Author: Chris Klem

Trauma-Informed Care in the Aging Field

Written by: Chris Klem, MS (he/him)
Trauma throughout the lifetime

As we age, our chances of experiencing some form of trauma increase. By the time we reach retirement, we may have lived for six to nine decades, leaving ample opportunity for hardship and trauma. Given this reality, one might expect that professionals who work with older adults are well-trained in Trauma-Informed Care. However, this assumption is often not true. When we examine programs specifically designed for older adults who are experiencing harm, Trauma-Informed Care is seldom addressed or taught to staff in the aging field. In fact, the term “trauma” is rarely mentioned.

Why is Trauma-Informed Care Lacking in this Field?

Many would agree that abuse and neglect of older adults can lead to significant trauma. Unfortunately, professionals who are responsible for supporting older adult victims often lack training in Trauma-Informed Care. Here are three ideas that illustrate why these concepts may be absent in the aging field:

Childhood Trauma and Older Adults

1. Trauma is frequently associated with experiences from earlier in life, such as childhood trauma, bullying, sexual assault, and domestic violence. There is a common misconception that once individuals reach their sixties or seventies, childhood trauma is in the rear-view mirror, out of sight, out of mind.

2. Another damaging belief is that older adults do not experience trauma from events like domestic violence or sexual assault. In reality, older adults, particularly those with mental health issues or cognitive decline, are at a significantly higher risk of harm. According to the National Council on Aging, one in ten older adults report experiencing abuse, neglect, or exploitation, but only one in twenty-four cases are reported. Furthermore, older adults are rarely referred for therapy, and emotional support is often not prioritized in their care planning.

Vicarious Trauma and Burnout

3. Many professionals working in this field are over-worked and experience daily vicarious trauma or intense feelings of burnout.  The combination of these two things can decrease one’s capacity to empathize as a form of self-preservation. Often these programs are stretched thin, and training concepts like “Trauma-Informed Care” are labeled as non-essential and too time-consuming for the front-line staff.

Why Childhood Trauma Matters for Older Adults

The ACE Study (Adverse Childhood Experiences) was a large-scale research project that investigated the effects of childhood abuse, neglect, and other adverse experiences on individuals in adulthood. This study is well-known among professionals in the mental health field who work with both children and adults; however, it often does not reach those who work with older adults. It is important for professionals engaging with older adults to understand post-traumatic stress disorder (PTSD) and complex PTSD (CPTSD), as these conditions can significantly impact an older adult’s life. Additionally, the ACE Study highlighted significant correlations between childhood trauma and physical health issues later in life.

Complex Trauma throughout life-span

Working with clients who have multiple health conditions, low socioeconomic status, limited education, or unmanaged mental health symptoms requires a deep understanding of how their challenges may be rooted in childhood trauma or complex trauma. Recognizing the impact of ACE scores, Complex PTSD, and an individual’s history of adversity is essential for building strong relationships with our clients. Additionally, the six principles of Trauma-Informed Care offer a framework for professionals to provide high-quality, person-centered care, ultimately leading to improved outcomes for the organization.

Vicarious Trauma and Burnout

When professionals work with victims of abuse and neglect, whether they are children, adults, or older adults, they often experience a high rate of vicarious trauma. This trauma arises from indirect exposure to the victims’ firsthand narratives. These professionals frequently encounter poor living conditions and visible signs of abuse and neglect, and they may even face threats of physical violence themselves.

Working in underfunded programs can also lead workers to develop survival instincts, which can diminish a person’s capacity to hold space for empathy. This unrecognized, and often unsupported form of trauma, can have significant consequences that negatively impact not only the clients, but also the workers and the organizations they are part of. Ongoing, unsupported vicarious trauma can lead to harmful practices, liabilities, and staff turnover.

Why Should Trauma-Informed Care be taught to those working with older adults:

Trauma-informed care principles, the phoenix center training and workshops

Many professionals in this field are motivated by a genuine desire to help others, often inspired by personal experiences of caring for family members. While their intentions are typically well-meaning, these efforts may not always yield positive outcomes for the clients. Actions perceived as beneficial might not align with what is truly in the client’s best interest and could even lead to significant emotional harm.

Professionals require accessible tools to guide their decision-making, assess risks, and foster supportive environments that prioritize both physical safety and emotional well-being. It is also essential to provide ongoing support to address issues such as vicarious trauma, burnout, and compassion fatigue. Adopting Trauma-Informed Care principles and practices can address these needs, especially when these principles are integrated throughout all levels of an organization and included in annual continuing education.

How do we begin to integrate Trauma-Informed Care?

