Staff Therapist – Trauma Recovery Center

Gallatin Psychotherapy, Inc. (GPI) seeks a full-time licensed masters-level therapist or clinical psychologist to provide psychotherapy services with their Trauma Recovery Center. Please send CV and cover letter to Gretchen@gallatinpsychotherapy.com, or mail to Gretchen Lindner, Ph.D., 1902 W. Dickerson St., Suite 208, Bozeman, MT, 59718.

GPI is a well established and vibrant group-based private practice in Bozeman, Montana that strives to provide excellent individual, group, and couples psychotherapy. GPI’s current staff of five therapists has an emphasis on empirically-supported and state-of-the-art treatments; personal and professional growth; and enhancing client outcomes through consistent client feedback and explicit monitoring of therapy progress. We welcome you to visit us at http://gallatinpsychotherapy.com/ for further information about our practice.

We are looking to hire a mental health professional with specific passion and experience in the field of trauma recovery and PTSD. Someone with an openness to learning new approaches to therapy and to group consultation a must. This is a wonderful opportunity to be an integral part of helping to grow a trauma-focused center, and to learn new, cutting-edge therapies, such as Prolonged Exposure Therapy, Cognitive Processing Therapy, and Seeking Safety. Benefits include: billing/scheduling, health insurance, liability insurance, CEU dollars, group consultation, newly renovated office space, and provided referral base. Pay is negotiable and commensurate with experience.

The city of Bozeman is a small, but lively community that offers an endless amount of activities for the outdoor enthusiast. As it is surrounded by beautiful mountains, there are infinite opportunities for hiking, biking, skiing, running, and accessing National Parks. Bozeman offers an incredible standard of living, typified by year-round recreational and cultural events. The local Montana State University also infuses the community with additional intellectual vibrancy. Bozeman offers a small town feel with big city amenities.

Do you harbor hurt and resentment toward others or the one person closest to you? Do you have difficulty remaining calm under stress, or when threatened? Do you regret how you handle conflicts or upsets? Are you destructive toward people or things? Do you feel accused of having “anger problems” but unsupported in dealing with your own pain?

This group process will explore understanding sources of anger and resentment, trigger thoughts and impulsive behaviors, and underlying thoughts and beliefs about anger and obstacles to being free of compulsive behaviors.

The goals of the group include healing the hurt underneath the anger, creating healthy coping thoughts and positive personal beliefs about self and emotions, and creating healthy behaviors and relationships.

Are you unhappy in your close relationships? Do you find you are giving up your own needs, or putting up with abusive or neglectful behavior? Have you been attempting to help others change, or change yourself, without seeing any real results? Do you wonder about your own part in unhealthy relationship patterns? Do you know what a really healthy relationship looks like and how to create one?

This group will explore personality formation, how to build confidence and self-esteem, relationship dynamics, and effective ways to change unhealthy relationship patterns, including learning how to communicate in close relationships.

The goals of the group are to access and live with healthy personal power, and understand and know how to create and maintain healthy close relationships while accessing the healthiest parts of your personality.

Do past stressful or traumatic experiences still bother you? Have you had problems coping with past memories, strong emotions, or difficult relationships? Do you tend to fall back on unhelpful strategies to manage when things get hard, like drinking, smoking, over-eating, gambling, or over-working?

Seeking Safety is a class that is designed to help you learn how to cope with the lingering, negative impact of past experiences (e.g., sleep problems, anxiety, relationship struggles). In this class we do not go back and talk about the past, but instead focus on how to cope more effectively in the present, without relying on addictive and potentially harmful behaviors. The class will teach you skills to attain more safety, stability, connection, and happiness in your life.

This structured, manual-based class is well researched and shown to be effective in helping people heal from trauma and addictive behaviors. A new topic and skill will be covered each week, and the facilitator will provide handouts and practice exercises. The group will work together to decide on relevant topics from the manual, but can include classes covering ways of distancing from emotional pain, creating meaning, having compassion for yourself, coping with triggers, or setting boundaries in relationships.

What does being a strong, healthy man look like? Do you want to find more energy, passion and desire in life? Do you want to feel more powerful and in control of your life, while gaining cooperation and respect from others?

This group will explore aspects of masculine psychology, help each group member gain greater access to their own unique personality traits, and define what it means to be a healthy man.

Goals of the group include healing emotional wounding, growing personal power, discovering inner personality traits that support healthy personal power, and finding your own voice, goals, and desires.

Do you ever wonder what it would be like to live a healthy, energetic lifestyle that is free from depending on alcohol, drugs, shopping or other addictions to de-stress and find joy in social situations and life in general? Do you want to find more of your own energy and power, but find the lure of a drink or other addiction is too powerful to resist?

This group will explore the lure and costs of addictive behaviors, identify physical and psychological barriers to cutting back or stopping, explain why will-power alone is insufficient to change habits and addictions, and identify effective strategies for living addiction-free.

