Bryn Mawr Trauma Therapy: 3 Things to Consider When Searching for a Trauma Specialist

1. Do you want to learn skills or go deep?

Before searching for a trauma specialist in Bryn Mawr, Pennsylvania, you may want to consider what, exactly you are looking for.  Do you want to learn skills to help you tolerate the trauma memories?  Or would you prefer to engage in deeper therapeutic work to get underneath the trauma so that it can heal at the core?  

Skills such as DBT Skills are extremely helpful for daily life.  

DBT has 4 tenants: distress tolerance, interpersonal effectiveness, emotion regulation and mindfulness.  These skills are essential when doing trauma work for PTSD and for many other difficulties such as anxiety, depression, anger management, eating disorders, self-harm and addiction.  

If you’d prefer to get underneath the trauma, you will need a therapist who can help you with skills to stabilize and one who is able to help you heal at the root of the problem. 

These skills are the building blocks that will allow you to be able to function and tolerate uncomfortable memories and emotions as you dive deeper into the healing work.  

2. Which Therapeutic Models Do you Prefer?

When looking for a trauma specialist in Bryn Mawr, you’ll also want to take the time to find out the model or theory that the therapist uses to help navigate your therapy.  If you’re looking for a safe space to process and talk things out make sure you find a counselor who is great at talk therapy. If you are looking for evidence based interventions to help you DO something with the traumatic material, you may want to investigate something like EMDR.  If you want to work more from the body or a creative place, you may want to look for an art therapist, a yoga therapist or an experiential or psycho-dramatic therapist.  Ideally, you’ll find a therapist who is able to choose a therapeutic tool from a large tool belt with many choices.  

3. What is your commitment level to healing?

Successful therapy is mostly about your commitment to healing.  Your counselor may ask you to consider abstaining from addictive substances, behaviors or eating disordered behaviors, especially while you’re engaged in trauma work. If you’re doing drugs, engaging in self harm or throwing up your food while you’re trying to heal from PTSD, it can side-track the process. Instead of taking the time in between sessions to allow your psyche to continue to process and digest the trauma, engaging in behaviors can numb the emotions and make it less likely that you will process and be ready for your next session.  When you commit to your own healing process, it means you are willing to look at all aspects of your life and work towards shifting the things that no longer serve you.  

Commitment to healing also means consistency.  

If you engage in therapy every week, it creates synergistic momentum as opposed to dropping in only when you’re experiencing anxiety or depressive symptoms. Committing to consistent therapy will help you heal faster and more completely.  What is your level of commitment to healing from a traumatic past?

If you’re looking for a trauma specialist near Bryn Mawr, Pennsylvania and need some helping finding the right person for you, please feel free to give us a call at 484-784-6244 for a free 15 minute initial consultation.  We are happy to help you find the right trauma therapist for you.

Anger Management: 3 Ways to Channel Your Rage

Anger is a tricky emotion, especially in our society.  We get messages that anger is “bad” and that we should never show it.  While we certainly don’t want to take our anger out sideways on innocent bystanders and we don’t want to rage at people we have anger towards, anger isn’t a “bad” emotion to be pushed away and shamed for. It is healthy to acknowledge, honor and express our anger as long as we’re not hurting anyone in the process.  Here are three ways to channel your anger:

1.  Acknowledge: 

Mindfully check in with your body and notice where the anger lives.  You may notice that when you’re angry, you clench your jaw. Many of us store anger in our jaws. Perhaps when you get heated, you feel your face flush.  Do you notice that you make a fist?  Or are you more someone who feels ashamed for having anger, so it’s stuffed down and manifests itself in an upset stomach or feelings of self-loathing?  However your anger manifests itself, the first step towards freedom is to acknowledge that you are, in fact, angry, even if you’re not quite sure why.

2.  Honor:

Trying to put the judgment aside, see if you can think back to when you first started noticing the anger.  Sometimes people believe that the key to anger management is to push the anger away and try to ignore it.  But, I’m of the belief system that what we resist, persists.  So if you want to get free of your rage and really learn anger management, try allowing yourself to be angry without doing anything about it, just noticing it in your body.

