Agnes Wohl, LCSW, ACSW

Psychotherapist

Consultation, Evaluation, and Psychotherapeutic

Treatment of the emotional, behavioral,

and social problems of children, adolescents and adults

 

Weekly Blog

Poem (Written by a Client)  03/02/2020

This is a poem not a suicide note. Its a song that screams, I promise not a suicide note. I want you to know what it

She is coming undone Still nobody comes She’s

said it,

she’s written it, she teaches it she shows it

means.

They talk about her when she’s not there. They warm their egos with her despair.

Still no one walks down the road.

She lay in bed while the conference on her sanity takes place with the people who brought her into the world and with the man that told her she was his world.

She’s come undone.

No one believes her even though she screams

No one believes her even when she starved

No one believes her even when she was found drowning in a bottle of Woodford Reserve.

They go buy some bourbon they pour for themselves, they toast in her name and go play slots at the casino because its too hard to be there for the CRAZY one . The crazy/capable one, who holds them all in heart and in her hands-until her heart feels like the blood has pooled at the small v at the bottom of it and her hands tingle from her broken back.

Humpty Dumpty sat on a wall-but all the kings horses and all the kings men tell her “no one is coming, you must put yourself together again”

She has come undone

She has been drowning for years

Taking her life is an option she holds

and only as an option it stays, because her heart belongs to that beautiful girl who she herself has betrayed.

She comes undone and unravels, hoping the pieces come back together and this young woman she loves with her full heart gets out of this prison,,,,and that she never ever has to come undone. People will love her and people will listen and no one will walk away even though her mothers pieces lay there -having done the best

she knew how.

She’s coming undone, fast. She wonders if she dies would she be found?

Her hands are made of sand

Her own love for herself slips through them.

She’s come undone but without the ability to do what she wishes she could

Can she take the step she cant take back.

She knows she cant because of the girl who lives in Baltimore and the boy who lives in the room with the bold stars and stripes.

She’s come undone. She is stopping caring

she wants to put everyone away into the ground and bury them and lower them with dirt and take a bat to flatten the earth over them. Now she’s outside them even more.

Is anyone out there listening?

When you come undone you really don’t form the words people need answers from;

“How can I help?” they ask

She can’t put the puzzle pieces together enough to be there to tell them.

She has come undone

She has to put her makeup on.

So she can open her door to welcome the other broken ones.

How does someone undone do what she needs to do the most. Even speaking is hard.

But still no one comes

No one is coming for the girl whose undone.

She is pretty

She is sweet

her heart lay at his feet, her body slumped in a corner . She watches her heart beat for everyone but herself.

She has said her goodbyes. And now she just tries to be undone while she’s together which makes no sense but whoever told her this world would know her?

There aren’t any promises, none people would keep. She stops believing in promises. All she wants is too hurt. To not feel like she must lay there alone, under the covers of the bed( which she makes so beautiful. For a princess.

She is only a princess when she lays there still, so they can fuck her.

Maybe they are all right. She is mentally ill. Lets give them something to talk about, dip their apples in honey, while you fill up their wine glass and bless this holy day.

She believes in the day of her death wishes it

fears it

believes it

wants it.

This wasn’t a choice. She asked for help. Again and again and again.

She runs away. They find her and are only mad at her and scared for themselves. Its always her fear that she gets captured and taken home to attend to heself.

Then she puts her phone on silent.

and the broken ones walk in.

Eye Movement Desensitization and Reprocessing (EMDR)   therapy and why it’s helpful to Trauma Survivors   02/24/2020

Introduction:

Trauma has a huge impact on a person’s mind, body, spirit, and behavior. EMDR is one good option that is used in the treatment of trauma along with the concurrent symptoms such as (but not exclusively) anxiety, depression, pain, fear, eating disorders, self-harm and substance use.

What is EMDR?

