trauma

The Three Important Elements of Self-Care for All Times, but Especially Now

Image by aedrozda from Pixabay

Image by aedrozda from Pixabay

It has been over a month since our Gov. Jay Inslee issued a “stay-at-home” order” order in WA. Usually, a month goes by and we don’t even notice. But, the quote circulating around social media is funny because it’s true: it really does feel like there are five years in April. Ok maybe not five years, but it does feel like we’re on the 12th week of April at my house!

Just when you think you have transitioned, think again

Now that we’ve had six weeks of practice (or, 5 years depending on how you experience time), we should have it down by now, right?! After all, we just need to carve out a space to work from home, make a schedule of things to do with the kids, meal prep for the whole week, cook endlessly, remember to fit in workouts because that’s what healthy people do, and then repeat. No big deal. 

Just writing all that makes me want to crawl back into bed. 

Whether you’re an essential worker who’s exhausted from your shifts, someone working from home or recently unemployed, or a parent who never signed up to homeschool your kids, it has been one adjustment after another. With the constant transition of new protocols at work, no school during spring break to now five assignments a day, it can be easy to forget what self-care looks like for you. Before the pandemic, you used to know how to do this, but now it takes so much more.

Self-care according to popular culture

Most people think about self-care as eating well, sleeping well, regular exercise, meditation, etc. It is all that and then some. Taking care of your basic needs is only one aspect of taking care of yourself. While doing the basics can be stabilizing during a health crisis; you might find yourself needing more with the passing of time. While you might not feel like you have the bandwidth to do more, engaging in these activities can actually strengthen your bandwidth. 

Do productive work 

Statewide, nearly half a million people are unemployed from the coronavirus. Meanwhile, people on the frontlines might feel like they’ve worked multiple shifts in one. In either case, we’d need to redefine work. If you went from having a regular work schedule to now being out of work and stuck at home, productive work is no longer limited to paid work. Instead, it can mean navigating the unemployment website, looking for a job, scheduling out your week with activities that are a little bit challenging, but not overly so, and actually doing them. If you’re a frontline worker and you often leave work feeling like there’s more work to be done, it’s a different strategy for you as well. 

If you’re unemployed

Self-mastery is a fancy term that speaks to gaining a sense of mastery over your life by doing things that help you feel more confident and in control. This is especially crucial during a time when you did not choose your circumstances, and things are very shitty right now. Self-mastery involves doing tasks that require some effort, but you’ll feel good about yourself when you’ve done them. Here are some additional examples of productive work during our shelter-in-place:

  • Take care of your personal hygiene even if you have nowhere to go

  • Pick up and sort through mail 

  • Do laundry

  • Clean up around the house 

  • Take care of people in your home

When you don’t have income coming in, it can be tempting to stop all forms of work. But, when you engage in activities that you know need to get done, it can help you feel a sense of accomplishment, that today counted for something. It’s not meant to be life changing; but it can help move the needle forward in the slightest ways.

If you’re a frontline worker

If you’re not asked to do more during each shift, you might be “strongly urged” to pick up additional shifts. With needs that don’t seem to be letting up, it’s hard to feel like you’ve done enough after a day’s work. And no matter what you did, there were things outside of your control. Perhaps a patient died during your shift, you came back to a warehouse full of next day deliveries, you could’ve been even more thorough with disinfecting that near empty office… Did you make a dent today? 

You did. 

You did the best that you could for the day. Unless you’re a robot, your best fluctuates each day. With the current state of affairs, it’s hard to be firing on all cylinders, day after day. So productive work is more about having done your best and then coming back the next day and being okay with your best then too. 

It can also help for productive work for frontline workers to include non-paid work. Having a small project where you get to see the beginning, middle and end could help you feel like you were able to tie a bow on something. Here are some examples: 

  • Putter around in the yard and plant something 

  • Change out that burned out bulb 

  • Cook your favorite comfort food recipe

  • Clean out your garage (Yes, this can be a big ask. Even just a corner of it is enough)

  • Tackle a jigsaw puzzle that is a bit difficult for you

Engaging in these or other activities can remind you there are ways to feel accomplished outside of work. And, work is not all that there is. 

Take care of basic needs

So, what are our basic needs? It’s actually a pretty long list:

  • Rest the brain with sleep

  • Drink water

  • Stay hygienic 

  • Eat food that fuels the body 

  • Empty our bladder and bowel 

  • Feel safe in our environment 

  • Have a shelter over our head 

  • Wear comfortable clothing 

While none of the above are rocket science, we do put our bodies through a lot and expect it to bounce back. With the stress of life, we may sometimes forgo some basic needs without recognizing it. And yet, it is especially during these trying times that we need to pay close attention to our basic needs. Because, when was the time you did the following:

  • Stayed up too late or stayed in bed for too long? 