While we may not be able to resolve issues related to funding and caseload sizes, many organizations can improve the training, education, and support they provide to their staff. The six principles of Trauma-Informed Care should be integrated into the onboarding and training of all staff who work with trauma survivors, regardless of their clients’ ages. There have been programs that have made progress over the years and have started incorporating Trauma-Informed Care into their practices, however, these training practices should be the standard across all organizations.

The Phoenix Center offers tailored Trauma-Informed Care training specifically designed to meet the needs of organizations serving older adults. We have trained numerous trauma-focused organizations in the Philadelphia area, including Women Organized Against Rape, the Delaware Coalition Against Domestic Violence, and the Chester County Department of Human Services, among others.

In addition to Trauma-Informed Care training, we also collaborate with teams to develop trauma-informed leadership, foster group cohesion, and enhance workplace wellness. We can assist organizations in recognizing signs of burnout and promoting healthy relationships between leadership and frontline staff. Contact us today to learn more about our workshops and training opportunities.

Doomscrolling and Trauma

By: Meryl Lammers, LSW, MT-BC
Doomscrolling and Anxiety

Doomscrolling, the compulsive and prolonged consumption of negative news online, can significantly impact mental health and potentially lead to vicarious trauma and re-traumatization, especially for individuals with a history of trauma. It can exacerbate existing mental health conditions like anxiety and stress, can trigger trauma responses, and lead to a cycle of negative emotions and behaviors. 

Recognizing the potential dangers of doomscrolling and taking steps to break the habit is crucial for protecting one’s mental and emotional well-being. These effects for someone with a trauma history and doomscrolling may include:

  • Triggering Memories: Negative news and images can trigger traumatic memories, causing flashbacks, nightmares, and heightened anxiety. 
  • Hypervigilance: Doomscrolling can increase hypervigilance, making individuals more sensitive to perceived threats and potential dangers in their environment. 
  • Difficulty Regulating Emotions: Individuals with trauma may struggle to regulate their emotions, and doomscrolling can further exacerbate this difficulty. 
  • Seeking Control: Some individuals with trauma may engage in doomscrolling as a way to feel in control of a chaotic world, even if it means focusing on worst-case scenarios. 
  • Re-traumatization: Individuals with a history of trauma, especially complex trauma, may be more susceptible to re-traumatization through doomscrolling. 
  • Numbing and Avoidance: Doomscrolling may be a manifestation of the PTSD symptoms of avoidance and numbing if it is used to dissociate or avoid life, relationships, or feelings.

Doomscrolling and the Brain: Why Can’t I Stop?

Political upheaval at home and abroad can create a sense of lack of safety. Many of us turn to coping mechanisms to soothe our anxieties, yet some may be more detrimental than others. Maybe you have tried to reduce or stop your screen time, but you’re having a hard time putting the phone down. You may be wondering, “Am I addicted? Do I like to be punished? Why can’t I stop?” Maybe you fear missing out on the latest news or feel a sense of control if you are up to date, but you’re still noticing that you just feel worse off afterwards.

There are biological reasons for what you are feeling:

Biology and Doomscrolling
  • Altered Neural Pathways: Repeated exposure to negative information can strengthen neural pathways associated with fear and anxiety, making your brain more likely to trigger these responses in the future. 
  • Increased Amygdala Activity: The amygdala, which processes emotions like fear and anxiety, can become overactive during doomscrolling, making you more sensitive to stress and negative emotions. 
  • Impaired Prefrontal Cortex Function: The prefrontal cortex, responsible for decision-making and impulse control, can be negatively impacted by chronic stress and anxiety from doomscrolling, potentially affecting your ability to regulate emotions and think rationally. 
  • Reduced Attention Span: Constant exposure to short, attention-grabbing content can make it harder to focus on complex tasks, such as reading or engaging in deep conversations. 
  • Erosion of Critical Thinking: Doomscrolling can hinder your ability to think critically and evaluate information, especially with the prevalence of misinformation online. 
  • Emotional Fatigue: Constant exposure to distressing news can lead to emotional exhaustion and a feeling of helplessness. 

Doomscrolling’s Impact on Mental Health

Doomscrolling and headaches

Even if you don’t have a history of trauma, the negative impacts of doomscrolling are plentiful. Doomscrolling can amplify negative emotions, leading to increased anxiety, sadness, and feelings of despair. Individuals with pre-existing anxiety or depression may find their symptoms worsen with excessive exposure to negative news. Doomscrolling exposes individuals to distressing events, even if they are not directly involved. This can lead to vicarious trauma, where individuals experience psychological effects like those who experienced the trauma firsthand. Doomscrolling can also manifest in physical symptoms, such as headaches, muscle tension, elevated blood pressure, and sleep disturbances. 

