Let's Talk About Complex Trauma

By Concentric Counselor Jordan Perlman, LPC, NCC

I imagine many people have heard of Post-Traumatic Stress Disorder (PTSD) but not nearly as many are familiar with Complex Post-Traumatic Stress Disorder (C-PTSD) which is lesser-known and unfortunately, not yet recognized in the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-V). And while an individual with a PTSD diagnosis, which is often the result of an isolated incident, a person who experienced complex or repeated traumas requires different considerations.

But first, it’s important to understand the differences between each:

PTSD

According to the DSM-V, PTSD is diagnosed when an individual meets the following criteria that create distress or functional impairment last more than one month, which is not a result of medication, substance use, or other illness. The individual was exposed to one of the following: 

• Death or threatened death 

• Actual or threatened serious injury

• Actual or threatened sexual violence 

• Witnessing trauma

• Learning that a relative or close friend was exposed to trauma 

Indirect exposure to aversive details of the trauma (usually in the course of professional duties), the individual must have at least one intrusive symptom that causes the persistent re-experience of the trauma in the following ways:

• Nightmares

• Flashbacks

• Emotional distress after exposure to traumatic reminders

• Physical reactivity after exposure to traumatic reminders

The individual must also experience avoidance of trauma-related stimuli after trauma either by trauma-related thoughts or feelings, or trauma-related external reminders.

Two negative alterations in cognitions and mood must be present where the negative thoughts or feelings began or worsened after trauma in the following ways:

• Inability to recall key features of the trauma

• Overly negative thoughts and assumptions about oneself or the world

• Exaggerated blame of self or others for causing trauma

• Negative affect

• Decreased interest in activities

• Feeling isolated

• Difficulty experiencing positive affect

 Lastly, there must be alterations in trauma-related arousal and reactivity that began or worsened after trauma in the following ways: 

• Irritability or aggression

• Risky or destructive behavior

• Hypervigilance

• Heightened startle reaction

• Difficulty concentrating

• Difficulty sleeping

 C-PTSD

Trauma typically associated with C-PTSD tends to be long-term, where the individual is generally held in a state of captivity, physically or emotionally. In these situations, the victim under the control of the perpetrator has little or no chance to get away or escape from the danger. Some examples might include:

• Long-term domestic violence

• Long-term child physical and/or sexual abuse

• Neglect

• Organized exploitation rings

• Concentration/Prisoner-of-War Camps

• Prostitution brothels

• Recruitment into armed conflict as a child

• Sex trafficking or slave trade

• Experiencing torture

• Exposure to genocide campaigns

• Other forms of organized violence

Some might be wondering, why is this difference important then? This is because of exposure to long-term or prolonged or repeated trauma results in a broad range of symptoms that go beyond the diagnostic criteria of PTSD, a.k.a “simple” PTSD.  As such, the basic symptoms of C-PTSD are:

• Somatization (physical problems, associated pain, and functional limitations)

• Dissociation (a division of the personality into one component that attempts to function in the everyday world and another that regresses and is fixed in the trauma, spacing out, daydreaming, or feeling strong sensations of being disconnected from one self or the world)

• Affect Dysregulation (difficulty with emotions, such as experiencing and/or expressing them, alteration in impulse control, attention and consciousness

• Self-Perception (experience of their own perspective tends to be drastically different from how others perceive them)

• Interpersonal Relationships (tend to be a struggle, difficulty with engaging with others, feeling distrustful of others)

• Perception of Perpetrators (can be skewed, or longing to be loved by their abuser)

• Systems of Meaning (doubt there is any goodness in the world, outlook on life can be dark)

Further, a 2018 study by Karatzias et al. found the most important factor in the diagnosis of C-PTSD was negative cognitions about the self, characterized by a “generalized negative view about the self and one’s trauma symptoms; attachment anxiety which is defined as involving a fear of interpersonal rejection or abandonment and/or distress if one’s partner is unresponsive or unavailable; and expressive suppression, conveyed by efforts to hide, inhibit, or reduce emotional expression.”

For those who may wonder why people affected by a long-term trauma “can’t just get over it,” the answer lies in the fact that even after a person is removed from the event, their brain may be permanently affected by that intense and prolonged trauma. And since a person’s nervous system is shaped by his or her experiences, stress and trauma over time, can lead to changes in the parts of the brain that control and manage feelings and the long-term effects are found on a physical and emotional level.  