3.  Expression:

Here are some skills you can try for expression of your anger.  Take what you like and leave the rest:

• Journal about the anger
• Write a ‘do not send’ letter to the person or thing you’re angry at
• Sweat it out - Go for a run or engage in another form of physical exercise
• Vent to a friend, therapist or another safe person not involved in the situation 
• Rip up a phone book
• Punch a punching bag
• Create some art expressing your anger
• Write out the story of what happened, then rewrite it with what you wish would have happened
• Practice progressive relaxation
• Learn assertive communication skills and directly address the issue with the person or situation

For more help with anger management, contact us here.  

What else do you find helpful for anger management?  Write your responses here:

5 Ways To Be A Better Listener: Communication Through DBT Skills

DBT for Communication

by Megan Delp, MFT

The Dialectical Behavioral Therapy (or DBT) tenant called Interpersonal Effectiveness teaches us how to be a more effective communicator through learned to be a better listener.  We have always known that progress depends on the ability to communicate effectively.  The most effective communication does not begin with what a person says, but how well they hear the person they are communicating with. Only by listening effectively can you respond appropriately inany situation.

Throughout all forms of communication (reading, seeing, speaking, listening), we spend 40% of that time listening.  And yet, we get less training in listening than in any other kind of communication. All throughout childhood, we are taught how to speak, how to read, but very little time is spent on learning how to listen.  Learning to listen is difficult, but worth it.

For instance:

• You can not NOT communicate.  We're communicating verbally or nonverbally all the time.

• Whenever contact is made, some form of communication does occur.

• The true meaning of something is not in the words we use, it's in how people interpret the words.

• Yet the meanings cannot be transferred. We can't just put a computer file directly in someone's head. We can only send the words. So listening becomes a critical skill if we are going to fully understand the meaning someone is trying to send us.

We have the ability to listen in many different ways - it is important to be able to distinguish how we are approaching our communication so that we are prepared to handle it effectively.

The Five Listening Approaches are:

1. Appreciative:

People are more likely to listen if you feel inspired by what you are hearing or if you are enjoying yourself. You’re not necessarily interested in the details when you are using Appreciative Listening, rather you are more focused on the impression of the experience.

2. Empathic:

This style is often a sounding-board to others. A person would offer support to the person they are listening to.  They focus specifically on the feelings revealed by the person they are listening to. If you are often approached by people who need to confide or vent about something, you will know that's your typical approach to listening!  This style is much more focused on offering compassion.

3. Comprehensive:

A comprehensive listener can recognize key details between one message and another even when the speaker is less than organized. They can also recognize when someone doesn't understand what is being said and can re-explain clearly in their own words.

4. Discerning:

This approach of listening wants to get all the information and may take detailed notes.  Distractions can be very disturbing when using this listening approach. An example would be when other people are talking in class and you are trying to get all the notes.

5. Evaluative:

When listening with an evaluative approach, the listener will not automatically accept what is being said as true just because an expert says it. If they disagree, they will simply stop listening. They will also be more doubtful if the speaker is too passionate about their topic. This approach can be helpful when evaluating something and making a decision about it.

It can be highly useful to adapt your listening approach to the needs of the situation.  For example, if a close friend is sharing their difficulties with you, you would want to be empathic and not evaluative.  You have probably had the experience of someone giving you unsolicited advice when you really just wanted them to empathize with you!  The opposite can also be true. When you recognize the correct listening approach in any situation, and use the appropriate listening approach, you can build better relationships, make the correct decisions and use your interpersonal effectiveness skills.  It all starts with learning how to listen!

Megan Delp, MFTI

Megan is a pre-licensed Marriage and Family Therapist specializing in couples counseling and individual therapy for those struggling with depression, anxiety and relationship issues.  Megan practices with Spilove Psychotherapy in West Chester, Pennsylvania and on the Main Line of Philadelphia in Bryn Mawr.  For more information or to schedule a free 15 minute phone consultation, contact us here.

5 Things You need to know before you start counseling

So, you’ve decided to start counseling and you’re ready to go.  Perhaps you’ve never done therapy before or maybe you’re looking to take a new approach.  Here are some things you need to know before you start counseling.

