counseling

Deborah Horton

Trauma In The Body

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In working with clients with trauma, I talk often about the effects of experiencing trauma and holding unprocessed trauma in the body on the body and physical health. Trauma affects all parts of the mind and body and unprocessed trauma can manifest as many physical illnesses and symptoms. The “bible” of my practice is the book The Body Keeps The Score by Dr. Bessel Van Der Kolk and I recommend it to anyone who has experienced trauma in their lives.

I work with adult women with trauma and have found that unrpocessed trauma presents in their bodies in repetitive, similar ways. The symptoms and illnesses they have are repeated from client to client to client. In my experience, women hold unprocessed trauma in areas of their body that can be tied directly to their trauma some of the time. Such as a client with sexual abuse can have body issues represented in their reproductive and genital regions that result in symptoms and illnesses related to those areas. But not always is it tied directly to the area of trauma and not all trauma people experience is physical. A great deal of trauma is emotional and mental that can represent in the body in all sorts of ways.

However, most of my clients present with similar body presentations related to their unprocessed trauma experiences. Neck, shoulder and upper back pain is almost universal. Very tight neck and shoulder muscles, sometimes as hard as rocks, resulting in back pain related to these tightened muscles. Another almost universal presentation is headaches, many times migraine headaches. Most of my clients experience some type of headache on a daily basis.

Sleep issues are also almost universally common. They can range from not being able to go to sleep, not being able to stay asleep, waking up often in the night, dreams and nightmares. Many of my clients state that they d not have restful sleep and always feel tired which then affects how they feel in their entire bodies over the course of the day.

Digestive issues are also very common among my clients. These issues can range from irritable bowel syndrome, to poor absorption issues, to ulcers, to eating disorders and more. Most of my clients state that they have some sort of digestive issue and many are on medications for those issues to try and manage them but they are still present.

Reproductive issues are also a common issue. Everything from difficult menses, to extreme PMS, to ovarian cysts, PCOS, and genital area issues such as repetetive yeast infections and unexplained pain. Many of my clients struggle with fertility issues and issues with intimacy.

Musculoskeletal issues are also very common. Unexplained body pain, inflammation, soreness. Issues such as chronic fatigue and fibromyalgia are very common. My clients often say that their bodies just hurt all the time and there is no diagnoses just the pain.

The ongoing hypervigilant state of many people with trauma also contributes to a constant fight or flight anxiety that their bodies experience all the time. This state leads to an increased production of adrenaline and cortisol that affect many of the body’s areas and systems.

Many people will say that these types of issues are common amongst all sorts of people, which is true, but my belief is that most people have some sort of unprocessed trauma in their lives that leads to many of these issues. It is too repetitive and too often repeated from client to client to client to be coincidence or just something people have.

Again, I highly recommend that people read Dr. Van Der Kolk’s book if they have experienced trauma as it is so very helpful to understand how what we have experienced has affected all of our bodies and minds. Trauma in the body is a very real and often very painful thing and understanding why and beginning to work to process the reasons can improve not only our mental health but our physical health.

Until next time be well.

Deborah Horton

Magic Fix

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It is not often that I have clients who think therapy will be a quick magic fix for their problems. Many times, clients come in thinking this but after a few sessions they quickly realize this is not the case. Every now and then though I do have one who finds it hard to let go of this belief and that can make things even more difficult for them.

Many of the clients who cling to the quick magic fix are those who have spent the majority of their lives in control mode or avoidance mode by way of control. They often believe that they can “fix” any problem by controlling everything around it or by applying control so that they can avoid the problem and pretend it does not exist or affect them.

They can spend years of their life thinking that they are strong and that all the trauma they have experienced has no affect on their decision making or responses. In fact, just the opposite is true. Their control mechanisms and avoidance is a response albeit one they have chosen and reinforced.

However, control and avoidance does nothing to process through the problems. They continue to affect them whether they realize it or not or more to the point choose to acknowledge what they know to be true. The only way to let the past stay in the past is to process through it, accept that it happened, and then retrain the mind to think and believe differently in order to awaken who they truly want to be.

