Pregnancy and Postpartum · Anxiety

Postpartum Anxiety and Feelings of Overwhelm

It may seem that being overwhelmed is just a given. You’re up to your eyeballs in dirty diapers and wet burp clothes. You can’t remember the last time you had more than a few hours of rest. What even is breakfast? You run on a steady stream of coffee and fistfuls of cheerios. When you put this all together, postpartum anxiety (PPA) and feeling overwhelmed seems to be par for the course.

If being overwhelmed or anxious has been your experience for the past few weeks (or months, or years), it is not fair and it’s not okay. It does not have to be like this. Postpartum is not meant to be a painful or miserable time. If you’re struggling with PPA (or similar symptoms), here are some tips to help.

Know the Signs of Postpartum Anxiety

Postpartum mental health gets overlooked because so many of its symptoms are normalised. Unfortunately, because having a new baby comes with lots of questions, PPA can get mistaken as “normal” adjustments to parenthood. Someone out there has claimed it is acceptable that you are this tired and irritable and anxious.

Yes, it’s normal to have questions and worries. This is part of being human, and certainly a part of being a new parent. However, it’s not normal to have these worries keep you up at night, cause conflict with your partner, or make you avoid time with the baby. Anxiety is only considered “normal” when it’s within your capacity to address it (a.k.a. your window of tolerance).

Postpartum anxiety is a genuine illness that requires attention and help. Here are the symptoms to look for:

  • Inability to stop worrying
  • Racing thoughts
  • Difficulty with sleep or appetite
  • Difficulty with focus and concentration
  • Inability to rest or relax
  • Feeling on edge
  • Panic attacks
  • Irritability or rage
  • Physical cues: tightness, tension, dizziness, nausea, hot flashes

One quick way for you to check about the severity of your postpartum anxiety is through the Edinburgh Postpartum Depression Scale. This is a screening tool that is used to identify postpartum mental health struggles (including PPA). Specifically, any score above 12 on this depression scale indicates a high probability of postpartum mood and anxiety disorders.

Three quick grounding techniques

If you’re struggling with overwhelming anxiety, you likely want these feelings to calm down ASAP. Here are three quick grounding techniques that can help reduce the panic and overwhelm.

1. Butterfly Hug

The Butterfly Hug is a popular technique used in Eye Movement Desensitization and Reprocessing (EMDR) to quickly settle your body and mind.

Why it’s helpful:

  • Does not require much thinking: This approach does not need you to think through things calmly. You don’t have to “logic” your way out.
  • Helps your brain process in a unique way: EMDR uses bilateral stimulation to activate both your left and right hemisphere while addressing extreme anxieties, traumatic memories, or distressing events
  • Activates your parasympathetic nervous system (the parts of your brain needed for relaxing)
  • Reduces your cortisol level (a.k.a. your stress hormones)
  • You can use this strategy anywhere. It does not require any “equipment”.
The following video shows the steps of the Butterfly Hug:

2. Temperature Change

The temperature change exercise is a great strategy that comes from Dialectical Behaviour Therapy. This approach triggers the mammalian dive reflex. This reflex occurs when we are submerged in ice cold water. In order to survive, our body is forced to slow down our heart rate and oxygen is only sent to key organs that are needed. Everything that is considered “non-essential” is overlooked.

Why it’s helpful:

  • Tricks your brain: Your body cannot go into “survival mode” and panic at the same time. Your heart rate is forced to slow down. Your oxygen level drops, thereby making it hard to panic.
  • Provides about 5-20 minutes of calmer thinking. This gives you some time to problem solve or find alternative coping strategies.
  • You don’t have to “think through” it to feel calmer.
The following video shows the steps of the Temperature Change technique

3. Mindful conversation with another person

Using distractions is really helpful to get through a distressing moment. However, if you cannot find a distracting enough activity, your mind tends to wander back to its original anxious thoughts. Participating in mindful conversation with another person face to face is more effective in helping you stay out of the overwhelm. Rather than focusing on the anxious thoughts, you’re turning your attention to the other person, asking and answering questions, and staying present.

Why it’s helpful?

  • When your postpartum anxiety is highly activated, your sympathetic and parasympathetic nervous system work overtime. Your body turns to survival strategies like fight, flight, freeze/shut down in order to cope. Social engagement, on the other hand, activates our ventral vagal pathway. This pathway tells our brain that we are in a safe and socially connected space.
  • Focusing on topics outside of your postpartum anxiety helps your system recognize that there are still safe options in your world.
  • Gives you the option to engage with someone else outside of your baby.

