody else, ask yourself “how would I want to be treated in this situation?” and then treat the other person that way. And to give the golden rule the golden respect it deserves…. It really helps in a lot of situations. However, there is an even better rule/guideline for how to treat others that is not as commonly known nor applied. And this rule/guide is especially important in our personal relationships, the “platinum rule”:
DO UNTO OTHERS AS THEY WOULD HAVE YOU DO UNTO THEM.
Seems similar, right? But when you really break it down, it’s a little more complex. To apply the platinum rule of relationships, you have to go beyond knowing yourself and how you would like to be treated in a relationship and actually do the hard, important and often confusing work of learning who the other person is. It requires being willing to sincerely ask and then truly listen to what they say about their hopes, dreams, wants, needs, etc. And specifically within a long-term committed relationship like a marriage, it requires learning what “speaks love” to one another. For example, in his book “The 5 love languages” author Gary Chapman talks about different ways people express or experience love including 1) physical touch/affection, 2) words of affirmations, 3) quality time, 4) Acts of service, and 5) meaningful/thoughtful gifts. Using these 5 areas as a starting point can help couples get clarity about what helps each one to feel loved and prioritized. And then with that understanding, each partner can begin doing and saying those things that help the other person feel that love…even if it feels like speaking a foreign language!
So how can you become an expert at applying the platinum rule of relationships in your own life? There are 4 components to this:
Knowing your own wants, needs and “love languages”
Sharing those in a clear, honest way with partner
Knowing your partner’s wants, needs and “love languages”
Making sincere efforts to meet those wants/needs and to speak his/her “love language”
1. Knowing your own wants, needs and “love languages”:
In order to let your partner know how you want to be treated in the relationship so they can successfully apply the platinum rule of relationships, you need to know yourself. Many people go blank when asked “what do you want to do for dinner tonight”, or “what do you want to do for your birthday?”, or “how can I best support you in this difficult thing you’re going through?”. Self-awareness can be scary because if we truly know what we want and need out of our intimate relationships- we can start to develop hopes of getting those met. And if we are vulnerable in sharing those things with a partner, we can get let down and hurt when those wants and needs are not met.
The most fulfilling relationships are those in which each partner is willing to make sincere efforts to meet the wants and needs of the other person, as long as doing so does not go against their own sense of values, health or well-being. So choosing to be vulnerable by letting the other person know what you want out of the relationship is a key part of living the platinum rule.
There are different “types” or categories of intimate connection, including emotional, physical (non-sexual), sexual, intellectual, spiritual, recreational and social (relating to others as a couple). In most relationships, there are gaps between the needs and wants of each partner across these different domains. One tool you can use to get more clarity about your own wants and needs in these different areas is to simply write down anything that you would like to experience more in your relationship(s).
The distinction between wants and needs can be difficult at times, but one way you can do so is to ask yourself “is this something that is a preference (and maybe even a REALLY STRONG preference!) but the relationship can still be a really good one without it, OR is it something that is core to my sense of relational well-being?”. For example, someone might have the awareness that in order to be fulfilled in their marriage they NEED physical affection and closeness, and he/she WANTS (prefers) it to come in the form of holding hands while walking around outside. If the spouse happens to be uncomfortable with PDA (public displays of affection) he/she may not get that WANT met, but hopefully will get the NEED met later that night as they hold hands or cuddle while watching a movie at home.
2. Sharing those in a clear, honest way with partner:
Using the example above, component number 2 of applying the platinum rule could be where a wife lets her husband know how important physical affection is for her and how much she would love to hold hands when they walked around in the mall. If her partner consistently fails to do so despite knowing how important it is, she would need to work hard to not take it as a sign that he doesn’t love her, and instead accept that there may need to be a different way of him meeting her need. She could either suggest something else (e.g. holding hands while they watch a movie at home) or ask him what he would be comfortable with.
3. Knowing your partner’s wants, needs and “love languages”
Hopefully your partner is doing a good job with component number 2 and you therefore know what your partner wants to be experiencing in the relationship. If not, however, the work of component number 3 is to be curious, open-minded, and to ask sincere questions about how you could more fully meet needs and even some of their wants if at all possible.
4. Making sincere efforts to meet those wants/needs and to speak his/her “love language”
When I was in college, I took a course in Chinese with hopes of adding that to the 2 languages I already spoke fluently (English and Spanish being the others). I soon learned how different and how much more difficult it was learning Chinese compared to learning Spanish. In Spanish, “radio” was spelled the same way, but was pronounced differently. There were, in fact, a LOT of words like that. However, there was no place in my brain where I could connect the dots between what I already knew and what I was learning (or trying to learn) in my Chinese 101 class. After a few weeks I called it quits. Learning any new language is hard, with some being particularly challenging. And while the same is often true for learning to speak your partner’s love language, it is important that you don’t “drop the class” and that you continue to make efforts…even if your accent is thick and your grammar is well-butchered. On the other hand, the ways your partner “feels or hears” love may be similar to your own ways making it a little bit easier to align. Either way, being honest in expressing what you want or need and being consistent in your efforts to treat your partner the way he/she wants to be treated will likely add to a much better relationship over time. And remember that no matter how much you like surprise birthday parties, if your partner tells you he/she doesn’t like them, ask him/her about suggestions for the guest list and then plan a great party together!
Epistemic trust is a term with which many may be unfamiliar. It began as a term used in sociology before being adopted into the vernacular of psychologists in more recent years. The most basic definition is “one’s trust in communicated knowledge.” However, it can be more specifically described as “the capacity of the individual to consider the knowledge that is conveyed by others as significant, relevant to the self, and generalizable to other contexts” (Campbell, 2021). This communication can be in many forms, such as spoken words, non-verbal communication cues like body language, or reinforced messages communicated across a lifetime. The development of epistemic trust begins early in life as we interact and learn from those around us and is continually refined throughout our lives to adapt to our social environments.
Most of the psychological research studies on epistemic trust focus on personality disorders, specifically borderline personality disorder (Fonagy et al., 2015). However, more recent studies are considering epistemic trust as it relates to other kinds of psychopathology, and its implications for belief in conspiracy theories has even been considered (Tanzer et al., 2021). Unfortunately, due to the novelty of this concept in psychological studies, there is a shortage of available research to explore this topic further, especially in trauma-related areas. However, the recent development and validation of a questionnaire to measure an individual’s level of epistemic trust, mistrust, and credulity can aid in this area. This questionnaire allows for a closer and more standardized look at individuals’ epistemic trust and can be incorporated easily into future research (Campbell et al., 2021).
Considering epistemic trust and how it pertains to clients can also be useful in the treatment planning process. For example, one study highlighted that individuals diagnosed with personality disorders who had an elevated level of epistemic mistrust had poorer outcomes from their therapy experiences (Knapen et al., 2020). This may be the case for many that enter therapy with complex trauma backgrounds or other conditions that have reinforced a distrust in communication from others. This opinion can be supported by the argument that “epistemic trust may be the final common pathway through which aversive relational experiences in the past result in interpersonal dysfunctioning, which in turn result in dysfunctional therapeutic relationships, rendering it difficult for patients to trust whatever is offered to learn in therapy” (Knapen et al., 2022).
Little research has been done on achieving the restoration of epistemic trust, but it is believed that therapeutic interventions may be the most beneficial (Kamphuis & Finn, 2019). To date, there has been no known study that aims to investigate the relationship between trauma-focused therapy and restoration of epistemic trust. Such a study may prove to be a critical piece to understanding how epistemic trust impacts this population of therapy clients and whether trauma-focused therapy is an effective tool in the restoration of epistemic trust. As this concept continues to gain interest, we can expect a wealth of exciting developments in this area that will ultimately lead to improved therapeutic outcomes for clients everywhere.
References
Campbell, C., Tanzer, M., Saunders, R., Booker, T., Allison, E., Li, E., O’Dowda, C., Luyten, P., & Fonagy, P. (2021). Development and validation of a self-report measure of epistemic trust. PLOS ONE, 16(4), e0250264. https://doi.org/10.1371/journal.pone.0250264
Fonagy, P., Luyten, P., & Allison, E. (2015). Epistemic Petrification and the Restoration of Epistemic Trust: A New Conceptualization of Borderline Personality Disorder and Its Psychosocial Treatment. Journal of Personality Disorders, 29(5), 575–609. https://doi.org/10.1521/pedi.2015.29.5.575
Kamphuis, J. H., & Finn, S. E. (2019). Therapeutic Assessment in Personality Disorders: Toward the Restoration of Epistemic Trust. Journal of Personality Assessment, 101(6), 662–674. https://doi.org/10.1080/00223891.2018.1476360
Knapen, S., Hutsebaut, J., van Diemen, R., & Beekman, A. (2020). Epistemic Trust as a Psycho-marker for Outcome in Psychosocial Interventions. Journal of Infant, Child, and Adolescent Psychotherapy, 19(4), 417–426. https://doi.org/10.1080/15289168.2020.1812322
Knapen, S., van Diemen, R., Hutsebaut, J., Fonagy, P., & Beekman, A. (2022). Defining the Concept and Clinical Features of Epistemic Trust: A Delphi study. Journal of Nervous & Mental Disease, 210(4), 312–314. https://doi.org/10.1097/NMD.0000000000001446
Tanzer, M., Campbell, C., Saunders, R., Luyten, P., Booker, T., & Fonagy, P. (2021). Acquiring knowledge: Epistemic trust in the age of fake news [Preprint]. PsyArXiv. https://doi.org/10.31234/osf.io/g2b6k
I have been at Psychological Counseling Services (PCS) since 2012. One of the most difficult parts of being a therapist is meeting a client in their current crisis and as you join and get to know them better, you realize there is a treasure-trove of historical harms that desperately need attention and may even be exacerbating the issue at hand. In a weekly or bi-weekly therapy model, however, there may be little time to excavate and address the root of the matter.
I’ll give you an example: A client enters therapy for their significant other’s betrayal, and they struggle to find strength and obtain positive traction. Underneath this recent trauma lies the fact they lost a parent in a car accident when they were twelve and maybe they were also severely bullied in high school, or their parents fought constantly and eventually divorced.
It’s not that they cannot heal in weekly therapy, they can; it will just take much longer. Not only because there may be a complex history of trauma, but also because “real life” just has the advantage. We are all familiar with the scientific word “homeostasis”, or as my beloved colleague, Marilyn Murray (PCS Trauma Consultant and author of “The Murray Method”) would say, “the baseline for normal”. It means we have formed a certain muscle memory around how things tend to be, and we become comfortable in that space and often resist change or the unknown. Therefore, it is common for a client to grab important insights within the confines of the one to two hours a week in a therapy office, but then outside the office the pull towards the “old baseline” wins out. They want to make changes but need a space and time to build traction and momentum in a different direction. It is then that intensive therapy becomes an appealing suggestion and opportunity.
