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Episode 787: Traumatization and Its Aftermath with Antonieta Contreras · The Trauma Therapist

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  All right, welcome back to the Trauma Therapist Podcast. My name is Gamiferson.
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  My mission is to help trauma therapist be their incredible selves, to be
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  human, to be real, not just a clinician. I'm a big believer
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  in who we are is more important than what we know, and this requires
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  cultivating authenticity, genuineness, and vulnerability, and that requires intention. Can learn
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  more about my courses and workshops by going to the Trauma Therapist project dot com.
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  That's the Trauma Therapist Project dot com. Let's get started. So five
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  four, three, two and one, our folks, welcome back to the
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  podcast. Very excited to have as my guest today. Antonia Contraras Antonieta.
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  Welcome, thank you, thank you, nice to see awesome so. Antonia,
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  a former banker urgently educated as a mathematician, is a trauma psychotherapist who
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  graduated with a master's in Social work from NYU after forming her clinical skills as
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  a gestalt therapist and training at agencies with highly traumatized people. She received a
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  specialization in trauma studies from the Institute of Contemporary Psychotherapies and in Human Sexuality from
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  NYU School of Medicine. Antonia maintains a private practice where she combines different trauma
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  modalities as well as a contemplative techniques that she learned from studying within Buddhist traditions.
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  Her book, Traumatization and Its Aftermath, A Systemic Approach to Understanding and
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  Treating Trauma Disorders, received the award for the Best Book of twenty twenty three
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  in the category of Psychology Mental Health Division by the American Bookvest ANTONIEA. Welcome
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  to the podcast. Thank you. So before we get going, share with
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  the listeners where you're from originally and where you are currently. I was born
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  in Mexico City and I live in New York City. Now big cities.
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  Okay, okay, So this book. We're going to talk about this book
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  today. This is very comprehensive. I mean, you pack a lot in
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  here and in a very interesting way. So let's start. Why. What
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  was the impetus for writing this? Two main things. One was that I've
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  been teaching, was teaching for several years the foundation of the Trauma Studies Program,
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  a postgraduate program for clinicians, and I really went into the research of
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  what it means to be traumatized, and I discovered every year I taught for
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  several years that every year there were new findings, and new findings are more
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  understanding and different perspectives, different options like even last week are very important.
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  Finding came out about memory, how memories get that actually are not memories,
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  so kind of many of the principles that we use in some of our techniques
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  are going to be redefined because of the findings. So that's what I noticed.
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  That there were findings all the time that we're really changing the conversation about
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  what trauma was, and that many people had a staged in the original description
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  of flight, flight and simple things that it has become much more complex.
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  So that was one of the reasons to include all the new findings and bring
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  them into updating the concepts of trauma. And the second one was that I
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  participate a lot in platforms in social media or and there are so many questions
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  about trauma and so many misinformations and misunderstanding of what it means. And it
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  breaks my heart to see that people get confused, assigned labels to themselves,
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  they feel defeated, and they were not going to get better. So I
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  answer a lot of these questions, and I noticed that there was the need
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  to solidify all those answers in a book that responds to all these questions that
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  people have. So give us an example of one such bit of misinformation that
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  people might have. You mentioned a couple of things, but shure with us.
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  Well. For example, the New York magazine a couple of months ago,
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  i think or last month came with a cover says trauma America's favorite diagnosis.
