Neurosurgery is to medicine as traumatic stress studies are to mental health care.
Among the general public and within the mental health community itself, there remains a naive assumption that all mental health professionals are well-trained specialists in the treatment of traumatic response when, in fact, at the graduate level, specialty care education in traumatology is almost nonexistent. Imagine medicine without the specialty care of neurosurgery or cardiology: that is the unfortunate state of mental health care education today.
Trauma courses for mental health professionals.
The Houston-Galveston Trauma Institute provides specialized training and education covering a wide range of trauma-related issues, including:
- Assessment protocols for adult trauma survivors
- Attachment and trauma
- Chronic stress in childhood and the developing brain: Fight-flight-freeze
- Couples therapy for trauma survivors
- Diagnoses and symptom profiles in trauma responses
- Dissociation: How the self and the outside experience is fragmented in trauma
- Ethics and the treatment of trauma-related disorders
- Expert witness training for psychological evaluators of persons seeking asylum in the US
- Mental health care for refugee and non-refugee immigrants
- Post-traumatic reactions: How PTSD symptom clusters are hidden in the symptom patterns revealed in therapy
- Refugee care for primary care physicians and ancillary PC personnel
- The brain and medication: Not just a psychological problem
- Transference and countertransference
- Trauma and affect regulation
- Trauma memory and perception
- Trauma therapy stages of treatment: Whys and pitfalls
- Traumatic attachments and reenactments
- Vicarious traumatization: What happens to the therapist and how to deal with it
Professional Course List Click on a course category below to open or close that section.
Recovery from Trauma:
Broad-Spectrum Trauma Training
"A poet’s work is to name the unnamable, to point at frauds, to take sides, to start arguments, to shape the world, and stop it from going to sleep."
- Trauma theory
- Trauma practice: Client/patient emphasis
- Vicarious trauma: Effect on the worker/clinician
Trauma Training Courses
Broad-spectrum diagnostic and symptom profiles, co-morbidity and trauma.
The Brain and Trauma
Traumatic stress and the brain; how medicine works and why.
Couple’s Therapy with Trauma Survivors
Phase-oriented couple’s therapy with trauma survivors: theory, practice, experience in role-play; ethics and boundaries and contra-indications.
Dissociation: the Primary Defense
Understanding how dissociation helps and is a problem; assessing for subtle to profound dissociation both in the person’s experience of the outer world, and in the experience of the self-identity; how the clinician must stay grounded.
Memory, Cognition and Perception
The reweaving of the story understanding how memory and perception are impacted by traumatic experience; contra-indications.
Stages of Trauma Treatment
0 stage, first-, middle- and late-stage trauma treatment; recognizing and developing a stage-based rationale for treatment planning.
Substance Abuse, Compulsivity and Trauma
How addictions (and obsessive compulsive disorders) can be both a symptom and a management adaptation to traumatic life experience, and how it relates to PTSD symptom clusters.
Trauma Assessment Protocols for Adults
Assessment scales to assess PTSD, traumatic histories, anxiety, depression and dissociation—how and when to use them; how do they help in developing treatment plans?
Trauma and Attachment: Disorders of Personality
The self and the capacity to manage disorders of personality as seen through the lens of trauma.
Traumatic relationship patterns, from subtle issues of dependencies and detachment to abuse and violent patterns; basic understanding of family and couples’ patterns .
Vicarious Trauma on the Helper
How “risking connection” (Pearlman and Saakvitne) with traumatized people affects the helper; self-care is a parallel process.
Transference and Countertransference in Working with Trauma Survivors
Recognizing and dealing with the common tendency of complex trauma clients and their therapists to confuse boundaries and unrelated past relationships, transferring feelings (most often, unconsciously) toward one other and impeding the therapeutic process.
Didactic Trauma Theory and Training
Didactic trauma theory is combined with experiential process to include practice development.
Didactic training can be combined with monthly case consultation in group and individual experiences. Bimonthly group and monthly individual consultation is the ideal. Groups of no more than five clinicians present ongoing case material over time, offering an exceptional training opportunity.
Executive director/clinical director
Ethical standards and codes of conduct are essential for professional behavior, and they play a crucial role in the successful treatment of trauma survivors. Therapists and clinicians must understand what is expected of them, both morally and legally. Rosalie Hyde offers ethics courses for groups of four or more people. These can be focused on a variety of issues and pitfalls in working with traumatized people.
Ethics: What Happens Between the Therapist and the Client, Developmental Issues and Traumatic Reenactments
Powerful transference and countertransference issues and how they inform the therapy. Mindfulness in treatment is an issue of ethics. and this course outlines the gray areas of boundary-violation possibilities in working with traumatized people. Call HGTI for more information.
