“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
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.
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.
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.
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.
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).
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.
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.
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.
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.
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.
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.).
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.
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