The PCS Intensive Program
The PCS Intensive is a weekly offering built around “The Murray Method,” developed by Marilyn Murray in the early 1980’s. Clients begin the process on a Saturday, with Marilyn’s workshop and explore “The Scindo (Latin for “split”) Syndrome,” looking at how adverse childhood events cause “survivor” parts to develop, who try to cope and manage their powerless and painful circumstances, the Circles of Intimacy, helping to organize a hierarchy of healthy intimate connections, and lastly, the Trauma Egg, a document the client creates that chronicles difficult traumatic life events, so the client can understand patterns in negative internalized messages and coping styles.
From there, the client begins the weekly process of over 30 individual therapy hours, which include Family Systems, CBT, DBT, Emotionally-Focused Therapy, Art Therapy, EMDR, and other experiential therapies. Additionally, there are 25 group hours, that includes Equine Therapy, Psychodrama, Anger and Forgiveness, Compulsivity, Codependency, Emotional Regulation, Communication, Mindfulness, Boundaries, Courageous Living, and the Power of Positivity and Play.
The days are roughly 7AM to 7:30PM with a few short breaks in the middle, and the individual work ends Friday at 5PM. The intensive then concludes with a follow-up to Marilyn’s Workshop on Saturday morning (9AM to 12PM).
The groups are mixed-gender and incorporate individual and couple’s clients who are dealing with a broad scope of issues, including substance and process addictions, complex trauma, relational trauma and issues, betrayal, divorce, blended family concerns, grief, career concerns, and severe life crises.
No matter what modality is used, all the therapists speak the same language in terms of helping clients grieve what they needed and deserved, but did not receive. Clients are helped to grow a wise-minded, healthy, balanced Adult Self who can “parent” the parts of self that get activated in grief/sadness, over-functioning or over-caretaking, defensiveness, anger, rebellion, or deception.
A PCS Intensive works for those who are:
Highly motivated and want to jump-start their therapeutic process and utilize a program where sessions build off one another, creating a greater possibility of transformational change.
“Stuck” and desire a safe place to face their fear of what change will mean in their life, fear of the unknown.
Making some progress in weekly or bi-weekly therapy, but not the broader changes they are looking for.
Busy with work and home and find it difficult to keep consistent weekly or bi-weekly appointments and would prefer a shorter, but more intensive span of time to create movement.
Experiencing an intense current crisis and struggle to manage daily living, needing a space to stabilize and strengthen in grounding and coping skills.
Making some gains in recovery, but still experience relapses due to their need to process the deeper causal roots to their problematic or addictive behaviors.
A PCS Intensive does NOT work for those who are:
Signing up because someone else in their life is making them do it, and they otherwise would stay home.
Pointing the finger in defensiveness and blame, struggling to face what makes them difficult to those around them.
Using the intensive as a checklist, and uninterested in making genuine changes.
Resist transparency and are not ready to tell the truth.
Experiencing severe mental illness, including auditory hallucinations, extreme paranoia or delusional thoughts.
Actively suicidal or homicidal.
Continuing to act out or use substances.
The Process
The work I get to do with intensive clients is a unique and fulfilling aspect to my job, because I typically get to help heal deep, difficult life experiences and I get to do that work as part of a therapeutic team. Each intensive has a Case Manager and a team of 4-5 additional therapist who are assigned different areas of focus, such as a genogram, a trauma egg, setting up targets and processing with EMDR (Eye Movement Desensitization and Reprocessing), somatic experiencing, experiential work, addiction and relapse prevention work, relational processing, understanding offensive behaviors and patterns, healthy intimacy, boundary-work, and health and wellness work.
Typically, clients arrive guarded, unsure and at times, overwhelmed. Still, the process begins very quickly by excavating their history and significant life experiences, in order to understand patterns and themes that have impacted their lives. As clients gradually begin to open-up, they start to positively affect each other and instigate change. The bonding begins early with Equine Therapy on Sunday evening and intensifies as they experience their first Psychodrama Group process, where they help a volunteer from the group put a piece of their story in action with the goal of experiencing catharsis and resolution. By Tuesday morning, they typically are ready to share in a meaningful way in their first processing group. The more clients talk about what is uncomfortable to share, the more they inspire others in the group to do the same. The sharing is spiritually powerful and moving, because clients are allowing themselves to be vulnerable and experience real connection; a connection they are encouraged to replicate with the important and healthy people in their lives.
Many clients will express how much they “get it” in an intellectual way. However, what frustrates them is how much they do not feel it. The most satisfying aspect of my job typically happens closer to the end of the week when I witness a client fundamentally shift what was once intellectual, into a “felt” experience; they no longer know they are lovable, deserving, worthy, good-enough, empowered or trust-worthy, they feel it.
At the end of my first week at PCS, I saw a client from the East Coast who completed a 2-week process, smiling, whistling and practically skipping to his car. He jumped in and was headed to the airport – back home, back to his family. I don’t think his journey ended that day, in fact, he was really at the end of the beginning, but it was awesome to see how good he felt!
Let’s start with the obvious:
It is o.k. to be wowed by another person’s look, be attracted to them. It is o.k. to desire sex; it’s o.k. to be sexual.
It is actually more than o.k.! It is part of healthy development and being human.
Moreover, attraction is at the foundation of our survival as species. A mean to mate, procreate and continuing to exist.
SO WHERE IS THE PROBLEM?
There isn’t, unless we define people solely by their sexuality and what can we get from them. If we reduce them to their looks only and we ignore them as a whole person with feelings and thoughts.
This state of mind narrows them down to a shiny object that’s all about satisfying OUR needs and here to be used. It takes away their agency since they have no say. Do you sense the sexual violence?
Should they be flattered that we find them attractive in this way?
Striping them from their humanity is devaluing, as if all their worth is their body and not the wholeness of mind, body and soul. There’s no respect in that.
Objectifying is association to self-centeredness and entitlement. It is dissociation from empathy. We are drifting away from the ability to be in someone else’s shoes, acknowledging their uniqueness, rights, likes, dislikes, different part of their personality, needs, wants, thoughts, and emotions. We are all about fulfilling our immediate need. We might move on shortly to the next shiny object, which means, we are objectifying ourselves as well. By narrowing down ourselves to lust, the physical need only (leading with our body or maybe with our money) we are depriving ourselves love, intimacy, emotional bond, and emotional safety with another human being.
We deserve the whole package!
Why settle for less?
Do you ever wonder what you can tangibly do to get ahead for
the New Year? As I reflect on 2019, I think back to many moments during the
year that included positive growth, hardship, connection, and loss. I started a
life changing internship (Thank you PCS!), while continuing to take classes and
work on my Master’s program at ASU. I moved to a new state away from my family
and friends. I lost and gained friendships. I felt homesick and leaned on
others. With all of this, I will be the first to tell you that I was not
prepared for much of what 2019 threw at me! While being unprepared might have
served a wonderful purpose (as I grew immensely as a person), I continue to
embrace the importance of being present, grounded and mindful when looking
forward and taking on new challenges and A NEW YEAR!
Here are some tips for starting your New Year on the right
foot:
Reflect (with Self-Compassion): It is
important to begin with self-reflection about how you showed up in the last
year for yourself and for others. What went well? What could be better? If 2019
felt like a hard year, this is especially important. Giving yourself compassion
for the hardships endured or where things fell short allows you to open the
door to change for the coming year.
Compassion for others: As you grow your
compassion for self, extend this to others.
Get Grounded and Set Intentions: What do
you wish to be different for your New Year? This could look like creating a
mental or physical list of what you want to accomplish or change. Even if you
had a spectacular year, we can always push ourselves!
Get Specific: How will you act on these
intentions?
Seek Support and Connection: We are not
meant to do this all alone. There are people who will support you in your efforts
to create change in your life. Seek these people out and watch the team effort unravel
positive growth.
Appreciation and Gratitude: Studies have
shown that showing gratitude positively effects one’s social and psychological
well-being. Showing your gratitude will also allow your connections to grow.
From all of us at PCS, we wish you a joyful and prosperous New
Year!
Article by Kaitlyn Beckham, BA, Intern
Kaitlyn is a Master of Counseling student at Arizona State University graduating in May 2020. She enjoys working with adults who have experienced trauma, as well as those who struggle with anxiety, depression, relationship issues and self-esteem issues.
Everyone struggles in relationships, especially with their intimate partners. Some people struggle a great deal and can see patterns showing up over and over again in relationship after relationship.
Why is this? What makes relationships so difficult and why do we see the same challenges showing up over and over?
Recent research has looked at relationship difficulties through the lens childhood adversity and asked the question “what is the impact of childhood abuse, neglect, and trauma on our relationships?” No one has a perfect childhood. I thought I did… until I started looking deeper and asking myself hard questions. In all my years at PCS, I am yet to meet someone who emerged from childhood entirely unwounded. And do I see my childhood issues playing out in my marriage? You bet I do!
We have learned a lot in the past 20 years about the lasting impact of adverse childhood experiences (ACEs). The ACE Study, conducted in the late 1990s, startled the medical world by showing conclusively that different forms of childhood trauma, alone or in aggregate, increase the risk of many major mental health and physical health problems—by up to 5 or 10 times (or more!). The study called out specifically the risk associated with ten childhood risk factors: physical abuse, emotional abuse, sexual abuse, emotional neglect, physical neglect, and living in a home with domestic violence, alcohol or drug abuse, depression or mental illness, divorce/separation/death of a parent, or incarceration.
Having any of these risk factors in your childhood was found to raise your risk of physical, emotional, and/or psychological problems later in life. And it doesn’t seem to matter how often bad things happened or how bad they were—it simply doesn’t take much to wound a child. Relatively few of us can claim to have none of these risk factors.
Fortunately, many of us are able to adapt to some forms of abuse and bounce back without much consequence—our resilience can offset the risks. However, having four or more of these factors may exceed a child’s ability to adapt and may interfere with the child’s emotional, psychological, neurological, and physical development and may lead to substantial problems in life.
We now understand that childhood adversity multiplies your risk for developing addiction, chronic depression, suicidality, smoking, IV drug use, domestic violence, criminality, and teenage pregnancy. Childhood abuse, neglect, and trauma also dramatically increase the risk of diabetes, obesity, heart disease, cancer, stroke, sexually transmitted diseases, and premature death. And not surprisingly, they also increase the risk of failure in the workplace and failure in relationships.
So, what is it about childhood adversity that messes with our ability to have happy relationships as an adult? Here the research has been very illuminating as well.
Studies have shown that kids who have been traumatized may grow up to be adults who need to be perfectionistic, having learned that anything less than perfect behavior less brings abuse or neglect. They may be prone to anger–anger that may become a personality trait or lead to domestic violence. They may be sensitive to negative emotions and highly reactive when triggered. They may have an anxious attachment to others– worried about losing important relationships or unwilling to get close in the first place. They may not tolerate stress very well, becoming controlling, aggressive, or shutting down altogether. It is not surprising that these traits would make it difficult to be successful in relationship (just ask my husband!).
