trauma

I will never forget you. 

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It’s been 17 years since you died. Every year, I’m reminded of it. The 25th of October you left this world after being hit by a car. You flew through the air, and I wonder: What were your last thoughts? Did you realize this would be your last seconds? That you never would see your family and friends again?

Who would you be today, if you were still here? You were only 16. We talked about moving in together when I was 16, because we needed to spend as much time together as possible. You always made me smile, no matter how bad my day was. But after you died, smiling was harder. For years there was only blackness. When I saw other friends, it did not feel right, because I knew there never would be another you. Nobody could replace you, no one understood me as well as you did. You loved me to bits, and it was mutual.

I don’t know if there is a life after this. I’ve pondered that possibility since you died. To never see you again, feels terrible. I hope you are sitting on a cloud, watching over me. Are you sad? Sad because you had so many dreams that never will come true?

I’ve felt guilty for years. Why did I survive when you didn’t? I’ve been in two car accidents, but I’m still here. You were at the wrong place at the wrong time, and that feels unfair. You were loved by so many people, and you always saw the good in everyone around you. I’ve tried to keep that in mind, to bring it with me whenever I encounter new people. I am blessed to have known you.

Are you proud of me? Did I manage to become the person you hoped I would become?

17 years later, and I can still see your face and hear your voice when I close my eyes. The memories we shared are so precious to me, and I can’t and won’t ever forget you.

Love, Nina

 

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Expectations

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The following days will be hard. 17 years ago I lost my best friend. She was hit by a car and died immediately. I was only 15 and it turned my world upside down. Grief doesn’t stop, it’s always there with you. And I’m glad. It means I have loved and cared about somebody deeply. 

For years I was afraid of becoming too attached to people. I feared they would leave me behind. But I couldn’t resist. I’ve loved a lot of people, even if they have left me behind and broken my heart.

I expect the following days will be hard, but I will get through it. I will be with people I love and appreciate that they’re in my life. Life is all about relationships, and when my best friend died, I really understood that fully. 

Changes

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It’s been a long time since I’ve written. Mostly because I’ve been busy in my new job and with suddenly having a new family to adjust into. 

When I started working clinically with adults again, it felt like coming home. The only worry was that I just had a contract for one year, so I was nervous about if I would get a permanent job. I really love it here, there a so many experienced therapists and in addition to that, many group therapies for different diagnoses. When I started, I was asked if I wanted to try to be a group therapist myself, something I was really excited about. This fall, I got the chance to be a therapist together with two other colleagues, and I have already learnt so much. The group is for patients with PTSD, and we work after a manual that focus on stabilization and education about trauma. To see how healing it is for traumatized individuals to meet others who struggle with the same symptoms as they do, has been a revelation. Logically, I know how good it must feel to meet others in the same situation as yourself, but seeing it with my own eyes is uplifting. I can almost see the light in the group members eyes when they emotionally feel that their reactions might be normal based on what they’ve been through. 

In August, I had another interview with my leader, after I applied for a permanent job here. On my birthday, my leader came into my office and delivered the good news: I got the job! So now I know I can be here as long as I want, and it feels amazing. My leader told me that they wanted to transfer me to working with psychosis, something I haven’t done much in the past. But I look forward to it. I have met people with schizophrenia before, and those I’ve talked with are often fascinating people with many resources. I also have a soft spot for them since my grandfather had schizophrenia, and he was one of the kindest human beings I’ve ever met.

It will be a bit sad to say goodbye to the patients I’ve having now, but I’m ready for new tasks and new challenges. I’ve always liked to learn more, and this is a chance to work with the system around the patients, and working in a team with experienced therapists who love what they do. 

So, even if it’s always scary to start with something new, I am ready to grow and learn.

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EMDR and Interhemispheric integration

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When I wrote a paper to become a specialist in clinical psychology, I focused on EMDR (eye movement desensitization and reprocessing) and the brain. When I woke up today I was inspired to learn even more, and maybe try to do more research the coming years. To summarize my paper, I tested a woman with neuropsychological test before and after treatment with EMDR to see if there were any changes in the test results. The result showed that her memory scores became better after EMDR. To educate myself further, I started to read an article today about trauma and the brain, where EMDR was one of the treatment methods mentioned. I want to share the most interesting part of the article, here.

