Ryan Chambers is a NWFL affiliate therapist. His clients often include people struggling with stress, depression, traumatic experiences and anxiety. He speaks to us here about therapy as a place to be seen in order to find options for change.
You’ve said that how we make sense of the world influences how we experience it; that our stories inform our patterns. Can you tell us more?
Oh, this is such a great topic. I developed my clinical mind at a graduate school that bridges psychology and theology. I made that choice because I think how we make meaning is hugely important to the patterns we develop and the limitations we face. As a therapist, I’m not in the business of shaping people’s beliefs but I think it’s hugely important to connect with threads of meaning woven through their lives. For example, the process of being seen is important to me. It shaped my previous work. And if I look back across my life I can see how that need that I faced outward speaks about an internal need I was trying to work with.
How does your work as a photographer dovetail with therapy?
Great question… I spent about a decade really focused on visual language and the power of bearing witness. The medium of photography relies on this process of taking the time to see: people, space, light, etc. And as I spent more time working with portraiture, the process of bearing witness started taking on an almost spiritual dimension. I think the process of being seen is, itself, healing. I realized therapy could be a way of moving more directly into that space. At the core of our work is a hope that if we sit with our clients, they’ll teach us who they’re becoming. It’s a process of unfolding.
You’ve said that you can’t really intervene or change something before someone feels seen. Can you talk about this, in the context of therapy and with children?
Ha! This is a great lesson my toddler’s been working with me on! The work of connecting with people is really one of being with them where they are even if it doesn’t make logical or emotional sense. And my son’s been driving home the point in a multitude of creative ways, mostly dealing with food or how I put his clothes on. He’s teaching me to find language for his experience first, wait for the connection, and then look for options. Dan Siegel talks about it with the shorthand of “connect and redirect.” This has been the same process my clients have been teaching me too, I need to see them first. When they feel felt options for change open up.
Talk to us about health as an integration between the mind and body of an individual and of other people.
With integration, I’m thinking within the context of Interpersonal Neurobiology (IPNB). IPNB offers me a really grounding framework of the mind being a relationship between body, brain and others. And it looks at health as a flexible exchange of energy and information between the parts. The really amazing thing is that who we connect with and how we connect with others is actually part of our mind, not just our mind connecting to another mind. It’s an actual neurological patterning. With this framework depression isn’t just a psychological problem and trauma isn’t necessarily an individual problem. So my work is about looking for areas where the flow of energy or information gets rigid or chaotic, understanding how that process is meeting an important need for the people I work with, and then looking for ways to honor that need better.
You mentioned that the WA state dept of health came out with a study on the mental health impact of Covid and that the risk right now is depression from loneliness and disconnection.
Yeah. The Washington Department of Health came out with predictions of the impact of COVID on the general population. And while trauma was my first thought they actually think depression is the most likely result. The level of psychic and bodily isolation that we’re experiencing is pretty amazing. We’re pack animals and connecting to others involves all of our senses along with our big fancy brains. Technology allows me to reach across space to connect with my family and clients. But the creature of me doesn’t feel the same sense of belonging. So it can be helpful to think about what that creature needs: maybe participating in an old hobby, eat food that smells like home, maybe looking at family pictures or listening to music from a time when life was full of expectation.
One of the “stabilization tools” I use in EMDR is peaceful place or safe space imagery. And we go through the senses in the environment the person is creating. While working with a client in my general practice we realized we could use the same technique with remembering people… creating space to go through what it feels like to be with them and connecting to each of the senses. It allowed my client to enhance their feeling of connection with others through drawing on the latent memories of connecting. I imagine there’s some potential there for developing a more secure attachment as well.
You incorporate EMDR into your work. Would you explain briefly what this is, in lay terms if possible please?
Yeah, I remember first hearing EMDR and thinking there’s no way I can guess what that means. It stands for Eye Movement Desensitization and Reprocessing. Helpful right :D?!? Basically, we learned that when there’s quick eye movement back and forth it seems to initiate a process that’s akin to REM sleep. And that process has the effect of reducing the intensity of feelings, desensitizing. So it’s used a lot with PTSD and severe anxiety. But it can also be used with addiction and problematic arousal. The goal is to reduce the severity of emotions when a certain part of us gets activated and then link that part of us with a better-resourced part of ourselves, reprocessing. My favorite description I’ve heard is that like a zipper we want to zip this more scared part of ourselves with a more capable, integrate part of ourselves. So when the scared part gets activated again we can access these other faculties. It’s kind of magical. But certainly doesn’t replace therapy because often there’s little internal structure in the areas of our lives that were filled with intense fear.
How can parenting be a chance to re-parent oneself?
Oh man. So when we interact with the brain of another, especially in distress, our brain fires as if it were in the same situation. And then, if we can’t reshape our experience, we recreate it. So through each of my kids’ ages, I’m coming into contact with these young parts of myself. And my default is to recreate the experience I had for my kids. My work as a parent is to slow down this process and make choices at those critical junctions so that I can both shape my child’s experience differently and, because memories change when we recall them, I also change my own.
It sounds pretty tidy when I type it out but it’s actually a pretty painful experience. I lost my dad when I was pretty young so there’s this kind of voidy abyss that I’ve been working with. And parenting my kids is bring me ever closer to the edges of those experiences. Moving towards change and healing can sure involve a lot of pain.
Talk to us about stress response systems overdeveloping, as in the case of trauma.
There’s a lot of different ways we can speak about trauma. I’ve liked hearing it talked about as an overdevelopment of the stress response system. Some life circumstances required us to be stronger than we should be and these muscles overdeveloped. The effects can be debilitating but it’s actually our body’s best effort to keep us safe. And my goal working with my clients is to help develop the other internal muscles to match the strengths they already have: the ability to acutely monitor their internal state, the ability to shift their mood, the ability to grieve, the ability to reliably connect with others…
How do we calm our distress systems when they are activated?
What an important question. Polyvagal Theory has been really helpful in shaping how I work with the symptoms of distress system activation and how I conceptualize healing since it really focuses on the body response. In really general terms, our system is telling us it feels unsafe. First, we honor that and look for immediate danger. Assuming there isn’t immediate danger, we want to communicate to our body that it’s safe. The urge is normally to solve problems with our minds. But the issue is that the alarm is too sensitive or going off too intensely. Trying to use thoughts to solve the problem can often enhance the distress. Instead, we want to focus on turning off the signal. There are different routes for that and everyone will have their preferences: getting a hug, exerting physical energy, taking a bath, crying. But ideally the actions we take communicate to the creature of us that we’re safe. There’s a lot more to it but hopefully this offers a frame.
Would you speak to some of the ways that people get prepped for domestic violence?
For many of my clients, we often discover that DV relationships echo or link up with other relationships. And we often discover there were ways they were prepped for the DV relationship. I haven’t discovered a tidy way to say exactly how. For some, it seems to be feeling overly responsible for others or finding an external voice to echo an internal negative self-perception, for others it’s the sense that they aren’t allowed to have a mind that’s different from those they love. So working through a DV relationship often involves grieving deeper wounds. Therapy is a place to bring curiosity and care to these parts of our story. And the rewards of the work are greater resiliency, connection with others and belief in yourself. It’s a hugely hopefully process and one I’m often in awe of.
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