트라우마 치유하기: 치료 방식과 자기 조절에 대한 이해

### 트라우마와 치유에 대한 이해 치료와 자기 조절의 역할
* 🧠 트라우마는 개인의 집중력과 집중력을 압도할 수 있으며, 종종 **ADHD 증상과 유사**하지만 피상적인 진단명으로는 근본적인 문제를 해결하지 못합니다.
* 💡 EMDR 및 뉴로피드백과 같은 다양한 치유 방식의 효과는 개인마다 다르므로 **각자에게 가장 적합한 접근 방식**을 결정하는 것이 중요합니다.
* 🎭 연극 치료에 참여하면 개인이 **다양한 정체성과 경험**을 탐색하여 자아 개념을 재구성하고 자신감을 얻을 수 있습니다.
* 📜 언어는 개인이 자신의 감정과 경험을 표현하고 자신에 대해 더 깊이 이해할 수 있게 해주기 때문에 **치유에 중요한 역할**을 합니다.
* 🏥 현재의 정신 건강 환경은 종종 개인을 단순한 증상 프로필로 축소하여 **치유에 필수적인 타인에게 알려지고 보이는 것의 중요성**을 무시합니다.
* 🌍 자기 조절은 가르치고 배울 수 있는 핵심 생활 기술이며, **개인이 평온하고 집중할 수 있는 요인**을 발견하는 것이 중요하다는 점을 강조합니다.
* 🎶 노래와 춤과 같은 문화 활동은 감정을 관리하고 공동체 의식을 함양하는 효과적인 방법으로, **치유 과정을 향상**시킬 수 있습니다.
* 🌱 궁극적으로 치유에는 **자기 인식, 효과적인 의사소통, 지지적인 관계와 관행에 참여할 수 있는 능력**의 조합이 필요합니다.

치료사는 경직된 치료 라벨과 양식보다 각 개인의 고유한 요구 사항을 이해하는 데 우선순위를 두어야 합니다.

[Music] and things like ADHD. For instance, when I was reading your book, it was fascinating because you talk about how trauma really, you know, overwhelms your capacity to filter and it overwhelms your capacity to focus and concentrate. And it really sounded like a description of ADHD. Yeah, but see, so people buy these labels, but what does the label mean? The label means this person is unable to pay attention and sit still. Yeah, why you just say this person unable to sit still rather than using fancy language that obscures the reality. But because there's all kinds of underlying issues, it doesn't tell us anything. Um, every traumatized kid I've ever met probably meets diagnostic criteria for ADHD. That doesn't mean that every person has ADHD has been traumatized. So the surface phenomena are the same, but for God's sake, you're trained. We pay you a lot of money. You need to do better than giving a superficial label to people, you know, completely. Yeah. And so in terms of healing trauma, what? So you've tried so many different

modalities. I mean, you talk about EMDR, you talk about neurofeedback. I didn't. I studied each one of these things, and you stud. That's very. I'm just not a fan. Yeah, when I see something, I say it seems to work for whom. Does it work for whom? It doesn't work, and we really. That's what I've done in my life. I don't just. I'm not a philosopher. I'm an empiricist, and God. For whom does it work? For whom? It doesn't work, and so yes, I did the first study on EMDR, and it worked for some people and not for other people. I did the first study, scientific studies, yoga. It worked for some people and not for other people, and they need to figure out for whom does it work and for whom it doesn't work. That's really what meaning scientist means. You need to really know this stuff. Yeah, yeah, and so how is it the skill of the therapist or the skill of the psychiatrist that then manages to correlate what they think will work best.

