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From the archives: Ruth Lanius, PhD · The Trauma Therapist

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Speaker 1: Are Today we even another episode from the archives with
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Speaker 1: one of my incredible guests. Enjoy. Welcome to the Trauma
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Speaker 1: Everport's podcast, a show about the incredible people dedicated to
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Speaker 1: helping those of experienced trauma. My name is Goy McPherson,
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Speaker 1: and my mission is to raise awareness of trauma and
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Speaker 1: to inspire each of us to help those around us.
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Speaker 1: All right, guys, welcome back to the Trauma Therapist podcast.
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Speaker 1: My name is gy McPherson. Today, really excited to introduce
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Speaker 1: my guest, Ruth Lenius. Ruth, are you ready to go?
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Speaker 2: Yes, I'm ready to go. All right, Thanks for having
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Speaker 2: me you, guys.
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Speaker 1: You are so welcome. Ruth is a professor of psychiatry
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Speaker 1: and the director of the post Traumatic Stress Disorder Research
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Speaker 1: Unit at the University of Western Ontario. She established the
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Speaker 1: Traumatic Stress Service and the Traumatic Stress Service Workplace Program,
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Speaker 1: both services that specialize in the treatment and research of
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Speaker 1: post traumatic stress disorder and related comorbid disorders. Ruth's research
1:00
Speaker 1: interests focus on studying the neurobiology of PTSD and treatment
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Speaker 1: outcome research, examining various pharmacological and psychotherapeutic methods, with regular
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Speaker 1: lectures on the topic of PTSD nationally and internationally. She
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Speaker 1: has recently published a book titled Healing the Traumatized Self
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Speaker 1: Consciousness Neuroscience Treatment with Paul Freuen. I'm holding that book
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Speaker 1: in my hand here. It is a tour de force definitely,
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Speaker 1: But Ruth, again, thank you so much for taking the
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Speaker 1: time to do this. So let's let's kind of get
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Speaker 1: in here and first kind of give us a little context.
1:36
Speaker 1: Tell our listeners where where you're calling from, and maybe
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Speaker 1: where you're from, and then let's get going.
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Speaker 2: Yeah, so I'm calling from London, Ontario, which is located
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Speaker 2: in the middle between Toronto and Detroit, so in southwestern
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Speaker 2: Ontario from.
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Speaker 1: Canada, and that is that where you're from.
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Speaker 2: No, I was actually originally born in Germany and my
1:59
Speaker 2: family moved to Canada when I was thirteen.
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Speaker 1: Well, okay, so nice. So let's start out here, you know,
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Speaker 1: at the Trauma Therapists podcast here, this really is to
2:12
Speaker 1: put the highlight on you, and we start out with
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Speaker 1: either a quote, a mantra, something to give our listeners
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Speaker 1: and understanding of what's inspired and kind of guided you
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Speaker 1: and the work you're doing.
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Speaker 2: I think a mantra that has really inspired me and
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Speaker 2: sort of kept me going has been never lose hope.
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Speaker 2: There's always light at the end of the tunnel. And
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Speaker 2: I think that's really important if you're a trauma therapist,
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Speaker 2: but I think it's equally important if you're a client,
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Speaker 2: and so I think it sort of keeps that patient
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Speaker 2: or client therapist diet really going in times when it
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Speaker 2: can get very difficult and when a lot of suffering
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Speaker 2: can come up. I think that's really something that's guided
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Speaker 2: me both my profession but also in my personal life.
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Speaker 1: So how I mean, if we were to maybe dial
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Speaker 1: in and look at how that's impacted you professionally or
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Speaker 1: how that quote began to resonate with you, can you
3:14
Speaker 1: share a story of when that I mean, obviously, you
3:17
Speaker 1: know we talk a lot about the word hope in
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Speaker 1: this particular specialization, But for you, when did that become
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Speaker 1: resonant for you? Ruth?
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Speaker 2: I think very early on when I started working with
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Speaker 2: traumatized individuals, and I'm thinking of a particular one that
3:32
Speaker 2: actually I met during my residency, and you know, she
3:36
Speaker 2: had spent about eight years as a psychiatric impatient. You know,
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Speaker 2: she'd had a terrible journey and she'd really lost hope,
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Speaker 2: and so intuitively. You know, when I first saw her,
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Speaker 2: I thought, wow, you know, she's such a competent woman,
3:53
Speaker 2: even though she's so ill. You know, I sort of
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Speaker 2: saw how I imagined her after good treatment. And you know,
4:03
Speaker 2: I said to her, you know, I realized, you've been
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Speaker 2: incredibly sick, but you know, I see all these strengths,
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Speaker 2: and so I think there's a lot of hope here.
