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A group music and imagery (GrpMI) intervention was found to be effective at treating women with posttraumatic stress disorder (PTSD) or complex posttraumatic stress disorder (CPTSD). These findings were published in the European Journal of Trauma & Dissociation.

Women (N=45) who were referred for PTSD/CPTSD treatment at a private clinic in Sweden in 2016 to 2018 were recruited for this study. Participants were evaluated by questionnaire about psychiatric symptoms and functioning. Patients were matched based on age and severity of symptoms and randomized to receive wait list (n=23) or the GrpMI intervention (n=22). The primary outcome was the change in PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (PCL-5) score.

The intervention comprised 12 weekly 2-and-a-half-hour group sessions with 5 to 7 participants which used the Bonny Method of Guided Imagery and Music method. During each session, a therapist would guide participants with dialogues during a 30–45-minute classical music program. The guided imagery focused on self-exploration and working through inner conflicts and trauma.

The intervention and control cohorts were aged mean 45.2 (SD, 10.7) and 42.2 (SD, 9.10) years, 77.3% and 87.0% experienced both adult and childhood trauma, 50.0% and 52.2% were on sick-leave from work, 59.1% and 47.8% were married, and 86.4% and 73.9% had children, respectively.

Compared with controls, the GrpMI intervention associated with significant changes to the PCL-5 (F[1,42], 8.68; P ≤.01), Hopkins Symptom Check List-25 (HSCL-25; F[1,42], 7.94; P ≤.01), HSCL-5 Anxiety Subscale (F[1,42], 7.94; P ≤.01), PCL-5 Dysregulated Self Organization (F[1,42], 5.37; P ≤.05), HSCL-25 Depressive Subscale (F[1,42], 4.45; P ≤.05), Dissociative Experience Scale (DES; F[1,42], 5.59; P ≤.05), and Positive States of Mind Scale (PSOMS; F[1,42], 5.17; P ≤.05).

More patients who received the GrpMI intervention had a diagnostic change (38.1% vs 4.3%; χ2, 9.50; P =.023) and a 10 or greater point change in the Rate of Clinical Improvement (57.1% vs 17.4%; P =.007).

This study may have been limited by choosing a nonactive control condition.

The study authors concluded, “The result of the present study suggests that the phased trauma-focused modification of the GrpMI method may be a promising treatment modality for PTSD and CPTSD. Additional studies are warranted to confirm the efficacy of the method and to investigate the specific mechanisms relevant to the treatment effect.”

Reference Rudstam G, Elofsson UOE, Söndergaard HP, Bonde LO, Beck BD. Trauma-focused group music and imagery with women suffering from PTSD/Complex PTSD: A randomized controlled study . EJTD. 2022;6(3):100277. doi:10.1016/j.ejtd.2022.100277

i am not a Hero
Just an old man in my bed
i try to sleep at night
With memories in my head

The storm at night now scares me
The lightning and rumbles above
The memories of the war i went to
But yet did nothing a Hero would speak of

i canʼt help myself with these feelings
i fear what has already past
As i lay hear in my safe bed
With the prayers that this storm wonʼt last

i try to prepare for the worst
Thoughts and fear run through my head
But i canʼt help think of those soldiers
As i lay here in my safe bed

i am not a Hero
i studied, i trained, i went
But nothing except bad memories
Of when i layed there in my tent

But now many things scare me
That i have never feared before
As i lay here in my safe bed
With memories i have from war

i try and try to hold it
These emotions that i have
And the ones who are now my protectors
Continue to come home to a grave

i am not a Hero
There are others who deserve that praise
But the price that they pay for their service to us
Is forgotten in not many days

As i continue to live life and get older
My children live safe and have grown
i cannot help but think of the days
When i was the one who was gone

Once young and eager to serve my country
There was nothing that i would fear
But now i lay in my safe bed
Afraid of the sounds that i hear

There are Heroes that deserve our thanks
Even more for what they endured
For their fearless and selfless service
Now unable to hear our word

i am not a Hero
Just an old man that doesnʼt understand
Why i have fear of things like never before
Such as the shadows i see from my hand

