adult woman stressed due to ptsd sitting

The Effects of Childhood Trauma on Adults Who Have Bipolar Disorder & Schizophrenia

Health experts have long understood that untreated trauma can have a profound negative impact on a person’s well-being. For example, people who have a history of trauma may be at increased risk for a variety of physical, mental, and behavioral health concerns.

In recent years, research into the effects of trauma has shed new light on the relationship between childhood trauma and quality of life among adults who have bipolar disorder and schizophrenia.

What Is Childhood Trauma?

When the term “trauma” is used in a mental health context, it typically refers to the psychological impact of a life-threatening or otherwise horrific event.

People of all ages, including children, can develop trauma in the aftermath of one terrifying event, multiple traumatic occurrences, or continued exposure to certain distressing experiences over an extended period of time. Trauma can result from direct involvement as well as from witnessing traumatic events that occur to someone else.

Examples of events that can lead to trauma include physical assault, sexual abuse, verbal attacks, domestic violence, extreme neglect, serious illnesses, acts of terrorism, and the death of parent, partner, or other significant person.

Sources of childhood trauma are sometimes referred to as adverse childhood experiences, or ACEs. According to the U.S. Centers for Disease Control and Prevention (CDC), more than 60% of adults lived through at least one adverse childhood experience, and more than 15% of adults report having four or more ACEs before they reached their 18th birthday.

Effects of Childhood Trauma

Among the general public, post-traumatic stress disorder, or PTSD, is perhaps the most widely known effect of trauma. But PTSD is far from the only disorder or concern that can occur in the aftermath of traumatic events or other adverse childhood experiences.

Since 2009, the CDC has collected data on childhood trauma through the Behavioral Risk Factor Surveillance System (BRFSS). The BRFSS, which was launched in 1984, is an annual randomized telephone survey of adults in the United States.

Information gathered through the BRFSS reveals an association between childhood trauma and significant physical, mental, behavioral, and social challenges later in life. Adults who have a history of childhood trauma may be more likely to experience the following negative effects:

  • Depression
  • Substance abuse
  • Heart disease and other medical problems
  • Lower educational advancement
  • Unemployment

Additional research has demonstrated a relationship between childhood trauma and the development of mental health concerns such as bipolar disorder and schizophrenia during adolescence or adulthood.

In addition to putting people at elevated risk for developing these disorders, childhood trauma may also increase the likelihood that people who have bipolar disorder or schizophrenia will experience more severe symptoms.

Childhood Trauma & Bipolar Disorder

A 2016 study in the International Journal of Bipolar Disorders found that childhood trauma is associated with an earlier onset of bipolar disorder as well as an elevated risk of certain symptoms and effects, including impaired cognition, substance abuse, and suicidal behaviors.

“Childhood trauma leads to alterations of affect regulation, impulse control, and cognitive functioning that might decrease the ability to cope with later stressors,” the study’s authors wrote. “Childhood trauma interacts with several genes belonging to several different biological pathways … to decrease the age at the onset of the disorder or increase the risk of suicide.”

These findings were supported by a 2020 study from the journal Neuropsychiatric Disease Treatment. This study, which was led by Yann Quide of the School of Psychiatry, University of New South Wales, found that exposure to childhood trauma is associated with the following effects among adults who have bipolar disorder:

  • More severe clinical presentation of the disorder
  • Increased severity of depressive and manic symptoms
  • Increased severity of delusions
  • Deficits in verbal and visual recall memory
  • Less effective inhibitory control
  • Diminished cognitive performance
  • Diminished ability to identify anger

The 2020 study also noted that adults who had both bipolar disorder and a history of childhood trauma often show evidence of decreased volume in certain areas of the brain, including the corpus callosum,  amygdala, right dorsolateral prefrontal cortex, and right thalamus.

Childhood Trauma & Schizophrenia

A March 2019 study in the journal Frontiers in Neuroscience explored the association between childhood trauma and schizophrenia.

This study, which was led by David Popovic of Ludwig Maximilian University of Munich (Germany), reported that “[c]hildhood trauma can be assumed to be a severe form of stress that renders individuals more vulnerable to developing schizophrenia.”

The study’s authors also noted the following about how childhood trauma’s effect on the brain can lead to cognitive deficiencies among people who have schizophrenia:

“In a theory of mind task reflecting social cognition, childhood trauma was associated with activation of the posterior cingulate gyrus, precuneus, and dorsomedial prefrontal cortex in patients with schizophrenia.

In addition, decreased connectivity was shown between the posterior cingulate/precuneus region and the amygdala in patients with high levels of physical neglect and sexual abuse during childhood, suggesting that disturbances in specific brain networks underlie cognitive abilities.”

According to the March 2019 study, exposure to adverse childhood experiences and other sources of trauma can also lead to dysregulation of the hypothalamus-pituitary-adrenal (HPA) axis.

The HPA axis is part of the endocrine system. Among its functions, the HPA axis regulates the production of cortisol, which is a hormone that can help the body respond to stress.

HPA axis dysfunction can also negatively impact mood and cognition, with possible effects including anxiety, depression, decreased ability to concentrate or focus, and impaired memory retrieval.