The goals of the group include understanding the effects of alcohol and other addictions physically and emotionally in the short- and long-term, understanding physical and psychological barriers to their reduction or elimination, and identifying pathways to finding joy and balance without addictions.

What would a day look like without restricting food, binge eating, purging, or thinking about food all day long? How would it feel to be comfortable in your own skin and feel confident about who you are as a woman? Imagine what life would be like without it being controlled by food.

This group will explore how our eating disorder dictates our every move, how it serves us, and how our life is structured around it. We will learn how our daily tasks, how we relate to ourself and others, and everything we do keeps our eating disorder in place. We will validate how our eating disorder benefits us and how we can achieve these same benefits in healthy ways. We will learn great new copings skills, learn how to recover from our eating disorder, manage stress and anxiety around food, and feel good about our own bodies.

Are you a business owner or manager? Do you understand how critical a high ratio of positive to negative interactions is to your organization’s success? Do you typically respond with genuine enthusiasm, positivity and effectiveness to whatever comes up during your work day? Do you have the attitude, knowledge, skills and support you need to respond positively and constructively to threats, conflicts, problems, and good news, in order that your organization and its people can flourish?

This class will review the science of positive psychology and its relevance to the workplace. It will explain why and how your organization’s Losada ratio (ratio of positive to negative interactions) is so critical to its success. The class will teach, coach, and shape methods of active constructive responding, how to differentiate active from passive responding, and constructive from destructive responding. Experiential exercises will cover a range of situations, from responding to good news, giving and receiving compliments, to expressing conflict, concerns, and responding to negative news and others. This class is focused on excellence and is not billable to health insurance.

We understand that many of our country’s servicemen and women have faced unique challenges and traumatic experiences during their deployments or while in service. Combat-related trauma can be particularly challenging, and can continue to cause difficulties even after returning stateside. We have significant expertise and experience in working with veterans and combat-related PTSD. We have treated veterans of all eras (e.g., WWII, Korean War, Persian Gulf War, Vietnam War, OIF, OEF) and have been trained in the PTSD therapies endorsed by the Veterans Affairs Administration. We would like to thank you for your service and open our doors to serve you.

The goal of the Trauma Recovery Center is to provide people who have experienced trauma with the very best treatments available to help them recover. We provide research-based, state-of-the-art treatments that are highly effective in diminishing problems associated with trauma and improving quality of life. Treatments include Cognitive Behavioral Therapy, Cognitive Processing Therapy, EMDR, Prolonged Exposure, and Seeking Safety. We work with each client to develop a plan that is best for them.

What is Trauma?

A traumatic event involves witnessing or experiencing a violent or harmful situation that is emotionally overwhelming. At the time of the trauma it is common to feel fear, helplessness, horror, or loss of control. Examples of trauma include physical or sexual assault, child abuse, accidents, combat experiences, and natural disasters.

Veterans and Active Duty Personnel

Common Symptoms of Trauma

• Trouble sleeping or nightmares
• Replaying the events in your mind
• Irritability or anger
• Relationship problems
• Feeling constantly on guard
• Numbness or the urge to numb out
• Difficulty being out of the house or in crowded places
• Increased anxiety or depression

What is Trauma?

A traumatic event involves witnessing or experiencing a violent or harmful situation that is emotionally overwhelming. At the time of the trauma it is common to feel fear, helplessness, horror, or loss of control. Examples of trauma include physical or sexual assault, child abuse, accidents, combat experiences, and natural disasters.

About Us

• Gretchen Lindner, Ph.D., is the Director of the Trauma Recovery Center. She is a licensed Clinical Psychologist who has spent her career specializing in helping people with trauma.
• We have a staff of skilled and well-trained psychotherapists.
• We are committed to excellence in quality of service and helping you accomplish your personal goals. We track our progress in meeting your goals in several ways throughout treatment.
• We meet you where you are and help you to move forward at your own pace.
• We teach you what you want to know about trauma and recovery so that you remain in charge of the process.
• We challenge you to clearly articulate your goals and help you find a successful path to achieving them.
• We engage you with warmth, friendliness, and empathy. Where appropriate, we engage you with light-heartedness, humor and creativity.

While people often seek psychotherapy to reduce symptoms of unhappiness, we find that psychotherapy can be most effective and beneficial when people also work to increase levels of happiness. To assess your degree of happiness, and to get a better sense of what happiness looks like, ask yourself the following four questions.

1. How protected and supported am I?

The more you feel protected and safe from emotional, physical and sexual harm, the more you can relax and focus your energies on positive interests and pursuits. Beyond providing an invaluable “secure base” that enables you to explore the world with confidence, the people you live and work with can be powerful sources of strength. You will flourish and grow when those around you ask about and support your needs and interests; when they are curious, empathic and insightful rather than judging or blaming when you make mistakes or fail; and when they are sources of calmness and compassion when you are distressed.