Those serving us now are the true Heroes
For the comfort that they give
Those warriors who fight for our freedom
So old soldiers like me can live

They protect us and fight for our freedom
Earn ribbons they wear on their chest
Yet these Heroes when they return
Are praised with “They were the best”

There is nothing we can say or do
To prevent this bittersweet calling
Thank them now for their service to GOD and country
In case some day they have fallen

i am not a Hero
Just an old man in my safe bed
With the pride that i served so others may live free
And the fear of whatʼs in my head

os, SFC Ret

SK

Itʼs likely youʼve heard by now that exercise can be an effective tool to manage mental health symptoms. Itʼs equally likely that 99% of the people reading this also just let out a groan at the thought of having to sign up at a gym, wake up an hour earlier in the morning, dig your old gym shoes out from the bottom of your closet, work up the courage to go to the gym or find a time of day it isnʼt blazing hot to go on a run (I mean who wants to run in Texas in the summer anyway?), and get that popularly touted, mental health curing workout in.
Not really your style? Thatʼs ok.

Movement (or exercise) can look entirely different for everyone and still accomplish the same benefits. The most important thing is finding something that makes your body and mind feel good. For some people, this does mean going to the gym and getting an intense workout done. For others, it means going on a run. But for many people, it can be even simpler than that.

Walking is one of the most underrated forms of movement. Weʼve all heard the “10,000 steps per day” nonsense (as in thereʼs no research to show that 10,000 steps is an effective number and was actually arbitrarily picked by fitness watch manufacturers to sell watches, but thatʼs another story) but walking doesnʼt have to be that long or measured in any way to be beneficial. Even getting out for a 5 minute walk can improve your mood dramatically, or distract you from self destructive behavior, or be the stepping stone for creating the changes you want to see in your life.

There are numerous reasons that walking can be game changing for your mental health. Spending time in nature has been shown to reduce feelings of depression and anxiety, as well as promote grounding and relaxation. Walking helps tie physical movement to regulated breathing, which has a calming effect on the nervous system. Going for a walk is also a lower impact form of movement than running, while still improving your cardiovascular health and muscle tone. All of these benefits can be available to you in as few as 5 minutes of walking.

Interested in more on the effects of movement and mental health? Keep an eye out for more blog posts coming soon!

Bea Morrealle, LPC

So you thinking about going to therapy…
Recognizing that you need help is the first step in becoming a more resilient version of yourself. Therapy can help you overcome both long term and short term issues that are causing distress or impairments on your day to day living. Whether you have struggled your whole life, or are just going through a difficult stage, seeking a mental health counselor can help you unravel distorted thoughts, self sabotaging beliefs, and unhealthy habits that hinder you from living a more fulfilled life. Therapy can also help you get a more clear perspective and flexible mind, while processing events in a secure, non-judgmental environment. Here is a brief guide on what you need to know before going to therapy.

1. Find a therapist! This can seem like the most daunting part, because there are several therapists out there. You can start with identifying what you are seeking therapy for and search for someone who specializes in that particular issue. For example, if you are experiencing anxiety, try to find a therapist who is familiar with evidenced based therapy techniques to help you manage anxiety symptoms. Therapists can specialize in trauma, marriage and family issues, kids, personality disorders, mood disorders, veterans, etc. Much like doctors, therapists can treat very basic issues, just like a general practitioner, or more specific issues, such as eating disorders or OCD. Itʼs important to find someone who knows how to help you with your specific concerns.

2. Figure out finances. Most major insurance companies cover mental health, such as individual therapy, and even higher levels of care such as intensive outpatient therapy programs. You can contact your insurance company to figure out your benefits, or call our staff at Innova Recovery Center and we can check on benefits for you. Most therapists also offer private pay option as well, if you choose to forgo insurance, or if you do not have coverage. If finances are an issue, please let us know so we can give you options.