Interestingly, research has also shown that people who live through aversive childhoods tend to be more resilient—to have more grit, that is, a better ability to bounce back from difficulties. So curiously, while childhood adversity seems to set us up to have difficulty in our intimate relationships, it also makes us more able to weather and overcome the challenges that we create.
Perhaps we can have a bit more compassion for ourselves and our partners if we remember that the lingering effects of childhood adversity and trauma can cast a shadow over our intimate relationships. While it does not give us an excuse to misbehave, the tough parts of childhood (which we likely had no control over) continue to influence our way of looking at the world and the choices we make, day in and day out.
So, what can we do? Fortunately, there is growing evidence that trauma-informed therapy techniques can help to heal the wounding that happened to us when we were children. Treatments such as EMDR, somatic experiencing, and psychodrama (among many others) can effectively address the pain of childhood neglect, abuse, and adversity. This may allow us to become healthier, happier adults, and thereby pave the way for us to have healthier intimate relationships.
“Participating in a PCS Intensive Treatment Program is an opportunity each of us have longed for, yet avoided. In 8 days and 68 hours your story has time to unfold and be received by a team of compassionate professionals whose primary purpose is to create a safe and equally challenging environment. The treatment process involving 35 hours of individual therapy brings an appreciation and understanding for the journey you have lived, including the detours, and offers the discovery of the journey awaiting you.”
– Dr. Marcus Earle, PCS Clinical Director
How it all begins…The Murray Method
Preparatory Workshop
The preparatory workshop begins your PCS Intensive Treatment Program. Each group member shares their reason for participating in the intensive, is introduced to our treatment model, and begins constructing a few key elements of their treatment process. Once the ice is broken, the workshop facilitator presents a framework from Marilyn’s Murray’s work called the Scindo Syndrome. The presentation sets the stage for much of the work to come, offering a way of understanding how the difficult and disturbing experiences in our early life shapes how we think, feel, and behave. It outlines what we strive for at PCS: to become a Healthy Balanced Person intellectually, spiritually, emotionally and physically. The Scindo Syndrome, along with the Circles of Intimacy, Responsibility, and Impact, provide the foundational scaffolding that the coming work can build. Not only does it help a person organize and understand their own story, but it also illustrates how we are similar to the others in the group (and in the world). This preparatory workshop is where the first homework assignments are given. The assignments include exercises such as the Trauma Egg, Genogram and Scindo Syndrome drawings to encourage clients to explore and identify what has shaped their thoughts, their feelings — their lives. These exercises guide clients to discover what is underneath even if they are uncertain what motivates their behaviors that ultimately led them to PCS.
Concluding Group
The Concluding Workshop on Saturday mornings is the final piece of the intensive program; a space to celebrate the integration of the Healthy Balanced Adult with the client’s Original Feeling Child (the “child” they are at the core). Clients share with one another their strongest “ah-hah” moments of the week, along with their Trauma Eggs, and their “Child” drawings. In their final moment, clients reaffirm their gratitude for the group work and the gains they achieved during their time at PCS.
Not Just Mental Health
As
part of the intake process, Dr. Rick Isenberg completes a comprehensive medical
history to identify significant symptoms and illnesses, along with self-care
practices, substance use, and compulsive behaviors which may impact the
treatment process. Our physical well being is entwined with our emotional
and relational health.
Interestingly, for some, the medical history may even identify symptoms, or ailments that point toward an underlying emotional issue that may be unknown to the client. We look for these clues and follow them backwards to see what we find. We also look for medical conditions that may contribute to the client’s emotional issues (like diabetes, sleep apnea, hypothyroidism) that are either not yet diagnosed, or neglected and need to be treated.
As part of the initial assessment, Dr. Isenberg also reviews the ACE Questionnaire with the client. This tool looks at adverse childhood experiences and allows PCS to help the client put psychological and medical problems in a family/historical perspective. Dr. Isenberg also administers a neurocognitive screening assessment that helps to identify brain skills that may be lagging. It is important to have our brains working at their best, so we provide tools to allow our clients to buff up brain performance. When our brains work better, life is better.
How Your Team is Assembled
After the client has filled out the registration materials for the intensive program, they will be required participate in a phone prescreen session with one of our team members. Not only does the prescreen ensure that PCS will be an appropriate fit for the client, but it also assists in selecting the individual and/or couple’s therapists assigned to each program with the background information provided. Every schedule includes at least one EMDR therapist. However, clients who are coming to work on trauma or other related concerns could find two or three therapists that utilize EMDR in their sessions. We also look at the other therapy modalities that would be beneficial for the client such as SE, CBT, DBT & EFT to help in the process of building a schedule for each individual or couple.
Clients who are interested in the intensive program but are on a strict budget can have the opportunity for interns, as well as licensed associate counselors (LAC) to be assigned to reduce the cost of their program. The advantage of having a large team of over 25 therapists allows flexibility in the selection of a client’s team and provides the ability to choose appropriate lower cost therapists while still receiving the full benefits of the process.
EMDR, SE, EFT, ETC. – What is EMDR?
Eye Movement
Desensitization and Reprocessing (EMDR) is a trauma therapy developed by
psychologist Dr. Francine Shapiro. Dr.
Shapiro made the chance observation that eye movements can reduce the intensity
of disturbing thoughts when she noticed her own stress reactions diminished
when her eyes swept back and forth as she walked through a park.
EMDR involves recalling a stressful past event and “reprogramming” the memory in the light of a positive, self-chosen belief, while using rapid eye movements to facilitate the process. EMDR (Eye Movement Desensitization and Reprocessing) incorporates elements of cognitive-behavioral therapy with bilateral eye movements or other forms of rhythmic, left-right stimulation. One of the key elements of EMDR is “dual stimulation.” During treatment, a person is asked to think or talk about memories, triggers, and painful emotions while simultaneously focusing on his/her therapist’s moving finger or another form of bilateral stimuli. Other forms of external stimuli that may be used in EMDR therapy include bilateral tactile sensations and sounds (e.g. alternating hand taps or a chime that pans back and forth from ear to ear).
How Does EDMR Therapy Work?
At the time
of a traumatic event, strong emotions may interfere with our ability to
completely process the experience and the moment becomes “frozen in time.” Recalling the traumatic event may feel as
though the person is reliving the event all over again because the images,
smells, sounds, and feelings still exist and can be triggered in the
present. When activated, these memories
cause a negative impact on our daily functioning and interfere with the way we
see ourselves and our world, and how we relate to others.
EMDR therapy appears to directly affect the brain by “unfreezing” the traumatic memories, allowing them to be resolved. Over time, the disturbing memory and associated beliefs, feelings, sensations become “digested” or processed until the event is able to be thought about without reliving it. The memory is still available, but it is less upsetting.
The exact mechanism for the effectiveness of EMDR is unknown. It appears that using rapid eye movement relieves the anxiety associated with the trauma so that the original event can be examined for a more detached perspective. This is somewhat like watching a movie of what happened. This enables a person to access positive ways of reframing the original trauma (reprocessing), and to release the body’s stored negative emotional charges around it (desensitization). Some experts have noted that the eye movements during EMDR might be similar to what occurs naturally during dreaming or REM (Rapid Eye Movement) sleep. It may be thought of as a physiologically-based therapy that allows a person to see material in a new and less distressing way. Others believe it reactivates parts of the brain that were “shut down” as a coping mechanism. In this way, cognitive reorganizing takes place, allowing the negative, painful emotions to give way to more resolved, empowered feelings.
What is Somatic Experiencing (SE)?
Somatic Experiencing was
developed by Dr. Peter Levine and is practiced all over the world as an
intervention to resolve trauma. Dr. Levine theorized that trauma is not
necessarily about an event, but about what happens after the event, at the
physiological and biological level. How our nervous system responds, how those
around us respond, how we recall the incident and the ultimate meaning we give
to the experience will determine our chance of resolving trauma in the moment
or increase the likelihood of experiencing PTSD in the future.
SE recognizes that
trauma is a natural part of life. Trauma is not a disease or an anomaly. Its
effects do not mean a life sentence or permanent incapacitation. Instead,
trauma can be viewed as an injury to the autonomic nervous system with the
understanding that our bodies have an innate capacity to return to a regulated
state of being.
SE is a short term,
holistic and naturalistic approach that encourages mastery, empowerment,
self-direction and resiliency. SE focuses on “sensate” or “felt sense” of the body by recognizing and
accessing physical sensations, imagery and motor patterns to renegotiate trauma
through physiological channels of the autonomic nervous system – from brain
stem to limbic system. The body remembers everything even if the brain cannot
access certain experiences and unlike traditional therapies, SE brings sensory
experience to the foreground while supporting thought, feeling and emotion in
the background.
How Does Somatic Experiencing Work?
SE is a body oriented
approach to renegotiate trauma. It involves grounding, orienting, noticing the
felt sense of the body and tracking with curiosity how it experiences
activation and then de-activation. With the support of a trained therapist, we
can touch into the nervous system, mind and body and prepare for a reparative
action. This “pendulation” of pleasant, unpleasant and neutral sensations
increases our range of resiliency and facilitates nervous system regulation. We
enter the “here and now” instead of being stuck in the “there and then.” We
become able to recognize and express instinctive responses to threat. Expanding
a person’s tolerance of bodily sensations facilitates their trust in the body’s
wisdom and capacity to heal itself by uncoupling incomplete and undischarged
bio-electric circuits. Symptoms diminish in strength and frequency when the
cycle of discharge that have been fueling the symptoms of unresolved trauma are
released. Discharge my take the form of flushing, muscle contraction/release,
yawning, deep breathing, sweating, tears as well as other somatic responses.
Humans often thwart the natural mammalian instinct for fight, flight, freeze or collapse because we filter our experiences through the frontal cortex, thereby minimizing our “animal” instinct. For example, if a child cries we often attempt to sooth by telling them “Don’t cry, everything is fine.” This shuts down energetic discharge. Patients often experience shaking coming out of surgery. Instead of allowing an individual to discharge energy caused by a traumatic experience (cutting, being tied down, having a mask over one’s face) they are often given warm blankets or medications to dull the sympathetic nervous system. When individuals fidget, we tell them to stop. We manage to stop energetic discharge throughout our day. Our sedentary lifestyles and cultural beliefs disconnect us from the body. If our natural, self-protective responses are not completed, this energy does not discharge and we are at risk of our nervous system getting “stuck on” or “stuck off.” We may not feel safe in our own bodies and so we “numb” with substance addictions (using alcohol or drugs) or with process addictions (gambling, sex, shopping, work, etc.) By bypassing the thinking brain and accessing the nervous system we can reclaim the body’s ability self-regulate.
Mindfulness
Living Without Awareness = Impulsiveness and Mood Dependent Behaviors.