  • Felt dehydrated?

  • Fished clothing out of the dirty laundry basket?

  • Ate what you knew would make your body feel bad, ate too much or skipped meals? 

  • Held your pee or your poop when you needed to go? 

  • Ignored your body’s signals when you felt either too cold or too warm?

  • Stayed in the same posture for way too long?

When we’re not in a pandemic, we may go through moments where we ate out a lot, got little sleep, survived on energy drinks and (hopefully) recovered. When things are going awry, taking care of our basic needs is a buffer against the constant stress and illness. It doesn’t mean you have to do everything perfectly, but being mindful of the elements that are missing and being intentional about ways to bring them back would be helpful.

Make time to play

It’s not enough to do productive work and take care of your basic needs; you also need to find time to play. If you equate cleaning with play and find it exciting to meal prep many times over, these activities help, to a certain extent. You also need to laugh, to have fun, to allow room for creative endeavors. 

When there’s a shortage of time and money, here are possible solutions: 

  • Show up for a scheduled online board game

  • Work on an art project 

  • Go for a bike ride with your kids

  • Take a walk and notice the blooming flowers and young leaves

  • Try a new recipe 

  • Play your guitar, piano, cello, something

  • Try an online class that you’ve been meaning to take in person 

  • Do kids yoga as a family, even when you don’t have kids

  • Watch this short video about how a music teacher is coping with teaching online:

The key here is not to achieve something; that’s under the section of productive work. Rather, it is to have a good belly laugh, to let yourself cut loose, and to share fun times. There are enough seriousness, restraint, and unknown in the world right now. People’s opinions about COVID will always be there. You’ll hear about plans for re-entry when it comes. Trips to the grocery store aren’t going to feel normal for a while.  But when you play, you’re shaking off the cumulative stress. 

It’s the restoration we can all use right now.


Hi, I’m Ada. Here’s how I’m (trying) to practice what I preach -

  • For productive work, I wrote this blog post today.

  • For basic needs, I made too much food last week and too little this week. Next week, I might have a better handle on things. I’ll do my best then. 

  • For play, I’m taking an online class where I learn to illustrate recipes. It actually works better for my schedule. 

I hope you find your work, (body) care and play too. 

Warmly,
Ada

A Simple Word Exercise to Help Frontline Workers Decompress During their Breaks

Photo by Ashkan Forouzani on Unsplash

Photo by Ashkan Forouzani on Unsplash

Being Adaptive

I once went to a training where an ex-firefighter turned marriage counselor told the story of post-911 rescue efforts. He was in a damaged building next to “the Pile” with his buddies, looking for survivors. They moved cautiously and strategically for fear that what remains of the building would collapse. They had to muster up the courage to keep going and push aside any feelings of vulnerability. It was only when they were back at the station could they commiserate about being incredibly scared that they might not make it back to their families. 

He went on to explain that the most adaptive people he knows are those who have learned when to turn their emotions on and when to turn them off. It’s not functional to wall off your family at home because you’re still in work mode, and nor is it helpful to melt into a puddle at work. 

This is not to say you can’t have a bad day at work, especially during a time like this. I’m not going there with you right now, not in this post. I am explaining how I’ve structured these exercises as a way to help you turn on and off your emotions, depending on where you are in your shift.

Statements to help prepare you for work, during work and after work

Below are statements that I’ve come up with to help ground you throughout the day. While I’m not in your line of work, I try to put myself in your shoes and walk around in them as I reflect on what statements could be helpful. If you can come up with better statements, or can ask your partner, your kids to give you a phrase to remember at work, please do. “Mom, I’m so proud of the work that you are doing!” is a good one. Remember that some statements may be more helpful at certain times than others. Statements like, “Daddy, I miss you! Come home to us!” may trigger more vulnerable feelings at the beginning of your shift than when you’re on your way home.

As you read the statements out loud to yourself with an emphasis on each of the bolded words, please let that statement sink in, time and again. The statement may feel differently to you, depending on where the emphasis is. They’re meant to help anchor you into the reality of the statement, to steady you, so please don’t be so quick to brush them aside. While they’ll not magically make you feel better in the moment, with practice, they can help you feel more present and centered. Reading them out loud and taking your time with them is the best way to practice this exercise but it’s also possible to do the emphasis quietly within. Read it together with a colleague, six feet apart, except for when you’re in the loo, of course. Or, read it by yourself.

