Diana Trevino

CONTACT

Am I the right therapist for you?

by Leave a Comment

Coming to therapy can really be a tough decision. Finding the right therapist for you can be daunting.

A scary decision.  Especially if it’s your first time. There are many therapists out there. Finding the right therapist for you is key.  The most important thing is that you feel comfortable with the therapist that you’re working with. No matter what type of therapy they do. The number one thing is do you feel safe and comfortable.  The next key step, is this the right therapist for the goals you want to achieve in therapy?

I wanted to take this moment to introduce myself.  Allow myself to give you a little bit of who I am, what I focus on,  and what you can expect from therapy.

I have been practicing for close to 15 years now. This year will be 15 years. It’s gone by really quick and worked, as most therapists, through non-profits as they work towards their license. Close to the end, I realized I enjoy working with those who have experienced trauma in their past. Either growing up as a child with a series of different difficult experiences.  Experiences that tend to get carried on through to adulthood.

A lot of times when we have difficult experiences, we carry certain beliefs about ourselves, about others, and about the world. We carry it into adult relationships and find ourselves stuck in a similar relationship that we grew up with.

A lot of times we try our best not to do that and to try to do the exact opposite. Somehow it just happens. As I was working with clients, I realized the type of therapy that I was practicing, called EMDR (Eye Movement Desensitization, and Reprocessing), was so effective with the clients that I was working with.

Seeing the transformation of those clients has really given me more passion to share it with others.

In another video, I’m going to explain a little bit more about EMDR, as well as other therapies that I now incorporate it with.  I just wanted to give you a little bit of my background and what you can expect when you start therapy with me.

When you give me a call, I try to ask questions to make sure that we are the right fit. Am I the right therapist in the sense of what you’re looking for? What your goals are for therapy? What you’re wanting out of therapy? And the type of therapy that I do is right for what your goals are. Once we square that out of the way, we discuss schedules and fees to make sure that our schedules will work together.

We can work on a weekly basis, I feel it’s so important to meet once a week because I find that clients just progress more and more quickly with that as well as with EMDR it’s just important that I am checking in with you each week just to make sure that things are going pretty smoothly.

Every two to three months, I’m checking to make sure that we are sticking to the goals you originally came in for. Are we on the right track? Do we need to tweak them a little bit? Do we need to adjust them a little bit? Or maybe you’ve worked through some of the things you originally came in for, but now you’re realizing there’s other things that you want to focus on. We talk a lot about your goals.  Making sure that we’re checking that we’re on the right path. Depending on what you’re coming in for, I will focus on some coping skills right away. If you feel pretty ready to dive in, then we’ll dive in pretty quickly.

The right therapist will meet you where you’re at.

The right therapist will meet you where you're at

It’s so important that you’re feeling just as ready to move forward. I will never force you to do anything that you’re not ready for.  We will take small steps if we need to. Once we work through some of the more difficult things that you might have experienced, we then check in with what you need now.

Do you need to learn how to express yourself? Some communication skills? Learning how to stand up for yourself? Are those things that you need next before you end therapy? Part of the coping skills is to make sure you have the tools to use once you leave therapy.  These are tools you can always come back to.

I can’t take all the problems of the world away.  I can’t take all the problems that will come up in your life down the road. But, I can give you the tools that you need to manage them and get through them when they come up.

When we realize you’ve met your goals and things are going smoothly, we don’t stop right away. I will slow down to every other week or once a month to make sure things continue to run smoothly.  Then once we do, it does not mean  you have to end forever or that you cannot come back. Therapy can come in phases. Maybe you don’t need to come back.  Maybe there’s another series of stressors that came all at once and you just need to re-charge.  We can meet again.

I wanted to give you a bit of my background.  Give you video too so that you can get to know who I am.  If I’m the right therapist for you, if you would like to learn more about the therapy I practice, I’m  happy to talk with you . My areas of focus are anxiety, panic attacks, developmental trauma, PTSD, post-traumatic stress disorder and a lot of my therapies mainly focus around those areas.

Again, if you are wanting to know a little bit more, making sure that we are the right fit, please definitely check out my website. I’d be able to talk with you further.

