Doing TIR Online: Can I Really Treat my Trauma with Teletherapy?

 

          

You may be thinking that treating trauma with Traumatic Incident Reduction (TIR) is too intense to do with someone through a screen, and that it may not be doable. So you would rather wait till the pandemic is over, or just not do it.

Except that your life and your issues are happening now, regardless of what is going on in the outside world.

You really would rather see someone in person, in their office.  This is understandable, and it’s ok to acknowledge that this is what you want.  As with anything involving human connection, there are pros to doing TIR in person.  You meet with your facilitator in their workspace, which is a contained environment away from your daily working and living space.  You both share that physical space in the time that you are working through your distress.

But right now, there are still health risks to meeting in-person with someone outside of your home, so most practitioners and viewers are needing to prioritize safety and do sessions online.  For many of us, that’s been a sudden and significant change in how we work together.  I had always been an “old school” practitioner myself until COVID hit, and then I knew I had to adapt to this new reality. Was this going to work?  I didn’t know.

One year out, I have some good news.  Since March of 2020, I have been facilitating TIR sessions only online.  People viewing with me have reported that through our work, they have been feeling relief, less stress, and being more present in their lives, even during the pandemic.  Most of them have never met me “in person”, but they still work successfully with me.  And there are pros to online sessions. One big pro is not having to take time or effort to travel to a physical office. Also, people with mobility and/or chronic health issues can meet with facilitators with greater ease.  So yes, you can work through your issues, even treating trauma, with online sessions. You just need to do a few things to prepare for this work.

Set up a comfortable, private, distraction-free place to do your work.

The environment you choose will not just be private, but distraction-free.  So beyond just a door that closes and locks, if needed, think about what might be a distraction:  A partner or other family member working in the office next door?  Small children that could come knocking in the middle of your session?  Construction going on in the apartment next door?

You do what you can, of course, but it is important to consider how your environment might affect your ability to open up and focus on the session.  It can feel awkward to talk about conflicts and emotions you are having about your partner or other family members when they are in the room next door.  They may not be snooping on purpose, but you may still be concerned about what they hear.   And with trauma treatment, this focus is especially important. TIR sessions are often more intense and focused than “typical” talk therapy. These qualities help make it effective in relieving your symptoms, but they also make the need for a distraction-free environment more crucial.

So if this means putting a “white-noise” machine outside your door [such as a fan] or having someone else on “childcare duty” during your session, it may truly be worth it so that this cuts down on distractions. You may even feel more comfortable doing sessions from your car or a closet.   That’s fine with me, and it is likely ok with your facilitator.  The fewer distractions you have in your environment, the more you can engage and benefit from the session.

Make sure that you have a good internet connection.

I use a secure, encrypted portal for viewing.  Avoid using social media platforms like apps related to Facebook, Instagram, and such because at the time of this writing, they are generally not private or secure.  I do need to see your face, and you need to see mine.  Even if you close your eyes during your session, your face and mine need to be in visual range.

Note:  If you have visual impairment, it is still important that I can see you. A phone connection alone isn’t ideal. With TIR, a facilitator needs to be able to observe more than just your voice – they observe what is going on in your face and even your body. So please stay in visual range, at least with your face.

If something distracts you from your viewing, it’s not the end of the world. I have heard kids yell, family members knock on doors, and dogs barking. Just like with in-person sessions, a distraction may occur. You handle it as you need to and then continue the session.

Occasionally, you might lose the internet connection for whatever reason. Bad weather or a downed server can do this.  When this happens with my viewers, we just reconnect and pick up where we left off.  If the internet connection does not improve within a few minutes, it’s a good idea to reschedule the session for a later time or another day. The more stable your internet connection is (grounded, WiFi or cellular/smart phone), the fewer interruptions you will have.  Also, I ask folks to kindly park their device, whether it is an iPad, iPhone or Laptop, on a stable surface, even if it is a book or a shelf. It’s far easier to focus on you and the session if I am not getting dizzy, after all.

So things may happen.  The best approach is to prepare for things that could be an ongoing or frequent distraction from their viewing.  Dogs barking in the background don’t bother me if they don’t bother you.  A kid knocking on your door every five minutes, asking for you, is going to be more of a distraction that needs planning in the form of a sitter or responsible older person.  It’s good self-care to build your session in as your time “away”, just as though you would for a work meeting.  And please choose the helping person carefully. Someone you’ve been living with is preferable from a health standpoint, but if it needs to be someone outside your home, do what feels necessary for you and your co-habitating people to be safe these days.