in terms of healing modality and then match that patient to the healing modality is that you know and then how do you determine okay for this person you're feedback will work better for this person EMDR will work better for this person psychedelics might work better well that's because you really at some point you really know the modalities available there's really problem in the field of therapy is that most many therapists say everybody many therapists become religious people yeah they happen to have read some Freud and they say I'm a Freudian and somebody else happens to have read some yian and say I'm a yian and then somebody learns EMDR and said I'm an EMDR therapist that is just a technique they were two flawed guys with interesting Notions but what is it that you need is not what I my religious Believers in these dead guys it is do you think F psych analysis would help you probably not will little Union stuff help you let's find out but you need to really go like

everybody who does this work should know a whole host of different modalities, first of all. And so, yes, EMDR turns out to be a very helpful treatment for many people. So, that's one of the tools I have in my toolbox. But if you are chronically unable to focus and to concentrate and pay attention, I wouldn't do EMDR on you. I would say this person's mind is unable to focus and concentrate, and I think, let's see if neurofeedback can help you and do some computer brain interface working you where I help you to regulate your brain waves so you can actually focus your attention better. Yeah, and if you continue to live in a whole atmosphere of danger and fear that is for global these days, I would say be very helpful if you can try psychedelic agents to you for you in a very safe environment where we can allow you to go very deep into altered realities and help you to rearrange what is real for you. But it needs to be done extremely carefully. Yeah, completely, and so you

know other therapies that you talk about are theater therapy, for instance, so reimagining a different outcome of what happened. That's not quite it. I got into theater because people's identity gets formed in a certain way, and they say, Um, I need to be the tough person on the block, otherwise I'll get hurt, or I will always be ineffective, so I always need to suck up to other people, and that becomes their identity, that character in a way. And then we were inspired by a program in my neighborhood called Shakespeare in the Court. When you are a juvenile delinquent in my particular county, you have a 50% chance if you commit a minor crime as an adolescent that the judge says to you, You have a choice. You can either go to jail or you can become a Shakespearean actor. I come from a civilized part of the world, actually, and so half of the kids go through jail because it's safer, half of them go Shakespearean actors. And when you play these roles and you

play the role of Lady Macbeth when you're a very scared little girl, and you play the role of a mighty Queen who tells her husband, I want you to kill your king, otherwise I'll never have sex with you anymore. And the guy goes, I don't really want to kill my king. And then you, as the mighty queen, say, If he had not so resembled my father, I would have done the deed myself. And you play that role, you go like, Oh my God, that's what it feels like to be a mighty Queen. I will try that out a little bit more. And so people get the experience of being somebody other than the identity they have acquired. That's why do Theater, which is key. Now we're almost, I think we are almost at our 45-minute mark. It's gone very, very quickly. Yeah, you barely scratched the surface. We barely scratched the surface. I agree, it's very frustrating. Current treatment guidelines, at least in the UK, so NICE guidelines are, you know, for NICE, the National Institute of Health.

me out here. What does NICE stand for? Okay, anyway, it's the GUID. It's the guidelines for prescribing in England, NICE guidelines. So, they're the guidelines for prescribing. So, basically, if you're a psychiatrist, then you'll go to the NICE guidelines, and they'll say, Okay, if you've got depression, you prescribe an SSRI, or you prescribe CBT. Those are the two sort of treatments that are currently most prevalent in the NICE guidelines, so SSRIs and CBT. What is your view on those two sort of standard of care modalities of treatment? Yeah, I don't live in that world anymore, and I didn't start off in that world because I lived in the world of ignorance, of ignorance, ignorance, and that's a very good world to live in because then little lights start shining from time to time. Once you know the truth, you don't learn anything anymore. And so, what I've seen happen in our profession, and you may not know this, but I'm really quite an old guy, is that

these days, people try to manage other people, and I supervise a lot of young people. I say, How do I manage this? I go, I have no idea. I can barely manage myself. How can they manage somebody else? But maybe I can help you to figure out what it is that you feel you need and what works for you. And so, like, there's this CBT stuff, the cognitive behavioral treatment, where you tell people to not have their irrational thoughts. I do that with my wife all the time. I tell her that her thinking is off, and it's a miracle for our relationship. She's always so grateful when I point out to her how her thinking is not. How did psychology sink so low as to do a stupid marital argument with people, like telling people that their thinking is abnormal? Doesn't really help people to become mindful people, you know? Like, what the hell? Medication sometimes can be helpful, but if that's the only thing you know, that's the only thing you do. Yeah, agreed. I mean, I think

everybody in and a very important part of my trading back then was still you have to do your own work, and you have to really examine who you are. And at that time, it's all psychoanalysis, but you need to actually. And what has happened in their field is that people say you're screwed up, and I'm not. You're mentally ill, and I'm perfectly normal, and I'm doing a later thing later on this week about here about what is normal. I've never met a normal person in my life. Everybody has their quirks and their abnormalities. And so to say you're messed up, you need a drug, and I'm not. That's not the world I live in. Say you have problems getting close to people, or you have problems focusing and concentrating, or you know what is it going on with you that gets in the way of optimal functioning. And so what we really should be doing is to study what would be your best level of functioning and what gets in the way of your fulfilling what could.

