Back From The Brink: Trauma and Homemopathy

My career in psychotherapy actually started when I found out that a local Rape Crisis Center was desperately in need of volunteers. This was in the early 80′s. I was young, still in freelance advertising, but searching for a new path. “Just come to one meeting,” the woman on the phone said. “No obligations.” Before I could say “sure,” I was in the middle of an eight-week intensive training in crisis counseling and in short order taking shifts on the hot line at three in the morning.

It was an initiation that retrospectively reminds me of the polar bear club-those insane men and women who jump into icy waters in the middle of winter. They call it brisk. I call it shocking.

And I was shocked-by what I heard, by what I felt, by the incomprehensible ways that people hurt one another and the long, lonely road to recovery so many had to walk in those days.

PTSD, now a part of our common parlance, was then a fairly new addition to the Diagnostics and Standards Manual (DSM) that mental health professionals use for assessments. In fact, while I was still in college, I proposed a research study on the long-term effects of severe stress on Holocaust survivors to the dean of psychology at a “prestigious” university in NY. He laughed and told me that it would be impossible, that I was overly-ambitious, and besides there was no such thing as stress-disease in the way that I had framed it. There wasn’t even a diagnosis for it at that point.

Yet, those people who didn’t exist for that Dean managed to find me…on the hot line and then in my office after I finished graduate school. And what I came to find in them was a variation and complexity much broader than I had been prepared for. Trauma is rarely the result of one horrifying moment. It is almost always compounded by constitution, causality (was the event precipitated by a loved one?), and consequences (was the person ignored, dismissed after the trauma?). Just as Hahnemann teaches us, every person comes to his or her life with a unique individuality. Every event is received and integrated differently and every person must be approached with that understanding-we treat the person not the disease. No two people-and no two traumas-are alike.

For that reason the techniques I had learned in graduate school and in post-graduate study were good, but they weren’t going as deep or lasting as long as I had hoped. Hypnosis was great, but only up to a point. NLP helped but, again, just so far and for just so long. EMDR was terrific for short-term relief, but so many variables had to be addressed it took forever and seemed similarly superficial. Each one of these modalities has been invaluable and I still use them in the course of treatment (* for a list of excellent books to read, see end of article) but they never seemed to go far enough, reach wide enough or sink deep enough on their own for me to consider a case completely curedI struggled and juggled technique after technique until I gratefully found homeopathy. Then I started seeing some real miracles.

Case #1: Ailments from Disappointed Love

17-year old Lena (name changed) came to my office in acute distress. Her mother brought her in one day after discharge from a psychiatric facility. She presented with a flat affect, spoke in word salad, and stated that she was pregnant despite medical evidence to the contrary. Her abdomen was quite distended. She had been put on Abilify, Cogentin, Risperdal and benzodiazepines. They planned on weaning her off after her outpatient treatment had started.

Approximately one week before going into the hospital, she had returned from a party in what her mother called a “euphoric” state, “completely changed.” Prior to the party she had been an A+ student, an athlete, popular, diligent, responsible, socially skilled. “Everyone wanted to sit next to Lena,” her mother said.

When asked about the party, Lena was incoherent, answering in rambling, irrelevant monologues. I asked her if she understood what she was saying and she responded, “I’m confused. I’m having so much word salad.” She seemed genuinely frustrated.

Although she couldn’t articulate what had happened at the party that might have contributed to her current state, she did say: “All I want to do is be with my boyfriend.” She had been dating the same boy since she was 15.

According to her mother, Lena’s boyfriend was “a good boy,” although she was worried that Lena’s psychiatric condition would put a strain on the relationship and didn’t know how that would affect her daughter. (As soon as she’d gotten out of the hospital she’d gone to see him at his parents’ home and had started talking in rather vulgar terms about their sexual life in front of the family. She stated she had no memory of it but was told about it by her boyfriend.)

