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Mooli Lahad Ph.D. Forging Community Resiliency in Shmona Israel: from the archives · The Trauma Therapist

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Trauma Therapist Podcast, Episode four hundred thirty. Hey guys, welcome to the
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org forward slash TTP. That's Traumahealing dot org forward slash TTP. Alright,
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guys, welcome back to the Trauma Hippers podcast. I am very excited to
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have back a very special guest, Professor Mulli Lahad. Doctor Lahad, welcome
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back. Hi, I'm very happy to be here with you. So.
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Doctor Lahad is a senior medical psychologist who's been working with individuals, civilians,
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as well as soldiers and veterans suffering from PTSD since nineteen seventy five. Doctor
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Lahad is a founder and president of the Community Stress Prevention Center in Kiryat Shmona,
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Israel, the oldest center in the world that deals with community as an
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ecological entity for recovery and healing pre and post critical incidents. Doctor Lahad is
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author and co author of thirty five books on resiliency and coping from early childhood
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old age has developed the intricative model of coping and resiliency. His most recent
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book is The Lonely Ape That Told Himself Stories The Necessity of Stories for human
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Survival, Doctor Lahad, welcome back. You know, before we were,
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you said, you know when when you saw my invitation, you were,
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you were happy and surprise and you were wondering why I wanted to have you
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back, and I wanted to share that with everyone. I've been doing this
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for you know a few years now, and after four hundred plus interviews,
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naturally, there are certain interviews that that stick with you, and there are
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certain people that stick with you that certainly stick with me. And you're one
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of those people because of your passion, plain and simple and and that's what
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this is about, you know. I hope this, this podcast is about
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that passion, the human spirit and and for helping other people at its most
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elemental. So welcome back, Thank you very much. I'm really honored.
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So let's um you you joined us back on episode one on one for those
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people who maybe didn't catch that episode, and I would definitely encourage people to
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after they hear this to go back and listen to that. Give us a
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snapshot, if you would, Molly, of where where you're located and the
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how you got into this, and then we'll dive into what we were talking
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about before. Okay, I'm living in the north of Israel or in general
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and Israel, because I would say that Israel is a natural laboratory for trauma
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and resilience and all that. The story of how I got into it is
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a very kind of simple story in many ways, but yet special for me.
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I came to a place that was in those days in nineteen seventy nine,
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under constant shelling and lots of fears from what then was considered terrorist attacks
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or some people called it political in conflicts or whatever. Kahmuna was a very
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remote town at the time. It's still the very northern town of Israel,
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but then in those days, from Tel Avision to kiachnight was over four and
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a half hours in a country that altogether from north to south is five hundred
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kilometers. It looks as if it was far far away. And I came
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for one year because I wanted to work with the children there who were under
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shelling, and tourists infiltration for since the seventies. And what I realized,
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and this was, I would say, the turning point is that people are
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making it. People are living despite ongoing threat, and you know, every
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so often shelling and they make it. They leave, they they marry,
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They have of course bad times and times all together, they manage. And
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so I started to look into the question. It in those days was mostly
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termed cooping. Nowadays it might be seen as resilience, and that led me
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to my first study and then a series of studies on how people are making
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it in impossible situations and ongoing situation where adults and kids are in the same
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under the same threat. Earlier on when I studied was mostly on patients or
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soldiers, and here it was civilians. And so the basic pH which we
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talked last time the model came out and I realized that there is a lot
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of I would say, challenges and many many things that I can experiment with
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and develop, and that the field is very, very open, at least
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in those days, for creative approaches. I think I mentioned to you that
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when I started talking about resilience or coping a net in this manner in the
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early eighties, late seventies, people thought that I'm probably affected by the rockets,
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and I'm probably also a bit confused because who was talking about people making
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it trauma meant only to make you disabled, not to make you thrive.