be your destiny, yeah. And what can we do to help you to lead a more satisfying life? That's very beautiful. So, unfortunately, we're running 5 minutes over. Um, it feels like we've only just started, but um, I think what we're going to do is break up for a drink. Um, and um, not too much, yeah. And then come back, uh, and finish up a few more questions. And then we're going to open it up to the um, audience. And so, there should be a QR code um, at some point coming up on the screen. And then you can send in your questions. Good. So, yeah. So, I think I've got this right. I mean, it feels like it was not 45 minutes, but I think it was so. So, in terms of what we were just starting on, which was sort of the healing, which is really, you know, what can you do. I mean, there's so many different modalities. And we were talking a little bit about how you choose those modalities for each person. And one of the things that I was looking at um, was

you know, it's not so much the modality, but it's what it actually does. And so, I sort of picked out a few things from your book that need to happen for you to heal. One of them is what you mentioned, reestablishing a sense of safety. And so, my question is, you know, what is the best way of doing that? You know, how do you? Because you say, and I'm going to quote, These early explorations shape the limbic structures devoted to emotions and memory, but these structures can also be significantly modified by later experiences for the better, by close friendship or beautiful first love, for example, or for the worse, by violent assault, relentless bullying, or neglect. Now, say it again, sorry. So, so, for example, you guys hear the microphone, but I don't quite hear the... He wrote this, or for the worse, by violent assault, relentless bullying, or neglect. And so, what you're saying is essentially the neuroplasticity, that there is hope that once you've had this trauma, which has

been ingrained in your nervous system essentially, and at one point you talk about how when stress hormones accompany the event, it grooves the experience deeper into your brain, right? And so really, in order to heal, you need to reestablish that sense of safety. You need to have these positive experiences, which then can reshape the neuroplasticity to be in a better place. So what are the best ways of doing that? Well, you know, you bring up a really important issue that's not part of the trauma spectrum, and it's the neglect issue. And so if you grow up in a very chaotic environment and you're yet another child who is a burden, you're just a pain in the ass person who bothers people in some ways, and so nobody is particularly glad to see you. There's no sense of joy in seeing you, and that, of course, is very different from most people I know who plan their kids, and when they have their kids, they really treasure those kids. Maybe they over-get-over-involved with their kids, but you know, we're not like old-time families.

that some people in this audience I'm sure came from where you have seven kids and they amaze each other in a way uh and so a very important part to become Who You Are is to be known and to be seen to be known and to be seen and that is much even bigger than the whole trauma issue is uh do people know me do people see me and that of course is a big issue in medicine and Psychiatry today also because you are a list of symptoms and nobody gets that's interesting I live in Boston that Boston is had hospitals around within a mile from my house all say we're the greatest Hospital in the world and I bet they are great if you get really sick but when I go to any of these hospitals I'm just a chemical profile nobody knows me where do you got to get my Healthcare in a small village in Northern Vermont where Bry Sandos also goes and they know me and I walk in there they know me and I remember me from last year and and I feel really secure because I'm

a known entity, and they say, How are you doing? If you're just part of a large machine, it's, Oh, let me look at your values, or They're off, okay, you should increase your... that you should get... uh... uh... come back in three months. That doesn't give you a sense of security that people are looking after you. So, it is critical for us, for all each one of us, to be known and to be seen, huh? And that is really where safety starts. If somebody knows you and knows something about you, that's special. You feel like, Oh, I count, I matter. Is that the beginning of becoming healed? Is somebody who actually knows you and sees you? And that's also a very important part of where therapy starts, is that you need to be seen and you need to be known, but you also need to know yourself. And a lot of traumatized people don't know themselves. And so, maybe the beginning of healing from trauma is to find language for yourself and to be able to talk about what happens inside of you. And so, I think language is still