If however, they continue to hold on to the idea that a magic fix can happen or that they can somehow just magically fix the issue without the actuall processing part, they will be very disappointed. Sometimes even angry and depressed at the realization that this is not possitlbe. That all the years they spent believing they can fix or control anything has been a lie.

They typically do not want to do the processing work and find it extremely uncomfortable. They think that to acknowledge and accept that they cannot control or fix makes them weak and vulnerable something they believe they must avoid at all costs to protect themselves from further trauma.

The only way is through with acknowledgement and acceptance and then work on changing long held beliefs. It is the only way to real freedom from past trauma. A magic fix is not possible.

Until next time be well,

Deborah

Deborah Horton

Trauma Responses

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In my work as a therapist, I have come to believe that everyone I have encountered has experienced trauma in their lives. I believe also that most people in the world have experienced at least one trauma in their lives. Trauma can be anything that affects someone in a negative way that then causes them to form beliefs and responses as a result. All trauma is personal and what some might view as a minimal experience the person experiencing it can view it as something much greater – to them.

Trauma responses which are formed as protection, or assumed protection against further trauma, then become what people view as their “personality traits” for individuals and as “family traits” for families. However, they are in fact, responses to trauma which continue with each passing day that the trauma is unprocessed. These responses lead people to react and interact with others in a variety of ways depending on what their trauma assumed as protection.

The four main responses to trauma are fight, flight, freeze, and fawn. These responses then lend themselves to a broader list of other protective responses that get incorporated into our lives and relationships.

In the unhealthy or unprocessed trauma version of fight, the assumed protection responses can be anger, aggressiveness, need for control, perfectionism, bullying others to get what is wanted, narcissism, taking energy and time from others without considering how they feel about it. The underlying response will usually be driven by a need to control situations and people to feel safe or to push them away with anger and aggressive behavior to again feel safe.

In unhealthy or unprocessed versions of flight, the assumed protection responses can be escaping or avoiding, seeking avoidance in substances such as alcohol and drugs, avoiding responsibilities, avoiding being out of your comfort zone, escaping or avoiding relationships that are uncomfortable, moving from relationship to relationship. The underlying response will usually be driven by a need to escape situations and people to feel safe.

In the unhealthy or unprocessed version of freeze, the assumed protection responses can be numbing our feelings and needs, being stuck, dissociation, detaching from everything around us, shutting down, not attaching emotionally to others, isolating, suppressing our feelings. The underlying response will usually be driven by a need to not feel or think about how we feel.

In the unhealthy or unprocessed version of fawn, the assumed protection responses can be putting all our needs aside and focusing on the needs of others, co-dependent relationships, people pleasing, trying to fix others, having no boundaries, not saying no, being used by others. The underlying response will usually be driven by a need to please others.

If we can identify the responses we have assumed to protect ourselves from further trauma, we can acknowledge it, name it, and understand why we are continuing these repetitive patterns of behavior. In this process, however, we must start with the root of these responses which began where our trauma began. This will likely require an investment in individual therapy to process and move through the trauma so that we can reorient our responses and change them along with changing ourselves.

Until next time be well,

Deborah

Deborah Horton

Process Equals Progress

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I am often still surprised by new clients who have the mistaken belief that trauma therapy can be some kind of magical fix. That if they come to a few sessions, I will somehow give them ability to magically cure themselves of years long trauma and negative beliefs about themselves. Unfortunately, that is not true nor is it possible.

To make progress in living with traumatic experiences and negative beliefs, one must go through the process of confrontation and move to reprocessing and then acceptance building in positive beliefs along the way. This is not an easy process or a quick one. There is no magic wand to erase what has happened to us or our conditioned responses as a result of our experiences. There is only the process.

This is where the rubber meets the road in therapy. Clients will decide in the moment that they realize they will have to go through the process whether or not they wish to continue therapy. They will make these decisions based on a variety of emotions, mainly fear, and then will either never come back or gather the strength to push on.

It is not easy to process through trauma and negative beliefs that have resulted from those traumas. It is not fun. It is difficult, emotional work. However, it is the only way through to moving to a place where what has happened to us no longer causes us to believe negative things about ourselves or respond in trauma conditioned ways.