Treatment Options for Childhood Trauma, Bipolar Disorder, & Schizophrenia

Effective mental health treatment must address the full scope of the client’s needs. If a person with bipolar disorder or schizophrenia has a history of childhood trauma, then appropriate trauma treatment must be included in their care plan.

Cognitive behavioral therapy (CBT), prolonged exposure therapy, and eye movement desensitization and reprocessing (EMDR) therapy are among the recommended approaches for people who have PTSD or who have been otherwise affected by untreated trauma.

Comprehensive treatment for bipolar disorder and schizophrenia often involves various forms of psychotherapy as well as certain prescription medications.

CBT and dialectical behavior therapy (DBT) have proved to be effective therapeutic elements for people who have bipolar disorder. Depending on the nature and severity of the symptoms that a person has been experiencing, the medication component of their bipolar disorder treatment may include antidepressants, antipsychotics, or mood stabilizers.

Among people who are receiving care for schizophrenia, CBT and behavioral skills training may be particularly beneficial. Antipsychotics are typically the most effective medications for easing the symptoms of schizophrenia.

Many other therapies and services can also have a significant positive effect on the quality of life of someone who has a history of trauma in addition to bipolar disorder or schizophrenia. What’s most important is finding a provider that will conduct a thorough assessment, then select the elements of care that align most closely with the individual’s needs and goals.

If someone that you care about needs personalized outpatient treatment for trauma, bipolar disorder, and schizophrenia, please contact Crownview Co-Occurring Institute today. A member of our team can answer all your questions and help you make the most informed decision for your loved one.

soldier clasping hands stressed

How Do You Recognize the Symptoms of PTSD?

Post-traumatic stress disorder (PTSD) is an anxiety disorder that can cause significant disruption in daily life. The symptoms of PTSD can impact personal relationships, family dynamics, work performance, and academic achievement. While many people associate PTSD with the psychological symptoms combat veterans experience when returning from a war zone, evidence shows that any stressful event or series of stressful events can cause PTSD.

The National Institute of Mental Health (NIMH) identifies the following common causes of PTSD:

  • Experiencing or witnessing violence
  • Experiencing or witnessing war/living in a war zone
  • Physical abuse
  • Sexual abuse
  • Emotional abuse
  • Natural disasters
  • Car accidents
  • Major illness
  • Loss of a loved one

PTSD is more common than most people think. Data from the Department of Veteran’s Affairs (VA) and a recent large-scale study indicate the following prevalence rates of PTSD among adults in the U.S.:

  • PTSD diagnosis in the past year (12-month prevalence):
    • Total: 4.7%
    • By Gender:
      • Males: 3.2%
      • Females: 6.1%
    • By Age:
      • 18-29: 5.4%
      • 30-44: 5.7%%
      • 45-64: 4.7%
      • 65+: 2.2%
    • PTSD diagnosis at any time (lifetime prevalence):
      • Total: 6.1%
      • By Gender:
        • Males: 4.1%
        • Females: 8.0%
      • By Age:
        • 18-29: 6.6%
        • 30-44: 7.1%
        • 45-64: 6.6%
        • 65+: 3.2%

Those statistics make it clear: PTSD affects the lives of millions of people every year. Let’s attach real numbers to those percentages to drive the point home. The first figure – 4.7% of adults in the U.S. – works out to roughly 12 million people. That means it’s likely you know someone with PTSD. It might also mean you’re asking yourself this question:

How can I tell if a friend or loved one has PTSD?

The knowledgeable, compassionate staff at Crownview Co-Occurring Institute can help you answer that question.

How Does PTSD Affect People?

PTSD can manifest in many ways. It can develop immediately after a traumatic event. It can also develop after weeks, months, or years.


Because every person is different, and every brain responds to trauma in different ways. There is no one way for the brain to process trauma. Some people experience repressed memories, which is how the brain protects itself from reexperiencing the initial traumatic event. Those repressed memories may not reappear until they’re triggered by something related to the traumatic event, such as a specific smell or sound, which causes the symptoms of PTSD to appear. In other cases, the brain does not repress traumatic memories, and the symptoms of PTSD appear almost immediately.

What are the Signs of PTSD?

People with PTSD often experience challenges participating in the basic activities of daily. Challenges can include difficulty paying attention in school, problems focusing on tasks at work, strained relationships with family or friends, neglecting personal hygiene, or abandoning healthy habits like eating a balanced diet and exercising every day. It’s also common for people with PTSD to attempt to manage difficult or uncomfortable symptoms with alcohol or drug use, which is a phenomenon known as self-medication. In some cases, people with PTSD may engage in self-harm or suicidal behavior, up to and including attempting suicide.

Mental health experts define four types of PTSD symptoms:

  1. Intrusive memories
  2. Avoidance behaviors
  3. Changes in thought/mood
  4. Changes in physical/emotional reactions

We’ll explain each of these types of symptoms now, beginning with intrusive memories.