Breaking the Doomscrolling Habit

Doomscrolling and setting limits

Some suggestions for ways to break the habit of doomscrolling include noticing how you feel after spending time on social media, setting time limits on social media and news consumption, curate your feed to follow accounts that provide positive and uplifting content, find activities that help you disconnect from your phone and engage with the real world, and seek professional help if you are struggling with the effects of doomscrolling, especially if you have a history of trauma.

If you are noticing that doomscrolling is triggering your past traumatic experiences and you are experiencing flashbacks, hopelessness, heightened anxiety or depression, or nightmares, experiential trauma therapy can help. Call the Phoenix Center today to schedule with one of our trained trauma therapists. You don’t have to navigate your experiences alone. We are here to help!

Meryl Lammers Trauma Therapist, Delaware County PA

Written by: Meryl Lammers, LSW, MT-BC

Early Sobriety and Trauma Therapy

Written by: Meryl Lammers, LSW, MT-BC

Early sobriety and trauma therapy go hand in hand. Whether you are the person in recovery or the loved one of someone who is, early sobriety can feel like a roller coaster: You may experience emotional ups and downs that you never have before. There’s the fear of a relapse, anger and resentment, sadness and grief, and wreckage of what a life in active addiction can cause. Many people in recovery and their loved ones have experienced traumatic events, whether from early childhood, or during active addiction, and these experiences can be triggered during early sobriety. Addiction and trauma affect the whole family system and therefore it’s important for everyone to seek support.

What to Expect in Early Sobriety

For the Person in Recovery

Early Sobriety and Trauma Therapy Levels of Care, Inpatient and Outpatient

For the person in recovery, early sobriety can manifest in different ways. You may need to go to an inpatient facility or partial hospitalization program (PHP) for 30-60 days to help with medical management of withdrawal or detoxification and need to be physically separated from your drug of choice in a safe environment. You may need to take leave from a job and your living environment. This time away from your life can be a crucial part of the healing process, as you will be offered medical and psychological support to get through the hardest part: Detaching from your drug of choice.

But the journey doesn’t end with inpatient treatment. Most often, you will then be referred to an Intensive Outpatient Program (IOP) for 2-3 days a week to continue with support with relapse prevention through group and individual therapy. Trauma therapy in conjunction with other modalities usually starts in these programs as a form of relapse prevention.

Mutual aid programs such as Alcoholics Anonymous, Narcotics Anonymous, and SMART Recovery are highly recommended during this time for continued community support. Once IOP is completed, often the recommendation is to attend an outpatient therapy facility for individual, couples, and/or family therapy.

Maybe you didn’t go to treatment due to lack of resources/finances/insurance. Maybe you’re not sure what to do. Mutual Aid Programs like AA, NA, SMART Recovery, and Dharma recovery are free community resources filled with people in recovery eager to help the newcomer to sobriety that can be easily accessed through an internet search or phone app. You may also find support through religious and spiritual organizations. If you need medical detoxification for withdrawal, it is best to seek help at your nearest emergency room.

For the Loved Ones

Substance Use and Loneliness - Finding Help for yourself

For the loved ones, you can expect to be living alone or feel an emptiness while your loved one is in treatment, all while carrying the burden of the household. You may have already been experiencing this loneliness during active addiction. Maybe your partner/loved one was physically present, but unable to connect with you, share with domestic labor, or help financially due to their substance use. Or maybe they were physically absent all together.

Resentment, fear, and frustration can build during this time due to the unfair burden. The stress and emotional toll are immense during this time. Many of the programs listed above offer couple and family sessions, which would be beneficial to join. Trauma therapy is also an option for you, as living with someone in active addiction can be traumatizing, or maybe you’ve experienced past traumas that are being triggered by your loved one’s behavior.

Al-Anon, Al-Ateen, Codependents Anonymous (CODA), and Adult Children of Alcoholics and Dysfunctional Families (ACA) are free supportive community organizations that can also provide needed support during this time. You can do a quick internet search for these programs in your area.

Types of Therapy

Many inpatient, PHP, and IOP programs offer Cognitive Behavioral Therapy (CBT) and Dialectic Behavioral Therapy (DBT), which are a top-down approach where the focus is on how the individual’s thoughts are affecting behavior. These techniques are helpful for relapse prevention and increasing awareness of patterns of destructive thoughts and behaviors and actionable steps to take towards change. This is usually implemented once the individual is clear from withdrawal symptoms and can be useful for relapse prevention and coping skills.

What About Trauma

If you are someone who experienced trauma, being clear minded in early recovery can be a double-edged sword. You are physically clear from your drug of choice, but you may start to have memories or flashbacks from traumatic experiences that you used the drugs to forget.

substance use recovery and nightmares, trauma therapy

You may experience the following:

  • Nightmares related to traumatic memories or dreams about using drugs/drinking
  • Heightened anxiety/nervousness
  • Depression/hopelessness
  • Thoughts of using drugs/drinking to cope with memories
  • Feeling disconnected from your body

This is a common experience, and you are not alone. There is help available.

