Positive Approaches Journal, Volume 13, Issue 2

Volume 13 ► Issue 2 ► September 2024

Understanding Trauma: Expressive Therapies

We have been engaged in a long journey, helping folks to see the relationship between a person’s intellectual and neurological differences, mental health issues, challenging behaviors, and their experiences of complex and on-going trauma. In the 1980’s and 90’s our focus was on changing the professional and clinical opinions that individuals with intellectual disability (ID) “could not experience or suffer from the consequences of trauma”. Much headway has been made in changing that perception. We now acknowledge the high incidence of trauma and the wide range of sources of trauma in people with ID. However, there is still much to learn and share about best and promising practices to support people in recovering from trauma, to move forward with a fulfilling, joyful life.

In the early 2000’s, The PA Dual Diagnosis Initiative introduced eye movement desensitization and reprocessing (EMDR) as a useful tool to help people heal from trauma through the teaching of Andrew Seubert. Through a grant from the Office of Developmental Programs (ODP), we provided intensive EMDR training for practitioners. While many clinicians were trained, we were faced with skepticism, and didn’t train to the scale we had hoped for. There weren’t any studies at that time directly supporting the use of EMDR with people with ID. As a result, we decided to conduct preliminary research using case studies of EMDR practice with people we worked with having Dual Diagnosis, showing the positive effects on individuals with ID without requiring them to be articulate or verbal. ¹ For each person to qualify for the study, they had to have experienced at least one significant trauma in their life and be referred to us for help with their challenging behaviors. We were able to identify the traumas each participant in the study experienced using a biographical timeline exploring the person’s life. Therefore, we did not need to rely on a verbal report of the trauma experienced by the participants. Each person in the study showed significant gains. Their challenging behaviors subsided, replaced by more pro-social behaviors. Some folks also showed dramatically improved memory and capacity to organize their thoughts. For example, one person was able to ask questions about issues that had bothered them for years but had been unable to articulate their questions before engaging in EMDR.

We saw that we could impact a person’s mind/body trauma loop through the EMDR practice, with special focus on bilateral stimulation as a significant aspect of the process. (This article continues to be cited in many countries and is still being used as a launching off point to explore a variety of promising practices supporting people with ID to heal from trauma).

Using EMDR and seeing the impact of bilateral stimulation on individuals, regardless of their verbal abilities, heightened our interest in pursuing other means to offer body-based interventions from Lifestyle changes, including movement and nutrition, to Mindfulness and stress reduction practices, as well as a host of body-based therapies, including Neurofeedback, Neuro Entrainment, Biofeedback, Havening, Tapping, Music, Art, Equine and Animal assisted Therapy, and an ever-evolving group of therapies. ²

No matter which approaches we use, their success is predicated on the person having a safe, trustworthy, fulfilling homelife. We must always keep our focus on developing and sustaining a healing lifestyle. Together we are in this for the long haul, and as they say, “life happens”. People have triggers and setbacks, new losses and fear inducing situations, but can rebound well when they are supported by people they trust and know truly care for them.

In this issue of the Positive Approaches Journal, we see that there have been important strides in identifying the prevalence of trauma and the complex consequences of trauma from multiple sources, including social adversity, abuse and neglect.  The focus is on the importance of taking this into consideration on every level, from systems collaboration, to how we assess, diagnose, treat, and offer restorative environmental supports to individuals with intellectual disability and autism (ID/A).