4:12
Speaker 2: And I think that hope really helps us to have
4:15
Speaker 2: light at the end of the tunnel. And you know,
4:18
Speaker 2: she told me later that it was this hope that
4:22
Speaker 2: had really helped her keep going during very very difficult
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Speaker 2: times because you know, during treatment, she you know, had relapses.
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Speaker 2: You know, obviously her symptoms didn't disappear all of a sudden.
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Speaker 2: You know, it was a lot of very very difficult work.
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Speaker 2: But you know, she said, you know, she could hold
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Speaker 2: on to that hope and really follow that light at
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Speaker 2: the end of the tunnel. And she said, you know,
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Speaker 2: sometimes when she could no longer see the light at
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Speaker 2: the end of the tunnel, she knew that I was
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Speaker 2: holding up the light for her. And so what that
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Speaker 2: taught me was, yeah, it's so key to really provide
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Speaker 2: somebody with hope, and you know, guidance throughout the difficult
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Speaker 2: path of treatment, and you know, provide light at the
5:10
Speaker 2: end of the tunnel, and if the person loses sight
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Speaker 2: of it, then you hold up the light for them.
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Speaker 1: So you were a resident at the time, Yes, I
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Speaker 1: was a relatively you know, newer clinician. Did you yourself
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Speaker 1: have hope?
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Speaker 3: Yes.
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Speaker 2: When I saw her, I thought, wow, you know, I
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Speaker 2: think she's really treatable. And she'd had a number of
5:30
Speaker 2: diagnoses that you know, didn't quite make sense to me,
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Speaker 2: and you know, I interviewed her and it really seemed
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Speaker 2: that the trauma she'd experienced, which was horrendous, seemed to
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Speaker 2: be at the root of all these vastly different symptoms
5:44
Speaker 2: she'd been experiencing.
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Speaker 1: Awesome story. So as as we move on here, Ruth,
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Speaker 1: we get to the question of how you got into
5:54
Speaker 1: this field. I mean, you've been doing this for a while,
5:57
Speaker 1: you were, you know, speaking both nationally and nationally. People
6:01
Speaker 1: get into this field and the specialization of trauma obviously
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Speaker 1: for many different reasons. You know, I've often talked about
6:07
Speaker 1: one of my inspirations, which was my brother who came
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Speaker 1: back from Iraq with PTSD and how I just pastored
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Speaker 1: him to talk about his experiences and I blew it.
6:17
Speaker 1: But share with our listeners and take us there, you know,
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Speaker 1: share a story. How did you get into this field?
6:26
Speaker 2: Well, it's actually funny because I had originally signed up
6:29
Speaker 2: for neuropathology, so working with brains after people had died,
6:35
Speaker 2: and I think that came for my research in neuroscience.
6:39
Speaker 2: I had done a combined mdphd program in neuroscience and
6:43
Speaker 2: so I thought, you know, maybe neuropathology would be a
6:47
Speaker 2: good way to continue my interest in neuroscience. And then
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Speaker 2: I started my internship at the University of Western Ontario
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Speaker 2: here in London, Ontario, and my first elective was psychiatry,
7:00
Speaker 2: and I worked on a very nice inpatient unit that
7:03
Speaker 2: actually had a lot of trauma patients. They weren't labeled
7:06
Speaker 2: as such, but they had experienced a lot of trauma.
7:09
Speaker 2: They were there because they were very justsregulated, suicidal, didn't
7:12
Speaker 2: really have a sense of self. And so I was
7:15
Speaker 2: exposed to a lot of clients with that history, and
7:19
Speaker 2: I remember, you know, spending a lot of time with them,
7:22
Speaker 2: listening to their stories and really trying to figure out
7:26
Speaker 2: how the mind had adapted to their horrendous experience and
7:32
Speaker 2: I think that's when I really started being very interested
7:37
Speaker 2: in trauma because I realized how much you could do
7:41
Speaker 2: for somebody like that, you know, working with somebody like that,
7:43
Speaker 2: how you could help them to you know, change their
7:48
Speaker 2: sense of self or either or even have a rebirth
7:51
Speaker 2: of the sense of self if somebody has never had
7:53
Speaker 2: a sense of self because of the experiences they've had.
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Speaker 2: And you know, I realized how difficult it can sometimes be.
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Speaker 2: But I thought, compared to other disorders, if you hang
8:05
Speaker 2: in there, like we talked about, if you you know,
8:08
Speaker 2: keep having that hope and keep having that light at
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Speaker 2: the end of the tunnel, you can get somewhere and
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Speaker 2: you can really change someone's life. And I think that's
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Speaker 2: something that really really inspired me.