1.  Finding a therapist that you feel safe with is most important. 

You can line up a bunch of great therapists, but if they’re not the best fit for you, you’re not going to do the intense, deep work you’re looking to do.  The role of a therapist is to be a guide through your journey, reflect back to you what we see and help you to overcome obstacles towards meeting your goals.  If you don’t click with your therapist or don’t feel safe enough to trust them, reaching your goals with them is unlikely.  Your therapist should be someone you can relax around and speak freely without fear of being judged.  Trust and safety are of paramount importance when you’re looking to do deep work on things like eating disorders, trauma, PTSD, couples’ work or issues specific to the LGBTQIA community.

2.  Specialties mean that there’s been special training in a particular issue. 

Our training in graduate school and doctoral programs very rarely provides training for specific diagnoses like PTSD, eating disorders or addictions.  So when a therapist decides to have a particular specialty, we need to seek out training geared specifically towards these issues.  If you notice that a therapist you’re interested in has indicated that we specialize in a particular area, you might want to ask us what sorts of training we’ve done to qualify us as an expert.  This will give you a better idea of how equipped we are to help you with your specific struggle.

3.  When you hire a therapist, you are paying for a space that is yours, for you.

I’ve heard people say that therapy is like paying someone to be your friend.  This is actually not true.  When you hire a therapist and you pay money, what you are paying for is a safe, neutral, objective space and time where you can do your work.  It is an energy exchange.  You are not paying your therapist to care about you, you are paying for an hour in a room that is completely and totally about you and no one else.  In friendships, there’s a give and take, there’s a social obligation to ask how they are and be a support to them.  In a relationship with your therapist, you are taking time for yourself only and receiving support that is not reciprocated emotionally, only financially.  This dynamic can be extremely healing and empowering and for many, it is the only time and space where healing can truly take place.

4.  The more consistently you go, the more effective therapy is.

Sometimes, in an attempt to save money or save time, people want to schedule therapy sessions every other week or once per month.  While there’s nothing particularly wrong with scheduling like this, you may want to rethink the frequency and consistency of your therapy schedule.  You don’t have to be in therapy forever.  You can establish and work towards specific measurable goals with your therapist and see regular progress.  However, progress is more difficult to measure when you attend therapy inconsistently.  You may be having symptoms of PTSD, for example, and when several weeks go by without working on those particular symptoms, it is more difficult to get traction.  If you’re struggling with binging and purging and you go every week, you can check in with your therapist about the particular triggers and behaviors that may have lead to your binge and purge.  Don’t take my word for it, check it out for yourself.  Set a goal with your counselor and try going weekly, write down your progress and notice the differences between your weekly sessions over a period of at least 3 months versus bi-weekly or monthly progress over a 3-month period.  You may be surprised with the results.

5.  Therapy happens in stages.

Sometimes we think that as soon as we set foot in the door of a therapy office, we will be “cured” immediately or within a few sessions.  The reality is that there’s a therapeutic process which happens in stages.  The first stage is joining with your therapist or learning to trust them.  When we meet a new friend, we don’t usually tell them our deepest darkest right off the bat, it takes time and trust building to get to a place where we know they are a good friend.  A similar concept is applied in therapy.  Depending on the client, the level and amount of trauma and defenses, this stage can take anywhere from about a month to sometimes a year or even more.  Safety, trust and a therapeutic bond, known as a therapeutic alliance, is formed in order for the therapist to really know and understand the client and for the client to feel safe enough to open up and do their work. 

The second stage is where the work is done.  Since there’s now an underlying foundation established between therapist and client, the second stage is about vulnerability.  There is an unpacking, uncovering, examining and exploring the process that happens with the client and their trauma or their history.  This stage is where people see their patterns and make shifts and changes in their thoughts, beliefs, and behaviors.  The second stage of the therapeutic process is where clients reach their goals.

The third stage may or may not be part of the therapeutic process, dependent upon the client’s preference.  This stage is for maintenance.  The client continues therapy but perhaps doesn’t come every week any longer.  They use their therapist to check in with, get help with issues as they arise and review the goals and behaviors they established during the second stage.  Some people choose to forego this step and skip to the fourth stage.

The fourth stage of counseling is a closure process.  After attaining goals in the second stage, and maintaining new behaviors and thought processes in the fourth stage, this last and final stage is a review of accomplishments, work together and closure of the therapeutic relationship.  If the client chooses to end counseling, this practice of review and closure can be especially healing for those who have experienced traumatic grief or loss.  Saying goodbye in a healthy way, honoring the relationship without suddenly cutting it off is a beneficial process to learn about emotional maturity and sophistication. 