We can not get rid of what has happened to us in the past. Those things exist and will always exist. We can learn to change how we think about those things and how we let them affect our lives now. Processing is a method to change how we think about what we feel. Traumas will make us feel a multitude of emotions – anger, sadness, fear and many more. Traumas will make us feel responsible, which is not true. Traumas will make us believe negative things about ourselves that are not true and did not start with us. Processing allows us to understand all these things and change how we think and what we believe.

Processing is the only way through. It will be difficult, but to be free of the control past trauma has over your life now, the choice is only one path – to process completely.

Until next time be well,

Deborah

Deborah Horton

Beyond Fear

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For many people, choosing to start therapy can be a very scary decision. Opening up to someone you do not know about the intimate details of your life can seem very frightening. Many people who feel that “everyone is judging” them in some way may also feel that their potential therapist will judge them in the very same ways. Still others are afraid of the changes that will come as a result of how they may change during the therapeutic process.

During my time as a therapist, I have had many potential clients come for the initial consultation, which is a time to see if we are a good fit and they seem willing and ready to start therapy. They will then come for one or two sessions and then I will never see them again or they text to say they are not ready to proceed. They can get beyond their initial fear of making a consultation appointment but when things become more in depth they are too afraid to continue.

I know that there are many others who cannot get over their fear even to make the initial consultation appointment. There are potentially thousands and thousands of people in the state where I live who contemplate therapy or who want to reach out for help and try to change their lives, but they cannot get beyond fear.

It is true that the therapist does not know the client and vice versa. However, this is a good thing allowing the therapist to be objective. It is also true that there are some therapists, unfortunately, who will make judgments about clients even though one would hope that they do not. Therapists are still human beings and as such are not always capable of separating their personal views from the counseling office. It is further true that if clients change during the process of therapy and the people around them do not change or do not accept their changes, relationships can be impacted and even ended.

I always try to get clients to do a risk/benefit analysis of continuing therapy in spite of their fears. What are the risks if they continue and change their beliefs about themselves and others, their boundaries, and what they are willing and not willing to tolerate in their lives. What are the benefits of these changes in their lives? Will they be able to live happier, stronger, less toxic lives? Is it worth the risks?

Only the client can decide these things. No matter how much the therapist might wish that they choose therapy, the client is the only one to decide to proceed and the only one to evaluate the risks they are willing to accept. The client is also the only one who can decide to do the work of therapy and implement the skills and tools the therapist provides. No matter how much the therapist provides, the client decides what they will do with it. The work resides with the client as does the decision to do the work.

If you are trying to decide if therapy might help you navigate your past, present and future please consider the risks and benefits and decide if the benefits can help you get beyond your fear. You might find that it leads you to a better life and a better you.

Until next time be well,

Deborah

Deborah Horton

Necessary Awareness

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Awareness is a necessary ingredient for change.

In order to change anything, we must first be aware that there is something that needs to change. Anyone with trauma will have great difficulty finding this awareness due to the ongoing conditioning and responses caused by internalized negative beliefs and subsequent responses to those beliefs.

In fact, most people find it difficult to be aware of things outside of their normalized thoughts and behaviors. Only through awareness can thoughts and responses be addressed. Only through awareness can we know what there is to be addressed.

In order to be aware, we must be able to recognize the thought processes we have. Recognize that they are there. Recognize where they began. Recognize how we internalized them. Over time, these thoughts, that we gained from other people, become internalized in our brains as truths about us. The become so ingrained in our beliefs that we start to think we started them. Most all my clients will say that they have always believed the negative things about themselves as if they were born with them. They were not and neither was anyone else.

To be aware of these thoughts, we must be able to pause the process when it starts. The process of thought, emotion, reaction or response. This cascade happens instantaneously with the normalization of the process. This is the thought we always have. This is the emotion we always have with this thought. This is the reaction or response we always have with this thought. So we just let it flow without awareness.

