• Do you have a deep desire for connection yet a deep fear of abandonment?

• Are you used to living in scarcity with unmet needs and lack of love?

• Have you been on the receiving end of betrayal trauma?

• Are you unable to stop your addiction and/or hurting those you love?

• Have you been involved in a single incident trauma or the subject of repetitive emotional, sexual and/or physical abuse?

We all experience trauma at one moment or another in our lifetime; most of us more than one.

Trauma is a fact of life. It does not, however, have to be a life sentence.

Trauma happens in everyday life. It shows up in so many ways. Veterans deal with the painful aftermath of combat; one in five people have been molested prior to the age of 18; 18% women have been raped; over 2,700 died in 9/11, yet it touched the lives of millions. Statistics are infinite. And these are the ‘big T’s’. Death, divorce, health changes, job loss, addictions, terrorism, being bullied—these are all traumatic events we face on a daily basis. Less severe trauma can be overwhelming on the psyche as well if the event is too much for our ego to handle.

Developmental trauma occurs when “emotional pain cannot find a relational home in which it can be held” (Epstein, 2014). Vulnerability to trauma, resilience, varies as a function of ego strength, early bonding and attachment, trauma history, developmental maturation and genetic predisposition. It is understood that when the trauma is too big to process and we are unable to fight or flight, energy gets deactivated and trapped on our neural networks. Symptoms include emotional (anxiety, panic, nightmares, rumination, depression, helplessness, etc.) and physiological (insomnia, chronic pain, migraines, gastrointestinal issues, etc.) manifestations. The dissociative continuum reflects symptoms that result typically from repetitive trauma to include, for example, states of compartmentalization, dissociation and full fragmentation.

Developmental trauma directly affects our core needs—connection, attunement, trust, autonomy and love/sexuality, and for each there is a survival pattern. Early trauma challenges the healthy formation of self-regulation, self-esteem and capacity for relationships. At the time, these coping patterns are effective. However, these same strategies prove ineffective as we attempt to negotiate healthy relationships—with others, sex, food, money and objects. Developmental trauma shapes our relational, emotional and physiological patterns.

We deal with trauma on many levels but typically we dissociate from it, we leave it, we avoid it. Trauma repetition, or repetition compulsion as it was formerly labeled, delineates the reenactment of the trauma as a means to control that which we were unable to. Acting as a sex worker may in part be an indication of earlier child sexual abuse. Working through betrayal trauma will often re-activate the experience and associated emotions. Each pattern holds with it specific connections to the original trauma; these need to be addressed in treatment.

Trauma and Post-Traumatic Stress Disorder are typically identified in treatment of the following:

• Anxiety Disorders
• Behavioral problems
• Dissociative Disorders
• Infidelity and Betrayal
• Mood Disorders
• Personality Disorders
• Sexual Dysfunction
• Substance and Process Addictions
• Violence

In response to trauma we leave; that is the first step towards dissociation. There is, however, a continuum of adaptive responses that reflect our degree of alertness and detachment. At one end is distraction. At the other end is a numbing and a splitting off of the experience and all of the components (thoughts, emotions, sensations, feelings) that accompany it. When child abuse is severe and ongoing, there is a compartmentalization of the memories that have split off into separate and distinct personalities. It is the brain’s only way to adapt to an intensely stressful situation.

Some experience numbness, some depersonalization and some have what was formerly called multiple personality disorder, now referred to as dissociative identity disorder. Chronic and intense developmental trauma can result in split-off parts of the self, akin to what has been seen in the Three Faces of Eve or Sybil, or more recently glamourized Hollywood depictions. This is real, and with the appropriate therapist, treatable.

Dissociation plays a role in addictions and the failure to establish healthy relationships. Individuals who struggle with complex trauma and dissociation are laden with loneliness, isolation, emotional dysregulation and the inability to experience attunement and secure a healthy attachment.