Stabilization

Trauma specific therapy is often introduced in early sobriety, sometimes in higher levels of care, but more often addressed once you are in outpatient therapy. This is because of the need for physical stabilization and emotional safety offered in higher levels of care. Experiential Trauma Therapies typically use a bottom-up approach, which prioritizes addressing trauma starting with the body’s responses and sensations, rather than focusing on the thoughts and memories associated with the traumatic experience.

Re-telling of traumatic experiences in early sobriety can cause emotional dysregulation and intense physical discomfort, which could lead to urges to drink or get high. However, at the same time, engaging in trauma therapy in early sobriety can help prevent relapse fueled by unresolved trauma or loss.

Trauma therapy in early sobriety often involves somatic approaches:

Somatic Therapy in Trauma Therapy and Early Recovery
  • Breathing exercises
  • Yoga postures and movement
  • Mindfulness
  • Progressive muscle relaxation, movement
  • Expressive arts therapies (art and music)
  • Psychodrama techniques
  • EMDR Resourcing and grounding techniques

The Bottom-Up Approach

The bottom-up approach enhances relapse prevention and creates safety and stability. This sets the stage for deeper trauma work down the road, such as reprocessing and desensitizing traumatic memories using Eye Movement Desensitization and Reprocessing (EMDR).

These bottom-up approaches are also useful for loved ones of those in early recovery to help manage anxiety, fear, frustration, anger, and even traumatic experiences caused by your loved one while in active addiction. If you are experiencing the following, you may benefit from therapy as well:

  • Resentment/Anger
  • The intense need to control and micromanage
  • Increased stress/anxiety
  • Flashbacks/Nightmares
  • Sleeplessness
  • A sense of dread
  • Increase in your own substance use to cope with emotions/stress
Meryl Lammers Trauma Therapist, Delaware County PA

Addiction affects the whole family. But help is out there. Recovery is available to all those who seek! If you are in early sobriety or the loved one of someone who is and you’re in need of help, call the Phoenix Center today to book with one of our trained experiential trauma therapists. You are not alone.

Navigating Perimenopause and Trauma

Meryl Lammers Trauma Therapist, Delaware County PA
By: Meryl Lammers, LSW, MT-BC

Is it perimenopause or trauma? Mood swings. Body changes. Brain Fog. Anxiety. Sleeplessness. Why don’t I feel like myself? I don’t recognize my own body. Why does it feel like I’m going through puberty all over again? Why do my joints hurt all the time? Where did my patience go?

If you are in your late 30’s-early 50s and you are a woman or person who menstruates, you may be experiencing perimenopause.

What is Perimenopause?

Perimenopause is the transitional period before menopause. This is a time when bodies of people who menstruate begin to change and prepare for the cessation of menstruation. This phase, which can last for 3-14 years, is characterized by hormonal fluctuations, particularly in estrogen and progesterone levels, leading to various physical and emotional symptoms. These symptoms may include:

the road through perimenopause, perimenopause symptoms, managing emotions through perimenopause by Meryl Lammers
  • challenging emotional changes
  • sleeping disturbances
  • decreased sex drive
  • fatigue
  • weight gain
  • cognitive change
  • dry skin
  • joint pain
  • muscle aches
  • headache
  • heart palpitations
  • changes in taste
  • digestive problems

People who have a trauma history may experience more severe perimenopausal symptoms, including hot flashes, sleep disturbances leading to fatigue, difficulty managing emotions, and heightened anxiety and depression.

Perimenopause and Trauma

Studies indicate that people with a history of trauma, particularly during childhood or adolescence, may experience a higher risk of depression and PTSD symptoms during perimenopause. Some red flags to look out for include:

  • Increased feelings of depression/loneliness/isolation/anxiety
  • Flashbacks of traumatic memories
  • Inability to regulate emotions
  • Increased suicidal ideation
  • Feelings of hopelessness

Perimenopause and Neurodivergence

Is it ADHD or perimenopause? The rising diagnosis rates of neurodivergent conditions, like ADHD and autism, in people undergoing perimenopause is a phenomenon linked to hormonal changes and the impact of masking strategies. The decline of estrogen during perimenopause can worsen symptoms associated with neurodivergence, making previously masked traits more apparent and leading women to seek diagnoses.