Several days after the party in question, she began speaking unintelligibly and complaining of an inability to urinate. She was soon taken to a physician’s office and transferred to the E.D., where her case was eventually given to the psychiatric department because of her manic presentation. She had insisted that she was pregnant despite sonograms and blood tests to the contrary. She was so sure of her pregnancy that she slept with her hand inside her vagina to keep the baby from falling out.

She hated the hospital and often was more than resistant, having to be restrained. She recalled being put on Fentanyl, feeling paralyzed, raped and hysterical as they catheterized her to release retained urine. They also found it very difficult to draw blood from her, even though her mother stated that was very unusual for her.

Her mother stated there were no infections and that all the medical tests came back normal.

Her case unfolded in starts and stops. While it seemed that there was a clear point in etiology, the cause remained unclear and the symptoms scattered. We asked her and her mother for some general information:

She tended to be chilly and preferred spring and fall for the temperate climate. She liked ice cream and ices. She had left-sided ovarian pain with ovulation and a cyst on the right ovary. She often had faintness during menses and sometimes passed out. She had a tendency to hemorrhages and, despite the experience in the hospital, normally bled easily. She had a vivid imagination, was artistic and said she drew like “Tim Burton.” She played piano, loved animals, had nightmares as a child and sometimes reported seeing angels or spirits.

She presented as very sympathetic and personable. In fact, as soon as she came in, she offered a hug and said, “You look good. Nice outfit.”

Her mother reported a normal pregnancy with Lena although she was delivered via c-section due to mother’s lack of dilation. She was the youngest and a very quiet, easy-going baby. No major childhood illnesses reported.

She had excelled in academics and was quite diligent. When she had this psychotic break, she was just about to graduate with additional certification and get to work right out of high school.

Without more to go on, her first repertorization appeared thus:

Mind, delusions, pregnant

Mind, sympathetic

Generals, faintness, menses

Mind, delusions, specters

Mind, insanity

Mind, thoughts, rush of

Although I had initially felt a strong calling to Phosphorous because of her sympathetic nature, her clairvoyance, and cystic constitution, this first repertorization came up Ignatia. But the whole case seemed wanting. I already knew that Ignatia was a good hysteria remedy, but a psychotic break?

I called Dr. Karl Robinson when he came into town and I ran the case by him. He was intrigued by the depth and clarity of her delusion. Once he’d heard the case out, he asked me, “So, what happened at the party?”

To my utter chagrin I had to say, “I don’t know. I couldn’t get much detail out of anyone.”

In no uncertain terms, he gave me my work orders, “You need to know what happened at that party!!! That’s where the case is!” And he was absolutely right.

By the time I saw her next, her affect and thought processes were clearly still impacted (free associating, rambling speech, affect blunt), but she was slightly more coherent due to the allopathic medication and could begin to recall what happened before her hospital admission.

Apparently at the party, she had found out that her boyfriend was cheating on her. She remembered that she began “yelling and screaming” until she “couldn’t breathe.”

From that point she became and stayed hysterical. It was trauma. And insanity. The ailments were from disappointed love and mental shock.

With that, the case was revealed and the rubrics were expanded as follows:

Mind, delusions, pregnant

Mind, sympathetic

Mind, ailments from, disappointed love

Mind, ailments from, shock, mental

Mind, insanity, grief,

Mind, insanity, cheerful, gay

Mind, sentimental

Mind, conscientious about trifles

Mind, speech, wandering

Mind, thoughts, wandering

Mind, delusions, specters

Bladder, retention of urine

Generals, faintness, menses

Generals, lack of vital heat

Again it came up overwhelmingly Ignatia and we finally had the emotional point of origin: disappointed love, mental shock. This was yet another crucial lesson to me about trauma: that it was the Great Imitator. It could induce a multitude of symptoms with a range so wide it could look like, act like and feel like any number of other disorders.

She received Ignatia 10M.

