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Removing the Stigma from PTSD
Trauma is not a disorder, but a normal adaptation and response of the nervous system to psychological trauma.
Featuring:
Dr. Seymour was an officer with the United States Public Health Service, where he served as mental health director of the Tucson Area Indian Health Service (IHS). For 10 years, he served as the assistant medical director of a residential behavioral health and substance abuse program focused on the healing of mind, body, and spirit. Dr. Seymour is board certified by both the American Board of Psychiatry and Neurology and the American Board of Addiction Medicine. Additionally, he is a Somatic Experiencing® practitioner.
Dr. Seymour’s areas of expertise include trauma recovery, addictions, cognitive behavioral therapy (CBT), and somatic mind-body therapies. Dr. Seymour believes strongly in the resilience of the human spirit and views the role of the psychiatrist as assisting the person in removing obstacles to the natural healing and recovery process.
Dr. Seymour approaches psychological and post trauma symptoms as the natural nervous system’s response to trauma, rather than a disease or disorder, with a primary focus on increasing the capacity for better nervous system regulation, improvement in navigating interpersonal relationships, and mindfulness to support and encourage positive results in each individual. In addition Dr. Seymour believes that those individuals with a serious mental illness need trauma informed care and individualized attention to help heal the emotional wounds which are invariable consequences of having to deal with problems such a Schizophrenia ad Bipolar Disorder.
James Seymour, MD
James Seymour, MD, joined Sierra Tucson in 2010. Upon receiving his medical degree from the University of Tennessee and completing his psychiatric residency at the University of Virginia in 1987, Dr. Seymour trained for several years in Intensive Short-Term Dynamic Psychotherapy (ISTDP).Dr. Seymour was an officer with the United States Public Health Service, where he served as mental health director of the Tucson Area Indian Health Service (IHS). For 10 years, he served as the assistant medical director of a residential behavioral health and substance abuse program focused on the healing of mind, body, and spirit. Dr. Seymour is board certified by both the American Board of Psychiatry and Neurology and the American Board of Addiction Medicine. Additionally, he is a Somatic Experiencing® practitioner.
Dr. Seymour’s areas of expertise include trauma recovery, addictions, cognitive behavioral therapy (CBT), and somatic mind-body therapies. Dr. Seymour believes strongly in the resilience of the human spirit and views the role of the psychiatrist as assisting the person in removing obstacles to the natural healing and recovery process.
Dr. Seymour approaches psychological and post trauma symptoms as the natural nervous system’s response to trauma, rather than a disease or disorder, with a primary focus on increasing the capacity for better nervous system regulation, improvement in navigating interpersonal relationships, and mindfulness to support and encourage positive results in each individual. In addition Dr. Seymour believes that those individuals with a serious mental illness need trauma informed care and individualized attention to help heal the emotional wounds which are invariable consequences of having to deal with problems such a Schizophrenia ad Bipolar Disorder.
Transcription:
Scott Webb: Since 1983, Sierra Tucson has have held a longstanding legacy of clinical excellence and compassionate care. A multidisciplinary team of professionals utilizes the Sierra Tucson model, a bio-psycho-social spiritual approach to individualized treatment. Sierra Tucson combines integrative and experiential therapies with evidence based practices to provide a full range of treatment modalities to address addiction, mood, pain, trauma, and co-occurring disorders. Residents receive the resources, support and tools necessary for long-term change, including connect 365, complete with a certified recovery coach and customized mobile app and a lifetime of alumni services. And joining me today to discuss how we can remove the stigma from PTSD is Dr. James Seymour, Director of the Chrysalis Program at Sierra Tucson. This is Let’s Talk: Mind, Body & Spirit from Sierra Tucson. I'm Scott Webb. So Dr. Seymour, thanks so much for being on today. We're talking about PTSD. So how do you define psychological trauma?
Dr. Seymour: Well, people define psychological trauma in different ways, but I define it in these two ways. First of all, anything that overwhelms the capacity of our system to cope effectively, I think of is psychological trauma. The other thing is, is that trauma comes from the ancient Greek word trauma, which means to wound. And although they used it just to look at physical wounds, we also look at as psychological wounds. The other thing is, I like to say that the trauma is not in the event itself, but in the body's reaction to the event and how we're able to manage and deal with that reaction.