Before your shift

The last day you worked is behind you. Whether that was just hours ago or a few days ago, it’s most helpful to focus on what’s ahead. While our mind might want to trick you into thinking that you’re still reliving a past experience, your body resets every time you wake up. Today is indeed a new day. 

The past is behind me. Today is a new day. 

The past is behind me. Today is a new day. 

The past is behind me. Today is a new day. 

The past is behind me. Today is a new day. 

The past is behind me. Today is a new day. 

The past is behind me. Today is a new day. 

The past is behind me. Today is a new day. 

The past is behind me. Today is a new day. 

The past is behind me. Today is a new day. 

The past is behind me. Today is a new day

During your bathroom break

You’re taking a breather but you don’t have a lot of time. Instead of scrolling through your phone while you’re on the can, read this statement instead: 

I am taking care of others. This is me taking care of myself. 

I am taking care of others. This is me taking care of myself. 

I am taking care of others. This is me taking care of myself.

I am taking care of others. This is me taking care of myself. 

I am taking care of others. This is me taking care of myself. 

I am taking care of others. This is me taking care of myself. 

I am taking care of others. This is me taking care of myself. 

I am taking care of others. This is me taking care of myself. 

I am taking care of others. This is me taking care of myself. 

I am taking care of others. This is me taking care of myself. 

I am taking care of others. This is me taking care of myself.

I am taking care of others. This is me taking care of myself. 

I am taking care of others. This is me taking care of myself.

During your lunch break 

I am doing the best that I can. That is all that I can do. 

I am doing the best that I can. That is all that I can do. 

I am doing the best that I can. That is all that I can do. 

I am doing the best that I can. That is all that I can do. 

I am doing the best that I can. That is all that I can do. 

I am doing the best that I can. That is all that I can do. 

I am doing the best that I can. That is all that I can do. 

I am doing the best that I can. That is all that I can do. 

I am doing the best that I can. That is all that I can do. 

I am doing the best that I can. That is all that I can do. 

I am doing the best that I can. That is all that I can do. 

I am doing the best that I can. That is all that I can do. 

I am doing the best that I can. That is all that I can do. 

I am doing the best that I can. That is all that I can do. 

I am doing the best that I can. That is all that I can do

On your way home

You have carried the weight of the day on your shoulders; it’s now time to let go of that load. Up until now, you’ve needed to wall off your vulnerable emotions to stay sane and do your job well. It’s time to turn them back on. If that means you need to cry in the car, shake your body out (in no particular fashion), call up a good friend, pray to your higher power... do what you need to do. Then consider this last statement to prepare you to go home: 

My shift is behind me. My family is before me. 

My shift is behind me. My family is before me. 

My shift is behind me. My family is before me. 

My shift is behind me. My family is before me. 

My shift is behind me. My family is before me. 

My shift is behind me. My family is before me. 

My shift is behind me. My family is before me. 

My shift is behind me. My family is before me. 

My shift is behind me. My family is before me. 

My shift is behind me. My family is before me

And please make it safely home.

Warmly,
Ada

Resources for Exhausted Front-line Workers During the COVID-19 Outbreak

Photo by 烧不酥在上海 老的 on Unsplash

Photo by 烧不酥在上海 老的 on Unsplash

This one’s for the cashiers. The janitors. The delivery drivers. The food packagers and the gas station attendants.  It’s for the doctors, the nurses, therapists and front desk crew at the ER. To anyone who’s working overtime while the world stands still in fear, we want to sincerely thank you from the bottom of our hearts.

While half of your friends and loved ones are unemployed and figuring out what to do with newfound free time, you’re working round the clock. You’re overwhelmed, burned out, and constantly worried. We see you and we want to thank you for putting yourself in the front lines during a pandemic. You are essential. 

We’ve compiled a short list of community resources that will hopefully help you get through the coming weeks.

Mental health sessions at free or reduced rates for frontline workers

Seattle COVID Worker Care Network 

Washington COVID-19 Mental Health Network

CORONAVIRUS online therapy

Project Parachute: Pro Bono Teletherapy for COVID-19 Frontliners

Free mindfulness apps and workout videos 

If you have time after a long shift, take a yoga class and stretch it out with the following free resources -

Downdog App is offering free workout videos through July 1st.

Headspace has free access to meditations through 2020.

The YMCA regularly releases free workout videos.

Orangetheory helps you work your whole body in 40-ish minute segments.

Free food and additional perks for frontline workers

Food freebies according to Business Insider

Additional perks listed in the Seattle PI


We hope that you are able to find time for yourself to reset on a regular basis. To say that you deserve it is an understatement.

