Today, more and more people are turning to the internet to get the help they need to cope with anxiety, depression and stress issues, and for help in healing the deep and painful traumatic memories associated with PTSD. With the advent of Skype video conferencing it is now possible to see a therapist online. It feels like we are in the same room, but it is very much more convenient for you, the client.
The advantages of online therapy for PTSD through Skype:
- Convenience. You can schedule a therapy session when it suits you, and there is no time spent in commuting to a therapist’s office.
- Anonymity. You may prefer to select a therapist who is not associated with your local community or place of work.
- Geographical isolation. You may simply not have access to the right kind of therapist where you live. This is particularly the case if you are living, or stationed abroad.
- Sense of self-empowerment. Online clients feel much more in charge of their recovery process.
- Less intimidating. You feel more comfortable calling from a familiar location such as your home.
- Online clients are more likely to continue their course of therapy and reach a successful outcome for all of the above reasons.
What is Post-traumatic Stress Disorder?
Post-traumatic stress disorder (PTSD) can be defined as recurrent episodes of intense anxiety and panic attacks triggered by memories of a past trauma. A trauma in this context is an experience that is overwhelming at both the sensory and emotional levels to such an extent that the mind cannot process and assimilate the experience. The trauma, which is the combination of both the intense sensory memory along with associated emotional energy, becomes repressed as an emotional complex, only to reoccur in the future when the appropriate sensory triggers are activated. The basic direction in psychotherapy is, therefore, to help the client re-process and re-assimilate both the sensory and emotional memory.
Post-traumatic Stress Disorder (PTSD) first came to the attention of doctors during the First World War when relatively large numbers of soldiers returned from combat exhibiting intense emotional distress in which they seemed to re-live the terrifying events of war long after the event.
Veterans should visit the National Center for PTSD to learn more about the symptoms and treatment of PTSD.
Emotional Abuse Therapy
However, war is only one context in which PTSD arises. Later, it became clear that this phenomenon of delayed emotional reactivity could result from many other contexts such as accidents and illness, physical assault, rape or witnessing acts of violence and devastation, natural or man-made. Childhood abuse is now recognized as one of the major sources of PTSD.
In general PTSD can be defined as severe recurrent emotional anxiety reactions that originate from an intense and traumatic experience. A trauma occurs when there is a combination of sensory and emotional overload that cannot be processed and integrated into the psyche.
A war scenario provides many intense visual, auditory and contextual stimuli that are completely foreign to the average person, as does sexual abuse, rape or witnessing a car accident. Context plays a very important part as in the case of childhood abuse, where the child’s model of how his parents should behave cannot be reconciled with the parent’s actual behavior.
The experience of intense fear that accompanies trauma becomes encoded into the internal memory imprint of the associated sensory experiences. The unprocessed sensory experiences and associated emotional reactivity become submerged and repressed in the subconscious mind as a core emotional complex. When the appropriate stressors are present or when the suppressive activities of the ego are weakened, as is the case during sleep this repressed emotional complex is activated leading to a repeat experience of the emotional trauma, often with the associated visual imagery in the form of flashbacks.
Like other core emotional complexes, the repression is never complete and negative emotional energy leaks into present experience leading to general anxiety, phobias, recurrent anger, sleep difficulties, depression, obsessive-compulsive behaviors and substance abuse. These can be described as the layers of secondary reactivity that form around the primary trauma reaction and which, in their own way, shield the core emotional complex from further processing and integration by the psyche.
The most familiar form of PTSD is seen in returning veterans who have experienced traumatic events, death and injury and the senseless madness and chaos of war.
It is extremely difficult to process such memories and the intense emotions that are associated with such intense memory images. Similar violence-related PTSD is often experienced by fire fighters, police, ambulance personnel and other emergence responders, including medical doctors.
PTSD can occur after the trauma of sexual abuse or rape. This seldom gets the same level of attention as combat-related PTSD, but it can be equally devastating, and the number of abuse-related PTSD victims is very high indeed.
A third form of PTSD receives even less attention: The trauma of giving birth, or the aftermath of a major operation, or the loss of a relative or dear friend. As with all PTSD, the central problem revolves around very intense sensory and emotional imagery that the mind cannot process and digest.
An Outline of Online Therapy for PTSD
Today, more and more people are turning to the internet to get the help they need to cope with anxiety, depression and stress issues, and for help in healing the deep and painful traumatic memories associated with PTSD. With the advent of Skype video conferencing it is now possible to see a therapist online. It feels like we are in the same room, but it is very much more convenient for you, the client. I find the Skype option to be equally effective as in-person sessions, and online therapy sessions might even be slightly more effective, because clients feel more relaxed calling from the comfort of their home.
The approach I use to help people recover from PTSD is called Mindfulness Therapy, which is remarkably effective for most people and works extremely well for the Skype session format.
There are two fundamental areas that you will need to work on for full recovery from post traumatic stress. The first is to resolve the primary traumatic memories, and the second is to resolve your emotional reactions to those memories.