Host: So why should we think of trauma, not as a disorder necessarily, but as a normal adaptation and response of the nervous system to psychological trauma?
Dr. Seymour: We should think of trauma not as a disorder because it's really not. I talk with all my clients or patients about the fact that they may have symptoms and they may have significant interpersonal difficulties, but that there is essentially nothing wrong with them. They don't have a disease, a disorder, a sickness, an illness. They don't have to be fixed. They're not just a diagnosis, but what happens is the body goes into animal defenses when our life is in danger or life of someone else that we care about is in danger. And this affects the nervous system to where that we get several different reactions. Some of which include the fight or flight response or a collapse or immobilizing response that some people refer to as the freeze reaction. So the body response to the trauma, and it's the response that continues. That is what really causes problem for people. Unless there's some interruption in the process those responses become conditioned responses or what I call default mechanisms to deal with any other kind of anxiety that comes up later.
Host: Yeah. And I think that we're all familiar with those feelings that you're describing the fight or flight, the freezing that can happen. And as you say, that that's all just normal stuff, right?
Dr. Seymour: Yes, very normal, very normal. So all of us experience psychological trauma, but some have much more than others. The other thing I think of is that there are two major kinds of traumas that I think of, one of them is event trauma. And that is something that happens to us. That might be a fall, an injury, a medical complication, a sudden death of someone that we love, a sexual assault, a physical assault, being involved in a natural disaster, also dealing with this whole covert situation. And those are things that happen to us and they're events. And those are things that sometimes will lead to what we consider post traumatic stress disorder. Now, I like to call it post traumatic stress response to emphasize that it's not a real disorder. So people use the term PTSD. I use the term, PTSR the other kind of trauma we have is a complex developmental trauma.
And this is trauma that occurs from an early age and the environment in which we are growing up in is a traumatic environment. And I think of a couple of things in that regard. One of them is if we have to walk on eggshells, when we're in a childhood and growing up, then we probably got developmental trauma. The other thing that I think about is if we're in an environment which is a frightening or scary environment, or we have a frightening or scary caregiver, we're most likely to then have what I would consider developmental trauma, that is trauma is not an event, but the situation in which we grow up in.
Host: So why is it important to understand that we don't really treat trauma?
Dr. Seymour: One of the biggest things that occurs after trauma, particularly developmental trauma, is that people experience a great deal of shame. The world is not as they thought it would be, and a lot of people blame themselves for the difficulties. So again, that's why I like to say that you have symptoms and you may have interpersonal difficulties, but there's essentially nothing wrong with you. The other thing is that the trauma has occurred in the past. Now some people that we see are in ongoing trauma situations and that's a different picture altogether, but for most of our clients or patients, the trauma is already over, it's over in the past. And we need to help people recognize that they have survived. They've had a lot of resources that they've used to be able to survive. And what we need to do is not to treat a disorder, but to help them tap back into those strengths and resources that they've used before to get through difficult situations in life.
Host: Absolutely. So for someone who is suffering from trauma, what recovery options are available to them?
Dr. Seymour: Well, the first thing that I think about is that recovery are not just things having to do with individual or group therapy, anything or any activity that we participate in that allows us a sense of connection and safety are things that help trauma recovery. So things outside of a therapy session include yoga, therapeutic, massage, cranial therapy, music, dance, group activities. And then in terms of other things that people think of as traditional therapy there's cognitive behavioral therapy, dialectical behavioral therapy, EMDR, which is eye movement, desensitization reprocessing, somatic experiencing, central motorcycle therapy, just a variety of things. But a lot of times we need to have some activities that work through the body. When we think about trauma symptoms, a lot of those are body symptoms. So we like to work with the body in various different ways, in addition to the emotions and the thoughts
Host: That sounds really good. And I know that music and dance is, is very therapeutic for people, especially right now, as you know, probably know, Tik Tok videos are very popular. Everybody wants to show off their dance moves. And I think there is something very therapeutic to that. So can you define trauma informed care. What does that mean exactly?