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Speaker 1: I love I love that phrase and the idea of
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Speaker 1: a rebirth of a sense of self. Can you share
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Speaker 1: with our listeners when that became an idea for you
8:33
Speaker 1: or was an individual that you worked with that you said,
8:38
Speaker 1: wait a minute here, you know, maybe there's something to
8:41
Speaker 1: this idea.
8:43
Speaker 2: Yes, Actually, I think it came about working with a
8:47
Speaker 2: number of individuals and I keep asking them, you know,
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Speaker 2: tell me about yourself, you know, tell me about who
8:53
Speaker 2: you feel that you are, and so often people say,
8:56
Speaker 2: you know, I really have no idea who I am,
9:00
Speaker 2: And so I realized, wow, you know, it's really the
9:04
Speaker 2: sense of self that is so much affected by trauma,
9:08
Speaker 2: and that's something we really have to either change or
9:12
Speaker 2: sometimes build up from scratch if somebody really has had
9:17
Speaker 2: a tremendous history of neglect and abuse. And so over
9:21
Speaker 2: time we began thinking about that more and more, and
9:27
Speaker 2: in addition to clinical work, I also do a lot
9:29
Speaker 2: of research doing brain imaging, really seeing what brain areas
9:33
Speaker 2: are affected by early life trauma. And we were starting
9:39
Speaker 2: to do brain scans, so looking at brain activity at
9:42
Speaker 2: rest and the network that's really active at rest, which
9:46
Speaker 2: is called the default mode network. We hypothesized maybe the
9:50
Speaker 2: reflect the sense of self, and so we compared that
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Speaker 2: in individuals with the chronic early life trauma history to
9:58
Speaker 2: healthy controls, and we really found that this network was
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Speaker 2: profoundly disrupted. You know, you don't have to know anything
10:06
Speaker 2: about neuroscience or neuroimaging research. If you compare the two
10:09
Speaker 2: pictures which I can share with you, you know, you
10:12
Speaker 2: really see a profound impact on that network. And so
10:16
Speaker 2: we speculated on whether that may be one model of
10:19
Speaker 2: the sense of self and the brain regions that are
10:22
Speaker 2: involved in this network really involve, you know, brain regions
10:26
Speaker 2: involved in knowing what you feel, in regulating your emotions,
10:31
Speaker 2: on integrating past memories and looking into the future. What's
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Speaker 2: your key elements of you know, a functioning sense of self.
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Speaker 1: I think that gives a clinician, and you know, someone
10:47
Speaker 1: who is sitting with someone who's been traumatized, it really
10:51
Speaker 1: provide them such a grounding or a mooring, if you will,
10:56
Speaker 1: from which to work. I mean to as you described,
11:00
Speaker 1: you know, invite a client or a patient to talk
11:03
Speaker 1: about who they are and to discover and hear them
11:08
Speaker 1: say well, or to even just express I don't know
11:11
Speaker 1: who I am. And I think that really gives us
11:14
Speaker 1: as clinicians a key from which to work from where
11:20
Speaker 1: to begin working. And it's just really, yeah, that's so rich.
11:23
Speaker 1: I really love that rather than just you know, talking
11:27
Speaker 1: about symptoms, and not to say that we're all people
11:31
Speaker 1: are all doing that, but it just kind of really
11:35
Speaker 1: brings into the whole question here, the existential component, if
11:40
Speaker 1: you will, and you know how important that is impacted
11:44
Speaker 1: by by trauma.
11:46
Speaker 2: Absolutely. I think any treatment we engage in we are
11:50
Speaker 2: working on that sense of self.
11:52
Speaker 1: Right, Yeah, I love that. And was that something that
11:56
Speaker 1: really inspired you your research? When did this whole or
12:00
Speaker 1: how did the research component come into it for you?
12:03
Speaker 1: Related to trauma?
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Speaker 2: Very early on during my residency already, my mentor Peter
12:08
Speaker 2: Williamson allowed me to do brain scans of people who
12:11
Speaker 2: had been traumatized, and so we got into the neuro
12:14
Speaker 2: imaging very early on when it first started, and so
12:17
Speaker 2: it allowed us really to make that invisible injury, which
12:21
Speaker 2: psychological trauma is and psychiatric disorders were at the time, Right,
12:27
Speaker 2: It allowed us to make that invisible injury more visible.