Mindfulness Therapy provides us with very effective ways of changing the internal imagery, which is essential for the successful reprocessing of the traumatic experience and for resolving emotions such as guilt, anger, denial, depression and fear that develop as reactions to the memory.
There is now a growing body of evidence supporting the finding that Mindfulness Therapy works for PTSD (http://health.usnews.com/health-news/articles/2015/08/04/mindfulness-therapy-might-help-ease-ptsd). Mindfulness Therapy allows you to completely transform your relationship with traumatic memories and emotions.
Changing Traumatic Imagery Essential for PTSD Recovery
The actual experience of a traumatic event generates very intense stimulation at both the sensory and emotional levels. The mind finds it very difficult to process this and literally experiences sensory and emotional overload. The intense emotional energy of the event remains unresolved in the mind and creates equally intense internal memory images These inner images are what keep the trauma alive causing the common flash-backs and obsessive reactive thinking associated with PTSD.
In order to recover from PTSD you need to change the structure of these internal memory images; change the imagery and you change the intensity of the associates emotional reactions.
During Mindfulness Therapy you learn how to look into the structure of the traumatic imagery. You begin to discover what makes the imagery so powerful and so emotional. Typical structural properties that are associated with traumatic imagery are SIZE, POSITION and COLOR INTENSITY. There are many more, but these will serve as an example, and you can investigate this for yourself.
In order for an image to be intensely emotional it MUST appear large and close. If your memory is a “distant memory” the imagery will probably appear small and far away in your inner mind and will have little emotional effect, but if the inner image is close and large then it is far more likely to be intense and literally “overpowering.” If we find this to be the case for our traumatic images, then we we can change its size and position, moving the image further away and making it smaller. This is entirely possible, and the only reason why we remain stuck with the unresolved emotional trauma is because we normally not aware of this inner imagery. Mindfulness is a penetrating awareness tool that allows us to look and see into the structure of the imagery to see how it works. What we see we can change as described above.
Color intensity is another sensory property that you can experiment on changing. Memories that are neutral usually have neutral colors; intense emotions are structured around intensely colored imagery. When we become aware of this imagery we can experiment changing the colors and “turning down” the intensity of the imagery.
Using mindfulness to investigate the structure of our emotions in this way we can begin to take charge of how we feel and through making subtle changes in the imagery we can begin to facilitate the inner resolution of the experience so that it becomes manageable. Then we can begin the process of cultivating a caring and compassionate relationship with those parts of ourselves that has been so traumatized and hurt.
Building Inner Compassion
Mindfulness is all about building relationships internally (or externally). The hurt parts of our self needs our friendship and compassion, those parts of our self need us to build a compassionate presence with them in exactly the same way that you would do with a comrade or a friend in need or a hurt child. You already know how to do this externally; mindfulness teaches you how to do this internally as well, where it is so needed.
In order for pain to heal you must establish conscious and compassionate PRESENCE with that pain; learning to hold it in your awareness like a mother holds her baby in her arms.
This well-tested principle as, of course, at the heart of all religions and is something that the Buddha emphasized in great detail in his teachings. Mindfulness has an extraordinary healing power (mindfulness=awareness+compassion) that is often likened to the power of sunlight to warm and melt a block of ice, releasing it back into its fluid state as water. When you shine mindfulness on emotional suffering it melts in much the same way, becoming fluid again, which allows it to transform and heal.
Mindfulness Therapy for PTSD
In the words of one client,
“Before starting sessions with Peter, I was struggling with PTSD, just barely getting by, constantly living in fear of my memories. Peter helped me understand that its not the content of your experience that matters, so much as your relationship with it. He showed me how to healthfully work with my experiences and change my relationships with them for the better. Now I have that understanding that I can use to skillfully, and compassionately embrace each new experience for the rest of my life.”
One approach, which I have found particularly helpful, is a form of psychotherapy that combines mindfulness and experiential imagery, in what I call Mindfulness Meditation Therapy (MMT) or just Mindfulness Therapy, which is available online through Skype sessions. In this approach, the client is guided to form a unique relationship with the felt-sense of the emotional trauma. The felt-sense can be defined as the general feeling tone of the experience, which is quite distinct from the complex structure of an emotional reaction and does not involve thinking, but rather sensing.
Mindfulness describes a particular quality of conscious relationship with an experience, which is open and accepting. Mindfulness is being completely present with whatever is being experienced as an interested observer eager, to investigate and learn. Mindfulness is the absence of reactivity, either in the form of identification with the story line of our experience, or aversion to what we are experiencing. These qualities are invaluable in psychotherapy, because they allow the client to investigate the deep structure of his trauma, rather than staying stuck at the superficial surface structure. If we do become reactive, or start identifying with an emotion, then mindfulness also teaches us to recognize what is happening so that we can stop the reaction in its tracks and return the primary relationship of mindful-observation. Mindfulness has both active and receptive aspects, and both are needed. When both are functioning, then the individual is able to establish a dynamic relationship with his inner memories and emotions, and this mindfulness-based relationship creates a highly transformational therapeutic space.