Dr. Seymour: When I give talks, I like to, my first live usually says in terms of what is trauma informed care. I always say trauma informed care is shame reduction and shame reduction equals trauma informed care. And then I sit down and say any questions? As if that's my presentation, but then I do give some information trauma informed care, the idea came from the Substance Abuse and Mental Health Services Administration who wanted us to recognize that there are many psychological disorders that are due to psychological trauma. And this comes from the 1990s study, the Adverse Childhood Experiences Study, which showed that there's a great deal of psychological effects of negative or adverse environments in childhood. So mood disorders, anxiety disorders, eating disorders, substance abuse disorders, personality disorders are often secondary to trauma. The other thing that was an emphasis on is that the environment, that the treatment environment should be something that's welcoming, something that makes the client or the patient feel good about themselves. And the third thing is a real work towards rapport, respect, and collaboration. If we get those things, then we're going to put people in a safe position where they have a good interaction with us and feel genuinely that we care about them. As opposed to sterile offices and authoritarian view and those sorts of things.
Host: Yeah. That's probably so key for people to just feel comfortable, to feel like they're in a warm, caring environment. That sounds really good. Yeah. So what key principles are important to you when working with trauma patients?
Dr. Seymour: Well, the key principle may sound a little odd to some people, but I think, and I tell a therapist when I'm working with them in supervision or consultation is to love your clients or your patients. And one of the things I like was in the seventies, Juan Kurts, who was a psychologist that formed the Hakomi method, which is a precursor to some other body oriented therapies. He said, my first inclination with meeting the patient is to try to find something to love in them, something to admire. And so I think of love as treating other people with the same respect that we would want to be treated ourselves with loving kindness and compassion, but also to find something admirable or heroic in them, it makes a big difference when you're working with a client and you're looking for something in them that has been a very positive admirable qualities, heroic in overcoming certain degrees of trauma. I think the first important business is to find those things.
The second key principle is to do anything to reduce shame and be very careful to understand what we may do unintentionally in creating some additional shame. Shame is the strongest emotion that most people with significant trauma are left with. And it's more difficult to work with then the other emotions. The third thing I think about in working with trauma patients or any other clients that we work with is that we want to start with the positive first when I'm working with someone, I know usually what's wrong with them, but what I want to know and what I want the client or patient to know is what's right with them. So when we're doing a work in trauma, we want to make sure that people feel good about themselves, that they understand the positive aspects of themselves, that they can feel that and have a felt sense of those positive aspects before we get into the difficult areas of trauma. So always starting with what is right, rather than what is wrong is the third key principle.
Host: That's such great advice for your work and for everybody else right now, like let's focus on the positive, what's right with us, what's right in the world. And maybe just try to, you know, to keep our focus on that. And not necessarily what's wrong because as we know through COVID and other things, there's a lot wrong and let's just try to stay positive, right?
Dr. Seymour: Yes. There's a lot wrong.
Host: Yeah. As we wrap up here today, anything else we want patients to know about your approach to dealing with trauma to PTSD, or as you said, PTSR, anything else?
Dr. Seymour: I want all people to know that anyone can recover from their trauma, even if it's very early life developmental trauma, including sexual or physical abuse with both people can recover. The other thing is you can recover at any age. Even the elderly can recover from earlier trauma because of the way that the brain operates. So I like to tell people, it doesn't matter how severe your trauma was, how long it was or how old you are, you can recover.
Host: That is so great to know. And a great note to finish on that. All of us need to know that recovery is possible is likely. So Dr. Seymour, thank you so much for being on today and stay well. Help is available. Sierra Tucson offers superior residential programming for adult men and women who wish to overcome a traumatic past. Call (800) 842-4487, or go to Sierratucson.com for more information. Sierra Tucson, where change begins. If you found this podcast helpful, please share it on your social channels and check out the full podcast library for topics of interest to you. This is Let’s Talk: Mind, Body & Spirit from Sierra Tucson. I'm Scott Webb. Thanks for listening.
Scott Webb: Since 1983, Sierra Tucson has have held a longstanding legacy of clinical excellence and compassionate care. A multidisciplinary team of professionals utilizes the Sierra Tucson model, a bio-psycho-social spiritual approach to individualized treatment. Sierra Tucson combines integrative and experiential therapies with evidence based practices to provide a full range of treatment modalities to address addiction, mood, pain, trauma, and co-occurring disorders. Residents receive the resources, support and tools necessary for long-term change, including connect 365, complete with a certified recovery coach and customized mobile app and a lifetime of alumni services. And joining me today to discuss how we can remove the stigma from PTSD is Dr. James Seymour, Director of the Chrysalis Program at Sierra Tucson. This is Let’s Talk: Mind, Body & Spirit from Sierra Tucson. I'm Scott Webb. So Dr. Seymour, thanks so much for being on today. We're talking about PTSD. So how do you define psychological trauma?