Working with your anxiety

So now that you’ve coped more effectively in reducing the anxiety, you may be wondering about your next steps. After all, these earlier coping strategies only resolve things for a short time. They’re not actually fixing the issue, and instead, providing brief respite. This is where the hard work of listening to our anxiety comes into effect. In order for you to gain more clarity, you will need to work with your postpartum anxiety.

Internal Family Systems Therapy (IFS) explains that there is always a positive intention to our worries (even though it rarely feels “positive”). It’s challenging to slow our body and mind down enough to hear what your postpartum anxiety has to say. But, we can break down the steps to better support our mental health.

Step One: Find where your anxiety is in your body.

Daniel Siegel coined the term “name it to tame it”. Basically, when you are able to find the feeling in your body and label it, you can get a bit of space from that feeling. Rather than “being” the emotion, you can observe it. So, call out what and where you are feeling things: “I am feeling scared… There is a ball of anxiety in my chest… my shoulders are feeling tense and stressed.”

Step Two: Stay curious

In this step, you will use a bit of mindfulness to approach your emotions. Now that you’ve noticed the emotion, keep your awareness on this feeling. Be aware of the thoughts, sensations, memories, and whatever else comes to mind as you focus on this feeling.

This step involves staying curious about your anxiety is telling you without judging it, trying to get rid of it, or needing it to change. Your anxiety will start to share more as you stay open to it.

As a word of caution, your anxiety may not share the nicest feedback. It may share beliefs such as: “Get me away from this baby! I can’t do this! What was I thinking? I need this to stop!” Stay aware of these thoughts so long as you are within your window of tolerance.

Step Three: Understand what your anxiety is trying to protect

IFS recognizes that our anxious parts are trying to help out in some way or form. Because they tend to communicate in harsh and overwhelming ways, it’s often difficult to understand what our anxieties are trying to achieve.

As you complete step one and two, you will start to identify what your anxiety is telling you. Then, ask yourself, what would happen if these anxious thoughts stopped? What is your anxiety trying to prevent? For example, if your anxiety is often saying, “Get me away from this baby”, what would happen if this warning was no longer present? You might presume that you’d be calmer. While that’s true, what else would happen? Would you suddenly be considered calm enough that others encourage you to parent independently? Would you spend more time with your newborn and make a mistake? What if your baby keeps screaming and you’re reminded that you’re not cut out for this whole parenting thing?

Sometimes your anxiety gets triggered, and it forces you to escape the circumstances. Your brain says, “This is too much, I can’t cope,” and you turn towards avoidance, drinking, zoning out in front of your phone or some other strategy. I’m not saying that these are effective ways to manage things. In all likelihood, this form of “self-soothing” will create new problems. But, as far as your anxiety is concerned, it is satisfied that it has reduced your distress and gotten you away from the “danger” (e.g. time alone with baby).

Step Four: Befriending

Have you seen “Beauty and the Beast”? The Beast is known for being a lousy character. He’s rude, ill-tempered, and scary. But, we see that meeting the Beast with compassion (mixed with assertive boundaries) helps him shift out into a kinder character. (For those who are cringing reading this example, humour me. It’s an analogy. I’m not trying to condone Stockholm syndrome).

In many ways, your anxiety is like the Beast. It’s loud, frightening and has awful manners. However, what happens when you approach your anxiety with compassion or confidence? Have you ever shown any desire to get to know this part of you? What happens when you acknowledge what your anxiety is actually trying to do? Imagine what it would be like to approach your anxiety by saying: “I get it… I get that you’re really scared of me making a mistake… I know this feels like the only way you can help me.” How would it respond to you?

Becoming kinder to yourself

IFS brings in a different level of self-compassion. We are not only meeting our inner system with kindness, but we’re also identifying what our anxious parts are attempting to achieve. When we treat ourselves in this manner, our anxieties will soften. These steps don’t cure postpartum anxiety. We have to address the actual issue, whether it’s the fear of making mistakes, feeling insecure about parenting, or addressing our own childhood traumas. But, meeting our anxiety in this way will reduce the overwhelm.

Curious to learn more?

Postpartum anxiety is treatable. If you found the above examples helpful in reducing your overwhelm, please let me know. If you have any questions about the above steps, or want to work with your own unique circumstances, reach out.

Kasi Shan, MSW, RSW
Kasi Shan, MSW, RSW

Kasi Shan Therapy is located in Kitchener, Ontario. She offers in-person and online appointments supporting individuals with struggling with trauma and perinatal mental health.

