Welcome To Syrona

Short-Term, Intensive Therapy For

Trauma & PTSD

Do You Feel Stuck Between A Rock And A Hard Place, Because Of Your Trauma?

shutterstock_164692313If you have a trauma-based past, life can be very challenging. Despite knowing intellectually that you have moved “beyond” your trauma, you may be still experience emotional reactions that seem out of place, extreme, or just plain confusing.  It’s as if you are stuck in an emotional time-warp, where you body is still living in the past while you and your rational mind are trying to live in the present.

You are not alone. Many people with trauma histories are often given well-meaning advice about how to get past it, like, “move on”, “don’t think about it”, or even worse, the old “others have had it worse” comment.  What’s worse, if you try to follow these suggestions, and they don’t work (not for very long anyway), you might start feeling like there is something wrong with you.  Now you have trauma and low self-esteem!

Trauma, especially childhood trauma, changes people, physically and mentally.  Now, we are learning newer ways to help people overcome some of the negative, lasting, side effects of trauma.  Whether your trauma is with a capital “T” or little “t”,  there is help.  We know now that it is important to get to know your UNIQUE story.  It is your perceptions, not anyone else’s, that matter.

Read through the following statements, and see if you relate to any of them.  All are common to people struggling with trauma histories, but as you can see, individual reactions can be all over the emotional map:

  • I hate that I overreact to small things that other people seem to handle easily
  • It is hard for me to calm down once I get upset.
  • I am anxious/scared all the time but I don’t know why
  • I am in therapy but I don’t seem to be getting anywhere
  • I often feel like a robot, walking through life
  • I try not to feel very much because it hurts too much
  • People say that I am too independent, but I don’t trust people to really be there for me
  • I probably drink too much to “numb” out or keep me from thinking about my past
  • I don’t like getting close to people.

The Syrona Intensive Is An Innovative, New Way To Do In-Depth, Trauma Therapy

The Syrona Intensive is good therapy done in a different format.  It  offers short-term, but in-depth psychotherapy for individuals who want focused work that delves into, and helps heal, past trauma. The Syrona therapy format provides 7 hours of therapy per day, for periods ranging from one through five days. This allows us time to “get into the issues” and stay there, helping you move through the emotional impasses preventing you from fully living life.

* To give the clearest picture of how we work, we would like to share with you a case study of a client who attended a two-day Intensive. While we have drawn on real experiences, the need for confidentiality required us to change identifying aspects of both the story and client. However the treatment, the rationale for the treatment, and the follow-up remains true to the essence of what transpired.  

THE CASE OF HENRY

shutterstock_44258968Background History: Henry presented to the Intensive as a forty-five year old, married male, with 2 young adult children. He was referred by his current therapist who was seeing him once a week in an outpatient, private practice. Henry was employed professionally in the medical field.

The trauma: Henry reported that he was attacked by a stranger while walking home from work in the city, late one night. The attacker used a blunt object repeatedly, and Henry sustained life-threatening injuries. In order to escape the attacker, Henry fought back, ran, and threw himself into the street where he flagged down a stranger, entered the car and lost consciousness. He woke up in a hospital bed.

Previous therapy: Henry reported that he had sought out therapy for PTSD five times in the past, with varying results. He reported that the primary treatment interventions focused on helping him refocus and distract himself, in order to minimize triggers. He also did some EMDR, but he stopped the treatment prematurely because he felt it was making his body memories worse. Henry reported that he was prescribed a wide range of psychopharmacological medications, some of which he reported helped calm him down and obsess less about the trauma, but did not stop the pain of his body memories. He also felt he was becoming dependent on the medications. Henry expressed a desire to “. . .not be on meds” for the rest of his life because of his past trauma. His current therapy was supportive in nature, with an emphasis on CBT interventions.


Presenting Problems:
Henry presented to therapy approximately 9 years after the attack. Henry was a highly competent employee who worked in a fast paced, stressful setting. Henry reported having intrusive body flashbacks off and on since the attack. That is, he could feel the pain of the attack, but had little visual memory of the experience. He stated that these body “memories” initially trigged only when he was working on a patient whose injuries where similar to his own.

Over the past several years, he noticed that the flashbacks were beginning to increase in both frequency and intensity, even without an identifiable trigger. His body would register both dull and sharp pain, for about 20 minutes. Henry reported that he coped with these body flashbacks by either a) trying to ignore the pain and riding out the flashback, b) taking medications or, c) going into a room by himself until the painful body flashback was over.

One of Henry’s biggest health concerns was that he was smoking excessively, and he felt it was hurting his health and his work.  He believed he was smoking to help prevent his body flashbacks from occurring.