I hope these tips have been helpful.  Please feel free to comment below with any other tips or feedback you have on this topic.  If you’d like to speak further about starting counseling or have any other questions about some of the things I’ve mentioned, please contact me at TiffanySpilove@yahoo.com or call 610-314-8402.  I wish you luck in your endeavors and look forward to hearing from you soon!!

"We cannot love others until we love ourselves" by Mikala Morrow

 "We cannot love others until we love ourselves"

by Mikala Morrow, Villanova Graduate Counseling Intern

This saying has been a cliché statement that has been thrown around as a way to encourage self-care or even used as a convincing statement to those who find it hard to love themselves. What does this statement truly mean?

It means that someway, somehow we must find, within us, love. This must mean that love is an innate ability and we all possess the ability to love ourselves without the assistance of others.

Personally, I do not believe this to be true. Can we truly have an innate ability to love ourselves without any help from others? If we truly cannot love others until we love ourselves, we have to be able to love ourselves without help, right? Which comes first, the chicken or the egg? Which comes first, our innate ability to love? Or is love taught to us from our caretakers, partners, peers or a higher power?

What if, “We cannot love others until we love ourselves” becomes “We cannot love ourselves and others until we have been loved.” My argument is that in order to learn to love others, we must first be loved. We must learn how to love and what love is.

Imagine a child who is neglected by their caretaker. This child never truly learns love. Instead, to them, love means neglect. Later on in life when meeting new people, how will they love them? If all this older child has known is that love is neglectful, they too will neglect those that they love.

Compare the first child with someone who has a loving caretaker who has shown interest in who they are. This child will grow up with the idea that love is showing interest in others and will love in this way. These examples may not be true for all, but it is something to think about. The child in the first scenario may

learn somewhere how to truly love but this will not come as easily as the child in the second scenario.

We need to learn what love looks like towards us and we also need to learn how we love.  We may love by giving others gifts or our time. We may show our love through compliments or by offering a shoulder to cry on. We all have a unique way to show love. In order to practice our ways of loving, we need people around us to accept our love. If our unique way of showing love is rejected, we learn that we are not good at loving, or our way of loving is wrong.

Let’s say you show love with your time but your partner becomes annoyed and tells you they just want space. Your way of loving has been pushed away. We need other people around us to affirm the way we love.  While the statement, “We cannot love others until we love ourselves” has a good message at the core, it can be damaging for those who have never learned how to love themselves.

We all need love whether it is from other humans on earth (maybe even from a pet) or a supernatural love. Then we can truly love others’ authentically and comfortably.

Mikala has an intensely compassionate and unique way of connecting with you to help you identify and express your feelings and your deepest sense of self.  She is persistent and encouraging in the face of hopelessness and despair.  She especially loves working with women to provide tools to alleviate anxiety and depression.  Mikala has a wealth of experience and is skilled in the mental health field working with domestic violence, food & body issues and addiction.  If you're struggling to tolerate your emotions and you're looking for a guide to help you get to know yourself better, give her a call now at 570-412-4516. 

Guest Writer: My Journey With Bulimia by Melissa King

A brief update from the author:

I wrote the following post just over 6 years ago. I had been fully recovered from bulimic symptoms for about 4 years at the time. It’s now been 10 years of recovery and I still deeply believe in all of the words I speak in this piece. The only thing that’s changed is that I feel even further away from experiencing desires to binge or purge. There was a time when it was hard to imagine feeling completely comfortable around food, easily stopping when full, and not thinking about the ice cream in the freezer constantly. I hope this article helps some of you! Be brave. Recovery is totally possible! - Melissa

My Journey With Bulimia

December 6, 2010

About ten years ago I developed a condition known as bulimia. I never would have guessed that a smart girl like me would struggle with something like that. I knew better. I had learned about eating disorders when I was younger and could never make sense of why someone would force themselves to vomit after eating or avoid eating all together.

