While professional coaches are not in the business of providing psychotherapy to men and women suffering from Post-Traumatic Stress Disorder (PTSD), they need to know about this challenging condition, given that they are often working with coaching clients who have suffered from trauma. Dror Green offers a new approach to working with traumatized men and women—an approach known as Emotional Training. This approach is based on a different model of the emotional process. Instead of the vague definitions of ‘normality’ and ‘pathology’, Dr. Green suggests two other poles of emotional health: one is ‘anxiety’ and the other is a ‘safe place’ (or ‘secure frame’). Anxiety is the natural response to dangers in reality, and especially to death that we all meet during our life circle. The ‘safe place’ is a frame we create in order to protect ourselves (a house, a family, religion, country, culture, etc.). When the ‘safe place’ is not strong enough, our anxiety increases correspondingly. All emotional damages are actually a manifestation of a low level of ‘safe place’ and an increasing level of anxiety. Severe trauma, such as shell-shock or a rape, is a manifestation of extreme anxiety and almost a total lack of a ‘safe place’.
Anxiety, Safety and Trauma
Anxiety and a ‘safe place’ are not natural situations, deriving from our organic system, but acquired skills that enable us to cope with reality. Therefore, we cannot ‘cure’ anxiety and expect that the ‘safe place’ would also be rehabilitated by itself. Traumatic damage means that our skill of creating a ‘safe place’, which we had acquired slowly during our lives, does not function any more. Instead of ‘curing’ the trauma we can improve our emotional skills, through which we can create a ‘safe place’. This is the purpose of Emotional Training.
The trauma of being aware of the trauma
The traumatic damage increases with every new traumatic experience. Unfortunately, when one becomes aware of the trauma, one experiences a new traumatic process that may increase the trauma or postpone the appropriate treatment. Contrary to the psychoanalytic assumption that awareness relieves or decreases the traumatic symptoms, awareness to a traumatic event does not bring any relief. Veterans who realize that they suffer from post-trauma must cope with more difficulties and new kinds of traumatic pain.
The reason for this phenomenon is simple. Self-awareness of the trauma shakes the foundations of one’s biography and forces new understanding of the personal history. Post-traumatic victims are forced to re-evaluate their whole life system, their choices, their values, their professional career and their family and personal relationships. It is no wonder that many veterans who recognize their trauma lose their jobs, divorce and draw away from their social circles.
PTSD victims often experience the first awareness of their symptoms with even more traumatic reactions. Some of them become violent and aggressive, and have to cope with disemployment and divorce. Others, who are still serving in elite military unites in their reserve service, refuse to face their symptoms. Their wives and partners speak of their panic attacks, about nights without sleep and about emotional difficulties that damage their family lives.
The trauma of coping with family and friends
When one decides to share his secret, concerning PTSD, with his family and partner, one has to cope with a new kind of traumatic experience. There are various kinds of reaction by close relatives to such exposure, but simple understanding and support is seldom one of them. Since PTSD is interpreted by the public as a kind of mental illness, many people are still deterred by the stigma. These kinds of reactions are so painful and traumatic that many PTSD victims disconnect themselves from their partners and families, and do not expose their difficulties any more.
The trauma of coping with the bureaucracy of the helping systems
Israel could be the international center for methods and information concerning PTSD. Wars and terror are part of everyday life in Israel, and hundreds of thousands of Israelis were exposed to traumatic experiences. Paradoxically, the terms ‘shell shock’ and ‘post-trauma’ were not accepted in either the professional jargons or the spoken language of Israel. The military administration in Israel did not want to recognize shell shock and post-trauma and believed that such recognition might weaken the spirit of the soldiers. The civil society in Israel (which is not tolerant of people who are deviating from the conventional system) labels post-traumatic victims as traitors, spoiled or insane. Although the term PTSD became familiar in Israel during the last decade, the helping systems and administration in this country are still alienated. Most of PTSD victims are not treated and no serious attempts have been made in Israel to develop new therapeutic approaches in the treatment of PTSD.
This same condition exists in the United States and in many other countries in which trauma occurs as a result of wars, terror, violence or natural disasters. Post-trauma is not visible as are other kinds of injury, and human beings prefer to ignore intimidating phenomena as much as they can. For PTSD victims, who need support and recognition, this reaction is hard and distressing. Soldiers who have been exposed to traumatic events during a war or civilians have been present during horrifying events (such as a terrorist attack or hurricane) need to be treated by the official helping system within a short period of time after the event. Unfortunately, post-traumatic symptoms appear a long time after the event. It can take weeks, months or many years after the traumatic event. The helping system does not support people who were exposed to traumatic events, and in most cases, they have no means to support people who ask for help. No one can anticipate the long-term effects of the trauma and each PTSD victim processes the symptoms in a special and unique way. The best support at the time of the event can be made by family members and close friends, who can accept the trauma and offer continuing emotional support.
PTSD victims usually approach the helping systems many months (or even years) after the traumatic event. They do so after coping alone with the increasing symptoms, the traumatic process of being aware to the trauma, and the traumatic reactions of their family members. The interaction with the helping systems is hard and traumatic, since it involves meetings with officials and administrators that have no helping qualifications, and demand proofs for each claim.
During this stage, PTSD victims are vulnerable and anxious, and each interaction increases their pain and their disbelief. They are forced to see specialists and medical boards, and hire lawyers that will represent them. This exhausting process may take months or years, and many PTSD victims prefer to give up and stop it before there are any results. PTSD victims who can survive this painful process and are entitled to be supported by the helping systems must depend on the administration as long as they need support. This means that in spite of its proclaimed role, the helping system is also a factor that enhances the trauma.