Symptoms may manifest as:

• Eating disorders

• Substance abuse

• Alcoholism

• Promiscuity

• Chronic pain

• Cardiovascular and gastrointestinal problems

• Migraines

• Rage displayed through violence, destruction of property, or theft

• Depression, denial, fear of abandonment, thoughts of suicide, anger issues

• Flashbacks, memory repression, dissociation

• Shame, guilt, focusing on wanting revenge

• Low self-esteem, panic attacks, self-loathing

• Perfectionism, blaming others instead of dealing with the situation, selective memory

• Loss of faith in humanity, distrust, isolation, inability to form close personal relationships

Special Considerations for Survivors of C-PTSD from Childhood 

Many survivors of C-PTSD also experience Attachment Disorder which is a huge consequence of individuals who suffered complex trauma as children. Attachment Disorder is the result of a person growing up with primary caregivers who were regularly dangerous. Recurring abuse and neglect habituate children living in fear and sympathetic nervous system arousal, which over time creates them an easily triggerable abandonment mélange of overwhelming fear, shame, and depression. 

Because a child’s main attachment (to their primary caregiver) helps them learn to control their emotions and thoughts, when a caregiver’s responses are in tune with a child’s needs, the child feels secure. The child then uses this relationship pattern as a practice to build coping skills.

However, children who receive prolonged confusing or inconsistent responses from their primary caregiver are prone to be fussy, have a hard time calming down, may often withdraw from others and may have frequent tantrums. Unlike adults who have more tools to understand what is happening to them, children often do not possess these skills or have the ability to separate themselves from another’s unconscionable actions. Consequently, the resulting psychological and developmental implications become complexly woven and spun into who that child believes themselves to be, thereby creating a messy web of core beliefs that are harder to untangle than the flashbacks, nightmares and other posttraumatic symptoms that may surface later. Further, these disorganized attachments and mixed messages from those who are supposed to provide love, comfort, and safety - all in the periphery of extreme trauma - can create even more unique struggles that PTSD-sufferers alone don't always face.

Treatment Considerations 

While the symptoms can be daunting and the future seems bleak for someone who appears to be suffering from C-PTSD regardless of whether an individual has been diagnosed with a trauma-related disorder or not, there is help out there and there are ways to manage and help the individual cope. 

Treatment challenges include, Survivors:

• Avoiding thinking and talking about trauma-related topics because the feelings associated with the trauma are often overwhelming

• Relying on alcohol or other substances as a way to avoid and numb feelings and thoughts related to trauma

• Engaging in self-mutilation and other forms of self-harm

• Who have been abused repeatedly are sometimes mistaken as having a “weak character” or unjustly blamed for the symptoms they experience as a result of victimization and often have comorbid disorders such as dissociative identity disorder (DID), other specified dissociative disorder (OSDD), borderline personality disorder (BPD), depressive or bipolar disorders, anxiety disorders, obsessive-compulsive disorders, eating disorders, and substance abuse

Since many trauma specialists see Attachment Disorder as one of the key symptoms of C-PTSD, a relational, individual, approach will often be most beneficial for many of these clients. For many survivors, therapy is the first opportunity to have a safe and nurturing relationship.  Therefore, the therapist must be especially skilled to create the degree of safety that is needed to build trust or risk adding to the attachment trauma. Working with these clients is essential to the development of trust and relational healing and the four key qualities are empathy, authentic vulnerability, dialogically (when two people move fluidly and interchangeable between speaking and listening) and collaborative relationship repair. This makes therapy a teamwork approach where there is mutual brainstorming and problem-solving in a respectful way implying mutuality. All of these steps will provide the client with a “good enough secure attachment” to serve as a model for other relationships. 

However, and as expected, there is no “one size fits all” approach to working with individuals who have survived trauma, but one thing is for certain: recovery from Complex PTSD requires restoration of control and power for the traumatized person. Survivors can become empowered by healing relationships which create safety, allow for remembrance and mourning, and promote reconnection with everyday life. 

If you feel as though you have experienced complex trauma, it is important to know what happened to you was not your fault. While it is undeniable trauma changes the way we experience the world, I strongly believe like a phoenix, a person who suffered from trauma can arise from the ashes, stronger than ever before. This “stronger than ever before” is also known as “Post-Traumatic Growth.” Post-Traumatic Growth identifies a shift in personal strength and worldview as a consequence of trauma. Although you can’t change it, you can change what your life looks like going forward. One step you can take towards recovery is calling to schedule an appointment with a therapist who can help guide and support you on your healing journey. 

The Value of Vulnerability

By Concentric Counselor Christian Younginer, LPC, NCC

Life XXXV by Emily Dickinson

I CAN wade grief,

Whole pools of it,—

I ’m used to that.

