
Mindful Trauma Treatment in Wilderness Therapy
Kim Kelley, M.Ed., LPC | Clinical Therapist | Adolescent Girls Group
Featured Team Members: Kim Kelley, M.Ed., LPC, EMDR Certified
When an individual has experienced trauma in his or her life, a fundamental result is the belief that the world is not a safe place. The individual then internalizes and generalizes this belief, feeling personally unsafe even in safe situations. As you can imagine, this generalization breeds a distrust in one’s internal and external worlds. The wilderness therapy environment, rich with support and structure, facilitates powerful results when addressing trauma.
At Open Sky, the Clinical Team starts the process of evaluating trauma with a thorough intake assessment. Through this process, we not only identify upsetting or painful experiences, but also gather insight into how the student learns, processes, and tolerates upsetting emotions. We then use this information to help the student develop skills to regulate emotions. These skills are needed frequently during trauma-related treatment.
In my work in wilderness therapy with adolescent girls who suffer from trauma, I use EMDR treatment (Eye Movement Desensitization and Reprocessing). The EMDR approach is based on studies showing that past emotionally-charged experiences are overly influencing your present emotions, sensations, and thoughts about yourself. EMDR uses a set of procedures to organize your negative and positive feelings, emotions, and thoughts. Then, bilateral stimulation, such as eye movements or alternating tapping, is used to help you effectively work through those disturbing memories.
I want to prepare the student for trauma-focused work by getting to know her common responses to upsetting memories and emotions. If distress-tolerance skills are under-developed, we will focus on building them. The wilderness is a helpful setting for this because a student usually experiences a natural degree of distress when she is removed from familiar surroundings and placed in a new or uncomfortable setting. Due to the student’s “perceived risk”, she will typically fall into emotional and behavioral patterns that she has demonstrated in the past when overwhelmed or upset.
Common external indications of a trauma response include dissociative reactions like distraction or loss of awareness of surroundings; avoidance of internal or external material that serves as reminders of the trauma; irritable behavior and anger outbursts with little or no provocation; self-destructive behavior; sleep disturbance; and abnormal awareness of environmental stimuli (hypervigilance).
Additionally, when an individual experiences upsetting and/or uncomfortable emotions, he or she turns to certain behaviors and relationships to help cope. Coping mechanisms (like substance use) or unhealthy relationships (dependent or abusive) have quite different effects than a positive coping skill and healthy relationships.
When the student is in a stress state, it is difficult for her to experience a natural sense of calm. Therefore, it is imperative to slow down emotionally, physically, and cognitively and help her build the skill of “Resourcing”. Resourcing involves identifying and cultivating any skill or relationship that supports well-being. It allows the student to self-regulate when experiencing upsetting emotional states. It also allows the student to feel a sense of control over emotions as she processes what internal material is fueling them.
To build Resourcing, we teach a variety of distress tolerance skills at Open Sky, such as a skill called X-Y-Z:
X: Taking three deep, full-body breaths. These are slow inhales, holding the air briefly and slowly releasing the air. This slows the body down and calms the nervous system.
Y: Mindfully feeling emotions, which includes taking notice of location, size, shape, color, temperature or any other aspects of the emotion. This gives the student the opportunity to be the ‘observer’ of the emotion rather than being caught up in it.
Z: Changing and/or disputing negative or irrational thoughts. By challenging these thoughts, she becomes aware of her common cognitive distortions and she experiences power over her thoughts. Once her thoughts are changed, feelings and behavior will typically follow.
As an individual builds her own unique resources, she has a variety of tools to choose from and feels a sense of control over herself. This will translate into her sense of wellbeing in the world and she’ll become an active participant rather than a victim of people, events, and beliefs. Ultimately, Resourcing is the foundation for a student to move into trauma processing, since she knows she will be able to tolerate and manage her emotions even when upsetting memories are reviewed. She will begin to know what feeling safe actually feels like.
Wilderness therapy is also helpful in developing self-efficacy through basic outdoor living skills. With the guidance of the Field and Clinical teams and her peers, a student learns and masters skills that teach her nervous system that she can take care of herself. Through this process, she’ll begin and continue to build internal trust.
Resourcing is a fundamental phase of trauma treatment and requires time, patience, and creativity. The wilderness is the ideal setting for satisfying these criteria. As the student understands the power and control she has over her surroundings (i.e., building fire), self-care (i.e. staying properly hydrated), and self-exploration (i.e. communication styles with peers), she develops a sense of strength and pride. This is fundamental stabilization. Building students’ resources through wilderness experiences is the cornerstone of my approach to trauma treatment in wilderness therapy.