Symptoms: Henry sought out help mainly because of the increasing severity of the consequences of his body flashbacks. He reported the following symptoms:shutterstock_375518761-2

  • Increased problems with sleep.
  • Increased anxiety, at times waking up with panic attacks.
  • Personality changes, with his normal fun-loving, outgoing nature shifting to being withdrawn, irritable and sullen. He stated his personality changes were straining his marriage.
  • Increased fear, out of concern that he would be triggered if he went out or spent time being social. He was developing early signs of agoraphobia, which now had him concerned about losing his job.

As the intrusive flashbacks increased, Henry stated that he was losing his energy and enthusiasm for life. He reported feeling depressed, anxious and disengaged from the world. He struggled with the feeling that he should have been strong enough to deal with the trauma on his own, especially because he had experience in the medical field and intellectually understood the workings of PTSD. Unable to predict when the next flashback would sweep over him, Henry began to lose hope of a full, productive life.

Treatment: As an intelligent man in the medical field, Henry had been compartmentalizing and intellectualizing his experience for almost a decade. In order to help him finally find relief from the pain of the attack, we engaged Henry in a three-step process over the two-day Intensive.

shutterstock_294848708First, Henry had to work to reverse his avoidance of visual and auditory memories so that he could access and integrate the full experience his body went through during the attack. Then, he had to reverse his avoidance of the physical pain associated with the flashbacks. Finally, Henry had to emotionally allow the “truth” of his experience to be true. He had fought the good fight and survived, but his poor body had indeed lost the “war”. In other words, Henry had to find a way to let go of the fight long past, and accept that while he survived (heroically), his body had indeed been horrifically injured, and had experienced a lot of pain. Henry had to “surrender” to this truth.

FIRST DAY

After initial introductions and background history, We introduced Henry to an overview of the treatment plan. We briefly outlined the physiological, psychological, and behavioral effects of a trauma like the one Henry experienced. We then explored Henry’s concerns in depth and explained the rational behind this kind of trauma work. Henry expressed deep appreciation for having an “intellectual footing” underneath him as he moved into the first stage of the process.

Henry then told the story of his attack. He went through his first telling with flat affect, reciting the events with little to no emotion. He also skipped over many of the details, and used vague language on the few details he was able to address. We explored Henry’s reactions in detail. Henry expressed significant anger and fear at his flashbacks. He was dismissive of the experience, as if it was just a large (and painful) irritation. He became annoyed at our questions, especially when they were directed at getting specific details. While Henry was aware that the body pain was connected to his actual wounds and injuries, he did not want to know any of the details associated with the particular pain. He just reported that he was “confused” as to why the pain was not going away – 9 years after the wounds had healed.

We discussed the need to have Henry willingly access his full knowledge (including what he saw, heard, and felt) of the attack – and, to acknowledge, at least to himself, the details that he remembered, in order for his body memories to stop getting activated. While Henry was clearly motivated to have his pain stop, he also expressed understandable reluctance to willingly go back and revisit in any detailed way, the “worst night” of his life. It surprised Henry to realize that his anger/irritation/dismissiveness was really a front for his fear. He blurted out at one point “Heck, I’m scared, ok?”. This opened the door for us to normalize his fear and for Henry to realize that he wasn’t being judged for being afraid. He was, however, judging himself for being so “weak”. Breaking through Henry’s wall about fear really helped him alter how he approached the rest of the Intensive. He now at least had some degree of willingness to be scared that helped him move into the deeper work.shutterstock_271391279

In this way, Henry presented with the type of ambivalence many trauma clients experience: while genuinely wanting to do the work, his body and mind were equally fighting the work. It was important that we made full room for Henry’s “resistance”. We deeply respected it, highlighting for Henry the role our natural resistance to pain plays in all of our lives. Henry stated that this discussion was a major factor in his ability to press forward through his fear. He admitted that he had been secretly afraid of not being able to “go there”, even after spending all this time and money for the Intensive!

