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Post-Polio Health (ISSN 1066-5331)

Vol. 18, No. 3, Summer 2002

A Guide for Exploring Polio Memories (pg 3)

Treatment for Trauma

Most individuals who want to resolve the impact of their polio memories enter therapy on an outpatient basis. However, individuals who have experienced ongoing, intense traumas (e.g., abuse) may require clinical programs that offer the needed level of assistance and expertise to reduce their distressful symptoms and safely support them through the process of working through memories.

When a survivor's symptoms interfere with their ability to function and/or to process memories on an outpatient basis, and, if a client's physical reactions to the distress of the process present a risk to the individual (e.g., some physical health conditions may require monitoring of cardiac and respiratory function), then an intensive outpatient or inpatient program is medically necessary to prevent the development of further symptoms.

Structured Trauma Programs are usually affiliated with major medical centers or universities or are a service offered by select behavioral health treatment centers. They are available in some countries, but not all. Effective, ethical programs can help stabilize disruptive symptoms such as compulsive eating, excessive sleeping, flooding of feelings, and prepare a client for continuing therapy with an outpatient therapist.

For those who choose to address their polio memories, trauma specialists agree that treatment needs to be approached in phases. The International Society of Stress Studies recommends that treatment focus on:

Harvard University Professor Bessel van der Kolk and other trauma specialists state that processing trauma information involves identifying, exploring and modifying the effects of memories. In addition, they emphasize the need to teach survivors how to create and use plans that can prevent them from slipping back into unhealthy coping behaviors such as self-neglect, gambling and other addictions, and neglect of responsibilities (Glaser, 2000).

During this process, individuals need to learn how to listen to their bodies' messages ("gut feelings") and to respect their intuition. The success of their recovery involves learning how to nurture and fulfill their present-day physical, emotional, relational and intellectual needs to counter the effects of traumatic situations from their pasts. This requires a compassionate approach, being responsible for their behaviors and treatment, and developing internal and external support.

How Our Minds Adapt: Understanding the Effects of Experiencing Trauma

Many people claim that "the past is past." While that is true, researchers have found physical evidence in brain scans indicating that trauma physically affects the brain and neurobiology of a trauma survivor (Bremner, 2002).

Research continues to reveal that traumatic experiences affect the body, the mind and a person's neurology, and that these are interconnected. For example, trauma affects the mind when it results in a person developing limiting beliefs about self or the world. One illustration is a child, who was emotionally injured by a caretaker, thinking that she is bad and the world is not safe; another is a young adult, who contracted polio in a country where the disease is considered an evil curse, believing that he is unworthy to succeed in marriage or a career.

Trauma can leave long-lasting effects including low self-esteem or depression, blocked energy in the form of fatigue or decreased motivation, and physical symptoms ranging from digestive trouble to pain similar to that experienced during the original traumatic incident (Bieniek & Kennedy, 2002).

In recent years, psychiatry has rediscovered that dissociation plays a critical role in the development of trauma-related symptoms and conditions. "Dissociation" occurs when a person is overwhelmed by an experience and puts the experience out of his/her conscious mind because it is too difficult to integrate. In other words, the reality of what happened is too much for the person to deal with at that time. This happens not only at the time of the traumatic event, but also can continue as a long-term consequence of the trauma (van der Kolk, 1996).

Clinically, dissociation occurs in a variety of ways on a continuum of related psychological conditions. For example, in veterans who have post-traumatic memories of military scenes, symptoms may include intrusive recollections, nightmares and flashbacks that can limit their concentration and functioning (van der Kolk, 1996).

For example, some individuals who lost a parent as a child may numb their feelings of grief by reading excessively or overusing alcohol. They may distract themselves from their feelings by taking care of others or talking compulsively. Extreme forms of dissociation can develop from chronic or intense neglect, or from physical, sexual or psychological abuse that often occurred at an early age (van der Kolk, 1996).