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So I believe that since then things have changed and there later on I developed
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or developed more methods, mostly using creative methods with the trauma processing, and
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a lot of time spent on developing resilience programs and opening the first I would
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say community stress prevention center, which is nowadays with a game, being called
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a resiliency center rather than stress revention, which is basically working throughout the year,
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not just following a crisis. I mean, we worked then and we
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still work on what might be seen as a kind of inoculation or helping people
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to develop those methods that can help them in times of distress. And I
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think that I mentioned one last thing that I'll stop is that what I found
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that recovery from trauma needs to be in the ecology of support. It means
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you need to look at the community, you need to look at the family
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in order to help those who are affected to recover. Really, since then,
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I'm mostly dealing with the power of imagination and playfulness in helping people to
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recover from people. Okay, so so many things are coming into my mind
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here. The first which is just a reaction and I know I had this
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last time. I could not imagine living in a zone where there's the ever
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present threat of these bombings, of these shellings. I mean, and you're
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talking about this this you were surprised to see people coping like through almost would
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you use the word thriving or getting through getting that did? But I mean
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on the main impression that I had is that what I studied. And I
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came to the North from a mental health a very heavy mental health institude,
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which told me that to look for pathology all the time. And here I
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did see pathology, but I also saw people making it living, some of
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them of course thriving. But I wasn't talking about then about post traumatic growth.
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I was just saying, well, not everyone is affected, and people
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can leave in such situations. And what surprised me and what made me study
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what actually is helping them? That was the main question, because I came
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brief preconceived ideas of what is the effect of trauma? Well, that's it,
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that's it. That's a great question, so what did what did you
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find? Well? I actually found in the very early studies that people are
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using various methods that could be seen as the defense mechanism. And I immediately
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not the contum of defense is stopping the world from coming in. Where I
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thought, maybe the better way to it is how do they go out to
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the world meet the world? And so the first studies was done with children
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and adults, and I I was surprised to see that, of course there
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are differences, but altogether they're using this what I call the six channels that
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I mentioned the last time, which is the belief system that means people who
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have either self esteem or outside belief like religious believe or they're looking for meaning
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what does it mean to me that I'm living in this situation. The second
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way that we found is the affective mode. Those for them meeting the challenge
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is by expressing their emotions either directly or indirectly that could be through music,
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through meditation, whatever. And then I looked at the other channels, which
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is the third one is social that means those who are driving or coping or
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making it by either taking a role or needing to be in a group or
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taking upon themselves a role with others asking for support, and with the teachers.
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I found that for them it was very important that there is a system,
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means there is a system that supports them whilst they are taking care of
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so many kids. Then the other way we found was imagination. That's the
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eye of the basic pH and the eye means you are using imagination. And
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basically that was the beginning of my studies about the impact of imagination because again
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in my upbringing, and you know that I have two PhDs, and I
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did lots of studies, and what I learned in the past was that imagination
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is basically a way to understand your subconscious and all this. And here I
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could see how people using imagination, humor, creativity and other ways of being
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what you call it improvisation to make it. So I started listening and looking
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into that and we might talk about it later. And that's the imagination.
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Then, of course cognition, which is very very known, or those who
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are mostly focused on problem solving, making sense of things, making priority orders,
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etc. And the last mode of coping that we found was the physical
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one that is either being active but not only active. Again, there was
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a misunderstanding that only if you are active cope, for you are really coping.
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But I found it people have a passive mode like relaxation, like going
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to sleep, like eating, and again, because I came from clinical psychology
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background, all of that were looked as a negative way, unproductive way,
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and I said, no, no, look at how these people are using
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it in order to make it through ongoing situation, as you said, shelling,
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infiltration of terrorists, et cetera. Now, just to be clear,
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these qualities or elements that you're talking about, these were utilized by people kind
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of unconsciously, not as ortaciously spontaneously, right. They weren't oh, I'm
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going to go to the therapist and learn how to do X or y.
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This is just what they were doing naturally. Indeed, indeed, my main
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quest in this life is to look how people recover on their own, what
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helps them, and after observing and learning about it, I try to see
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if we can make a model or just learning from what is helpful to people.
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Now I was talking as if it's either or, but people can be
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both imaginative and cognitive, both emotional and physical. I mean they can use
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variety of those, and the more channels you have the more ways you have,
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you're more flexible. And only in later years, I would say in
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the late nineties the idea of resiliency as flexibility came about in the professional books.