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  Right, So right there, Trauma is not a diagnosis, for instance,
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  right, but it's our favorite one. What's going on? What is
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  the diagnosis? What is the injury? What is the disorder? Instead of
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  like calling trauma everything from the event, many people say, oh, the
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  trauma that somebody gave me, Like, trauma is not something that people give
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  you, right, Like it's an injury that your nervous system goes through,
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  or your whole system goes through when you confront situations that are extremely dangerous or
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  activating and you can't handle them. So trauma is not the event. Trauma
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  is not only the injury. Trauma is not the diagnosis. Trauma is not
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  the reaction. Trauma is not is many things. Right, So that is
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  an example. Okay. You also, prior to that, you mentioned something
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  about fight and flight saying it's not really that simple. Stand on that please,
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  Yeah, Well, I really make emphasis in my book about post traumatic
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  and per traumatic mechanisms that we have because the fire flight normally describes stress,
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  like we all experience fire flight when we get angry, for example, but
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  that doesn't mean that the survival circuits are activated or that we are fearing for
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  our lives. Right, And even so when we get really scared, some
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  mechanisms start getting activated. But then once the danger goes away, there are
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  other things that happen to the system. The post traumatic let's say that we
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  adopt as strategies. I also make the differentiation into preventive and protective mechanisms at
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  the per traumatic ones, because for instance, freeze is mechanism that people confuse
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  whether comes after five flight freeze that comes after the fight, right, and
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  that is not really freeze. Well people call it that, but there is
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  a preventive mechanism that actually paralyzes us in a rigid way before the fight and
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  flight mechanism gets activated because we need that time to really understand the level of
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  danger before we act, and then after the fighter flights the immobilization comes.
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  There are very different in terms of what happens, what is happening to us,
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  And in freeze in is rigidity. In immobilization is a loss of tone
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  or most of tone, and et cetera. And they need different interventions.
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  We need to understand, if for instance, between them, in order for
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  us to help the clients that take that strategy as a survival way to cope
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  with their lives. Right. So, a rigid person is very different,
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  needs very different interventions than a dissociated person that comes from modalization. Right,
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  So those little differences are very important in terms of how we treat our clients.
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  So in terms of the book, how did you organize the book?
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  Oh my god, it took me like a lot of work to organize it
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  because there is so much information that I needed to share. So first the
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  part one, I wanted to talk about the whole neurobiology and all the consequences
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  and all the elements that take part have a role into all these emotions and
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  memory and all this that I call them trauma domains that get affected. Right,
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  So I explain the process. I explained the in aurviology, I explain
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  all the mechanisms, and then in part two I separated the different types of
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  traumatization. Of the traumatization is the process that starts when we get really act
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  afraid, scar shot, surprise, like really is afraid of our lives right
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  to the moment that we resolve the fear of the or the belief that we
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  can lose our integrity or our lives. That process can be short or can
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  be prolonged for a very very long time if we keep thinking or feeling that
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  we are in danger, because the brain recognizes those signals as the Q to
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  stay in survival mode. Right. So the second part I wanted to be
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  very specific on the types of alterations that our system goes through with each one
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  of the different ways to get traumatized from day one to For instance, complex
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  drama. People talk about PTSD and c PTSD, complex PTSD, right.
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  Complex PtD includes everything that means prolonged or repeated sense of threat or danger.
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  Right. But it's very different if you get it young at one or a
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  three, or at seven, or at twenty or at sixty. Right.
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  There are differences in when you get that type of problem because it doesn't mean
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  like there are people that have good childhood, but then they have a bad
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  relationship and then they endure years of abuse, they were healthy, but that
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  endurance it starts affecting the little by little, and of course the consequences are
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  different than if you have to endure it when you are two years old.
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  Right so, I wanted to separate all the different types of ways we can
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  get traumatized and the effects. So if it's attachment thing before we are born
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  or at birth, or if it's social and institutionalized oppression, or if it's
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  I separated, for instance, abuse from neglect, normally they put it together.
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  So I have separated separated them because abuse has different conceptus in the system
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  than neglect, for instance. Right so, I tried to dissect as much
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  as possible the different reasons we can get traumatized, and I separated them in
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  the reasons and the consequences. Let's let's highlight that for a little bit.
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  Abuse and neglect talk a little bit about how they're different and how they with
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  the understanding that it impacts people differently, of course, right well, abuse
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  abuse is a a frontal we call it. It asks for a reaction right
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  away, right right away. If I scream at you, you have to
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  react there with aggression or with avoidance, right it's easier to identify the wound
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  if it's abuse, then if it's neglect. Because neglect, there are many
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  other elements that can play a part on the traumatization or not. Some people
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  are neglected and are actually not traumatized. They learn to hope, They may
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  internalize certain ideas about themselves, but they don't fear for their survival, so
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  the survival mechanisms don't get activated the same way as if somebody is hitting you
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  right or punishing you or insulting you. So I want to normalize but also
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  to the pathologize trauma that not everybody that was even abused or neglect developed trauma.