12:31
Speaker 2: And that was incredibly validating for people as well, right,
12:35
Speaker 2: because so often traumatized people get told, you know, there's
12:38
Speaker 2: nothing wrong with you, get over it. And so when
12:42
Speaker 2: they were able to see that their brains were actually
12:45
Speaker 2: activating differently from people who hadn't experienced trauma and who
12:49
Speaker 2: didn't have post traumatic stress disorder and related disorders, it
12:53
Speaker 2: was incredibly validating. And then we always talked about, you
12:56
Speaker 2: know the goal of therapy is to read you know,
13:00
Speaker 2: levels of brain activation that are similar to people who
13:03
Speaker 2: don't have these disorders. And again, I think it gave
13:07
Speaker 2: people hope, and it gave people validation, and people felt
13:11
Speaker 2: less abnormal, right As you know, when people first come
13:14
Speaker 2: in with PTSD and related disorders, they think they're the
13:19
Speaker 2: only ones experiencing these horrendous symptoms. They feel so alone
13:24
Speaker 2: and so validating that for them, that was a big shift.
13:29
Speaker 1: I love that Ruth share with our listeners and early
13:33
Speaker 1: clinical error. You know, obviously you've been doing this a
13:37
Speaker 1: long time. You kind of referenced a point when you
13:40
Speaker 1: were doing your residency, But take us back and tell
13:46
Speaker 1: us a story about one of the kind of you know,
13:51
Speaker 1: errors you've made and how that impacted you.
13:54
Speaker 2: Yeah. I think it was an very important learning experience,
13:58
Speaker 2: and I think it repeated itself throughout my early clients
14:02
Speaker 2: that I was seeing. And I think when you're treating
14:05
Speaker 2: traumatized individuals, the suffering is so great, and you see
14:09
Speaker 2: the distress people are in. I think you feel that,
14:14
Speaker 2: you know, you want to move in there and you
14:16
Speaker 2: want to change things, and you know, I think sometimes
14:21
Speaker 2: you move in too much and you think you actually
14:23
Speaker 2: have more power than you do. And over time I realized,
14:29
Speaker 2: you know, my clients are incredibly resilient. They've experienced things
14:35
Speaker 2: I could probably never have survived. They've got tremendous strengths.
14:40
Speaker 2: I think I need to sit back more. I'm a coach.
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Speaker 2: They have all the strengths, they can get through this.
14:47
Speaker 2: What they need is a coach. And it was that
14:51
Speaker 2: shift where I was able to be more relaxed because
14:55
Speaker 2: I think I was having more skills, you know, and
14:58
Speaker 2: they were coming on board, you know, when I was
15:01
Speaker 2: able to sit back more and just believe that they
15:04
Speaker 2: can do it, believe in my clients and have less
15:08
Speaker 2: of this urge of having to move in and you know,
15:12
Speaker 2: help them change things. You know, they can change the things.
15:15
Speaker 2: All they need is the coach and somebody who guides
15:19
Speaker 2: them on the path. And I think, you know, giving
15:23
Speaker 2: a person in therapy that impression, believing in them like
15:27
Speaker 2: that and again creating that hope because you know they
15:31
Speaker 2: can do it, is very helpful and I think it
15:34
Speaker 2: really helps to decrease burnout as well.
15:37
Speaker 1: So as you're speaking, a couple of things come to mind.
15:41
Speaker 1: The first of which is can can you give us?
15:44
Speaker 1: Can you take a deep dive and share with us
15:46
Speaker 1: a particular experience when that happened and what that looked
15:50
Speaker 1: like for you. I mean, how did that impact the
15:52
Speaker 1: client you were working with. I'm curious about that, all right.
15:59
Speaker 1: I don't know if if you follow me on Instagram
16:01
Speaker 1: or not. But when I do interviews, I usually do
16:05
Speaker 1: two interviews a week. I conduct two interviews a week,
16:09
Speaker 1: and usually I get so excited. I get so pumped
16:15
Speaker 1: up after these interviews because I get to talk to
16:17
Speaker 1: incredible people. And what I usually do is they go
16:21
Speaker 1: on Instagram and I talk about it. I want to
16:24
Speaker 1: share that excitement. Usually there's about a two month turnaround
16:29
Speaker 1: on my podcast, which means that they don't go live
16:35
Speaker 1: for a couple of months, and I have a problem
16:38
Speaker 1: with that because I want to share it. I get
16:44
Speaker 1: so excited about these things. So what I've done is
16:47
Speaker 1: I've created a membership called Trauma Therapist Plus and allows
16:54
Speaker 1: people for five dollars a month to access these episodes
16:59
Speaker 1: about two months before they get published to the public.
17:03
Speaker 1: And you can also listen ad free, which is really cool.