Transform the core emotions through mindfulness of inner imagery
When one begins to investigate the internal structure of a traumatic memory, it is surprising to discover the wealth of subtle feelings that lie just under the surface. Differentiation of the feeling structure of an emotion like anxiety or panic is an essential part of any successful therapy, and the conscious experience of this inner structure is transformational. This is one of the key effects of mindful-awareness: we see more, and experience more, which allows the repressed emotional complex to surface into consciousness for re-processing and re-integration.
In addition to feelings, traumatic memories also have a specific internal structure in the form of intense experiential imagery. This imagery may be photographic in quality, revealing the actual memory of a traumatic event, but more often the memory-imagery has been processed post trauma, and takes on a more abstract structure with considerable symbolic meaning. This experiential imagery has an internal structure in the form of specific colors, shape and size, and often occupies a specific position in the inner visual field. Emotional energy is encoded in each of these specific sub-modalities of position, form, size, color, texture and movement. An intense emotion is likely to be encoded in intense colors, such as red and yellow, and the imagery is likely to be large and close-up in the person’s inner visual field, whereas neutral emotions are encoded in neutral colors, such as grey or white, and appear small and distant.
After the client becomes aware of this inner experiential imagery, he can begin to investigate what changes need to happen in the imagery that allow the emotion to be transform and resolve. Mindfulness helps this transformational process by creating a safe therapeutic space in which there is no interference from the ego, or judgemental mind. The client begins to discover intuitive changes that can be very subtle and beyond rational deduction, but are clearly felt to make a difference. It is also worth noting that as the client begins to see the specific details of his traumatic imagery, he is actually better able to maintain a relationship with the trauma, without becoming overwhelmed. This may seem counter-intuitive, but it is always what we don’t see that causes most mischief, and part of what sustains PTSD is the inability of the client to see the details of his inner imagery. The total experience is overwhelming, but the experience of its parts is not, and the more detail he can see, the less reactive he will become. The fear of the unknown is our worst enemy, and mindfulness is the process of making the unknown known, by paying close attention and investigating what arises.
Therapy for Physical, Sexual and Emotional Abuse
“I was amazed at the dramatic difference in my life after only a few sessions with Dr. Strong. I didn’t think it was possible to have daily relief from my PTSD. Although the process is very simple, you have to work diligently every day. I feel optimistic and hopeful now about my mental health.” – Karina, Atlanta, GA
One female client came to me to work on recurrent anxiety and fearfulness that formed part of her PTSD to the childhood sexual abuse inflicted by her father. When she focused mindfulness on the felt-sense of anxiety, it took a very specific position in her lower throat. With continued mindful-investigation, she became aware of a very clear image of a tightly wound tangle of prickly string, and this imagery that seemed to resonate very strongly with the feeling. When asked what needed to happen next, which is a question that is frequently asked by the therapist during mindfulness work, the tight ball clearly needed to untangle. She spent several minutes investigating how this might happen. At one point, she burst out with rage at what had been done to her, and it became clear that the unwinding ball of string had symbolic meaning and facilitated the release of all this repressed emotional energy. The imagery continued to unfold in many subtle ways, and during this process she discovered a new sense of inner strength and empowerment that allowed her to move significantly towards the completion and re-integration of these traumatic memories. Over the following weeks, she continued to work with unwinding the tangled ball in her throat, and each time she discovered more inner strength and more freedom from this traumatic episode in her past. Strand by strand, the ball unwound and eventually the trauma became just a bad memory that could be put to rest.
One could spend many hours trying to interpret and understand this imagery, but what was much more important, was her direct experience of the resolution process at the subtle and concrete level of her own experiential imagery, and this is made possible by mindfulness. The psyche thinks in pictures, not words, and experiential imagery is the natural language of the psyche. When we make this content conscious, the psyche uses imagery to heal itself. It is not what we do that matters, but how well we listen, with an open mind and open heart.
Throughout the whole process of Mindfulness Therapy for PTSD, the client is repeatedly exposed to the source of his or her fear, but in new ways that don’t involve being overwhelmed or becoming emotionally reactive. This exposure desensitization effect is regarded by most schools of psychotherapy as an essential part of overcoming PTSD, and Mindfulness Therapy provides a very subtle and specific way of doing this through the client’s internal experiential imagery. The imagery helps clients form new ways of relating to their traumatic memories and emotions that promotes transformation, resolution and healing from the inside out.
Online Treatment Therapy for PTSD
Online Counseling is Effective, Convenient and Affordable
Please contact me to learn more about Mindfulness Therapy for PTSD. This approach can be very effective for managing intense emotions and patterns of negative reactive thinking by teaching you how to relate to your emotions without becoming overwhelmed. This is the necessary condition in which healing can occur. I will teach you how to reprocess traumatic memories and imagery and give you the tools to reduce the intensity of your emotional reactions, anger, anxiety and depression.
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