Take a minute (or two, or five), to transition to your TIR space.

Once you step into your “therapeutic space”, close the door. Take a minute to just breathe deeply.

Get comfortable.

Find a good position, an easy chair, even your bed. Get a cushion if you need to.  Avoid standing, because that can get uncomfortable and distract you from your viewing, especially if you experience an intense body response. Doing a session online often means your body and head are facing in one direction more than would be the case when you are meeting with someone in-person. If you have been meeting with colleagues and friends through Zoom this past year, you already know about the eye- and body-strain that can happen. Fortunately, with TIR, you don’t have to be quite so formal as to be sitting straight up in a desk chair and  you can look anywhere you want to.

Try to designate one or two areas in your physical environment for your sessions. This can help you transition your mind and body into “TIR mode” more easily. You may even want to put up a soothing picture or object nearby to help ground you in this space.

Ok, I have my distraction-free environment. Now what?

You and your facilitator are ready for session. It usually only feels awkward in the first few minutes of the first few sessions, but that sensation will likely fade as you begin your viewing session.  My viewers and I can usually get right into the sessions pretty smoothly.

Is it really worth doing all this? Why don’t I just wait till I can go in person?

You may be tempted to hold off on doing this.  If you have a situation wherein having a private and distraction-free environment is impossible, yes, you may need to hold-off until you can see someone in person. If you are in an abusive or unsafe situation, or you don’t have a stable internet connection, online sessions may be a no-go.  But only if that is truly the case, would I recommend that.

If it is difficult but doable, then you may want to go ahead with TIR. Because you have been living with this trauma and the effects that it has on you, and you don’t have to do that anymore.  In fact, it’s part of self-care to do this work and get relief and resolution.  No matter where you do this work, whether or not there is a pandemic, your life is happening now.  When you can relieve the effects of traumatic incidents, you can live more fully in the present and participate in your life, and with the people who are important to you, in a better way than you do when you are carrying this burden around. That’s true whether you are home or out and about.

You may have heard that self-care is like filling your gas tank. If your gas tank is nearly empty, it’s hard to drive yourself where you need to go, much less anyone else.  This work helps you fill your gas tank.

So the bottom line is, yes, Traumatic Incident Reduction works, and it even works online.

You can take this step for yourself and for people you care about, right now. So I wish you well as you start this process. May your benefits be excellent!

 

 

It’s So Easy to Stay Mad: When You’re So Done With Everything.

When you’re so done with everything.

These days, it’s so easy to get mad, and stay that way.
I was just thinking this after an intense Labor Day weekend. Most of it was fun.    My family and I went hiking to forest preserves and biking around town. Hints of Fall are creeping in, with shadows getting longer and a slight chill in the air in the morning and at dusk.
The weather is getting more tolerable, now that it’s a wee bit cooler. The Pumpkin Spice Latte and those good caramel drinks are back at the coffee places.  
School is on again . In Northern Virginia, kids are mostly going online.  We’re six months into the pandemic and it’s getting old.
Opinions differ on what we should do, how much we should worry, when and how to go back to work and socializing.  Sometimes, we get unsolicited opinions and advice, and we feel invaded or judged.  And, well, tensions build. I was driving down my street on the way home yesterday and passed a neighbor’s house. The guy outside turned toward my car, looked at me, and gestured with his hands flat, pushing downward. I waved at him. A minute later, I realized what he was signaling. It looked like his gesture meant, “slow down”.
And I got VERY annoyed. After I pulled my car into the driveway, I had an urge to storm over there on foot and start lecturing him about who does he think he is, telling me to slow down, when he and his family and friends are always out there without masks, but of course it’s all about them, etc. Words to that effect.
I’m glad I didn’t actually do it. But I did envision it. In that moment I was aware of my anger, accepted it, sat with it for a minute…But thankfully, I didn’t act on it.
So maybe he was being annoying. And maybe I was driving a bit fast for our relatively quiet street. It didn’t hurt me to slow down.  But, still.
 Do you feel sometimes that your moods are swinging more?  Like even if you are overall doing well, having a good day, but then something happens, your mood takes a nose dive? If so, you’re not alone.  Whatever life concerns we already had have been exacerbated by working at home (that is, if our jobs and school even allow us to do that) and being with our families or roommates almost constantly. We are saving lives and health, but it’s hardly ideal for our kids to be learning remotely. And to top it off, it’s an Election Year. Not exactly things that contribute to calm and cool living.
It’s understandable that you feel on edge.
There’s a whole lot of stuff to be charged up about.
So what can you do?

