Having a Trauma Lens: Why Multifocals are Essential
Now the word ‘trauma’ is in such common usage, it is even more crucial for therapists to be able to differentiate between different types of trauma, and non-traumatic experiences. As Tracy Jarvis, trauma specialist and director of Psychotherapy Excellence, suggests, a ‘multifocal’ trauma lens can help us track the key categories and choose the right therapeutic path.
Nowadays it seems that the effects of trauma are everywhere. You just have to turn to Twitter to see some sort of re-enactment being played out between global leaders. Listen to the news and there is another mass shooting or terrorist attack.
Thanks to neuroscience, we are beginning to understand the impact of abuse, neglect and other traumatic and adverse experiences on individuals, families and communities; that of epigenetics, maladaptive behaviours and stress on the nervous system.
Without doubt, maladaptive behaviours and stress on the nervous system show up in our clinics daily. You’ll notice this in client symptoms such as hypervigilance, pain, anxiety, sleep problems and depression, not to mention the plethora of DSM diagnoses.
Tracking the impact of epigenetics in clinic is a little harder. Epigenetics is the ability for genes to be turned on and off and expressed differently through changes in environment and behaviour over time. Put simply, it is how stress and trauma can be transmitted biologically across generations. Epigenetics now gives us greater understanding into transgenerational trauma.
These developing neuroscientific understandings can, and should, be used to ensure we are working effectively with trauma in therapy. Many organisations are now trauma-informed, from the military to schools and businesses. But can all mental health professionals say that we are trauma responsive?
Firstly, it is important to understand what trauma is, and what trauma is not (which I will elaborate on in my next blog). We need to know the difference between trauma and adverse experiences, because in trauma treatment we work with these types of experiences differently.
So when clients present to us, we need to view their history and issues through what I call a multifocal lens. This enables us to track for three key categories of experience, which Pat Ogden, the Founder of Sensorimotor Psychotherapy, describes as:
1. Trauma related tendencies These are related to overwhelming experiences that cannot be integrated, and typically elicit sub-cortical animal defensive mechanisms and dysregulated affect.
2. Maladaptive attachment-related tendencies These stem from non-traumatic experiences with early childhood caregivers – experiences that cause emotional distress, but do not overwhelm the individual.
3. Relational trauma This ensues when the above experiences are overwhelming or perceived as dangerous, such that animal defensive tendencies are employed.
I’d like to add in a fourth category: which is adaptable adverse experiences (Jarvis, 2019). These present as standard therapy issues, such as strict or judgemental parenting, non-traumatic bullying, identity, relationship or money issues, to name a few.
As you can see from the above, if you are working with trauma clients without being specifically trauma trained, you might be doing more harm than healing. It is therefore ethically and critically important that all mental health professionals be trauma trained, in both trauma and development trauma.
If you’d like to start your trauma training – and I don’t just mean a two or four day course – you might want to take a look at The Sensorimotor Psychotherapy Institute or Pat Ogden’s Online Training. And don’t forget to wear your multifocals to ensure your eyes are open to the various categories of traumatic and non-traumatic experience, and that you and your clients are heading down the right therapeutic treatment path.