Intrusive Memories

Intrusive memories, also known as flashbacks, are unpleasant memories that appear in the mind of a person with PTSD. These memories are unwanted and can disrupt daily function. Intrusive memories/flashbacks may include:

  • Recurring memories of the event
  • Reliving the trauma as if the event is still happening
  • Disturbing nightmares
  • Difficulties sleeping
  • Adverse physical reactions to memories of the event

Now let’s look at the next symptom: avoidance.


Avoidance behavior is exactly what it sounds like. It’s when a person with PTSD goes to extreme lengths and spend a disproportionate amount of energy to avoid anything that reminds them of or anything that remotely resembles past traumatic events.

Avoidance may look like:

  • Trying not to think about the event or acting like it never happened
  • Refusing to go to certain places or interact with certain people that remind you of the event
  • Leaving a situation due to extreme anxiety

Everyone avoids things they don’t like, sometimes. That’s typical behavior. In the context of PTSD, however, avoidance is extreme, and can impair participation in the basic activities of daily life.

Changes in Thought/Mood

A person with PTSD often develops negative patterns of thinking and feeling. These patterns can take on various forms, depending on the individual, the nature of the trauma, and their current circumstances. Examples of negative patterns of thinking and feeling associated with PTSD include:

  • Feeling depressed about the future and the world
  • Prolonged sense of hopelessness
  • Detaching from social life and other once-enjoyable activities
  • Difficulty feeling happy
  • Difficulty feeling any positive emotions
  • Prolonged emotional numbness

We recognize that almost everyone experiences dark and/or negative thoughts. Everyone also has bad moods, on occasion. However, for a person with PTSD, these moods and patterns of thought are persistent, disruptive, and overwhelming. In most cases, a person without PTSD can cope with negative thoughts and moods and return to balance quickly, whereas a person with PTSD – especially if it’s untreated – may become overwhelmed by their negative thoughts and moods.

Changes in Emotional and Physical Reactions

In many cases, people with PTSD develop atypical emotional and physical reactions to common external stimuli. For instance, a person with PTSD may:

Get startled or scared very easily

  • Feel like they’re constantly on guard for new dangers or threats
  • Engage in risky, destructive behavior such as excessive drinking, fighting, or sexual activity
  • Have angry outbursts/tantrums
  • Feel an overwhelming sense of shame or embarrassment

If you or someone you love shows any of the signs and symptoms of PTSD, the best thing to do is arrange a full biopsychosocial evaluation with a licensed, qualified, mental health professional experienced in working with anxiety disorders. A mental health professional can arrive at an accurate diagnosis and make recommendations for appropriate treatment and support.

What Does PTSD Treatment Look Like?

Mental health professionals are trained to help individuals with PTSD manage their symptoms and formulate a treatment plan that promotes recovery and full, independent functioning. Treatment for PTSD include a combination of psychotherapy, community support, lifestyle changes, and medication, if needed.

We understand that people with PTSD might not want to talk about their trauma. However, it’s important to understand that talking about trauma in a therapeutic context is a well-documented, evidence-based path toward healing and recovery. Processing past trauma the with a trained, unbiased third party in a safe, professional setting can be lifechanging. Talking with a therapist can validate the emotions and experiences of a person with PTSD, and help them develop the coping skills and stress management tools necessary tools to create a new normal.

What Forms Can Therapy Take?

Therapy for PTSD depends on the unique needs of each individual. Treatment may include medication, psychotherapy, a combination of cognitive-behavioral therapy (CBT) or dialectical behavior therapy (DBT), or inpatient treatment, which typically involves all of the above. Whatever the form of treatment or therapeutic modality, the goal of treatment is to target the core traumatic issue that caused the PTSD symptoms, and create a coping plan that helps restore balance and participate fully in all aspects of daily life.

What Does a Coping Plan Look Like?

Each personal coping plan is as unique as the individual it serves. Some people with PTSD need a robust plan for dealing with triggers, others need help dialing in their support network, while others need suggestions for how to practice self-care. Through exercise, meditation, or regular visits with a therapist, each individual finds what works best for them, and learns  to stay present and calm in the face of overwhelming emotions and fears.

Ready to Take the Next Step?

Contact our admissions team to learn how Crownview can help you or your loved one.

Call Now 760.433.4357

woman with therapist during inpatient treatment

When is Psychiatric Inpatient Residential Treatment the Right Choice?

Mental health treatment is an important topic in the U.S. right now.

Two and a half years of stress and disruption caused by the coronavirus pandemic and various other social and political factors have increased the need for effective, evidence-based treatment for mental health, behavioral, and/or alcohol/substance use disorders. If you or someone you love developed a mental health or addiction problem during the pandemic – or if the pandemic exacerbated a previously diagnosed disorder – you may not know which type of treatment offers the best hope of recovery.

We can help.

This article will address the two most immersive levels of mental health/addiction treatment available: psychiatric inpatient residential treatment and inpatient psychiatric hospitalization.

We’ll define both levels of care, explain the difference(s) between psychiatric inpatient residential treatment and inpatient psychiatric hospitalization, and identify the reasons a person with a serious mental health disorder might choose treatment at a psychiatric inpatient residential treatment center rather than an inpatient psychiatric hospitalization program.

