Talking and beyond

A counseling session with a therapist or psychologist can go many different ways depending on the person and the type of help they are seeking.

For some, counseling can mean multiple sessions with a counselor discussing any number of topics and memories. For those suffering from trauma or abuse, counselors may utilize very specific methods and even physical interventions.

In an effort to understand just a few of the options out there, Live Well spoke to two local professionals about their practices and specialities.

By no means a comprehensive overview of the field or the options available to local residents, the goal is to offer a better understanding of how much treatment can vary on a case-by-case basis.

“Talking is wonderful, but there are some things that talking does not remedy,” said Ashely Notestine of Evergreen Counseling & EMDR Therapy in Coeur d’Alene. “Therapists and consumers need to be educated about what works and what doesn’t work for different situations.”

Eye Movement Desensitization and Reprocessing (EMDR) for trauma

Notestine is a licensed professional counselor with her own practice, but she is also the lead counselor at the Safe Passage Violence Prevention Center, a North Idaho non-profit that offers programs and services to assist victims of family violence. She is primarily a trauma counselor, helping those who have been victims of violence, sexual assault, car accidents, etc., but she also helps those suffering from less obvious forms of trauma. Those can include incidents, memories or even indirect occurrences that can can result in anxiety and panic-related symptoms.

“People’s childhood and background histories, as well as their environment and sense of safety is often a big determiner in how people are able to move through the world and function with trauma,” Notestine said. “All of us deal with it differently.”

She is trained in EMDR therapy, which stands for Eye Movement Desensitization and Reprocessing. The method is recognized by both the Veterans Administration (VA) and the American Psychiatric Association (APA) for its effective treatment for trauma and Post Traumatic Stress Syndrome (PTSD).

For Notestine, the EMDR is a well-scripted process in which a very specific aspect of a trauma trigger is recalled while utilizing some for of dual-attention stimulation, like holding a buzzer in your hands and or listening to different tones. The method has been around for years, but Notestine said doctors and counselors are still learning more and more about how the therapy works neurologically for patients.

“We think through this process of dual attention stimulation we are kind of mimicking the rapid eye movement process (REM) in sleep,” Notestine said. “What’s happening is during REM we are processing the events of our day and of our lives and filing them where they need to go. The traumas are the things that are stuck.”

The intention is to process the trauma to the point where it isn’t a debilitating memory or a situation that you relive over and over again, she said. An EMDR session or sessions can essentially help people desensitize the trauma.

“If our brains are stuck in… perceiving a threat, we go into a survival state where we are not in our intelligent, prefrontal cortex mode,” Notestine said.

The process helps to take a specific memory and turn it into something that can be recalled without reliving the trauma. It’s also intended to remove negative personal feelings associated with the trauma, for example if a person is holding onto unwarranted blame or guilt about an incident. A patient may need to work through different aspects or “triggers” before being fully able to process the full traumatic incident.

Notestine said she’s found EMDR to be effective in helping people move on.

“What we know about trauma is that simply talking about trauma does not make trauma go away, and often times people can retraumatize themselves when they have to continue to repeat their story,” she said.

Note: The Safe Passage Violence Prevention Center has a 24-hour hotline. If you are a victim of violence or are in fear for your safety, call (208) 664-9303 for immediate assistance, or visit www.SafePassageID.org for more information.

For more information on EMDR and other trauma-related counseling inquiries, contact Ashely Notestine at (208) 717-1208 or visit www.EvergreenTherapyCdA.com

Emotionally Focused Therapy

Stacy Card is a licensed mental health counselor and has her own practice in Spokane Valley. She specializes in Emotionally Focused Therapy (EFT) for couples, helping marriages that have grown apart or have been stuck in cycles of conflict.

“(EFT) is based in attachment theory, with the premise that just as children bond with their parents or caregivers, couples form a bond as adults,” Card said. “When there is distress or disruption in their relationship and disconnection occurs, couples get into predictable distress cycles.”

The process was conceptualized by Dr. Susan Johnson and Dr. Leslie Greenberg in the 1980s, and Card said research studies have found the counseling process to help couples make significant improvements to their relationships. She said it offers a process offers a new experience to a relationship rather than a behavior modification that ultimately isn’t sustainable.

“We don’t just tell clients to stop doing the ‘bad’ behavior and start using tools to help them behave ‘good,’” Card said. “I have found that when couples are guarded, hurt and don’t feel secure in their relationships, they are unlikely to use the tools they learn at marriage workshops and through self-help books.”

An EFT therapist helps couples identify common patterns that define the conflict that leads to partners feeling alone and defeated in the relationship, Card said. Nine steps within three stages of the therapy process help the couple move from distress to more emotionally-connected, she said.

The first stage focuses on mapping the distress cycle in a relationship, working to understand and organize “distressful interactions instead of pathologizing behavior,” Card said.

“We all have behavior that we don’t necessarily want to do and may agree isn’t healthy or helpful but have been unsuccessful in stopping,” she said. “We often feel the same way about our spouse and think, ‘if they would just stop doing fill in the blank, our relationship would be fine.’”

“At the end of Stage one, couples are de-escalated, less reactive and more attuned to themselves and their partner,” Card continued.

Stage two involves “reorganizing and restructuring the attachment bond so that couples can be accessible, responsive and engaged,” Card said. In Stage 3, couples look to find new solutions to their issues.

Card said the therapy process can take anywhere from 12 to 30 sessions or more depending on levels of distress or factors like an affair or past trauma. She did say, however that emotionally-focused therapy is not recommended if there is ongoing abuse and/r physical violence present in the relationship.

For more information on emotionally-focused therapy for couples, contact Stacy Card at (509) 534-1600 or visit www.SCCounseling.net for more information.

Worth Repeating: If you are a victim of abuse and/or are in fear for your safety, call the 24-hour hotline for the Safe Passage Violence Prevention Center at (208) 664-9303 for immediate assistance, or visit www.SafePassageID.org for more information.