2. How lovable am I?

You are lovable to the extent that you know and care about your own needs, thoughts and feelings and are confident in asking others to consider them too. You are lovable when you are open and genuine about yourself, while expecting others to have their own, equally important, needs, thoughts and feelings. You are lovable to the extent you are comfortable “tuning in” and “putting yourself out there,” without feeling the need to use force or guilt to get what you want. As a small but illustrative example, if you don’t pay attention to a strong desire for some spicy Thai food, no one, including you, will care about what you want. If you don’t bother to mention it, your spouse won’t care. If you “guilt” your spouse into taking you out for Thai food, you may go but you won’t feel happy. If your spouse takes you out for Thai food without considering that it will make them sick or that they can’t afford it, you won’t be happy. If you and your spouse understand how much you’d love Thai food tonight, and make a decision to go out or not go out that doesn’t exaggerate or discount the importance of your desire, you will feel loved.

3. How responsible am I?

You are responsible to the extent that your intentions, actions, and words take into account not just one part of your mind and body, but all of you. When you remain aware of your whole self, you are not mindlessly driven by the need or impulse of the present moment, whether it be an urge to eat the bowl of potato chips placed in front of you or to respond to a friend’s request. For example, if your friend asks to borrow some money for rent, a part of you may be afraid to disappoint them, while another part of you may feel it is in your and your friend’s best interest to refuse. Ignoring the wise part of your mind in order to avoid disappointing your friend is being irresponsible. When you consider your whole self, you make wise rather than impulsive decisions. As you become more conscious of the large number of perspectives you have to any issue and are able to take more and more of these into consideration, you create increasingly less unintentional harm, and do increasingly more intentional good.

4. How powerful am I?

You need to feel empowered to have a positive impact on your own life, those of your loved ones, and your community at large. Accurately understanding and accepting what you are and are not capable of doing is key to being powerful, and to avoiding suffering over that which you cannot do. You are powerful when you feel you have choices in any given situation, and when you are confident that your choice is most beneficial. You are powerful when you know yourself well, and freely speak your mind clearly and with compassion. You are powerful when you rely on mutual desire and cooperation rather than guilt or threats to achieve your goals. You are powerful when you achieve your goals with the least force required. You are powerful when you take care of your body, mind and soul to feel physically and mentally strong and energetic. You become increasingly powerful as you become increasingly connected with people, knowledge, spirituality and other resources around you.

Easy but beneficial for all levels

• Grateful List. Each day, make a list of up to five things, including people, you feel grateful for, taking a moment to reflect on each one. This is a powerful way to shift your mood and feel more positive energy.
• Treat yourself every day to a 15-minute fantasy vacation, fresh-picked flowers, a slow self-massage, bath by candlelight or anything else you really enjoy and is guilt-free. Feel better immediately and slowly increase your self-esteem over time.

Moderate

• Integrity Stones. At the start of your day put 10 very small river stones in your left pocket or larger stones on the left side of your desk or kitchen sink, wherever they will be most accessible to you during the day. Each time you act with less than full integrity (complete fairness and honesty to yourself and others) move one stone to the right. Your goal is to reduce the number of stones on the right at the end of the day.
• Set Boundaries. Pay attention to the extent that demands and request from others are harmful to you. These could be direct, such as visits, phone calls or expectations others have of you, or indirect, such as noise and the flurry of distractions around you. One at a time, as you are able, set a boundary to reduce these. For example, you might turn off your cell phone for periods of time. You might say, “I only have 15 minutes to work on this.” You might replace distressing background noise with soothing music. You might say “no” to requests that drain you.

Difficult

• Be Nondefensive. Keep track of any occasions in which you feel judged, blamed or attacked. Instead of defending yourself or withdrawing, practice looking at the judgment, blame or attack for any portion that feels valid to you, and state your agreement with that. Practice doing so in a way that is lighthearted, nonjudgmental and forgiving of both yourself and the other.

Assert with Integrity.

Reflect on what you would like from others in terms of better understanding, cooperation, mentoring, or assistance. Ask for what you want without using any guilt, threat or coercion, in a such a way that it is great if the other says “yes,” but perfectly fine also if they say “no.” Keep asking different people until you find someone who wants to give you what you are looking for.