The things you read about with unplugging from news and social media?  They really help. The internet can be a double-edged sword. Right now, we are relying more on these outlets for resources, work, and social connection. But they can also be hotbeds for angry discourse and hurtful statements.  The psychologist

Brene Brown

 once aptly referred to the “comments” section of something she posted,  “the cesspool.”

I find that if I spend too much time scrolling through social media and news, my mood starts to tank. So, its really important to limit screen time and keeping interactions this side of civil. I have a better day if some chunk of it is spent in 3-D.

Here’s a good adage that helps me when it comes to potentially tense interactions: 

Is it kind, necessary, or true?

 

It should ideally be at least 2 out of these 3 things if you engage with someone.  I don’t know who said it. I just find it helpful.  
In the moment, I could really have let off steam by snapping at my neighbor. I could maybe have said things that were true (at least from my point of view), but they wouldn’t have been kind or necessary. And there are times when these folks have done me good turns.  It’s been years since we’ve chatted, but that counts for something.
And even if they hadn’t….What would I have added?
I haven’t always responded mindfully. None of us are perfect, and we get mad and let it out sometimes. The issue is, is it getting to be your modus operandi? Does it help?
But pushing your feelings down only helps for so long. So, what do you do with them? They are still there. They came from somewhere, and they can still take up time and energy.

As I’ve discussed on my videos, it always helps to just step back and observe your thoughts and feelings. 

Tara Brach

describes a nifty process to work through difficult feelings with a technique called R.A.I.N. 

We need to first know what’s there, before we can work on it.  This can be true of just about anything that is causing you anger, hurt or pain.    And sometimes, we want to talk to someone. The main thing is, even now, you don’t have to go at it alone or bottle it up.    
But you also want to talk to someone who won’t judge you. You want to let it out, but be understood. You want change.
This is where therapy can help. Especially if you find yourself with thoughts and feelings that are so powerful that they are getting in the way of your functioning, and they make it that much harder to be in the present. I’m especially big on the kind of work that I am doing, LSR and TIR. We start with what is charged for YOU. It might be something recent, or something from long ago. If your attention is on it, it’s important.
I don’t challenge your viewpoint. I help you look at the stuff that is charged in a way that will bring you relief and resolution. I believe in this method, not only because I’ve been trained in it, but I’ve been on the receiving end of it, too, and I can tell you that it works. It has helped me.
Sometimes, we just get plain tired of pushing things down that are charged. It costs us. We need to work through these things, but in a way that helps. This work gives you an opportunity to bring it up and look at it in a contained, guided way, so you get relief without all the fallout and kickback that can happen of we just react in daily life.
And this can lead to a better, more self-aware existence.   Yes, even during a pandemic and an Election Year!  To me, that’s totally worth it.

What can you do?

Call me

I’ll give you a free, 10-minute consultation.  If we decide to go ahead and schedule, we”ll  work together to bring you relief and resolution for a better quality of life.

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“Sometimes, we want to talk to someone. The main thing is, even now, you don’t have to go at it alone or bottle it up.”

 

Wouldn’t therapy be worth it?

 

 

 

If therapy could…

-help you feel less anxious, more calm

-add a supportive, non-judgmental person to your life

-help you get help with a trying life situation

-and, most importantly, give you tools for you to make some positive changes in your life

So that…

Instead of walking around feeling overwhelmed, alone, rudderless, you can feel calmer, supported, and focused on the here and now…

Wouldn’t it be worth it?

 


I’ve never heard anyone say they regretted doing therapy.

So you’ve been thinking about a particular issue, person, or big life change that may be on the horizon.  It’s weighing on you, occupying your mind, making you question yourself and your decisions.  You are thinking, you could use some help, maybe in the way of therapy, but you’re not sure therapy is the way to go.  Here are some reasons people say they are reluctant:

“I can’t afford therapy.”