Hormonal Changes and Neurodivergence

ADHD and Perimenopause, Meryl Lammers, Phoenix Center for Experiential Trauma Therapy

The hormonal fluctuations during perimenopause can directly impact dopamine regulation, a neurotransmitter crucial for focus and executive function. This can lead to an increase in symptoms like brain fog, forgetfulness, and difficulty concentrating, which are often associated with ADHD. Similarly, for autistic women, hormonal changes can exacerbate sensory sensitivities, social anxiety, and challenges with executive function.

Masking and the “Tipping Point”

Many neurodivergent women may successfully mask or hide their traits for years, particularly in childhood and adolescence. However, the physical and emotional changes of perimenopause, combined with life transitions, can overwhelm existing coping mechanisms. This can lead to a “tipping point” where previously hidden traits become more noticeable, prompting a diagnosis.

Increased Awareness and Intersectional Considerations

Increased awareness about neurodivergence and a shift towards more intersectional diagnoses are also contributing to the rise in late-life diagnoses. Additionally, the physical and emotional symptoms of perimenopause, coupled with the psychological impact of a late diagnosis and potential trauma history can make this transition particularly challenging for neurodivergent people who menstruate.

Support during Perimenopause, Therapy in Delaware County, PA

Where Can I Get Help?

If you…

  • believe you are experiencing perimenopausal symptoms, first and foremost contact your medical doctor/gynecologist.
  • you are in perimenopause and now curious if you are neurodivergent, please speak to a doctor, psychologist, or psychiatrist who can direct you to health care professionals that conduct neuropsychological examinations for neurodivergence.
  • you’re having thoughts of harming yourself or others, please call 988 or 911, or go to your local emergency room.
  • you are experiencing an increase in PTSD symptoms or difficulties managing your emotions, experiential trauma therapists are trained to help you through this challenging life transition.

The Phoenix Center

Experiential Trauma Therapy uses evidenced base techniques that can be beneficial for people in perimenopause of all neurotypes who are experiencing these symptoms. Research suggests that somatic or body-based therapies are effective in helping people in menopause cope with trauma. At the Phoenix Center, we specialize in providing EMDR, IFS, Psychodrama, Somatic work, and Creative Expressive Arts, such as music and art therapies, which all have a somatic component. We are here to support you through all life phases!

If you’re ready to get support during this significant life change, contact The Phoenix Center today to schedule with one of our experiential trauma therapists.

Parenting Children with ADHD: Emotional and Physical Burnout

By Meryl Lammers, LSW, MT-BC
Parenting Children with ADHD: Emotional and Physical Burnout

Parenting is a complicated job, full of joy, unimaginable love, and a level of stress many are not expecting. When you are parenting children with ADHD (Attention Deficit/Hyperactivity Disorder), or other forms of neurodivergence, there are forms of burnout that parents of neurotypical children may not experience to the same degree. It’s a form of being tired you’ve never known before.

WHY?

Children with ADHD need more co-regulation, more reminders, more structure, and more patience. They need to be parented perhaps differently than you/we were. There must be a focus on building relationships, providing structure and support, managing impulsivity, and meeting behavioral and educational challenges. This includes creating a positive and supportive environment, using effective communication and discipline strategies, and understanding the unique challenges ADHD presents. Parenting this way may feel foreign, which requires more work and learning for you.

It’s the constant mental load of parenting a child whose brain works differently.

You’ve put your own needs to the side to care for your child. You’re always juggling meltdowns and tantrums over getting dressed, eating breakfast, or transitioning from one task to the next. You’re managing both you and your child’s emotional regulation. You’re going to therapy and doctors’ appointments, activities, advocating with insurance companies, schools, and health care providers. You’re navigating a healthcare system that feels impossible and you’re constantly wondering why it feels so hard to get the support you and your child need. You’re attending IEP meetings, fielding phone calls, emails, letters home.

You’re working a job in addition to parenting. You’re not sleeping well because your child isn’t sleeping well. Maybe you’re parenting more than one child, all of whom have different needs. You’re always in decision making mode and it’s hard to make mental and physical space for things you love or need.

It’s the constant worry, “Am I doing enough? Am I enough?”

Why does this feel so hard?

Because your cup isn’t full. Maybe you don’t have enough familial or community support. Maybe you don’t ever get time by yourself because you’re the default or only parent. Maybe you weren’t taught how to support their nervous system through your own. Maybe you weren’t taught how to support your own nervous system.

And our society is not currently set up to support parents, especially parents of children with differences. Maybe you’re faced with judgement from others or society on how you’re parenting. Maybe you’re also neurodivergent and the stress and sensory input of parenting overwhelms your system. Maybe you weren’t parented with patience or love and are trying to break generational patterns of unresponsive parenting. Maybe you have past trauma resurfacing and you’re not sure how to cope. You’re running on empty.