Mental Health

The fear of abandonment: Why am I trying so hard?

Does the fear of abandonment push you to act in undesirable ways? How often do you jump through hoops to suit another person? Do you feel a constant pressure to do more and be more so that others are not upset with you?

To cope with these fears, you may have learned to keep your guard up. Rather than acknowledge your humanness, you may try and hide inabilities or flaws. By demonstrating only these “acceptable behaviours”, you have managed to stay safe. This way, others will not walk away, be upset or disappointed with you.

Sound familiar?

The need for connection

I hope the above words do not cause shame or embarrassment. I am writing them to emphasize the commonality of this experience. Many of us fear being alone. This is normal. In its own complicated way, the fear of abandonment is meant to be helpful. To be human is to want connection. From an evolutionary standpoint, those who had community, had more resources and support.

“We humans are social beings. We come into the world as the result of others’ actions. We survive here in dependence on others. Whether we like or not, there is hardly a moment of our lives when we do not benefit from others’ activities. For this reason, it is hardly surprising that most of our happiness arises in the context of our relationships with others.

Dalai Lama

Understanding the roots of our fear:

The fear of abandonment does not come out of nowhere. It is a learned survival mechanism that comes after experiencing some form of hardship. I want you to consider how your own history. How did your experiences influence having this fear? The following questions can help you explore further:

  • Grief and Loss: Have you lost an important person in your life growing up? Did this experience cause you to worry about others leaving you?
  • Learned messages from parents: What were the rules growing up? What did your parents require of you? What behaviours did they praise and what did they reprimand? How did your parents respond to your successes versus failures? Did your parents’ love feel unconditional?
  • Learned messages from culture and society: What was idealized in the media? What were the rules that your parents followed, and then, asked as of you? If you witnessed others rebel outside of these standards, how were they treated?
  • Friendships: What messages did you pick up from your friends about fitting in? What caused fights? Did you experience rejection from peer groups? How did this come about? What did you do to “repair” the relationships?
  • Romantic relationships: How did your romantic partners treat you? What did your partner expect in a relationship? How did you handle things when the relationship ended? What happened when you set boundaries? Were your words respected or were they questioned?

Managing the fear of abandonment:

If you’ve ever struggled with the above scenarios, chances are that your system learned to protect itself with some careful strategies. There are two common protective patterns that show up to manage this fear of abandonment. The first strategy is to work incredibly hard to meet the expectations of others. These folks tend to:

  • Predict what will make others happy
  • Be hyper-alert about verbal and non-verbal cues (tone of voice, facial expressions, comments, etc)
  • Feel triggered by negative feedback because they fear it means others no longer like you.
  • Focus on people-pleasing tendencies to maintain peace
  • Say “yes” often (despite it feeling uncomfortable with their boundaries)

The second protective pattern that arises is the urge to stop trying all together. After all, if something scares you, why put yourself in that situation? These folks often appear dismissive. They may spend a lot of time alone. They prefer not to rely on others, or avoid getting close to someone. They fear that these actions will put them in a vulnerable place where they get attached to another person, and this person could have the power to hurt them.

What do I do?

fear of abandonment. Fear of being alone. How to address.

Working hard to meet others’ expectations is a form of coping. You don’t have to face the fear of abandonment so long as you follow these expectations. Staying isolated or avoiding any close relationship is a form of coping. You will not deal with rejection so long as you never get to a place of vulnerability.
At the end of the day, coping strategies are meant for short-term relief. They address the anxiety in that moment, but they do actually fix the core issue. Unfortunately, the fear is still there. So what else can you do? The following options can lead you to more long-lasting relief:

1. Seeking therapy to address the underlying wound.

If you have survived hardships like the loss of a parent, bullying, or abusive relationships, these are not small issues. Your system has experienced rejection and loneliness. It learned to cope in the safest way it knew at the time. Trauma approaches like EMDR and Internal Family Systems Therapy are wonderful strategies to help address the root causes for the fear of abandonment. Your system can feel less fearful once these underlying wounds have been healed.

2. Assess if your relationships are healthy.

This is obviously easier said than done. There is a lot of grief and stress in acknowledging unhealthy relationships. However, I want you to consider what may happen if you did not comply with someone else’s expectations. Will they abandon you? Is their love truly unconditional? Sometimes we need to break away from our unhealthy attachments to make space for new healthy relationships.