What is Mindfulness? Mindfulness has been described as “paying attention in a particular way: on purpose, in the present moment, and nonjudgmentally.” Mindfulness is the practice of being completely aware of what you are doing in the moment, when you are doing it. It is you being in control of your mind, instead of your mind being in control of you.
Mindfulness is about: learning to maintain awareness of your mind, body, and surroundings. It is about staying in the present moment and noticing when your mind drifts into the past or future. It is learning to enjoy life in the here and now. Finally, it is about finding and connecting with one’s sense of self. When you are aware of what you are experiencing, you can make the choice to change or accept it, thus decreasing your suffering.
Benefits of Mindfulness: Mindfulness increases awareness. It allows us to be completely connected to our environment, reduce stress, and improve our overall well-being. Studies show that practicing mindfulness can reduce blood pressure, increase the immune system function, relax muscles, improve quality of sleep, and increase focus and concentration.
Why Learn Mindfulness?
Mindfulness skills help you to tolerate distress, that is, tolerating emotions and situations that feel intolerable; riding your intense emotions (urge surfing) rather than doing things to shut them off or distract from them, OR from engaging in self-destructive behaviors.
Mindfulness skills help you to regulate your emotions. The more skilled you are at noticing and identifying your emotions, the better chance you have of being able to adjust their intensity. If you are aware of what you are feeling you can change emotions you want to change, OR you can choose to stay with the feelings, knowing you are in control.
Mindfulness skills help you to be more effective in interpersonal situations. Increased awareness helps you decide when and how to make decisions about dealing with people and setting boundaries and limits, i.e. “asking for what you want” and “saying no”. Maintaining healthy relationships (or ending destructive ones!) requires the ability to be able to connect with your emotions and to be able to keep them in check if you want to.
Relapse Prevention: (e.g. relapse to undesirable mood states–depression, anxiety, anger, etc.–or impulsive/unwanted/self-destructive behaviors). Mindfulness teaches you how to recognize and disengage from emotion mind at times of potential relapse. Inability to do so may result in a downward spiral, and eventually, the onset of relapse. To avoid this, you must be able to disengage from emotion mind, bring in reasonable mind, and find wise mind. This will allow you to process mood related information in ways that are less likely to provoke relapse. Awareness of the patterns of thoughts, feelings, and body sensations that characterize relapse-related mind states is an essential first step in recognizing the need for corrective action.
Nutrition Makes A Difference
Taylor
Aasand, MPH, RDN, our registered dietitian (RDN), conducts nutritional
assessments of the complete diet of clients; including foods, beverages,
supplements and medications that could influence medical status. The
dietitian also takes note for any special dietary patterns, food allergies, and
religious beliefs that affect intake.
The RDN
provides education around the link between nutrition and mental health,
emphasizing that the brain and body must be adequately nourished and hydrated
to do intensive therapy. Some clients benefit from additional
dietary services depending on a medical diagnosis or an eating disorder or
disordered eating history. The client and dietitian work together to
develop a more structured dietary plan for their programming that may include
planned meals, grocery lists, challenging food fears and rules, and body
attunement exercises to help clients meet their individual nutrition
goals.
All this allows PCS to help the team assigned to understand the client more comprehensively and provides additional avenues for intervention. The complete Wellness Assessment allows us to recommend changes in bad habits and lifestyle that may lead to a healthier life, better brain performance, and easier recovery from the addiction, depression, trauma (etc.).
Working Together
We enjoy talking about you. The PCS Intensive Treatment Program is a team approach model. During your intensive over 7 professionals focus their attention on how best to facilitate discovering those issues inhibiting personal and relationship growth. The case manager assigned to you communicates with your primary therapist before, during, and after your program while monitoring treatment process. Through notes, emails, and conversations your individual and group therapists continue to update one another of how best to promote change and growth. The Wednesday staffing offers a unique opportunity for reviewing your process, with you present, by our entire team of over 25 therapists.
To learn more about the PCS Intensive Treatment Program, please contact our office at 480-947-5739 where our Intensive Coordinators can supply more information and start you on the journey to discovering a better you.
It’s 2:00 pm on the hottest day of the year and I am watching the men lay brick in the full sun, building a second story on the building next door. As I watch them labor and sweat, I am reminded, in this Pride Month, that the rights and freedoms I enjoy today—being able to marry the man I love and live openly as a gay man—were built on the backs of a generation of men and women who labored and fought for the right to live without discrimination. I owe a lot to those courageous people, many of whom stood in the Stonewall riots of 50 years ago– many of whose names line the walls of AIDS memorials across the country.
Pride Month is a time to honor the victories and sacrifices of the past and to look forward to the challenges of the future. For this is not an easy time to be LGBTQ in our society. Regressive forces are pushing back. This is a time to rally in support of the rights of the next generation.
PCS stands with the LGBTQ community. We acknowledge the enduring spirit of this community that was once considered a mental illness. We stand against bigotry, conversion therapy, and the denial of transgender rights. We support those who remain closeted out of fear of retribution and those who struggle with their faith. We support those living with HIV/AIDS and those who have lost dear ones to the plague. We stand with those who feel alone, different, bullied, abandoned, and afraid. We help them heal.
At PCS, we affirm the value and uniqueness of every individual and strive to help everyone celebrate and live fully in their authentic selves.
Brick by sweaty brick. This is how we have reached this day and this is how, together as advocates and allies, we will build a future for the next proud generation.
“The essence of recovery is embracing and growing from our mistakes and missteps rather than avoiding pain and discomfort.”
My recovery from sex addiction started when I was 28. I was fortunate to participate in a group my father organized consisting of therapists and clergy. It was during one of these meetings a group member divulged his struggle with sex addiction which prompted me to tell my story, one I had hidden until then. This took place just after joining PCS and may have saved my career. The term sex addiction fit. My behavior felt consuming, my efforts to stop failed, real and potential consequences were not a deterrent, marriage and a loving and compassionate wife did not stop the behavior, and no amount of will power could stop the energy which continued to well up inside of me, leading me to “act out.” I am aware as I write this how inadequate words are to express the churning of guilt, shame, and fear I was experiencing.
I moved into recovery and while the support and therapy helped me stop the behavior it is clear to me now the internal struggle continued to percolate. We had children, immersed ourselves in parenting and building relationships with other families. Business grew at a steady pace, but then exploded as our children reached their teen years. This turned out to be terrible timing, and I began to lose myself in work. It took time, but eventually the stress and disconnect from relationships brought back that which had never fully left and I began acting out again. Thankfully, I eventually summoned the courage to disclose to my wife. Individual and couples therapy resumed, and I reached out for support in ways I had not previously done.
Soon after this Doug Braun-Harvey provided an in-service training for our PCS therapists. I found it resonated with me and began questioning whether labeling myself as a sex addict was a way to hide from some erotic conflict I was uncomfortable facing. His six principles of sexual health proved helpful in my journey. They are:
Consent
Nonexploitation
Protected from STI’s and unintended pregnancy
Honesty
Shared Values
Mutual Pleasure.
I found these principles began to shift my perspective on my sex addiction and created a different internal dialogue which in turn influenced how I shared with others. I embraced a gentler and more compassionate view of self. Around this time I stumbled upon Dr. Daniel Sumrok’s phrase, “Ritualized Compulsive Comfort Seeking.” Dr. Sumrok believes what we label as addiction is a normal childhood response to adverse childhood experiences. This perspective generated another question, had I simply developed a distorted, intimacy blocking relationship with my sexuality born from challenges in my childhood? The answer was clearly yes, but where did this leave the “sex addict?”
Would I discard the term sex addiction, no. Currently, I find it helpful to embrace myself as an addict. Not as a way of negatively labeling or pathologizing myself, but to respect and honor that which comforted me through the challenges of growing up. This ongoing change toward increased self-compassion is progressively shifting how I view my past and present-day choices. Integrating my addiction recovery, trauma work, and the six principles of sexual health serve to broaden my recovery and support a gentler approach to self. I desire to continue affirming, as an adult, I now have choices and resources I could not grasp as a child. I am striving to develop a relationship with my wife which is safe, consensual, nonexploitive, and mutually fulfilling. Recovery is a becoming; I hope you agree.
When a partner or spouse in a relationship learns that the person whom they have trusted has been unfaithful to them, the pain of that discovery can be incredibly intense, leaving the person with an overwhelming sense of betrayal.
Betrayal as an Attachment Trauma
Betrayal in a committed relationship includes the violation of relationship norms. When a partner violates the standards considered to be the norm in the relationship, relational trauma may be experienced. Relational traumas are attachment injuries, which occur when “one individual betrays, abandons, or refuses to provide support for another with whom they have developed an attachment bond” (Steffens & Means, 2010). According to Judith Herman, attachment injuries are a “violation of human connection” and lead to the relationship being perceived as a source of danger rather than a safe haven.
PTSD Symptoms
Many betrayed partners, after learning about the betrayal, exhibit symptoms of Post-Traumatic Stress Disorder (PTSD). PTSD symptoms may include:
Increased anxiety, which may include the following:
Hypervigilance (scanning the environment for any signs of potential danger/threat)
Paranoia
Overwhelming terror
Insomnia
Inability to concentrate
Startling easily
Avoiding reminders or conversations of the event or not being able to remember some or all aspects of the event (blocking/denial)
Re-experiencing the event through invading thoughts or memories that can’t be held back, be it through flashbacks and/or nightmares
The person’s distress can grow so intense that it impacts them in multiple areas of their lives (e.g., their ability to work, take care of day-to-day responsibilities, or participate in relationships).
Carol Juergensen Sheets has created a powerful short video that explains the “brain science” of partner betrayal and how these acute symptoms can manifest in a partner’s life. Please be aware that the video depicts a cisgender female in a heterosexual relationship. It is important to be aware that partner betrayal can occur in any relationship, regardless of sexual orientation and gender identification. https://youtu.be/Sbfkj-T6g0M (The animated video starts at 5:15 minutes.)
Betrayed Partner Needs
Following Discovery of the infidelity, betrayed partners often need the following:
To feel a sense of emotional safety in the relationship
To feel that their partner is willing to change and make a serious commitment to do so (Certified Sex Addiction Therapists – CSATs may be found at: IITAP Community )
To feel the betraying behavior has stopped
To feel that repair of the relationship is the betraying partner’s #1 priority
How Betrayed Partners Can Begin Their Healing Process
Learn and practice grounding/mindfulness techniques to help them stay in the present.
Regular individual therapy sessions with a betrayed partner specialist or a therapist who understands betrayal trauma (partner specialists may be found at: Our Specialist List – APSATS)
Time for practicing your spirituality (e.g., praying, meditating, walking in nature, etc.)
While healing from betrayal trauma can be a long and arduous process, recovery of the partner’s sense of a “Reintegrated Self” is absolutely possible! The right tools and resources can facilitate that process.