Filed Under: anxiety, EMDR, Post Traumatic Stress, therapist

9 Tips to Support You & Your Spouse with PTSD

by Leave a Comment

Feeling lost on how to support yourself and your spouse with PTSD?

Are you not feeling heard?  Your partner is not able to hear or handle your emotions.  Being extra cautious? You don’t know what or when he or she will be triggered.  Need tips to help you and your spouse diagnosed with Post Traumatic Stress Disorder (PTSD)?

As a trauma therapist, I love seeing the influx of articles, resources, and therapy treatment information growing to help change the stigma of PTSD and mental health.  My heart is filled when I see how many veterans, first responders, and other adults with childhood trauma are seeking therapy to heal from their traumatic experiences and regain a sense of stability and control again. But,

What about you, as the spouse, of a partner with PTSD?

Who is helping you to understand, cope, and later adjust to the changes that are happening in therapy?  When do you get to be heard and understood?  How do you know what is a healthy reaction or a PTSD trigger?  And what do you do when he or she is triggered?

These are common questions that I hear from partners of my clients or my clients reports of what their hearing from their partners.

Let me give you the key.

It’s important for you to support your partner during his or her time in treatment for PTSD, BUT, also important that you feel supported during his or her treatment too.  So, what does this look like?  Here are a few tips that can help.

  • Have a conjoint session with your partner and the therapist sometime within the first 6 weeks of his or her treatment. 

Notice I say not the first or even second session, but sometime early in therapy.  It’s important that your partner begins to build a sense of safety and trust with the therapist.  This step sets an important foundation in the therapeutic relationship, which is one of the contributing factors to a person’s success in therapy.  It’s okay to let your partner make the decision as to when the conjoint session should take place, and it may be the first session.  But it’s important that he or she decide with their therapist.  This provides them with some control over their treatment, which helps to maintain an openness to therapy.

A conjoint session early in therapy should cover the following:

Understanding the biological, emotional, and behavioral effects of traumatic experience.

How long the therapist believes therapy will take for your partner.  Understand that this is often estimated and may change as therapy progresses.  It can range from a few months, to a year, to a few years.  Usually, the longer the history of trauma, the longer the therapy.

Attempt to identify what each of you need currently to build that support.  For example, maybe a client’s trigger is a raised voice.  For his partner, it’s needing him to let her know where he is when he leaves after being triggered.  She may agree to watch her tone when upset and he agrees to send her a text that he is safe.  This is a perfect example of each one supporting the other during his or her treatment.

  • Know his or her triggers.

As therapy progresses, your partner will be getting better insight into his or her triggers.  Some may know even before therapy.  Either way, have your partner share this information with you.  This will allow you both to be more conscious and at least attempt to minimize them.  Understand, you are both human.  You’re not perfect and will forget.  That’s okay.  You can’t control everything.  Again, it’s about minimizing triggers.

  • Ask your partner to show you the coping tools he or she is learning to manage triggers.

Coping tools are the first step in therapy.  Your partner and therapist are identifying, practicing, and learning what coping tools work best for him or her.  When you learn what works best for your partner and practice with him or her at home, it reinforces the practice and builds your partner’s ability to reach a relaxed state.  These coping tools most likely will benefit you as well.  In fact, have the kids join in at homework, dinner, or bedtime.  Deep breathing benefits us all!  Finally, when your partner gets triggered, as they begin to come down from the trigger, reminding them of these coping tools will help.  Again, this is as they are coming down.  It may not be possible initially.

  • Pick and choose your battles and when to go into battle

You know your partner best.  The facial expressions, body gestures, mood.  If there is something you need to talk to your partner about, try to make sure he or she is in a good place.  If you’re not sure, ask.  Be willing to wait if he or she may say its not a good time, BUT, also let them know its important to you and if he or she can check in with you later or vice a versa.  You have a right to be heard too, but also know that it can be very difficult for your partner.  If it’s something you feel is not crucial and can let go, then try.  Not all issues can be let go and that’s okay.  It’s important that present issues are attempted to be resolved.

You also know yourself best.  If you notice emotions are high for you, most likely you will also react with emotions. You’re human.  Take space for you too.  Use your own coping tools to deescalate.   A resolution will more likely happen when you’re both in a calm state.  Both will feel heard and satisfied.

  • Your partner’s action of walking away may be to protect you, not hurt you.

