Get Proactive About Flashbacks and Intrusive Thoughts

What is PTSD? 

According to the fifth edition of the Diagnostic Statistical Manuel of Mental Disorders (DSM V), Post Traumatic Stress Disorder or PTSD is a cluster of symptoms stemming from exposure to an event that was traumatic.  In an attempt to heal, our bodies tend to re-play upsetting memories until the memory can be resolved.  PTSD can seem difficult to manage.  PTSD symptoms include things like intrusive thoughts and flashbacks.  While the key to healing PTSD requires more involved therapeutic interventions such as EMDR, there are ways to manage some of the symptoms to make life in between therapy sessions a bit easier. 

What is a Flashback?

Jane, a 28 year old abuse survivor, was out to dinner with her friends.  Suddenly, a waiter drops a tray of food and the sound carries through the restaurant.  Jane hears the clattering of dishes and silverware hitting the floor.  Her body believes she is back in the kitchen from her childhood when her parents fought and kitchenware broke.  Jane crawled under the table, and ducked her head under her arms.  When one of her friends reached out to her under the table, she flinched and apologized to her mother, reliving the childhood scene with her parents.  This is one example of what a PTSD flashback can look like.

A flashback is when a person who has experienced a traumatic event, re-experiences that event in their body.  Flashbacks can be so powerful, that the body believes that the event is happening to them in real time. 

Anticipating a Flashback

While there’s no way to be able to fully anticipate when a flashback might occur, there are some preventative measures you can take. 

Learn what your triggers are -

Scan your history with flashbacks and traumatic situations to see if you can find some themes.  In the example with Jane, she experienced trauma in the kitchen with sounds of breaking plates and glass.  You might notice that there are certain situations like restaurants, the beach, or the grocery store – that can be triggering.  There might also be objects, sounds, smells or people that can set off a flashback. 

Be Prepared -

Once you have a good idea of what your triggers are, see if there’s a way to prepare for them.  In Jane’s example – she might decide to avoid restaurants or just loud, busy ones for a while until some of her symptoms decrease.  She might sit with her back to the wall so that she can see what is happening around her in real time. 

Practice Mindfulness –

You can practice mindful awareness by checking in with yourself regularly to see what you are experiencing in your body.  Notice if any anxiety or dissociative sensations are heightened.  Some people describe their PTSD symptoms as sensations of feeling floaty, spacey, leaving their body, spacing-out, zoning out, feeling overwhelmed, high anxiety or easily startled.  If you experience any of these sensations, pay attention on a regular basis.  These sensations are warning signals that you could be easily triggered when you are in this state.  If you catch the trigger early enough, you can avoid a flashback.

What to do when you’re triggered –

Once you notice that you are in a heightened state of anxiety or dissociation, use some tools to stay in the present; in your body.   

Tools for PTSD Symptoms:

(note: don’t use any techniques or tools you find triggering)

Use the senses – taste, touch, smell, sound and sight

Drink some water slowly.  Notice the cool sensation of the glass on your lips, the water in your mouth and the sensation as it goes down your throat.

Hold an ice cube.  The cold can help you stay in your body by bringing your awareness to your hand.

Smell essential oils such as Bergamot (good for panic attacks) or Lavender (good for stress relief).

Light some incense – watch the smoke rise and coil, inhale the aroma.

Listen to music you find grounding.  Pay attention to the words, tap your feet to the rhythm. 

Play with Silly Putty or clay – notice the texture.  Pay attention to the sensation of the clay in your hands.

Distract yourself and enlist friends to help you distract –

Try to think of as many baseball teams as possible.  Take turns with friends in thinking of the names of all the teams.

Count backwards or say the alphabet backwards

Try to think of other categories such as names of movies, bands, TV shows, etc.

Ask someone else about how they’re doing

Get involved in a project like building model airplanes or re-arranging your closet.  Something tactile that also involves thought is helpful.

Read an engaging book – this uses your sight, engages the sense of touch and distracts your mind.

When you’re thinking about where to put your shoes, your brain is less likely to slip back into a trauma memory.

To learn more about PTSD treatment, contact me at TiffanySpilove@yahoo.com

How to Find a Trauma Informed Eating Disorder Therapist in West Chester, PA

West Chester, PA is a dynamic place to live.  If you already live here, you probably know that - if you don't live here, you might not have heard of it.  We have the wonderful West Chester University right here and an historic downtown with cute shops and great restaurants.  With Everhart and Goshen Parks in town and and Valley Forge in our back yard, we sure are lucky to have so much nature at our fingertips.

