While it is of course vital to challenge negative and illogical thought patterns and seek to find more healthy and affirming ways of thinking, we should not ignore the simple healing power of the body. Exercise, rest, deep breathing, stillness, meditation and deep relaxation are the body’s tools of soothing mind and spirit. But we are less attuned to it often than we are to our thoughts and “figuring out how to solve” our problems exclusively with our brainpower.

As a culture we are still caught in the mental/physical divide, prone to thinking of psychiatric illness as either “all in your head” or, conversely, as “chemical imbalances” or “organic brain diseases.” None of these is a helpful or accurate description of any psychiatric condition. We cannot isolate the brain from life experience and the environment. They are inextricably entwined. What happens to us becomes part of us, body and mind.

The New York Times Monday February, 20th 2012

February 18, 2012, 3:00 PM

Reliving the Crash

By SIRI HUSTVEDT

 

Anxiety: We worry. A gallery of contributors count the ways.

TAGS:

ANXIETY, MENTAL ILLNESS,NEUROSCIENCE, POST-TRAUMATIC STRESS DISORDER

In August of 2002 I survived a car accident. Although I can still see the van speeding toward us, I cannot bring to mind the crash itself, only its aftermath. I see the ruined windshield in front of me, the Brooklyn street, the sky and clouds. Everything is black, gray and white — no color. My husband is speaking to me from the driver’s seat, but I cannot answer him. All I know is that I do not want to move. I feel at once serene and distant. I have this thought: If I’m going to die, this is not such a bad way to go. Some time later, a man’s voice tells me that the Jaws of Life will make a lot of noise, and I think to myself, I don’t care.

What happens to us becomes part of us, body and mind.

As I lie on a gurney in the emergency room and a woman cuts off my clothes with large scissors, I feel grateful that I’m wearing jeans and a cotton sweater and not something expensive. After two CT scans, it is clear that my neck is not broken. I am bruised and battered. That is all.

For four nights after the accident, I relive what I cannot remember by day — the moment of impact, the blasting jolt to my body, the roar of collapsing metal and splitting glass in my ears — and I wake with a scream in my throat, my heart racing, my limbs stiff with terror. It feels as if the collision were happening again.

Noah Frase

Although it was terrible, I am oddly grateful for the experience because it offered me an insight into the strange realities of emotional trauma. Although I recall those nighttime flashbacks, I still am unable to remember the smash-up itself. My inability to recall the collision, my frozen indifference to what had happened to me, and my nightmares are classic symptoms of trauma. My suffering was too short-lived to have qualified me for a diagnosis of post-traumatic stress disorder. I fit the criteria, however, for acute stress disorder, which must last at least two days but no longer than a month. According to the Diagnostic and Statistical Manual of Mental Disorders, or DSM, acute stress disorder, like PTSD, begins with an “extreme traumatic stressor,” followed by intrusive memories or nightmares of that event. Further, the person must show dissociative symptoms — numbing, detachment, depersonalization or emotional unresponsiveness. The DSM defines dissociation as “a disturbance or alteration in the normally integrative functions of identity, memory, or consciousness” — all of which are understood as “psychological phenomena.” But what is psychological? And how is it different from physiological? Even the DSM acknowledges that the distinction between mental and physical is “a reductionistic anachronism of mind/body dualism.”

After the accident, I was clearly in a dissociated state — weirdly detached from myself — and although I left the hospital without an injury that could be seen on a CT scan, both my memory and my sense of self had been altered by the shock.

My amnesia for the accident and the flashbacks that followed, belong to my psychological state, but they are also, of course, part of my physiological state that involved changes in my brain. This is obvious, and yet this truth has led to a lot of confusion, not only about PTSD, but all mental illnesses.

Both depression and anxiety disorders, for example, are repeatedly described in the media as “chemical imbalances in the brain,” as if spontaneous neural events with no relation to anything outside a person’s brain cause depression and anxiety. No doubt, people find the idea of “a chemical imbalance” comforting: It’s not all in my head, there’s something really wrong with me physically — a brain problem. Just balance out those neurochemicals, and I’ll be fine.