EMDR is a structured method that systematically uses bilateral stimulation to take the patient through an eight-phase treatment that assists them with distressing memories, anxiety and other trauma-related symptoms. This is an evidence-based therapeutic intervention in which, after a careful history is taken, the client is assisted in being able to tolerate, consolidate and digest traumatic memories. Later in the process, the bilateral stimulation elicits repressed information, reprocessing within the remaining seven phases of the therapy. Initially, Shapiro introduced this method of treatment for Post-traumatic Stress Disorder. Now, it’s widely used for a variety of issues.

Why is it helpful for trauma survivors?

1. History Taking: the first phase is attaining a detailed history about the client that identifies the readiness for treatment, healing and prognosis, and helps in treatment planning. A sequence is established in which a priority of target memories or dysfunctional patterns becomes the blueprint for the treatment.

2. Client Preparation: in this phase, the therapeutic alliance is made between a therapist and the client. A reasonable level of expectations is established with the client and therapist. The client further receives self-soothing and emotional regulation strategies: this helps in maintaining stability in the client’s functioning and lays the groundwork for the next phase. Instructions about using metaphors and stop signals to provide a sense of control are also given. The client also learns about the active processing of traumatic symptoms.

3. Assessment: in these sessions, the client and therapist work together towards the target memory. With that memory, an image is associated and related negative beliefs. After that, insights into irrational beliefs are developed. The emotional and physical sensations are elicited verbally. Then the positive emotions and “cognitive interweaves” (resources) are suggested.

4. Desensitization: insight is elicited in the stage. The emotional and physical sensations are again measured and evaluated to monitor the progress, and the techniques are continued as needed. Use of a stimulus also continues such as tapping, alternating lights, eye movements or sounds are used.

5. Installation: with the use of deep breathing, set of eye movements or other bilateral stimulation is used simultaneously with target images. After each set of movements dysfunctional memories are worked through, digested and traumatic memories are replaced with less activity and more functional interruptions of the events.

6. Body Scan: the focus on the body identifying if there is any distress in the body missed in the processing, then it will again be reprocessed with the use of sets of bilateral stimulation.

7. Closure: self-regulation techniques are taught again for long term effectiveness and stability.

8. Reevaluation of Treatment: the original target is again brought up and reassessed to be sure it is no longer a charged memory.

Conclusion:

As time passes, this treatment method had gained much attention and professional recognition that it is used for the trauma and for various other psychological issues. The acceptance of the working strategy of EMDR had proven its efficacy and is considered and evidence-based treatment for a wide range of populations and is utilized

 

HOW DO YOU SUPPORT A FRIEND OR FAMILY MEMBER WHO HAS BEEN SEXUALLY ABUSED? 02/13/2020

 

If a friend or relative shares that they have been sexually abused, it may be very difficult to digest and elicit powerful emotions within you. The pain and suffering of a loved one is a difficult event to experience.  Having the love and support of others greatly helps a person to recover faster from the trauma.  

Sexual abuse is not selective, anyone can fall victim.

Sexual abuse can be a single episode or multiple recurring incidents; by the same person or different people. Although the terror of the abuse is indelible, neither can your words erase all the hurt. Being believed is primary. Being supportive involves many things, but some of the best ways to support a friend or family member who has been sexually abused are listed in this blog.

Understand the Aftermath

Without a proper understanding of how victims feel and what they think is complicated.

Some common consequences of being Sexually Abused;

ï A feeling of isolation and loneliness

ï Boundaries have been severely violated

ï Disconnection from the world

ï Nightmares and disrupted sleep

ï A feeling of guilt, shame and dirtiness

ï Confusion

ï Trust disturbance

ï Fear of not being believed

ï Lack of self-confidence

ï Loss of appetite or overeating

ï Feeling of anxiety

ï Hypo or hyper-sexual feelings and actions

ï Depression

ï Self-blame

ï Changed view of the world

 

How to Show support

Patience is the most important.