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We already talked about it in nineteen eighty two, but we didn't know
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that the concept of flexibility, but the ability to use variety of modes was
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very apparent with those who really had hard times but could recover on their own
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accord, in their own way. And this is as fontaneous, I definitely
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say in hindsight. After we studied the way and we started teaching these modes,
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people could learn to use it. But the basic thing was that we
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were looking at how people are hoping and analyzing it into this or categorizing into
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the six channels as we cod it is one of the things that you know,
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we're not alone here in the States and in the West about the stigma
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of post traumatic stresses or the stigma of trauma. Just being able to talk
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about it it is a great first step. Did you find that, given
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the context in the situation, that people were more understanding or more accepting of
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the fact, well that this could potentially be traumatic, that we are living
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in this type of zone was that I hope that I understood you correctly.
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I think that they knew where they leave. They were using terms that I
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could the non naming way of coping. That means they never said rockets or
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katusha rockets. They said the visitors. But one of the things. I
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mean this was in the eighties, but the effect of Community Stress Prevention Center
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that is there all the time has helped people to understand they can use those
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terms. They can be open about it because it's not saying anything about their
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I would say abilities, disabilities, and of course about the mental stability,
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but I mean to destigmatize it. It takes a long way. I want
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to tell you that on the entrance to our center it says in bold letters
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trauma because I think that you need to say to people you're suffering from something.
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We are willing to talk about it, because I think there is a
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dual suffering. Once you're suffering from trauma, and then you suffer from not
18:53
being able to say I have trauma. So you're kind of retraumatized by that
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or over traumatized by the fact that you can't share it, and the more
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you normalize it. Unfortunately, Yes, I know that majority of people who
19:08
are exposed to trauma recover on their own accord, quicker or slower. But
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those who have been traumatized many times as themselves. Am I crazy because I'm
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the only one that is behaving this way and there were other people, especially
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when you're talking about the community. I could see my neighbors, I could
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see my spouse, I can see my children. Why am I suffering?
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And so it's even more important to say, yes, we don't know why
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you personally have developed these symptoms, but it's not an abnormal condition. In
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fact, we are trying to tell people that PTSD is not a oology.
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It's a kind of a failure in the process of recovery because so many people
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have been exposed and only and all of them were on the road to recovery,
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and some didn't make it. It's not pathology, it's about my mind.
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Something happened on the course of recovery, and we will help you to
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join the course of recovery as much as possible. Let's let's talk about the
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role of imagination and how it plays out with kids with adults. Talk to
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us about that. I'm using both imagination and play for us because what we
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observed, and what we have observed for a long time, is that people
20:45
who are suffering from PTSD cannot be playful. They can't play mostly because they're
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getting into this mode that they called on guard. They are standing on guard
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not to remember, not to be exposed to anything that might trigger their emotions,
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and so they're on guard all the time. Once you're on guard,
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you can't be playful and you don't use your imagination. I need to correct
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myself. They use imagination only in negative terms. That means they keep being
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overwhelmed or trying not to be overwhelmed by the images that have been the outcome
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or the result of the trauma. And the principle that we have developed is
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based on, first of all, that they are not playing because they're frozen.
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They're refraid. I mean, if if you see a very very traumasous
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child coming into the playroom or the room, in most cases, they will
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be very very uptight and frozen, or they will be so mum in a
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position that they can't really relax that they will basically destroy the whole room.
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Um. So what we realize that you have to reintroduce imagination and playfulness.
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I agree that imagination is a source of a lot of suffering. But again
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coming from this idea that you might call homeopathy, that saying cure says I,
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if imagination is the problem, then imagination needs to be the solution.
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And to so many clients who said that I can't use imagination, said,
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but your experts of imagination, all these nightmares, all these flashbacks are basically
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images that are coming from the inside. They are not outside, and you
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know they're not outside, but you're sure that once they are overwhelming you,
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you can't really differentiate, or you can't give yourself a chance not to be
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hyper alert, hyper vigilant, not to feel, not to get into any
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excitement I mean negative excitement, of course. So based on that, based
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on my studies, I came to a conclusion. Of course, it's my
23:25
conclusion that for PTSD people, people who suffering from from PTSD, images are
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the part that are the most difficult for them. And in imagination images memories,
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pictorial memories, visual memories that are not in existent because it's something of
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the past, or basically making the life impossible. And together with that inability
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to play, I can tell you one kind of once told me you see
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If I am sensitive to my kids and they will start crying, this will
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put me off my own guard position. If, on the other hand,
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I will react to them, I will immediately be immersed with my emotions,
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which I don't want because they'll be of my own guarding position. And so
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from that moment we develop a method too slowly, slowly reintroduce the idea of
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playfulness and for then we develop a method called c far CBT that is a
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combination of body imagination, playfulness and cognition. And we're using cards. We're
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using cards in order to encourage the client to retell the stories. And because
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cards, I would say, and images pictures are international language, we found
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that you can use it both with children, adults, and in various cultures.