On the first dose, she broke out into hives and went to the bathroom until her bowels were emptied of what appeared to be two weeks’ worth of stool. When she came back in to the office, it was as if she were a new person, mentally and emotionally calmer, a clear gaze and expressions that indicated a wider range of emotions. She was more capable of accessing information from memory and expressing it in an understandable manner. Her medications were being reduced but her well-being continued.

She began to have the insight appropriate for a young woman of her intelligence and sensitivity. When she discussed her bowel movements, she said, “It was like having a miscarriage.” When asked how it made her feel, she said, “Sad.” When asked why, she explained that she would have liked to have had a baby and wondered if maybe it was a way of keeping her boyfriend close to her.

She has begun to have other similar insights into her family life, her disappointments, and the way she has been the emotional cornerstone for her family.

It has been approximately 3 months as of this writing. She has broken up with her boyfriend, gone back to school, and continues to pursue her career. While she surely has a way to go emotionally, no clear, new symptoms have developed and she remains calm with no delusions.

Case #2: A Secret Teenage Abortion

Stacy, 35, came in complaining primarily of her relationship with her mother, which was “awkward, tense, uncomfortable.” She was unable to identify why in the initial interview except to say that she felt every conversation with her mother ended in annoyance or anger. “She’s always analyzing me.”

She had no outstanding medical history, denied any sexual or physical abuse, and claimed to have had a happy childhood. She was raised in a split household religiously. Mother was an agnostic/humanistic psychologist but her father was a Catholic who regularly went to church. She often found herself trying to be a peace-maker. “I was the kid who wanted to make other people happy.”

Although the initial complaint was her relationship with her mother and she denied any overt traumatic event, it turned out that she was experiencing a wide range of stress symptoms since she had started a new job working with abandoned children. As she spoke about work, she began to cry. “No one wants them.”

She disclosed that she was often sleepless, intensely sensitive, and frightened for no apparent reason. She had become irritable with her boyfriend and was concerned her mood changes were going to chase him away.

No other symptoms were admitted until the third or fourth session when she disclosed that she’d had an abortion at 16 years old.

“I didn’t want it. I just didn’t know what else to do. My mother wouldn’t help me. So I went alone. I haven’t been whole since them,” she said, sobbing openly. It was more than grief. It was a stricken conscience. She wept as she wished she had been smart enough or informed enough to put the baby up for adoption. “I was just so scared. But I hurt someone for my own gain.”

“And,” I asked her, “your job? The children there?”

“They’re just left. No one wants them. I worry that my baby felt that way about me. That I didn’t want her.”

Now, we started to see the case open up. She complained of occasional vertigo at work, chilliness aggravation with menses, menses irregularities, difficulty getting out of bed in the morning.

I took the following rubrics:

Mind, ailments suppressed/silent grief

Mind, terrors of conscience

Mind, self-reproach

Mind, desire for solitude

Generals, Vertigo

Sleep, prolonged morning

The prescription was Cyclamen 30c, once a day for three days.

She felt immediately relieved as the dam was raised and her memories about the abortion and her feelings of abandonment were released. Interestingly, she got her period at precisely 28 days and did not have any of the pain or clotting she normally associated with it. She got a return of migraine symptoms she hadn’t experienced since the abortion, which promptly disappeared.

After approximately 2 months of psychotherapy in which we focused primarily on processing her loss and anger over the way her pregnancy was handled, what began to emerge was a slightly different picture, one that resonated to me as a deeper level of the same constitution:

She described her shame at not being perfect, her feeling the need to control things because of an exaggerated sense of duty and a profound sensitivity to the horror of the world. She preferred to suffer silently and was generally averse to consolation, although she was highly predisposed to offer consolation to others.

We re-took the case: Despite the initial intake in which all the following was denied, she described a history of allergies since infancy, moles and a personal history of precancerous lesions on her face, a childhood history of eczema and nail biting, a personal history of pneumonia, a fear of failure, and numerous serious, early childhood diseases, including scarlet fever. This is one of the many important reasons to continue pursuing the case even though you think you’ve already taken it! Even a client as open and honest and diligent as Stacy may not think of things at the outset of treatment that in homeopathy are considered important. Especially in the treatment of trauma, where there are layers of fear, forgetfulness, and detachment, we will need to ask questions more than once over time.