Warmly,
The Tribe at People Bloom

What 9-11 has to Teach us about Human Connection

Tim Marshall/unsplash.com

Tim Marshall/unsplash.com

We all remember

I venture to guess that we all remember where we were on Sept 11, 2011. I had recently moved to Seattle and I was living with my aunt. I got up to get ready for work and turned on the radio for background noise. Then I heard the news. It was surreal. While we were still sleeping in Seattle time, all four planes have crashed and the twin towers have collapsed. I quickly woke up my aunt and we raced downstairs to watch the news. Our hearts sank. As a Chinese Canadian new to living on American soil, “Is this what happens in America?” It was unbelievable.

I have another aunt who lives in Long Island, NY and her husband works in Manhattan. We promptly made calls to all their numbers. Busy tone. We might have made other calls to family members; I no longer remember. Seeing that there was little we could do, I was late, but headed into work. My aunt left work early that day. We got in touch with Aunt Noelle later on that night. The rest was a blur.

What people did that day

It made sense that the phone lines were busy. The cell phone network was overloaded as most people called somebody they knew in NYC. Family, friends, colleagues, past nanny. Somebody.

And the interesting thing is, we did not just call people in NYC. We also called and spoke with others who didn’t live there. I spoke with my parents that night and they live in Vancouver, BC, Canada. We called my Aunt Lisa who lives in town. Where they resided was irrelevant. When we sense fear, and a terrorist attack would do that to us, we reach for connection with the people closest to us. We reach for them because they matter to us and they bring us comfort. If people we know are not around, we reach for strangers because any human connection is better than no human connection.

A culture of self-reliance

But, aren’t we an individualistic society? We’re often self-sufficient and capable and many of us go about our everyday lives with little help from others. Even if we have a need, we might hesitate to speak it. If we ask and don’t get a response, we might decide to do without the help. We pride ourselves in being independent.

Could it be that we need each other more than we’re willing to admit? Could it be that our desire for closeness and connection in times of threat speaks to that need?

Coming together

16 years ago, we sought comfort and connection from each other following one of the worse terrorist attacks in American history. Similar stories follow when we go through other crises: an increase in political unrests bans us together against the many “isms” in our society; the wake of Hurricane Harvey prompted Houston and nearby residents in rescue efforts using boats, stand up paddle boards, or just wading through chest deep water.

And it’s not over yet. Hurricanes Irma and Jose are happening as I type this. There will be many more natural and man-made disasters to come. But, we will have each other. Coming together and seeing the value in being with each other will help buffer us through the storms of life.


People Bloom Counseling Redmond Couples Cancer Ada Pang.png

Ada Pang is the proud owner of People Bloom Counseling, a Redmond psychotherapy practice in WA. She helps unhappy couples find safety and connection in their relationship. She also helps cancer thrivers and their caregivers integrate cancer into their life stories. She can be reached at ada@peoplebloomcounseling.com.

The Great Divide. I’m not having it.

maria_savenko/stock.adobe.com

maria_savenko/stock.adobe.com

Way to start the New Year’s

I woke up on Sat Jan 28, 2017 to the start of Jan 1, 2017 on the Chinese lunar calendar. I happened to be in Vancouver, BC, Canada for a two-day training prior to the festivities and stayed with my folks. I had a rather slow morning and came downstairs to my Mama’s homemade CNY brunch. My aunt came over, my sister and niece have spent the night and all was well until I got a text from my husband.

He was asking when I’d be home. Later in the eve, I conveyed, not knowing what’s the hurry. He then mentioned some executive order that Trump has signed that morning. I looked it up and it was f*cking unbelievable.

I am a Hong Kong-born Canadian citizen green card holder living in America and I was shocked. I cannot imagine what it is like for refugees and Muslim brothers and sisters around the world.

I felt very uneasy and after a late lunch, left for the border. For the first time, I didn’t know what to expect. While Canada and the US are allies and I have all my documentation, a “Muslim ban” from selective Muslim-majority countries has me wondering what’s next.

Back on US soil

The border was uneventful, as if nothing has happened. I almost wish that something was different because this is NOT okay. I’m now back on US soil. And for the first time in my 15.5 years of living in the US, I felt different, like I don’t belong here. My countries of origin and naturalization aren’t even on the blacklist. I’m not even Muslim. But to exclude immigrants and non-citizens is to exclude me and to exclude people like me. I realize to make America great again is make America white again.

Pulling away

During my 2-hour drive home, I became increasingly aware of my “other-ness”. I feel threatened by the future possibility of not being welcomed in this country. I find myself emotionally pulling away from my white community. I picture the faces of these people I have come to know and like, and already, I feel further from them.