Before we get into the details about these levels of care, however, we need to ensure everyone reading this article understands the scope of the problem at hand. To that end, we’ll present the latest facts and figures on mental health in the U.S. and the world, with an emphasis on the increase in mental health disorders and overall psychological distress reported since the beginning of the pandemic.

Mental Health in the U.S. and the World: Facts and Figures

We’ll start with a narrow focus: the six-month period between August 2020 and February 2021. In a report published in late 2021, the Centers for Disease Control (CDC) indicate that during that six-month, mid-pandemic period:

  • The percentage of adults with symptoms of anxiety or depression increased from 36.4% to 41.5%
  • The percentage of adults with unmet mental health care needs increased from 9.2% to 11.7%
  • Young adults 18-29 experienced the greatest increases in symptoms of anxiety and depression

Keep in mind those statistics are for the U.S. and cover a relatively short period of time. Now let’s expand our scope and look at a large-scale meta-analysis performed in the United Kingdom (U.K.) that includes data on almost 50,000 people collected between 2006 and 2021. Note: a meta-analysis includes data from the most relevant studies on a specific topic in order to identify trends or changes over time. This meta-analysis used data from eleven separate studies on psychological distress based on measures of depression and anxiety among adults in the U.K. before and after the pandemic.

Before and After: Mental Health and the Pandemic

  • One study showed an increase of 16.5%:
    • Pre-pandemic: 11.5% of adults reported symptoms of anxiety or depression
    • Post-pandemic: 28.0% of adults reported symptoms of anxiety or depression
  • Another showed an increase of 22.6%
    • Pre-pandemic: 11.4% of adults reported symptoms of anxiety or depression
    • Post-pandemic: 35.0 .0% of adults reported symptoms of anxiety or depression

Now let’s look at a report from World Health Organization (WHO), which identified increases similar to those found in the U.K.:

  • During the first year of the pandemic, worldwide prevalence of anxiety and depression increased 25%
  • Women and young adults reported the largest increases

We’ll end with data from closer to home, extracted from the National Survey on Drug Use and Health (NSDUH), an annual, large-scale survey that includes data collected from over 70,000 people in the U.S> every year. The following statistics appear in the 2018 NSDUH and the 2020 NSDUH, and include information on substance use disorder (SUD) as well as mental health disorders.

Mental Health Disorders and Substance Use Disorder (SUD) in the United States: 2018 and 2020

  • Diagnosed with mental illness:
    • 2018: 47.6 million adults
    • 2020: 52.9 million adults
  • Diagnosed with serious mental illness:
    • 2018: 11.4 million adults
    • 2020: 14.2 million adults
  • Among those diagnosed with mental illness:
    • 2018: 9.2 million also had SUD
    • 2020: 17 million also had SUD
  • Among those diagnosed with serious mental illness:
    • 2018: 3.1 million also had SUD
    • 2020: 7 million also had SUD

This last set of numbers give us valuable information and clearly outline the scope of the mental health and addiction problem in the U.S. For the two years for which we have reliable before and after data, we can see significant increases in people with mental illness and serious mental illness. And among those, we see the number of people diagnosed with a mental illness and an SUD – called co-occurring disorders or dual diagnosis – almost doubled.

That’s why we’re writing this article. The statistics demonstrate a significant need for increased mental health support in the U.S., specifically for people with serious mental illness and a co-occurring substance use disorder.

We’ll now talk about how psychiatric inpatient residential treatment – as opposed to inpatient psychiatric hospitalization – might be an appropriate choice for someone support for a mental health disorder, a substance use disorder, or both, i.e. co-occurring disorders.

Psychiatric Inpatient Residential Treatment or Inpatient Psychiatric Hospitalization: What’s the Difference?

There are significant differences between psychiatric inpatient residential treatment and inpatient psychiatric hospitalization, but let’s start with one thing they have in common: the inpatient component. What inpatient means is that the individual in treatment lives at the treatment center or hospital and receives 24/7 medical support and monitoring.

In mental health and addiction treatment, inpatient means the same thing: the individual lives on-site and receives 24/7 support and monitoring during treatment. However, after that basic similarity, these two levels of care diverge. The relative divergences are primarily related to the overall goals of treatment and how clinicians and staff help individuals meet those goals.

Before we describe these differences, we need to add a disclaimer. This article is neither a diagnosis nor medical advice. Licensed and qualified mental health professionals such as psychiatrists and therapists are the only people who can diagnose a mental health and/or substance use disorder and refer you or a loved one for mental health treatment. This is an essential step you can’t skip. If you think you need or a loved one needs psychiatric inpatient residential treatment or inpatient psychiatric hospitalization, we recommend arranging a full biopsychosocial evaluation administered by a licensed and qualified mental health professional: that’s the first step toward recovery.

Now let’s talk about these two levels of care, starting with inpatient psychiatric hospitalization.