3. Is there truth to your fears?

Sometimes are our thoughts are just thoughts. They don’t have a lot of evidence behind them, but the fear alone drives us to stay complacent. If it is safe, talk to the other person and ask how they’re feeling. Clarify what you’re seeing or hearing, and ask about the other’s intentions. You may perceive a look or comment to mean abandonment, whereas the other person has zero intention of ending the relationship.

4. Take small steps to trust.

For those who are fearful of committing to a relationship, consider what feels like a safe starting place. You may not be ready to let your colleagues know about your deepest secrets, but you may feel more comfortable sharing how your weekend went, or discussing a difficult work project. In this situation, exposure therapy may be helpful in creating a shift.

5. Slow down

In similarity with exposure therapy, I encourage you to take a step back from the “do more, be more” approach. What happens when you don’t work so hard? What happens when you make small mistakes? I know this option isn’t easy, and I suggest you take the smallest step manageable in creating this change. It’s important for your system to be cautious and monitor how change is perceived. You may surprise yourself in seeing that a) others do not leave when you show your human side, or b) you start to step away from these difficult relationships.

Learn More

If you’d like to learn more about your own system, or you’d like to address fears of abandonment, reach out.

Kasi Shan, MSW, RSW
Kasi Shan, MSW, RSW

Kasi Shan Therapy is located in Kitchener, Ontario. She offers in-person and online appointments supporting individuals with struggling with trauma and perinatal mental health.

Trauma

Considering trauma therapy? How to tell if EMDR is right for you

If you have been searching for trauma therapy, chances are that you have come across the term “EMDR”. While there are many types of therapy that can address trauma, EMDR has become well known in the counselling world as being an excellent and fast option for processing difficult life events. But how do you know if EMDR is right for you? I hope this post will provide you more clarity and answers.

What is EMDR?

What is EMDR and how do I know if EMDR is right for me?

EMDR stands for Eye Movement Desensitization and Reprocessing. Many clients come to counselling expecting a traditional talk therapy session. They may expect to share lots of details about their lives, and have the therapist ask stereotypical questions like, “How does that make you feel?” EMDR is not at all like this.

EMDR involves the use of bilateral stimulation (BLS) to process traumatic events. BLS is a fancy way of saying that a therapist will be adding some visual, auditory or tactile prompts during therapy. For example, you may be asked to follow a ball moving across the screen or listen to audio prompts. A shift starts to occur when you combine these sensory inputs while also thinking of a traumatic event. The understanding from EMDR creator, Francine Shapiro, is that this combination activates an adaptive neural network in your brain. What we see is that EMDR clients feel calmer when they think about these disturbing situations. To learn more about what an EMDR session is like, I’d encourage you to read this earlier post or watch the following video:

Why use EMDR?

EMDR has been proven to work quickly in processing disturbing events. This is especially the case for those who have survived a single traumatic event (as opposed to complex trauma where a person has survived years of distressing circumstances). This therapy can be used irrespective of when the trauma occurred, be it yesterday or 50 years ago. EMDR has been effective in meeting the needs of diverse clientele regardless of age, race, gender and other identifiers. Beyond past events, this therapy can also help clients work through fears of a similar trauma happening again in the future.

How to tell when EMDR is working:

For clients who have had success with EMDR, they will notice several indicators to healing:

How do I know when EMDR is working?
  • Clients can speak and think about these traumatic events more calmly
  • Clients notice a change in their thinking pattern. Negative beliefs are transformed into more compassionate and positive perspectives. For example, a client who initially believed “I should have done more” may shift into thinking,”I did the best I could.”
  • Clients notice improvements of PTSD symptoms (e.g. intrusive thoughts, flashbacks, nightmares, anxieties, hypersensitivity).
  • Clients’ physical pains starts to ease. They can speak about the trauma without feeling tense, clenching their muscles, or experiencing other signs of constriction.

What prevents EMDR from working?

While all of this sounds great, there are some factors that can affect whether EMDR is right for you. As with any therapy, there is no guarantee that one approach will be the miracle cure. While EMDR has a high success rate, the following points should be considered:

1. Readiness:

Before starting EMDR, clients have to be open to addressing a painful part of their lives. While this may sound obvious, I want to emphasize how incredibly hard it is to sit with memories and thoughts that you have worked to avoid. Avoidance is a natural way to manage anxiety. If we find something frightening, we protect ourselves by staying away. As with any form of therapy, readiness involves taking the chance to stop avoiding in order to address these fears. This is much easier said than done.