One of the coping tools clients learn is to walk away or take a time out if they’re noticing that anxiety, anger, or another trigger is beginning to take over. Many trauma clients fear their anger and will walk away to make sure they won’t hurt anyone.  This is especially true with someone they love.  You, as the partner, make take this as he or she is ignoring me, doesn’t care, or “I’m not important.”  This is where feeling unheard or sense of unfairness comes up.  Wait until your partner returns or deescalates, then ask.  He or she may be doing this because of the exact opposite.  They love you so much, they don’t want to hurt you.

  • Triggered Reaction or Appropriate Reaction?

If your partner has been suffering from PTSD for a long period of time, it can be difficult to distinguish if a reaction is a trigger or is it a normal reaction to what is happening in the moment.  A trigger is often excessive or out of proportion to the situation, impulsive, escalates very quickly, and lasts much longer than just a few minutes.  No matter what you say, it’s as if they don’t hear you or not in the room with you.  Many trauma survivors describe it as someone hijacking their mind.  They feel embarrassed, scared, or guilty for their reactions once they are able to deescalate from it.  It’s not until after that they are able to recognize the intensity that took place.

An appropriate reaction can be escalated, but makes sense to the situation.  It is a more gradual escalation, and usually, deescalates within a few minutes to an hour depending what is happening.  They can listen to what you’re saying and respond.  You sense that he or she is present in the room with you.  This leads to Tip #7.

  • Come back to conjoint session towards the end of treatment if needed

One of the many things I hear from clients as they are overcoming symptoms of PTSD, (and have more appropriate reactions to situations), is they don’t feel they’re being heard.  A sort of Role Reversal.  Mainly because when he or she becomes angry or frustrated, their partner contributes it to his or her PTSD rather than being angry because they’re angry.  Many feel that they’re being dismissed. It’s often by this time, without realizing it, you may have developed automatic reactions to your partner’s reactions.  For example, walking away yourself, not listening, and waiting for your partner’s reactions to pass.  Perhaps, difficulty trusting it. 

Built up anger or resentment for having to place your own needs aside for so long can make it difficult to continue to be patient and open.  A few conjoint sessions are not uncommon and can be helpful to readjust as your partner improves, and provide you space to express how difficult it has been for you.  He or she is now in a better place to handle it.

  • Remember, therapy takes time and is not linear

Typically, in therapy, there is progression with the middle being most difficult.  But regression for brief periods of time is to be expected and does not necessarily mean progression is not being made.  There are many different reasons.  Life is still happening beyond therapy, bringing present stressors.  An unexpected, unrealized trigger.  While working through trauma, a new memory is recalled to the surface.  Waves of progression and regression should be expected.   Leading to Tip #9.

  • Take care of you!

Make sure that you are taking care of you too.   Have your support system of family, friends, church community, or your own therapist in place.  Make sure you have a tool box of coping tools.  Exercise, Yoga, hobbies, getting out, meditation/prayer, things you enjoy.  Journaling or art is an effective tool to give you a place to express and release your emotions.  If you are a spouse of a veteran or first responder, is there a community of spouses you can connect with?

It’s easy to feel at a loss of what to do and of being heard yourself as a partner of someone with PTSD.   It’s a diagnosis that impacts the entire family.  Open, timely, and patient communication to support both of you are key and can ultimately strengthen your relationship even more.  Taking care of yourself and having support another important key during your partner’s treatment.

If you would like to know more about PTSD and possible treatment such as EMDR, you can click on my Services page.  You can also go to my Meditations page if you are looking for some more coping and relaxation tools.

Below are links to further information on PTSD symptoms and treatments:

www.ptsd.va.gov

Posttraumatic Stress Disorder (PTSD)

www.emdria.org

Filed Under: EMDR, Post Traumatic Stress, PTSD, Trauma

Depression: Clinical vs. Situational & Options to Treat

by Leave a Comment

You may already know the signs and symptoms of depression:

  • Feeling sad daily or almost daily
  • Low energy and difficulty facing the day / tasks
  • Difficulty concentrating
  • Difficulty experiencing joy, pleasure, or interests in things you used to0
  • Wanting to be alone
  • Loss of appetite or over eat to soothe or distract

But in order to overcome depression, we need to understand whether our symptoms are clinical (more physiological) or situational.