Inpatient Psychiatric Hospitalization

  • Goals:
    • Safety
    • Stability
  • Population:
    • People with mental health disorders or mental health-related behaviors that put them in imminent danger or expose friends, family members, or anyone else to immediate risk of harm
  • May be necessary when:
    • Symptoms, emotions, or behaviors associated with a mental health disorder place an individual at personal physical risk
    • Symptoms, emotions, or behaviors associated with a mental health disorder are disruptive enough to prevent them from participating in the typical activities of daily life and functioning
  • May be mandatory and involuntary when:
    • An individual in crisis needs close physical and medical monitoring until the crisis passes
  • Length of stay:
    • 3-10 days
    • Longer in some cases

There are three operative words to consider then thinking about inpatient psychiatric hospitalization: safety, stability, and crisis. A person who is aggressive or violent, actively suicidal, or engages in excessively risky behavior as a result of their mental health or substance use disorder may need inpatient psychiatric hospitalization. If an individual arrives at an emergency room during a mental health or addiction crisis, an on-call psychiatrist may order a mandatory, involuntary referral for inpatient psychiatric hospitalization for the duration of the crisis. When medical staff determines that individual is safe, stable, no longer in crisis, and no longer a threat to themselves or others, they discharge that individual to a less immersive – and typically voluntary – level of care.

We can sum that up: if you’re in active crisis and a risk to yourself or others, inpatient psychiatric hospitalization may be appropriate. If you’re not in active crisis and don’t present an immediate risk to yourself or others, then psychiatric inpatient residential treatment may be appropriate.

We’ll talk about that level of care now.

Psychiatric Inpatient Residential Treatment

  • Goals:
    • Safety
    • Stability
    • Recovery
    • Therapy
    • Skill-building
    • Lifestyle change
    • Independence
    • Reintegration
  • Population:
    • People with mental health disorders or mental health-related symptoms and/or behaviors that are extremely severe, disruptive, and uncomfortable
    • People with mental health disorders or mental health-related symptoms and/or behaviors that prevent them from meeting the obligations or participating in the typical activities of daily life.
      • Typical daily activities include work, school, family life, social life, and personal hygiene
    • May be necessary when:
      • Symptoms, emotions, or behaviors associated with a mental health disorder prevent an individual from meeting their personal needs
      • Symptoms, emotions, or behaviors associated with a mental health disorder prevent an individual from meeting family, work, or school obligations
    • Psychiatric inpatient residential treatment is always voluntary
    • Length of stay:
      • 3-6 weeks
      • Typical time-in-treatment is around one month

Although this is an oversimplification, the one operative word to think about when comparing psychiatric inpatient residential treatment to inpatient psychiatric hospitalization is time. Hospitalization is not really about therapy and recovery: it’s about getting a person past a crisis so they can then participate in the types of therapy and recovery offered in residential treatment, which we’ll talk about in more detail now.

What Happens During Psychiatric Inpatient Residential Treatment?

Upon admission and intake to a high-quality psychiatric inpatient residential treatment program, you receive a full biopsychosocial evaluation and psychiatric assessment. Based on the results of your admissions interviews and intake assessments, you then collaborate with treatment center staff on an individual treatment plan that leverages your strengths, recognizes your challenge areas, and gives you the best chance at achieving sustainable, lifelong recovery.

In a top-quality treatment center, your individualized treatment plan will include a combination of the following:

  • Therapy:
    • Individual
    • Group
    • Family
  • Common therapeutic approaches include:
    • Dialectic behavioral therapy (DBT)
    • Cognitive behavioral therapy (CBT)
    • Trauma-informed DBT and/or CBT
  • Lifestyle supports, including:
    • Nutrition counseling
    • Recreation/exercise
    • Stress management techniques
    • Mindfulness/meditation
  • Experiential therapies, including:
    • Outdoor recreation
    • Equine therapy (horses)
  • Medication, as needed

The specific elements of your treatment plan depend on your unique treatment needs and goals. What works for one person might not work for another. What works when you initiate your plan might change as you make progress in treatment, and the plan you begin with may be different than the plan you follow upon discharge.

The length of time you spend in a psychiatric inpatient residential treatment program also depends on you and the therapeutic milestones you set with your treatment team upon admission and intake. When you and your treatment team decide you’re ready for a less immersive level of care, you create a plan, set a discharge date, and prepare your transition.

Which Option is Best for You?

The answer to that question should be the result of communication and collaboration between you, your family, and your treatment team.

If you or a family member are in mental health or addiction crisis, please dial 988, the National Mental Health Crisis Hotline.

If you’re not in crisis, but know you need – or a family member needs – immersive treatment for a mental health or substance use disorder, then you can use this article to help make your decision.

The information above shows that psychiatric inpatient residential treatment and inpatient psychiatric hospitalization are quite different. While both support the ultimate goal – recovery – one is about short-term stabilization, while the other is about long-term treatment and growth.

During psychiatric inpatient residential treatment, you have the time and space to focus on therapy and healing. You’re free from the distractions of daily life, which allows you to direct your energy toward creating new psychological, emotional, and interpersonal skills. You receive around the clock medical monitoring in case of emergency, just as you would during a hospital stay, but your days are filled with therapy, treatment, and recovery activities. Your evenings are often busy: community support meetings, recovery homework, or additional group activities and educational workshops all coordinate to help you meet your treatment goals.