Childhood abuse and trauma: The broad spectrum of sequelae
The discussion takes off from two readings. The first article describes data from a longitudinal psychoanalytic study of individuals evaluated from birth to age 30: at the final adult evaluation, 10 of 76 reported childhood physical and/ or emotional abuse. This prompted retrospective analysis of the previously collected observations. These 10 individuals differed from their peers along three axes: psychiatric symptomatology, immaturity of defenses and presence of a pervasive feeling tone of sadness and disconnection. The second reading looks at these parameters in a detailed historical case, Franz Kafka. His life and work give us a richer sense of the ways in which fantasy and sublimation become both a communication and a protection in situations of developmental adversity. Using these theoretical tools and insights, the group will then examine ongoing case material, looking at questions of psychodynamic assessment and treatment planning.
Massie, Henry and Szajnberg, Nathan. My Life is a Longing: Child Abuse and its Sequelae, International Journal of Psychoanalysis. 87: 471-496, 2006. Goodwin, Jean and Attias, Reina. Metamorphosis: The Self Assumes Animal Form. Goodwin, Jean and Attias, Reina. Splintered Reflections: Images of the Body in Trauma. New York: Basic Book, 1999, 257-279.
Trauma dissociation: A new model of understanding post-traumatic, borderline and dissociative symptoms
Psychological trauma has been defined in many ways, most simply as an event that overwhelms the capacities of the self. This model proposes that one essential aspect of the response to psychological trauma is the creation of a dissociative barrier – fight or flight, freeze or surrender, tend and befriend – to isolate the everyday self and the everyday world from the disruptive impacts of the trauma memories and the trauma emotions.
In post-traumatic stress, this process produces a somewhat numbed and constricted everyday self, beset intermittently by flashbacks, sudden fears or nightmares coming from the trauma zone. In complex post-traumatic syndromes, which often resemble borderline disorders, the split in consciousness can produce disparate presentations. The patient may appear for one session seemingly fully cognizant of the here-and-now goals of therapy and the here-and-now roles of the therapist and patient. However, in another session, he may experience the treatment as a repetition of his traumatic memories and place the therapist in the role of abuser or victim. In severe dissociative syndrome, each trauma emotion – fight, flight, freeze, and so forth – may have spawned a discrete trauma self, often named, which then intrudes into the here-and-now life of the trauma survivor.
Sadistic abuse: Pitfalls for victims and therapists
Victims of sadistic abuse may come to treatment because of continued victimization by childhood perpetrators by new perpetrators or by their own self-systems. Victims should be screened for victimization of others, for antisocial traits and for self-harm behaviors because control in these areas usually takes precedence over reconstructive and other therapeutic work. Keeping track of multiple symptoms, multiple prior traumata and multiple treatment modalities is a major part of the therapist's task. Years may be required to establish a "good enough" benevolent environment within the treatment alliance, the patient's home and work environments, and the patient's self-system. Not until this is achieved can reconstruction, insight and developmental work take place. Therapists working in this area need advanced skills in selecting and creating benevolent environments in treatment teams, therapeutic milieus and their own support networks. These victims are uniquely susceptible to involvements with malevolent institutions and individuals and will involve their therapists in such encounters as well.
The course covers:
- Training in assessments for refugees and torture survivors
- Tips and advice for successfully working with interpreters
- Training for primary care physician and other health care personnel, based in the Harvard Refugee Trauma model
Pro bono mental health assessment training:
Executive director/clinical director Rosalie Hyde offers training and mentoring for mental health clinicians as an expert witness doing pro bono psychological assessments for persons seeking asylum in the United States. These are psychological evaluations on victims of torture, gender violence, female gender mutilation, domestic violence in another country and seeking asylum. Call HGTI for more information.
- You can feel what they feel: hopeless, sad, depressed
- You can think as they think: the world is not safe, become suspicious
- You can not sleep, or sleep too much
- You can remember their stories when you don’t want to
- You can overreact to everyday things
- You can be overprotective of your own family
- You can feel tired, burned, angry, impatient with family
- You can say or do things that don’t seem like you
- You can find yourself daydreaming or going away
- You can have nightmares or fitful sleep
- You can find that you don’t take good care of yourself
"When we open our hearts to hear someone's story of devastation and betrayal... we are changed."
Pearlman and Saakvitne
The workshop covers:
- Understanding the nature of vicarious traumatization and how the self is affected
- Assessment and recognition of the personal experience of vicarious trauma in participants using tests and questionnaires
- Strategies for transforming traumatic stress
- Strategies for first responders to maintain a long-term commitment to self care and management of work-related traumatic stress
"At best, treating trauma is hard work; at worst, it can be traumatic. All of us who do this work need all the help we can get."
Jon Allen, MD
For more information please call HGTI or email Rosalie at ObscureRosalie.