Over a hundred years ago, the French philosopher and physician Pierre Janet (1859-1947) argued that the emotional shock, which accompanies a terrifying event can result in dissociation. The memory of the experience vanishes from ordinary waking consciousness and then appears in nightmares, waking reenactments, or takes the form of various bodily symptoms. For Janet this was a psycho-biological phenomenon that involved both “ideas” and physical “functions.” Janet’s theory prefigures contemporary thinking. Emotionally charged, unbearable memories of violent, terrifying experiences appear to be processed differently from ordinary autobiographical memories, the ones we can voluntarily summon in words and locate in the past: “I remember my lunch with Fred last week” or “I used to love visiting my grandmother on Sundays.” Janet maintained that what was missing in reenactments was a sense of both will and ownership, the “I feel” or “I remember.” Flashbacks are involuntary, inflexible and appear to be far less subject to change than the memories we can actively bring to consciousness. Flashbacks rarely involve language. Mine certainly didn’t. They were visual, motor, and sensory, and they took place in a relentless, horrifying present. The terror that escaped my dissociated post-accident self returned with a vengeance as a nightmare, and although I recall those nighttime flashbacks, I still am unable to remember the smash-up itself.

Neurobiological research has shown that in people with chronic PTSD both stress hormone secretion and areas of the brain connected to memory function, such as the hippocampus, appear to be affected, although exactly how and why remains controversial.  And it does not necessarily follow that PTSD is caused by an “imbalance” in a stress hormone like cortisol or an altered  hippocampus. Cause is a tricky concept, one the DSM has chosen to avoid altogether in favor of purely descriptive diagnostic criteria. An adequate description of PTSD or depression or any mental disorder must include the patient’s subjective experience.

Scientists continually warn that “correlation is not cause.” The relation between a person’s inner psychological reality and its “neural correlates” remains an enormous philosophical and scientific problem.  In the name of the easy reductive answer, however, the popular media in all their forms mostly ignore the issue.

It is not known why some people develop traumatic symptoms and others don’t. My husband, daughter, and the family dog were all in the car with me, and I was the only one who came down with acute stress disorder. Then again, I took the brunt of the shock. The van hit the side of the vehicle where I was sitting. Apparently, children of people who suffered from  PTSD have a greater chance of developing the illness, but why they do remains mysterious. There is no PTSD without emotional trauma, but some of us may be temperamentally more disposed to become ill with it than others.

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More From Anxiety

Read previous contributions to this series.

My late father, who fought in New Guinea and the Philippines during the Second World War, had repeated flashbacks at night after he returned to civilian life, and once while he was awake —  the intrusive memory seemed to have been triggered  by a hymn he was listening to in chapel. As the horrible images unfolded before him, he began to shake uncontrollably, and he found himself back in the Philippines witnessing what he believed was the unwarranted killing of a Japanese officer.

As an infant I had febrile convulsions. In 1981 I had a brief seizure that threw me against a wall, followed by a yearlong migraine. In 2006 I developed a mysterious seizure disorder that manifests itself in violent shaking, which I now control with medicine. The shaking symptoms first appeared when I gave a speech in memory of my father, but I also once had a seizure while climbing a mountain, which was probably caused by hyperventilation.

It is tempting to link my shaking and my flashbacks to my father’s. The question is how? If there is a genetic susceptibility to PTSD, it remains unknown, but both strong emotion —  a psychological state —  and a lack of oxygen —  a physiological  one —  are known to cause seizures.

PTSD is a relatively new term, but emotional trauma has been cataloged in various ways and gone by many names over time — soldier’s heart, railway spine, shell shock, battle fatigue, hysterical neurosis and the one I think is most apt, physioneurosis. The last term was coined by Abram Kardiner in 1941 to describe the enduring psycho-biological damage sustained by his patients on the battlefield.