_______________________________________
For additional information related to betrayal trauma and healing, the following resources are recommended:
Your Sexually Addicted Spouse: How Partners Can Cope and Heal, by Barbara Steffens, Ph.D., and Marsha Means, MA
Mending a Shattered Heart: A Guide for Partners of Sex Addicts, edited by Stephanie Carnes, Ph.D.
Courageous Love: A Couples Guide to Conquering Betrayal, by Stephanie Carnes, Ph.D.
Help.Them.Heal: Teaching You Both How to Heal Your Relationship After Sexual Betrayal, by Carol Juergensen Sheets, LCSW, CSAT, CCPS-S, CPC-S, PCC
Intimate Deception: Healing the Wounds of Sexual Betrayal, by Dr. Sheri Keffer
Out of the Doghouse: A Step-by-Step Relationship-Saving Guide for Men Caught Cheating, by Robert Weiss, LCSW, CSAT-S
A Man’s Tools for Addressing Betrayal: Keys to Unlocking Freedom & Moving Forward, by Sibylle Georgianna, Ph.D.
“How could she not love that – I put so much thought/time into making her birthday special!”
Many many years ago when I was in the first few years of my 1st marriage I planned what I was sure to be the best birthday party ever for my wife. It was a surprise party! I had invited all her friends and family members and arranged for them to, if possible, all be there when we showed up back to our little apartment after a romantic dinner. I’ll spare you most of the details, but I will say I arranged it for them to decorate the apartment while we were gone and despite this being in the pre-cell phone days, we timed it all perfectly!
After the party was over I was looking forward to hearing how much she loved it, how special the night was, and if I’m honest- also hoped to hear what an amazing, thoughtful husband I was. She was gracious in how she expressed it, but after thanking me for the gesture and the time I put in to it, she expressed that she was anxious and uncomfortable most of the night. She clarified that she was uncomfortable with knowing they were all there and she hadn’t had a chance to clean the apartment the way she would if she knew a bunch of people were coming over. Perhaps more importantly, she shared with me that she had told me on more than one occasion that she didn’t like surprises in general and surprise parties specifically- and clarified some of the reasons why.
Upon hearing all that, I felt both sad and offended in that I had put so much time and effort in to something that was not appreciated. After all, I would have LOVED IT! In fact, several of my favorite birthday parties had elements of surprise in them. Most Christmas morning’s were unexpectedly awesome in part because the days leading up to them included at least 1 comment about how this year’s presents were going to be limited because things were a little bit tighter financially…but the family room was as full of treasures as it ever was!
So what was the problem!?!? To put it simple, I was acting on what I wanted or liked, not on what my wife wanted or liked. With the best of intentions, I was operating from what by many is known as the “golden
DO UNTO OTHERS AS YOU WOULD HAVE DONE UNTO YOU.
Great rule- right! If you’re not sure how to treat somebody else, ask yourself “how would I want to be treated in this situation?” and then treat the other person that way. And to give the golden rule the golden respect it deserves…. It really helps in a lot of situations. However, there is an even better rule/guideline for how to treat others that is not as commonly known nor applied. And this rule/guide is especially important in our personal relationships, the “platinum rule”:
DO UNTO OTHERS AS THEY WOULD HAVE YOU DO UNTO THEM.
Seems similar, right? But when you really break it down, it’s a little more complex. To apply the platinum rule of relationships, you have to go beyond knowing yourself and how you would like to be treated in a relationship and actually do the hard, important and often confusing work of learning who the other person is. It requires being willing to sincerely ask and then truly listen to what they say about their hopes, dreams, wants, needs, etc. And specifically within a long-term committed relationship like a marriage, it requires learning what “speaks love” to one another. For example, in his book “The 5 love languages” author Gary Chapman talks about different ways people express or experience love including 1) physical touch/affection, 2) words of affirmations, 3) quality time, 4) Acts of service, and 5) meaningful/thoughtful gifts. Using these 5 areas as a starting point can help couples get clarity about what helps each one to feel loved and prioritized. And then with that understanding, each partner can begin doing and saying those things that help the other person feel that love…even if it feels like speaking a foreign language!
So how can you become an expert at applying the platinum rule of relationships in your own life? There are 4 components to this:
Knowing your own wants, needs and “love languages”
Sharing those in a clear, honest way with partner
Knowing your partner’s wants, needs and “love languages”
Making sincere efforts to meet those wants/needs and to speak his/her “love language”
1. Knowing your own wants, needs and “love languages”:
In order to let your partner know how you want to be treated in the relationship so they can successfully apply the platinum rule of relationships, you need to know yourself. Many people go blank when asked “what do you want to do for dinner tonight”, or “what do you want to do for your birthday?”, or “how can I best support you in this difficult thing you’re going through?”. Self-awareness can be scary because if we truly know what we want and need out of our intimate relationships- we can start to develop hopes of getting those met. And if we are vulnerable in sharing those things with a partner, we can get let down and hurt when those wants and needs are not met.
The most fulfilling relationships are those in which each partner is willing to make sincere efforts to meet the wants and needs of the other person, as long as doing so does not go against their own sense of values, health or well-being. So choosing to be vulnerable by letting the other person know what you want out of the relationship is a key part of living the platinum rule.
There are different “types” or categories of intimate connection, including emotional, physical (non-sexual), sexual, intellectual, spiritual, recreational and social (relating to others as a couple). In most relationships, there are gaps between the needs and wants of each partner across these different domains. One tool you can use to get more clarity about your own wants and needs in these different areas is to simply write down anything that you would like to experience more in your relationship(s).
The distinction between wants and needs can be difficult at times, but one way you can do so is to ask yourself “is this something that is a preference (and maybe even a REALLY STRONG preference!) but the relationship can still be a really good one without it, OR is it something that is core to my sense of relational well-being?”. For example, someone might have the awareness that in order to be fulfilled in their marriage they NEED physical affection and closeness, and he/she WANTS (prefers) it to come in the form of holding hands while walking around outside. If the spouse happens to be uncomfortable with PDA (public displays of affection) he/she may not get that WANT met, but hopefully will get the NEED met later that night as they hold hands or cuddle while watching a movie at home.
2. Sharing those in a clear, honest way with partner:
Using the example above, component number 2 of applying the platinum rule could be where a wife lets her husband know how important physical affection is for her and how much she would love to hold hands when they walked around in the mall. If her partner consistently fails to do so despite knowing how important it is, she would need to work hard to not take it as a sign that he doesn’t love her, and instead accept that there may need to be a different way of him meeting her need. She could either suggest something else (e.g. holding hands while they watch a movie at home) or ask him what he would be comfortable with.
3. Knowing your partner’s wants, needs and “love languages”
Hopefully your partner is doing a good job with component number 2 and you therefore know what your partner wants to be experiencing in the relationship. If not, however, the work of component number 3 is to be curious, open-minded, and to ask sincere questions about how you could more fully meet needs and even some of their wants if at all possible.
4. Making sincere efforts to meet those wants/needs and to speak his/her “love language”
When I was in college, I took a course in Chinese with hopes of adding that to the 2 languages I already spoke fluently (English and Spanish being the others). I soon learned how different and how much more difficult it was learning Chinese compared to learning Spanish. In Spanish, “radio” was spelled the same way, but was pronounced differently. There were, in fact, a LOT of words like that. However, there was no place in my brain where I could connect the dots between what I already knew and what I was learning (or trying to learn) in my Chinese 101 class. After a few weeks I called it quits. Learning any new language is hard, with some being particularly challenging. And while the same is often true for learning to speak your partner’s love language, it is important that you don’t “drop the class” and that you continue to make efforts…even if your accent is thick and your grammar is well-butchered. On the other hand, the ways your partner “feels or hears” love may be similar to your own ways making it a little bit easier to align. Either way, being honest in expressing what you want or need and being consistent in your efforts to treat your partner the way he/she wants to be treated will likely add to a much better relationship over time. And remember that no matter how much you like surprise birthday parties, if your partner tells you he/she doesn’t like them, ask him/her about suggestions for the guest list and then plan a great party together!
Epistemic trust is a term with which many may be unfamiliar. It began as a term used in sociology before being adopted into the vernacular of psychologists in more recent years. The most basic definition is “one’s trust in communicated knowledge.” However, it can be more specifically described as “the capacity of the individual to consider the knowledge that is conveyed by others as significant, relevant to the self, and generalizable to other contexts” (Campbell, 2021). This communication can be in many forms, such as spoken words, non-verbal communication cues like body language, or reinforced messages communicated across a lifetime. The development of epistemic trust begins early in life as we interact and learn from those around us and is continually refined throughout our lives to adapt to our social environments.
Most of the psychological research studies on epistemic trust focus on personality disorders, specifically borderline personality disorder (Fonagy et al., 2015). However, more recent studies are considering epistemic trust as it relates to other kinds of psychopathology, and its implications for belief in conspiracy theories has even been considered (Tanzer et al., 2021). Unfortunately, due to the novelty of this concept in psychological studies, there is a shortage of available research to explore this topic further, especially in trauma-related areas. However, the recent development and validation of a questionnaire to measure an individual’s level of epistemic trust, mistrust, and credulity can aid in this area. This questionnaire allows for a closer and more standardized look at individuals’ epistemic trust and can be incorporated easily into future research (Campbell et al., 2021).
Considering epistemic trust and how it pertains to clients can also be useful in the treatment planning process. For example, one study highlighted that individuals diagnosed with personality disorders who had an elevated level of epistemic mistrust had poorer outcomes from their therapy experiences (Knapen et al., 2020). This may be the case for many that enter therapy with complex trauma backgrounds or other conditions that have reinforced a distrust in communication from others. This opinion can be supported by the argument that “epistemic trust may be the final common pathway through which aversive relational experiences in the past result in interpersonal dysfunctioning, which in turn result in dysfunctional therapeutic relationships, rendering it difficult for patients to trust whatever is offered to learn in therapy” (Knapen et al., 2022).
Little research has been done on achieving the restoration of epistemic trust, but it is believed that therapeutic interventions may be the most beneficial (Kamphuis & Finn, 2019). To date, there has been no known study that aims to investigate the relationship between trauma-focused therapy and restoration of epistemic trust. Such a study may prove to be a critical piece to understanding how epistemic trust impacts this population of therapy clients and whether trauma-focused therapy is an effective tool in the restoration of epistemic trust. As this concept continues to gain interest, we can expect a wealth of exciting developments in this area that will ultimately lead to improved therapeutic outcomes for clients everywhere.