a very important part of who we are and being able to articulate what we feel, what we see, what we like and don't like. And you're not a list of symptoms; you are a person, a person who likes certain things and doesn't like other things, and that's where you start. We need to be known, and the core of therapy is to feel known, not only by other people but by yourself. And if you have been neglected and abused, you may not know yourself. So finding language for yourself, writing about yourself, is very important to be able to write, This is what I feel, this is what I see, this is what happens to me. And that's what we have language for, so language is terribly important. It's very interesting because you mentioned, you know, in your book that people who have been traumatized have a really hard time figuring out what they want, you know. They have a hard time making decisions often; they have a hard time feeling a purpose or a sense of meaning in their life. Yes, sometimes they do, sometimes, but there's a lot of internal

confusion, yes, and what language is an important way of beginning to know what's going on here and to also discover. Sometimes I feel the way, and other times they feel a different way, so language helps you to focus and to become aware and to become somebody. I encourage everybody to have kids because kids will show you in the first three, three and a half years. There is no language. They're very aware. They're very around. You see the temperaments that they're very important for people, and then they slowly develop language and say, I'm sad. I'm angry. And when you have attentive parents, you learn to identify your feelings, and you learn to know who you are. If nobody talks to you, you do not learn who you are, courtesy of John Balby, who taught us but cannot be told to the mother. The other can be not be told to the self. So being able to tell each other how we feel and what like is a very important part. Not, I'm not going to fix you until you should do something.

because you have to fix yourself, but you cannot fix yourself unless you know yourself. And unless they say, Boy, how is it going? and I'm interested, and when you have done something and I go, Wow, that's amazing that you did this, we able to do it all the time. No, under some conditions, it's not working. Say what happens, Okay, you can really investigate yourself. I'm always astounded by how many people go to doctors and expect the doctors to know what's going on with them and to passively receive what people do to them. But at the end, it is your life. For example, the issue of suicidality, very Central, the big thing in US mental health, is this person suicidal or not. If a kid is suicidal, I wonder why does this kid not want to live anymore. And you know, when you're my age, you better think about suicide because do I really want to end the last 20 years of my life in a nursing home being fed, or do I want to be in charge of my own

death. It's a very immature thing to have to consider, but very normal to think about these things, and you have to make that decision one way or another. If a kid gets to start thinking about it, why is this kid thinking about killing himself? Because something makes it terrifying for him to live. And my attitude is always, That's good, you know, a way out that gives you power. And so maybe, Can I help you to see if there's something else that's worth living for? Not like, Let's make sure you don't want to kill yourself. It is, Let me make sure I can help you that you have something to live for. That's the task of the therapist, not to get the lawyers off your back, to hold you responsible for somebody's death. I'm responsible to help you, to try to have a life. So how can I help you to find things that are worth your, well, yeah, and you can always kill yourself. It doesn't work, but let's see if it's worthwhile for you to do something.

else and so you talk about Language by way. I've never had a suicide until today, but I never know it may happen, but it's not my responsibility whether you kill yourself or not. I feel sad if you do it, but it's your life. It's your life, and this is my life. I cannot run your life for you. Yeah, yeah. So, okay, so feeling safe, being able to have a sense of yourself, and being able to verbalize that sense of self, and to be seen, and to be seen. I think that communal thing is so important that most adolescents go through terrible times, but my parents will be disappointed if I kill myself. Yeah, let me get some good grades for my parents, at least part of me, something, because we are interpersonal creatures, and we always are thinking about what other people are thinking of us, and we make a good impression because that is our nature, is to be interconnected. So, the question is, who are you playing to? Yeah, who are the people whose judgment is important to you? Yeah, and if a kid says

nobody gives a about whether I live or die. Go, that's a problem. You have to matter. You have to matter. And I think all the programs that we are involved with in my organization are programs that help kids to know that they matter. One of them, that's why I love theater, for example. If you do a piece of theater, which we have done a lot of in the Boston City Schools, if you don't show up, the play cannot go on. So I need to go to my play. It matters. I'm on my team. And if the sports team, if I don't show up, my team is going to lose. We need to have that feeling that I'm an essential ingredient for other people's lives and not only my own. That's our nature. Argue with me if you don't agree because I love to argue with people, but that is my idea about who we are. And so another state, another sort of prerequisite for healing, um, is to get into the right state. And you say, and I'm going to quote again, mainstream.

