The beginning of the end… I recently received a new, unexpected diagnosis when I went to a skilled EMDR therapist for help with chronic pain: Post-traumatic Stress Disorder (PTSD- DSM-IV definition and PTSD DSM-5 definition)
Guest author: Lesa Fichte, LMSW
I recently received a new, unexpected diagnosis when I went to a skilled EMDR therapist for help with chronic pain: Post-traumatic Stress Disorder (PTSD- DSM-IV definition and PTSD DSM-5 definition). Eye Movement Desensitization and Reprocessing (EMDR) is an evidence-based treatment for trauma developed by Francine Shapiro, PhD. I have a less severe form of PTSD than many others who have been through horrific experiences. I have what Shapiro calls “small t” trauma. LOTS OF IT! “Big T” trauma is comprised of the things people typically think about as major causes of PTSD (see the chart below).
For me, one more thing happened this year and my resilience and coping efforts were just worn out. My already daily pain escalated. Many of us have “small t” trauma and our own unique levels of resiliency. I grew up as a Campbell’s Condensed Soup kid (tomato was my favorite). Going into treatment I felt like a can of “Trauma Soup”- lots of trauma ingredients packed tightly into the can of mind/body/spirit! Yet I never really considered these “small t’s” as causing my pain and other struggles. I felt as if I had these evil gremlins clinging to my mind and body, persistently resisting cognitive-behavioral efforts to make them let go of me.
It bothers me greatly that people often focus on the “big T” trauma and overlook the damaging power of “small t” trauma. Many of our clients have both types, and tragically for some, years of horrific “big T” trauma. “Small t” traumas can also derail quality of life and functioning. Universal trauma screening could identify many trauma survivors, change treatment plans, and CHANGE THEIR LIVES! Psychological trauma is a hidden epidemic. 90% of clients in public behavioral health settings have experienced trauma. – SAMHSA-HRSA Center for Integrated Health Solutions.
Below is a chart that shows some differences between “small t” and “big T” trauma. “Small t” trauma is sometimes called complex trauma and those with multiple incidents of “big T” trauma can also have complex trauma.
View a client video about EMDR including the effect of PTSD on the brain (this video shows the use of EMDR equipment instead of therapist fingers for the eye movement).
Trauma is NOT about what is wrong with someone, it is about what HAPPENED to them. Needing treatment to heal and asking for it is about COURAGE, not about society’s perception that it is a weakness.
We need to remember that there two faces of trauma, “Big T” and “small t”- both deserve equal respect and a nonjudgmental approach. Evidence-based practices and a good therapeutic relationship can take you behind the human curtain and help a person heal. When trauma is not treated, people do not heal and sometimes they die. EMDR is evidence-based, fast, and life changing. We need more skilled EMDR therapists across our country, throughout the world.
EMDR International Association
Trauma Institute and Child Trauma Institute (Ricky Greenwald, PsyD)
EMDR Institute, Inc. (Francine Shapiro)
National Center on Trauma-Informed Care
National Child Traumatic Stress Network
International Society for Traumatic Stress Studies
Trauma-Informed Certificate Programs: University at Buffalo School of Social Work Office of Continuing Education
University at Buffalo School of Social Work Institute on Trauma and Trauma-Informed Care (ITTIC)