References
Campbell, C., Tanzer, M., Saunders, R., Booker, T., Allison, E., Li, E., O’Dowda, C., Luyten, P., & Fonagy, P. (2021). Development and validation of a self-report measure of epistemic trust. PLOS ONE, 16(4), e0250264. https://doi.org/10.1371/journal.pone.0250264
Fonagy, P., Luyten, P., & Allison, E. (2015). Epistemic Petrification and the Restoration of Epistemic Trust: A New Conceptualization of Borderline Personality Disorder and Its Psychosocial Treatment. Journal of Personality Disorders, 29(5), 575–609. https://doi.org/10.1521/pedi.2015.29.5.575
Kamphuis, J. H., & Finn, S. E. (2019). Therapeutic Assessment in Personality Disorders: Toward the Restoration of Epistemic Trust. Journal of Personality Assessment, 101(6), 662–674. https://doi.org/10.1080/00223891.2018.1476360
Knapen, S., Hutsebaut, J., van Diemen, R., & Beekman, A. (2020). Epistemic Trust as a Psycho-marker for Outcome in Psychosocial Interventions. Journal of Infant, Child, and Adolescent Psychotherapy, 19(4), 417–426. https://doi.org/10.1080/15289168.2020.1812322
Knapen, S., van Diemen, R., Hutsebaut, J., Fonagy, P., & Beekman, A. (2022). Defining the Concept and Clinical Features of Epistemic Trust: A Delphi study. Journal of Nervous & Mental Disease, 210(4), 312–314. https://doi.org/10.1097/NMD.0000000000001446
Tanzer, M., Campbell, C., Saunders, R., Luyten, P., Booker, T., & Fonagy, P. (2021). Acquiring knowledge: Epistemic trust in the age of fake news [Preprint]. PsyArXiv. https://doi.org/10.31234/osf.io/g2b6k
I have been at Psychological Counseling Services (PCS) since 2012. One of the most difficult parts of being a therapist is meeting a client in their current crisis and as you join and get to know them better, you realize there is a treasure-trove of historical harms that desperately need attention and may even be exacerbating the issue at hand. In a weekly or bi-weekly therapy model, however, there may be little time to excavate and address the root of the matter.
I’ll give you an example: A client enters therapy for their significant other’s betrayal, and they struggle to find strength and obtain positive traction. Underneath this recent trauma lies the fact they lost a parent in a car accident when they were twelve and maybe they were also severely bullied in high school, or their parents fought constantly and eventually divorced.
It’s not that they cannot heal in weekly therapy, they can; it will just take much longer. Not only because there may be a complex history of trauma, but also because “real life” just has the advantage. We are all familiar with the scientific word “homeostasis”, or as my beloved colleague, Marilyn Murray (PCS Trauma Consultant and author of “The Murray Method”) would say, “the baseline for normal”. It means we have formed a certain muscle memory around how things tend to be, and we become comfortable in that space and often resist change or the unknown. Therefore, it is common for a client to grab important insights within the confines of the one to two hours a week in a therapy office, but then outside the office the pull towards the “old baseline” wins out. They want to make changes but need a space and time to build traction and momentum in a different direction. It is then that intensive therapy becomes an appealing suggestion and opportunity.
The PCS Intensive Program
The PCS Intensive is a weekly offering built around “The Murray Method,” developed by Marilyn Murray in the early 1980’s. Clients begin the process on a Saturday, with Marilyn’s workshop and explore “The Scindo (Latin for “split”) Syndrome,” looking at how adverse childhood events cause “survivor” parts to develop, who try to cope and manage their powerless and painful circumstances, the Circles of Intimacy, helping to organize a hierarchy of healthy intimate connections, and lastly, the Trauma Egg, a document the client creates that chronicles difficult traumatic life events, so the client can understand patterns in negative internalized messages and coping styles.
From there, the client begins the weekly process of over 30 individual therapy hours, which include Family Systems, CBT, DBT, Emotionally-Focused Therapy, Art Therapy, EMDR, and other experiential therapies. Additionally, there are 25 group hours, that includes Equine Therapy, Psychodrama, Anger and Forgiveness, Compulsivity, Codependency, Emotional Regulation, Communication, Mindfulness, Boundaries, Courageous Living, and the Power of Positivity and Play.
The days are roughly 7AM to 7:30PM with a few short breaks in the middle, and the individual work ends Friday at 5PM. The intensive then concludes with a follow-up to Marilyn’s Workshop on Saturday morning (9AM to 12PM).
The groups are mixed-gender and incorporate individual and couple’s clients who are dealing with a broad scope of issues, including substance and process addictions, complex trauma, relational trauma and issues, betrayal, divorce, blended family concerns, grief, career concerns, and severe life crises.
No matter what modality is used, all the therapists speak the same language in terms of helping clients grieve what they needed and deserved, but did not receive. Clients are helped to grow a wise-minded, healthy, balanced Adult Self who can “parent” the parts of self that get activated in grief/sadness, over-functioning or over-caretaking, defensiveness, anger, rebellion, or deception.
A PCS Intensive works for those who are:
Highly motivated and want to jump-start their therapeutic process and utilize a program where sessions build off one another, creating a greater possibility of transformational change.
“Stuck” and desire a safe place to face their fear of what change will mean in their life, fear of the unknown.
Making some progress in weekly or bi-weekly therapy, but not the broader changes they are looking for.
Busy with work and home and find it difficult to keep consistent weekly or bi-weekly appointments and would prefer a shorter, but more intensive span of time to create movement.
Experiencing an intense current crisis and struggle to manage daily living, needing a space to stabilize and strengthen in grounding and coping skills.
Making some gains in recovery, but still experience relapses due to their need to process the deeper causal roots to their problematic or addictive behaviors.
A PCS Intensive does NOT work for those who are:
Signing up because someone else in their life is making them do it, and they otherwise would stay home.
Pointing the finger in defensiveness and blame, struggling to face what makes them difficult to those around them.
Using the intensive as a checklist, and uninterested in making genuine changes.
Resist transparency and are not ready to tell the truth.
Experiencing severe mental illness, including auditory hallucinations, extreme paranoia or delusional thoughts.
Actively suicidal or homicidal.
Continuing to act out or use substances.
The Process
The work I get to do with intensive clients is a unique and fulfilling aspect to my job, because I typically get to help heal deep, difficult life experiences and I get to do that work as part of a therapeutic team. Each intensive has a Case Manager and a team of 4-5 additional therapist who are assigned different areas of focus, such as a genogram, a trauma egg, setting up targets and processing with EMDR (Eye Movement Desensitization and Reprocessing), somatic experiencing, experiential work, addiction and relapse prevention work, relational processing, understanding offensive behaviors and patterns, healthy intimacy, boundary-work, and health and wellness work.
Typically, clients arrive guarded, unsure and at times, overwhelmed. Still, the process begins very quickly by excavating their history and significant life experiences, in order to understand patterns and themes that have impacted their lives. As clients gradually begin to open-up, they start to positively affect each other and instigate change. The bonding begins early with Equine Therapy on Sunday evening and intensifies as they experience their first Psychodrama Group process, where they help a volunteer from the group put a piece of their story in action with the goal of experiencing catharsis and resolution. By Tuesday morning, they typically are ready to share in a meaningful way in their first processing group. The more clients talk about what is uncomfortable to share, the more they inspire others in the group to do the same. The sharing is spiritually powerful and moving, because clients are allowing themselves to be vulnerable and experience real connection; a connection they are encouraged to replicate with the important and healthy people in their lives.
Many clients will express how much they “get it” in an intellectual way. However, what frustrates them is how much they do not feel it. The most satisfying aspect of my job typically happens closer to the end of the week when I witness a client fundamentally shift what was once intellectual, into a “felt” experience; they no longer know they are lovable, deserving, worthy, good-enough, empowered or trust-worthy, they feel it.
At the end of my first week at PCS, I saw a client from the East Coast who completed a 2-week process, smiling, whistling and practically skipping to his car. He jumped in and was headed to the airport – back home, back to his family. I don’t think his journey ended that day, in fact, he was really at the end of the beginning, but it was awesome to see how good he felt!
It is o.k. to be wowed by another person’s look, be attracted to them. It is o.k. to desire sex; it’s o.k. to be sexual.
It is actually more than o.k.! It is part of healthy development and being human.
Moreover, attraction is at the foundation of our survival as species. A mean to mate, procreate and continuing to exist.
SO WHERE IS THE PROBLEM?
There isn’t, unless we define people solely by their sexuality and what can we get from them. If we reduce them to their looks only and we ignore them as a whole person with feelings and thoughts.
This state of mind narrows them down to a shiny object that’s all about satisfying OUR needs and here to be used. It takes away their agency since they have no say. Do you sense the sexual violence?
Should they be flattered that we find them attractive in this way?
Striping them from their humanity is devaluing, as if all their worth is their body and not the wholeness of mind, body and soul. There’s no respect in that.
Objectifying is association to self-centeredness and entitlement. It is dissociation from empathy. We are drifting away from the ability to be in someone else’s shoes, acknowledging their uniqueness, rights, likes, dislikes, different part of their personality, needs, wants, thoughts, and emotions. We are all about fulfilling our immediate need. We might move on shortly to the next shiny object, which means, we are objectifying ourselves as well. By narrowing down ourselves to lust, the physical need only (leading with our body or maybe with our money) we are depriving ourselves love, intimacy, emotional bond, and emotional safety with another human being.
Do you ever wonder what you can tangibly do to get ahead for
the New Year? As I reflect on 2019, I think back to many moments during the
year that included positive growth, hardship, connection, and loss. I started a
life changing internship (Thank you PCS!), while continuing to take classes and
work on my Master’s program at ASU. I moved to a new state away from my family
and friends. I lost and gained friendships. I felt homesick and leaned on
others. With all of this, I will be the first to tell you that I was not
prepared for much of what 2019 threw at me! While being unprepared might have
served a wonderful purpose (as I grew immensely as a person), I continue to
embrace the importance of being present, grounded and mindful when looking
forward and taking on new challenges and A NEW YEAR!
Here are some tips for starting your New Year on the right
foot:
Reflect (with Self-Compassion): It is
important to begin with self-reflection about how you showed up in the last
year for yourself and for others. What went well? What could be better? If 2019
felt like a hard year, this is especially important. Giving yourself compassion
for the hardships endured or where things fell short allows you to open the
door to change for the coming year.
Compassion for others: As you grow your
compassion for self, extend this to others.
Get Grounded and Set Intentions: What do
you wish to be different for your New Year? This could look like creating a
mental or physical list of what you want to accomplish or change. Even if you
had a spectacular year, we can always push ourselves!
Get Specific: How will you act on these
intentions?
Seek Support and Connection: We are not
meant to do this all alone. There are people who will support you in your efforts
to create change in your life. Seek these people out and watch the team effort unravel
positive growth.
Appreciation and Gratitude: Studies have
shown that showing gratitude positively effects one’s social and psychological
well-being. Showing your gratitude will also allow your connections to grow.
From all of us at PCS, we wish you a joyful and prosperous New
Year!
Article by Kaitlyn Beckham, BA, Intern
Kaitlyn is a Master of Counseling student at Arizona State University graduating in May 2020. She enjoys working with adults who have experienced trauma, as well as those who struggle with anxiety, depression, relationship issues and self-esteem issues.
