Lydia Peckover on art and play therapy, EMDR and DBT skills
Lydia Peckover is a Northwest Family Life affiliate therapist working with children, teens, parents, individuals and couples. Her specialties include trauma and PTSD, behavioral issues, and life transitions. She often works with art / play therapy, EMDR and DBT skills.
Research shows encouraging results around art / play therapy, especially when compared with talk therapy. Can you talk about this?
Dr. Karyn Purvis states, “Scientists have recently determined that it takes approximately 400 repetitions to create a new synapse in the brain -unless it is done with play therapy, in which case it takes between 10 and 20 repetitions!” To put this in perspective talk therapy requires about 400 instances of talking about the new habit before the brain creates a new connection to exhibit a new behavior with more ease. That is more than a year of weekly sessions! Play therapy would take about 10 to 20 sessions before the brain would create a connection to do the new behavior. Why? Because the brain is more active when we use a sand tray, play, art, music, movement, and/or creativity. This research encourages people to be more open to using play therapeutic techniques in therapy, such as a sand tray.
About half of your work is with children. Can you tell us what happens in sand play?
A sand tray is an Expressive Arts and Play therapeutic technique. The goal is to express your thoughts in the sand. The person (of any age) creates a story in the sand using miniature characters, objects, etc. This form of play therapy is a way to see our thoughts (or the story) as objects in the sand, and it helps to organize our thoughts to help us feel better. A sand tray helps all ages and can be used with dry sand (trauma sensitive) or wet sand, using warm water.
You also use expressive arts therapy with adults. How is using art to access different parts of the brain effective?
Expressive Arts is a way of communicating without necessarily using words. Brain scans have shown more activity in the brain when using creativity, art, music, and movement than when a person is using speech alone. I use somatic experiencing therapeutic techniques, expressive arts, and even “sessions while walking” in therapy because I have seen that when people use more areas of the brain in therapy it speeds up the healing process. Our brain naturally wants to help us heal, we might as well allow more areas of the brain to participate in therapy!
You do a lot of work using dialectical behavior therapy (DBT). Can you tell us about the skills that DBT teaches?
The four types of DBT skills includeMindfulness (being present to experience what’s happening now as a way to take a break from worrying about the past and future), Distress Tolerance (Dr. Marsha Linehan describes it as “how to survive the crisis without making it worse” and skills to “accept”), Emotional Regulation (understanding emotions and using skills to maintain a balance), and Interpersonal Effectiveness (people skills). Many people I work with tell me they like to learn DBT Skills because each skill is described simply and it’s like having an instruction book on how to live a better life.
Who can benefit from utilizing DBT skills?
Everyone, young or more mature, can benefit from using DBT Skills. This is a behavior therapy that helps us change behaviors to “live a life worth living” and to “reduce pain and suffering.” (quotes by Dr. Marsha Linehan, founder of DBT.) I use DBT Skills with children, teens, adults, parents and mature adults. Parents find helpful skills to parent more gently and effectively. DBT is an evidenced based practice for suicidal ideation, bipolar disorder, borderline personality disorder, depression, anxiety, and trauma/PTSD (Post Traumatic Stress). DBT is well researched and proven effective with addictive behaviors as well as preventing nightmares, sleep disorders, grief, schizophrenia, and many other mental health disorders. People who are suicidal come in for DBT Skills therapy because of the pain of living. I have seen many begin to use DBT Skills and begin to participate fully in life.
Tell us about your work with EMDR trauma therapy and how it can heal trauma wounds.
EMDR therapy, founded by Dr. Francine Shapiro, uses the Adaptive Information Processing (AIP) theory; it is our body’s natural tendency to heal itself. For example, with a bacterial infection, our body automatically works to heal the infection. Using the AIP theory, EMDR therapy’s goal is to activate the brain using bilateral stimulation (left and right sides of the body) with either eye movements, sound or touch (like tapping) so the brain can be fully on board to reprocess stressful/trauma memories.
These memories are stored improperly in the brain and cause a trauma response. After EMDR therapy people have found results such as lack of distressing thoughts, emotions, and body sensations. Here is an example of healing traumatic body memories: A survivor of domestic violence has discomfort in a new relationship because they cannot be touched without being triggered by a body memory from past abuse. After using EMDR therapy, this person has reprocessed the body sensations and has no body triggers. This person can be touched and feel the natural feelings of safety and healthy attachment in the new relationship.