The increased stress and burnout of parenting can lead to:

  • Increased cortisol levels (stress hormone) leading to negative health outcomes.
  • A decrease in distress tolerance or ability to cope with daily living.
  • Increase in yelling and fighting with your child or partner.
  • Insomnia or poor sleep hygiene.
  • Increased anxiety, depression, feelings of dread.
  • Increase in irritability.
  • Feelings of guilt and shame.

This increase in stress has the potential to trigger past unresolved trauma. Here are some Red Flags to look out for:

  • Increased feelings of depression/anxiety.
  • Nightmares.
  • Flashbacks of traumatic memories.
  • Feeling disconnected from your body or from others.
  • Intrusive thoughts.
  • Persistent negative thoughts or beliefs about yourself.
  • Reduced interest in enjoyable activities.
  • Feeling unsafe in everyday situations.
  • Feeling helpless or hopeless

If you are parenting children with ADHD or neurodivergence, and are experiencing these symptoms, it may be time to reach out for help.

Benefits of working with an experiential trauma therapist include:

  • Increased ability to cope with life’s stressors.
  • Reduced PTSD symptoms.
  • Learning how to regulate your emotions so you can help your child regulate theirs.
  • Improved relationships with your child/partner/family.
  • Increase self-esteem and self-awareness.
  • Increased feelings of empowerment.
  • Ability to regain a sense of control over your life.

Remember: You are NOT failing. You are carrying a load that no one else sees. We cannot recover alone and you’re already doing so much for others. You deserve support, too! Please call the Phoenix Center to schedule an appointment with one of our skilled experiential trauma therapists.

Meryl Lammers is an Experiential Trauma Therapist and Music Therapist at The Phoenix Center for Experiential Trauma Therapy. Meryl also provides Trauma Recovery Coaching.

Long Term Sobriety and Early Childhood Trauma

By Meryl Lammers, LSW, MT-BC
Long Term Sobriety and Early Childhood Trauma

Maintaining long term sobriety and leading a happy life is often not possible without addressing the underlying issues that fueled the addiction in the first place. A significant overlap exists between trauma and substance abuse. Studies indicate that a substantial percentage of individuals who have experienced Adverse Childhood Experiences (ACEs), or early childhood trauma, also struggle with substance use disorders (SUDs), and vice versa. Individuals with a higher ACE score are 7-10 times more likely to develop substance use disorders than people without ACEs or with lower ACE scores. Certain ACEs, like emotional neglect, sexual abuse, and physical abuse are particularly strong predictors of substance use disorders.

Early Stages of Sobriety

People in early sobriety may have not yet have established a sense of safety and stability required to proceed with trauma therapy and tend to benefit from focusing on coping skills for relapse prevention and build a strong supportive community, whether through drug and alcohol rehabilitation, support groups, 12 Step meetings, Dharma Recovery, friends, family, religious or community organizations. In the early stages of sobriety, both neurobiological and physical changes occur as the body and brain adjust to the absence of substances. Additionally, the brain also begins to recover its structural and functional integrity, which is a crucial step before engaging in trauma processing.

Going Back into the Past

As people continue to recover, they may rejoin their lives, their jobs, their families, and lead a fulfilling life. They may not see the benefit of going back into the past to work through difficult experiences because they start to feel better. Sometimes people in long term recovery can become complacent with what helped them get sober. Maybe they reduce or stop going to 12 Step meetings or mutual aid programs, stop therapy, or reduce their use of coping skills for staying away from substances.

Additionally, people may also experience common life stressors, difficulties, or even experience significant loss or trauma well into sobriety. These experiences have the potential to resurface past traumatic experiences that may not have been dealt with in early recovery. Left undealt with, the past experiences may increase depression, suicidality, and poor occupational functioning, or decrease your ability to handle stressful situations which can lead to relapse.

Potential Risks of unresolved childhood trauma in long term sobriety:

Relapse

New behavioral addictions

Depression

Anxiety

Low self-esteem or self-worth

Persistent negative view of self

Emotional numbness or intense emotional reactions

Avoidance and dissociation

Hypervigilance and difficulty concentrating or sleeping

Difficulties in relationships

Difficulty with daily functioning

Shame or self-blame

Intrusive thoughts

PTSD symptoms including flashbacks, nightmares, and strong emotional responses.

Twelve Step Programs

Bill Wilson, the co-founder of Alcoholics Anonymous (AA), experienced a childhood marked by the abandonment of his parents and a subsequent period of depression at 17 after the death of his first love. He wrote extensively about his struggles with depression, insomnia, and fatigue in long-term sobriety. He noted that depression specifically required its own unique recovery process.