Medical News Today defines clinical versus situational depression.  Specifically, “Disturbances in levels of certain chemicals — known as neurotransmitters….” in the brain creates a physiological reaction that leads to depressive symptoms.

And, “…., other factors are likely to play a role (in clinical depression), for example:

  • genetic factors may influence an individual’s response to an experience or event
  • major life events can trigger negative emotions, such as anger, disappointment, or frustration
  • alcohol and drug dependence also have links to depression” (https://www.medicalnewstoday.com/articles/314698.php)

Whereas, situational depression “is a short-term form of depression that occurs as the result of a traumatic event or change in a person’s life” (https://www.medicalnewstoday.com/articles/314698.php).

Examples:

  • loss of a job or loved one
  • relocating
  • a break-up or divorce
  • experiencing a horrific event.  (recently or repeated events that occurred throughout one’s life)

Trauma and depression often coincide.

Traumatic reactions are  experienced immediately, while depressive symptoms are more likely to develop if it isn’t processed within six months.  Here a few possible reasons why:

  • You feel alone because nobody can quite fully understand your experience
  • You fear uncontrollable emotions or reactions will come up in social settings, so you begin to avoid others, isolate, and feel safer being alone.
  • The images, emotions, and physiological reactions to the event can be persistent and intense.  It is our natural tendency to avoid them or any other reminders of the event which becomes physically and mentally exhausting.
  • Your view of the world and reality changes.  Bringing a sense of overwhelm, loss of direction, and loss of confidence in yourself.  Doubt of what you use to know and how to manage things.   Making it difficult to know how to move forward.

 

The Other Driving Force:  Negative Beliefs

Negative thoughts are developed through our experiences.  Those thoughts are then carried with us through later life experiences, creating certain (and often automatic) reactions.  Reactions towards others, impacting our relationships, which then reinforce what we believe.  We feel stuck in a vicious cycle as you see below.  Hopelessness  takes over.

So how do I break the cycle?

Many types of therapies that have shown to be effective in managing and treating depression.  Very Well Mind describes a few of them (https://www.verywellmind.com/types-of-psychotherapy-for-depression-1067407).

Clinical depression is best treated with medication and therapy.  Medication helps balance chemicals in the brain that then reduces depressive symptoms.  Therapy can help process life events and thoughts that contribute to the symptoms.

If depressive symptoms are a result of a life changing or traumatic event, Eye Movement Desensitization and Reprocessing (EMDR) may also be an option.

EMDR was developed by Francine Shapiro, Ph.D. as a treatment for trauma.  Trauma is defined in EMDR as big T’s for severe trauma and little “t’s” for less severe trauma.  Examples of severe trauma are childhood abuse, neglect, victim of assault, or witnessing tragic events.  Examples of less severe trauma are being bullied in school, a performance on stage gone wrong, or the teacher embarrassed you in front of the whole class.  Any can cause a negative belief about oneself which then lingers and is carried into the next situation.  Any can cause physiological reactions and cause similar reactions in the future.

Let’s take the later as an example.  If you believe, “I’m wrong,” how would you feel the moment you approach a group of peers or when your boss asks you a question? Anxious perhaps.  How would your body react? Freeze, shake, chest and chin sink in, maybe throat clinches.

EMDR helps to identify these incidents and process them until that incident no longer has such an impact on you today.  “I’m wrong” changes to a more adaptive belief, “I’m okay as I am.”  The body remains calm and the mind present.

How would you approach a group of peers or when the boss asks you a question with this new belief in mind?

If depression is driven by negative thinking, and the negative thinking is a result of an experience you had, then EMDR may be the answer to gain a better and more adaptive perspective on yourself and others.

Providing relief and a new way of looking at things.  A clarity and lightness.

If it’s difficult to determine where your depressive symptoms are stemming from, a counselor, psychologist, or psychiatrist can help with questions surrounding the history of symptoms, as well as family and medical history.

To learn more about EMDR, you can go to my Services tab or you can follow the links below:

www.emdria.org

www.emdr.com

You can also call for free consult to see if EMDR may be helpful for you.

Filed Under: anxiety, depression, EMDR, Post Traumatic Stress, PTSD, Trauma