2. Learning to work within our window of tolerance:

For EMDR to be the right approach for you, your therapist has to ensure that you are prepared. The goal of this therapy is to process disturbing events without overwhelming you. This means being able to think about these events without feeling emotionally hijacked. The point of EMDR is not to relive the trauma, but to recognize you are in a place of safety while thinking of a difficult past experience.

IS EMDR right for me? Trauma counselling online and in Kitchener, ON

If you go beyond your window of tolerance, the work will not feel safe. Your therapist will be monitoring how quickly or slowly to take trauma processing based on your emotional state. There may be pauses in treatment to help calm your system (e.g. deep breathing, relaxation exercises, calming visualizations, distress tolerance skills, etc). You may spend several sessions focusing on these calming skills before beginning BLS. This does not necessarily mean that EMDR cannot be used; however, there may be a delay in starting trauma processing.

3. Complexity:

Complex trauma and complex mental health (e.g. personality disorders, addiction) can take time to heal. Even with a fast approach like EMDR, clients may spend many months or years working through painful memories. You may have to spend a significant amount of time addressing these other mental health needs before starting to work through traumatic events. This does not mean that EMDR therapy is not helping; however, clients must be patient to work through these additional needs.

4. Current life stressors:

Is EMDR right for me? Learn about this form of trauma therapy

Are there current life stressors that are getting in the way? It is hard to focus on a past trauma if you are thinking about current financial struggles, work demands, or a recent arguments with your partner. When life feels unsafe or stressful, you may have a hard time focusing on the past. It is understandable that current needs keep distracting you. In these types of situations, you may need to pause EMDR, and address what changes need to occur today to help life feel more stable.

5. Fear of recovery:

This is a difficult point to make because the majority of people want to get better and the title insinuates that a person is avoiding healing. That is not my intent. There are a lot of changes that will happen in your life because of recovery. This may include embracing new routines after years of living a certain way. It may involve returning to work where there are old triggers and difficulties waiting. Perhaps recovery involves acknowledging that your parents were not kind or well-intentioned people. There is an understandable fear of what recovery might mean for a survivor, and those fears need to be supported and addressed prior to opening old wounds.

Is EMDR still right for me?

Trauma is a fact of life. It does not, however, have to be a life sentence. Not only can trauma be healed but with appropriate guidance and support, it can be transformative.

Peter Levine

While the concerns mentioned above may influence your therapy journey, EMDR can still be the right approach for you. It is best to speak with your therapist about these influences in order to problem solve. The solution may be to do EMDR in a slower manner to prevent overwhelm. Alternatively, your therapist may use a combination of other therapy styles (e.g. Internal Family Systems therapy, DBT) to address other mental health needs alongside trauma healing.

Traumatic events happen to every individual, and we cannot prevent it from taking place, unfortunately. While some recover on their own, many of us experience lasting symptoms from traumatic events. If you continue to be plagued by a traumatic event, reach out for support. EMDR may be the therapy you are looking for.

All the best,

Kasi

Kasi Shan, MSW, RSW
Kasi Shan, MSW, RSW

Kasi Shan Therapy is located in Kitchener, Ontario. She offers in-person and online appointments supporting individuals with struggling with trauma and perinatal mental health.

Trauma

Should I be concerned about PTSD?

If you have survived a traumatic experience, it’s natural that you are feeling worried about how to proceed. You may have many concerns running through your mind: How long will I feel this way? Am I supposed to seek treatment? Is it normal for me to feel like this? Whether it’s an unsettling birth experience, a difficult pregnancy, a sexual assault, or any other traumatic event, we are left feeling vulnerable and distressed. This post is for anyone concerned about experiencing posttraumatic stress disorder (PTSD). I hope the following information will provide you some clarity and empower you to seek the support that best meets your needs.

What is PTSD?

PTSD is a mental health diagnosis that occurs after an individual has survived or witnessed a traumatic event. What qualifies as a traumatic event differs for every individual. Whatever the circumstance, the individual experiences a significant threat to their physical, emotional or psychological safety, or the safety of a loved one. The situation is so distressing , that the person feels unable to cope.