17:06
Speaker 1: So if you're interested in that, if you're interested in
17:10
Speaker 1: listening to episodes before they get released to the general
17:12
Speaker 1: public and also listening ad free, check it out. Being
17:17
Speaker 1: access it by going to Apple Podcasts and just clicking
17:21
Speaker 1: on any of the episodes that has a plus plus
17:24
Speaker 1: before it. It's exciting. I'm excited about it, and you'll
17:28
Speaker 1: also help support the podcast. Thank you so much for
17:32
Speaker 1: being a listener. I really appreciate it. Take care.
17:35
Speaker 2: Yeah, I had one that client. She had PTSD, she
17:38
Speaker 2: had a severe eating disorder. She was very just regulated.
17:42
Speaker 2: She often threatened paris suicidal behavior. And I was quite tense.
17:48
Speaker 2: You know, it was very early on in my training.
17:51
Speaker 2: And you know, I remember I was out at a
17:54
Speaker 2: birthday party and I was very worried about her. And
17:58
Speaker 2: you know, I tried calling her a couple of times,
18:01
Speaker 2: and you know, she didn't answer the phone, and I think,
18:04
Speaker 2: you know, she was home, but you know, didn't really
18:07
Speaker 2: want to answer the phone, which she admitted to me later,
18:10
Speaker 2: and I just got I just got very tense, and
18:13
Speaker 2: my whole evening was taken up by thinking about this client.
18:19
Speaker 2: And you know, as you get more experienced, and as
18:22
Speaker 2: I think, you realize how many strengths these clients have
18:26
Speaker 2: and that they can get through it. I think if
18:29
Speaker 2: I had been more experienced, I could have sat back
18:32
Speaker 2: more and thought, you know, she's going through a rough time.
18:36
Speaker 2: We had an appointment today I'm going to see her
18:40
Speaker 2: again this week. She's going to be okay, you know,
18:45
Speaker 2: having that faith and having yeah, the realization that you know,
18:50
Speaker 2: she's been through so much, you know she can get
18:53
Speaker 2: through it.
18:55
Speaker 1: You know. The other thing that comes to mind, Ruth,
18:57
Speaker 1: is that you know, sitting back, you know, to to
19:01
Speaker 1: use the word you used and to kind of allow
19:06
Speaker 1: the client to allow of the client's strength to to
19:10
Speaker 1: come to the fore if you will. Ye, why does
19:14
Speaker 1: that Why is that challenging for therapists And why was
19:19
Speaker 1: that challenging for you?
19:21
Speaker 2: Because I think we're trained that we have to do
19:23
Speaker 2: things right, you know, we have to you know, if
19:28
Speaker 2: something happens, it's you know, it's really weird. I think,
19:31
Speaker 2: especially with trauma symptoms for example, you know, if a
19:34
Speaker 2: client cuts herself for himself, therapists feel that it's their fault,
19:40
Speaker 2: right for some reason, right. And you know, if a
19:43
Speaker 2: schizophrenic patient has hallucinations, we would never feel it's our fault, right.
19:48
Speaker 2: But so often when our clients self harm or you know,
19:52
Speaker 2: they're more suicidal, therapists tend to think, you know, it's
19:58
Speaker 2: their fault. I think we need to move away from that.
20:01
Speaker 2: It's a symptom. Right, it's a symptom of the illness.
20:05
Speaker 2: We're there to help the client overcome these symptoms or
20:10
Speaker 2: help them, you know, we're here to help them to
20:12
Speaker 2: regulate better. And we're really here to help. And I
20:16
Speaker 2: often use this analogy and treatment to watch the butterfly unfold,
20:22
Speaker 2: right that when we start, it's almost like we're working
20:24
Speaker 2: with the larva, right, and within that larva is a
20:28
Speaker 2: beautiful butterfly that needs space, that needs time to unfold.
20:35
Speaker 2: So I think that's, you know, one approach that's been
20:39
Speaker 2: very helpful for me.
20:40
Speaker 1: So what's what's I mean before we get to the
20:43
Speaker 1: the you know, your advice for clinder, So I just
20:45
Speaker 1: want to pull out here my take home here and
20:49
Speaker 1: this particular topic is, you know, realize and recognize that
20:56
Speaker 1: we're not here to fix our clients, you know, and
20:59
Speaker 1: we're we're here to coach our clients. What's what's the
21:02
Speaker 1: take home for for our listeners here that you feel?
21:06
Speaker 2: Well? I think if you're trying to fix your clients,
21:10
Speaker 2: you're actually implying that they're incompetent. Right, if we help
21:16
Speaker 2: them to fix themselves, we're telling them, you know, you're
21:20
Speaker 2: competent you've brought great strengths and we're to help here
21:23
Speaker 2: to help you to fix yourself. Does that make sense?
