Scott Webb (Host): This is Healthy Vitals, a podcast from Summa Health. I'm Scott Webb. And right now in the United States, many everyday pressures are weighing on people's minds and impacting overall mental health. And joining us today is Dr. Jennifer Knetig, a psychologist with Summa Health Behavioral Health Institute's Traumatic Stress Center, to talk about how we can help ourselves and loved ones and how she and her colleagues at Summa Health approach treatment, listening to clients and more.

Jennifer, it's nice to have you back on the podcast. This is part two. So for folks who are listening, if you clicked play here on part two, please go back and listen to part one and benefit from the conversation that Jennifer and I had about just really sort of defining stress and trauma and the differences between the two and how it affects all of us.

And Jennifer, for today's part, for part two, we're going to talk more about treatment and what that looks like. So, let's start there. What does treatment and support look like for folks who are dealing with stress and/or trauma? And just sort of get into this and lay the foundation here for how folks, if they've tried to help themselves, right, and now they're reaching out to a professional, how you can help them.

Dr. Jennifer Knetig: Yes. I think the first place we start with what might treatment look like for somebody who's reaching out for help is that we acknowledge how hard it is to do that, how hard it is to reach to a stranger and say, "Look, I'm really struggling." So, we start with being human and doing what we can to build a relationship with our clients who may feel like that's not an easy thing to do. So, people out there if you're thinking, you know, I might need to reach out, know that we know it's hard, and we're going to start with just helping you to feel safer with us. We are not applying a cookie cutter approach to it.

At the Traumatic Stress Center at Summa, we certainly strive to do what works. So, we're using science to inform what we do, and we're always starting with the relationship that we have built and we're trying to continue to build. It's typically time-limited for people. We know it's a big investment. And we start in that therapy, in that relationship, you know, building the safety and really exploring with our clients what does healing look like for you? So, like we talked before, trauma's different for everybody. It shows up in different ways, and healing looks differently for everybody. We don't just assume we know what you want.

Host: "Well, this worked for everybody else, so it's going to work for you," right?

Dr. Jennifer Knetig: Exactly. How will you know when you're better? That's the question we're asking, and then really building out a plan from that point.

Scott Webb: Yeah, I love that, just that patient-centered care or in this case, you know, sort of client-patient care. And I guess it makes me wonder, like when it is trauma related—Jennifer, like what kind of support and treatments are most helpful have you found? I know it's not cookie cutter and may not be the same for everybody. But really, what should folks expect when they reach out?

Dr. Jennifer Knetig: So, I have no doubt, you know, the listeners are pretty educated and they do a lot of research, right? There's a lot of information out there about trauma-focused therapy. We, as clinicians really, again, strive to do what works, what's been shown to be most effective. Prolonged exposure, cognitive processing therapy, EMDR, those are some of the things we do, dialectical behavior therapy. We have so many different options so that we can really try to tailor it for the client's needs. And again, really building out a plan that fits where they are, their comfort level, all of it

Host: Yeah. Yeah, as we're saying, it's all about the patient and what their maybe goals are or what healing looks like to them, which is a case-by-case basis. So if we care about someone, Jennifer, who's been through trauma, what are the most supportive things we can do? Maybe what should we avoid saying or doing? We said last time, you know, try to not say to ourselves, "Get over it," right? And so, we probably shouldn't say, you know, that to someone, "Hey, just get over it, will you?" But what should we, you know, say or not say, do, not do, that kind of thing?

Dr. Jennifer Knetig: I'm glad you brought that up, because I think when we're doing that, you know, and you may have a different view. But when I'm thinking that, it's usually because I'm unhappy, I'm anxious, because they're sad and I just want them to be better, right? And I think that's what most loved ones, that's where they're coming from. They just want the suffering to stop. So, it's like if the fast track is, you know, "Just please, could you just please get over it," then, you know, that's what they do. So, I think big picture as helpers, as loved ones, as support, just try to level set your expectations on what you actually can do. Even if your listeners out there are mental health professionals themselves, you know, if you have a loved one who's suffering, you cannot be their therapist no matter how qualified, how much education and training...

Host: Yeah. Best of intentions, but don't do that, right?

Dr. Jennifer Knetig: Yeah. You can't fix it. It's hard for people to fix it when they're trying to fix it themselves and they're really motivated to do it. I think what we can do is strive to be non-judgmental. So, you've got judgments that come up in your head, it's normal. Hold them there and support. Listening without advice, I think, is key. I think going back to we want people to feel better, we want it to stop, so we often jump into, "How can I fix this? How can I help you make this go away?" That is actually the opposite of what is needed. So, like you were saying earlier, you know, some things not to tell them, i think some common ones, you know, like, "It'll pass," you know, "It's really not that bad," or, you know, "It was like 20 years ago." Those things, they can be really invalidating for a survivor

Host: Right. Yeah, those of us parents in the group here having this conversation or listening, you know, same thing with my kids, right? Sometimes they just need dad, mom, dad, whomever to just listen. And I've had to learn that over the years, Jennifer, that tthey're not asking me to fix it necessarily. They just need me to listen and be their dad. And I am thinking about that and connecting it to the concepts here of stress and trauma, that sometimes folks just need to be heard and they don't need you to repair, right?