3. Make an appointment. During an initial session, the therapist will go over some paperwork, conduct an intake interview, and help you to set goals for therapy. It might seem intimidating to tell a stranger about your life and your problems, but this is what we are trained to do! And most therapists love their job! It is important for you to feel safe and comfortable because vulnerability can be difficult at first. The initial session should give you a general foundation of the therapeutic approach and guidelines for the therapy sessions. You can also ask your therapist questions about their approach, how long they have been in the field and what experience they have with your specific problem.

4. Be prepared for some discomfort. Although therapy is designed for healing, sometimes this healing can be challenging. Think about it like physical therapy for the mind, you might leave feeling “sore”, but working through the pain will eventually lead to relief. Itʼs normal and natural to become emotional in therapy, and even cry! This is 100% okay. If you have been holding in emotions for a long time, they will want to come out. Donʼt worry, we have plenty of tissues and healthy ways to talk about and feel your emotions in a way that will help you grow.

5. Keep on going! Remember, therapy is FOR you, not against you. As mentioned, it might be uncomfortable, but donʼt give up on yourself! Remember the reasons why you started therapy in the first place, and continue to go over goals and progress with your therapist. Donʼt be afraid to tell your therapist how you feel, what you are needing, and whether you need to slow down or speed up. There is no magical time frame- therapy can take a few months, or even several years. Give yourself the time and space you need to heal. Over the course of therapy, you will begin to learn more about yourself and settle in a place of true healing.

Innova Recovery Center has a wide range of therapist specializing in everything from working with kids, PTSD, marital issues, eating disorders, generalized anxiety and more! Each therapist brings a specialty niche creating a “one stop shop” for therapy for you and the whole family, if needed. Check out the “staff” page on our website to learn more about our therapist and find one that fits you and your needs. Then, take a deep breath, youʼre home.

By Alyssa Booth, LPC

1:3 girls and 1:5 boys are sexually molested by age 18. This means that roughly 20% of our population has had sexual abuse as a child. Up to 20% of those who have served in Iraq/Afghanistan have PTSD, in addition to the others who have symptoms that are not fully diagnosable. Over all, we have a significant part of our population that is at high risk to be triggered by masks.

If someone had their mouth covered while being raped, a mask brings up those same feelings. A mask also resembles a hijab, a face covering commonly seen in the Middle East, which is triggering for those who have served in the military. Those with a trauma history are already hyper vigilant, depending on reading peopleʼs facial cues to determine social safety, or someoneʼs general feeling of safety in a social situation.

Essentially, we must remember that mental health is JUST AS IMPORTANT as physical health. It is up to each individual to assess and prioritize their own health to determine how to best keep themselves safe. For some, having their mouth covered puts them at HIGH RISK for panic attacks, flashbacks, increased nightmares, and major depressive episodes. These things can take months to crawl out of and are not to be taken lightly by someone fighting a daily battle against their own anxiety. We cannot judge their decision as being reckless to physical safety any more than they can judge someone elseʼs based on recklessness to their mental stability. Additionally, someone should not have to disclose their trauma history to justify why they cannot wear a mask. Can you imagine having to share the worst memories of your life to be able to walk into Target?

Have grace. Everyone is fighting their own battle and we donʼt get to determine who their biggest enemy is.

If you have a loved one in therapy, you might be wondering what you can do to help. Here are a few tips for supporting a friend or family who is in therapy.

1. You can say things such as:
-Please let me know if you need to talk or if you need space.
-Therapy is such a brave decision.
– I am happy that you are choosing to get help.

Or ask:
-What are your triggers?
-How will I know if you are struggling?
-What are some skills I can remind you of when you are struggling?
-What can I do to support you?

2. Validate their emotions and experience. Sometimes all we want is to be heard. If your loved one is in therapy, let the therapist do therapy. Simple validation such as “wow you must be going through a lot”, “I see how much this is affecting you”, or “that must be such a hard situation to be going through” can help reduce shame and stress. It can also build a space for your loved one to feel safe.