About 56% of Americans are securely attached. People become securely attached when they have generally experienced others as available, empathic, and supportive. People who are securely attached have tremendous advantages in life. They feel safe and secure, trusting someone will be always be there to support them if needed. They are free to focus their energy outward, explore the world, learn, accomplish and take risks. They feel genuinely good about themselves and their worthiness of others’ unconditional understanding and support. They tend to be open to new ideas and perspectives, and to see and take responsibility for their own imperfections without being self-critical. They tend to be highly aware and caring of their own thoughts and emotions. They tend not to be overwhelmed by negative experiences or feelings, but to care for themselves and reach out for support when desired. They have a stable, internal source of high self-esteem and are not dependent on other’s approval. On a typical day, they tend to have many positive feelings and few negative ones. When they have emotional impulses, they tend to pause before they act to select the most constructive response. They tend to have high work satisfaction and success, and to be realistic, flexible and adaptive in setting goals and how they go about achieving them. They tend to feel confident they can handle what life throws at them. They tend to be in tune with their bodies, be healthy, live long, and to have mature levels of religiosity or spirituality.

People who are securely attached also have tremendous advantages in their ability to get along with others. They tend to respond to others with openness, respect, and caring, even when they disagree, and to expect the same consideration in turn. They tend to see others as inherently good, even when others behave in harmful ways. They tend to be good at protecting themselves from unwanted demands from others as well as at enrolling others to help them achieve desired goals. They tend to understand, forgive, and constructively manage conflicts. When they hurt others, they tend to feel appropriate guilt and care for the other’s hurt. They tend to express themselves openly and nondefensively, and not to feel threatened by other’s accomplishments, difficulties, or differences. They tend to have a network of people they can rely on and care for and find simply being with those people naturally rewarding. When they lose a loved one due to death or breakup, they tend to experience normal grieving that eventually heals. They tend to keep their emotional bonds with those who have been lost through death or separation. They tend to feel confident they can build new relationships to meet their ongoing needs for closeness.

In short, people who are securely attached are emotionally and socially intelligent.

In an ideal world, everyone would be securely attached. In real life, war, poverty, natural disasters and tragic accidents happen. Parents become physically absent, preoccupied, anxious, overprotective, critical or controlling, or unable to protect their children from physical or emotional harm. Their children become insecurely attached and their children tend to raise insecurely attached children and so on, such that the effects of disasters on attachment can be felt for many generations. Insecure attachment, though less than ideal, is a normal adaptation to difficult real life circumstances, increasing survival in very stressful conditions. Researchers generally describe three main types of insecure attachment.

About 25% of Americans are avoidantly attached as a result of consistently painful past experiences with caregivers they needed to feel secure and safe with. People with avoidant attachment suppress their innermost feelings and needs for closeness. With avoidant attachment, the painful feelings they’ve had with those they’ve relied on are suppressed because they have no better way to deal with them. People with avoidant attachment tend to become highly self-sufficient, minimizing their own vulnerabilities and needs for support. They tend to set very high standards for themselves, and to be self-critical if they don’t meet those standards. They can often feel highly self-confident because of their ability to survive on their own. They can have a strong sense of accomplishment because they have been able to succeed without much help. Deep down, however, they tend to feel inadequate in some way. Their earlier life experiences may have created difficulty trusting that others will respond well to their emotional needs and vulnerabilities. Avoidantly attached people may expect to be hurt and may hurt others if they get too close. They may keep others at a distance by staying in control and discouraging intimacy. They may manage their relationships with others, tending to impress or placate. Avoidantly attached people can be well-liked and admired in the community at large but may have interpersonal problems when others see them as uninvolved, overly competitive, or controlling. People who are avoidantly attached tend to become defensive and angry when criticized. They may sometimes sense they don’t know themselves very well, and may feel more comfortable in work and community relationships than with their family. Romantic relationships may be rocky and may seem not worth the effort. Intensely uncomfortable feelings can occasionally arise, and people with avoidant attachment tend to do their best to avoid them or push them away. They may have a sense they are missing out on something, but may be skeptical that more to life is possible.

About 19% of Americans are anxiously attached. Anxious attachment results from inconsistent experiences of support, sometimes empathic and sometimes painful, from those they have relied on. Because people with anxious attachment have learned they can never be certain whether or not caregivers will be there for them, they tend to not be certain of their own self-worth or the trustworthiness of others. As a result, they may spend significant mental time and energy on their relationships. They tend to feel strong needs and desires to be close to others, but at the same time are wary of hurt and betrayal. They may be clingy, needy, helpless or demanding in their efforts to get what they need from others. They tend to feel vulnerable to rejection and abandonment and spend much of their energy paying attention to others whereabouts, well-being and emotions. They may have less energy to pursue personal growth and achievement. They tend to feel close to others and experience positive emotions on a daily basis, but may also feel many negative emotions. They may feel easily insulted and become angry at others when they feel slighted. They may become emotionally overwhelmed by distressful events, which interferes with their ability to perform well at work. They tend to feel dependent, blame themselves partly for everything, and stay stuck in unhappy relationships. They may be generally very warm and pleasing, often going along to gain other’s approval, yet may become hurt, angry or demanding when they feel ignored. Deep down they may feel humiliated when they feel rejected, and deeply shameful when they hurt others. They may miss out on what their life could be like if they were more confident in themselves and didn’t have to spend so much energy on their relationships.