I think very differently about eating disorders today. You can be intelligent, self-aware, and informed about eating disorders and still struggle with the “disease.” I remember the first time I displayed signs that I was at risk for developing bulimia. I was reading a book about how bad refined sugar was, and I was doing an excellent job of eliminating it from my diet—that is until I was tempted by a birthday cake brought into work one day. I decided to treat myself to a slice, and as I was finishing it, I felt deeply concerned about how the sugar might be harming my body. I don’t know what made me think of it because I had never chosen to throw up food before (nor did I know of anyone who had), but I quickly went to the bathroom and vomited in a stall.

I felt much better after getting rid of the sugar and didn’t think of it again until a year later. I had begun a big transformation in my life. I was starting to question my faith, my choice of career, the reasons for my failed romantic relationships, etc. I decided to go to counseling, and after a few sessions the counselor asked, “Where is Melissa?” I didn’t understand what she meant, but after some back and forth, she finally explained, “You tell me everything you think you SHOULD do and SHOULD want, but you don’t tell me how YOU feel and what YOU want.”

No one has said anything that has impacted me more deeply than that statement. I realized that I had become so good at assessing what I thought other people wanted that I had become disconnected from my own desires, feelings, and opinions. It’s like they were crowded out by the noise of all the other expectations and demands I thought I had to meet.

After that session, I started concentrating on my inner world and made a lot of effort to to connect more deeply with myself. As part of that exploration, I went back to dance class. Dance was an innate joy for me. It was my childhood passion, something I knew that I didn’t do to please anyone else. I hoped that dance would remind me of what it was like to feel.

And it worked. The feelings that dance inspired in me became recognizable in other areas of my life. In an attempt to follow this, I started spending more time alone so that I could learn to hear my own voice. I stopped going to church so that I could figure out what I really believed about God, without pressure from others. I also got a second job and began saving to spend six months in New York studying dance. New York was a place I had always wanted to live and I wanted to gift myself with the opportunity. And lastly, I decided to finally lose the weight I had gained since high school. For the first time, I was choosing to take my dreams seriously and have confidence in my ability to achieve them.

Several months later the pounds were coming off and I felt amazing. I was losing weight in a healthy way and sticking to a diet plan longer than ever before. I felt like I was discovering my real body: lean, healthy, strong, and energetic. I felt beautiful inside and out.

Somewhere close to my goal weight, I gave in and ate something that I knew was higher than the amount of calories I needed. I became afraid. Seeing myself eat food that was not in my plan made me fear that I was stepping back into old behaviors. In the past, I would stick to a diet for a little while but would always end up giving into temptation, promising myself that I would start again the next day. It was a bad cycle that I didn’t want to continue. Not only that, but I was falling in love with the “new” me, the me that was living from her heart, the me that was committing to her goals, and the me who was coming out of her shell and no longer hiding under extra weight. I felt more confident. I was getting attention from boys, and I was interacting more with people. I didn’t want to lose those things. That’s when I remembered my experience with the sugar elimination diet. I realized that I could just get rid of what I ate in the bathroom and my problem would be solved. So I did.

I never imagined that I would do it again. I thought it was a one-time thing. But it did happen again. Not often, at first. But every time I felt unsure about the calories I had consumed in a meal or I knew that I had too many, I ultimately found myself in the bathroom.

At one point, I became concerned that I might have an eating disorder. I remember going online and looking up the symptoms for bulimia. The criteria noted that an individual must have a certain number of symptoms to be diagnosed. Although I thought I might need help, my symptoms didn’t match enough of the criteria. I wasn’t bingeing at all and I wasn’t vomiting enough over the course of a week. As a result, I worried that I would not be taken seriously, so I was too embarrassed to seek help.

Eventually the symptoms did grow. It became harder to vomit if I didn’t eat enough, so I started to binge. My bulimia began to look very “textbook.”

In May of 2001, I moved to NYC. I accomplished some amazing things and had some wonderful experiences. During that time, I had periods when I went for months without symptoms and others when I vomited every day. I eventually went to counseling again, and during those sessions, my counselor offered me one important insight about bulimia. She simply said, “Maybe you’re not ready to give it up.” For the first time I considered the notion that I could give myself permission to continue. What a scary idea, but she was right to suggest it. 