Finding an Eating Disorder Trauma therapist in West Chester, PA

seems harder than it should be.  With Bryn Mawr's Graduate School of Social Work close by, Villanova and St. Joseph's University, not to mention University of Pennsylvania, Swarthmore and LaSalle, we have many talented social workers and other clinicians in the counseling profession.  So, how do you determine which person will be the best fit for you?  Choosing a therapist is a very personal decision.  If you are looking for a counselor, psychologist, life coach or therapist - I'd like to help you find someone who can help.

Here are some ways to search

Ask around

I bet you know some people who are in the mental health field or who know other people who are.  Think about asking someone who works for a rehab or treatment center, your doctor or someone at your school.  Therapists that come highly recommended are a good way to make sure they have a good reputation.  

Google

Type in to Google your town and the issue you are looking for help with.  For example, "Downingtown Anxiety" or "Paoli Trauma" and see what comes up.  In the top things that come up in your search, you will hopefully see some links to therapists that specialize in your particular need.    

Psychology Today

What you will most likely see is a result that links to a Psychology Today profile for therapists in your area that have indicated these specialties.  Psychology Today is a great site that is most commonly used for therapists to post their profiles and for clients to find a therapist nearby.  The great thing is that you can refine your search by specialty.  The unfortunate thing is that therapists can indicate that we specialize in as many topics as we'd like.  Although a therapist might indicate that they specialize in anxiety, if it's really something we want to work with, we usually spend lots of time talking about it on our websites.

Websites

Check out the websites of potential therapists.  If you are looking for help with panic attacks and the website you are visiting talks a bunch about panic attacks, that's a great sign!  If you are looking for help with PTSD symptoms and you're on a website that doesn't mention them, you might want to keep looking.  

Phone consultation

Often, therapists will offer a free 15 minute phone consultation for potential new clients.  This is a great service and a good opportunity for you to interview your potential therapist.  You are going to be spending a good amount of time and money on therapy to help you achieve your goals.  It is very important that you find the right fit for you.  

Here are some questions to get your started that you can ask your potential therapist on your phone consultation

• What model of therapy do you use and why?
• How long do your clients usually see you for before they start to see relief from their symptoms?
• Why did you decide to become a therapist?
• Do you specialize in my specific need and if so, how do you work with it?
• What can I expect from therapy if I work with you?

If you are looking for a therapist who specializes in eating disorders or trauma, here are some things to remember:

Eating disorders and trauma are very complex issues and require special training to know how to treat properly.  

A team of specifically trained eating disorder specialists is usually necessary for successful resolution of eating disorder symptoms.  

Genetics loads the gun, circumstance pulls the trigger.  

Eating disorders are caused by a complex interaction of genetic, biological, behavioral, psychological and social factors. There is no single factor and there are different opinions among experts in the field.  

For this reason, many people with PTSD and eating disorders choose to get counseling privately.  But how do you know if the therapist is legit?  How do you know if they really "get it"?  How do you know if they don't just want you to rehash your past rather than provide a strategy to help you get to the other side of it?

Here is a list of questions to ask a potential eating disorder and trauma therapist:

1. What method do you use to treat eating disorders?
2. What method do you use to work with PTSD?
3. How effective are those methods?
4. Have you worked with people who struggle with food and body before?
5. Do you believe in full recovery from an eating disorder or do you believe you have to abstain from certain foods for the rest of your life?
6. Do you get to the root of the problem or work mostly with the symptoms?
7. Do you think you can help me and why?

In an ideal world, you would find a therapist who has special training and expertise in the methods that show the best results and someone who has tons of experience working with eating disorders and trauma.  Unfortunately, this is not an ideal world.  So you'll need to search a bit further.  You'll be searching for someone that you connect with, who you feel comfortable talking to, someone who will be honest with you and you'll know you can be honest with them.  

I hope this helps you in  your search for the right therapist in West Chester, Pa.  If you want some tools to help now, sign up for my newsletter to get some tips and tools for managing PTSD and eating disorders.  If you are still feeling stuck, feel free to call me at 610.314.8402 for a free 15 minute phone consultation.  I am available to listen to what's happening and help direct you to the right person.  If you are looking for help with eating disorders or PTSD, you can read more about how I can help here.