Dr. Jennifer Knetig: Such a great parallel, a great example, and I'm with you on that. I'm telling you this. And then, I certainly struggle myself with not shifting into it. So, I would encourage you to be gentle with yourselves. If you're hearing this and you're like, "Oh my, I've done everything that they said not to do."

Host: Yeah. And we talked last time about just grace and allowing ourselves a little grace. And we may not be perfect at this. We may not nail it every time and just do our best in those moments, of course. And thinking about that, I'm thinking about sort of like, "Okay, we've had a traumatic event." And so, we're dealing with that. But then, we add on, because you said last time, that not all stressful things are traumatic, but most traumatic things are stressful. So when we think about the stress and building on the stress, that chronic stress, right, work, caregiving, financial strain, I'm sure it makes it all more difficult, more challenging that we're already suffering trauma and from a traumatic event, and then we add on, you know, life and living and all of that, right?

Dr. Jennifer Knetig: Oh, yeah. That's a great-- Really a good point about, you know, adding the life and living. Since COVID, we see there's objectively more stress happening in the world. I mean, there's more violence, there's more intimate partner violence that, that happens after, you know, a natural disaster.

So if people out there are feeling more stretched, it's real. And if someone has limited, like, emotional bandwidth before something traumatic, then trauma can absolutely stretch their ability to be resilient. And honestly, resilience is our default setting. We are born, our bodies are designed to heal. And so, kind of like chronic stress has a way of chipping away at that. And if you're in chronic stress state, it can be harder, you know, to take care of your physical body, your emotional self, your spiritual health, if that's important to you. And as we've talked, it can really undermine relationships, which is what we really need to recover from trauma.

I would say that like self-care, just eating right, getting exercise and sleep, we all have heard it from our doctors, and some of us roll our eyes when, you know, people tell us, you know, doc tells us to do it. That stuff is a buffer. It's a buffer between you and trauma, and chronic stress can really undermine that.

Host: So, we talked last time, Jennifer, about how we can maybe help ourselves. What can we do in the short term? But let's think a little more long term here, frame this a little more long term. Like, if someone feels that they're in crisis, feels unsafe, what should they do?

Dr. Jennifer Knetig: So there are several options. 988 is something anybody can do. You can text them, you can call them. A real person, a human will answer. I know people may be reluctant to do that. They say, "If I do that, somebody's going to, you know, send the police for me," though that I have a lot of clients that use that on the regular, like at night when they're struggling. Maybe they don't have anybody available to talk to. So, it's a great resource. People can also reach to us. Traumatic Stress Center at Summa is designed to provide—I mean, this is what we do every day. We have a great staff here.

Host: Well, Jennifer, as I told you before we started the first recording, when we recorded part one, that we probably wouldn't get to everything, but we would hopefully be able to help folks, educate them a little bit, share with them your expertise and knowledge and some of the help and resources that are out there.

Just as we wrap up part two here, what message do you most want listeners to hear about when we think about trauma recovery, especially if they feel like they should be over it by now? Like, what would be your parting words?

Dr. Jennifer Knetig: I think the key is, and we've definitely been hitting on this, I think in the conversation, is recognizing that these things, these disruptions, being haunted, being on high alert, struggling to connect with people, feeling, you know, sadness, whatever it is, it's happening for logical, rational reasons. Again, we are designed to heal, our minds and bodies, as they are to promote our healing and resilience. So if something's going on, rather than—and I know folks can feel a lot of shame about it—but rather than labeling that as there's something really wrong with me, looking at, "Okay, what do I need to know about what's going on with me that I can't sleep?" So, that's important data. All of this is data. And approaching it with some curiosity and talking to someone who knows about trauma, I think, and if you can't, even just a safe person to sort through. This stuff's happening for a reason. Let's figure it out

Host: Yeah, that's well put, right? Whatever happened, happened. And we're now trying to make sense of it and to deal with it in the moment and long term. And then you add on things we've talked about here, the chronic stress, work, caregiving, financial strain, whatever it might be. It's a lot. It's a lot for us, it's a lot for those around us, and it just may be time to speak with a professional, a clinician, to try to sort through some of this stuff and figure out what does healing look like? What do I need to be able to live my life, right?

Dr. Jennifer Knetig: Absolutely.

Host: Well, that's perfect. I am so glad to have you on and benefit from your time, your expertise, your compassion. As I said, we have two parts here. Please listen to part one, then listen to part two, and go back and listen to it if you need to, or you can reach out to Summa Health Behavioral Health Services.

You can go to summahealth.org/behavioral or call 234-475-HELP. That's 4357. So 234-475-HELP, 4357, and thanks for listening. And if you enjoyed this episode of Healthy Vitals, we'd love it if you'd leave us a review. Your review helps others find our educational content. I'm Scott Webb. Thanks for listening, and we'll talk again next time.