Is that what you are thinking?  Most of us have spent money, time, and energy this Holiday season, or at many points throughout the year.  Understandably, you are trying to be watchful of your budget.

If the Holidays were fun and meaningful for you, I’m truly glad. Even if they were, maybe old issues, difficult relationships, or memories resurfaced with one or more people.  Maybe you used tips from my November blog post to get through the holidays, or other techniques to help you get through the tense times.

Maybe a big transition just happened or is on the horizon.  Job change, concerns about a friend, partner or relative?  You are worried about it, and it would really help to talk about it, but you aren’t sure these are concerns you want to lay out with someone in your personal life.

Maybe you did talk to friends, and it helped to get their support.  That’s something! But you may still be confused and this issue is hanging over you. You really don’t have huge amounts of time or energy. So for now, you are just hanging on, going with the flow and seeing what happens.  That can work  — for a while.

But sometimes it is MORE costly to put therapy on the back burner.  Namely, in quality of life and in the frustrating things that never seem to change, so that you lose sleep, or feel irritable, less energetic to deal with what needs dealing with.  This is especially true of trauma and severe stress. We actually spend more energy trying to “push down” our strong feelings. Or, they come out in a way that is not helpful, like temper outbursts, body/headaches, chronic distraction.

If therapy could help you feel less anxious, add a supportive, non-judgmental person to your life, get some ideas for help, and, most importantly, give you tools for you to make some positive changes in your life, so that instead of walking around feeling overwhelmed, alone, having no idea how to proceed, you can feel more calm, mindful, supported, and focused on what you need these days…Wouldn’t it be worth it?

“I’m super busy.  Who has time?”

It’s true.  You, like so many people, have work, parents, kids, school, and any number of responsibilities. 

You may want to try a person close to your home or work (or other place that you frequent often).  I typically see clients once weekly, but may see someone more frequently than that for trauma sessions.  It’s best to find someone close to your comings and goings. I’m in the City of Fairfax, Virginia, not far from George Mason University.

Pick a date and time with your therapist and make it part of a weekly routine. This will actually make it easier to stick with it.  Look at this as part of your “healthcare” routine and as something necessary you are doing for yourself.  And by the way, you send a very good strong message to your loved ones when they see that you are making this time for something important to you and that you stay with it.

For those of you who travel a lot or have health issues that make traveling difficult, teletherapy might be the way to go.  I don’t offer that at this time, but it is out there.  I’d rather you get the help you need and be honest with you about where to get it.

If your schedule needs to change, by the way, discuss this with your therapist. Most of us know that can happen. We try to work with you on this.

“I’ve done therapy.   I already know what my problems are. There are some things I just can’t change, and they are in the past, so I really don’t want to talk about them.”

I am not offering a “magic wand” that will make all your problems go away.  (And if anyone is doing that, they are not being straightforward with you, especially if there is a complex or ongoing life situation like a chronic illness in a loved one, chronic workplace upheaval, and such.  These things happen and I get that they don’t magically disappear.)   But I DO offer methods that will help you deal with these problems in a way that is calm and proactive, instead of dealing with them being terrified and reactive.  And those things that happened and are in the past?  The trauma therapy I do works on changing the memory, so that it does not affect you the same way.  It works.

Imagine having a game plan or a shift in your attitude in dealing with a person in your life who has often caused you stress or worry. Imagine how that would change things.  Instead of feeling like a powerless, out-of-control person, you will begin to feel more centered, deserving of good treatment and respect. (Respect is not fear, by the way.  Many people are in therapy because important people in their lives have confused these concepts.)  And when we believe we are worthy, things often begin to change.

So as you start out into the New Year, bearing the colder temperatures and looking ahead, think about the issues you would like help with.  If you read through this article all the way to this point, odds are, you are seriously considering therapy.  You know what it’s like not to do it. Maybe it’s time to try something different.

When you feel ready, call.

“Why can’t I get over this?” – When Trauma therapy Can Help

Happy September! 

Labor Day was yesterday, and summer is, for all intents and purposes, over.

You can feel the transition in the air. School has started, traffic is heavier, and the vibe is…well, stressful.