If that level of immersive support and care sounds like what you need, or what a loved one needs, then you may have the answer to the question we pose in the title of this article:

When is Psychiatric Inpatient Residential Treatment the Right Choice?

Ready to Take the Next Step?

Contact our admissions team to learn how Crownview can help you or your loved one.

Call Now 760.433.4357

Understanding the 8 Phases of EMDR

Understanding the 8 Phases of EMDR

Eye movement desensitization and reprocessing (EMDR) therapy was initially established in 1987 to treat post-traumatic stress disorder (PTSD) and is driven by the Adaptive Information Processing model. The Adaptive Information Processing model assesses symptoms of PTSD that result from past distressing experiences and continue to cause suffering because the individual was unable to manage the memory effectively. The untreated memories include the emotions, thoughts, beliefs, and physical feelings that transpired during the event. When the memories are initiated, the disturbing emotions are felt and trigger the symptoms of PTSD.

EMDR therapy is considered a non-trauma-focused treatment that seeks to decrease PTSD symptoms, but not by targeting thoughts, memories, and feelings related to the traumatic event. Instead, the methods focus on relaxation, stress training, or interpersonal therapy.


EMDR therapy varies from other trauma-focused treatments. It does not incorporate extensive exposure to stressful memories, comprehensive descriptions of the trauma, challenging dysfunctional beliefs, or homework assignments. Managing a particular memory is typically completed in an eight-phase approach within three to 12 sessions.

EMDR is a psychotherapy approach that encourages the client to momentarily focus on the traumatic memory while instantaneously experiencing bilateral stimulation (BLS), which is associated with decreasing the intensity and emotion related to the traumatic experiences.

The Phases of EMDR

EMDR therapy uses an eight-phase approach that includes history-taking, preparing the client, assessing the target memory, processing the memory to adaptive resolution, and evaluating treatment results.

Phase 1: History-Taking

Obtaining a comprehensive history and conducting assessments need to be completed first. Next, the counselor and client work together to acknowledge targets for treatment, such as memories, triggers, or goals.

Phase 2: Preparing the Client

The counselor explains the treatment and introduces the client to the procedures by practicing eye movements and relaxation practices.

Phase 3: Assessment

This phase involves activating the memory targeted in the session by identifying and assessing the memory components: image, cognition, affect, and body sensation. The counselor will use two different measures during the EMDR therapy sessions to evaluate changes in emotion and awareness called the Validity of Cognition (VOC) scale and the Subjective Units of Disturbance (SUD) scale. Both standards are used again throughout the treatment process, agreeing with the standardized methods. Examples of each are provided below:

  • Validity of Cognition (VOC) scale: The counselor would ask, “When you think of the experience, how true do those words (the positive cognition) feel to you now on a scale of one to seven, where one is completely false, and seven is entirely true?"
  • Subjective Units of Disturbance (SUD) scale: After the client states what emotion they are feeling, the counselor would ask, “On a scale of one to ten, where zero is no disturbance or neutral and ten is the highest disturbance, how disturbing does it feel now?”

Phase 4: Desensitization

The client concentrates on the specific memory and engages in eye movements. Next, the client will report any new thoughts, and the counselor determines the focus for the next set of BLS. This phase continues until the client no longer feels stress with the memory.

Phase 5: Installation

In this phase, an emphasis is placed on the optimistic belief that the client decides upon.

Phase 6: Body Scan

The client is asked to observe their physical reaction while thinking of the experience and the positive cognition while identifying remaining somatic distress.

Phase 7: Closure

This phase occurs when the sessions are coming to an end. If the targeted memory is not fully managed, specific guidelines and methods are applied to offer control and confirm safety until the next session.

Phase 8: Re-Evaluation

The counselor assesses the client’s psychological state, if treatment effects have been sustained, what memories have developed since the last session, and works with the client to recognize targets for the current session.

Benefits of EMDR for PTSD

The efficacy of EMDR therapy corresponds with the many benefits the treatment provides. When a client completes EMDR treatment, they will benefit from positive outcomes, including:

  • Reduced PTSD symptoms
  • Reduced anxiety
  • Increased capability to handle fear
  • Reduced sensitivity to traumatic experiences
  • Decreased fear
  • Enhanced functioning
  • Improved social skills
  • Increased mental stability

Seeking Help for PTSD

It can feel overwhelming when searching for help with mental health disorders. The Substance Abuse and Mental Health Services Administration (SAMHSA) offers the Behavioral Health Treatment Services Locator to help find mental health services in your area. In addition, you can find helpful information about treatment facilities that provide specialty care by using SAMHSA’s Early Serious Mental Illness Treatment Locator.

There should be no shame in seeking help for a mental health disorder. Post-traumatic stress disorder (PTSD) is one of the most misunderstood mental health illnesses. Eye movement desensitization and reprocessing (EMDR) therapy can help decrease PTSD symptoms and bring peace of mind with recovery. If you or a loved one are ready to begin your journey to recovery, we want to help. Crownview Co-Occurring Institute in Oceanside, CA, provides psychiatric treatment for many levels of mental disorders. Our individualized approach ensures that each client receives excellent care with positive results. CCI offers treatment plans to meet the physical and emotional needs for recovery. We will support you from crisis to independence by providing a healing environment with a considerate team of professionals ready to help you regain control of your life. Let CCI help you with evidence-based treatments for a successful long-term recovery. Call us today at (760) 477-4754.

