Hello everyone! We're back for Week 4.

If this is the first time you’re reading this, welcome! We’re so happy to have you here. However if you’re just starting out please do head back to the first session. We build on material throughout the weeks, and we don’t want you to miss anything!

The goals for this session are:

• Learn about different trauma approaches in therapy
• Understand how a therapeutic space and relationship works
• Knowing your options

As always, let’s start with our grounding exercise!

**Today’s grounding exercise will be…
**Imagine yourself as an animal. What would it be? Imagine yourself moving as that animal. Are you swimming? Are you crawling on the ground? Do you make a sound? And do you have fur, or smooth skin, or some other texture? Take a moment to inhabit the body of that animal.

Fun question: Do you have a particular kind of video that you find relaxing?

Today, we will be focusing on trauma therapies. We will be walking you through some of the best and most well-known approaches, so you can learn about them and maybe consider if any of these sound right for you to pursue outside of the course.

Historically, there have been a lot of taboos when it comes to going to therapy, requesting mental health support, or simply asking for help. Sometimes, it’s not well-seen in our culture at large. Or it’s unknown within our families.

Sometimes, we approach therapy with an internal belief that we are weak if we seek out that support. Let us reassure you that asking for support is a sign of strength. It speaks of high emotional intelligence to be able to tell when you are reaching your limits and need a hand.

Think of it this way: imagine there’s a table in front of you and on it is a glass jug. In it, there is clear water. This water represents all of you. Slowly you start adding sugar and salt to that water. It starts to dissolve. You take a spoon and start spinning it to speed up the process. But, as time goes on, and there is no stopping whatever sugar or salt that gets added to our lives - the good and the bad. And, no matter how hard you spin the spoon, there’s no way one person can work hard or fast enough to keep dissolving what gets added. In fact, now that the water is cloudy with visible particles, the spinning only spins out the precious (and limited) water. Why is this? Because the water has reached its saturation point. This is the stage beyond which no more of something can be absorbed or accepted. You could think of yourself as the jug and the clear water.

Your asking for help speaks of your willingness to work on difficult things. Of your openness to try new things that can help you grow and feel better. Let’s remove the shame of asking for support once and for all. Also, nobody needs to know if you don’t want them to. Therapy is your business. There is nothing to be embarrassed of but you also have no obligation to tell people how you are choosing to work on your recovery. Just know you are not expected to go through this on your own.

At Bloom, we may be guiding you through new topics and techniques, but we believe that you are the best expert to decide what works best for you. There’s no therapist that will know better than you do and what you need, unless you have a medical issue that needs to be treated with intensive care or specialised treatment. So - while it’s likely that therapists will ask you a lot of questions to try and understand what kind of support you are looking for, what usually works for you, what doesn’t, and what you expect from a therapeutic space - it can be reassuring to remember you have control over your therapeutic process. This is something you can communicate to your therapist, so that adjustments can be made to make things easier and more accessible for you.
For example, some people really benefit from knowing what they will be working on in each session in advance, it helps them reduce their levels of anxiety before the session and prevents disengagement from therapy. Know when you go into these resources, that you get to ASK for what type of learning may suit you best.

Another thing to take into account is that, as with most things in life, compatibility and interpersonal connection play a big role in the therapy process. If you meet a therapist and do not feel comfortable, it’s okay to decide that it was not a good fit. The important part is to try different tactics and people and interactions - and not to see this as a personal defeat or abandon the idea of therapy altogether.
We know for many who have joined the course, therapy was not the right fit for you, or has been an aggravating process. However, we don’t want your therapeutic journey and relationship with self-processing to be cut off or limited be over just because you haven’t found the right therapist for you, or had the best past experience.  Human connections and relationships are not always a success. Just because someone is qualified and a professional, it doesn’t just happen that you automatically like the person you have in front of you, or that you have to feel comfortable. The therapeutic relationship can take some time to grow, so we would suggest giving it a bit of time. But, if it’s not working for you, there’s nothing wrong with moving on until you find the right person.

Now, we are going to disclose two main psychotherapy approaches for people experiencing PTSD.

Cognitive behavioural therapy (CBT): in this type of therapy, you talk through your experience with a professional who helps you make links between your thoughts, feelings, and behaviours. CBT targets current symptoms and problems, and you work as a team to identify unhelpful patterns in your thoughts and feelings related to your trauma, including our "stuck points." Stuck points are certain thoughts related to the trauma that are preventing your recovery, like what we avoid.
The goal of this therapy is to help you gain a greater sense of control in your thoughts and behaviors, feel new hope for the future, as well as help you to change or reduce past negative coping mechanisms or negative personal beliefs.

Eye movement desensitisation and reprocessing (EMDR): EMDR is a growing treatment in the field of trauma therapies and it can help reduce PTSD symptoms: such as being easily startled. In this kind of therapy, the therapist helps stimulate both parts of your brain by making you tap your knees or by following an object with your eyes while recalling a traumatic event. The rapid eye movements are intended to create a similar effect to the way your brain processes memories and experiences while you’re sleeping. The process allows your brain to re-integrate the sensory information from the traumatic memory without our attentional mechanisms becoming too over-stimulated. This method usually involves less discussion over the traumatic event, so it can work well for people that find it very difficult to talk about their feelings.

There are also other therapy approaches with less scientific validation but that still help many people around the world:

• Psychodynamic therapy (also known as Psychoanalysis): helps us connect our behaviours with the unconscious feelings and motives we may be repressing. Catharsis and the use of the therapeutic relationship (also known as transference) can be very helpful in reinstalling a sense of safety and trust for people experiencing trauma.
• Narrative Exposure Therapy (NET): the aim is to build a chronological narrative with a focus on the traumatic experiences. The idea is that fragmented reports of the traumatic experiences can be transformed into a coherent narrative.
• Somatic Trauma Therapy: an integrative method with a main focus on “putting on the breaks”: teaching survivors ways of coping with the intrusive memories and focusing on safety as the main rule.
• Relaxing therapies such as **yoga, massage **and acupuncture can also help. These can help to alleviate some of the symptoms of hypervigilance, by helping us to relax and teaching us to manage stress.

This is not an exclusive list and people’s ways of coping with traumatic stress can vary depending on their culture, religious belief, personal interests, and many other factors. But many have found these therapeutic approaches helpful, which is why we dedicated this session to telling you about them.

The homework for this week is… Making some lists! We want you to make three lists in your thought diary. Focussing on the theme of how we can reach out for support whether or not we are attending therapy, these three lists are:

1- What I can do to help myself

2- What my friends can do to help me

3- What a therapist can help me with

Now’s a good point to remind ourselves - while it’s not essential to do the homework, we recommend doing it for a number of reasons. One of them is the sense of control - while we may have had our feeling of control or agency taken away from us in a moment of trauma, an important part of our recovery is regaining that feeling of control. Practising different kinds of techniques such as we’ve been doing in our homework - that address our body’s physical relaxation, our thoughts, our feelings, the ways we can reach out to our community for support - contributes to this process of regaining control.

So remember, this is an investment in your own journey to recovery. Give yourself the best chance to build resilience. You can do this.