Yet, this can mean positives, too:  The weather is a wee bit easier to bear, especially for those of us in the DMV area, making it less of a chore to go out and about.  The structure of school gives many kids structure and purpose, so parents have some welcome relief from trying to plan activities all summer. 

And at work, Fall can be a time when projects that have been in the works come to fruition. Such has been the case for me:  After a few months of planning, I am officially practicing at a new location, The Growth and Recovery Center.  This is quite a transition.  The new location is ADA accessible, so there are elevators and accessible restrooms.  Beyond just the physical space, the psychological change opened up channels for my practice, and my goal is to share my “growth process” as a clinician.

I am especially interested in trauma and how it affects us. Most of us are familiar with the concept, and we often think of trauma as resulting from a big, obviously terrible event.  No doubt, this is often true:  If you survived or were in a war, an act of violence, or assault, you may very well be suffering from symptoms of Post Traumatic Stress Disorder (PTSD).  But there are less obvious, more hidden forms of trauma.  It may have been bullying in your childhood, a betrayal you witnessed or experienced.  As Sydney the psychiatrist from M*A*S*H said, “It’s the little battlefields….The ponds, the bedrooms, the schoolyards…That can leave the worst scars.” 

The big question is, what do we do with it?  Well, talk therapy can be a good start.  You’d be surprised at how healing it can be to have someone listen to you.  I do this, but I do this in a slightly more structured way than you may be used to, if you have had more conventional talk therapies.  I still want to form a therapeutic relationship with you, of course. Yet I do this with something called Life Stress Reduction Therapy.  I’ll look at what is worrying or upsetting you together with you, no matter how big or small your issue is.  

Okay, so let’s say you have done conventional therapy and it did you some good. That is excellent. But some things that have happened either recently or ‘way back when, you just always have tucked away in the back of your mind.  Here are some “red flag” thoughts with trauma:

Or, “I know rationally this person/thing/situation can’t hurt me anymore.   I still don’t believe it.  It doesn’t help when people tell me that.  I still have nightmares or get anxious out of nowhere. I feel so stuck.”

“I am so tired of feeling awful about this thing that happened so long ago/last year/last month, so it feels stupid.  Maybe it wasn’t really that bad.  I want to move on with my life and get it out of my head. Why can’t I just do that?”

I’ll tell you why.  It seems like it’s just in your head, but the thing is, it’s in a deep part of your brain, and probably, in your body, too.  Trauma is stored in the deep, fight/flight/freeze part of your brain, and it affects your nervous system.  As Besser Van Der Kolk said, “The body keeps the score”. And  although you don’t realize it, you are probably spending a lot of emotional and even physical energy trying to “push down” these strong reactions, just to get through your day.  Understandable.  But maybe it’s time to do something else.

So you may want to consider targeted trauma treatment for this kind of thing, even if you think it’s stupid.  If you are in or around Northern Virginia, know that I and other practitioners do this therapy in the form of TIR (Traumatic Incident Recovery). What is hard about trauma therapy is that we will view the traumatic event. I know you don’t want to do that.  That feels intense, hard. But we will do it in a structured, safe way, so that you begin experiencing it differently and not feel so “pulled down” by it.  Plus (and here’s what I love about TIR specifically, and trauma therapy generally), I am not going to be telling you MY opinions, reactions, or interpretations about YOUR trauma.  I will be present, I will guide, but I will do it with YOUR stuff.  

It is worth doing, whether the issue is that you were yelled at when you were three, 10, 20 or 50 years old, or whether you experienced an assault of some kind.  The point is, it’s still often there.  If it bugs you, it’s worth looking at.

Many of you who have mustered up the courage or trust enough to talk to others a bit about your trauma know that you have heard things that were meant well, but are just not helpful:  “Don’t think about it”, “God doesn’t give you more than you can handle”, or “It’s over! Let it go.”  If anything, these statements activated your anxiety or feelings of isolation even more.  You felt like a freak because the thing was still affecting you.  Or, those responses may have made you not want to deal with sharing the trauma more with people who just didn’t get it.

I get that.  And during a TIR session, I’m not going to do that.  I will work with what does come up, instead of trying to push it down.  That way you “discharge the dynamite”, rather than push it down.

So, as you transition into this Autumn state of mind, think about what might be on your mind and emotions that you might want to work through in therapy, whether it is a current stressor, or a past one.