To pause the process, we must be able to name the catalyst. The thought or thoughts. They must have identifying names and we must understand how we came to believe them. Where they started, with whom, and in what circumstances. Almost all will be traced to our initial caregivers as they are the teachers of all things including the beliefs about ourselves. From birth to age seven, these beliefs are taught to us just as we are taught to talk, eat, dress, read. Name them, know them, recognize their beginning, and know they are not true nor are they yours.

It is then that we can have awareness when they come up to have the margin or pause to stop the cascade of events that follows. With awareness, we can say, I see you thought. I know you thought. I recognize where you came from thought. I do not have to respond or react to you thought. I can pause and replace you thought. I know it sounds like a lot but with practice it can be done. Over time, negative thoughts can be replaced with positive truths that do come from you.

Start with one thought that causes you the most negative emotions about yourself and the most issues with relationships with others. Name it. Name the emotion. Name the reaction and responses. Name the starting point. Accept that you did not start the thought. And start to replace it with an opposite, absolute positive that comes from you.

Do that repeatedly. Form a new habit. Create a new normal. Foster awareness as a necessary component of change.

“Awareness is like the sun. When it shines on things, they are transformed.” ~ Thich Nhat Hanh

Deborah Horton

Trauma Healing Quotes

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Most all of the work I do with clients is in relation to their trauma history. The processing of trauma and moving through to acceptance and letting go can be a very difficult journey. To live a full and free life after experiencing trauma it must be completely processed and let go. If you are thinking of starting this journey or are in the midst of it, maybe these quotes can help you begin or to press on.

“Traumatized people chronically feel unsafe inside their bodies: The past is alive in the form of gnawing interior discomfort. Their bodies are constantly bombarded by visceral warning signs, and, in an attempt to control these processes, they often become expert at ignoring their gut feelings and in numbing awareness of what is played out inside. They learn to hide from their selves.” ~ Bessel A. van der Kolk

Dr. van der Kolk is the author of the book “The Body Keeps The Score” which is effectively the “bible” of my therapy practice and the best book on how trauma affects us body and mind when unprocessed.

“We cannot have a world where everyone is a victim. “I’m this way because my father made me this way. I’m this way because my husband made me this way.” Yes, we are indeed formed by traumas that happen to us. But then you must take charge, you must take over, you are responsible.” ~ Camille Paglia

We are conditioned and taught by our traumas to internalize negative beliefs about ourselves. However, moving through and past our traumas is our choice and our responsibility.

“Trauma is personal. It does not disappear if it is not validated. When it is ignored or invalidated the silent screams continue internally heard only by the one held captive. When someone enters the pain and hears the screams healing can begin.” ~ Danielle Bernock

Finding a therapist that fits you, someone to hear you, objectively, can make all the difference in being able to walk through your personal pain.

“Every day begins with an act of courage and hope: getting out of bed.” ~ Mason Cooley

Not every day will be filled with huge strides and big wins over the past, sometimes the best we can do on any given day is just to get out of bed.

“Trauma is perhaps the most avoided, ignored, belittled, denied, misunderstood, and untreated cause of human suffering.” ~ Peter Levine

It is my experience that almost everyone has some kind of trauma and almost everyone carries on as if they do not by avoiding, ignoring, denying, controlling how they truly feel.

“Instead of saying ‘I’m damaged, I’m broken, I have trust issues.” I say “I’m healing, I’m rediscovering myself, I’m starting over.” ~ Horacio Jones

The journey to trauma recovery is almost entirely based on what we say to ourselves every minute of the day. Are your words hurting or helping you?

“Healing from trauma can also mean strength and joy. The goal of healing is not a papering-over of changes in an effort to preserve or present things as normal. It is to acknowledge and wear your new life – warts, wisdom, and all – with courage.” ~ Catherine Woodiwiss

We can never change what has happened to us, but we can learn to live better with it and in spite of it.

Until next time be well,

Deborah

Deborah Horton

Learning Resilience

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Resilience is defined as the capacity to recover quickly from difficulties or toughness. Some people feel that others they see who are able to get through hard times seemingly easily are just born that way. I think resilience is a learned or a conditioned behavior response and I think that everyone can learn resilience if they invest in the process. People can seem to be resilient who are still living with the effects of their past trauma, but most are addicted to control and reacting in their long held trauma patterns.