Stellate Ganglion Block: A Breakthrough for Trauma Victims

Stellate Ganglion Block: A Breakthrough for Trauma Victims

According to the Evidence Synthesis Program (ESP), post-traumatic stress disorder (PTSD) is the third most common psychiatric diagnosis among veterans treated by the Veterans Health Administration (VHA), with more than 7 million adults in the United States struggling from the disorder. PTSD occurs subsequently with traumatic events such as natural disasters, terrorist situations, severe accidents, abuse, traumatic childhoods, critical health concerns, or physical or sexual assault.

The Department of Defense and healthcare scientists spent years searching and pursuing a series of solutions that would be safe, successful, and fast-acting in treating PTSD. Around 2010, military medical facilities started offering clients with PTSD a procedure customarily used to treat and relieve pain. The procedure was known as Stellate Ganglion Block (SGB).

What Is a Stellate Ganglion Block?

I bet you’re asking yourself what a stellate ganglion block is and how it can help trauma victims. The stellate ganglion is a cluster of nerve cells located in the spine. An SGB is an outpatient procedure involving the injection of a local anesthetic surrounding the stellate ganglion to obstruct sympathetic nerve impulses to the head, neck, and face. In other words, healing PTSD is now possible by administering a shot.

How a Stellate Ganglion Block Is Administered

The client is typically sedated during this procedure. A fine needle is positioned near the stellate ganglion using x-ray guidance, and an anesthetic is injected. The cluster of nerve cells that make up the stellate ganglion help control the body’s “fight or flight” reaction. The fight or flight response is a common reaction to shield an individual from potential danger; the nerve bodies transport fight or flight messages to the spinal cord and brain.

Individuals who struggle with PTSD can experience extreme and debilitating symptoms, including anxiety, depression, insomnia, avoidance of situations similar to the trauma, lack of emotions, and disturbing flashbacks. Almost everyone will experience a variety of responses after a traumatic event, but most people experience improvement in primary symptoms without treatment or medication. However, if symptoms do not decrease, an SGB could benefit the individual.

Benefits of a Stellate Ganglion Block

  • Improves PTSD symptoms
  • Reduces pain
  • Provides a biological approach
  • Offers fast-acting relief within minutes or a few days after the procedure
  • Enhances mood
  • Increases compliance to participate because it does not require daily administration

What Else Can a Stellate Ganglion Block Treat?

Along with improving and reducing PTSD symptoms, an SGB can also be administered to:

  • Detect the cause of pain in the face, head, arms, and chest
  • Manage pain in the head, neck, chest, or arms that result from nerve injuries, the effects of shingles, or angina
  • Decrease sweating of the face, head, arms, and hands
  • Treat sympathetically maintained pain
  • Minister complex regional pain syndrome
  • Reduce migraines and hot flashes
  • Treat the peripheral vertebral disease

How Effective Is a Stellate Ganglion Block?

The effectiveness of a stellate ganglion block varies depending on the individual. Some clients report pain relief directly after the injection, but there is a chance the pain may reoccur hours later as the local anesthetic wears off. In contrast, other clients have increased extended-term relief that endures the local anesthetic period and helps them decrease their medication use and increase their involvement in physical therapy.

How long the relief continues is different for each person. Some clients could go days or weeks without pain or presenting PTSD symptoms. Clients typically need a series of injections to continue the positive results. There are occasions where it will only take two injections, but other times it could require up to ten injections. Fortunately, the comfort tends to last longer with each treatment.

Side Effects and Risks of Complications of a Stellate Ganglion Block

There is a very low risk of complications from an SGB. The client will not feel any numbness in the face, but they will have a droopy eye, redness of the eye, warmth in the face, and may become hoarse. The side effects are temporary and only last a few hours. Some may not detect relief immediately, but most clients report feeling results within minutes or days.

Possible complications could include:

  • Vascular puncture
  • Neural puncture
  • Pneumothorax
  • Thyroid injury
  • Esophageal or tracheal puncture
  • Transient Horner syndrome
  • Intravascular injection
  • Infections

After the procedure is complete, the client should avoid driving or participating in any energetic activities for 24 hours. The individual should relax and take it slow until the following day when they can resume normal behaviors.

If trauma symptoms continue after an SGB procedure, the client is at an increased risk of stress. It is essential to recognize SGB as a highly effective treatment method that can provide quick results with extended relief from unbearable symptoms.

Stellate Ganglion Block (SGB) is a true breakthrough in PTSD treatment. It is a powerful opportunity for people with PTSD and other co-occurring conditions to find relief from debilitating symptoms. If you or a loved one could benefit from SGB, we want to help. Crownview Co-Occurring Institute in Oceanside, CA, offers psychiatric treatment for various levels of mental health disorders. Our individualized approach guarantees that each client receives quality care with successful results. We will support you from crisis to independence by providing a healing environment with a caring team of professionals ready to help you gain control of your life again. At CCI, we offer treatment plans to meet every physical and emotional need for recovery. Let CCI alleviate the trauma in your life with evidence-based treatment services for a successful long-term recovery. Call (760) 477-4754 today to learn about our effective treatment programs.