In working with prenatal and postpartum parents, I see a lot of caregivers who have experienced trauma in the following circumstances:

Is it PTSD? What to do about trauma. Kasi Shan Therapy: counselling in Kitchener, ON
  • Prenatal Loss: e.g. stillbirths, miscarriages, unsuccessful IVF treatment
  • Unplanned pregnancies and abortions
  • Domestic violence, affairs, or marital separation
  • Pregnancy complications: e.g. infections, preeclampsia
  • Early labor or NICU visits
  • Unexpected health complications: e.g. positive screening for trisomy 21 or 18, car accidents

Not every traumatic experience leads to PTSD. There are many components that can influence your healing. Having resiliency factors (e.g. coping strategies, support from loved ones) can greatly improve how you process and move forward from this experience. Having a relatively safe life and limited trauma prior to this event can help us trust that the world is a safe place once again.

Depending on whether the traumatic event was a one time incident (e.g. mugging) versus a repeated event (e.g. ongoing civil war) can impact your healing. When it’s a one time event, our system is better able to see the situation as an anomaly. When there are repeated infractions, we struggle to see the world as a safe and predictable place, and there is increased risk for PTSD.

During a traumatic event:

PTSD versus trauma. what to do after a traumatic event. how to recover from trauma. Kasi Shan therapy: online counselling. Kitchener, Ontario

During a traumatic situation, our survival system kicks in automatically. We are outside of our window of tolerance because this event was unexpected, and our nervous system is experiencing a threat to our well-being. Without conscious effort, our traumatized mind shifts to a state of flight, fight or freeze. We try and escape the situation as quickly as possible, or we try and attack and fight our way forward. If neither option works, we fall into a state of shock or freeze response. When safety is returned, most of us can calm down. However, for traumatized individuals, it’s like their mind is still hooked in that place of danger, and they continue to respond in a flight, fight or freeze manner.

Symptoms of Trauma

A traumatized individual will show symptoms such as:

What should I do about trauma? Being aware of PTSD. Kasi Shan Therapy. Online therapy. Counselling in Kitchener,  Ontario
  • Hypervigilance: a need to assess for constant threat. This involves a high degree of alertness for anything related to the disturbing event.
  • Reliving the traumatic event: e.g. through flashbacks, memories, dreams or intrusive thoughts
  • Avoiding reminders of the disturbing event: this can involve avoiding even the most basic connection. For example, a mother with birth trauma may avoid going to hospitals or visiting medical professionals. She may refuse to talk about her birth experience or listen to others’ birth stories. In the hardest of scenarios, she may avoid any interactions with her newborn.
  • Increase in negative thoughts and feelings: e.g. numbness, guilt, shame, anxiety, irritability, hopelessness. The traumatized person often feels the world is unsafe or unfair. He or she may be cautious about trusting others.
  • Hyperarousal: Feeling on edge, jittery, difficulty relaxing
  • Dissociation or impaired memory recall: In some cases, the individual may forget parts of the trauma, or have blocked out this entire event.

Usually, we experience these symptoms right after a traumatic event; however, some individuals have a delayed onset.

When is it “normal” and when is it PTSD?

Posttraumatic stress disorder. What does it mean, and how do you get help? Kasi Shan Therapy. Online support. Kitchener, ON

The majority of us have survived a traumatic situation. In the beginning, we feel jittery, hyperalert, and avoidant. This is normal. There are parts of our system that are scared of a similar event happening again. In order to ensure safety, these parts will assess for danger and remain hypervigilant of repeat offences. During this time, you will likely experience a lot of distress. However, trauma symptoms tend to dissipate on their own within a month without any major influence. Short-term therapies, medication, and support from loved ones are effective tools that can help with this transition.

In order to have a diagnosis of PTSD, you must experience continue to experience trauma symptoms a month after the traumatic event. These symptoms may last for months or years following, and they cause significant impairment in the person’s daily life and relationships. If you are concerned about experiencing, PTSD, you can take the Posttraumatic Stress Disorder Checklist (PCL-5) as a self-assessment. Any scores approaching 40 warrant a conversation with your family doctor or a mental health professional.

What can I do if I still feel traumatized after a month?

I encourage you to seek therapy as soon as you feel ready to process the traumatic event. While counselling is not meant to be triggering, it can be hard to revisit a difficult memory. If you feel too overwhelmed to even think about the traumatic incident, your system may benefit from extra support to manage this anxiety first. This may involve medication, or specific counselling strategies focusing on distress management.

There are many different counselling approaches that can be used to process traumatic events. Some well known options include: include cognitive processing therapy, sensorimotor psychotherapy and narrative therapies. The following three options are services that can be provided via Kasi Shan Therapy.

Eye movement Desensitization and Reprocessing (EMDR)

EMDR. Eye movement desensitization and reprocessing. treating traumatic events. Kasi Shan Therapy. Counselling in Kitchener, ON and online.