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And these are not cards that specifically made for trauma or for revealing your
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story. These are cards that we call therapeutic cards because they have been used
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in mostly am bibiotherapy and storytelling methods. But they are any cards can do
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it. Unlike virtual reality, I don't need to produce anything. I just
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allow the client to find six. Six is a number that I like.
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As you understand, six cards to start with, and just they either tell
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me the story whilst looking at the cards, or they don't need to tell
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me a story, but they look at the card and whenever they move from
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one card to the other, they just know me their head and I know
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they slowly slowly started to tell themselves or to me the story. But where
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is the playfulness. The playfuln is that I allow them to take out a
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card that they don't that they would like to get rid of, which is
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impossible in reality because the trauma was a trauma. And I also encourage them
26:14
to look for cards and have they been with them, which I call fantastic
26:18
reality because it wasn't in reality anyway, have they been with them in this
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situation they could have helped them even though the situation has happened and they can't
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change the outcome and the impact of playing with the cards, moving the cards,
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adding cards slowly slowly introducing them a very simple concept of being flexible,
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playful and using imagination and for me and the method is of course studied,
26:52
and for me this ability to help the client, unlike other methods, to
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be active in the player in the I would say re narration and editing of
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the story. But more than that, to be in an observer of their
27:11
own trauma, because you see, in most methods you're asking the client to
27:17
close their eyes to bring the story over, their eyes open to remember the
27:21
story. But here, because they have the cards in front of them,
27:26
they're actually observers in their own trauma. And I think that this ability to
27:33
this and being an observer in your own trauma and the editor of your trauma
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and the player in your cards is a new concept of how to help.
27:49
I love that that's what we do. One of the things that strikes me
27:55
about that, Molle is you know you talked before about one of the symptoms
28:02
people are dealing with sometimes are these flashbacks, these images, and it can
28:07
be quite frightening for someone to start working with with the imagination. How do
28:15
you create that space of I would imagine it would have to be a really
28:18
safe space. How do you what do you do to create that? So
28:25
many methods are using the concept of safe place. For instance, MDR is
28:32
asking the person to imagine a safe place. Again, because I'm so much
28:37
into the visual apparatus, based on many studies which you don't have time now,
28:41
I think to address, we are actually starting by asking the client to
28:48
choose a card, to put it on a piece of paper and to expand
28:52
it with colors slowly, slowly to create the card they're choosing, are accorded
28:57
for them, reminds them, or is an image of safety, serenity,
29:03
etc. So we starting with that. The first phase of the methods for
29:10
CYBT is very much about teaching the client how to reduce arousal and anxiety,
29:22
resourcefulness, how to find basic page, how to find their own resources.
29:26
Only when they gained all these methods and slowly, slowly they are playing with
29:33
the cards before they start telling the trauma, because they're using it as images
29:37
of support, images of safety. Then we go into the reneration and there
29:45
are the intermediate phases, but the first part of the treatment is safety and
29:49
security, and we say them we won't move anywhere before I'm sure that you
29:55
have the tools to help yourself. Talking about this image, it's interesting.
30:00
I was working with parents of children who have been abused, most of them
30:04
sexual abuse, but not by family members. And what the parents told me,
30:11
you see, I am seeing movies of this horrible event although they haven't
30:18
been exposed to the situation, but their imagination is working over time and they
30:22
see again and again like flash books of something they haven't been part of.