From the time my symptoms began, I was resistant to them. After every purge, I promised myself it would be the last time. My mind was filled with figuring out ways to keep it from happening again. By accepting bulimia’s place in my life, I was able to learn from it and understand why it was there. Since my mind was free from thoughts of guilt, criticism, and resistance, I had space to feel the emotions that bulimia was trying to bring to the surface. I started recognizing the feelings I felt when I would binge and purge and realized how they were connected to other challenges in my life. When I saw the connections, I could start resolving the problems in other ways.

It took awhile, but I eventually let bulimia go. I would stop for several months, have a bout, then stop for many more months, have another bout, then stop for a longer period of time, etc. It’s been over three years now, maybe almost four, since the last period of symptoms.

I believe my bulimia represented a step toward healing. It often felt that people around me viewed bulimia as a problem, as a step backward, as something I was doing wrong. At first, I joined them in this conclusion. But bulimia came into my life when I was beginning a fight to be true to myself and resist the external pressures around me to please others, to follow another’s lead, to do what other people thought was good rather than what I felt was good. I didn’t know how to say “no.” I didn’t know how to negotiate. For years I had been taking in, absorbing and adjusting to what others wanted so that I could gain their approval and respect, ultimately depending on them for assurance and confidence. Simultaneously, I ate all the time. That’s how I gained weight in the first place. I just consumed. I dealt with my problems by eating. I couldn’t say no to food either. 

I was finally coming to a point in my life where I wanted to trust myself, but I was scared. It was a battle. I was taking food in (symbolically, others’ opinions, desires, and expectations) but realized that I didn’t want it. So I would push it back out. I was starting to say no and bulimia represented a violent fight inside me. 

It’s hard to be yourself in this world. There are a lot of demands, many that are indirect, and it was hard for me to resist the impulse to meet all those demands. Food was my vice, so it makes sense that my relationship with food symbolically paralleled my relationship with myself and with the world.

I think my bulimic episodes ended when I started trusting myself more and worrying less about others’ opinions, worrying less about someone being upset if I told them “no.” I knew that I didn’t want to continue bingeing and purging because the health risks weren’t worth it to me. So, eventually I chose to stop, probably when I had the internal strength to make that choice for myself (rather than just to appease others). Much of it was learning how to have boundaries. Just like I had to learn how to have boundaries with people, I had to learn how to have boundaries with food.

Does this mean that I have perfect boundaries with people now, that I never overeat, that I trust myself completely all the time? No. I still struggle with these things, just like everyone does. But the experiences I had while dealing with bulimia transpired into major changes in my life, changes I certainly benefit from now. My boundaries are much stronger and clearer, and I have more awareness of when I am compromising who I am. In fact, if I ever have the urge overeat or vomit, and I do sometimes, it’s a great clue to me that I’m not dealing with something in my life the way that I need to. I know that now, so I can take a step back, look at the problem, and figure out a more productive solution. It’s funny, because that solution often means asking for help or making myself more vulnerable with someone (letting someone in), or saying what I feel and risking possible rejection - again, all connected to boundaries. 

Bulimia is complicated and very layered. I haven’t addressed all of those layers here. Furthermore, I can only speak from my own experience; I don’t mean to represent others’ experiences. Over time, I’ve learned that people’s stories and the reasons behind their personal challenges are varied and don’t all fit into a neat little defined box. But I do believe that for many people, symptoms of bulimia actually symbolize an attempt toward health, the body reacting in order to make something right. I believe the symptoms are symbolic of the internal fight of an individual trying to find their voice, to find confidence, to look for a way to move out of whatever problem they have been dealing with, a problem that existed before symptoms of bulimia showed up. It’s never just about bulimia, it’s always about something much deeper. I think that many individuals with bulimia are trying to figure out how to finally have boundaries—with themselves and with the world. If they can find support to understand and transition through it, support to trust themselves, then the stage after bulimia can be fuller health, greater self-esteem and confidence, and healthier boundaries.

ABOUT MELISSA

Melissa King, LMHC is now a psychotherapist in New York City who works with women, gay/bi men, and couples in the first 10 years of a relationship. Find out more about Melissa here. https://www.myheartdances.com

If you have any questions or need support, please feel free to call me at 610.314.8402 for a free 15 minute phone consultation.

Please comment below and tell us your story !