EMDR is a powerful approach that divides a traumatic experience into smaller, manageable chunks to slowly process each part of the incident. Typically, the work starts with either the first or worst part of the memory, depending on what feels manageable for you. In EMDR therapy, we use a process called bilateral stimulation to help process traumatic memories (learn more about how EMDR works). IN EMDR, with each passing of bilateral stimulation, the traumatized individual starts to feel some distance from the traumatic event. The event feels less personal, and there is a continued lowering of distress level. An individual quickly moves from negative beliefs and high distress to more positive beliefs about themselves, less fear when thinking of the memory, and calmness in the body.

EMDR does not require you to go into specifics of a traumatic event. Instead, clients can express barebone details aloud while still making sense of a unpredictable and nonsensical event. This can feel helpful for those who are not ready to speak about the traumatic event in detail as of yet. In fact, for those who do get stuck in the narrative of a traumatic event, your therapist will keep checking that you are properly processing a memory versus getting retriggered.

Cognitive therapies and prolonged exposure

When it comes to traumatic events, we form negative beliefs about ourselves and about the world. Cognitive therapies help us challenge these beliefs by assessing their validity. We look at whether our assumptions about the world, others, and ourselves are fair and consistent. The therapist and client works to start formulating more neutral or balanced thoughts.

In addition, many therapists will encourage clients to practice in some form of exposure therapy. With trauma, there is a lot of avoidance of the traumatic event. Prolonged exposure involves slowly approaching the activities or individuals that remind us of the traumatic event. This is done at a gradual pace in order to not overwhelm the system, and to help build confidence in our capacity to manage distress and test out problematic beliefs.

Internal Family Systems Therapy (IFS)

internal family systems therapy. IFS and trauma.

IFS recognizes that our system can become divided following a traumatic event. There are parts of us that carry the wound of a traumatic event. We often bury or push this part away from our awareness. These exiled parts typically carry a lot of shame, guilt, fear or overwhelm. Because they are so overwhelming, we have other protective parts that compensate. We have proactive parts that prevent us from triggering these wounds. We also have reactive parts that respond when we are triggered trying to manage the intensity of these exiled emotions.

For example, following a miscarriage, we may have an exiled part of us that believes we are responsible for the pregnancy not lasting. Because this is such a painful burden to carry, we may have proactive parts that do not let us get pregnant again, cancel IVF appointments, or push fights with our partner to prevent intimacy. If another miscarriage occurs, we may have reactive parts that become extremely angry at ourselves or our partners. This part may lash out through verbal attacks, or may cause physical harm onto our own bodies in order to deal with the pain.

In using IFS to treat trauma, we have to work with all parts of your system. Rather than diving straight into addressing the wound, we work with these protective layers first. We focus on building trust and safety with these protective parts. When they have relaxed, we then start to work with the core traumatic wound.

Reach Out

You may notice signs of healing within the first month, and not require additional support. However, if it’s been longer than a month and you continue to express traumatic symptoms, interventions can be helpful. Trauma and PTSD do not have to be a life sentence, and there are ways to help your recovery. If you or a loved one is struggling after a traumatic experience, reach out.

Take care,

Kasi

Kasi Shan, MSW, RSW
Kasi Shan, MSW, RSW

Kasi Shan Therapy is located in Kitchener, Ontario. She offers in-person and online appointments supporting individuals with struggling with trauma and perinatal mental health.

Trauma

What is EMDR therapy and how does it help my PTSD?

It’s frustrating when you’ve been to therapy for many years and no amount of talking has truly helped you recover from traumatic events. While I practice CBT, DBT and other forms of traditional talk therapy, I have shifted my practice to focus heavily on EMDR to help process difficult memories that seem “stuck”. EMDR therapy, a.k.a. Eye Movement Desensitization and Reprocessing, is highly effective in working through single traumatic events as well as long-term distress (e.g. childhood trauma, bullying, anxiety, depression). In fact, the EMDR International Association boasts that single-event traumatic experiences can be resolved within 3 sessions.

What is EMDR therapy and how does it treat PTSD?

Why can’t I get over it on my own?