Everyone has some degree of anxiety and some degree of avoidance (or both) in relationships – it’s a matter of degree. The less anxiety and the less avoidance you have, i.e, the more secure you are, the better off you are. You can find out how much anxious and avoidant attachment you have by taking the on-line survey .

Keep in mind that when we are anxiously and avoidantly attached (or both, called fearful attachment), it’s difficult to even imagine what we are missing out on, kind of like trying to imagine the color “red” when we are color-blind. Yet becoming aware of the degree to which we have anxious and avoidant attachment styles is the first step toward increasing our self-esteem and personal effectiveness.

Much of what happens in the attachment system, and in our mind in general, happens outside of conscious awareness. In psychotherapy, becoming more securely attached involves becoming increasingly aware of your automatic feelings, beliefs and ways of interacting with others. It involves developing compassionate understanding for yourself and your suppressed or distressing feelings. It involves revisiting and reprocessing the childhood or later experiences that are the source of your anxious and avoidant attachment. The psychotherapeutic relationship itself provides the responsiveness, comfort and understanding you need to feel safe during this process, and to begin to experience new ways of being with yourself and others. As work continues, you may develop increased feelings of warmth and self-esteem, new self-awareness and personal insights, and new, more effective ways of being with yourself and others.

An estimated 16.4% of Americans have an Anxiety Disorder within any given year. -US Surgeon General, 1999

Two-thirds of people with diagnosable mental disorders do not seek treatment. -US Surgeon General, 1999

Most cases of anxiety disorder can be treated successfully by appropriately trained health and mental health professionals. -American Psychological Association, 2008

What is Anxiety?

We have all experienced worry, fear, trepidation and even terror. We all rely on these emotions to survive and get through life’s challenges. Anxious feelings warn us when we are in danger, and heighten our body’s ability to pay attention. When we perceive danger or a threat we react by fleeing, fighting or freezing (avoiding calling attention to ourselves when something threatening is nearby). We also experience these same emotions when we are not in any actual danger, for example, whenever we watch an action movie. Reportedly, when movie audiences in France first saw a movie of a fast approaching train, they ran screaming from the theatre! Because we understand what movies are, the fear we feel during an action movie is enjoyable. We know we are really safe, and we have control over the experience. We choose to be there and can leave when we want.

Anxiety is excessive worry, fear, dread, feeling overwhelmed, or panic that we don’t enjoy and can’t control. Anxiety has physical symptoms that may include increased heart rate, tightness or nausea in the abdominal area, shortness of breath, sweating, chest pain or discomfort, feeling dizzy, trembling, feelings of unreality, and chills or hot flashes. Anxiety’s mental components may include thoughts like “I can’t handle this,” “This is too much for me,” “This is too hard,” and “What if something really bad happens?” Anxiety may be triggered by specific situations, such as taking an exam, socializing, getting on an airplanes, or being somewhere similar to a place that was previously dangerous, embarrassing, or difficult. Anxiety can seem to come from out of the blue, triggered by unconscious internal events. Anxiety can vary from mild, infrequent feelings to intense, nearly constant feelings. Anxiety increases our stress, and taxes our body’s ability to stay healthy.

People who experience anxiety may or may not have panic attacks. Panic attacks, also called anxiety attacks, are sudden and overwhelming surges of terror, feeling that one is losing control, or that something inside oneself is terribly wrong. The person may believe they are having a heart attack or are dying, and may go or be taken to the hospital emergency room. A panic attack is diagnosed when four or more of the following symptoms appear abruptly: accelerated heart rate, palpitations, or pounding heart; sweating; trembling or shaking; sensations of shortness of breath; chest pain or discomfort; nausea or abdominal distress; feeling of choking; feeling dizzy, unsteady, lightheaded or faint; derealization (feelings of unreality) or depersonalization (being detached from oneself); fear of losing control or going crazy; numbness or tingling sensations; and chills or hot flashes.

Is Anxiety always bad?

No, anxiety is helpful to us in useful amounts. Worry and stress are normal parts of people’s lives. Worry, stress, and fear feelings try to alert people to problems or situations that need to be dealt with and provide the energy to cope. Anxiety becomes a problem when it interferes with rather than helps a person’s ability to handle life’s challenges.

How do I know if I could benefit from professional help?

Excessive worry, panic, fear, feelings of being overwhelmed become problematic when they are chronic and upsetting enough to make people feel uncomfortable, out of control, or helpless. If you have trouble making the transition from feeling worried or fearful to getting into action to address your situation or problems, then professional help may be beneficial for you. If your symptoms interfere with your personal life, work life, of any other important area of your life, you should definitely consider seeking professional help. People who have recurrent panic attacks should always seek professional help.