Long Term Sobriety and Trauma Therapy

Bill began therapy years into his depression in the 1940s (40 years before PTSD was recognized) with a Jungian therapist and shared that therapy helped him work through what he called “psychic damages,” which included inferiority, guilt, shame, and anger. He wrote that doing a “psychic inventory,” like the moral inventory of AA, would help reduce the effects of these “psychic damages.” His therapeutic work later informed his writing in the 1953 book, Twelve Steps and Twelve Traditions, which were essays expanding upon the 12 Steps from the 1939 book, Alcoholics Anonymous.

Individuals with long term sobriety and a history of childhood trauma would benefit greatly from engaging in trauma therapy to help maintain both physical and emotional sobriety. For many people in long-term recovery, trauma therapy is a necessary form of relapse prevention.

Benefits of trauma therapy for people with long term sobriety include:

Improved emotional regulation.

Reduced symptoms of PTSD, depression, and anxiety.

Greater sense of hope, meaning, and purpose.

Stronger relationships.

Fostering a sense of empowerment and well-being.

Improve self-esteem and self-worth.

Peace of mind and sense of safety

Gain a greater understanding of themselves and their reactions to trauma.

Relapse prevention.

If you are someone in long-term sobriety who has an interest in working through traumatic experiences, please call the Phoenix Center to schedule an appointment with one of our skilled experiential trauma therapists to help enhance your emotional sobriety and overall well-being.

Meryl Lammers is an Experiential Trauma Therapist and Music Therapist at The Phoenix Center for Experiential Trauma Therapy. Meryl also provides Trauma Recovery Coaching.

Parental Stress and Trauma

By Meryl Lammers, LSW, MT-BC

In August of 2024, the acting Surgeon General, Vivek H. Murthy, issued an advisory on the health and well-being of parents in the United States. This advisory called attention to the growing rates of stress experienced by parents and the direct impact that stress has on childhood development and well-being. Parental stress, coupled with trauma can be a particularly challenging experience.

Sources of Sessors for parents:

1) Financial Strain, Economic Instability, and Poverty can make it difficult for many families to meet their children’s basic needs, pay for childcare costs, and provide for children’s health and education expenses. Financial worries continue to be a top stressor among parents.

2) Time Demands: The increase in time spent both on work commitments and with family responsibilities can contribute to work-family conflict, burnout, and stress.

3) Children’s Health, including mental health challenges, intellectual and developmental disabilities, and acute or chronic illnesses, can add to parental stress levels.

4) Children’s Safety: Parents report concerns about their child being bullied, abducted, or attacked. Firearm-related injury has become the leading cause of death among U.S. children and adolescents ages 1-19 and parents report that the possibility of a school shooting causes them significant stress.

5) Parental Isolation and Loneliness: Parents struggle with loneliness at higher rates than non-parents, which can exacerbate parental stress.

6) Technology and Social Media: The rapid adoption and evolution of technology and social media have been difficult and stressful for parents to manage, including by posing new risks to children’s health and safety.

7) Cultural Pressures and Children’s Future: Cultural expectations, societal norms, and pressure to meet perceived parenting standards can contribute to parental stress.

Parental Stress and Mental Health

Chronic or excessive stress, coupled with other complex environmental and biological factors, can increase the risk of mental health conditions for individuals. Some of those factors include:

1) Exposure to Alcohol and Drugs

2) Discrimination and Racism

3) Adverse Childhood Experiences (ACEs): Abuse, Neglect, Trauma, Death/Loss of Loved Ones

4) Neurochemical Factors influenced by genetics, epigenetics, and hormonal fluctuations associated with pregnancy and the perinatal period

5) Predisposition to mental health conditions

Disproportionate Mental Health Conditions Among Certain Parents and Caregivers

1) Community Violence: Parents who are exposed to violence (e.g., intimate partner violence), are incarcerated.

2) Racism and Discrimination: Parents who are of racial and ethnic minorities, are sexual and gender minorities, are immigrants, are parents and caregivers of undocumented children

3) Poverty: Parents and caregivers who live in low-income households, experience job instability or unemployment, and experience food insecurity.

4) Gender: Women in heterosexual relationships disproportionately carry the physical, emotional, and mental labor of childrearing compared to male counterparts.

5) Other: Parents who are divorced, are in the military or deployed, have disabilities or experience chronic medical problems or trauma.

Parental mental health can influence the emotional climate, responsiveness, and consistency of caregiving at home, all of which are crucial for a child’s emotional and cognitive development.

Impacts to Children

Importantly, how a parent’s or caregiver’s mental health affects their behavior and functioning is a critical factor in determining how it impacts a child.

Children of a primary caregiver who reported poor mental health were four times more likely to have poor general health (5.1% vs 1.3%) and two times more likely to have mental, behavioral, or developmental disorders (41.8% vs 21.0%). Additionally, these children are prone to cognitive, academic, and interpersonal struggles.