The first thing on the path to resilience is processing past trauma. Until the past is addressed and the reactions to that trauma are processed and understood, it is very difficult to break the response patterns that are a result of unprocessed trauma. These patterns lead to negative thinking patterns, fear of failure, being in a constant state of fight or flight, and any of the hundreds of conditioned beliefs that have formed in our brains as a result of this trauma. Therapy is the road to being free of those things.

While in therapy, you will hopefully learn how to recognize negative beliefs and thought patterns. One of the greatest barriers to resilience is any belief that prevents you from knowing you can go through hard times and come out stronger on the other side.

In order to be resilient in the face of hard times, we must be able to form a positive thought process about the current situation to confront it without fear and/or having it polluted with our past trauma responses. We must also be able to have positive thought processes to disable catastrophic thinking patterns. We have to believe that we can overcome the hard times without fear and trauma responses and that we will be okay in the future.

Learning resilience after we have processed our trauma allows us to be able to choose our responses and maintain perspective. When we are living in our trauma response brains, we can find it almost impossible to choose our responses to any situation. We can know logically absolutely what we should do or say or how we should act, but the trauma response brain is powered by emotions. These emotions overpower our logic and cause us to respond out of fear. Fear, being the strongest emotion in the world, causes us to lose all perspective in situations where we need to make a different response.

To keep building resilience we have to be able to learn from our mistakes and failures. In everything there are lessons to be learned if we can maintain our perspective and keep our thoughts out of the trauma negative zones. All life is a lesson. When we are living in our trauma response brains, the lessons of our experiences tend to be overlooked while we are in states of fear, fight or flight, or freeze. The lessons are also overlooked in negative thinking patterns of how the mistakes are our fault or that we are always failures, which is again a product of the trauma responses. Learning the lessons of failure and mistakes can make us much stronger going forward and can also teach us what we no longer want to repeat.

Be aware of your thoughts. Practice thought awareness. Meditation is a great way to practice thought awareness. It is also a great way to practice having those thoughts come and go instead of taking up root. Meditation can also be used as thought replacement practice. Our thoughts become our beliefs become our behaviors.

Resilience can be learned. We can all choose our responses, choose what we think and believe, and choose to maintain perspective. Each choice makes us stronger and more able to withstand hard times. Cultivate resilience.

Until next time be well,

Deborah

Deborah Horton

Winter Blues

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After almost a month of vacation and two weeks of family illness, returning to work has been difficult. Not only because vacation is a nice place to be, but also because winter in the northern rocky mountains is very cold, windy, and grey for the better part of January and February.

After the excitement of the holidays and fun of having time off, one can find that they have a lot less motivation for their required activities. Things like going to work, cleaning house, spending time with others, and even things we enjoy doing do not seem as appealing when enduring the winter blues.

So what can we do to cope with this time of year and the lack of motivation and even depression for some that comes with it?

Anytime the weather is even remotely nice, we need to get outside. Even if it is for a short amount of time, it can make a big difference. Getting out into the sunshine can be extremely beneficial during the “grey months”. A short walk or even a drive, a trip to the grocery store or to visit a favorite specialty store where we live, a cup of coffee with a friend at a local coffeehouse or restaurant can all provide a much needed escape from the housebound doldrums.

Being intentional about getting up out of bed, taking a shower, brushing your teeth, and changing your clothes. Often times, the urge to just stay in bed and do nothing can be powerful during the “grey months”. We can convince ourselves that because we can’t venture outside due to weather or don’t want to due to how we feel, that we shouldn’t bother with activities of daily living. No one is going to see us right? This only increases our feelings of loss of motivation and depression.

Making sure that you are eating regularly and healthy. Another thing we overlook during the “grey months” is eating properly. If we are doing a lot of nothing, we tend to not eat or graze eat anything that is handy. Usually those things are not that good for us, chips, cookies, candy, etc. Once again, we need to be intentional about getting proper nutrition during these times. Having food on hand to make small meals throughout our day that are warm and nutritious. Also making sure we stay hydrated with water is very important.