21:28
Speaker 1: It does? It does, And I just I just love
21:30
Speaker 1: this sense of empowering. You know, it empowers our clients. Yeah, yeah,
21:36
Speaker 1: which is exactly what they're coming into our office because
21:39
Speaker 1: they feel they don't have that power exactly. Yeah.
21:42
Speaker 2: So, and I think this is what prevents burnout as well.
21:46
Speaker 2: I really believe that if you can take that stance,
21:50
Speaker 2: you know, that coach stance and empower the client and
21:55
Speaker 2: you know, help them to fix themselves, I think that
21:58
Speaker 2: is the key to prevent birth out in secondary traumaization.
22:02
Speaker 1: Do you see? I mean, we're go going on this topic,
22:04
Speaker 1: but it's fascinating to me. But do you do you
22:07
Speaker 1: feel that it's It's something I mean for me. You know,
22:12
Speaker 1: I've spoken with a number of people on this podcast
22:15
Speaker 1: and this topic comes up a lot, and it all
22:18
Speaker 1: it comes up from seasoned clinicians like yourself who've had
22:23
Speaker 1: to learn that the hard way. Yeah. But okay, let's
22:29
Speaker 1: let's let's move on here and we get to really
22:32
Speaker 1: one of my favorite questions, Ruth, which is your why?
22:37
Speaker 1: What keeps you going? What is your why with this work.
22:43
Speaker 2: Well, I think you know, I've been witness I've had
22:46
Speaker 2: the honor really to have been witnessed to a number
22:49
Speaker 2: of these rebirths of the sense of self, and I
22:52
Speaker 2: think it's an amazing thing. And uh, I think that's
22:56
Speaker 2: what keeps me going.
22:58
Speaker 1: Very very powerful. I love that. So let's break it down. Now.
23:02
Speaker 1: You know a lot of people listening to this podcast
23:05
Speaker 1: are clinicians just beginning to get into the field of trauma.
23:10
Speaker 1: Some are more practiced yet really don't believe that they've
23:14
Speaker 1: been working with trauma clients. But what would you say?
23:19
Speaker 1: What would you advise individuals just getting into this field.
23:23
Speaker 2: Yeah, I think one I would probably advise a few things.
23:27
Speaker 2: One is, you really need a good treatment frame and
23:30
Speaker 2: set out your expectations right at the beginning. So, for example,
23:35
Speaker 2: how often are you going to see the client discuss
23:37
Speaker 2: it with them, how long is the treatment going to
23:40
Speaker 2: take place for, and how are the two of you
23:43
Speaker 2: going to manage crisis situations? So both you and the
23:47
Speaker 2: client have this treatment frame in your mind, and I
23:52
Speaker 2: think it's really important to stick to that because you know,
23:56
Speaker 2: traumatized clients' lives were very, very unpredictable. And so this
24:00
Speaker 2: is something you don't want to recreate in the therapy,
24:03
Speaker 2: So you really want to set up, you know, a
24:06
Speaker 2: treatment frame that's very predictable, which is very different from
24:10
Speaker 2: what they've had. Then I think creating hope right at
24:15
Speaker 2: the beginning is extremely important, and you know, empowering the
24:19
Speaker 2: client like we talked about earlier, Those are very important things.
24:24
Speaker 2: And then I think supervision is very important, right, and
24:27
Speaker 2: this is not just for early therapists, but this is
24:30
Speaker 2: also for season therapists. You know, difficult things arise, right
24:34
Speaker 2: these difficult clients to treat, you know, they suffer a lot,
24:39
Speaker 2: we're impacted by that, and so to have an experienced
24:43
Speaker 2: person for supervision I think is really important where you
24:47
Speaker 2: can run by some of your difficulties, discuss different management strategies.
24:52
Speaker 2: If you're working on a team, you know, have weekly
24:56
Speaker 2: rounds where you can discuss ideas with each other. I
25:00
Speaker 2: think those are really important things.
25:02
Speaker 1: Great, Okay, so one, two, and three begin by setting
25:07
Speaker 1: out a treatment frame, you know, set it out, create
25:10
Speaker 1: something that's really predictable, discuss how crises are going to
25:14
Speaker 1: be handled. So right from the get go, you're creating
25:17
Speaker 1: a sense of structure which oftentimes, as we know, a
25:21
Speaker 1: lot of our clients don't have number two create hope.