The mental health conditions of parents can pose greater risks for children when combined with additional risk factors like poverty, exposure to violence, and marital conflict, but they can be mitigated by protective factors like social support networks and positive parenting behaviors as well.

Government, health and social service systems, employers, community organization, schools, and even friends and families can all play a crucial role in helping support parents, which would require massive policy changes, allocation of federal and state tax dollars, and the overall shift in perception about parenting: It’s time to value and respect time spent parenting on par with time spent working at a paying job, recognizing the critical importance to society of raising children. These changes will take time.

But parents can start to implement change for themselves now:

· Community Care: Parenting is best done with the support of other parents, family members, and friends. Seek out or create relationships with parents of children across age groups. Such community can provide opportunities to share your feelings, concerns, and challenges while also learning from the experiences of other parents. Fostering a supportive environment can help reduce the stresses of parenthood.

· Self-Care: Some activities that can help reduce stress include exercise, sleep, a balanced diet, mindfulness, meditation, and recreational activities that bring joy. Self-compassion is also crucial, as parenting is incredible stressful, and no one is a “perfect” parent.

· Education about appropriate health care from credible sources: FindSupport.gov

· Learn to recognize the signs of how mental health challenges manifest and when it’s time to ask for help: If you feel bad and are not getting better, you need and deserve additional care. Don’t be afraid to ask for support from a peer, family member, mental health provider, or any medical professional.

The stress of parenting

The stress of parenting, including challenges like child behavior, sleep deprivation, and financial strain, can act as a trigger for past traumatic experiences. For parents who have experienced Post Traumatic Stress Disorder (PTSD), parenting can be a particularly challenging experience. The stress of parenting may lead to a reactivation of PTSD symptoms, including intrusive memories, flashbacks, and heightened anxiety.

Trauma can be passed down through generations, meaning that a parent’s past trauma can impact their parenting style and their child’s well-being.

Parents may experience a variety of symptoms when their trauma is triggered, including increased anxiety, anger, or emotional numbing. When parents’ trauma is triggered, it can affect their parenting style, leading to difficulties in communication, discipline, or emotional regulation. If parents are struggling with trauma and its impact on parenting, it is important to seek support from mental health professionals or support groups.

Remember, caring for yourself is a key part of how you care for your family. If you are finding the stress of parenting is feeling overwhelming, call the Phoenix Center today to find out more about our compassionate trauma therapists and how they can help lighten the emotional load of parenting.

Music Therapy and Trauma Healing

By Meryl Lammers, MT-BC (Music Therapist-Board Certified)

Music Therapy is the clinical and evidence-based use of music interventions to accomplish individualized goals within a therapeutic relationship by a credentialed professional who has completed an approved music therapy program.

MUSIC THERAPY AT THE PHOENIX CENTER

Clinical music therapy is the only professional, research-based discipline that actively applies supportive science to the creative, emotional, and energizing experiences of music for health treatment and educational goals.

Music therapists use music to enhance social or interpersonal, emotional, cognitive, and behavioral functioning in individuals who have experienced trauma. Research indicates that music therapy is effective at reducing muscle tension and anxiety, and at promoting relaxation, verbalization, interpersonal relationships, and a sense of connectedness. This can set the stage for open communication and provide a starting place for non-threatening support and processing symptoms associated with or exacerbated by trauma. A qualified music therapist can use music to actively connect a client to their emotional state quickly.

Benefits of integrating Music Therapy into trauma focused therapy:

· Improved mood

· Emotional regulation

· Development of coping skills

· Creative and emotional expression without the need to use words

· Decrease in anxiety and depression

· Increase feelings of safety and connection

You do not need to have musical ability in order to participate in or benefit from music therapy. Music Therapy is effective for people of all ages, is collaborative, and involves both the client and therapist to co-create goals and interventions.

Some interventions that help address symptoms related to trauma include:

· Drumming

· Instrument improvisation

· Song writing

· Progressive muscle relaxation to live or recorded music

· Vocalizations/singing

· Song choice

· Lyric analysis

· Creation of play lists related to specific emotions

· Movement to music

· Legacy projects

· Combining music and art

Various types of Music Therapy

These Music Therapy techniques are also complementary to other trauma related modalities and can be integrated with them, including:

· Expressive arts therapies

· Psychodrama

· IFS

· Somatic work

· EMDR

As an experiential modality, music therapy that has the capacity to create connection and community, which are important aspects of healing from trauma. The Phoenix Center is committed to finding individualized ways to help people recover from trauma and enhance personal growth through the use of different experiential therapies. Contact us today if you’re ready to begin your journey of healing.