New psychodrama & education publication in the University of Pennsylvania Doctorate in Social Work Newsletter – The Clinician. This article, by Phoenix Center’s Director, Scott Giacomucci, is titled “Psychodramatically Becoming Your Future Doctor Self: A DSW First Year Immersion Session”.
Experiential Group Tools for Post-Traumatic Growth and Networking | 3pm-4pm | 1 CE Hour Presented by the Phoenix Center team: Dr. Scott Giacomucci, Amy Stone, Rachel Longer, & Leela Ehrhart This event will highlight the importance of post-traumatic growth while connecting it to the symbol of the phoenix. We will demonstrate simple experiential group facilitation skills used to uncover similarities and connections within groups. In this context, we will use them as networking tools to establish stronger connections between attendees while celebrating post-traumatic growth in our clients. The clinical importance of safety, relationships, and connection will be emphasized as it relates to experiential trauma therapy.
Learning Objectives: 1. Identify one action-based group tool; 2) Define post-traumatic growth; 3) Explain the importance of connection in establishing safety
Phoenix Center for Experiential Trauma Therapy (Lic. #004115) is approved by the Pennsylvania State Board of Social Workers, Marriage and Family Therapists and Professional Counselors to offer continuing education for social workers, marriage and family therapists and professional counselors. Phoenix Center for Experiential Trauma Therapy, LLC maintains responsibility for the program. Phoenix Center for Experiential Trauma Therapy (Lic. # PSY000215) is approved by the Pennsylvania State Board of Psychology to offer continuing education for psychologists. Phoenix Center for Experiential Trauma Therapy maintains responsibility for the program.
Dr. Scott Giacomucci, DSW, LCSW, CTTS, CET III,
“It is impossible to
understand addiction without asking what relief the addict finds, or hopes to
find, in the drug or the addictive behavior.” –Dr. Gabor Mate
Among the most common underlying factors
of Substance Use Disorders (SUDS) and other addictive behaviors are unresolved
trauma, neglect and loss. Ignoring these
fundamental issues in treatment results in a focus on symptom control rather
than addressing the actual causes of addiction and relapse.
Addiction and Trauma—a Cyclical Relationship
Addiction and Trauma/loss have a
cyclical relationship, which means they fuel each other. Trauma and loss leave one vulnerable to
developing addictions, and addictions leave one more vulnerable to experiencing
further trauma and loss.
Trauma impacts our ability to
regulate ourselves and our emotions, which is where the addiction comes in to
play a role in helping us self-soothe and numb these emotions. Both addiction
and trauma are characterized by attempts to ‘get out of ourselves’ through
numbing, dissociation, and avoidance. Recent neuroscience research shows that social pain and physical pain look identical in brain scans – any opiate addict
will tell you how well opiates work at numbing both types of pain. These
findings further highlight the intersection between addiction, trauma, and
Trauma describes any experience that
overwhelms one’s ability to function and cope.
An inclusive definition of trauma might include experiencing or witnessing
violence (relational or collective), abuse (physical, emotional, or sexual),
death or loss, neglect, and abandonment.
Research has demonstrated a strong connection between trauma and many mental health issues—including addictions, depression, and anxiety. Post-Traumatic Stress Disorder (PTSD) symptoms include intrusions, avoidance, hyperarousal, negative thought/mood states and dissociation. These could simply be described as a manifestation of past experiences (feelings, thoughts, images, relationships, physical sensations, defenses, and behaviors) showing up in the present moment.
has shown a strong correlation between adverse childhood experiences (ACEs) of
trauma, neglect and loss, with adult alcoholism and addiction. The ACE study used a simple 10 yes/no
questionnaire inquiring about experiences of trauma, neglect, and family
dysfunction in childhood. For someone reporting four or more ACEs, the results
show a 500 percent increased chance of developing adult alcoholism, and a 1300
percent increased chance of developing an addiction. Higher ACE scores were
correlated with her rates of depression, suicide attempts, and other medical
4 ACEs =
500% increase in adult alcoholism
4 ACEs = 1300% increase in adult IV drug use
6 ACEs = 4600% increase in adult IV drug use
There are many different approaches
to trauma treatment and trauma recovery. While some people find traditional talk
therapy to be helpful, other therapy approaches are available and may be
more suitable for trauma work. Recent neuroscience research shows that the
language/speech parts of the brain are offline when one remembers a traumatic
event, which supports the use of or arts-based experiential therapy
approaches such as music therapy, art therapy, drama therapy, and psychodrama.
In the psychodrama approach, rather than talk about an issue or problem,
we can put the situation into action using role-playing techniques and practice
new ways of responding. In psychodrama, we could have a dialogue with God, with
a deceased loved-one, or even with yourself at a different point in time.
Psychodrama allows us to go places in therapy that would be impossible
Another highly recommended and
effective treatment for trauma is ‘EMDR’ or Eye-Movement Desensitization
and Reprocessing. EMDR works by first providing practical tools for dealing
with stress, anxiety, and overwhelming feelings. In EMDR, we call these resources; basically, there are about
accessing positive memories that can change how we are feeling currently. After
the resourcing stage comes the EMDR processing stage during which specific
traumatic memories are targeting using EMDR’s protocol. EMDR is incredibly
effective for single-incident traumatic events. EMDR and the creative-arts
therapies are unique in that you can heal from trauma without having to tell
someone every detail of your traumatic experience.
