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Treatment for Trauma and Adverse Life Experiences
Traumatic and Adverse Life Experiences

Experts who study and treat the negative effects of trauma distinguish between “big T” and “small t” trauma. “Big T” trauma includes experiences that would be traumatic for almost anyone, such as military combat, serious accidents, rape, battering, child abuse, and natural disasters. “Small t” traumas (also called “adverse life experiences” by Drs. Felitti, Anda and colleagues (1998) in the well-known Adverse Childhood Experiences studies, or “developmentally-disruptive experiences”, by Maureen Kitchur, (2001, 2005) typically involve what appear on the surface to be negative though small life experiences that however, have lingering effects that may create symptoms; these can include for example, bullying, personal betrayals, loss of close attachments and public humiliation.
Traumatic and developmentally disruptive experiences, unlike minor upsets, get “stuck in the nervous system” and can continue to produce symptoms for decades. Both types of trauma are surprisingly common and both can cause problems, especially when trauma is intense, repeated, cumulative, and/or occurs during childhood.
Traumatic and developmentally disruptive experiences are surprisingly common. With good support and benign life circumstances, many such experiences can be surmounted, with no lingering after-effects. However, in the absence of positive resources at the time these experiences occur, both can result in a wide range of problems, symptoms and disorders, including PTSD, complex PTSD, phobias, and trauma-based anxiety and depressive disorders, as well as many medical and health problems. (Surprisingly, research is showing that “small t” traumas are no less likely to produce PTSD and medical problems than “big T” trauma.) Both can produce PTSD – a condition marked by periods of chronic emotional numbing, detachment and avoidance of reminders of the experience alternating with intrusive elements of the experience, such as intense negative feelings and sensations, flashbacks and/or nightmares, all in the context of chronically increased arousal, such as sleep problems, being easily startled or being hypervigilant.
Some individuals know that they suffer from PTSD and hope treatment can provide relief from prolonged and painful symptoms. Others may experience many of the symptoms, but be unaware of the condition and its connection to past traumatic experiences.


Treatment for Trauma & Adverse Experiences

I have specialized in treating trauma for over 30 years. In 1983, I published an article on the persisting negative effects of child sexual abuse – the first in the professional literature to establish that these children suffer from the same syndrome – PTSD – as do combat veterans.  (My credentials about treating trauma can be seen in “About Dr. Gelinas”.)
General psychotherapy can only rarely resolve trauma-based problems. We now know that therapy for trauma needs to address unresolved traumatic material directly – what’s “stuck in the nervous system” – for treatment to be successful. I provide therapy for trauma that directly treats an individual’s traumatic experiences, using a phase-oriented treatment approach (the consensually accepted standard-of-care for trauma among trauma specialists). This involves three phases:
1.    Stabilization of functioning and reduction of symptoms;
2.    Processing of traumatic material;
3.    Rehabilitation of the self in the world.
Within that framework, I design an individualized treatment plan for each client.
In the first phase, I ask clients why they are seeking treatment, and what they want to accomplish. Comprehensive assessment usually takes three sessions, at the end of which I provide my clinical findings and treatment recommendations, including what therapy would probably entail. At this point, the client and I decide whether to embark on treatment together. If so, we begin stabilization (i.e. symptom reduction, self-soothing skills, managing current difficulties, and preparation for working with traumatic memories). The methods, timing, and pace of direct trauma work need to balance the degree of traumatization with the client’s resources for engaging in such work. My work integrates several clinical models including psychodynamic and EMDR approaches, as well as specialized approaches for structural dissociation when that is part of a client’s clinical picture.  EMDR – a valuable clinical tool for stabilization, rapid symptomatic improvement, and resolution of traumatic memories – may be used in any or all of the three phases, depending upon the client. (See “EMDR”.)
With the treatment that is right for them, individuals can and do recover from the effects of their past negative experiences and re-claim their lives and themselves.