And it’s a good thing I did, because another trauma remedy appeared: Carcinosin, which we gave in LM potency because of her history of pre-cancerous lesions. We started with LM1, 10 succussions, bid, and within the week she got symptoms of an ordinary cold-runny nose, stuffy sinuses, sleepy-while at the same time she described a sense of “being more centered.”

Over the next two months we moved her from LM1 to LM5, at which point, she reached a calm and happy plateau. With each new level she got a quick series of aggravations and a concomitant her sense of herself improving energetically. She handled her work with just as much compassion but with a healthier admixture of detachment so she could function smoothly. It has been two years since treatment and she regularly stays in touch to let me know how well she is and how different her experience of life has become.

Case #3: Stuck in a Nightmare

A woman in her mid-20′s sat in my waiting room, hunched over. She sat as if cowering, avoiding direct eye contact. She breathed in puffs, barely able to talk. She seemed genuinely horrified, as if she’d just seen a ghost.

When she finally started talking, bits and pieces of a story emerged in which she was used from very early childhood as a sex slave in a rural region of northern Nevada. The word she used over and over was “nightmare.” And, to my eyes, she was still there, a child, lost, bewildered, horrified, barely able to breathe from terror. She spoke hurriedly of waking up in the middle of the night, seeing a man in the room, sleep-walking, banging her head on a wall so hard and shrieking so loud that on several occasions the police had to come.

She then reported she’d been raped by a friend in her own home approximately six months prior to our first session and was terrified that someone was in her home and she was going to be attacked.

Without being able to take a clear history at that point, I just had to watch her. I came up with the following:

Mind, Ailments, fright

Mind, Ailments, violence

Mind, Ailments, sexual abuse

Respiration, puffing, expiration

Breathing, stertorous

Fear, attack

I gave her Stramonium 10M. Within one week, she came back and was able to sit and talk. Her nightmares diminished considerably. Within one month they were nearly gone. She was able to have a normal conversation. Her eye contact had improved. Her fear was being transformed. Instead of terror, she was beginning to access the anger and abject pain of being so unloved as a child.

Over the next couple of months, her nature began to emerge: She had been a good-natured child, clinging, wanting love more than anything else. She couldn’t understand how people could hurt her. She had chosen men poorly, tried to manipulate them to be nicer to her, but clung to them the way she clung to the adults in her early life no matter how they treated her. She wept openly, was sympathetic, and responded to consolation. She was warm-blooded, slept with her feet out of the covers on her back, craved dairy and ice cream.

The last remedy she got was Pulsatilla 1M. She has been steadily improving, finding an increased peace, exploring the possibility of dating again, and scraping off the last vestiges of her past.

These are just a few examples of what can be done with homeopathy in trauma. I have been working with cases of anxiety and trauma of varying degrees for more than twenty five years and I sincerely wish I’d had homeopathy in my tool chest from the beginning. The most important thing I’ve learned in using homeopathy with my patients is that even though there are so-called “trauma” remedies, any remedy can be used because it is not the trauma we’re treating. It’s the person. Always the person.

Short List of Recommended Books on Trauma Treatment:

  1. Rothschild, Babette, The Body Remembers (W.W. Norton & Company, NY, 2000)
  2. Erickson, Milton, H., Rossi, Ernest L, and Rossi, Sheila I., Hypnotic Realities, Irvington Publishers, N.Y., 1976
  3. Dolan, Yvonne, M., Resolving Sexual Abuse, (W.W. Norton & Company, N.Y., 1991)
  4. Wolinsky, Stephen, Ph.D., Trances People Live, (The Bramble Company, CT., 1991)
  5. For more information on classical homeopathy, please refer to The National Center for Homeopathy.