Suddenly, I realize what was happening. There is a great divide in our country and around the world and to pull away is to concede. In Trump’s promotion of all people white, male, straight, Christian, middle and upper class, able bodied and Euro American, he is shutting down those who don’t fit the bill.

I’m not having it.

Leaning into America

When I realized this, I made a conscious decision to lean in, instead of pull away. It helped that when I got home, my husband, who is 4th-generation Japanese American, hugged me for a long time. It helped that protests rose up at airports and city streets around the country as we stand with each other. It helped that I connected with my community the next day and saw how they were also affected by this news.

It helped that this is not the end; rather, the beginning.

We CAN find safety and shelter in each other. Notice where this was filmed:


Ada Pang, MS, LMFT is the proud owner of People Bloom Counseling, a Redmond therapy practice in WA. At the heart of what she does, she’s about helping people flourish and live compassionate and vital lives. She can be found at PeopleBloomCounseling.com.

There is Hope – Trauma Therapies that Re-wire the Human Brain

Tatiana Shepeleva/stock.adobe.com

Tatiana Shepeleva/stock.adobe.com

The word “trauma” on Google

When I google searched “trauma” the first definition that came up was “a deeply distressing or disturbing experience”. The word “trauma” is synonymous with “shock, upheaval, stress, pain, anguish, suffering, agony, misery” and the list goes on. The word has a Greek origin which literally means “wound”. When I pause to reflect on what these words actually mean, my heart becomes heavy.

Posttraumatic Stress Disorder re-triggered

I must say that while I’ve processed the trauma of my aunt’s death, watching an episode of Sherlock Holmes this past weekend was enough to trigger memories of her. I didn’t expect it; it just happened. Then I think about the many people who have been through a traumatic event and have not learned to process it and integrate it as a part of their life story. After all, it doesn’t take much to be triggered with the never ending information on social media, and to hide from triggers is to hide from life itself. If that’s your experience, I grieve with you. But, let’s not stay there.

A recap on CBT modalities for treating trauma

Last month, I wrote about Cognitive Behavioral Therapies (CBT) for the treatment of PTSD. CBT is about changing the way you think and feel about a traumatic experience. There is often an exposure component where you recall what happened in the safety of the therapist’s office and you learn to put the trauma behind you. Trauma-Focused Cognitive Behavioral Therapy (TF-CBT), Cognitive Processing Therapy (CPT) and Prolonged Exposure Therapy (PE) were amongst the treatments covered.

Trauma therapies that re-wire the brain

Today, I’m excited to call upon additional experts in the Seattle area to talk about other forms of PTSD treatment. They eloquently speak to modalities that use brain activation and body-mind integration to re-wire the brain and change the relationship you have with the traumatic event.

Without further ado, I give you Lorencita Villegas and Laura Moon Williams!

Eye Movement Desensitization and Reprocessing (EMDR)

Lorencita Villegas, LMHC, NCC is a certified EMDR psychotherapist. She writes, “Eye Movement Desensitization and Reprocessing (EMDR) is a therapy modality that helps process traumatic or disturbing life experiences or memories. It follows an eight-phase protocol where I’d ask you to recall the memory and the negative thoughts associated with it, as well as the positive thoughts you’d rather have about yourself. The goal is to replace the negative cognitions with the positive, and allow the trauma to move.

Trauma moves by allowing the brain to create new pathways that are more adaptive. To allow movement we will use eye movements (or other bilateral stimulation) to activate your brain. EMDR allows you to access your intellectual and emotional processes on your own, unlike talk therapy where the clinician would help interpret them.

It is important to note that EMDR will not change the memory of the particular event, but will change the thoughts and physical reactions associated with it. For example, a person who experienced a car accident may go from experiencing high levels of stress to having a more adaptive thought such as, “I can control my driving.” EMDR has been recognized by the World Health Organization and the Veterans Affair as a leading treatment for Posttraumatic Stress Disorder.“

Lifespan Integration Therapy (LI)

Laura Moon Williams, MA, LMHCA is a Lifespan Integration (LI) therapist. This is how she explains LI, “Those who have had a traumatic experience(s) often feel stuck reliving the event through intrusive memories, flashbacks, dreams or physical and emotional responses to reminders/triggers of the traumatic event. These PTSD symptoms occur because the person doesn’t fully and truly know that the traumatic event is over; the body-mind system is stuck in the experience and continues to respond to its current environment as if the event had just happened.