When seeking professional help, the first professional you should see is your family doctor. They can determine whether your symptoms are due to a medical condition or an anxiety disorder. If due to an anxiety disorder, then we recommend you seek help from a qualified mental health professional.

Are there different types of anxiety disorders?

Yes, anxiety disorders are often classified into six major types, including Generalized Anxiety Disorder (GAD), Social Phobia, Panic Disorder, Specific Phobias, Obsessive-Compulsive Disorder (OCD), and Post-Traumatic Stress Disorder (PTSD). For anxiety symptoms to qualify as a full-fledged Anxiety Disorder, the symptoms must cause significant distress to the point that they interfere with one’s social or family life, work, or other important area of functioning. People with an Anxiety Disorder may suffer from more than one Anxiety Disorder, depression, and alcohol or drug abuse.

What is Generalized Anxiety Disorder (GAD)?

With GAD, people worry a lot about a variety of everyday problems, like family, personal health, money, and work. They constantly think about the bad things that might happen. Even though they realize they are “worry warts” they can’t seem to stop or control themselves. People diagnosed with GAD have three or more of the following symptoms: restlessness or feeling keyed up on edge, being easily fatigued, difficulty concentrating or mind going blank, irritability, muscle tension, and problems with sleep.

What is Social Phobia?

People with Social Phobia are afraid and overly self-conscious in everyday social situations. They are afraid others will judge them in harsh, critical and negative ways. While they may be aware these fears are irrational, they can’t control them. People with Social Phobia are likely to avoid social situations, and to experience intense discomfort before, during and after a social encounter. Physical symptoms include blushing, trembling, difficulty talking, nausea and sweating. Sometimes people experience Social Phobia only in specific social situations or with specific types of people, but sometimes the fear is so general that almost all social encounters are uncomfortable.

What is Panic Disorder?

People are diagnosed with Panic Disorder when they have had repeated panic attacks not attributed to a medical condition, and they have anxiety about having another attack. Panic attacks are very distressing experiences and often people cope with them by trying to avoid situations that may trigger another attack, or cause embarrassment if a panic attack happens there. Changing one’s life because a panic attack may happen can become even more disabling than the panic attack itself.

What is a Specific Phobia?

People with a Specific Phobia have an intense, irrational fear of some specific thing that in reality poses little danger. Common examples are fear of being in elevators or other enclosed spaces, heights, flying on an airplane, getting injected with a needle, or dogs. Often people can avoid the thing that are afraid of, and seek treatment only when it becomes important to overcome their fear for their personal or work situations.

What is Obsessive Compulsive Disorder (OCD)?

People with OCD have obsessions (distressing thoughts that won’t go away) and compulsions (ritualist behaviors that are performed over and over again to attempt to try to make the distressing thoughts and feelings go away). Common obsessions can be about germs, imperfection, intruders, and thoughts of doing something violent, deviantly sexual or otherwise completely counter to one’s value system. Common compulsions include washing one’s hands, straightening and cleaning, locking doors, checking things, counting, touching things, saying things and hoarding. Try as they may, people with OCD have difficulty controlling their obsessive thinking or stopping their compulsive behaviors.

What is Post-Traumatic Stress Disorder (PTSD)?

PTSD develops in some but not all people after a traumatic experience. PTSD is well known among veterans, but can also develop after traumas such as child sexual or physical abuse, rape, violent assault, kidnapping, accidents, natural disasters, and being a witness to a traumatic event to someone else. Symptoms usually begin within three months of the trauma, but can begin years later. Symptoms include flashbacks (vivid reliving of the traumatic experience) while awake or in nightmares, avoiding situations that may trigger remembering the experience, feeling emotionally numb, and feeling keyed up or on edge. People with PTSD may also experience other problems such as alcohol or drug use, feelings of depression, problems in work, and problems in personal relationships including withdrawal or violence.

What are the best treatments for Anxiety?

Anxiety is generally treated with medications, psychotherapy, or often both. Many research studies show that medications and psychotherapy are equally effective in reducing the symptoms of anxiety, while psychotherapy is more effective at reducing future recurrences of anxiety. Medications help many people reduce their anxious symptoms quickly and effectively. Medications are reasonably affordable in the short term and take no more effort than taking the medication. On the other hand, medications do not treat the causes of anxiety, so anxiety symptoms may come back when the medications are stopped. Some anti-anxiety medications have side effects and some are addictive.

Psychotherapy works to resolve the underlying cause of people’s anxiety. These can include patterns of thinking or behaviors that have developed over time, and problems in the past or present that aren’t resolved and often not understood or only partially understood. Psychotherapy is effective at helping to identify, understand and resolve sources of anxiety. On the other hand, psychotherapy generally takes longer than medications to reduce anxiety symptoms. Treatment of uncomplicated cases is generally about three months, though it can sometimes take two months or less, while complicated cases may take six months to years. In the short term psychotherapy is more expensive than medication. Psychotherapy is a collaborative process that requires the person to find a psychotherapist to work with that is skilled in this area and who they really like and trust. Finally, of course, clients must put forth effort to work with their psychotherapist to understand themselves and make changes.