But the least push of joy

Breaks up my feet,         5

And I tip—drunken.

Let no pebble smile,

’T was the new liquor,—

That was all!  

Power is only pain,         10

Stranded, through discipline,

Till weights will hang.

Give balm to giants,

And they ’ll wilt, like men.

Give Himmaleh,—         15

They ’ll carry him!

Emily Dickinson’s word choice in the first line sticks with me- she can “wade” grief. She can trudge through the thick, tarry mire of sadness, pain, loss, and sorrow. It really feels like that, doesn’t it? This viscous bog of grief, she’s “used to that”. It’s familiar for her. But joy is foreign. 

Although she can bear the pain of life, let life surprise her with joy and she will stumble, drunkenly. This voices a common human experience: Let something test our resolve, and we will meet that challenge. But let us be vulnerable, and we will dissolve.

It is easier to harden, than to soften. Give comfort and love to giants, and they will “wilt” into ordinary men, but ask them to carry mountains (‘Himmaleh’ is the archaic form of ‘the Himalayas’), and they will offer up themselves.

This brings us to the question of this post: How does a person allow themselves to be vulnerable, without wilting? How do they remain resilient when life gets hard, without hardening themselves?

What is vulnerability?

The insightful Brené Brown defines vulnerability as both “the birthplace of love, belonging, joy, courage, empathy and creativity”, but also as “uncertainty, risk and emotional exposure” (Daring Greatly). So, our options are: recoil at the latter and tell ourselves we don’t need the former OR accept the latter because we accept that we need the former.

There were times in my life where I clung to the idea that ‘ I don’t need others’- to avoid feeling exposed. That idea eventually spoiled, and I was faced with the reality that I DO need others. While I was aware of the fact, I had not yet accepted it. It was not until I accepted that I need others that my journey towards understanding vulnerability began.

Being vulnerable feels like the difference between writing in the 3rd person and 1st person. It is keeping others at a distance, to avoid the pain of feeling exposed- of not being accepted. If you notice, I switched from using “they” and “them” to “I” and “we”. As I wrote, I noticed feeling exposed, but I also noticed feeling satisfied with my self-awareness and honesty. That is, I felt joy in sharing this part of myself so that it might be of help to someone. It is this ‘trade-off’ that I believe Brené Brown is describing. If we can be ok with feeling a little exposed, we can receive wonderful gifts of acceptance, approval, validation, and love.

The Alternative.

In my pursuit of understanding vulnerability, I came to a choice. Would I rather feel uncomfortable or alone? My choice to embrace vulnerability and accept the possible “emotional exposure”, speaks to not only my desire for connection with others, but to the horror of the alternative: feeling alone. Jumping from a burning building does not mean that jumping is not scary, rather the alternative is too horrifying to consider.

Resilience.

What I am suggesting almost seems oxymoronic: Become vulnerable to become stronger. Invulnerability is not a superpower. Unless Superman exists and no one told me. Rather, accepting that we need others is the true superpower. One powerful result of letting ourselves connect is resilience. That is, if we temper ourselves in the furnace of vulnerability, we become stronger than we were. This is possible due to what Brené Brown references as the gifts of vulnerability: love, belonging, joy, courage, and empathy. Having these in our arsenal make us stronger humans, less prone to burnout and emotional distress.

Let us learn to enjoy the intoxicating effects of joy and not let it cause us to stumble. Carry the mountain if asked, because you are strong enough to shoulder it. But also do not wilt at receiving comfort or help. If we accept that we not only need others for support, but also that they have gifts to offer us, we become stronger. More resilient to carry the mountains when we need to and more courageous to be vulnerable when we just can’t carry anything else. It is the courage and strength to say: “ I’m not ok right now. But I will be.”

Better Understanding Grief & Loss→

By Concentric Counselor Jennifer Larson, LCPC, NCC

During the Spring of this year, I popped onto the Dear Abel and Sofi advice column for the first time and came across a story about a Firefighter’s struggle with grief & loss after he needed to leave the workforce due to injuries he sustained on the job. He was in the rebuilding stage and had recently turned his passion for woodworking into a small business that had been met with tireless effort and financial struggles. While this former firefighter shared his story and posed questions on the advice column, I could not help but see his intrinsic desire to connect with other people as he grieved and was rebuilding his life. Seeking connection, feedback, validation, and ideas from others was a part of this man’s grieving and recovery process.