During traumatic experiences, your brain is focused solely on survival. It’s not paying attention to nuances. Instead, it is trying to gather just enough information so that it can make a fast decision on how to keep you safe. During this quick processing, your brain stores traumatic information poorly. Rather than processing the event and filing it away as completed and safe, your compromised mind does not communicate properly with the parts of your brain in charge of the flight/fright/freeze responses. Unfortunately, these traumatic memories then get stored with the same emotional duress and physical sensations that took place during the event. Therefore, years later, when we become triggered, we experience the same emotions and physical states that we did during the time of the traumatic event. Because these memories are poorly stored in our brain, it also struggles to make connections with new or positive experiences.

what is emdr therapy and how does it help

EMDR therapy believes that your brain is able to recover from traumatic experiences; however, there are certain blocks that prevent this natural healing from taking place. Consider how your body works to heal a cut on your hand. You don’t have to address the wound; your body will naturally try to heal this wound on its own irrespective of your interventions. However, if there is repeated irritations to the wound, it becomes difficult for the cut to heal quickly or effectively. Your brain works in similar ways to your body. It is capable of healing from trauma; but, if there are repeated afflictions (e.g. negative beliefs stemming from that memory), it makes it harder for your brain to recover. Once these afflictions are addressed, your recovery can take place.

How does it work?

I have to preface that EMDR feels incredibly bizarre at first! If you are used to traditional talk therapy, EMDR will feel a tad surreal. During therapy, your EMDR therapist will ask you to review the traumatic memory in a very unique way. You will be asked to focus on one specific moment within your traumatic memory, and rate the level of distress you experience when you think of this moment. Your therapist will then support you in understanding the negative beliefs you now hold because of this memory. Afterwards, your therapist will ask you to think about the image while also having you pay attention to an object that is moving back and forth (a.k.a. bilateral stimulation). Bilateral stimulation is the distinctive factor in EMDR. It involves getting both your verbal and non-verbal (left and right-hemispheres of your brain) to be activated while addressing a traumatic memory. Bilateral stimulation can be done in various ways like back and forth eye movement, audio cues, or hand-held pulsers.

What does EMDR feel like?

During the time that the bilateral stimulation happens, your mind will wander (and your clinician will encourage this!). Your mind will start to create all sorts of connections stemming from that original memory. You may think of other memories, beliefs, images, emotions, etc. With bilateral stimulation, your brain is making connections between that original memory and it’s impact on other events in your life. Therefore, it’s creating new neural networks in your brain, shifting your original beliefs about that memory. Depending on where your mind wanders, your EMDR therapist will guide you in between sets of bilateral stimulate to choose the next aspect of the memory to focus on, thereby helping the processing move forward.

EMDR can help people of all ages

Why does it work?

There are several theories as to why the bilateral stimulation is so effective in processing traumatic memories. Some believe that it is due to your working memory being taxed because you’re focusing on the traumatic memory and the bilateral stimulation at the same time. Others have argued that it is because the bilateral stimulation is similar to rapid eye movement during sleep, which is a primary time when you process and store information in your brain.

“EMDR Therapy changes maladaptive neural networks by connecting the traumatic memory with new information. The distressing thoughts and emotions are blended with new positive thoughts and emotions; embodied awareness allows frozen sensations in the body to resolve through healing movements.”

Arielle Schwartz

How else is EMDR different from other therapies?

If the thought of using bilateral stimulation hasn’t made this therapy look unique enough, there are a few other details that may help.

  • EMDR does not require a lot of talking about the difficult memory. Truly, the work is happening in your mind, and your brain is working hard to remove all of the afflicted connections from the original memory. You do not have to explain lengthy details to your therapist, if you are not comfortable.
  • Your therapist will be fairly silent during bilateral stimulation. This builds on the above point that the work is happening internally when you process a traumatic memory in combination with bilateral stimulation.
  • There is a lot of specific ‘resourcing’ exercises used to support your nervous system prior to starting trauma processing. Everyone feels vulnerable when it comes to addressing traumatic memories. To do the work safely, a lot of time can be spent to ensure that you feel safe and confident prior to starting the work.
  • There are no homework assigned. Don’t worry, if you love homework in therapy, we can figure something out! However, the primary focus of the work happens in session.
  • There are no arguments or time spent convincing you about changing your beliefs, thoughts or emotions. Instead, we acknowledge the negative belief that this traumatic memory has fostered, and we let the bilateral stimulation do the work. There is no time spent on thought records, or trying to look at the evidence for or against beliefs.
Here’s a quick video to summarize EMDR

After learning all of this information about EMDR, what questions do you have about this counselling approach? I’m happy to chat about EMDR, and how it may best serve your needs. Please reach out for a free consult to see if EMDR may be a good fit for you.

Cheers,
Kasi