Robyn E. Brickel, MA, LMFT

It was an honor to join Laura Reagan LCSW-C for another talk on her Therapy Chat podcast. 

In this conversation, Laura and Robyn described what the terms “top-down” and “bottom-up” mean in reference to trauma therapy and how to help survivors heal.

“Bottom-up” therapy always begins with finding and exploring safety and stability for our clients. 

Once there is an established safer foundation, including calmer nervous system, clients can begin to notice what happens for them on the inside or in their body as they are present in current day safety while they process the past.   

Noticing both what you’re thinking and feeling — with support, in small steps — can help trauma survivors manage the sensations without becoming overwhelmed. Check out the podcast episode here.

More Resources

Why a Bottom-Up Approach to Trauma Therapy is So Powerful

Calming the Nervous System: Another Talk on the Therapy Chat Podcast Read More »

What if nothing feels “right”?

When it comes to making choices, sometimes there’s a clear winner. The decision is easy. But it seems like these days especially, every choice is harder. There are so many shades of grey. Confusion and uncertainty persist. Information is constantly changing, and we don’t know what’s accurate or what’s going to happen next.

With access to COVID vaccines, it seemed like we were coming to a light at the end of the tunnel. Now as the delta variant continues to spread, the uncertainty that we felt for so long is again looming heavily in the air.

And as we try to regain some sense of “normal” living, the choices we have to make may feel particularly difficult. Should I wear a mask? Should I go there? Is interacting with family safe? Should I send the kids back to their activities?

Decision-making for trauma survivors

5 tips for making decisions when everything feels risky Read More »

The word trauma is so important to help those who suffer from emotional injury.  Yet people so often think of trauma as only including physical or sexual injury.   Many overlook its role in their overall health and quality of life. They don’t know they are struggling with a changed nervous system that leads to a wide range of physical and emotional symptoms. Confusion about the emotional injury we call trauma is a barrier to care.

That’s why it’s important to help more people understand the emotional side of trauma. By being clear that we use a definition of trauma to include the impact of mental and emotional issues, we can help more people better understand and talk about their mental health care.

Promoting an inclusive definition of trauma

When I talk about trauma survivors, I am speaking about anyone who has survived any type of physical, emotional or sexual trauma. Working with a trauma survivor means working with anyone who seeks to heal from the resulting personal impact on their lives. It doesn’t matter whether the impact looks like PTSD, CPTSD, coping mechanisms, dissociation, difficulty in relationships, addiction, eating disordered behavior, a myriad of other “symptoms,” or any of all of the above.

Recently I tried to bring clarity and dive a little deeper into the exact terminologies and what they look like. I’ve addressed complex post-traumatic stress disorder (CPTSD), PTSD,  and how CPTSD is different from PTSD. These specific terms have their place in describing deeper aspects of trauma. However, we also need a way to

Understanding that trauma includes emotional injury will help more people get the care they deserve Read More »

Trauma can take many forms. You may have heard of post-traumatic stress disorder (PTSD). Most people have at least heard of PTSD, as it relates to veterans. Did you know it impacts many others as well? Have you heard of complex post-traumatic stress disorder (complex PTSD or CPTSD)? People often ask how CPTSD and PTSD are similar and different. I want to help more people have a deeper understanding of what they are experiencing and ultimately get the help they deserve.

My goal, as a trauma-informed therapist, is to raise awareness and treat trauma of all kinds. When I use the word “trauma,” I am incorporating all aspects of trauma, all kinds of trauma that impact the nervous system. Trauma describes the adverse effect of any experiences that felt unsafe, physically, sexually or emotionally, or were perceived as a threat to life or survival. This includes profound emotional neglect and attachment trauma.

People can experience different kinds of symptoms depending on their experience. Trauma can come from a single incident, or from recurring incidents of emotional, physical or sexual trauma. Trauma that develops within an important early relationship, as with a parent or caregiver, can lead to attachment trauma that is complex, developmental and relational and anything in between. Relational, attachment and complex trauma are some of the traumatic variations we see most often at Brickel & Associates.

You may be asking what complex PTSD feels like or wondering if you’re facing PTSD or CPTSD. My goal is to help you see how the two are similar and different,

How is CPTSD Different from PTSD? Read More »

One of the positive outcomes of the COVID-19 pandemic is that it has increased mental health awareness. Limiting our activities and contact with others has led to so much talk about fear, loneliness, disconnection and mental health. These experiences have made people notice their needs and feel more comfortable seeking help.

More people now seek therapy

For some, actually getting help has been easier because they could reach out from their living rooms and receive virtual therapy. Yet for others, it has been harder because they didn’t have the privacy to address the issues they are facing.