Reading this story jogged my memory about a blog post I started in August 2018 (and didn’t finish) about grief & loss. At that time, I became re-enlightened about the additional types of grief & loss that exist, namely the loss of thoughtfully designed objects and structures in our country, and the unfortunate outcome this can have on social and human connectivity. I’ll touch upon that later in this blog post.

For many, grief & loss cannot exist without experiencing some form of connection with oneself or others, and rebuilding in the wake of grief & loss cannot exist without human connection. The firefighter's story made me think about my own grief & loss experiences felt during the earlier part of the year.  The flood of feelings and experiences that emerged from within me were great, and subsequently, I decided to really reach out to others.      

During my grief & loss earlier this year, I allowed myself to feel and accept my grief by intentionally creating space and capacity to feel a myriad of feelings.  I also reached deep within to try to understand the messages, gifts, and lessons in my losses. Reaching out to family, friends, my therapist, and colleagues granted me the opportunity to take care of myself and to feel their heartfelt and unwavering support. The swell of feeling cared for, respected and supported by others was truly one of the best gifts I ever experienced.  Eventually, I felt myself naturally propelling forward by carrying my values with me and, yet, creating a semi-new reality ahead. My grieving process, particularly connecting with others, reminded me of the firefighter’s desire to connect with others through the advice column as he grieved and re-built his life.  

For some, grief & loss can be experienced as a harrowing crisis and this crisis can truly be fodder for future opportunities and growth. And, through my own experiences as well as listening to others’ experiences, I have come to truly appreciate that grief & loss comes in many forms and shapes.

Long gone are the days when we thought of grief & loss solely as one facing their own mortality due to a terminal illness or losing a loved one to death. These are most certainly some of the most difficult types of grief & loss people can face in a lifetime as it can bring about great pain and suffering. The loss of a loved one can stir up a deep emotional response, physical and behavioral changes. Other forms of losses can bring about up deep emotional, physical, and behavioral responses and changes as well.

Experiencing a significant life transition (such as entering into college or parenthood), a childhood robbed of important attachment figures or childhood experiences, the demise of an intimate relationship through betrayal & infidelity, and the loss of being connected with one’s feelings or reality by route of escaping into addiction, perpetual distraction or fantasy -- all of these examples fall under the umbrella of grief & loss. 

People who experience grief & loss can go through a number of stages, sometimes in sequential order, other times bouncing back-and-forth among the stages, and for some, remaining stuck in a stage or bypassing certain stages all together. There are a number of identifiable stages of grief listed, one of the more common models is Dr. Kubler-Ross’ modified 7 Stages of Grief & Loss. For brevity, here are those 7 Stages:

1. Shock (Initial paralysis hearing the news)

2. Denial (Trying to avoid the inevitable)

3. Anger (Frustrated outpouring of bottled-up emotion)

4. Bargaining (seeking in vain to find a way out)

5. Depression (Final realizations of the inevitable)

6. Testing (seeking realistic solutions)

7. Acceptance (Finally finding the way forward)

Having the understanding and knowledge of The 7 Stages of Grief & Loss can be instrumental in cultivating understanding which can eventually contribute towards facilitating growth and change. As I highlighted earlier, I believe interpersonal relationships -- connecting with others -- is also important to incorporate during the grief & loss process and survival.  Whether it’s with a trusted family member or friend, therapist, or your community can be healing as your experience and move through your grieving process and recovery. 

Being there for people by exercising empathy, attunement, and being fully present is critical as one heals.  Also, giving yourself permission to be vulnerable to express yourself with people you feel safe with creates a holding space for you and your experiences. Emotional and relational connection like these brings about a deeper understanding of one’s experiences which can then help promote compassion, transformation, healing, and recovery. The emotional-felt experience within a relational context is vital for healing and survival during grief & loss.

I am going to revisit something I referenced earlier in the blog, and I know it may seem like I am veering off (which I am) and going on a tangent, but this is an area I want to weave into the area on grief & loss.   

Around last summer, my mother-in-law remarked how the United States tends to tear down old buildings to make space for newer buildings to be built.  She conveyed her concern about our country undermining the inherent value, respect of others, its history and imprint, and ultimately the loss of felt social and human connection by tearing down old buildings. The decimation of older structures and the lack of integrating new and old buildings together equates with grief & loss for the people of this country.  This was the message I heard, and it struck me.   