Dr. Seymour: Well, people define psychological trauma in different ways, but I define it in these two ways. First of all, anything that overwhelms the capacity of our system to cope effectively, I think of is psychological trauma. The other thing is, is that trauma comes from the ancient Greek word trauma, which means to wound. And although they used it just to look at physical wounds, we also look at as psychological wounds. The other thing is, I like to say that the trauma is not in the event itself, but in the body's reaction to the event and how we're able to manage and deal with that reaction.
Host: So why should we think of trauma, not as a disorder necessarily, but as a normal adaptation and response of the nervous system to psychological trauma?
Dr. Seymour: We should think of trauma not as a disorder because it's really not. I talk with all my clients or patients about the fact that they may have symptoms and they may have significant interpersonal difficulties, but that there is essentially nothing wrong with them. They don't have a disease, a disorder, a sickness, an illness. They don't have to be fixed. They're not just a diagnosis, but what happens is the body goes into animal defenses when our life is in danger or life of someone else that we care about is in danger. And this affects the nervous system to where that we get several different reactions. Some of which include the fight or flight response or a collapse or immobilizing response that some people refer to as the freeze reaction. So the body response to the trauma, and it's the response that continues. That is what really causes problem for people. Unless there's some interruption in the process those responses become conditioned responses or what I call default mechanisms to deal with any other kind of anxiety that comes up later.
Host: Yeah. And I think that we're all familiar with those feelings that you're describing the fight or flight, the freezing that can happen. And as you say, that that's all just normal stuff, right?
Dr. Seymour: Yes, very normal, very normal. So all of us experience psychological trauma, but some have much more than others. The other thing I think of is that there are two major kinds of traumas that I think of, one of them is event trauma. And that is something that happens to us. That might be a fall, an injury, a medical complication, a sudden death of someone that we love, a sexual assault, a physical assault, being involved in a natural disaster, also dealing with this whole covert situation. And those are things that happen to us and they're events. And those are things that sometimes will lead to what we consider post traumatic stress disorder. Now, I like to call it post traumatic stress response to emphasize that it's not a real disorder. So people use the term PTSD. I use the term, PTSR the other kind of trauma we have is a complex developmental trauma.
And this is trauma that occurs from an early age and the environment in which we are growing up in is a traumatic environment. And I think of a couple of things in that regard. One of them is if we have to walk on eggshells, when we're in a childhood and growing up, then we probably got developmental trauma. The other thing that I think about is if we're in an environment which is a frightening or scary environment, or we have a frightening or scary caregiver, we're most likely to then have what I would consider developmental trauma, that is trauma is not an event, but the situation in which we grow up in.
Host: So why is it important to understand that we don't really treat trauma?
Dr. Seymour: One of the biggest things that occurs after trauma, particularly developmental trauma, is that people experience a great deal of shame. The world is not as they thought it would be, and a lot of people blame themselves for the difficulties. So again, that's why I like to say that you have symptoms and you may have interpersonal difficulties, but there's essentially nothing wrong with you. The other thing is that the trauma has occurred in the past. Now some people that we see are in ongoing trauma situations and that's a different picture altogether, but for most of our clients or patients, the trauma is already over, it's over in the past. And we need to help people recognize that they have survived. They've had a lot of resources that they've used to be able to survive. And what we need to do is not to treat a disorder, but to help them tap back into those strengths and resources that they've used before to get through difficult situations in life.
Host: Absolutely. So for someone who is suffering from trauma, what recovery options are available to them?
Dr. Seymour: Well, the first thing that I think about is that recovery are not just things having to do with individual or group therapy, anything or any activity that we participate in that allows us a sense of connection and safety are things that help trauma recovery. So things outside of a therapy session include yoga, therapeutic, massage, cranial therapy, music, dance, group activities. And then in terms of other things that people think of as traditional therapy there's cognitive behavioral therapy, dialectical behavioral therapy, EMDR, which is eye movement, desensitization reprocessing, somatic experiencing, central motorcycle therapy, just a variety of things. But a lot of times we need to have some activities that work through the body. When we think about trauma symptoms, a lot of those are body symptoms. So we like to work with the body in various different ways, in addition to the emotions and the thoughts
Host: That sounds really good. And I know that music and dance is, is very therapeutic for people, especially right now, as you know, probably know, Tik Tok videos are very popular. Everybody wants to show off their dance moves. And I think there is something very therapeutic to that. So can you define trauma informed care. What does that mean exactly?