The brain is a dynamic, plastic organ. It develops and changes through our experiences in the world. Our subjective feelings of joy, sadness, irritation and shock may all be understood as fluctuating brain states, but they are responsive states that occur in relation to what happens to us. This is brutally clear when it comes to PTSD.

When I wobbled out of the hospital in my huge paper scrubs, after losing my clothes to that pair of scissors in the emergency room, I was told to return if I developed headache, nausea or dizziness (signs of a head injury missed by the scan), but no one mentioned that I might be subject to nightmarish repetitions of the accident.

As a culture we are still caught in the mental/physical divide, prone to thinking of psychiatric illness as either “all in your head” or, conversely, as “chemical imbalances” or “organic brain diseases.” None of these is a helpful or accurate description of any psychiatric condition. We cannot isolate the brain from life experience and the environment. They are inextricably entwined. What happens to us becomes part of us, body and mind.

Luckily, my flashbacks disappeared, but I am still often anxious when I ride in a car. My muscles become tense. I feel a constriction in my lungs, and I avoid looking ahead into the traffic. A bump in the road, a sudden stop, a loud noise — all of these make me gasp in fear. I am not entirely free of the “physioneurosis” that began with a car accident almost 10 years ago.

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Siri Hustvedt is the author of a book of poetry, five novels, two collections of essays and a work of non-fiction, “The Shaking Woman or A History of My Nerves.” Another collection of essays, “Living, Thinking, Looking,” will be published in June.

Most of us are aware of the physical benefits of exercise. Lower blood pressure,  controlled weight, increased endurance etc. But less well known are the emotional benefits.

Decreased anxiety, improved sleep, greater self-confidence  and a renewed appreciation for the natural world are also attainable. Some studies show that  a regular regiment of exercise is as effective or more than anti-depressant medications in counteracting depression and anxiety. Our concept of time can change as well as a 30 minute cycle to work can feel quicker than 20 minutes in the car crawling in traffic.

The gradual improvement in achievement, in endurance, speed, stamina and strength can be satisfying and confidence building. The social opportunities to connect with other like minded people is an additional benefit. One of the greatest pleasures of a hard exercise session is the deep appreciation felt for rest and renewal afterwards. We seek to appreciate the little pleasures of life and to be present in the moment to moment of our lives. Sitting in a comfortable chair, drinking a cup of coffee and reading a magazine or listening to music after an intense physical effort can be profoundly pleasurable and deeply appreciated.

When my baby was recently diagnosed with an infantile hemangioma (vascular birthmark), I found myself doing exactly what I tell my clients not to do when they have anxiety about a health issue.  I started “googling” uncontrollably.  I spent weeks looking at horrific google images of hemangiomas and reading about brain disorders that rarely are associated with hemangiomas.  After weeks of incessantly and obsessively googling, I was convinced that I knew more than
my pediatrician.  Rationally, I knew that googling was magnifying my anxiety, yet, I could not stop myself.

What I discovered online both hurt me and helped me.  I convinced myself that his birthmark would permanently disfigure his face and that his cerebellum was damaged.  This realization led to total panic, loss of appetite, and sleepless nights.   Fortunately, my “google diagnosis” turned out to be wrong and I had
unnecessarily and prematurely spent weeks worrying endlessly.

My “google diagnosis” and elevated anxiety did eventually lead me to seek expert advice from hemangioma specialists and away from the virtual world of terror.  Seeking such consultation was not an option my pediatrician presented for my son, and, it turned out such consultation was necessary to determine an appropriate course of treatment.

If your guts tells you that your primary care physician may not have all the answers, please trust your instinct and do your own research.  However, if you decide to research your concerns online, do so knowing that what you find can easily be misinterpreted and seek a second opinion from a specialist.