Keeping up our physical health by getting some form of exercise most every day and by taking healthy vitamins and supplements to keep up our immunity. The “grey months” also bring a variety of illnesses that we need to be strong to have minimal symptoms should we get sick. Exercise offers two benefits, keeping us active and healthy and releasing endorphins to keep our brain active and happy.

If where you live there is little sunshine during these months, a seasonal affective light could be extremely helpful. Getting light is so very important to how we feel.

Writing and/or journaling about how you are feeling, making goals and plans that you can follow through on, adding in some creative touches and artwork to your writings can all help you release emotions held in the body.

If you feel that you are getting very depressed and cannot seem to do any of the things above most days, seeking out help through therapy and/or adding medications to your mental health management can be very helpful. Reach out for help.

The “grey months” can be tough for a lot of people but there are things you can do to endure them in a more healthy and happy way. Start with one thing and keep doing it and then add another and another. If you need more help, please seek it out. And remember, this is a moment in time and brighter, warmer days are coming soon.

Deborah Horton

You Are My Sunshine

Living in the northern latitudes, such as Montana, means that we are exposed to far less sunshine than other parts of the United States. The lack of sunshine exposure especially in the winter months, with much shorter daylight hours and lots of cloudy, snowy days, we get a lot less Vitamin D than many of our southern neighbors.

The time change ushers in days that get darker and darker earlier and earlier as we venture deeper into the winter.  There can be overcast days where the sun is never seen and darkness can descend by 4:30 in the afternoon making for very long nights and very little light.

Many studies have been done on this lack of Vitamin D and the connection to depression and depressive symptoms. Montana has a very high rate of depression and suicide and this can be one of the reasons why. It is not the only reason, but many of the people I have worked with over the last few years have been very deficient in Vitamin D. Some when having their blood work done, have found that they had almost NO Vitamin D in their bodies and all of them had depression and depressive symptoms.

One study Depression and Vitamin D Deficiency: Causality, Assessment, and Clinical Practice Implications talks about the various causes for this deficiency and ways of possible treatment. It lists many foods from which we can get Vitamin D and unfortunately many of them are not foods that a lot of the people I see eat, such as liver, sardines, tuna, salmon, swordfish. Other causes are insufficient sunlight and malabsorption diseases such as irritable bowel syndrome, celiac disease, and others.

Anyone can be Vitamin D deficient. The only way to know for sure is to have blood work tested. Correction can be made in several ways adding Vitamin D2 or D3 supplements daily, increasing certain foods in your diet, and getting sunlight either outside or by using a seasonal affective disorder light.

I am NOT saying that a Vitamin D deficiency is the ONLY cause of depression nor am I saying that taking Vitamin D will cure all depression or that anyone should take Vitamin D instead of prescription medications. I am saying it can be an additional cause of depression and depressive symptoms and in some people a significant cause depending on the level of deficiency. If it can help then it is a very easy and natural way to boost how we feel.

If you or someone you know living in northern areas of the country has depression and/or depressive symptoms, it may very well be worth the time to have some blood work done to see about Vitamin D deficiency. It could be of a great deal of help to know and then to work to reduce it.

Here are some other articles for the link between Vitamin D deficiency and depression:

Vitamin D and Depression: Where is all the Sunshine?

Vitamin D Deficiency and Depression  

There are other ways to battle “seasonal depression” or “seasonal affective disorder” to either go along with Vitamin D or be separate from taking supplements.

VeriLux Happy Light

There are many options of SAD lights on the Internet.  You have to look to see which would fit what you need most and make sure to read the reviews as well.  The above listed lamp is fairly affordable and has some very good reviews.  Make sure that you get out into the sun anytime it is out in winter even if it is cold.  Go outside, bundle up, and stand in the sun for a few minutes at a time.  When the sun is out during winter, open the curtains and let it in your entire house and sit in it inside the house.  Schedule social activities and follow through with them to connect with other people.  Increase your exercise doing it inside if it is too cold to be outside.  Seek out therapy to get you through the winter.  Therapy can serve to offer not only someone to talk to but tools for managing season depression.

Until next time be well,
Deborah