Category: Uncategorized

Can things go back to normal after a traumatic event?

Alexandra Marinova

The aftermath of trauma: From PTSD to Post-Traumatic Growth

You’ve survived the worst. But now your nervous system can’t find its breaks. A traumatic event rips you out of ordinary life and shatters your assumptions about human nature and the reliability of the world.

If you were lucky, you’ve had a good life up to the traumatic event and didn’t pay attention to where you were walking because the ground underneath your feet was always there to catch you. And one day, suddenly and without any warning your feet don’t meet the ground because the ground is not there, and you free fall into an abyss. Nothing makes sense and nothing can be trusted in the abyss.

Your nervous system responds by going into full gear to help you survive. Meanwhile, life goes on as usual for everyone else who is on the outside and they can understand in theory and to some extent what it must be like for you but they are still on the surface and have no reason to mistrust the ground. But for you, everything has changed.

Now you are out of whatever hole you fell into and the ground is back underneath your feet. It should be a relief, to be safe finally. Yet you can’t trust that. If the ground has fallen out once, what’s stopping it from falling out again? Your body has learned to be prepared for the worst and it is doing so to keep you alive. You live on – but you are living with all the symptoms of PTSD and can hardly call that a good way to live.

This would be a very depressing end to the story, and sometimes it ends like this. But for many there is another chapter where something amazing can happen – you can also experience Post-traumatic Growth (PTG). There is the idea of “good stress” which is experienced positively and the fact that changing one’s attitude towards stress can turn a crisis into an opportunity. However, “stress” is a great understatement of what PTSD is. That is why research on PTG has been focused on identifying what determines whether a person develops PTSD or undergoes PTG following a traumatic event.

PTG is defined as both a process (specific things you can do to overcome the trauma response) and the outcome of your improved mental health, even better than before the trauma.

But how could that be? How you face the crisis is a critical part of the process and perhaps the one aspect that is entirely up to you. Other factors include the support system you have around you, your belief system, financial resources and access to services.

Research shows PTG is not the same as going back to baseline. The fact an awful thing happened to you will never be ok and you may never be grateful or glad that it happened. You may have mixed feelings about your PTG. You may wish it wasn’t so difficult for you and resent the fact you had no choice but to go through this pain and grow because of it. At the same time, you can also be incredibly proud and find your journey awe-inspiring; you have somehow transcended the circumstances and found in yourself the strength and resilience of the human spirit that is universal and bigger than you but also entirely your personal achievement.

Trauma cuts deep, to the core of your being. You can try to stitch it up quickly with some self-help and positive thinking and that helps you to keep going for some time but the wound will eventually get infected. What is necessary is a deeper dive, one to get to the bottom of things and clear the infection. You may need to do that several times and do more than one course of antibiotics. Eventually, the wound will close and heal but your skin won’t look the same – it won’t be smooth and spotless like before. In its place, there will be scar tissue that will remind you that you have fallen out of the Garden of Eden and that you have what it takes to live in the real world where awful and beautiful things exist at the same time.

You can’t pretend terrible things haven’t happened and couldn’t happen again. And you don’t have to live in fear of that, surrounded by your own protective walls that also cut you off from life. You can rebuild your strength and self-trust which will give you the confidence you can thrive in an uncertain world; you can (re-)learn how to trust others too, in a realistic and not a naive way; you can find a purpose that makes the hardest parts of your journey worth it. In summary, life after trauma can be richer, braver and deeper.

If you or someone you know are struggling with PTSD, Dia-Logos Counselling is offering trauma-informed counselling in-person and online. If you are currently in a crisis, please call 911 for emergency services, 988 for the national distress line or BC crisis line at 1-800-784-2433.

Dia-Logos Counselling offers virtual and in-person individual depth psychotherapy (Existential Analysis), short-term CBT-based coaching and Gottman method couples counselling. In-person appointments are available in Burnaby. To request an appointment: Book an Appointment – Dia-Logos Counselling (dialogoscounselling.ca)

Is counselling better Online or in person?

Alexandra Marinova

To Zoom or not to Zoom? That is the question

The Pandemic very quickly revealed how much of work could easily be done remotely and forced us to move our social and professional lives online. This proved that the very small and until then overlooked counselling niche of teletherapy or virtual therapy could be viable, or at least, good enough for the time being. Since March 2020, online and over-the-phone counselling has been streamlined and greatly improved but is no longer the only option. Given the choice of skipping the commute to your counsellor, should you do it? Is there anything lost or gained with all this advancement of technology that has normalized telehealth?