EMDR therapy is an evidence-based practice for PTSD (Post Traumatic Stress Disorder). It has been shown to effectively relieve anxiety, depression, chronic pain, migraines, addictive behavior, grief, insomnia, and more. Some therapists listen for negative beliefs in therapy as an indicator of who can be helped by EMDR therapy, because they believe the anxiety, depression, pain, etc. were likely caused by the negative beliefs about themselves.
Negative beliefs such as, “It’s all my fault,” “I have no control,” or “I’m not safe” are formed at the same time as a stressful situation or traumatic event. The goal in EMDR therapy is to create positive beliefs. Holding positive beliefs about one’s self can reduce trauma responses such as depression, anxiety, unexplainable pain or sickness, overreacting or feeling numb, feeling triggered, memory absences, avoidance, nightmares, etc.
Many people have said EMDR therapy has fast results, especially in children and teens. EMDR therapy can be used with other therapeutic techniques such as Attachment Focused therapies, Expressive Arts, Somatic Experiencing (body work) and Play therapy. There is a need for assessment and preparing people for EMDR therapy. DBT Skills help prepare people to stabilize behaviors so they are ready for trauma therapy such as EMDR therapy.
Talk to us about “Installing a future template.”
EMDR therapy provides many therapeutic techniques that help therapists become more effective and efficient. EMDR therapy works on the past, present, and future. Installing Future Templates is an EMDR therapeutic technique that helps therapists see how the person would handle stress in the future. Installing a Future Template also identifies any developmental gaps. For example, if a person experienced a medical trauma, child abuse or substance abuse (such as drug use) in their teen years, this traumatic event could stop or delay development. The adult may need skills to be able to understand their own identity or have difficulty solving problems on their own because they were unable to learn these vital developmental skills as a teen. So we would work on those skills in therapy. Installing Future Templates is a quick check-in and helps a person assess ability just by asking a few questions.
You also work with couples. Tell us about using Gottman skills and DBT skills in this work.
Many times couples ask for the Gottman therapeutic techniques in therapy because of it’s great results. I have found many couples need steps before jumping into using Gottman’s techniques. DBT Skills can be used as steps to help couples understand how to communicate better in a relationship. For example, DBT skills such as the GIVE skill (be gentle with yourself and others, act interested, validate the valid, use an easy manner) can be used to build healthy relationships or the FAST skill to keep your self-respect in relationships. These Interpersonal Effectiveness DBT Skills may be used with Gottman’s “Four Horses of the Apocalypse,” the predictors for divorce (Defensive, Criticism, Contempt, Stonewalling). Also, sometimes therapies can cause a trauma response in those who are trauma sensitive. This is why treatment plans in therapy are unique and tailored to the individual and/or couple’s needs. Some find DBT Skills as a more trauma sensitive approach for couples, yet there is such an effective framework provided by the Gottman Institute. For couples, I like to use both Gottman techniques and DBT Skills.
In your work with families, you’ve said that a big part of it is teaching parents how to calm down. If the parent can self regulate, what can follow?
When the child’s environment is calm the child can work on issues causing distress and engage in trauma work. As the child or teen does their therapy, I continue to work with parents toward healthy attachment with their child and what is developmentally appropriate.
How can trauma affect developmental stages?
Trauma responses include fight, flight or freeze modes. Reliving the traumatic event can mean living in one of these states, in other words, a pretty intense survival mode. These high levels of distress cause our brain to focus on surviving the danger and development is put on hold. An example is a child who experienced early childhood trauma and has speech delays. Later on, the child needs support to develop speech.
Another example is if a person experienced a medical trauma or substance abuse (such as drug use) in their teen years. This traumatic event could have caused their development to stop during the time of danger and could cause a gap in their development. As an adult, they may need support to be able to understand their own identity or have difficulty solving problems on their own because they were unable to learn these vital developmental skills as a teen. So we would work on those developmental skills in therapy.
You can connect with Lydia via her website, https://arisewellcounselingservices.com