Recovery from a traumatic event, any event, but particularly one deemed as catastrophic, requires not that someone return to normal, but find a new-normal or a new level of homeostasis. No matter how touched by the event, whether up-close or from a distance, we are, in some manner, forever altered, necessitating the establishment of a new equilibrium.

As we begin to integrate the experience, there is both progressive and regressive movement as trauma materializes in our thoughts, emotions, memory, identity and body elements. While there is often an attempt to shut-down and avoid, there is a simultaneous awakening as intrusive symptoms emerge (flashbacks, dreams, thoughts, body memories etc.).

The adaptive-information processing model provides a structure in which to assimilate the new experiences into our already, sometimes strong yet frequently fragile, existing networks. It is the model upon which EMDR (eye-movement desensitization re-processing) is based.

In the recent aftermath, in the weeks and up to a year following a catastrophic event, memories begin to become consolidated. With early emotional dysregulation, there is a need to contain and begin to organize the events.  The R-TEP (Recent Traumatic Events Protocol) and G-TEP (Group Traumatic Events Protocol) protocols allow for early intervention and a focused processing of the trauma so that symptoms subside and further work can be processed.

As an EMDR certified therapist, Dr. Winter provides assistance to the teens and families for the trauma from recent events that occurred in Parkland.

Eye Movement Desensitization and Reprocessing (EMDR) is a method, originally developed for single episode trauma but is utilized in developmental trauma as well, that brings about change to the distress associated with traumatic and unsettling memories. Using a specifically designed protocol and through the use of bilateral stimulation during the retrieval and activation of the traumatic memory, new neuro-pathways are made. Emotional and physiological activation is reduced and negative and limiting beliefs are modified. Dr. Winter has been using EMDR since 2007 and is an EMDRIA certified practitioner.

EMDR is a powerful tool utilized in trauma processing. Please refer to my EMDR page for a more detailed explanation of the process and the importance of selecting a qualified clinician.

Dr. Winter offers weekly EMDR sessions in various formats. EMDR is often interwoven into weekly therapy however there are various protocols that can effect change faster and more efficiently. EMDR can be done intensively (2-3 hours sessions scheduled as needed) or in an intensive, working over subsequent 2-3 days on either a single episode trauma (ie-shock trauma) or on more developmental and ongoing trauma in a storyclearing intensive , both done in 2-3hr sessions per/day. Intensives are for those out of the area or who want a more rapid intervention. Check out more on intensives and their benefits here. 

There is multiple research and treatment in areas of neuroplasticity, developmental and shock trauma, attachment and separation, combat veterans and post traumatic stress disorder, childhood trauma and dissociation, and addictions and more.

Dr. Winter knows that the effects of stress and trauma linger and show up unexpectedly in our lives and our relationships in painful and confusing ways. Whether it is a single incident trauma, ongoing wounding or childhood trauma showing up in your present life, she can help you heal from the anguish and move on. Learning to observe your thoughts and embrace your pain as well as understand and change your reactions utilizes talk therapy (both traditional and current day methods) and mindfulness based practices. In addition to these methods of trauma counseling, Dr. Winter offers and is certified in state-of- the-art Eye-Movement-Desensitization and Reprocessing therapy, which is a rapid resolution process that addresses the trauma head on.

“I don’t have the time or the financial means.” . . . It’s hard sometimes to prioritize our needs and take care of ourselves, especially when there has been a trauma history; it’s an ingrained survival strategy to not take care of yourself. When you have lived with trauma and the daily limitations and unhappiness or dissatisfaction, It’s hard to know that life can be different. It can; your pain does not have to define you! Therapy is an investment in you.

“I have heard from others that the work is painful, and I don’t know if I can do it.” . . . Although unavoidable, trauma work can be painful as memories from the past and present together may cause flooding; there can also be challenging times between sessions. It is important to go at one’s own pace. Plus, treatment will teach skills to manage symptoms and moments of activation. Learning how to withstand and process your pain without falling apart is part of the process.