If you have a lot of health anxiety, I recommend staying off google entirely if you can control your impulses.  If not, here are some tips on how to googlemedical concerns responsibly:

• Information published on the internet is not regulated. Please check the source and the date of the information you find.
• Remember that blogs are often based on anecdote rather than the scientific method.
• Ask medical professionals to recommend credible web sites.
• Use the internet to educate yourself and gather more information but do not to self-diagnose.

“I Know What’s Gonna Happen Next”

Schema Therapy

The Powerful Influence of Our Mental Maps

1. WHAT IS SCHEMA THERAPY?

This article is largely based on the practice theories developed by Jeffrey E. Young, PhD in his book “Schema Therapy”. Our internal schematic is a pattern or an organizing framework which we personalize for ourselves over a lifetime. It is the lense through which we see ourselves and the world and thereby make sense of things “out there” as well as “in here”

Schemas are used as a “short cut” in which we make assumptions about a particular circumstance based on only limited information. Of course, this is a vital skill in negotiating the world and we do it many times a day, making determinations based on someone’s tone of voice or choice of words. But when we have developed a negative or destructive schema, there are many innocuous events or “triggers” which precipitate a set of assumptions about negative or harmful things which are about to happen or worse which cause a cascade of internal negative and self-defeating dialouge.

Schema Therapy is heavily influenced by Cognitive Behavioral theories (CBT) and can be effective over time with deeply entrenched and maladaptive or destructive thought patterns. Unlike traditional CBT which focuses primarily on breaking the cycle of maladaptive thoughts and actions, the Schema model also is focused on the initial etiology of the development which typically is most profoundly evident in childhood. In this way, Schema Therapy (ST) also shares roots with traditional psychoanalytic theory.

2. HOW DOES SCHEMA THERAPY WORK?

Because it is often used to treat longstanding conditions of problematic thought and behavioral patterns, ST typically takes a while to be effective. Two to three years of treatment is most often necessary to see significant change and improvement and rarely is the therapy less than one year. This is intuitive. It took a long time to build up the entrenched mental schematic and it will take time (though far less time) to change them to a more healthy one.

There are two primary approaches which the effective ST therapist will take with the patient. First is Empathic Confrontation. In this, the therapist acknowledges the reasonableness of the existing schema. He recognizes, appreciates and accepts the legitimacy of the development and enduring quality of the patients perspective. However, at the same time, this is gently but consistently challenged and questioned. The goal is to demonstrate that alternatives exist. That the way in which the patient sees themselves and the world is in fact not an objective truth, but a choice. And it is a choice that was reasonable at the time it was selected, but is no longer useful. In fact, it is destructive and must be changed. The fact that it “feels true” is only because it has gone unchallenged for so long.

The second approach is termed “corrective emotional experience through limited re-parenting experience”. In short, this describes an experience the patient has in which the therapist is parentified in a healthy and limited way, thereby allowing the patient to have an approximation of a different parent/child relationship than the one they in fact experienced. This creates an opportunity for the patient to directly and indirectly seek and to an extent have some of the caregiving needs that they failed to attain in childhood. While the above scenario may sound complex or contrived, it should be experienced as neither, but rather as a natural by product of a healthy therapeutic rapport between therapist and patient.

3. UNIVERSAL CORE EMOTIONAL NEEDS

ST presumes that we all have these core emotional needs. They include a need for safety, stability, nurturance, acceptance, autonomy, competence, self-identity, the ability to express oneself, play, and a world with realistic limits which encourages self-control. It is the goal of Schema Therapy to provide the patient with these experiences in an adequate and creative way so as to compensate for deficits in childhood and adulthood. For the therapist to be effective in this form of treatment, he must not only be well versed in the process and skilled, he must also have a genuine care for the patient, he must be flexible, creative and he must be comfortable being openly warm and caring to the patient.