25:25
Speaker 1: We've talked about that very powerful and finally consultation supervision,
25:31
Speaker 1: which is important and crucial for new therapists and seasoned
25:36
Speaker 1: clinicians alike. Awesome, all right, so before we get to
25:40
Speaker 1: your book, well, let's let's jump in and talk about
25:43
Speaker 1: your book, Healing the Traumatized Self Consciousness, Neuroscience and Treatment
25:48
Speaker 1: before we talk about you know what it is. Why
25:53
Speaker 1: did you write this book? What inspired you to write it?
25:57
Speaker 2: I think one thing Paul Frew and I have been
25:59
Speaker 2: in for a long period of time is really how
26:03
Speaker 2: dissociation affects mind, brain, and body. And as we know,
26:08
Speaker 2: dissociation is a strategy many traumatized people used during the
26:13
Speaker 2: trauma to help them to survive, right, whether that's in
26:16
Speaker 2: terms of detaching themselves from intense emotional states, or whether
26:21
Speaker 2: that's becoming so fragmented in order to survive. And yet
26:27
Speaker 2: when we were faced with these difficulties in the aftermath
26:30
Speaker 2: of trauma, we know how it can really prevent good
26:34
Speaker 2: quality of life, and so it's something we've been really
26:38
Speaker 2: interested both from a clinical perspective but also from a
26:42
Speaker 2: neurobiological perspective to really figure out what's going on in
26:45
Speaker 2: the brain when people have these responses. And so this
26:49
Speaker 2: is what we've wanted to focus on in the book,
26:52
Speaker 2: and we really wanted to bring together clinical work and research.
26:56
Speaker 2: So we interviewed a lot of patients to really get
27:00
Speaker 2: their own experience, and then we look at a lot
27:04
Speaker 2: of neurobiological research, and we really wanted to marry the
27:07
Speaker 2: two and come up with a model that helps us
27:10
Speaker 2: to distinguish associative symptoms in four dimensions of consciousness, time,
27:16
Speaker 2: body thought, and emotion from non dissociative symptoms. So that's
27:22
Speaker 2: sort of the focus of the book in a nutshell.
27:24
Speaker 1: Nice. So, one of the words that I want to
27:28
Speaker 1: excuse me pull out here is you use the word strategy. Yeah,
27:33
Speaker 1: talk about that a little.
27:34
Speaker 2: Bit, strategy in terms of what do you mean guys.
27:37
Speaker 1: Well, you said dissociation is a strategy that sometimes clients use. Yeah,
27:45
Speaker 1: And that to me is I love that term. Talk
27:48
Speaker 1: about what you meant by.
27:49
Speaker 2: That, yeah, And strategy sort of implies that you have
27:53
Speaker 2: control the birth right, and often dissociation you don't have
27:57
Speaker 2: control over it. It just happens. So I'm not sure whether
28:00
Speaker 2: it's actually the right word. But for example, we have
28:03
Speaker 2: an example in the book of a client who was
28:06
Speaker 2: repeatedly gang raped during her adolescence, and she describes how
28:13
Speaker 2: she was in the tree and how she was watching
28:17
Speaker 2: her body being raped over and over again, and she
28:21
Speaker 2: describes how she couldn't feel being raped because she was
28:26
Speaker 2: out of her body in the tree, and you know,
28:29
Speaker 2: you know, she also describes how she was able to
28:32
Speaker 2: have empathy for that shell really that was being raped
28:37
Speaker 2: on the ground. So I think it's just amazing what
28:40
Speaker 2: the mind can do to help us adapt to trauma.
28:44
Speaker 2: And yet, of course, when we're living trying to live
28:48
Speaker 2: a normal life, and we're so detached from emotions because
28:51
Speaker 2: of out of body experiences, then we can't experience the
28:55
Speaker 2: full range of emotions, right, you know, we feel dead,
28:57
Speaker 2: we feel numbed. So how can we help a person
29:01
Speaker 2: reconnect with those emotional states where the disconnection was helpful
29:07
Speaker 2: at the time of the trauma, but now is no
29:09
Speaker 2: longer helpful. So that's I think, really what I meant
29:12
Speaker 2: by strategy. You know, it can be adaptive and a
29:17
Speaker 2: productive strategy at the time of the trauma, and yet
29:20
Speaker 2: when it's occurring in the aftermath of the trauma. It's
29:24
Speaker 2: you know, no longer useful and it really prevents us
29:27
Speaker 2: from functioning fully in life.
29:29
Speaker 1: So you said you in the book kind of break
29:32
Speaker 1: down the association into four kind of components. Can you
29:37
Speaker 1: talk a little, just briefly about what those are, share
29:39
Speaker 1: with our listeners what those are.