PTSD as a societal disease
People are often afraid of emotional or so called ‘mental’ symptoms. Such symptoms, which represent invisible characteristics of the human nature, are regarded as demons that can endanger the social structure. As is the case with most symptoms of PTSD, these emotional symptoms in most cases, paradoxically, can be found separately in any normal person. Emotional symptoms are often the sign of a societal disease. This is especially true for PTSD victims. PTSD victims that were involved in military activity or rape are not responsible for their pain. They are the victims of a social activity in which they were forced to be involved. Social systems never like to expose their weaknesses, and it is conventional to blame the victims for the societal disease.
The attitude toward PTSD victims may reflect the nature and intensity of this societal disease. A negative attitude concerning PTSD victims expresses a high degree of social anxiety, while strong and secure societies are more tolerant to such weaknesses. A post-traumatic society, like that which exists in Israel (which has been exposed to traumatic events for more than sixty years), develops the same symptoms as PTSD victims: anxiety, violent behavior, xenophobia, and a tendency toward racism and fascism.
This means that post traumatic victims, whose trauma is common in wide parts of society, will not receive the help and support these victims need. As sad as it may sound, in areas where the trauma is widespread, less effort will be made to learn and to develop methods of rehabilitation. Post-trauma is not a mental illness but an injury as any physical damage or a limb amputation. It is an amputation of the sense of security, which is essential for adaptation to reality. Furthermore, it is a deep damage of the emotional skills that create the sense of a ‘safe place’. Post-trauma does not require therapy (psychological or psychiatric). It requires, instead, a restoration of the emotional skills that are required in creating a ‘safe place’. This can be made by learning and training, which is the essence of Emotional Training (an approach that coaches can use and that is described in Dror Green’s book, Emotional Training: The Art of Creating a Sense of a Safe Place in a Changing World). A brief overview of this approach follows. A fuller description is provided in Emotional Training which is now available on Amazon and Kindle. It is also available by contacting Dr. Green directly (see his biographical description below).
Emotional Training
Given the discovery that the sense of a safe place is the main benefit traumatized clients may find, Dror Green decided to research how this sense of security is created in psychotherapy and in other situations. This led him to identify seven categories of emotional skill with which we create the sense of a safe place, and without which we cannot survive in our contemporary world.
Emotional Training is designated to help PTSD victims identify their special and unique emotional skills, to understand how they use these skills to create a sense of a safe place and to improve them as a continuous process in their lives. This program is based on the practice of the seven categories of emotional skills. By simulations and practicing it becomes a simple and practical way of life that serves as an emotional immune system. Emotional Training is a basic and primary skill for rehabilitating the emotional process, and it can be integrated with any other skills and methods. It is beneficial for PTSD victims, since this approach does not relate to the trauma as an illness, and since it provide PDSD victims with emotional skills to efficiently cope with the post-traumatic symptoms. Emotional Training does not pretend to heal or fix the trauma, but it introduces practical tools to cope with the traumatic damage which cannot be healed and it enables PTSD victims to live full and creative life after the trauma.
The post-traumatic damage does not involve only PTSD victims, but also their family members and close relationships. The rehabilitation of PTSD victims requires a supporting environment in which appropriate tools are provided that enable the PTSD victim to cope with the difficult symptoms. A basic safe place is required in which emotional skills may be practiced with the assistance of a skilled professional.
In 2000 Dr. Green started an online support group for PTSD victims, which he is still running. Online support has some advantages for PTSD victims:
1. Accessibility. PTSD victims can join online support groups without leaving their ‘safe place’ at home. While many PTSD victims suffer from anxiety that prevents them of entering crowded or noisy places, they can participate in online interaction without losing their sense of control.
2. Anonymity. Many PTSD victims avoid exposing their trauma to their families or even to professional therapists. Open support groups enable them to experience and to share their feelings with other people who can understand them, while keeping their anonymity. This is the first step of joining a professional support group or personal online therapy.
3. Privacy. The virtual clinic provides more privacy than a physical clinic, since no one can see the client enter the therapist’s office.
4. Information. Online website that is dedicated to post-trauma is the best source of information for PTSD victims, where they do not have to expose themselves.
5. Social skills. Online support groups enable PTSD victims to re-engage with other people and recreate their damaged social skills in a secure environment.
Online communication is the best setting for PTSD victims, since it enables them to interact anonymously, or in the confidential setting of the online clinic, without leaving their houses.
As one of the pioneers of online therapy, Dror Green has developed the first (and only) online clinic. The online clinic is a revolutionary development in online support, since it includes all advantages of face-to-face support, and also creates a new kind of helping relationship which was never available before. This approach to assisting men and women who have experienced trauma can be of great assistance to those who are providing either personal or organizational coaching services. While a professional coach should never seek to do psychotherapy or assume that their services can take the place of psychotherapy when working with a severely traumatized client, this coach can assist those with trauma to deal immediately in a more effective manner with the trauma—leading either to a life in which their trauma is less influential in their life or to a decision that psychotherapy is necessary for them to move on to richer life experiences.
As noted above, a fuller description is provided in Dror Green’s Emotional Training: The Art of Creating a Sense of a Safe Place in a Changing World –a book which is now available on Amazon and Kindle. It is also available by contacting Dr. Green directly (see his biographical description below).