Everyone struggles in relationships, especially with their intimate partners. Some people struggle a great deal and can see patterns showing up over and over again in relationship after relationship.
Why is this? What makes relationships so difficult and why do we see the same challenges showing up over and over?
Recent research has looked at relationship difficulties through the lens childhood adversity and asked the question “what is the impact of childhood abuse, neglect, and trauma on our relationships?” No one has a perfect childhood. I thought I did… until I started looking deeper and asking myself hard questions. In all my years at PCS, I am yet to meet someone who emerged from childhood entirely unwounded. And do I see my childhood issues playing out in my marriage? You bet I do!
We have learned a lot in the past 20 years about the lasting impact of adverse childhood experiences (ACEs). The ACE Study, conducted in the late 1990s, startled the medical world by showing conclusively that different forms of childhood trauma, alone or in aggregate, increase the risk of many major mental health and physical health problems—by up to 5 or 10 times (or more!). The study called out specifically the risk associated with ten childhood risk factors: physical abuse, emotional abuse, sexual abuse, emotional neglect, physical neglect, and living in a home with domestic violence, alcohol or drug abuse, depression or mental illness, divorce/separation/death of a parent, or incarceration.
Having any of these risk factors in your childhood was found to raise your risk of physical, emotional, and/or psychological problems later in life. And it doesn’t seem to matter how often bad things happened or how bad they were—it simply doesn’t take much to wound a child. Relatively few of us can claim to have none of these risk factors.
Fortunately, many of us are able to adapt to some forms of abuse and bounce back without much consequence—our resilience can offset the risks. However, having four or more of these factors may exceed a child’s ability to adapt and may interfere with the child’s emotional, psychological, neurological, and physical development and may lead to substantial problems in life.
We now understand that childhood adversity multiplies your risk for developing addiction, chronic depression, suicidality, smoking, IV drug use, domestic violence, criminality, and teenage pregnancy. Childhood abuse, neglect, and trauma also dramatically increase the risk of diabetes, obesity, heart disease, cancer, stroke, sexually transmitted diseases, and premature death. And not surprisingly, they also increase the risk of failure in the workplace and failure in relationships.
So, what is it about childhood adversity that messes with our ability to have happy relationships as an adult? Here the research has been very illuminating as well.
Studies have shown that kids who have been traumatized may grow up to be adults who need to be perfectionistic, having learned that anything less than perfect behavior less brings abuse or neglect. They may be prone to anger–anger that may become a personality trait or lead to domestic violence. They may be sensitive to negative emotions and highly reactive when triggered. They may have an anxious attachment to others– worried about losing important relationships or unwilling to get close in the first place. They may not tolerate stress very well, becoming controlling, aggressive, or shutting down altogether. It is not surprising that these traits would make it difficult to be successful in relationship (just ask my husband!).
Interestingly, research has also shown that people who live through aversive childhoods tend to be more resilient—to have more grit, that is, a better ability to bounce back from difficulties. So curiously, while childhood adversity seems to set us up to have difficulty in our intimate relationships, it also makes us more able to weather and overcome the challenges that we create.
Perhaps we can have a bit more compassion for ourselves and our partners if we remember that the lingering effects of childhood adversity and trauma can cast a shadow over our intimate relationships. While it does not give us an excuse to misbehave, the tough parts of childhood (which we likely had no control over) continue to influence our way of looking at the world and the choices we make, day in and day out.
So, what can we do? Fortunately, there is growing evidence that trauma-informed therapy techniques can help to heal the wounding that happened to us when we were children. Treatments such as EMDR, somatic experiencing, and psychodrama (among many others) can effectively address the pain of childhood neglect, abuse, and adversity. This may allow us to become healthier, happier adults, and thereby pave the way for us to have healthier intimate relationships.
“Participating in a PCS Intensive Treatment Program is an opportunity each of us have longed for, yet avoided. In 8 days and 68 hours your story has time to unfold and be received by a team of compassionate professionals whose primary purpose is to create a safe and equally challenging environment. The treatment process involving 35 hours of individual therapy brings an appreciation and understanding for the journey you have lived, including the detours, and offers the discovery of the journey awaiting you.”
– Dr. Marcus Earle, PCS Clinical Director
How it all begins…The Murray Method
Preparatory Workshop
The preparatory workshop begins your PCS Intensive Treatment Program. Each group member shares their reason for participating in the intensive, is introduced to our treatment model, and begins constructing a few key elements of their treatment process. Once the ice is broken, the workshop facilitator presents a framework from Marilyn’s Murray’s work called the Scindo Syndrome. The presentation sets the stage for much of the work to come, offering a way of understanding how the difficult and disturbing experiences in our early life shapes how we think, feel, and behave. It outlines what we strive for at PCS: to become a Healthy Balanced Person intellectually, spiritually, emotionally and physically. The Scindo Syndrome, along with the Circles of Intimacy, Responsibility, and Impact, provide the foundational scaffolding that the coming work can build. Not only does it help a person organize and understand their own story, but it also illustrates how we are similar to the others in the group (and in the world). This preparatory workshop is where the first homework assignments are given. The assignments include exercises such as the Trauma Egg, Genogram and Scindo Syndrome drawings to encourage clients to explore and identify what has shaped their thoughts, their feelings — their lives. These exercises guide clients to discover what is underneath even if they are uncertain what motivates their behaviors that ultimately led them to PCS.
Concluding Group
The Concluding Workshop on Saturday mornings is the final piece of the intensive program; a space to celebrate the integration of the Healthy Balanced Adult with the client’s Original Feeling Child (the “child” they are at the core). Clients share with one another their strongest “ah-hah” moments of the week, along with their Trauma Eggs, and their “Child” drawings. In their final moment, clients reaffirm their gratitude for the group work and the gains they achieved during their time at PCS.
Not Just Mental Health
As
part of the intake process, Dr. Rick Isenberg completes a comprehensive medical
history to identify significant symptoms and illnesses, along with self-care
practices, substance use, and compulsive behaviors which may impact the
treatment process. Our physical well being is entwined with our emotional
and relational health.
Interestingly, for some, the medical history may even identify symptoms, or ailments that point toward an underlying emotional issue that may be unknown to the client. We look for these clues and follow them backwards to see what we find. We also look for medical conditions that may contribute to the client’s emotional issues (like diabetes, sleep apnea, hypothyroidism) that are either not yet diagnosed, or neglected and need to be treated.
As part of the initial assessment, Dr. Isenberg also reviews the ACE Questionnaire with the client. This tool looks at adverse childhood experiences and allows PCS to help the client put psychological and medical problems in a family/historical perspective. Dr. Isenberg also administers a neurocognitive screening assessment that helps to identify brain skills that may be lagging. It is important to have our brains working at their best, so we provide tools to allow our clients to buff up brain performance. When our brains work better, life is better.
How Your Team is Assembled
After the client has filled out the registration materials for the intensive program, they will be required participate in a phone prescreen session with one of our team members. Not only does the prescreen ensure that PCS will be an appropriate fit for the client, but it also assists in selecting the individual and/or couple’s therapists assigned to each program with the background information provided. Every schedule includes at least one EMDR therapist. However, clients who are coming to work on trauma or other related concerns could find two or three therapists that utilize EMDR in their sessions. We also look at the other therapy modalities that would be beneficial for the client such as SE, CBT, DBT & EFT to help in the process of building a schedule for each individual or couple.
Clients who are interested in the intensive program but are on a strict budget can have the opportunity for interns, as well as licensed associate counselors (LAC) to be assigned to reduce the cost of their program. The advantage of having a large team of over 25 therapists allows flexibility in the selection of a client’s team and provides the ability to choose appropriate lower cost therapists while still receiving the full benefits of the process.
EMDR, SE, EFT, ETC. – What is EMDR?
Eye Movement
Desensitization and Reprocessing (EMDR) is a trauma therapy developed by
psychologist Dr. Francine Shapiro. Dr.
Shapiro made the chance observation that eye movements can reduce the intensity
of disturbing thoughts when she noticed her own stress reactions diminished
when her eyes swept back and forth as she walked through a park.
EMDR involves recalling a stressful past event and “reprogramming” the memory in the light of a positive, self-chosen belief, while using rapid eye movements to facilitate the process. EMDR (Eye Movement Desensitization and Reprocessing) incorporates elements of cognitive-behavioral therapy with bilateral eye movements or other forms of rhythmic, left-right stimulation. One of the key elements of EMDR is “dual stimulation.” During treatment, a person is asked to think or talk about memories, triggers, and painful emotions while simultaneously focusing on his/her therapist’s moving finger or another form of bilateral stimuli. Other forms of external stimuli that may be used in EMDR therapy include bilateral tactile sensations and sounds (e.g. alternating hand taps or a chime that pans back and forth from ear to ear).
How Does EDMR Therapy Work?
At the time
of a traumatic event, strong emotions may interfere with our ability to
completely process the experience and the moment becomes “frozen in time.” Recalling the traumatic event may feel as
though the person is reliving the event all over again because the images,
smells, sounds, and feelings still exist and can be triggered in the
present. When activated, these memories
cause a negative impact on our daily functioning and interfere with the way we
see ourselves and our world, and how we relate to others.
EMDR therapy appears to directly affect the brain by “unfreezing” the traumatic memories, allowing them to be resolved. Over time, the disturbing memory and associated beliefs, feelings, sensations become “digested” or processed until the event is able to be thought about without reliving it. The memory is still available, but it is less upsetting.
The exact mechanism for the effectiveness of EMDR is unknown. It appears that using rapid eye movement relieves the anxiety associated with the trauma so that the original event can be examined for a more detached perspective. This is somewhat like watching a movie of what happened. This enables a person to access positive ways of reframing the original trauma (reprocessing), and to release the body’s stored negative emotional charges around it (desensitization). Some experts have noted that the eye movements during EMDR might be similar to what occurs naturally during dreaming or REM (Rapid Eye Movement) sleep. It may be thought of as a physiologically-based therapy that allows a person to see material in a new and less distressing way. Others believe it reactivates parts of the brain that were “shut down” as a coping mechanism. In this way, cognitive reorganizing takes place, allowing the negative, painful emotions to give way to more resolved, empowered feelings.
What is Somatic Experiencing (SE)?
Somatic Experiencing was
developed by Dr. Peter Levine and is practiced all over the world as an
intervention to resolve trauma. Dr. Levine theorized that trauma is not
necessarily about an event, but about what happens after the event, at the
physiological and biological level. How our nervous system responds, how those
around us respond, how we recall the incident and the ultimate meaning we give
to the experience will determine our chance of resolving trauma in the moment
or increase the likelihood of experiencing PTSD in the future.
SE recognizes that
trauma is a natural part of life. Trauma is not a disease or an anomaly. Its
effects do not mean a life sentence or permanent incapacitation. Instead,
trauma can be viewed as an injury to the autonomic nervous system with the
understanding that our bodies have an innate capacity to return to a regulated
state of being.