Complex Trauma Or DESNOS Increasing in Inpatient Eating Disordered Populations

In inpatient settings I have been seeing much more serious trauma in clients who are currently admitting for treatment. In fact we’re seeing so much trauma that we think that all clinicians should be trained in EMDR, one of the most effective trauma interventions used at this time. Experienced clinicians are needed when it comes to working with PTSD and childhood trauma and they should have the best tools available. Because so many people with trauma are admitting with severe trauma, I have been doing vast amounts of research on new information available in regards to trauma and its treatment.

I have found that the subject of complex trauma or DESNOS, a diagnosis of extreme stress not otherwise specified is in fact much more common than a diagnosis of straight PTSD.

PTSD was originally developed as a diagnosis in the 1970s to explain the symptomology of Vietnam veterans returning home after the war. Research has shown that men are traumatized most frequently by accidents, war, assaults, and natural disasters, single event occurrences.

Women are most frequently traumatized by childhood sexual abuse. B.A. van der Kolk (2005) reported that between 17 and 33% of women in the general population had histories of sexual-physical abuse while women who were in psychiatric treatment reported 35 to 50%.

PTSD has captured only a partial snapshot of posttraumatic psychopathology. The PTSD diagnosis does not capture the facets of long-term, repeated trauma. People with a history of physical and sexual abuse over long periods of time report many psychological problems such as substance abuse, borderline and antisocial personality disorders, eating disorders, impulsivity, self-mutilation and suicidality. They will be chronically depressed with dissociative episodes of varying lengths of time. Extreme aggression and impulse control difficulties are also present.

PTSD clinically has referred to these other problems as co-morbid conditions, as if they have occurred apart from the PTSD symptoms. As a result the authors of the DSM-IV began to separate these other symptoms under a category of extreme stress not otherwise specified (DESNOS). They found that the earlier the trauma the more severe the symptoms of DESNOS. Studies also have shown that it is possible to experience DESNOS without having PTSD, certainly above and beyond PTSD.

DESNOS represents a psychological injury from long-term social and/or interpersonal trauma that is characterized by lack or loss of control, disempowerment, and the victim is unable to escape.

In many situations such as caring for a mentally ill person at home, a care- giver may develop symptoms themselves of traumatic stress from prolonged exposure to traumatic stress.

When a patient admits to treatment, pre-treatment testing is needed, such as the Beck Depression Inventory, the Eating Disorder Inventory III, the SCL-90 including testing for trauma and dissociation. If the client has a history of trauma, clinicians should immediately focus on stabilization techniques.

The therapist must have the attitude that nothing is more important than safety and stability. The therapist must assume the role of teacher or guide for the client. Trauma survivors cannot teach themselves how to be safe and stable because

they have no baseline, no meaningful experience of what the words “safe ” or “stable” mean. This is where a strong, centered, grounded therapist is necessary to be the teacher. They help the client learn to ground herself and to find a safe place where she can go and be protected under any circumstances.

The therapist teaches the client that no recovery from trauma is possible without paying attention to issues of safety, learning to care for herself, making connections to other human beings, and a finding a renewed faith in the universe. The therapist’s job is not just to be a witness to this process but to teach the patient how.

Interviewing a New Trauma Therapist – Questions For Dissociative Survivors to Keep in Mind

Are you looking for a new trauma therapist? Do you need to find a therapist that specializes in trauma disorders?

When you are interviewing new therapists, in addition to clarifying that they have the skills and training it takes to provide proper treatment for your trauma issues, it is also important to ask about their approach to trauma work. Make sure their views match or blend with your own views, otherwise there will be conflicts ahead. There are a number of different approaches to trauma work — just as there are tons of different recipes for how to make a loaf of bread. It isn’t that one way is “THE” right way. You and/or the therapist may have very strong opinions for what works best, but the point that matters is if you agree with how your therapist approaches the issues with you.