 

Emotional Support:

ï Create enough time for them

ï Let them talk about the incident whenever they feel they want to

ï Don’t force the conversation but maintain a stance of willingness and openness

ï Believe them

ï Allow them some alone time, but not for too long

ï Let them express how they feel without trying to change their feelings

ï Do not decide you know what is best for them

ï Do your best not to be judgmental

ï Listen to what they have to say. Their thoughts, feelings, perceptions

ï When they are ready and if they agree, just hold their hand, offer a hug, or a gesture to help them relax and feel safely open

ï Let them cry

ï Just sit beside their tears, anger or whatever they feel

ï Don’t try to push any of it aside

ï Gently encourage them to seek professional help

 Physical Support:

ï Make sure their physical health is intact

ï Gently suggest a physical exam

ï If they are agreeable offer to accompany them

 

Physical Health and Lifestyle Support:

ï Spend time with them

ï Brainstorm with them about future goals an achievable step towards those goals

ï Go for a walk with them

ï Find outdoor activities that promote positive physical movement

ï Help them trust their bodies again through physical activity

ï Join a dance class together

 

Promote Mental Health:

ï Encourage them finding a group for people who have been sexually abused professionally led.

ï Help them enjoy life again through pursuing hobbies such as art, drama, music, etc.

ï For increasing positivity, create a gratitude jar with them, each day encourage them to put a note inside

ï Suggest they begin journaling

ï Adult coloring books for relaxing

ï Suggest creating their own superhero

ï Collage a recovery bridge

Conclusion

Continue building the support for the loved ones. There are many choices and never-ending options to seed hope for a better living in the minds of the abused ones.

 

 

 

Sexual Abuse of Men and How They Can Begin the Healing Process 02/01/2020

Sexual abuse is  a common problem in the world. We hardly go a day without hearing of abuse, of which we should all take note. Statistics have it that in every 140 seconds 2 sexual assaults occur, which involves more women than men.

However, this does not dispute the fact that men also get sexually harassed and abused. In most sexual occurrences involving a man, there tends to be a show an attitude of negligence and pure unconcern which can be heartbreaking. We forget that abuse is abuse and should not be gender-biased.

Just like other survivors, male victims have that feeling of self-disgust and sadness. These victims face a different quality of  trauma than women because of faulty thoughts towards  the sexually abused man.

Misconceptions on the Sexual abuse of Men

These perceptions are the reason

most male victims stay clear of the media and all other forms of exposure. Some of which are;

  • Men don’t get sexually abused.
  • Some people wrongly believe that men cannot be a victim.

       .All sexual abuse reported by men is false.

      .A man benefits when they are sexually abused by a woman.

All of these are wrong assumptions about men that have been abused. People are even more judgmental towards men than women, they may look at them with  disbelief. These men in turn lack self-peace, sanity and are prone to depression and isolation and don’t often seek help.

How to begin the healing process

Open up about the abuse.

Generally, admitting to being abused can be very difficult because of the stigma attached. Women speak up more than men when it comes to sexual abuse. The men have more fear of disbelief than women. You “remain” entrapped  when you “remain” silent.  Giving voice to the abuse begins to take your own power back.

Understand you are not to blame

You must understand that whatever happened was not your responsibility. The shame will be felt, but remember, sexual abusers are excellent at entrapment and you were not wrong to have trusted someone. Once you can establish this as a truth, it will be easier to free yourself from the guilt and the stuckness in many areas. So work hard towards self forgiveness.

Get set for flashbacks

There will be flashbacks and those memories will haunt you for a while. So, prepare your mind, take precautions and with time, they will lessen.

Tips:

Anticipate the flashback

Note things that trigger these flashbacks and steer clear of them when possible

Note symptoms that occur before a flashback

Take enough time to relax once you notice these symptoms

Nurture and reconnect to the world

Getting over an abuse may be difficult but taking care of your mind can hasten the process. For this reason, you must build your mind in the best of ways; avoid drugs, mind what you watch, engage in mind relaxing activities and connect with friends. You deserve to be happy, so reconnect with the world.

Gender doesn’t change the effect of the abuse on a person, because its impact is more mental than physical. The impact of sexual abuse yields a traumatic experience even in men, which includes depression and post-traumatic stress disorder. No matter the abuse you struggle with, do as much as you can right to keep you sane mentally, physically and emotionally.