The good news is that even if a person has had such a painful life history, treatment can effectively resolve or reduce the impact of these experiences. Trauma programs are especially useful for survivors of severe and ongoing trauma. One client who had problems functioning because of frequent shifts in his mood, energy, and ability to concentrate reports, "I was relieved to find professionals who understood the reasons for my intense distress. They helped me learn what I needed to get my life back."

Although trauma issues are difficult to face, there is hope. Skilled professionals who understand can help trauma survivors free themselves from the long-lasting effects of the painful experiences in their pasts.

The Fall 2002 issue of Polio Network News will explore the process of locating and selecting a therapist and additional treatment approach options.

The authors are grateful to individuals who have contributed to this article, especially to Marcia Kaplan, MA, for her editing assistance.


This article is third in a series in Polio Network News that explores emotional issues that can co-exist with physical problems in the survivors of polio. The articles are:

Emotional Bridges to Wellness
Linda L. Bieniek, CEAP
(Polio Network News, Vol. 17, No. 4, Fall 2001)

Improving Quality of Life: Healing Polio Memories
Linda L. Bieniek, CEAP, and Karen Kennedy, MSW, RSW
(Polio Network News, Vol. 18, No. 1, Winter 2002)

A Guide for Exploring Polio Memories
Linda L. Bieniek, CEAP, and Karen Kennedy, MSW, RSW
(Polio Network News, Vol. 18, No. 3, Summer 2002)

Pursuing Therapeutic Resources to Improve Your Health
Linda L. Bieniek, CEAP, and Karen Kennedy, MSW, RSW
(Polio Network News, Vol. 18, No. 4, Fall 2002)

Treatment Approach Options chart

References

Bieniek, L., & Kennedy, K. (2002). Improving quality of life: Healing polio memories. Polio Network News, 18(1), 1-7.

Bremner, J.D. (2002). Does stress damage the brain? Understanding trauma-related disorders from a mind-body perspective. New York, NY: W.W. Norton and Co.

Dayton, T. (1997). Heartwounds: The impact of unresolved trauma and grief on relationships. Deerfield Beach, FL: Health Communications, Inc.

Finney, L. (1995). Reach for joy: How to find the right therapist and therapy for you. Freedom, CA: The Crossing Press.

Gilligan, S. (1997). The courage to love. New York, NY: W.W. Norton and Co.

Glaser, D. (2001). Men and trauma: Myths, dynamics and treatment. Masters and Johnson Program, seminar presented in Chicago, IL.

Halstead, L. (1995). The lessons and legacies of polio. In Halstead, S. & Grimby, G. (Eds.), Post-Polio Syndrome. Philadelphia, PA: Hanley and Belfus, Inc.

International Society for the Study of Dissociation (ISSD). (2000). Guidelines for treating dissociative identity disorder in adults. Journal of Trauma and Dissociation, 1(1). Binghamton, NY: Haworth Press, Inc.

Napier, N. (1993). Getting through the day: Strategies for adults hurt as children. New York, NY: W.W. Norton and Co.

Nudelman, D., & Pearlman, L. (1994). Healing the blues: Drug-free psycho-therapy for depression. Pacific Grove, CA: The Boxwood Press.

Schiraldi, G. (2000). The post-traumatic stress disorder sourcebook: A guide to healing, recovery and growth. Los Angeles, CA: Lowell House.

Treigle, D. (2001). Dialectical behavior therapy for trauma recovery. Masters and Johnson Program seminar presented in Chicago, IL.

van der Kolk, B., et al. (1996). Dissociation and information processing in post-traumatic stress disorder. In B. van der Kolk, et al (Eds.), Traumatic stress: The effects of overwhelming experience on mind, body, and society. New York, NY: Guilford Press.

van der Kolk, B., et al. (1996). A general approach to treatment of post-traumatic stress disorder. In B. van der Kolk, et al (Eds.), Traumatic stress: The effects of overwhelming experience on mind, body, and society. New York, NY: Guilford Press.