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  And when I why we could develop a trauma disorder from the circumstances.
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  So, for instance, if you get neglected and then you develop huge sense
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  of shame for the neglect, the internalize it in that way, that could
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  be the trigger for you to activate those circuits. But then the intervention again
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  is very different than somebody that gets angry and immediately fight back. The neglected
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  person with shame is not going to fight back. It's going to probably dissociate,
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  and the intervention needs to go into the shame, not into the fear
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  first, right, So things like that. That's mind everyone. We're speaking
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  with Antonia Contrallras. The book is called Traumatization and Its Aftermath, a Systemic
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  Approach to understanding and treating trauma disorders. Be back in one second. Hang
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  on, all right. So when I speak with you, Antonia, I
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  realize how much there is to know and understand about. I mean, when
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  you started researching for this book, it seems like there's a wealth of information.
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  Is there a lot of information that a lot of people just don't know
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  about. Yes, there is a lot, because there are articles in journals
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  more than books. Right. I think we rely a lot on books,
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  and we rely a lot on the dozen of people that talk about one topic,
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  and then we hear the same idea over and over and over again.
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  And it's kind of it programs the way of thinking about certain things. But
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  we need to be actualized and put together things like we in psychology we still
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  use a very medical model. And if you think about medicine, well,
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  the cardiology has nothing to do with your stomach, right for example. So
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  a little bit like that. Sometimes in psychology you either take care of the
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  memories or you take care of the thoughts for right, and now you take
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  care of the body and we don't put them together. I missed to mention
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  that the third part of the book is about a model to apply all these
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  modalities that is integrative, because the integration of all our parts is essential for
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  us to heal. Right. Sometimes, for instance, let's say we are
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  processing memory, so we are talking or using cognition with a person that doesn't
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  have a sense of self developed or is very weak. The work is kind
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  of going into the ether because there is no self that can take in the
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  ideas or the progress of of the interventions or the treatment. So we need
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  to develop a sense of self first for having someone to observe themselves and have
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  reflective capacities on what is going on internally. Right, So that integration,
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  so that that I think that way of seeing things is not very popular.
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  We are not used to put together things, and that's what I was trying
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  to do in the book, to put together rejection is a very interesting thing.
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  For instance, is there kind of very separated from the trauma world,
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  and that it is essential to understand attachment injuries, right, because the main
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  injury is this sense, This is rejection sensitivity that people develop that that is
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  what becomes the fear. Right, the danger is to be rejected the threat.
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  So I brought that theory, the rejection sensitivity theory, into the book
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  to put it together with the other parts that we have as a way to
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  understand the big picture. You obviously and clearly have such a passion for this.
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  How did this develop the passion? Yeah, I have been always very
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  passionate in general, Like, it's part of my traits, right, I
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  also include all the chemicals and the neurobiology of temperament. For example, right,
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  if you produce more serotonin than dopamine, is you have different traits or
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  whatever? But yeah, I have always been very, very energetic and very
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  passionate, and I saw suffering as a Buddhist. I understood that it's it's
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  not the discipline only, is not the hope only, It's not the faith
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  only. It needs many more things and the support of a community. For
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  instance, in Buddhism, emotions and in other religions. I'm also Catholic,
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  and in Catholicism, being angry or experiencing envy is a sin for example,
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  right, or in Buddhisms is a delusion. And at some point I realized
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  that we as humans need to embrace those emotions in order for us to be
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  healthier emotionally, and if we didn't, we were just going to continue suffering
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  them and being ashamed of even having emotions because we are humans. So all
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  my and then the suffering in all sorts of environments, right, like people
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  suffer in different ways. I need all effects, it all get affected.
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  So yeah, I would like I want to. I would like to.
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  I want to continue helping and having the hope that I can continue helping people
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  and that more people need help. One of the reasons I became a teacher
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  was to train trauma therapists for them to be more of us, helping people
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  overcome this ugly place we live in when we don't get out of the trauma,
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  right of the traumatization, this darkness, this loss of hope, the
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  sense of defeat that is characteristic of a person that keeps in survival mode.