Dr. Seymour: When I give talks, I like to, my first live usually says in terms of what is trauma informed care. I always say trauma informed care is shame reduction and shame reduction equals trauma informed care. And then I sit down and say any questions? As if that's my presentation, but then I do give some information trauma informed care, the idea came from the Substance Abuse and Mental Health Services Administration who wanted us to recognize that there are many psychological disorders that are due to psychological trauma. And this comes from the 1990s study, the Adverse Childhood Experiences Study, which showed that there's a great deal of psychological effects of negative or adverse environments in childhood. So mood disorders, anxiety disorders, eating disorders, substance abuse disorders, personality disorders are often secondary to trauma. The other thing that was an emphasis on is that the environment, that the treatment environment should be something that's welcoming, something that makes the client or the patient feel good about themselves. And the third thing is a real work towards rapport, respect, and collaboration. If we get those things, then we're going to put people in a safe position where they have a good interaction with us and feel genuinely that we care about them. As opposed to sterile offices and authoritarian view and those sorts of things.
Host: Yeah. That's probably so key for people to just feel comfortable, to feel like they're in a warm, caring environment. That sounds really good. Yeah. So what key principles are important to you when working with trauma patients?
Dr. Seymour: Well, the key principle may sound a little odd to some people, but I think, and I tell a therapist when I'm working with them in supervision or consultation is to love your clients or your patients. And one of the things I like was in the seventies, Juan Kurts, who was a psychologist that formed the Hakomi method, which is a precursor to some other body oriented therapies. He said, my first inclination with meeting the patient is to try to find something to love in them, something to admire. And so I think of love as treating other people with the same respect that we would want to be treated ourselves with loving kindness and compassion, but also to find something admirable or heroic in them, it makes a big difference when you're working with a client and you're looking for something in them that has been a very positive admirable qualities, heroic in overcoming certain degrees of trauma. I think the first important business is to find those things.
The second key principle is to do anything to reduce shame and be very careful to understand what we may do unintentionally in creating some additional shame. Shame is the strongest emotion that most people with significant trauma are left with. And it's more difficult to work with then the other emotions. The third thing I think about in working with trauma patients or any other clients that we work with is that we want to start with the positive first when I'm working with someone, I know usually what's wrong with them, but what I want to know and what I want the client or patient to know is what's right with them. So when we're doing a work in trauma, we want to make sure that people feel good about themselves, that they understand the positive aspects of themselves, that they can feel that and have a felt sense of those positive aspects before we get into the difficult areas of trauma. So always starting with what is right, rather than what is wrong is the third key principle.
Host: That's such great advice for your work and for everybody else right now, like let's focus on the positive, what's right with us, what's right in the world. And maybe just try to, you know, to keep our focus on that. And not necessarily what's wrong because as we know through COVID and other things, there's a lot wrong and let's just try to stay positive, right?
Dr. Seymour: Yes. There's a lot wrong.
Host: Yeah. As we wrap up here today, anything else we want patients to know about your approach to dealing with trauma to PTSD, or as you said, PTSR, anything else?
Dr. Seymour: I want all people to know that anyone can recover from their trauma, even if it's very early life developmental trauma, including sexual or physical abuse with both people can recover. The other thing is you can recover at any age. Even the elderly can recover from earlier trauma because of the way that the brain operates. So I like to tell people, it doesn't matter how severe your trauma was, how long it was or how old you are, you can recover.
Host: That is so great to know. And a great note to finish on that. All of us need to know that recovery is possible is likely. So Dr. Seymour, thank you so much for being on today and stay well. Help is available. Sierra Tucson offers superior residential programming for adult men and women who wish to overcome a traumatic past. Call (800) 842-4487, or go to Sierratucson.com for more information. Sierra Tucson, where change begins. If you found this podcast helpful, please share it on your social channels and check out the full podcast library for topics of interest to you. This is Let’s Talk: Mind, Body & Spirit from Sierra Tucson. I'm Scott Webb. Thanks for listening.