Research shows that both medications and psychotherapy are effective treatments for anxiety. We believe that the best treatment for anxiety includes psychotherapy whenever possible in order to resolve the sources of anxiety as well as the symptoms.

What is the Anxiety Treatment Center?

The Anxiety Treatment Center at Gallatin Psychotherapy, Inc. is a core group of psychotherapists with the training and experience to give people the insights, skills, and changes they need to live a life free from anxiety. The Anxiety Treatment Center offers several types of clinically proven treatments, including Cognitive-Behavioral Therapy, EMDR, Acceptance and Commitment Therapy, Mindfulness techniques, education, peer support and skill training and development. We develop an individualized treatment plan with each person to provide the most effective means to reduce or eliminate each person’s anxiety symptoms.

The aim of EMDR treatment is to achieve the most profound and comprehensive treatment effects in the shortest period of time -EMDR International Association

EMDR was more successful than Prozac in achieving substantial and sustained reductions in anxiety and depression. -Journal of Clinical Psychiatry, January 2007

The speed at which change occurs during EMDR contradicts the traditional notion of time as essential for psychological healing. (EMDR integrates)… elements from many different schools of psychotherapy into (its) protocols, making EMDR applicable to a variety of clinical populations and accessible to clinicians from different orientations. -Bessel A. van der Kolk, MD, Professor of Psychiatry, Boston University School of Medicine

EMDR is proving to be the silicon chip of psychotherapy; it allows people to process incredible amounts of material in a shockingly short time. -Michael Elkin,Ph.D., Director, Center for Collaborative Solutions

EMDR quickly opens new windows on reality, allowing people to see solutions within themselves that they never knew were there. And it’s a therapy where the client is very much in charge, which can be particularly meaningful when people are recovering from having their power taken away by abuse and violation. -Laura S. Brown, Ph.D.

EMDR is the most revolutionary, important method to emerge in psychotherapy in decades. -Herbert Fensterheim, Ph.D., Cornell University

EMDR is the most powerful and integrative intervention I have learned in the past five years. -John C. Norcross, Ph.D., University of Scranton

EMDR is a significant component of treatment at the Menninger Clinic. -Bulletin of the Menninger Clinic

What is EMDR?

EMDR is a form of therapy that integrates some new and unique techniques with many elements of traditional psychotherapies. In many forms of psychotherapy, clients are encouraged to explore past experiences which were distressing or even traumatic, with the goal of understanding how these experiences have affected them in the past in order to change how the experiences affect them in the future. In EMDR, the way the client works through or “reprocesses” earlier memories is unique, and from our experience, remarkably fast and powerful.

To understand how EMDR works, an analogy might be helpful. One of the brain’s main functions is to make sense of or “digest” our experiences, in a similar way that our stomach and intestines digest our food. Our digestive systems takes out nutrients from our food that our bodies need and then eliminates what we don’t need. In a similar fashion, the brain will take out what we need to understand or learn from our experience and then eliminate the rest – meaning we will discard or eliminate experiences that are not helpful to us. When an event or experience is particularly emotionally charged or traumatic, that event can be like a large piece of food stuck in our throats – it is too big to get down to the digestive tract. Psychologically, a similar thing happens with emotionally charged events, they are too large to be digested psychologically, and so they tend to remain “stuck” in our minds. EMDR is very helpful in getting charged experiences “unstuck” and ready for processing or being made sense of. EMDR also helps our minds understand old experiences in new ways, even if we did not believe that these old events were particularly emotionally charged.

In an EMDR reprocessing session, the client is initially guided to remember a distressing experience which affected the client previously, and which is related to the client’s current difficulty achieving their goals. Even though for many people the link between current difficulties and early experiences is not immediately understood, coming up with a relevant early memory to work on is usually much easier than clients expect. Once the client has a distressing memory in mind, they are asked a series of questions designed to increase awareness of what is in consciousness, as well as to assess the level and type of disturbance. Once the client is fully aware of the memory, bilateral stimulation (see below) is applied and the client is instructed to bring that memory to mind.

The client starts with their awareness of the memory and lets whatever comes to mind, come to mind. The client is typically mostly silent during an EMDR reprocessing session, sitting back with their eyes closed and simply observing the stream of images, body sensations, thoughts, emotions, sounds, and sometimes even tastes and smells that come to mind. Many clients describe the processing as being similar to watching a movie or TV screen. Sometimes it seems that forgotten memories are uncovered. Sometimes what’s there is extremely vivid and intense, at other times vague or distant. Scenes may shift perspective, and new insights may arise. The important part is that the client not attempt to control what comes to mind, not try to make anything happen or prevent or shift anything that is happening, but that the client “lets go” and allows whatever unfolds to pass through their minds. As processing continues, the way the memory is stored changes. Typically, it changes from something that is distressing to something that causes no distress; from something that caused negative feelings about the self at the time, to something that now brings up positive feelings about the self.