For further information and training please visit the International Society of Schema Therapy
www.isst-online.com

Jamie, age 45, is by all measures a talented and hard-working person. He has earned multiple graduate degrees and amassed much professional expertise. Yet Jamie finds himself unemployed, with no immediate job-prospects. He is surprised to find himself in this position in mid-life, and has been experiencing feelings of anxiety and depression. He says:

“I’ve been feeling frustrated, wondering what it is that I can do, hating that I feel like I have to watch money more closely than I ever have before and not knowing how I’m going to pay bills or support my family. I’m intelligent and I’ve done things that are supposed to lead to success. And yet, here I am, not certain of what the future is going to bring. If I’ve worked hard and don’t have very much to show for it, it’s hard to say that I’m going to get up and feel that I can do it all again. When you get rejection from your efforts—and when that happens enough—it’s hard to get past.”

The current recession has brought unemployment concerns to the forefront of many people’s lives. As of July 2011, the Bureau of Labor Statistics reports that the unemployment rate in the United States is 9.1%. While the rate in Massachusetts comes in slightly lower at 7.6%, it is clear that unemployment is a visible and painful problem for many people. This concern is felt not only by the unemployed, but also by those who are worried about losing the jobs they have or finding a full-time job for the first time.

The John J. Heldrich Center for Workforce Development at Rutgers University conducted a survey of 1,200 unemployed American workers. Results indicated that a strong majority of those still jobless experienced daily stress and feelings of depression and helplessness. Many of those surveyed also reported having difficulties with personal relationships and sleep problems. The findings underscore the very real mental health implications of ongoing unemployment.

Experts have suggested ways that to cope with unemployment anxiety. Ideas include:

*Acknowledgment of Adversity

Recognize being in a difficult situation. Unemployment is not likely to be a problem that is easily resolved, and has a lot to do with factors beyond individual control. It is important to demonstrate self-compassion during this period of personal adversity.

*Avoiding Isolation

It is also helpful to remember that there are many, many, other people facing the same situation right now. Networking with other individuals looking for work and seeking out support of friends and family can help individuals cope with unemployment concerns.

*Keeping Active

Seeking out opportunities to engage in activity, including exercise, intellectual stimulation, and service opportunities can aide in maintaining physical and mental health and can help take the focus off of being unemployed.

*Re-Framing the Problem

While periods of unemployment can be challenging and uncertain, they can also be used to reevaluate professional goals, engage in new training, and think creatively about new directions.

*Remaining Committed

Retaining a commitment to seek work opportunities and acting on that commitment by continuing to apply for posted jobs, attending job fairs, and seeking out support from local resources can help promote hopefulness during unemployment.

There are additionally many local resources which aim to help those who are looking for employment network with each other and to access helpful information. Some of these include:

Boston Area Networking Group (BANG)
http://finance.groups.yahoo.com/group/bostonbusinessprofessionals/

Boston Women’s Network
http://www.bostonwomensnetwork.org/

Financial Executives Networking Group
http://www.thefeng.org/

Massachusetts Career Centers
http://www.mass.gov/?pageID=elwdhomepage&L=1&L0=Home&sid=Elwd

New England Networking
http://finance.groups.yahoo.com/group/NewEnglandNetworking/

Operation A.B.L.E (Ability Based on Long Experience)http://www.operationable.net/job_listings.html?fi=Sales+and+Marketing

(More comprehensive list can be found at http://www.job-hunt.org)

While the above coping strategies are useful, receiving more extensive support through psychotherapy may be helpful in cases where anxiety over unemployment issues is constant, manifested in physical symptoms (e.g., sleeplessness, muscle tension), and/or interfering with relationships and daily functioning.

Navigating unemployment anxiety is not easy and there will continue to be many people like Jamie, who struggle to cope with an unexpected turn of events in their professional lives. While solutions will not happen overnight, there is support available. If you feel the need to talk to someone about unemployment anxiety and/or professional transitions, please contact us at info@bostoneveningtherapy.com or call 617-738-1480.