To find a local psychodrama group
or workshop, use www.PsychodramaCertification.org
To find a local EMDR therapist,
Yoga and meditation
are wonderful resources for trauma and addiction recovery. A recent study found
yoga to be more helpful in reducing PTSD symptoms than any medication that has
ever been researched. Research on meditation supports its effectiveness in
rewiring the brain and strengthening one’s ability to tolerate discomfort,
empathize with others, and find inner peace.
Bessel van der Kolk, MD – The Body Keeps the Score: Brain, Mind, and Body in the Healing of
Peter A. Levine, PhD – In an Unspoken Voice: How the Body Releases
Trauma and Restores Goodness (2010)
Francine Shapiro, PhD – Getting Past Your Past: Take Control of Your
Life with Self-Help Techniques from EMDR Therapy (2013)
Christine A. Courtois, PhD – It’s Not You, It’s What Happened to You
Trauma exists upon a continuum or a spectrum.
There are experiences that we often describe as capital “T” Traumas, and other experiences
that we refer to as lower-case “t” traumas. Both can be equally disruptive in
one’s life, especially when experienced over and over again. One of every four
adults, and one of every two children, that experience a traumatic event will develop
It seems appropriate that PTSD and trauma are
often responded to with denial or dissociation – attempts to defend or protect
one’s self from the vulnerability and reality of surviving a traumatic event. However,
in order to fully recover from trauma and PTSD, one must come to a place of
acceptance of their past. Post-Traumatic Stress Disorder (PTSD) is one of the
most poorly understood mental health disorders. Interestingly, it is also one
of the few diagnoses which asks, “what happened to you?” rather than “what is
wrong with you?”.
According to Dr. Peter Levine, an expert on
“Trauma is a basic
rupture – loss of connection to ourselves, our families, and the world. The loss, although enormous, is difficult to
appreciate because it happens gradually. We adjust to these slight changes,
sometimes without taking notice of them at all…although the source of
tremendous distress and dysfunction, it (trauma) is not an ailment or a
disease, but the by-product of an instinctively instigated, altered state of
consciousness. We enter this altered state let us call it “survival mode”
when we perceive that our lives are being threatened. If we are overwhelmed by
the threat and are unable to successfully defend ourselves, we can become stuck
in survival mode. This highly aroused state is designed solely to enable
short-term defensive actions; but left untreated over time, it begins to form
the symptoms of trauma. These symptoms can invade every aspect of our lives.”
One of the most effective ways to evaluate if
you have been traumatized is to answer these simple questions about a
significant incident: when you remember the incident, is the memory exactly the
same every time? Or, is the memory fragmented or difficult to recall?
If an answer is yes, then the memory is likely
a traumatic one. By no means does one
traumatic memory constitute a diagnosis of PTSD; however, it does indicate that
the traumatic event has been stored in an unprocessed manner and continues to
cause you distress or require the defense of dissociation to avoid fully
accepting what happened.
a PTSD Diagnosis?
The Diagnostic and Statistical Manual of Mental Disorders or DSM5, offers multiple criteria for a PTSD diagnosis.
The first criterion relates to the actual trauma:
Directly experiencing the traumatic event(s)
Witnessing, in person, the event(s) as it occurred to others
Learning that the traumatic event(s) occurred to a close family member or friend
Experiencing repeated or extreme exposure to aversive details of the traumatic event(s); this does not apply to exposure through media such as television, movies, or pictures
The next four criteria for PTSD are outlined in this graphic:
According to Levine, “The symptoms of trauma may be continually present or they may come and go. They may even surface after being hidden for decades. Usually, symptoms do not occur individually, but in clusters grow increasingly complex over time. Unfortunately, they become less and less connected with the original traumatic experience, making it increasingly difficult to trace the symptoms to their cause, and easier to deny the importance of the traumatic event in one’s life. However, if we pay attention to these symptoms, for what they are – internal wake up calls – we can address and begin to heal our trauma.”
Experiencing trauma and/or PTSD is not rare
or uncommon. While many may suggest seeking treatment is a sign of weakness, we
would argue that it is a tremendously courageous act. Though it may not feel
possible at times, many trauma survivors report that they experienced growth
and positive changes after a traumatic experience and/or the treatment of PTSD –
this has been termed Post-Traumatic Growth.
Post-Traumatic Growth is not a new idea, it exists within all legends, myths, and holy books throughout time. The phenomenon of growing after hardship is quite common – nevertheless still remarkable. There are five common domains of post traumatic growth which include a new sense of personal strength, new possibilities, new appreciation of life, stronger emphasis on relationships, and spiritual/religious/existential changes. Even more hopeful, is the fact that around 2/3rds of trauma survivors report experiencing post-traumatic growth, making it more likely statistically than PTSD. After experiencing trauma, you are actually more likely to growth from it than to develop PTSD!
If you or someone you love may be impacted by trauma or post-traumatic stress, reach out to us for help at 610-203-2877