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  So we need to be more of us, We need to have more awareness,
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  We need to really battle that and make people more functional and more like
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  a capable of be happy. So who is the for? Is it for?
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  Just basically anyone who wants to learn about trauma? Is it specifically for
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  mental health clinicians who want to learn about trauma? I debated in which direction
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  to go, and then I sold the book to a publisher that publishes textbooks,
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  right, So it's both. I like the idea that the therapist reads
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  it and then share it with a client, maybe a chapter maybe two,
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  for them to understand certain things I believe in psycho education. Psycho education is
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  essential to heal. If we don't know what is going on with us,
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  we judge ourselves and we don't get over it. So I think it's a
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  very nice psycho education tool. But I already have a couple of new clients
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  and several calls consultations from people lay people that have read the book and that
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  are finding a lot of help in reading it. So it's for both people,
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  for both sectors in terms of UH trauma treatment. What are your thoughts
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  on how excuse me on the on the current state of trauma treatment modalities.
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  You were saying, you know, many therapists now are learning from the books
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  that are coming out, the popular books that are coming out from the twelve
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  popular people, and that makes a lot of sense to me. So in
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  response to that, what do you how do you feel in terms of the
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  trauma treatment modalities out there? Are they adequate? Are people learning enough?
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  Or what all of them are useful? People need to also know why they
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  are useful and when they are useful. Right, if they don't understand the
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  the difficulty is that the person has and the parts that need to be treated,
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  they can jump into one modality is kipping many steps that if they are
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  not treated, they are not going to have successful treatments. Right. So,
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  for instance, neuro feedback is an amazing tool for regulation, but it
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  doesn't help with processing. MDR is a great tool for processing or somatic experiencing
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  for processing, but they don't are not focusing and regulation and you need both
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  elements. But on top of that, what I think is that the treatment
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  needs to be understood as dynamic. So today we have a model that was
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  first proposed by escaping right now his name, but one hundred years ago Jenney
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  Jennet proposed a model for trauma that then you did Hermann adapted, adopted and
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  adapted, and then Ford and several others. But it's a linear model,
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  right is stabilization reprogram no processing and reprogramming, and it never happens that way.
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  We need to use a dynamic model that sees what is required and it
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  starts, I said, building blocks. Start using building blocks for the alterations
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  and the domains we need to work on in order to build the foundation for
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  a successful treatment. So that is also an important thing. People need to
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  understand what they are doing before applying a modality because a modality alone is not
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  going to make the trick. That's I think that's a good example. Trauma
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  treatment modality is that was put forth by you determined it's still used today very
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  commonly as you're saying, and people need to understand that it's not going to
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  go lineally like that. It's much more dynamic. So as a result,
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  are you saying that clinicians need to or therapists need to just study more modalities,
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  Well, first my book, because the book is going to tell them
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  what trauma treatment should move like, right, and then choose the modalities that
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  resonate more with them and know how they should be applied for certain things.
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  For instance, I do a junt work sometimes for EMDR. If somebody has
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  their therapist and they have been developing a relationship, and that's wonderful, but
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  at the moment that they are stable and need to process, they could be
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  sent to a different therapist to work on those pieces on that part of the
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  treatment. For instance, if somebody is not good at developing self and doesn't
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  understand that, well, maybe you find a colleague that is specialized in that
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  type of morality or you learn it right, but you need to need to
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  have a brother understanding of what it needs to be done for the person to
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  recover personality disorders for instance, right, you cannot go on process memories when
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  they don't even know where they are. You know, it's a different level
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  of understanding of what happened to them that made them adapt into that type of
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  behavior and regulation that needs to be addressed. As such, it's called trammonization
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  and it's aftermath a systemic approach to understanding and treating trauma disorders. If you're
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  a mental health clinician and interested in trauma or working with trauma, you need
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  to get this book. We'll have the links up at the show notes page
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  here at the Trauma Therest podcast dot com and Antonia they can get it at
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  your website obviously, which is what Antonias dot com. Okay, we'll have
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  that linked up as well. Antonia so inspiring. This book is a game
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  changer, and I want to thank you so much for being here and sharing
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  your inspiration with us. Thank you so much for having me. All right,
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  take care,