References:

Bureau of Labor Statistics
http://www.bls.gov/eag/eag.us.htm AND http://www.bls.gov/lau/home.htm

John J. Heldrich Center for Workforce Development , Rutgers, The State University of New Jersey (2009)

“The Anguish of Unemployment”

http://www.heldrich.rutgers.edu/sites/default/files/content/Heldrich_Work_Trends_Anguish_Unemployment.pdf

Leahy, R. L. (2009) Unemployment Anxiety, The Behavior Therapist, Vol 32(3), Mar, 2009. pp. 49, 51.

Leahy, R. L. (2009) Facing Unemployment: Ten Steps to Handling Your Unemployment Anxiety http://www.psychologytoday.com/blog/anxiety-files/200902/facing-unemployment-ten-steps-handling-your-unemployment-anxiety

Rampell, C. (May 19, 2011) Many With New College Degree Find the Job Market Humbling

http://www.nytimes.com/2011/05/19/business/economy/19grads.html

Other Sources:

http://www.job-hunt.org

http://moodletter.com/Unemployment.html

Author:  Sara Lafkas of Boston Evening Therapy Associates, Brookline, MA

Social Anxiety Disorder is the third most common psychiatric illness, and depending on the definition one uses- the incidence is believed to be anywhere from 5 to 13 percent of the population in the United States suffer from it in their lifetime.

Social Anxiety manifests in various ways some of which can be fairly innocuous. Everyone is nervous about social interactions from time to time, the difference with what would be understood as a Social Anxiety Disorder, is that it is experienced in a pervasive way which has a negative and sometimes harmful effect on an individual’s life. This type of condition may cause someone to pre-maturely leave social situations or avoid them altogether. It may lead to social isolation, poor work performance and troubled marital relationships. In most of these cases, people report having anxious thoughts such as: “People will notice how nervous I look,” “ I will say the wrong thing,” or “Everyone will think I am out of place and a loser,” which only adds to the anxiety level.

Taking the step to seek counseling is often a big decision and in itself can induce anxiety. At BETA, we will work with you at your pace and engage with you with skill, empathy and effectiveness. We will together and collaboratively seek to minimize anxiety and gradually replace it with confidence, hope and a sense of potential.

Common somatic complaints include:

• Pounding or racing heart beat
• Dry mouth
• Shaking
• Shortness of breath
•  Feeling dizzy

Fairly innocuous social actions may feel impossible. The thought of speaking to a group, socializing with strangers, or proposing a toast, can be absolutely terrifying to imagine. You may experience a racing heart, dizziness, sweating, or other anxiety symptoms. Often, if you do force yourself to socialize, you may feel miserable before, during, and after the event and replay the events in your mind. Typically, the problem isn’t limited to social events, but may affect your life at work and at school.

Getting Help for Anxiety:

There are a number of treatments for anxiety. Certain types of psychotherapy can help treat and manage social anxiety disorder. An effective therapist may use cognitive behavioral therapy, or CBT, the most widely researched intervention. CBT seeks to correct established patterns of negative thinking and the behaviors they cause by helping people face their social fears directly. Our therapists are highly trained in this and other treatment modalities.

We want to help. Very often good therapeutic interventions can therapy can address many of these issues and result in a notable improvement in comfort, confidence, performance, relationships and quality of life.  To arrange a session with one of our therapists, please contact us at info@bostoneveningtherapy or call us at 617-738-1480.

An Introduction to Internal Family Systems Therapy

To learn more about Dr. Schwartz’s model of therapy, I attended a conference where he was presenting. I had the opportunity to hear him lecture as well as interview him about the theory, practice, and thought processes that helped him to create Internal Family Systems Therapy.

In addition to a summary of key concepts that I took from his lecture and writings, this article also includes audio clips from my interview with him.

Dr. Schwartz theorizes that the mind is not a unitary entity, but is instead a system that contains multiple parts that work together for the greater good of the whole being. In addition to these multiple parts, we also have a Self that has the capacity to lead the system.