medicine is firmly committed to a better life through chemistry, and the fact that we can actually change our own physiology and inner equilibrium by means other than drugs is rarely considered. And so, one of the essential prerequisites for healing is being able to manage your own state. And so, what are the best ways that you would work with people to help them to manage their own state, to self-regulate, to self-organize? You help people to discover what makes them feel focused or calm, etc., etc., and it's always an experimental question. Let's see what happens if we take a deep, deep breath and breathe out slowly. And let's do that a few times. Do you notice that something is different? What happens if you touch your leg? What happens if you sit up straight? Let's discover what makes you feel well and to really see what makes a difference in your life. What sort of music do you like? What sort of sound do you like? So, really discover what your body responds to and how your body changes as you engage in

music or engage in sports or engage in activities. One thing that actually we talked about today in the meeting that you were in there for is that I advocate that all of our schools around the world teach the four basic Rs: Reading, Writing, Arithmetic, and Self-Regulation. And that's from kindergarten through the end of high school. Every week, you have classes and laboratories about who are we, how does our brain function, what's it like to be talking to each other, what's it like to sing together, what's it like to make music together, what's it like to throw a basketball, what's it like to engage with people, and to really discover who we are, not only what's out there but this is inside of us. And for people to become curious about our internal workings and to really practice what it does, what it does for you when somebody touches your arm, what's it like for you if you toss that basketball, to really become aware of how that internal creature responds to the world and what happens inside of you, and you

become curious about this immense universe that you inhabit. And so, because you know you talk about how learning to manage arousal is a key life skill, which is taught to you by your parents essentially. What if you miss that developmental milestone, and you were not taught by your parents? Is, you know, later on, can you still get back to that learning to regulate? Of course, you can have. We are malleable creatures. We have ongoing neuroplasticity, and you already have discovered that if you listen to Bring Springfield, you feel a bit calmer. And if you smoke a little dope, that when somebody else at you, it doesn't bother you so much. And so, let's discover what helps you to feel calmer and to be more mindful. And as you and I just discussed, mindfulness is very important, learning to notice yourself and to feel yourself. But for many people, being mindful is very scary because the body keeps score, and much you become quiet, all of this stuff starts coming up, and it may be a

very scary experience, but then what we discover is that if you do tai chi or yoga, you can fully engage with your body, but you also have to pay attention to how your body moves, and you still get that internal capacity for self-regulation. And around the world, everywhere except for the UK and the Netherlands, where I grew up, and New England, where I live now, people have traditions of moving together and singing together and dancing together as a way of regulating yourself. And what do you do with your kids when they are upset? You sing together, you move together, you do things together to calm yourself down. But moving and that sort of stuff is prescribed in our white, not European cultures, but the rest of the world does that beautifully, of course.

Trauma Has NO Quick-Fix | Dr Bessel van der Kolk on the Body Keeps the Score.

How To Academy

트라우마는 사람의 집중력과 집중력을 압도하여 종종 ADHD로 분류되는 행동으로 이어질 수 있습니다.

ADHD와 트라우마의 진단 기준은 겹칠 수 있지만, 이러한 분류는 근본적인 문제에 대한 명확한 이해를 제공하지 못할 수 있습니다.

EMDR 및 뉴로피드백과 같은 다양한 치료 방식의 효과는 사람마다 다르며, 숙련된 치료사는 특정 치료 방식을 고수하기보다는 개인의 필요에 맞는 치료 방식을 찾는 데 집중해야 합니다.

효과적인 치료를 위해서는 EMDR, 뉴로피드백, 환각제 등 다양한 치료 방식이 필수적입니다.