8 Tips to Navigate Food and Emotions this Thanksgiving

Thanksgiving can be about gratitude and joy for some and for others’, it’s extremely stressful – especially if you’re dealing with or in recovery from an eating disorder.  Here are some things you can do:

1.      Be Gentle with Yourself:

Remind yourself that this is just one day out of the year and it won’t make or break you.  Give yourself permission to eat foods that you like.  BREATHE and know that you are doing the best you can.

2.    Get Grounded:

BEFORE you leave your house.  What grounds you?  Do something that feels very grounding for you and set an intention to keep checking in with yourself during the day.  One of my favorite ways to get grounded is to ask myself “Where are your feet?” – then look down at them; wiggle my toes, feel my feet on the floor or in my shoes.  When I do that, I can rest assured that right here, in this moment, I am safe.  In this moment, where my feet are, I am okay.  Here are some other examples of grounding activities:

Prayer and meditation

Yoga

Coloring mandala’s or other coloring

Going for a walk

Make a list: of anxieties, gratitude’s or plans, etc.

Have a bit of a plan for the day – perhaps write it down in the morning.

Journaling

3.    Contain the Food:

Do your best to eat meals at the normal times you usually eat them.  So instead of skipping breakfast and going to Thanksgiving hungry, eat your normal breakfast.  When you get to your event, check in to your hunger cues – on a scale of 0-10, with zero being extremely starving, 5 is having a light sense of satisfaction – being neither hungry nor full and ten being the most stuffed you’ve ever experienced.  How hungry are you?  Aim for letting yourself empty out to a 2-3 before eating a meal.  See if you can stop eating at a 5-7.  Once you are hungry, rather than grazing on all the different foods, make a plate.  Allow yourself to put at least a little bit of each food you love on the plate or foods you’d like to try.  Skip the foods that don’t interest you much.  Sit down and really savor the foods you chose.  Check in with your hunger and satiety signals a few times while you eat your plate.  Once you are satisfied, tell yourself that you can have more when you are hungry again and follow through.  Making a practice of using hunger and satiety cues is extremely helpful in finding balance with food.

4.   Keep Your Boundaries:

People tend to project their OWN food and body issues onto others’.  So if you notice yourself engaged in a conversation with someone who’s trying to talk you in or out of eating or commenting on your body, take a step back.  Check in with yourself and see what YOU NEED, rather than what this person is trying to get you to do.  Saying you need to use the bathroom is always an easy out to give yourself some time and space to check back in with yourself and get grounded.  Take some deep breaths, splash some water on your face and ask yourself what you need in that moment to take care of yourself before you leave the bathroom.  Here are some examples of things you can say to people who are pushing you: “No, thank you”

“I’m okay right now”

“Yes, I’m going to enjoy this food right now”

“I’m not hungry”

“I’ll let you know when I’m ready for ...”

“I’d rather not discuss my body with you”

Practice saying these boundaries out loud BEFORE the holiday, so that when you’re in the moment, they flow easily and effortlessly.

5.    Make a Self-Care Plan:

If you notice yourself getting overwhelmed, come prepared with an exit strategy.  Here are some examples:

Playing outside with the kids (or adults)

Going into another room for a breather

Taking a walk with a trusted person

Making a phone call to someone from your support group

Taking a time out to journal or color

Going for a drive

6.    Ask for Help:

Enlist a member of your support group to be ‘Holiday Buddies’ to practice what I call ‘Book Ending’:  Have a few agreed upon times you with check-in with one another throughout the day – perhaps before, during and after.  You could plan to call or text one another to report how things are going.  If you don’t hear from your buddy, shoot them a text to see what’s going on.  In this way you have another person who has your best interest in mind to be accountable to.  This practice is also helpful in getting your mind off yourself and your own difficulties.

7.    Be of Service: 

If you’re feeling social anxiety, focus on what you can do to help.  Be it washing dishes, entertaining the kids, setting the table, taking out the trash – if you make it your mission to help out as much as possible, you’ll find yourself busy and this can really diffuse social awkwardness and anxiety.

8.    Trust:

Trust your body to make up for any ‘mistakes’ you may make.  One day, one meal, one bite at a time.  This day will not make or break you.  Try to turn it over and enjoy as much as possible.