30:26
But because the emotions and they need to have some kind of a grasp on
30:33
what have happened, they keep on imagining horrible things. And the first time
30:40
they said that someone really took it seriously and I said, okay, so
30:44
you have a movie in your head, try to find those six images here
30:49
that will help you to tell me this haunting so to speak. Movie was
30:57
a real relief for them because it wasn't only haunting them, and now it
31:03
was externalized and they could look at it. It was painful. I can't
31:08
say it's not painful, but it's manageable because, if, for instance,
31:12
the client feels overwhelmed, like in any card game, I said, well,
31:18
let's close all the cards. And this very act that the game is
31:22
of very known playful mode of of of games helps them to kind of ritually
31:33
ritualizing, you know, Okay, now we're closing the game and then they
31:37
can reopen it. One other thing I want to say about this method is
31:42
that you can tell the story from the end to the beginning because you have
31:45
all the cards, so you can say you can start with the end and
31:49
go to the beginning. What we call playback in in films, that you
31:56
go back, okay. So it's interesting way of helping people to muster,
32:05
to feel in control, and to start feeling that. Of course it's a
32:09
story. They have the feeling it's a frozen story, and now it's more
32:15
manageable and flexible. So inspiring. Molly, I love it. I love
32:21
talking to you. I'm just realizing that we didn't even get to your book.
32:25
I'm gonna have to. I'm gonna have to. I would love to
32:30
invite you back and we can talk about your book if you're up for that,
32:32
Okay, okay, okay, yes, And I encourage people to read
32:37
it before we speak because it's a It has lots of stories. Basically,
32:43
there is a chapter where I actually gave up all my stories because I decided
32:47
that this book will have all the therapeutic stories that I'm using. So not
32:52
only what is the meaning and why we need stories, but you have the
32:58
treasure of the stories that I'm using for forty years now. So that book
33:02
is called The Lonely Ape That Told Himself Stories the necessity of stories for human
33:07
survival. Will have that linked up here at the show notes page at the
33:10
Traumatist podcast dot com movie. As we close out here, do you have
33:15
any book recommendations for whether trauma or lad or not or story? I would
33:22
you recommend to you one very good book that is also using a concept of
33:30
drama, not only of trauma. It's called Trauma Centered Psychotherapy by very good
33:37
colleagues of mine from the States where I spend some of my sabbatical with them.
33:43
It's David Grey Johnson who is a psychologist and his wife who is a
33:47
psychiatrist, and him is Hada Lubin. It's an amazing book. Take it
33:53
from a different perspective, and I think it will be helpful to therapists and
34:00
be a more interested in this subject. Okay, so the Principles and Techniques
34:02
of Trauma Centered Psychotherapy by David Free Johnson and Padara Lubin. Yea, indeed,
34:10
Wullie, I want to thank you so much. We'll have you back
34:14
and we'll spend that time talking about the stories. Thank you so much.
34:19
You're welcome, Bye bye, all right, once again, thank you to
34:27
Semitic Experiencing for sponsoring this podcast. Semitic Experiencing Trauma Institute is a five O
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one C three nonprofit dedicated to resolving trauma worldwide by providing professional training and education
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in semantic experiencing. WHO was founded by doctor Peter Levine, author of the
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best seller Waking the Tiger, who developed semantic experiencing based on explorations of how
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animals deal with threat, nervous system, overwhelmed and traumatic experiences on a daily
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basis. Learn more about semantic Experiencing and see professional training program at trauma he
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dot org forward slash TTP. That's Traumahaling dot org forward slash ttp. OK,
35:08
guys, I just want to say that I am thrilled to have this
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podcast sponsored by CPTSD Foundation dot org. You know, a little while ago,
35:15
I actually got to meet the founder, Athena Moberg of CPTSD Foundation.
35:21
We met here in San Francisco, sat down, had breakfast, and it
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was amazing. You know. I got to feel and see her passion,
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the passion that she has for this work and not just for therapists and clinicians,
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but survivors as well. CPTSD Foundation provides pure led support and interjunctive care
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in between therapy sessions for survivors of complex trauma, seven days a week,
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three hundred and six to five days a year. Survivors can come together to
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give and receive support and validation and feel equipped with the knowledge and skills they
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can use every day. You check it out at CPSD Foundation dot org.
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Their website is amazing. They have daily recovery support, they have free support
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groups, they have a healing book club, and Trauma Therapist Podcast listeners get
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fifty percent off the first month when they joined the daily Recovery support calls.
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You can check that out by going to CPTSD foundation dot org. Forward slash
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Trauma Therapist Podcast. Once again, that CPTSD Foundation dot org slash Trauma Therapist
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Podcast. We're just heading over to the website at Trauma Therapist podcast dot com
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and click on the link there and you'll be in business.