3. Respect Boundaries. More likely than not, your friend or family member is working on setting their own boundaries in therapy. This might change the dynamic of the relationship they have with you, which can be a challenging road to navigate for both parties. Know that itʼs okay to feel the discomfort as youʼre both working on finding a rhythm that works. Give it time, and voice your concerns in a loving caring way.

4. If appropriate, ask to attend a session with them. Especially if you are a partner or family member, or a source of main support, attending a therapy session can help you better understand the nature of what is going on. There might be some things the therapist can explain that your loved one cannot put into words, and this gives you a space to share your own concerns as well, again, with the support of a therapist.

5. Give positive reinforcement. If you start to notice small positive changes in your loved one, let them know! Sometimes itʼs challenging for us to see our own progress since we are with ourselves everyday, so a gentle reminder can really lift our spirits. Plus, therapy is hard work! Your loved one will appreciate their hard work showing up in their real lives.

6. Practice healthy communication. The best way to do this is with (a) timing, (b) I statements, and (c) a caring tone. Make sure you and your loved one are in a good headspace for communicating, with timing. You donʼt want to catch someone off guard, or communicate with either of you is overly emotionally activated. Use I statements such as “I feel… (emotion word), when…” And lastly, use a loving and caring tone when communicating, again, to create a safe space of healing.

Some things to avoid saying or asking:
Itʼs not a big deal.
Everyone goes through stuff, not just you.
Youʼre being ridiculous.
Therapy is for crazy people.
People have it way worse than you.
Therapy is a waste of money; those people donʼt really care.
Why arenʼt you better yet?
What will people say if they find out you have to go to therapy?
Just donʼt think about it anymore.

Overall, going to therapy is a decision of empowerment and self care. Depending on the nature of the clinical concern will determine the nature of the treatment that needs to be done. Be patient and practice healthy communication. Your loved one will appreciate your kindness and support during a challenging time.

by Alyssa L. Booth, MA, LPC
Licensed Professional Counselor

Innova has been leading the way in telehealth treatment since 2016. We offer online counseling sessions for adults and children to treat anxiety, depression, trauma, PTSD and marital issues. We also have the best residential trauma treatment center in the US, right here in San Antonio

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Thomas B. Efird, LCSW, LCDC, EMDR Approved Consultant, San Antonio, Texas and Telehealth

So why on earth would a counselor promote cooking on a mental health website? Shouldnʼt I promote “donʼtʼ eat your feelings?” Well, yes. I like to cook. More importantly, I like to eat what I make. Even under shelter in place, I like to do both of these things. Why wouldnʼt I want to promote family fun time in the kitchen? There is a wonderful line from the Avengers Endgame movie said between a father and son “No amount of money ever bought a second of time.” Over the few months our world has radically changed-for better and for worse. As we shelter in place, we are all experiencing emotional upheavals and trying to find our way through this. I promote cooking together as a way to build families, homes and communities. It is an act of love to take the time to create something that others will hopefully enjoy. There is nothing like family bonding over a meal. So pretty please, with sugar on it, get in the kitchen, start cooking and have fun! Helpful hint: start with a scrambled egg. In real butter. Youʼll thank me later…. but I digest….

In my experience, there is one thing that unites us all. Every part of the world we have one common bond, our love of food. I have yet to meet a person who doesnʼt like food, especially good food. If itʼs not good, you wonʼt eat it. Ever try brussels sprouts? Those things are little green balls of death that smell like feet! No amount of cheese, salt or garlic will cover that! At a religious or family event where someone has brought homemade dishes, did you say “No thanks, I ate a hot dog at the gas station.” Hopefully you didnʼt. (If you did, please, make an appointment with us as soon as possible!). What I hope happened was you dug into the good stuff. The stuff that was homemade. The food that was gone in seconds. The stuff that made your tummy the happiest place on earth. Again…I digest…. (see what Iʼm doing there?).