The following day after my mother-in-law shared her perspective, I had read "He Knows What You Really Need" article in Psychology Today which highlights Glenn Adamson's perspective on the value of knowing how objects or things are made or cultivated. The article revealed Adamson's book, "Fewer, Better Things"  which highlights the act of purchasing or collecting mass-produced items can water-down the value and connection between consumers (people) and goods. Glenn believes diving deeper into learning more about the maker and the making process promotes greater understanding and respect for the maker and object, and overall promotes social and emotional connectivity.  Mass produced items create a lack of human connection - loss, in other words. Experiencing an artisan’s creative piece awakens our senses and taps into an emotional and human connection with its maker.

And then the following night back in August 2018 (yes, I’m serious about these sequential events), I found myself seeing these same themes emerge in the then new show, "Making It" hosted by Amy Poehler and Nick Offerman. The show is about bringing master craftspeople and artisans together to compete in a friendly and fun environment.  During the crafters' introductions, one of the makers remarked that crafting in today's culture has dwindled down as people expend more time and energy on their phones. Crafting with others creates memories, she added.  Memories filled with emotional and social connections. 

The idea is that thoughtfully-designed, emotionally and physically labored crafts, objects, and buildings promote greater human connectivity. Eliminating them only promotes greater relational loss. I really started to sit with the idea of how the loss of certain physical objects or structures impact us psychologically, relationally, and culturally, and what this could mean for us and perhaps, for human evolution.

Of course, facing a terminal illness or experiencing the loss of a loved one pales in comparison to the loss of not knowing the maker of a vase on your dining room table. I am not making the comparison that both are similar in terms of its impact when it comes to grieving.  But, I do think it’s worth acknowledging that grief & loss comes in many different shapes and forms. It’s not black-and-white.

So, here are my hopes. My hope is we can continue to acknowledge, better understand and define the various forms of grief & loss that touch people in various ways both intimately and globally. That we can all take a leap by vulnerably reaching out to others for support during our own grieving journey. We can be truly available and present to those who are grieving. We can take a moment to think about preventing unnecessary losses. And, we can appreciate the preservation of human connection, particularly in the wake of grief & loss. Because human connection is truly a powerful thing, take it from me.      

Finding Balance Between Healthy and Unhealthy Anxiety

By Concentric Counselor Charles Weiss, LPC

There are 10 seconds left of the clock in the state championship game and your team is down by 2 points.  You have the ball and the fate of the team is in your hands on what will you do next, either pass or take the game winning shot.  Sweat is protruding down your face, your heart is beating a thousand miles a hour, your mind is racing with a million and one different case scenarios on what you should do and then your anxiety starts to take over.  However, you realized that your anxiety has allowed you to think quicker on your feet and make better decisions, because you don’t let it control and consume you.  3, 2, 1 and throw up a prayer of shot from about 35 feet away from the basket, knowing that being vulnerable to your anxiety, you can live with the consequences…  Swish!  Game over and you have just won the state championship for your team.

Anxiety… What is it and what does to mean to us when it begins to take control; do we let it control our consciousness or embrace it as an opportunity of growth and self-discovery?  According to dictionary.com, anxiety is defined as “a feeling of worry, nervousness, or unease, typically about an imminent event or something with an uncertain outcome.”

When outcomes are uncertain to us in which we want to control, but can’t, anxiety can consume our every decision, thought and feeling.  It leads to panic, fear and vulnerability to the unknown, having us over-analyze every decision we make, postulating those “what if” scenarios.  Anxiety can so debilitating to someone when it’s severe and impacts our day-to-day activities.  Plain and simple, anxiety can suck!  Nobody wants to constantly live a life of panic, fear, worry and dread, wondering all the time, “What if?” When you let anxiety take control and inhibit your ability to just be “you”, it becomes unhealthy.

Is there a way to gain back that control over anxiety before it begins to consume us, crippling our sense of self and being vulnerable to “What if…?”  Anxiety is your body’s indication that something isn’t right, like a built-in warning system indicating that your homeostasis might be out of balance.  When we listen to our body as it talks to us and yes, our body does speak to us, you can begin to prepare and embrace for its impact and figure out how to manage it. Certain symptoms to be mindful of that can alert us when something “isn’t right” and anxiety begins to manifest itself within us, are the following:

·        Racing thoughts

·        Irritability

·        Headaches

·        Nausea/upset stomach

·        Disturbed sleep

·        Muscle tension/tightness

·        Shortness of breath

·        Mind going blank

·        Difficulty concentrating/focusing

·        Fatigued

·        Palpitations

When we are able to listen to these symptoms we experience, then we can to things to keep these symptoms in check before they exacerbate. Taking the time to do a body scan, deep breathing exercises, mindfulness exercises, progressive muscle relaxation techniques can all help keep the heightened level of anxiety at bay.

