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Creating Insight Alleviates the Intensity of Emotions

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Psychoeducation is an intervention that in certain cases provides a permanent cure for a client who struggles with feelings of worthlessness and/or guilt due to their past behavior. A therapist who explains to a client that dissociation is a coping strategy that helps avoid painful reality by providing a person with the escape he/she needs to avoid pain he/she is unable to tolerate. Dissociation is in the form of the client either binge eating, sex, and/or drug addiction rather than accepting excruciating pain. This provides a scientific explanation for promiscuous, gluttonous, or derelict behaviors over which the patient has no control and leaves them with feelings of shame and worthlessness. This knowledge alleviates their poor self-esteem and belief that these behaviors define who they are rather than an expression of agony too painful for them to bear and a need to release the intensity of the pain.

 

Mary is a woman in her seventies who is an only child of a veteran who fought in World War II in active combat. Her father never spoke about the horrors he witnessed nor was he proud of his service. He was a very short-tempered man who was constantly hollering at his wife and daughter who tiptoed around him fearing an outburst. Mary described him as a very stingy man who physically abused her using a belt when he spanked her that left welts on her skin. These abusive behaviors left her with poor self esteem and memories of feeling worthless. Her promiscuous behavior exacerbated her shame proving to herself that she is both bad and worthless. Furthermore, her poor choice of a marriage partner who was unfaithful and was emotionally abusive toward her was another consequence of her poor self-esteem. She found solace in having multiple affairs during her marriage that continued after her marriage which temporarily alleviated the intensity of her loneliness while simultaneously eroded her self-esteem and subsequently validated her father’s admonitions.

I used visual aid psychoeducation to educate Mary regarding the effect of trauma on our body. Mary was able to recognize her addictive behavior for sex as dissociation, an unhealthy coping strategy rather than promiscuity. Unhealthy coping strategies are what we resort to in desperation since healthy coping strategies are skills that we learn when our left brain, more commonly known as our thinking brain, is online. Trauma turns off our left brain so that our reptilian brain can protect us from danger. The reptilian brain resides in our brain stem and is seven times faster than our thinking brain. Since speed is essential for survival, the left brain automatically shuts off allowing the reptilian brain to use the speed that is necessary to fight imminent danger. The left brain remains shut off whenever any part of our five senses remotely resembles the scene of the trauma. The right side of the brain is the emotional part of the brain that processes the information using the five senses. The amygdala, the safety alarm of the brain is in the right part of the brain as well and stores the information provided by the five senses at the time of the trauma. Therefore, whenever anything remotely resembling the trauma such as a familiar feature of the villain, a similar noise such as a song, an odor is the most effective trigger that stimulates the amygdala that danger is imminent. The amygdala summons the body into danger mode which often triggers dissociation as a means of coping with these overwhelming emotions. Dissociation is a defense often manifested in dangerous behaviors such as binge eating, alcohol, sex, and drug addictions since these behaviors protect the victim from reexperiencing the trauma that is too overwhelming for the victim to fathom.

 This psychoeducation alleviated my client’s shame and helped her come to terms with her past, recognizing that her father was experiencing flashbacks and saw her as the enemy he fought in combat. She was able to have the peace of mind to forgive both herself and her abusive father once she understood the logic behind the destructive behavior.

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