Lifespan Integration provides a safe, therapeutic way of re-experiencing the event and demonstrating that it is over, without re-traumatizing. This is done by viewing multiple timelines, beginning with the event and continuing with everyday memories that bring you into the present moment. Seeing what happened in the days, weeks, months, or years following the event proves to the body that the event is over and allows the traumatic experience to be integrated into one’s larger story. People are often surprised by how quickly they experience relief from PTSD symptoms with Lifespan Integration.“

There is hope for you

If you struggle with symptoms of posttraumatic stress disorder, you don’t have to go about it alone. PTSD affects you when you’re waking or sleeping, when you’re alone or in the company of others, when you’re at work or at play. It doesn’t have to be this way! Lorencita and Laura are here to help you put trauma in its place. Reach out to them! Lorencita is here and Laura is here.


Ada Pang, MS, LMFT is the proud owner of People Bloom Counseling, a Redmond psychotherapy practice in WA. She helps distressed couples and breast cancer patients. She understands that she cannot be known for too many things, but yes, she also loves helping amazing but struggling people recover from trauma using CBT approaches. When she’s not seeing clients, she’s about working on her business and building relationships within the therapist community. 

There is Hope – Cognitive Behavioral Therapies for Treating Trauma

Sunset Girl/unsplash.com

Sunset Girl/unsplash.com

Trauma is prevalent in our society. Turn on the TV or go on any social media and there’s no shortage of natural disasters, accidents and injuries, abuse, threats of violence, violence itself, and sudden deaths. Sadly, this does not include traumatic events that have happened to you or to those you know. In my previous post, I gave an overview on trauma. In this post and next, I’ll be covering treatments for trauma.

Evidence-based treatments for Posttraumatic Stress Disorder (PTSD)

In the field of psychotherapy, “evidence-based treatments” are treatment modalities that have been proven by scientific research to be effective for treating a particular set of symptoms. In the case of PTSD, a subset of Cognitive Behavioral Therapies (CBT) have shown to significantly decrease PTSD symptoms and related conditions, and these benefits are sustained well after treatment is over. I’ll be writing about two types of CBT approaches that I practice at my Redmond office. I’ll also be calling on trauma experts in the larger Seattle community to comment on other approaches that they specialize in.

Trauma-Focused Cognitive Behavioral Therapy (TF-CBT)

Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) is designed to help children, adolescents and their families recover from trauma and related symptoms. Over the course of 12-16 sessions, children and their caregivers will learn about the particular trauma the child has experienced, common trauma symptoms, as well as the roadmap for treatment. Caregivers will also get support around parenting and learn ways to manage the child’s emotional and behavioral difficulties related to the trauma. Children will develop and practice relaxation techniques, ways to regulate their emotions, and skills to begin thinking about their trauma differently. They will also be asked to tell/write about their trauma experience in a safe environment, share it with a special person and learn ways to safely navigate the world going forward. At the end of treatment, many kids feel really empowered and their caregivers proud! And, the tools gained from treatment can be easily adapted to cope with other life stressors.

Cognitive Processing Therapy (CPT)

First developed for use with veterans who have experienced PTSD symptoms, Cognitive Processing Therapy (CPT) has been shown effective in treating other types of trauma. As in traditional CBT, CPT sees a strong connection between your thoughts, feelings, actions, and body sensations. And, to the extent that you have some unhelpful ways of seeing the world before and/or after the traumatic event, those beliefs will keep you “stuck in non-recovery”. When you’re “stuck,” you tend to be hard on yourself and others, mistrustful of the world, and feel numbed out and angry. The ultimate goals of CPT are to help you: 1) accept the reality that the traumatic event happened, 2) fully experience the emotions about the event in a safe environment, and 3) develop more balanced, realistic views about the event, yourself, and others. Clients who have completed 12-20 sessions of CPT have shown a decrease in PTSD and trauma-related symptoms such as depression, anxiety, shame or guilt. They have also reported feeling more present in their everyday life.

Now, calling my first expert! *Drumroll*

Prolonged Exposure Therapy (PE)

For years, Caitlin Vincent, MS, LMFT, CDP provided therapy at the King County Sexual Assault Resource Center. She writes, “I find people struggle most with the re-experiencing symptoms of PTSD (flashbacks, nightmares, intrusive memories and strong physical and emotional reactions when reminded of their experience). They often say that they feel haunted and raw, like the event just happened, even if it didn't. Prolonged Exposure (PE) is a form of therapy that is especially helpful for alleviating these symptoms of PTSD by safely revisiting painful memories in detail, from start to finish, in a process called Imaginal Exposure. Just as a once-scary movie becomes less shocking if you watch it several times, this process can allow someone to regain more control over their minds and bodies. By facing these memories thoroughly and directly, and then talking about the thoughts and feelings that arise, people can start to put the experience behind them, because finally allowing the brain to process the memory relieves its instinct to replay details over and over. PE is best for someone who has a clear and identifiable 'worst' traumatic incident that they can refer to and focus on, but can easily also be used for multiple traumas.”