After a person experiences a traumatic event, disharmony can develop among parts. In his book, “Internal Family Systems Therapy”, Dr. Schwartz writes, “A developing system will also be constrained if it accumulates burdens along the way. This happens when the system is traumatized (thrown out of balance) before it has fully developed. Trauma also has the effect of freezing or fixating members of the system at the point in time of the trauma. These frozen members are not only no longer available to help, but their extreme emotions further constrain the system and force other members into hyperprotective roles” (p. 21).

Dr. Schwartz believes that it can be valuable to get to know, understand, and show respect towards these protective parts before the therapist and client begin to explore the injured parts that they protect. Once they have done this, the client's protective parts will show enough trust to step back and allow the client to see those parts that have been exiled. The client and therapist can then begin to nurture and console these injured parts who remain frozen in past trauma. Additionally, they help the client's parts to once again place trust and confidence in the Self, who innately has the capacity to lead and care for the system.

Dr. Schwartz practices what he preaches. Despite following him through crowds of people as we talked, he remained soft-spoken, cool, and managed to exude a palpable calmness.

I started our interview by asking him to speak about what other therapeutic models, or systems of belief, had contributed to his creation of the Internal Family Systems model of therapy. Click here to hear the interview with Dr Richard Schwartz about his influences

I proceeded to ask Dr. Schwartz to speak in more detail about how he helps his clients, and himself, to stay in touch with the Self when they experience internal and external stressors. Click here to hear the interview with Dr Richard Schwartz about staying with the Self

Still amazed by Dr. Schwartz’s ability to appear so grounded and present in the moment, I asked him to speak more about how to help therapists to hold onto their sense of Self in session. Click here to hear the interview with Dr Richard Schwartz about therapist and self

One of the applications of his approach that I found most interesting, was how it could be incorporated into couples and family therapy. I asked Dr. Schwartz to speak about how this is accomplished. Click here to hear the interview with Dr Richard Schwartz and family therapy

Dr. Schwartz also spoke about how to help family members address anger they might hold towards each other, by helping them to check in with their parts and access their Selves. Click here to hear the interview with Dr Richard Schwartz and family therapy part two

Dr. Schwartz and I ended our interview with him describing to me how therapy and trauma work is like a bulb of garlic. Click here to hear the interview with Dr Richard Schwartz about trauma and the garlic metaphor

I would like to thank Dr. Richard Schwartz for taking the time to be interviewed for this piece.

The author of this interview, Katie Novick, LICSW, is a clinician with Boston Evening Therapy Associates in Brookline, Massachusetts.

After the conference on Saturday, I was sitting down by the Fort Point Channel, thinking about everything I had learned over the last three days. There was a heavy, moist, fog that had settled over the city. It left massive buildings truncated-their top halves completely obscured. As I looked out on this scene, I realized that the clock tower-usually a landmark seen from many points in the city-had disappeared. I was struck by the power of this fog to alter my perception of reality.

As human beings we are amazingly resilient. When faced with potentially traumatic or upsetting experiences our minds and our bodies go into action to protect ourselves from the environment. Our defenses roll in, like the fog, to protect us.

In this process, sometimes things become hidden. Like the clock tower, time becomes obscured. The past often finds its way into the present, while our fears for the future have a way of visiting us prematurely. And some of those things that make us most special, most unique, must also be hidden away because we don’t trust our environment or ourselves to keep them safe.

As therapists and as clients, it can be important to understand, and value, the protective purpose this fog has served rather than to simply hope for sun. Similarly, we must remember that underneath that protective surface, lies a whole and precious self.

In the coming months, I will interview therapists who are doing innovative work in the field of trauma and share with you what I learn.

My first piece will be from my interview with Dr. Richard Schwartz, who is the creator of the Internal Family Systems Model of therapy. He speaks eloquently about the protective powers of our different parts, and the whole and unscathed selves that we each possess.

Author post by Brookline Massachusetts Therapist Katie Novick, LICSW