When we asked Henry to tell the story of his attack for a second time, he was able to provide, in a halting way, a bit more of the details, despite the pain he was feeling during the retelling. Almost immediately after finishing, Henry’s body launched into a third telling involuntarily, as though he were unable to stop the momentum of his fragmented memories. This frightened him, but we let him talk his was through it while checking in to ensure that he was not having an abreaction. Although telling his story was intense, Henry stayed present in reality and reported that the pain was lessening with each telling. He was also able to bring more of what he remembered to the surface. Afterwards, Henry took a little break, exhausted, but surprised that he was able to talk so much about the attack – he told us that while he always “knew” what happened to him (because he never lost consciousness during the attack), he never allowed himself to speak about it out loud. After the break, Henry told his story for the fourth time. He was piecing together the events of the attack, and bringing together a more complete memory of the event. Henry reported that he felt stronger and more confident in being able to deal with the next step in the therapy process. We wrapped up by helping Henry connecting his experience to the theory of emotions. We shifted to an educational focus, which helped Henry connect his open emotional circuitry with his intellect. We discussed the basics about emotions and their primary link to action. We also prepared Henry for a potentially difficult night. We discussed ways Henry could manage spontaneous body memories and/or panic attacks that might arise overnight. Our first day was then over.

SECOND DAY

That night, Henry had a few painful body memories. His wife supported him through the difficult night, and Henry returned for the second day feeling a little less confident than when he ended session the day before. He had experienced a massive memory recall in the night, opening the portal to a fuller memory of the event, including the frightening way in which he had escaped from his attacker. He also became more aware of how the physical flashbacks were related to the pain of each blow his attacker had dealt. Henry was anxious to tell us his more complete story but, not surprisingly, wanted to run fast through the process. When we brought this up, he smiled and said “yeah, I want to get it over with”. However, we instructed Henry to really slow down during the next telling of his story. He was to breath deeply throughout and take his time, allowing the “truth” of what he was saying to register. With a deep breath, Henry began. This time, the story took longer to tell.  When Henry finished, he stated that the narrative was finally complete. He knew what had happened. He had regained his story. The last piece of the narrative “puzzle” was in place.  Although we celebrated this accomplishment, we all knew this was not where the treatment was going to end.

shutterstock_231330460Henry’s body was still holding onto the pain, although it was decreasing in intensity. Throughout the previous tellings of the attack, Henry would reach down and rub on the affected body part. He often groaned and grabbed at the pain, as if he could help it go away. Being fully committed and giving himself over to the process, Henry agreed to go through the trauma yet once again – only this time with a critical difference. Henry was instructed to sit on the couch, and NOT make any efforts to stop the pain. Not to grab or rub at the painful locations, or even say “ouch”. The goal was surrender. To ACCEPT that he was hurt, that the blows did land, that his body had broken, and he had pain. Henry now understood the theoretical/biological principles behind what we were asking him to do. He admitted how completely different this approach was to his own efforts to heal- by trying to “pretend” it never happened. This time, he was determined to accept all that did happen. So, Henry sat down, placed his hands quietly by his side, closed his eyes, and remembered. We asked him not to speak, but to stay attentive internally. And he did. Henry went back to the scene of the worst moments in his life and remembered everything. And he cried. As the tears rolled down his face, he began sweating. He laid his head back and let the tears, the sweat, and the pain flow. Not once did he clutch at his body. He didn’t even cringe. He allowed himself to feel the full weight of the grief he had been pushing away and accepted that his body had gone through something terrible.  Henry had surrendered to the full truth of his experience. 

shutterstock_329767169When it was over we all cried – with relief, admiration, sorrow for the fear and pain that he experienced, and for the years lost to the aftermath. Henry, despite having gone through a deeply intense and painful experience, looked like a new man. Literally. His faced glowed. His eyes shined. He reported that he felt “lighter”, “different”, and interestingly, kept reporting that he the colors around him were brighter. After proper closure, our work together came to a close.

FOLLOW-UP

Through our work together, Henry was able to more fully integrate the memories of his trauma and find relief from the intrusive body memories he had been experiencing for 9 years since his brutal attack. The next morning, he called to say that he slept the FULL night through – straight through until 7:30 am. No intrusive dreams, body memories, or panic attacks. He was elated! He also reported that the coffee and breakfast was the best he had ever had (given that he was drinking and eating at the same hotel he had been at for days, we wondered if all his senses might be more awake!). During the next four weeks, Henry stayed in contact with us via a weekly phone call. For the first two weeks, we also stayed in contact with his therapist, but after the second phone call, she reported that both she and Henry had mutually agreed to stop therapy due to the almost complete remission of his symptoms. Henry reported that 95 percent of his symptoms vanished the day after he completed the PTSD treatment and stayed gone for the weeks and months afterwards. Now six years later, Henry continues to write and reports that he is now living the joyful, peaceful life that he had almost stopped hoping for.  shutterstock_61610527

SUMMARY

One of the main questions that should be asked when doing in-depth trauma work is how the therapy will avoid simply re-traumatizing clients. To best answer this question, it is important to understand the rationale behind this PTSD treatment method. The Syrona Intensives are grounded upon current, state of the art theoretical and scientific principles of trauma and it’s various sequelae. The therapy work and the interventions arise from an understanding of how trauma changes the brain, and how intricately linked emotions are to the process. Using knowledge of the neurobiology of trauma, and an emotions-based approach, we view trauma as changing our biology, and our emotions as the primary drive of survival.