There is hope for you

If you suffer from trauma symptoms and these CBT approaches to treatment resonate with you, there is hope. Yes, it is scary. Caitlin and I hear you. We’ve been there with countless clients and have walked them through this painful and frightening journey into hope and recovery. We'd want to do the same for you. Let us know how we can help. I’m here and Caitlin is here.

Up ahead

Stay tune for other evidence-based approaches to treating trauma that I cannot even begin to describe! I’ll leave it to the experts.


Ada Pang, MS, LMFT is the proud owner of People Bloom Counseling, a Redmond psychotherapy practice in WA. She helps distressed couples and breast cancer patients. She understands that she cannot be known for too many things, but yes, she loves helping amazing but struggling people recover from trauma as well. When she’s not working or thinking about work, she’s eating or thinking about food. 

An Overview on Trauma

LoloStock/stock.adobe.com

LoloStock/stock.adobe.com

My trauma story

In June of 2014, my maternal aunt passed away. It was very sudden and traumatic. I still remember the call I got from mom and her words, verbatim, though spoken in Cantonese, “Ning has passed away.” It seemed very surreal, and I still remember I was in the kitchen, holding my phone, in shock.

What followed was an hour phone call with mom as she told the story and we wept together. Actually, I wasn't sure if it has been an hour because time took on a different dimension. My husband didn't know what to do. Though mom and I spoke in Cantonese, he was able to make out the content of what we were talking about. He just sat next to me and held me as I held the phone, and my mom.

My body's response to trauma

As mentioned in an earlier post, my body tends to hold stress and tension. In the days following, my body locked up and I felt very tensed. I went for my one and only massage with a gift certificate I have received years ago. It provided temporary relief. I went through waves of normal work and home life, followed by strong emotions and uncontrollable sobbing when a co-worker asked me how I was doing.

I stayed up in the middle of the night, recounting what happened, hearing my mom's voice, remembering the last encounter with my aunt. I was more sensitive to others' stories about the death of their loved ones, however they might have passed. I had a strong desire for people to stay alive. Above it all, I was angry that the sun was still shining, that life kept going for the rest of the world.

I know I needed to let go of this pain, this hurt and I finally went on a very long bike ride on my day off. I wasn't in bike-shape, but that didn't matter. It was also one of the hotter days in Seattle; 88-degrees outside. While I filled up on water at every juncture, I was still low at the end of the day. However, nothing compared to the flying feeling I experienced while on petals. It was as if the breeze took with it my burden, my tension, and leaving with me memories of my aunt. That was just the beginning of my healing process.

Trauma definition

The truth is, one in two people will experience trauma in their lifetime. That's 50%. And with the never-ending breaking news, I can only imagine that statistic going up.

Trauma is an emotional response to stressful and dangerous events that happened to you or other people. Examples of traumatic events include:

  • living through natural disasters
  • experiencing serious accident or injury
  • being a victim of crime, violence or abuse
  • witnessing someone else as a victim of crime, violence or abuse
  • going through a scary medical procedure
  • someone close to you dying suddenly

Trauma symptoms

Trauma symptoms are best described in four clusters:

  1. Re-experiencing: as you go about your day, you might experience intrusive thoughts about what happened. These thoughts take you back to the event as if you're re-living it. At night, you might dream about what happened. Sometimes you can pinpoint what triggered these memories; other times they come out of no where. You're likely to experience these symptoms at night, and when you're relax and less occupied.

  2. Arousal: memories of the trauma often bring strong emotions and physical sensations. Examples of arousal symptoms include trouble falling or staying asleep, anger and irritability, and difficulty concentrating. You might also have feelings of being on guard, like you're constantly watching over your shoulder, and being easily startled.

  3. Unhelpful mood and cognitions: as a result of the traumatic event, you might experience a lot of shame and guilt and blame yourself or others for what has happened. You might report feeling sad or hopeless, becoming less engaged in life and feeling cut-off from the rest of the world. It is also possible for you to have trouble remembering key aspects of what happened.

  4. Avoidance: because memories of the trauma are so hard to bear, there's a tendency to push away any thoughts, places, activities, people, facts or associations related to the trauma. You might avoid media content that reminds you of the event. You might actively try to avoid thinking about the trauma or feeling your feelings about what happened. Sometimes, avoidance strategies include the use of drugs and alcohol, staying busy, being promiscuous, or making other choices that provide temporal relief.