연극 치료는 개인이 자신의 정체성과 경험을 재상상하도록 돕는 데 중요한 역할을 합니다.

독특한 프로그램인 '셰익스피어 인 더 코트'는 청소년 비행 청소년에게 감옥과 연기 중 하나를 선택하게 하여 다양한 역할과 정체성을 탐구할 수 있는 기회를 제공합니다.

우울증에 대한 NICE 가이드라인 및 표준 치료법

NICE는 영국에서 치료법 처방에 대한 가이드라인을 제공하는 국립보건임상연구원(National Institute for Health and Care Excellence)의 약자입니다.

NICE 가이드라인에서 가장 널리 사용되는 두 가지 우울증 치료법은 SSRI(선택적 세로토닌 재흡수 억제제)와 CBT(인지 행동 치료)입니다.

연사는 표준 치료 접근법을 비판하며 자기 검진의 중요성을 강조하고 정신 건강의 정상이라는 개념에 의문을 제기합니다.

치유를 위한 안전 재확립의 중요성

초기 경험은 감정과 기억을 담당하는 뇌의 변연계 구조를 형성하기 때문에 트라우마 치유를 위해서는 안전감을 회복하는 것이 매우 중요합니다.

친밀한 우정이나 사랑과 같은 긍정적인 경험은 이러한 구조를 더 나은 방향으로 변화시킬 수 있지만, 괴롭힘이나 방임과 같은 부정적인 경험은 해로운 영향을 미칠 수 있습니다.

신경가소성은 긍정적인 경험이 뇌의 반응을 재구성하고 더 나은 감정 상태를 촉진할 수 있기 때문에 치유에 대한 희망을 제공합니다.

알려지고 보여지는 것의 중요성

특히 트라우마를 경험한 사람들에게는 자신의 정체성과 치유를 위해 자신을 알리고 드러내는 것이 중요합니다.

대규모 의료 시스템은 종종 개인을 단순한 화학적 프로필로 취급하여 안전과 치유를 촉진하는 개인적인 연결이 부족합니다.

언어는 자아를 발견하고 감정을 표현하는 데 중요한 역할을 하므로 트라우마 생존자가 자신의 목소리를 찾고 자신을 이해하는 것에 필수적입니다.

언어는 자기 인식과 정체성 형성에 중요한 역할을 하며, 특히 처음 의사소통을 시작하는 어린이의 경우 자각과 기질을 통해 의사소통을 합니다.

세심한 양육과 열린 의사소통은 아이들이 자신의 감정을 파악하고 자신을 이해하는 데 도움이 됩니다.

연사는 자신의 삶과 결정에 책임을 지는 것의 중요성을 강조하며, 위기에 처한 사람들이 삶의 의미와 목적을 찾을 수 있도록 도와줍니다.

자신의 정체성과 타인의 판단이 미치는 영향에 대해 고민하는 청소년에게 안전감을 느끼고 자아감을 갖는 것은 매우 중요합니다.

연사는 공동체적 관계의 중요성과 타인의 삶을 소중히 여기는 마음을 강조하며 모든 사람이 다른 사람의 삶에 필수적인 존재라고 느껴야 한다고 주장합니다.

또한, 자기 조절과 자신의 상태를 관리하는 데 도움이 되는 것을 발견하는 것이 치유의 핵심이며, 각 개인에게 가장 효과적인 방법을 찾기 위해 다양한 기술을 실험하는 것이 중요하다고 강조합니다.

학교에서 자율 규제를 가르치는 것의 중요성

이 연사는 유치원부터 고등학교까지 전 세계 학교에서 읽기, 쓰기, 산수, 자기 조절을 가르칠 것을 주장합니다.

자신을 이해하고 음악과 스포츠와 같은 활동에 참여하여 세상에 대한 내면의 반응을 발견하는 것이 중요하다고 강조합니다.

연사는 많은 문화권에서 감정을 진정시키고 조절하기 위해 함께 노래하고 춤추고 움직이는 전통이 있다는 점을 언급하며 자기 조절에 있어 마음챙김과 신체 움직임의 중요성을 강조합니다.