Accepting clients seeking DBT and DBT-SUD. Intake appointments in 1-2 weeks. Until I open an in person office, I provide telehealth appointments only.
What is Trauma and Traumatic Invalidation?
Lets start with the tough task of defining trauma. One way of teaching about trauma is through metaphor. Think of trauma as an injury or wound. For physical injuries, we can typically see, feel, and touch them. We often times have medicines and interventions that aid the physical healing process. When someone suffers a wound, that means they had a "traumatic event" that inflicted the injury and left a wound.
In a psychological sense, the traumatic event is what caused the injury and we are wounded on an emotional, cognitive, and spiritual level. This could be called traumatic invalidation as well. Similar to a physical wound, emotional wounds can be raw and sensitive to the touch and can limit mobility or functioning. They also can be scarred over and have different types of pain and limited mobility.
One misconception is that trauma can only be a major life event that dramatically alters someone's experiences of the world. Typically, people think of physical or sexual assault, an accident, combat violence, or witnessing a traumatic event. This isn't entirely the case.
The injuries and wounds that impact an individual can certainly be on a verbal or emotional level. There are factors at play that increase the likelihood of a long-lasting wound. An individual might have been rejected, abandoned, neglected, criticized, shamed, bullied, dismissed, trivialized, or disrespected. This could occur within the family system, peer group, romantic relationships, or culture as a whole. This is why it is especially important to take into account factors such as age, gender, race, ethnicity, financial status, appearances, and culture. Individuals who received this treatment may or may not meet criteria for Post Traumatic Stress Disorder (PTSD) but almost always have experienced traumatic invalidation.
DBT is based in exposure therapy which is one of the earliest and most researched methods of treating PTSD. Therefore, DBT when conducted with high quality incorporates these practices and procedures into the teaching, practicing, and planning of the skills and concepts.
What is DBT-PE?
In addition to the standard DBT program, a specific protocol called DBT-Prolonged Exposure (PE) can be incorporated. This method is customized to the individual.
After thorough assessment, this protocol involves the following:
In Vivo Exposure: Approaching situations and completing tasks that prompt PTSD and urges to avoid.
Imaginal Exposure: Recalling the memory of the traumatic event in vivid detail in a systematic way.
Emotional Processing: After conducting In Vivo or Imaginal Exposure, this brings up the emotions and gives the client and therapist an opportunity to describe and understand the experiences. This is an essential component to healing the trauma wounds.
Typically, this protocol's duration is 12-16 weeks and oftentimes significant symptom reduction occurs.