For example, if a survivor with DID / MPD said to me, “Help me get rid of all these pesky little parts that are irritating me. I want them totally gone and removed from my head.” Oh, well, you see… there are some therapists that would gladly approach therapy work with that goal in mind. I, on the other hand, would have a cow. A really big cow. If someone wanted me to help rid them of their insiders, I couldn’t do it. I wouldn’t do it. I don’t agree with that approach, and just couldn’t be convinced to go there. In that case, this person and I would be a therapeutic mismatch. We would not be aiming for the same goal, so it would not be a good idea for us to work together.

Before you share very much of your personal system information, please take the time to interview the therapist very closely. You must be VERY sure of the safety of the therapist before you disclose about yourself on those deep levels. There are lots of great therapists out there. There are also lots of clowns claiming they are trauma specialists. They may not be dangerous people, but they can do a lot of harm by not actually knowing how to treat trauma-related issues. Please be aware, there are also “double agents” out there — people who claim to be a helping person, but are actually working to support the dark side. Interview all therapists very very closely to make sure you find someone who is both safe and qualified.

When interviewing new therapists, some of the important areas to consider are:

Direct Experience:

  • How many years of experience do you have in working with trauma disorders?
  • How many dissociative survivors have you met?
  • How many survivors with dissociative identity disorder have you treated (as the primary clinician)?
  • What percentage of your practice has been filled by clients with trauma-related issues?
  • Do you have a web-site, any books, articles, or outside referral sources that can confirm your experience?

Education:

  • Where did you first learn about trauma and dissociation?
  • Who have you studied with, and/or who mentored or supervised your early years of trauma work?
  • What conferences and training programs have you attended?
  • What have you done to build and develop your expertise in the trauma field?
  • Where do you go for help if you have a clinical question?
  • Do you have a valid mental health license, and can you verify that your license is in good standing?

Approach:

  • In your opinion, what are the most important aspects of trauma work?
  • In your opinion, what do people need to do to process their trauma?
  • In your opinion, how long does it take to work through trauma-related issues?
  • What do you do if someone is stuck on a particular trauma-related issue?
  • How do you manage issues related to self-injury?
  • What are your office policies for emergency situations?
  • What are your policies and guidelines for regular therapy sessions?
  • If I need additional support between therapy sessions, what do you recommend?
  • What do you think of “so and so’s” approach to therapy? (insert the names of your favorite trauma therapists or authors)
  • What are your thoughts about ritualized abuse, cult abuse, and organized abuse?

Dissociative Specialty Questions:

  • How do you define Dissociative Identity Disorder?
  • In your words, what is involved in the treatment process for Dissociative Disorders?
  • When do you approach trauma / memory work?
  • In your opinion, when is a client not ready to do memory work?
  • What are your beliefs / perspectives about who the alters are?
  • Do you speak directly to insiders? Why, or why not?
  • Do you prefer all communication to go directly through the host / adult / front part? Why, or why not?
  • What kinds of homework will you expect my system to do outside of the therapy sessions?
  • What are your beliefs and approaches to integration?
  • How do you define “success” in terms of treatment goals for DID / MPD?
  • Have you ever worked with mind control issues? If so, what do you do?

Of course, as you go through the interview process, be sure to ask clarifying questions about the answers you are being given. Any therapist that understands trauma disorders is going to understand why you need to check them out thoroughly. Needing time to build trust is obvious, and having the same theoretical foundation is critical.

These are not personal questions. Keep your questions focused on the type of work that will happen in the therapeutic environment, and not on the therapist as a person.

Before you get emotionally attached to a therapist, please make sure that their approach fits with how you want to proceed with your own therapy.

Your healing journey belongs to you. You get to decide how it will look, and what paths you will take. Working with a therapist that fits with what you want is critically important. Otherwise, you will waste a lot of precious healing time struggling with opposite or conflicting goals. The journey will go much smoother if you and your trusted therapist approach your healing process from the same wavelength.