Decades ago, Harry Harlow compared monkeys raised with their mothers to monkeys raised with wire or terrycloth “surrogate mothers.” Monkeys raised with the surrogates became socially deviant and highly aggressive adults. Building on this work, other scientists discovered that these consequences were less severe if the surrogate mother swung from side to side, a type of movement that may be conveyed to the cerebellum, particularly the part called the cerebellar vermis, located at the back of the brain, just above the brain stem. Like the hippocampus, this part of the brain develops gradually and continues to create new neurons after birth. It also has an extraordinarily high density of receptors for stress hormone, so exposure to such hormones can markedly affect its development. Something as seemingly inconsequential as five minutes of human handling during a rat’s infancy produced lifelong beneficial changes. New research suggests that abnormalities in the cerebellar vermis may be involved in psychiatric disorders including depression, manic-depressive illness, schizophrenia, autism, and attention deficit/ hyperactivity disorder. We have gone from thinking of the entire cerebellum as involved only in motor coordination to believing that it plays an important role in regulating attention and emotion. The cerebellar vermis, in particular, seems to be involved in the control of epilepsy or limbic activation. Couldn’t maltreating children produce abnormalities in the cerebellar vermis that contribute to later psychiatric symptoms? Testing this hypothesis, we found that the vermis seems to become activated to control— and quell—electrical irritability in the limbic system. It appears less able to do this in people who have been abused. If, indeed, the vermis is important not only for postural, attentional, and emotional balance, but in compensating for and regulating emotional instability, this latter capacity may be impaired by early trauma. By contrast, stimulation of the vermis through exercise, rocking, and movement may exert additional calming effects, helping to develop the vermis.

A powerful new tool for treating PTSD is eye-movement desensitization and reprocessing (EMDR), which seems to quell flashbacks and intrusive memories. A moving visual stimulus is used to produce side-to-side eye movements while a clinician guides the patient through recalling highly disturbing memories. For reasons we do not yet fully understand, patients seem able to tolerate recall during these eye movements and can more effectively integrate and process their disturbing memories. We suspect that this technique works by fostering hemispheric (Reprint from www.dana.org a non-profit dedicated to brain research) integration and activating the cerebellar vermis (which also coordinates eye movements), which in turn soothes the patient’s intense limbic response to the memories.

 

You find the rest of the article by following this link:

http://www.theresiliencezone.com/wp-content/uploads/2015/03/Neurobiology-of-Child-Abuse.pdf

 

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The sound of earthquakes

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You stand there. From one moment to the next, an ordinarily day is turned into a nightmare. The earth starts shaking. Objects are falling down, shattering when they hit the floor. You freeze, trying to not move. Your heart thumps, terrified. Will you survive this earthquake ? 
earth

Finding a way through the darkness 

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I have been in my new job as a clinical psychologist for one month now, so it’s time for a update. I still can’t believe how fast the time has gone, it feels like the day is over before it even began. This is good, since it means that I am engaged. There is seldom a dull moment, and at the end of the day I look back and realize I have learnt something new. Already I have touching moments that I will carry with me until I take my last breath. 

I have met many interesting people with a plethora of problems. Some with depressions, one with panic attacks, several with traumatized childhoods and also people with anger issues, AD/HD and personality disorders. Since I still see new patients, I haven’t had many conversations with anyone yet, and for many we are still getting to know each other. Finding the correct diagnosis is important, and we can’t move on before we have pinpointed what needs to be looked at more closely.

But even if we haven’t started on direct treatment yet, this first phase is hopefully already a step in the right direction. Although it’s necessary to go through some surveys and standardized questions, there is room for therapeutic work. 

The first phase of therapy is often about stabilizion and education. By getting to know oneself better, the path for change is created. For traumatized victims, learning about how trauma effects the body, is crucial. For people with panic attacks, knowing the symptoms and normalizing them, helps a lot. If you understand what happens, it’s easier to start coping with it. In some ways, fear of symptoms is what many struggle with the most. When we face or monsters in a controlled way, we can finally watch them from afar and act like we want to.

 Elizabeth Gilbert described in her book ‘big magic’ how she looked at fear: Fear is always with her, telling her that she should be careful. Prodding her to not take chances, because she might get hurt. She has learnt to thank her fear, because it wants to protect her. At the same time she also tells her fear that it can be there and monitor her surroundings if it wants to, but she must take command. She soothes herself by accepting that she will feel terrified and unsafe, at the same time as she assures herself that she can cope with what comes. 

Many of my patients are still afraid. And that’s okay. We all are, often. I will not promise a rose-garden, but I want to explore the area they walk in no matter what is there. 

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