What do we do while sheltered in place with some time on your hands? Get yourself and your family into the kitchen. Donʼt know where to start? If you are fortunate to have a family member who can help, call them and ask for help. Ask them to walk you through how they made your favorite meal. I still call my mom and ask her how she did “that thing, that time, you know… it was when dad said this and you said…” And she can tell me, then we argue about which way to do it best. If you donʼt have that, check out Youtube. There are many things that can be made with a couple of ingredients. It doesnʼt have to be perfect. Like me, you will make mistakes. You will burn things; it wonʼt taste good (no matter how much cheese you add). I promise it wonʼt looked like that photoshopped picture. It just has to taste good. If you have kids, learning to cook instills life lessons, enhances family connections and creates a home. Kids love putting their hands on everything, why not put that curiosity to good use- start with canned biscuits and work your way up to real dough. Cooking teaches them a life skill and invaluable memories. Their significant others will thank you in the future.

Lonely? Learn to cook. It takes practice and many, many mistakes. Sometimes those mistakes will be quite delicious. When you get good at it, people will start coming around. My mom taught me the value of sharing food from a sense of love and compassion. Everyone was welcomed in her home at dinner time. There was never a stranger in our home, if you were there you were family. All were welcome. If you werenʼt hungry, you got something to take with you. Iʼve been in the kitchen since I can remember. Food was the bond between our family and neighbors. Cooking helped me survive when I left home. When I went to college, my culinary skills certainly helped to procure many a date and the gratitude of various roommates, friends and co-workers. Being able to cook can also help you land a spouse. True story. Like I said, people know where to go for a good meal- it will help you not be lonely.

Last thing- I watch Food Network and cooking shows. Those folks are professionals. They have the best gadgets, ingredients and kitchens money can buy. Iʼm not rich. What I own are a couple of stock pots, now a few quality knives and three cast iron skillets that I have acquired over the course of 30 years. When I moved out on my own, I had one stock pot (still in use), one cast iron skillet (still in use) and the rest were added over the years. A few years ago, I was bequeathed my grandmotherʼs cast iron skillet. It has a place of honor in my kitchen. Please donʼt be intimidated because you donʼt have a whatchadoohickey that turn apples inside out. When I was a kid, I watched my mom cook a full meal with one burner until we could get a new stove. It took about six months. She did it. Always remember, it is all about having fun putting meals together and having a lifetime of great memories.

That said-please be mindful of social distancing. Donʼt put yourself in a position to get sick or expose others. Be safe- if you canʼt share a meal face to face, use technology to eat together. When we can join our families and friends, we will and in person.

With the many unknowns and the anxiety of the world today, it may be hard to move forward in this new normal and coping with the changes. Dr. Kasi Howard, Founder of Innova Recovery Center, is sharing tips on how to cope with anxiety and depression during these difficult times. She also has resources for telehealth therapy from home.

As things are increasingly uncertain, anxiety can go up exponentially. Here are a few tips on ways to cope with isolation, uncertainty and finding a new norm.

Coping in Quarantine

1. Connect with others -Make it a goal to call/FaceTime/Skype at least one person every day

2. Focus on one day at a time.
-No one knows what this will look like so donʼt try to guess or forecast months ahead.

3. Give yourself grace.
-You child will be fine if they miss a few days of math this month. Your partner will be fine if they eat ravioli for a week. You donʼt have do everything perfectly. You have just taken on a lot of new roles which require an adjustment period.

4. Set a goal to do that thing you have always wanted to do but didnʼt have time.
-Focusing on what you are missing can be exhausting. Shift your focus to what you now have, which is a little more time to do that things you wanted to do. Take guitar lessons. Write a book. Draw. Learn to knit. Find one thing to give you a sense of mastery and commit to practicing it a little each week.

5. Remember that itʼs okay to not be okay.
-Itʼs okay to be scared. It is okay to be uncertain. Thereʼs not a “good” way to do this. Thereʼs no right or wrong. Just be. Just breathe. You will get through this.

6. Ask for what you need.
If you need help making ends meet, ask. If you need socialization, reach out. And if you feel you need professional help, many therapists are offering telehealth counseling now, easily accessible from your home. Your insurance will cover telehealth in the same manner it would an in-office visit. If you need help finding a counselor, call Innova Recovery Center today 210-254-3618 to speak with.