In order for EMDR to be safe and effective, it is important that the client and therapist have a strong and trusting relationship. In an EMDR reprocessing session, the therapist may interrupt periodically to ask something like “What do you notice now?” Often, the therapist simply listens to the client’s brief description then says “go with that,” instructing the client to continue processing. A key role of the therapist is to provide a safe base so the client can let themselves go wherever their mind unfolds. The therapist guides the client back to the original memory when the client’s processing takes them too far afield, intervenes with minimal necessary force when the client’s mind becomes “stuck,” encourages the client to make it through difficult material, and comes to the client’s rescue if they become overwhelmed by something unexpected, or by any emotions or memories the client feels are too much to handle. The therapist also keeps track of the time, and if it does not appear processing will complete spontaneously before the session is over, assists the client to leave off at a positive place.

What is Bilateral Stimulation? What do the headphones, hand buzzers, or eye movements do?

The client receives bilateral stimulation of some kind while they process distressing material. Bilateral stimulation is providing some kind of sensory input (sounds, touch, vision) that is given in such a way so that the information goes to the two sides of the brain in an alternating sequence. This may sound complicated, but is really as simple as wearing headphones and hearing a sound alternate between the left and right ears; or having a hand buzzer vibrate in the right hand and then next in the left hand and so forth. While not entirely clear why, it appears that this bilateral stimulation is an important component of the procedure. There are several hypotheses about the mechanism by which bilateral brain stimulation is helpful. One hypothesis is that by stimulating the right and left hemispheres of the brain in sequence, this encourages the two hemispheres of the brain to more actively communicate with each other and so produces a more integrated experience. A second hypothesis for why the bilateral stimulation is effective is that the bilateral stimulation promotes a sense of dual awareness – of keeping the mind in the present moment while at the same time it goes somewhere else. This may reduce the distress associated with what is being processed, as well as help the mind remain open to processing the material in new and different ways.

Can everyone benefit from EMDR?

No. EMDR is not recommended for people who are unstable, self-injurious, at high-risk of drug or alcohol relapse, or dissociative. It is not a recommended treatment for all mental health disorders, though we have often found it to be very helpful for the treatment of anxiety, depression, and anger problems as well as for working through trauma. We have also found EMDR very helpful for executive performance enhancement and personal growth. EMDR seems to not be effective for people who don’t feel much at all when they think of apparently distressing material, or for people who are extremely and easily overwhelmed by distressing material. Often, people who can’t feel anything or are too overwhelmed to do EMDR early in treatment become ready to do EMDR as treatment progresses in more traditional ways.

What are positive resources?

A new technique that developed as a component of EMDR therapy is the use of bilateral stimulation while the client relaxes and allows their unconscious mind to construct positive places, figures, qualities, and other positive associations. The bilateral stimulation seems to strengthen these positive resources so the client can bring them easily and vividly to mind in their daily life. When brought to mind, they bring up good feelings of calmness, safety, being loved, being protected, strength, courage and so on. Positive resources are very helpful for many people, and we may recommend them as part of many client’s treatment plans, whether or not we also recommend EMDR memory reprocessing.

Is EMDR similar to hypnotherapy?

EMDR and hypnotherapy are similar in that they both seem to get to the unconscious mind quite quickly and powerfully. One of the main ways that hypnotherapy works is by the therapist making suggestions to the client’s unconscious mind. The power of suggestion is not typically used in EMDR. While hypnotherapy can very occasionally induce false memories (if misused), EMDR does not, though EMDR may make previously distressing memories vague and difficult to recall. You don’t have to believe EMDR will help for it to work. We really enjoy working with clients who are completely skeptical about EMDR, only later to tell us how powerful it was!

Are there any risks to doing EMDR?

Yes, we are aware of two risks. First, distressing memories have a tendency to become vague and no longer distressing. If you will be testifying in a court of law about something distressing that has happened to you, you may need to talk with a lawyer about whether EMDR is advised prior to completion of your legal case.

Second, any traumatic experience you have had, even if you haven’t told anyone about it or even thought about it for a long time, has a tendency to come out. When something previously traumatic comes up, the memory can be extremely vivid, as if it were happening again in the present moment. Although it can be extremely healing to process any trauma from your past, we must both be prepared to do so. We don’t want you to be re-traumatized by reliving such an experience before you’re ready to handle the emotions and memories that arise. It is very important that you tell us before getting started with EMDR if anything traumatic has happened to you in the past. We will help you assess if you’re ready to handle this now, and if not, we can work together on giving you the skills and resources you need to reprocess the trauma successfully.