Can anxiety be healthy?

Anxiety can also be a way to motivate yourself to reach your goals and achievements that you have established.  It can better help prepare yourself to face as well as overcome challenges. When we approach anxiety as a hindrance, it can become unhealthy. You can instead capitalize on it as more of a way to inspire your self-growth and to live a more authentic life.  According to Katharina Star, Ph.D., anxiety is another way people can be more empathetic towards other people’s issues and concerns, and help with how they interact with others. She also stated that individuals who struggle with anxiety are often more cautious thinkers, problem solvers and decision makers because they are often building-in “back-up plans” for when things go wrong. 

Bottom line, anxiety isn’t always bad and unhealthy when individuals experience it, it can be a way people thrive if they are able to recognize it, understand it, and know how to cope and properly channel the healthy aspects of it. People can still live fully authentic lives when experiencing anxiety, it’s when it takes control and we begin to panic, that derails aspects of our lives.

If you are experiencing at least 3 symptoms of anxiety, that have been affecting your ability to function on a day-to-day basis in a variety of settings (i.e.: school, work, home) and those symptoms have been occurring for at least 6 months in which you find it very difficult to control that worry and anxiety, please contact your local mental health provider and schedule an appointment with a professional who can help you learn how to regain control over your anxiety and transform it into a healthier form of anxiety for you. 

The Role of Anxiety in Living an Authentic Life

By Concentric Counselor Christian Younginer, LPC, NCC

To be brief, anxiety can suck. The persistent worry of imagined scenarios can plague the mind and exhaust the body. It can manifest as brief periods of pronounced worry, a baseline worry for all things, and even panic attacks. But I would like to offer a perspective that may be overlooked in coping with anxiety. That is, can my anxiety teach me something?

Specifically, can my anxiety teach me how to live an authentic, meaningful life? This question shapes Existential Therapy. At its broadest, existential therapy is the endeavor of understanding one’s existence in a therapeutic setting. This is done via an honest exploration of one’s freedom, choice, responsibility, meaning, and inevitable death. Existential psychotherapist Irvin Yalom conceptualizes much of anxiety as death-anxiety (Existential Psychotherapy, p.189). That is, persistent anxiety can be explained as an underlying worry about a life without meaning in the face of approaching death. Death is what allows life to have meaning. If there were no end, then for what should we live? The finiteness of life can motivate, intimidate, and terrify. However, it is this anxiety that can be the canary in the mine of our life.

As we work, study, sleep, parent, eat, play, drive, and journey through life, meaning and purpose can slip through the cracks. Anxiety can creep in, seeming to have no definable impetus. Often enough the death of a loved one, or a diagnostic medical scare can bring perspective -- wherein we confront our death. But one does not need to wait for such a moment to ask these questions, such as “Why am I here?”, “What does it mean to exist?”, and “What is my purpose?”.

Anxiety can be that canary that alerts us of an inauthentic life. It warns of the finiteness of life, and the importance of living a life with meaning. This often manifests as a vague sensation of “running out of time”. Without meaning, one can find life pointless or trite. The finiteness of life no longer motivates, it terrifies. But if we listen to what our anxiety is telling us, perhaps we can redirect our lives towards meaning.

How does one do this?

An example from philosophy may be of use. In Frederick Nietzsche’s The Gay Science, Nietzsche offers the reader an aphorism he titles ‘The Heaviest Burden’. He proceeds to ask the reader: if a demon were to order that you must live this life in eternal recurrence, every moment, detail, pain, and triumph- would you thank him or curse him? (The Gay Science, Aphorism #341). So, do I live my life in such a way that were I to re-live this life on repeat, I would praise the demon with gratitude for the opportunity? Or would this prospect bring about the abysmal dread of re-living a meaningless life? It is this precise idea where anxiety comes into play. Am I experiencing the anxiety and dread of a life not worth re-living?

It is this question that can help steer us towards meaning. Do I live in such a way that were I to re-live this life on repeat, would I be in joyful contentment or in abysmal dread? This is a tough question with which to be confronted. However, we can use this question as a beginning: the moment one begins to ask “does my life have meaning?”. Rather than be frozen by the possible dread this question instills, one can frame this as the moment in which a new life begins. As always, Confucius said it best, “ We have two lives, and the second begins when we realize we only have one.”

Determining WHAT is meaningful is a personal journey that can take time to uncover. But knowing thyself was important to Plato for a reason. It is this existential journey of a human confronted with death, through anxiety, uncovering that which gives their life meaning.