SE is a short term,
holistic and naturalistic approach that encourages mastery, empowerment,
self-direction and resiliency. SE focuses on “sensate” or “felt sense” of the body by recognizing and
accessing physical sensations, imagery and motor patterns to renegotiate trauma
through physiological channels of the autonomic nervous system – from brain
stem to limbic system. The body remembers everything even if the brain cannot
access certain experiences and unlike traditional therapies, SE brings sensory
experience to the foreground while supporting thought, feeling and emotion in
the background.
How Does Somatic Experiencing Work?
SE is a body oriented
approach to renegotiate trauma. It involves grounding, orienting, noticing the
felt sense of the body and tracking with curiosity how it experiences
activation and then de-activation. With the support of a trained therapist, we
can touch into the nervous system, mind and body and prepare for a reparative
action. This “pendulation” of pleasant, unpleasant and neutral sensations
increases our range of resiliency and facilitates nervous system regulation. We
enter the “here and now” instead of being stuck in the “there and then.” We
become able to recognize and express instinctive responses to threat. Expanding
a person’s tolerance of bodily sensations facilitates their trust in the body’s
wisdom and capacity to heal itself by uncoupling incomplete and undischarged
bio-electric circuits. Symptoms diminish in strength and frequency when the
cycle of discharge that have been fueling the symptoms of unresolved trauma are
released. Discharge my take the form of flushing, muscle contraction/release,
yawning, deep breathing, sweating, tears as well as other somatic responses.
Humans often thwart the natural mammalian instinct for fight, flight, freeze or collapse because we filter our experiences through the frontal cortex, thereby minimizing our “animal” instinct. For example, if a child cries we often attempt to sooth by telling them “Don’t cry, everything is fine.” This shuts down energetic discharge. Patients often experience shaking coming out of surgery. Instead of allowing an individual to discharge energy caused by a traumatic experience (cutting, being tied down, having a mask over one’s face) they are often given warm blankets or medications to dull the sympathetic nervous system. When individuals fidget, we tell them to stop. We manage to stop energetic discharge throughout our day. Our sedentary lifestyles and cultural beliefs disconnect us from the body. If our natural, self-protective responses are not completed, this energy does not discharge and we are at risk of our nervous system getting “stuck on” or “stuck off.” We may not feel safe in our own bodies and so we “numb” with substance addictions (using alcohol or drugs) or with process addictions (gambling, sex, shopping, work, etc.) By bypassing the thinking brain and accessing the nervous system we can reclaim the body’s ability self-regulate.
Mindfulness
Living Without Awareness = Impulsiveness and Mood Dependent Behaviors.
What is Mindfulness? Mindfulness has been described as “paying attention in a particular way: on purpose, in the present moment, and nonjudgmentally.” Mindfulness is the practice of being completely aware of what you are doing in the moment, when you are doing it. It is you being in control of your mind, instead of your mind being in control of you.
Mindfulness is about: learning to maintain awareness of your mind, body, and surroundings. It is about staying in the present moment and noticing when your mind drifts into the past or future. It is learning to enjoy life in the here and now. Finally, it is about finding and connecting with one’s sense of self. When you are aware of what you are experiencing, you can make the choice to change or accept it, thus decreasing your suffering.
Benefits of Mindfulness: Mindfulness increases awareness. It allows us to be completely connected to our environment, reduce stress, and improve our overall well-being. Studies show that practicing mindfulness can reduce blood pressure, increase the immune system function, relax muscles, improve quality of sleep, and increase focus and concentration.
Why Learn Mindfulness?
Mindfulness skills help you to tolerate distress, that is, tolerating emotions and situations that feel intolerable; riding your intense emotions (urge surfing) rather than doing things to shut them off or distract from them, OR from engaging in self-destructive behaviors.
Mindfulness skills help you to regulate your emotions. The more skilled you are at noticing and identifying your emotions, the better chance you have of being able to adjust their intensity. If you are aware of what you are feeling you can change emotions you want to change, OR you can choose to stay with the feelings, knowing you are in control.
Mindfulness skills help you to be more effective in interpersonal situations. Increased awareness helps you decide when and how to make decisions about dealing with people and setting boundaries and limits, i.e. “asking for what you want” and “saying no”. Maintaining healthy relationships (or ending destructive ones!) requires the ability to be able to connect with your emotions and to be able to keep them in check if you want to.
Relapse Prevention: (e.g. relapse to undesirable mood states–depression, anxiety, anger, etc.–or impulsive/unwanted/self-destructive behaviors). Mindfulness teaches you how to recognize and disengage from emotion mind at times of potential relapse. Inability to do so may result in a downward spiral, and eventually, the onset of relapse. To avoid this, you must be able to disengage from emotion mind, bring in reasonable mind, and find wise mind. This will allow you to process mood related information in ways that are less likely to provoke relapse. Awareness of the patterns of thoughts, feelings, and body sensations that characterize relapse-related mind states is an essential first step in recognizing the need for corrective action.
Nutrition Makes A Difference
Taylor
Aasand, MPH, RDN, our registered dietitian (RDN), conducts nutritional
assessments of the complete diet of clients; including foods, beverages,
supplements and medications that could influence medical status. The
dietitian also takes note for any special dietary patterns, food allergies, and
religious beliefs that affect intake.
The RDN
provides education around the link between nutrition and mental health,
emphasizing that the brain and body must be adequately nourished and hydrated
to do intensive therapy. Some clients benefit from additional
dietary services depending on a medical diagnosis or an eating disorder or
disordered eating history. The client and dietitian work together to
develop a more structured dietary plan for their programming that may include
planned meals, grocery lists, challenging food fears and rules, and body
attunement exercises to help clients meet their individual nutrition
goals.
All this allows PCS to help the team assigned to understand the client more comprehensively and provides additional avenues for intervention. The complete Wellness Assessment allows us to recommend changes in bad habits and lifestyle that may lead to a healthier life, better brain performance, and easier recovery from the addiction, depression, trauma (etc.).
Working Together
We enjoy talking about you. The PCS Intensive Treatment Program is a team approach model. During your intensive over 7 professionals focus their attention on how best to facilitate discovering those issues inhibiting personal and relationship growth. The case manager assigned to you communicates with your primary therapist before, during, and after your program while monitoring treatment process. Through notes, emails, and conversations your individual and group therapists continue to update one another of how best to promote change and growth. The Wednesday staffing offers a unique opportunity for reviewing your process, with you present, by our entire team of over 25 therapists.
To learn more about the PCS Intensive Treatment Program, please contact our office at 480-947-5739 where our Intensive Coordinators can supply more information and start you on the journey to discovering a better you.
It’s 2:00 pm on the hottest day of the year and I am watching the men lay brick in the full sun, building a second story on the building next door. As I watch them labor and sweat, I am reminded, in this Pride Month, that the rights and freedoms I enjoy today—being able to marry the man I love and live openly as a gay man—were built on the backs of a generation of men and women who labored and fought for the right to live without discrimination. I owe a lot to those courageous people, many of whom stood in the Stonewall riots of 50 years ago– many of whose names line the walls of AIDS memorials across the country.
Pride Month is a time to honor the victories and sacrifices of the past and to look forward to the challenges of the future. For this is not an easy time to be LGBTQ in our society. Regressive forces are pushing back. This is a time to rally in support of the rights of the next generation.
PCS stands with the LGBTQ community. We acknowledge the enduring spirit of this community that was once considered a mental illness. We stand against bigotry, conversion therapy, and the denial of transgender rights. We support those who remain closeted out of fear of retribution and those who struggle with their faith. We support those living with HIV/AIDS and those who have lost dear ones to the plague. We stand with those who feel alone, different, bullied, abandoned, and afraid. We help them heal.
At PCS, we affirm the value and uniqueness of every individual and strive to help everyone celebrate and live fully in their authentic selves.
Brick by sweaty brick. This is how we have reached this day and this is how, together as advocates and allies, we will build a future for the next proud generation.
“The essence of recovery is embracing and growing from our mistakes and missteps rather than avoiding pain and discomfort.”
My recovery from sex addiction started when I was 28. I was fortunate to participate in a group my father organized consisting of therapists and clergy. It was during one of these meetings a group member divulged his struggle with sex addiction which prompted me to tell my story, one I had hidden until then. This took place just after joining PCS and may have saved my career. The term sex addiction fit. My behavior felt consuming, my efforts to stop failed, real and potential consequences were not a deterrent, marriage and a loving and compassionate wife did not stop the behavior, and no amount of will power could stop the energy which continued to well up inside of me, leading me to “act out.” I am aware as I write this how inadequate words are to express the churning of guilt, shame, and fear I was experiencing.
I moved into recovery and while the support and therapy helped me stop the behavior it is clear to me now the internal struggle continued to percolate. We had children, immersed ourselves in parenting and building relationships with other families. Business grew at a steady pace, but then exploded as our children reached their teen years. This turned out to be terrible timing, and I began to lose myself in work. It took time, but eventually the stress and disconnect from relationships brought back that which had never fully left and I began acting out again. Thankfully, I eventually summoned the courage to disclose to my wife. Individual and couples therapy resumed, and I reached out for support in ways I had not previously done.
Soon after this Doug Braun-Harvey provided an in-service training for our PCS therapists. I found it resonated with me and began questioning whether labeling myself as a sex addict was a way to hide from some erotic conflict I was uncomfortable facing. His six principles of sexual health proved helpful in my journey. They are:
Consent
Nonexploitation
Protected from STI’s and unintended pregnancy
Honesty
Shared Values
Mutual Pleasure.
I found these principles began to shift my perspective on my sex addiction and created a different internal dialogue which in turn influenced how I shared with others. I embraced a gentler and more compassionate view of self. Around this time I stumbled upon Dr. Daniel Sumrok’s phrase, “Ritualized Compulsive Comfort Seeking.” Dr. Sumrok believes what we label as addiction is a normal childhood response to adverse childhood experiences. This perspective generated another question, had I simply developed a distorted, intimacy blocking relationship with my sexuality born from challenges in my childhood? The answer was clearly yes, but where did this leave the “sex addict?”
Would I discard the term sex addiction, no. Currently, I find it helpful to embrace myself as an addict. Not as a way of negatively labeling or pathologizing myself, but to respect and honor that which comforted me through the challenges of growing up. This ongoing change toward increased self-compassion is progressively shifting how I view my past and present-day choices. Integrating my addiction recovery, trauma work, and the six principles of sexual health serve to broaden my recovery and support a gentler approach to self. I desire to continue affirming, as an adult, I now have choices and resources I could not grasp as a child. I am striving to develop a relationship with my wife which is safe, consensual, nonexploitive, and mutually fulfilling. Recovery is a becoming; I hope you agree.
(480) 947-5739
info@pcsintensive.com