Upset girl with her face in her hand

How Do You Recognize Symptoms of PTSD?

When you think of post-traumatic stress disorder, or PTSD, you may think of war veterans. It’s a common misconception that PTSD is exclusively for those who have served in the army. However, PTSD is a lot more common than you think. PTSD can happen to anyone after experiencing a stressful event. That event can be anything from a sexual assault, a natural disaster, a car accident, long-term abuse (physical or emotional), or the sudden death of someone you love.

Untreated PTSD can wreak havoc on one’s ability to function in everyday life. Work, school, and relationships can suffer, as PTSD affects more than just the person suffering from it. How can you know if you or a loved one is experiencing this mental health disorder? The knowledgeable, compassionate staff at Crownview Co-Occurring Institute can help you recognize the signs.

How Does PTSD Affect People?

There are many ways that PTSD can manifest in a person’s life. It can happen immediately after a traumatic event or be delayed by weeks or months. This is because there is no one way for the brain to process trauma. Some people may experience repressed memories, which is the brain’s way of protecting itself from being triggered or experiencing the trauma again. However, other people may not experience this symptom. It may not be until a person is triggered by – for example, a certain smell or sound that reminds them of the incident – that they start to show PTSD symptoms.

What Are the Signs of PTSD?

It’s not uncommon for people living with PTSD to experience challenges in everyday life. These challenges can include difficulty paying attention in school or focusing on tasks at work, strained relationships with family or friends due to isolation, or neglecting healthy habits. It’s also not uncommon for someone with PTSD to turn to unhealthy coping mechanisms, such as substance abuse, suicidal thoughts, or self-harm.

According to the Mayo Clinic’s page on “Post-traumatic stress disorder (PTSD),” PTSD symptoms have four forms: intrusive memories, avoidance, changes in thought pattern and mood, and negative emotional and physical reactions. PTSD also doesn’t just affect the one person who experienced a trauma; it can have a ripple effect on families or friendships as well.

You may want to consider seeking help if you notice any of the following patterns in yourself or someone you love:

Intrusive Flashbacks

Intrusive flashbacks may include:

  • Recurring memories of the event
  • Reliving the trauma as if the event is still happening
  • Disturbing nightmares
  • Difficulties sleeping
  • Adverse physical reactions to memories of the event


Avoidance may look like:

  • Trying not to think about the event or acting like it never happened
  • Refusing to go to certain places or interact with certain people that remind you of the event
  • Leaving a situation due to extreme anxiety

Negative Thought Patterns

Negative thought patterns can look like:

  • Feeling depressed about your future and the world
  • Prolonged sense of hopelessness
  • Detaching from social life and other once-enjoyable activities
  • Difficulty feeling happy and other positive emotions
  • Prolonged numbness

Changes in Emotional and Physical Reactions

When struggling with PTSD, you may also have changes in emotional and physical reactions, including:

  • Easily startled and scared
  • Feeling constantly “on guard” for new dangers or threats
  • Engaging in destructive behavior such as excessive drinking, fighting
  • Sudden bursts of anger
  • Overwhelming feelings of shame, also known as “survivor’s guilt”

What Does PTSD Treatment Look Like?

When healing from PTSD, it’s critical not to ignore the signs and symptoms. Mental health professionals are equipped to help deal with the impact of PTSD and formulate a plan to help you cope in healthy ways. It may be tempting to “shut down” and withdraw from the world or distract yourself in an attempt to forget replaying the memories. However, this rarely ever leads to successful healing.

It’s understandable to think that talking about trauma may make it worse. It can be damaging if family or friends pressure you to share details before you’re ready. However, with time, many people find it helpful to verbally process the event with a trained, unbiased third party in a safe, professional setting. It can be validating to share your experience and be assured that life as you know it does not have to stop. The right therapy can provide you with the necessary tools to create a “new normal.”

What Forms Can Therapy Take?

There are various treatments for PTSD depending on your unique needs. Treatment could include medication, psychological therapy, a combination of cognitive-behavioral therapy (CBT) or dialectical behavior therapy (DBT), or inpatient treatment. No matter the form of treatment, the goal is to target the core traumatic issue causing your symptoms to help you take back your life.

The therapeutic process should be on your terms; you should never be rushed to share more than you’re comfortable with. It’s essential to have patience with yourself as you process your reactions to trauma. It may take some time before you notice positive changes, and that’s normal.

What Does a Coping Plan Look Like?

Your personal coping plan is as unique as you are. It can look like creating a plan for dealing with triggers, figuring out a support network, or incorporating regular self-care into your routine. Through exercise, meditation, or regular visits with a therapist, you can find what works best to stay present and calm in the face of overwhelming emotions and fears.

Ready to Take the Next Step?

Contact our admissions team to learn how Crownview can help you or your loved one.

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