To conclude, yes, anxiety does suck. But as we work to cope with it, let us ask -- What is this anxiety trying to teach me?  Anxiety very well may lead us away from the existential dread of an unexamined life, and instead towards finding a meaningful life worthy of repeating.

Sexual Trauma, Triggers, & The 24-Hour News Cycle

By Concentric Counselor Katie Ho, LPC, NCC

You can hardly escape today’s current social and political climate - it’s on the news, in your social media, overheard at lunch, and even for therapists, themes in session. For those who have experienced trauma in their lifetime, past or ongoing, navigating topics like sexual assault can be overwhelming, scary, complicated and sometimes even powerful. How we take care of ourselves and the people around us who may be struggling with the complexity of their emotions has to be part of the larger conversation. It’s clear that avoiding or minimizing discussions on sexual violence and quieting the stories of survivors is not the path to atonement and reconciliation. But as we create space and lift up the voices of those who have suffered, we must also take inventory of what comes up in us and tend to those parts with kindness, care and nurturing.

The #MeToo movement, local and national advocacy groups and social justice organizations have been and continue to create a platform for those who have been victim to sexual harassment and assault. While the stories and accounts of these traumas seem to be daunting all of the sudden for those who have been unaware, statistics and experts have known for some time of these experiences. The National Sexual Violence Resource Center (NSVRC) estimates that 1 in 5 women will be raped in the United States in their lifetime, and that 1 in 3 women will experience some form of sexual violence. The majority of these acts are committed by acquaintances, partners or people who are known by the victim, and according to the Rape, Abuse & Incest National Network (RAINN), the majority of these events occur at or near the victim’s home. These of course are statistics, data and research gathered through reports from multidisciplinary agencies. There is undeniable value in knowing these numbers. And just as much, there is value in hearing the experiences and seeing the faces of survivors who have chosen to come forward.

As allegations and reports of sexual assault make the news, we are bombarded with information, opinions, commentary and even jokes on the matter. Survivors are subject to their own re-traumatization, which has an impact on psychological and physical health, triggered by both the details of these publicized allegations of assaults and non-believers who dismiss them.

In knowing that a trigger is a psychological stimulus that can be evoked through anything from sights, smells or sounds, it’s no wonder that the 24-hour news cycle is affecting so many people. Survivors are not alone in their strong reactions to the constant replaying and subsequent criticism, shaming or dismissing of survivor stories. Those who feel a connection or calling to the cause, whether it be through their empathic attunement or knowing a survivor, may also experience the distress and burnout that comes with the current climate.

So how do we take care? How do we balance the righteous anger and complexity of our other emotions, promote advocacy and change, all while healing and taking gentle care of ourselves? In doing this, one of the most important things to know is nothing can replace the support of others. So find someone, or a group of someones, who can help to support, validate and foster a safe environment for processing.

Find a tribe, or maybe even create one. Pay attention to your body, as our physical being can often tell us when stress is increasing and it’s time for tending and healing. Maybe that means physical exercise, movement, touch or a practice of progressive muscle relaxation (a quick YouTube search is all you need!). Set boundaries. Limit your intake of news and dialogue on the topic by knowing how much mental and emotional labor you’re able to give without overextending yourself. And if you find yourself overwhelmed, triggered or lost, use mindful grounding techniques to bring yourself back into your here and now. Feel your feet on the floor, describe and notice something around you, use your five senses to bring a consciousness into your physical environment and current moment in time and add in a quick reminder - “I am safe. I am in control. I am okay.”

A Thoughtfully Designed & Researched Blueprint of Your Relationship & Marriage

By Concentric Counselors Katie Ho, LPC, NCC & Jennifer Larson, LCPC, NCC

A large part of the human experience, including the joys, losses and challenges, gravitate around relationships. In social and cultural regards, finding a partner and committing to a person can be a marker of happiness, success or accomplishment. But like with any experience, obstacles lay ahead. All couples find themselves navigating conflict, life transitions or faced with heavy decisions, and the related stress that comes with these expected issues.

There are some couples, however, which continue to exist in this perpetual conflict - one that doesn’t appear to have any resolution and creates continual gridlock. Or perhaps there has been a significant breach of trust, or betrayal. Maybe communication is poor, and creates dysfunction during arguments or otherwise, or possibly there has been a traumatic event which has challenged the feelings of safety within the relationship. All of these reasons, and those that might even fall in-between, can be indicators that a couple may benefit from entering couples therapy.