Diagnosis of Posttraumatic Stress Disorder (PTSD)

While most traumatic symptoms surface within three months of the event, sometimes they remain dormant for a long time. It is normal to experience these stress reactions following a traumatic event and for some of us, these symptoms naturally dissipate. For others, these symptoms linger for at least a month and can affect home, work and social life. If that's you, it is important to meet with a mental health professional to determine whether you meet criteria for Posttraumatic Stress Disorder (PTSD).

Hope for trauma survivors

The initial symptoms I experienced following the death of my aunt were a normal trauma response. While I recovered naturally, I know that many people who have experienced trauma have not, and I want to help. If that's you, there is hope. PTSD is treatable. Trauma treatment is hard work but the results are evident and sustained overtime. In my next posts, I'll talk about the different ways of treating PTSD: Cognitive Behavioral approaches and mind-body integration.

In the meantime, let me know if you need help.


Ada Pang, MS, LMFT is the proud owner of People Bloom Counseling, a Redmond counseling practice in WA. She helps distressed couples and breast cancer patients. She has also seen a lot of improvement in her work with trauma clients. Since that initial massage, she has had many more massages. She realizes that when she is stressed and tensed, it feels good to be touched and cared for. She hopes you'll also find ways to care for you.

Holding Orlando in my Body

Shortly after writing and beginning to process the two tragedies in Orlando, a 3rd happen. I cannot imagine what it's like to have been there, to be the family, to be witness to such loss, to hope that it wasn't the case, to wish it away every time I think about it.

Microgen/stock.adobe.com

Microgen/stock.adobe.com

There is a tendency for me to enter into the experience of another and to carry this tension, this stress in my body. For days, I went around, trying to keep going, ignoring the signs that it's not possible. My neck and shoulders were sensitive to touch; I couldn't carry my usual backpack without having to put it down at every opportunity. My body was telling me I wasn't well. I didn't want to listen, until I could no longer ignore it.

I have a 4-day conference to attend and my backpack will be my constant companion. I finally made time for some mindful yoga, of slowing down to care for my body, to pay attention to it and let it know it is important. My body responded in kind.

I don't mean to undermine the magnitude of all that have happened in Orlando by talking about yoga as a solution. I do invite you to care for you, to listen to what you might need. Given all this, what would be helpful right now? What would still keep you close to the things and people that matter to you?

My body is crying writing this and it begs for another slowing down, another stretch. Just know that I'm here if you need anything.

Orlando Tragedies – How do I Respond? How can you Respond?

ThamKC/stock.adobe.com

ThamKC/stock.adobe.com

I love The Voice and I have an off and on crush on the winner of season 6, Josh Kaufman. As a result of listening to his music, I would come across the amazing voice of Christina Grimmie, who came in 3rd that season. I share the shock and grief of many fans around the world when I learned about her death over the weekend. I couldn't wrap my head around this reality and would go through moments in my day, thinking that it's surreal. Such a beautiful life, taken from us.

Before grief even had time to sink in, I, along with the rest of the world, experienced more losses in the worst mass shooting in US history. These 49 victims have names, faces, and ties to loved ones. They had aspirations, were wonderful students, and held jobs that served the communities in many ways. My heart is broken and my body is heavy. Those injured are still grappling with their own mortality.

How do I respond to NOT one, but two Orlando tragedies?

I can tell you I want to hide.

I want to withdraw from others.

I'm in shock and disbelief.

I feel cynical about the state of our world.

I want to give up.

I think the world is unsafe.

I feel like a news junkie, which is very unlike me.

I want to protect my loved ones.

I think about the last time I've lost a loved one and how difficult that was.

Those were my knee-jerk reactions. I let myself stay there for two days and tonight, I got online to write this post. I talked about it with my hairstylist, my sister, my parents. I gave my husband a long hug when he came home from work and I'm keeping abreast with what's going on without over-indulging.

What about you?

I want you, the reader, to know that your thoughts, feelings, urges to withdraw, desire to connect are very real. I'm with you. I also want you to know that prolonged viewing of these traumatic media coverage will lead to more stress reactions, as shown by UC Irvine researchers when studying media exposure to the Boston Marathon bombings.

Please, limit your media exposure to these Orlando tragedies. Know enough to know what has happened, but don't follow every post and definitely not the playing and replaying of related videos and audios. Turn off the TV, the radio, the computer, the phone. Connect on social media around your grief, but meet face-to-face. Go to a vigil; host your own mini one. Take a break from talking about these events and just be with the other. We are not meant to go through such atrocities alone.

And, let me know if you need help processing all this or if it's awakening past trauma. I'm still here