29:41
Speaker 2: Yeah, there are four dimensions of consciousness that have been
29:43
Speaker 2: proposed by Sahabi and Thompson originally, and they concern the
29:49
Speaker 2: dimension of time. So, as we know, our experience of
29:53
Speaker 2: time can be very affected by trauma, right. For example,
29:56
Speaker 2: when we have flashbacks, you know, individuals often feel like
30:00
Speaker 2: they're back at the scene of the trauma, right. They
30:03
Speaker 2: lose touch with the present time and they feel like
30:07
Speaker 2: they're reliving the trauma. And so that would be an
30:10
Speaker 2: example where the dimension of time would be really affected
30:14
Speaker 2: in terms of dimension of thought. You know, usually the
30:18
Speaker 2: way we experience life is almost akin sort of to
30:21
Speaker 2: a story.
30:22
Speaker 1: Right.
30:23
Speaker 2: Stories have a beginning, middle, and an end, and they're
30:27
Speaker 2: often told in the first person perspective normally, right, But
30:31
Speaker 2: when we think about our traumatized clients already, we can
30:34
Speaker 2: see that's not often the case. Right, So when we
30:36
Speaker 2: hear a trauma story, it usually doesn't have a beginning, middle,
30:40
Speaker 2: and an end, but it's very fragmented, right, and in
30:44
Speaker 2: severe cases, the first person perspective also changes and people
30:49
Speaker 2: can start to hear voices, so you're no longer the
30:53
Speaker 2: sole narrator of your experience or rather than you know,
30:57
Speaker 2: having a thought for example, I am bad. You now
31:01
Speaker 2: have a voice saying you're bad, and so your narrative
31:06
Speaker 2: now becomes shared among several narrators that can be in
31:10
Speaker 2: the form of voices. And I think that can be
31:13
Speaker 2: related to sometimes experiencing a fragmented sense of self and
31:18
Speaker 2: then the dimension of body. You know, an example would
31:23
Speaker 2: be these out of body experiences that we have just
31:26
Speaker 2: talked about. That that would be an alteration and consciousness
31:30
Speaker 2: of body. And then emotion, as we know, is very
31:34
Speaker 2: much affected by trauma. You know, people can have too
31:38
Speaker 2: much emotion, but they can also have too little emotion
31:42
Speaker 2: where they're really numbed out or they you know, they're
31:45
Speaker 2: very dissociated from their emotion. That the emotion also almost
31:49
Speaker 2: feels like it's experienced by a perceived other, which would
31:54
Speaker 2: be a real alteration and consciousness as well.
31:57
Speaker 1: Okay, so we've got time, we've got thought, body, emotion
32:02
Speaker 1: all impacted here, Ruth, the book is healing the traumatizedself
32:07
Speaker 1: by yourself with also Paul Frewin. Yes, share with our
32:12
Speaker 1: listeners a book that's inspired you and that can obviously
32:16
Speaker 1: be trauma related or not.
32:19
Speaker 2: I think the two trauma related books that have really
32:22
Speaker 2: inspired me are Trauma and Recovery by Judy Hermann, as
32:27
Speaker 2: well as The Body Keeps the Score by bessel Lander Koch.
32:31
Speaker 1: Okay, Trauma and Recovery of course comes up again again
32:34
Speaker 1: and besil ol Vandercook's most recent book, The Body Keeps
32:38
Speaker 1: the Score. What is the best way for people to
32:43
Speaker 1: get in touch with you, Ruth.
32:46
Speaker 2: I think through email, which is Ruth dot Lanius at
32:51
Speaker 2: l h SC dot O N dot ca.
32:57
Speaker 1: Okay, Ruth dot Lanius at l h SC dot O
33:01
Speaker 1: N dot c O A A C A got it
33:07
Speaker 1: all right. So we'll have links to all this up
33:10
Speaker 1: at the show notes page and including the link to
33:12
Speaker 1: your book. And Ruth, I really appreciate you taking the
33:15
Speaker 1: time to do this. It's been a delight speaking with you.
33:18
Speaker 1: I just love your ability to communicate the work you
33:23
Speaker 1: do in just accessible terms to our listeners. But it's
33:30
Speaker 1: it's inspiring to to hear the passion you have and
33:34
Speaker 1: the hope you have for the clients.
33:35
Speaker 2: Well, thanks so much for your time, guy, all right,
33:38
Speaker 2: really appreciate it.
33:39
Speaker 1: You are welcome.
33:40
Speaker 3: Take care, Yeah, take care, Bye bye them
34:08
Speaker 1: Common s