Caring for the Trauma Survivor Margot CroninFurman LICSW

Caring for the Trauma Survivor Margot Cronin-Furman, LICSW Clinical Social worker Beth Israel Deaconess Medical Center

• What makes you nervous about doing Reiki with trauma survivors? • What makes you excited about working with this population? • Who here has had something bad happen to them? • What helped? What really didn’t help?

Our default setting is resilience.

PTSD • • Intrusion/ Re-experiencing Avoidance Negative alterations in cognitions and mood Alterations in arousal and reactivity

How do people cope in the aftermath of trauma?

Maladaptive Coping • Numbing • High risk behaviors • Avoidance behaviors

Adaptive Coping • • Connection Spiritual Practices/ Mindfulness Perspective Humor Meaning making Self care, positive self image Seeking/ Engaging with formal treatment

Ameliorating factors • • Social supports/ connection Basic needs met Nature of trauma Personality style

Other Themes Feeling “stuck” “Some people's lives seem to flow in a narrative; mine had many stops and starts. That's what trauma does. It interrupts the plot. You can't process it because it doesn't fit with what came before or what comes afterwards. ” ― Jessica Stern

Other Themes Control

Other Themes “Shame is a soul eating emotion. ” – Carl Jung

Other Themes Denial “We must always take sides. Neutrality helps the oppressor, never the victim. Silence encourages the tormentor, never the tormented. ” ― Elie Wiesel

Treatment • Talk therapy – EMDR, hypnosis, neurofeedback • Body work • Spiritual practices • Advocacy engagement

How Reiki can be incorporated in the healing journey • • • Creating safety Restoring control Bearing witness Symptom relief Psychoeducation

“Our job is not to deny the story but to defy the ending – to rise strong, recognize our story, and rumble with the truth until we get to a place where we think, ‘Yes, this is what happened. This is my truth. And I will choose how this story ends. ’” – Brené Brown

Questions? Thoughts? Comments?

Selected References American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5 th ed. ). Arlington, VA: American Psychiatric Publishing. Brown, B. (2012): Daring Greatly: How the Courage to Be Vulnerable Transforms the Way We Live, Love, Parent, and Lead. New York City, NY: Gotham Herman, J. (1992). Trauma and Recovery. New York, New York: Basic Books. Levine, P. A. and Frederick, Ann. (1997). Waking the Tiger: Healing Trauma. Berkley, California: North Atlantic Books. Rothschild, B. (2000). The Body Remembers: The Psychophysiology of Trauma and Trauma Treatment. New York, New York: W. W. Norton and Company, Inc. Stern, J. (2010). Denial: A Memoir of Terror. New York, New York: Harper Collins. Van Der Kolk, B. A. (2005). Developmental trauma disorder: Towards a rational diagnosis for children with complex trauma histories. Psychiatric Annals, pp. 401 -408. The Trauma Center at the Justic Resource Institute http: //www. traumacenter. org/index. php The National Center for Trauma Informed Care http: //www. samhsa. gov/nctic The National Child Traumatic Stress Network http: //www. nctsn. org/

Case Study Maria is a 50 yo woman who was hit by a car while crossing the street 2 years ago. She broke her leg in two places and had several broken ribs. She was hospitalized for two weeks and spent another month in rehab re-learning to walk. While her physical recovery went very well she has continued to have fear about crossing streets, refuses to drive a car, and struggles to sleep due to nightmares/insomnia. She describes feeling short of breath at times without a medical cause. Her doctor prescribed her Ativan (anti-anxiety medication) which she takes beyond the recommended dose to combat these symptoms. Her family is supportive but confused as to why she continues to behave so irrationally this far out from the accident. In truth, she doesn’t really understand what is happening to her either. She’s been referred for Reiki but does not know much about it. • How would you approach this patient? • What would be important? • What red flags would you look for?