As you may expect, there is a list of pros and cons and some of the bullet points may be more important to you than others. Do you find your mind wandering and automatically tuning out sounds coming from your laptop? Does the person on Zoom seem less real to you than your neighbour especially if you have never met them in “real life”? Do you already look at a screen all day and suffer from “zoom fatigue”? Do you prefer modalities of counselling that use the body more than words, such as somatic therapy? Then the limitations of a screen may outweigh the comfort of being in your home clothes.

However, what if you recently moved and had a great relationship with your counsellor? What if there are no counsellors where you live who specialize in the kind of therapy you need? Or if you find the sessions less emotionally taxing online? Do you prefer a more cognitive approach like CBT that does not rely so heavily on your counsellor reading your body language? Then virtual counselling may be perfectly suitable and effective for you.

Personal preferences aside, in my experience, virtual counselling is a niche that requires more training and experience to achieve the same results. Besides the difficulty of creating an emotional connection through a screen and inevitable technical problems, if you are in a crisis your counsellor will not have the same tools to help you as when you are there with them in the same room. Therefore, although it may seem easier emotionally because it can be “less real” and therefore less intense, I would not recommend it for deep work such as Inner child work and processing of trauma.

What makes virtual counselling less intense is also what makes it less effective for deep work. You may not be able to feel your emotions deeply enough for the work to be meaningful and effective because being witnessed by an empathetic person deepens your experience and the presence of your counsellor makes it more difficult to communicate online. Have you ever told the same story to different people or in different situations and one time it was funny and easy to tell while another it evoked immense sadness? In the counselling session, the therapist takes your experience seriously and lets it affect them. Seeing the effect on your counsellor can make your story really sink in. (This is not to say your counsellor is doing their job correctly if they break down when they hear your story! More on that below.)

However, the opposite is also possible and more dangerous – what if you do feel your so emotions intensely that you start reliving your trauma? Would the voice from a screen be enough to ground you in reality when the counsellor themselves may not seem very real in pixels?

With emotionally intense work, the counsellor is responsible for making sure you don’t become overwhelmed in the session while also challenging you to go as deep as you can tolerate. This is mainly done through pacing and grounding exercises but also naturally regulating your nervous system when they remain grounded and present themselves. Anxiety is contagious and so can be calm.

A long silence over the phone is confusing, over Zoom could be taken as a technical problem, while silence in the room can be transformational. We can know many things with our minds but until the body believes it emotionally, knowing something in the abstract is mostly irrelevant and inconsequential to our lives. This type of embodied insight can be achieved through many different types of therapy and mediums. However, some mediums limit the information that your counsellor receives about your emotional state and add “noise” in their communicating that they are walking alongside you.

In summary, deep work requires an experienced therapist who can help you access your emotions without becoming overwhelmed and any technological challenges can interfere with this delicate and intense process. Therefore, when choosing virtual or in-person counselling, consider how much emotional vs cognitive work you believe you need.

Dia-Logos Counselling offers online and in-person counselling for individual depth psychotherapy, CBT-based coaching, and couples counselling using the Gottman method. In-person appointments are available in Burnaby. The principal counsellor, Alexandra Marinova, is a Registered Clinical Counsellor specializing in Existential Analysis and CBT.

True or False: You can choose to be happy?

Alexandra Marinova

The last thing someone struggling with low mood needs to hear is that they are failing at something apparently so basic as simply feeling good! But is it really so simple?

A short answer – no, it is not. Mood and emotions are the result of many factors coming together like a complex calculation that our bodies do to let us know what is happening on a feeling level and it is oversimplifying to state they can be changed as easily as choosing to look away from something sad.

While it is true that we can take actions to change our mood, it is not the same as having direct control over it like I can control my fingers to type this, for example.

We don’t have direct control over our emotions. But we can influence them.

If we had the option to feel happy all the time, we might choose that; yet negative emotions also add depth and meaning.

Trying to control, suppress or deny negative emotions also comes at a cost – because these could contain important information about what we need to change in our lives. Next time you feel low, pause, and listen to what this message could be – is it about a boundary you need to enforce? Or that you are missing something in your life?

Sometimes these emotional messages can be inaccurate, if for example everything is well in your life, and you still feel something is dreadfully wrong or if you are in a healthy relationship but keep seeing red flags. This can become a self-fulfilling prophecy. The reason for this inaccurate perception is usually a combination of biological and psychological causes.

A psychological cause would be unprocessed trauma such as betrayal that has become the lens through which you see the world. A biological cause can be substance withdrawals, endogenous depression, PMDD, concussion, etc.

The take-away is this: don’t rush to fix your unpleasant feelings and don’t discount either medication or counselling as unimportant to your mental health.

Alexandra Marinova

“You cannot stay on the summit forever; you have to come down again. So why bother in the first place? Just this: What is above knows what is below, but what is below does not know what is above. One climbs, one sees. One descends, one sees no longer, but one has seen.”

– Rene Daumal