Seeking couples therapy takes courage, as much as it takes hope - hope that the relationship can be repaired or healed, or maybe hope that both individuals can find strength in different directions. Using over 40 years of research, The Gottman Method - developed by Drs. John and Julie Gottman - has helped couples and clinicians create a blueprint of understanding the dysfunction within relationships and the need for building friendship, shared meaning and intimacy. This method was created to serve a deep need in helping find effective intervention for couples looking for repair, healing and happiness. It serves as a theory in which people are able to know both themselves and their partner on a more meaningful level, fostering intimacy, positive affect and skillful conflict management.

When a couple is seeking therapy, there can sometimes be an already significant level of distress present. In their research, the Gottmans found that on average it can take up to 6 years before a couple will seek therapy! This can mean there is a long history of experiences, life phases or challenges that have a need to be explored and understood. Partners may feel overwhelmed, flooded or unsure of where to even begin the healing journey. This highlights the need for a trained couples therapist, equipped with scientific evidence-based practices and the skills to empathize equally with both individuals to help navigate that process.

In working to repair and strengthen a relationship, much like with building a house, there has to be certain core foundational components. The Sound Relationship House from the Gottman Method explains that at its roots, marriage and relationships need to be built on friendship. The essential components of friendship are described as ‘Building Love Maps’, ‘Sharing Fondness and Admiration’ and ‘Turning Towards’. In the first mentioned, to build a Love Map means to truly understand know your partner’s internal world.

People’s internal world changes over time; who are the current people they are involved with, what are their immediate and long-term hopes and dreams, ambitions, or experiences from childhood that may be playing into their current situations. Asking open-ended questions, remembering the answers and actively listening promotes genuine connectedness and friendship. Sharing fondness and admiration, and turning towards your partner, are other components to strengthening and building the friendship of a marriage or relationship. They focus on scanning the environment for what one’s partner is doing right and engaging in appreciation, affection and respect. Additionally, the last level of foundation in ‘turning towards’ describes opportunities for couples to accept and receive bids from the other partner for emotional connection.

The higher levels of The Sound Relationship House include ‘The Positive Perspective’, ‘Manage Conflict’, ‘Make Life Dreams Come True’ and ‘Create Shared Meaning’. These levels of building a healthy relationship are built upon those above-mentioned ideas of friendship. They encompass skills necessary to navigate conflict and life changes, promoting positive affect and a deeper understanding of their partner’s underlying values and dreams and building a life of meaning together. Couples therapy addresses both the necessity for positive connection and friendship, while also acknowledging the dysfunction which makes that task more challenging.

Construction of homes need to be buttressed and supported by its internal supports otherwise houses would collapse.  The same is true of intimate relationships. Every relationship or marriage needs the supports and pillars of 'Trust' and 'Commitment' for stability, safety, and security.  If the 'Trust' or 'Commitment' reinforcements on The Sound Relationship House have been significantly damaged, the relationship can feel shattered and even decimated requiring much repairing and rebuilding.  Sometimes a relationship can be so damaged so that we tell couples relationship #1 has been damaged as if a hurricane or storm came barreling through wiping out your home.  The devastation and trauma is real, but with hope, commitment, and efforts, we can help you re-build relationship #2 as in the case when people experience great natural disaster in their communities requiring building home #2.  Some feel as though it requires blood, sweat and tears, but building relationship #2 can be done collaboratively with the support and care of a highly, skilled and trained couples therapist.   

Having the skills to identify and change maladaptive communication styles and behaviors that plague relationships is of equal value. In our work at Concentric Counseling & Consulting and using the Gottman Method, we incorporate the Four Horsemen of the Apocalypse - which is a metaphor in describing what can be a predictor for the end of a relationship. These include criticism, contempt, defensiveness, and stonewalling. In working with couples to address these maladaptive behaviors, the couples therapist will explain the antidotes, or remedies to address these bad habits in the work towards building healthier ones.

The goal for any couple is to promote understanding, connection, love, growth, and healing. That can look differently for every couple, as every couple experiences their own unique set of challenges and circumstances. The benefit of seeking a therapist trained in a data-driven theory and method such as the Gottman Method is that interventions and treatment plans are tailored to that couples’ needs through the use of thorough assessments and a framework that has been built based on research. The process to having a better, more enjoyable and healthy relationship takes commitment and hard work, but the reward exists within both the outcome and the journey.

For more information on The Gottman Method and services offered by Gottman-trained therapists at Concentric Counseling & Consulting, visit https://www.gottman.com/ and www.concentricchicago.com/couples-marriage-counseling.