Despite the central role emotions take in our work, feeling for feeling’s sake is not the purpose, or even the goal. The goal is to help our clients a) understand the nature of their symptoms and put them into the larger physiological/psychological context of trauma, b) carefully and as accurately as possible, identify their avoided emotionally-loaded, meaning-based “truths” and, c) provide therapeutic opportunities that will allow the required emotion-driven actions to take place that will restore the biological system back to productive functioning. In other words, we work hard to help clients get emotionally “unstuck”.

shutterstock_374506792Henry’s case study highlights a key aspect of our approach: we follow the “physics” of our client’s emotions. Despite the very real physical nature of Henry’s injuries, he also had powerful EMOTIONAL reactions to his attack. He was above all terrified. He thought he might die. He also had anger. These two emotions were driving him in powerful ways, including being able to fight back, find safety, and survive. Henry also had a lot of guilt,shame, and disgust about the attack.  And, in classic PTSD style, Henry actively avoided “looking” at what had happened to him once the initial crisis was over. Understandably, once his body healed, he wanted to get on with his life and move on. Henry was “grossed out” by the attack on his body, by his injuries. He had shame and guilt about being victimized.  About being scared, and running away.  About how badly his body was damaged. So he didn’t want to look. Who would? Aren’t we all a bit like Henry?

In our day-to-day lives, we often view our emotions as “just feelings.” We listen to our rational minds and often push away the (the unpleasant) feeling signals that tell us we are having a “stupid” or “silly” emotional reaction. The problem is that our emotions are not really that easy to reject. They don’t ask our “permission” to be here, they just arrive. Whether we feel them just a little or a lot, they arrive – depending on how we interpret the people, places, and things around us. Ignoring our emotions puts us at a huge psychological disadvantage. In doing so, we effectively cut ourselves off from not only knowing what to do, we become largely ignorant of WHY we feel the way we feel, do what we do, say what we say, and/or think what we think. By avoiding the feelings, we effectively end up “shooting the messenger” and never knowing what the message was meant to convey.

Emotions then, are better understood as action verbs – they are not static. They are goal-driven actions. Henry “did” fear and anger during the attack. In doing so, he became driven to act on these emotions. Fear and anger drove Henry to try and conquer the threat, to “win” the fight and then to seek safety. He was able to escape and survive. He found safety in the street. He was rescued. However, being able to find safety and successfully fight off the attacker did not stop Henry from also feeling horror and disgust at his injuries, or guilt and shame for being a “victim”.  He didn’t know what to do with these emotions, so he split off key aspects of his trauma.  While his intellect could compartmentalize away the trauma, his emotional “circuitry” was kept open, leaving him vulnerable to having his body “remember” when triggered. That is, Henry’s avoidance of the full truth of his experience kept the pain from the memory from being fully integrated into the full story of his attack.

shutterstock_373204006During the Intensive, in our PTSD treatment, Henry fully looked at what had happened to him. By facing and tolerating first his fear, then his shame, guilt, and anger, he was able to integrate the physical, visual and auditory experience of this unthinkable event into his memory and expand his tolerance for disgust so that he could look at the whole attack. After so many years of trying to “forget” this traumatic night, he was able to finally accept that he had been hurt. Badly hurt. And scared for his life. And ashamed.  And guilty.  After 9 years, Henry was finally able to surrender to his truth… that while he survived the attack, he had in essence “lost” the fight. And, Henry was finally able to have his sadness, to grieve the enormous losses he experienced, not only physically, but in so many other ways. In doing so, he was able to close the emotional circuitry that had been left open and active.

Get Started

Thank you for taking the time to read this case study. We hope you found it interesting and informative.

If you would like to talk more about PTSD/Trauma treatment for yourself or a client, please call or email. We would be glad to talk and explore if the Syrona Intensive meets your needs.

The phone NUMBER is: (407) 542-0035.

Email: drkelly@syrona-fl.com or drmruz@syrona-fl.com

* Please Note: Clients who come to a Syrona Intensive are prepared and ready for the emotionally-focused nature of the process. It is rare that we work with clients who are not, or have not been in therapy. The Syrona Intensives are designed to be an adjunct to ongoing therapy, not a stand alone experience.