Now we are transitioning to a new phase with COVID. As more people are getting dressed in work clothes again, going back to the office, and returning to activities and busier schedules — we are seeing even more people reach out for help.

We notice people having to manage new and increased anxiety and depression. We see more awareness around mental health, including the much-needed reduced stigma. And we see a greater number of people with an increased need for support because of COVID!

People need resources while on a waiting list for therapy

So many people are connecting after COVID — which is a beautiful thing! The tough part? Right now, there are not enough mental health providers for all those who want support. Across the country and around the world, many prospective clients are currently finding themselves on a waiting list for therapy and the care they deserve.

So, what can you do during this “wait” time? Even if therapy

How to Help Yourself if you’re On a Waiting List for Therapy Read More »

When a child experiences neglect, anxiety, or danger repeatedly in a close relationship, that child often grows up with a sense that they are not okay. Psychology has a name for the long-term, consistent type of trauma that leaves a person feeling insecure, overwhelmed and unsafe in the world: complex post-traumatic stress disorder, or CPTSD.

In our practice as trauma-informed therapists, we recognize that many of those seeking our care have a history of trauma throughout their childhood. It is likely they have complex trauma that has resulted in CPTSD. It’s hard for trauma survivors themselves to recognize this.

Because living in a triggered state of alarm is so familiar, many don’t realize trauma is the source of their feeling “not okay.” That’s why I want to address CPTSD here and to encourage those who feel overwhelmed or hopeless to realize they are not broken. They are injured, and these injuries are treatable.

What is complex trauma or CPTSD?

Complex PTSD or complex trauma is trauma that starts or happens in childhood. It’s relational (occurring in relationships, usually some of the most important ones) and developmental (happening during the formative years of childhood).

Complex trauma is usually recurring (happens more than once) and is inflicted by a caregiver, parent, guardian, or person who has close, repeated contact — like a clergy person, neighbor or family member. Complex trauma can consist of emotional, physical and/or sexual violence.

Every time I use the term “trauma survivor,” I use it to encompass all types of trauma: complex trauma, single-incident trauma, the list

Injured, not broken: Why it’s so hard to know you have CPTSD Read More »

A few early mornings last week, I was greeted by a pair of ducks in the parking lot.

Seeing them together got me thinking about the loneliness so many of us have been feeling during COVID.

Among the myriad of reasons why COVID has been so hard, the biggest may be the epidemic of loneliness for so many. Having to suddenly stop socializing has been especially hard for those who are single or live alone. People have become truly isolated!

So much loneliness!

Even for those in relationships or living with others, friendships and extended family relationships have been missing from the normal everyday lives that we had built pre-pandemic.

Humans are wired for connection

People need people to share and enjoy life. Our relationships help us balance each other emotionally in a world that can impose a dramatic range of daily ups and downs. We can manage all the changes and challenges by stepping through them together — just like my parking lot ducks. And COVID meant we were unable to be present with the people we love and enjoy.

Now, the vaccine is giving us hope for increased connection. Thank goodness! Because we need connections. Not just romantic relationships… friendships too!

I am so excited that my friends and I will be vaccinated soon and can finally share a hug again! Friendships are part of the relationships that are so important in life.

I know this idea of getting back to normal or more realistically, figuring out your new normal — may cause anxiety. We may need

Reconnecting after COVID: What’s next after the loneliness epidemic? Read More »

If someone tries to erode your self-confidence, deny your experience, or plant seeds of self-doubt, there’s a word for that: Gaslighting.

• “You only think you know.”
• “You have no idea what you’re talking about.”
• “I never said that.”

Gaslighting is abuse. It happens in relationships, often without the awareness of the person receiving it. It can cause trauma. And it’s never okay.

We need to know more about what gaslighting is, and why someone would use it. Trauma survivors may be more susceptible to this kind of abuse, so it’s important to understand what gaslighting is and realize when it is happening in a situation, and how to deal with it.

Gaslighting In a Relationship Explained: A Trauma-Informed View Read More »

After living through abuse, neglect, or violence, it’s normal to promise yourself you will never let that happen again. That promise seems to make sense. You need to feel safe, to find some sense of control. Otherwise, the danger and powerlessness you feel are too hard to live with.

Control As a Trauma Response: Knowing You Were Powerless Helps You Heal Read More »

If you and your partner want to pursue couples therapy, that’s commendable! There is so much hope and help available in therapy. What if you’re dealing with intimate partner abuse or violence (IPV)? Therapy for domestic violence requires a trauma-informed approach.

Safety First: A Trauma-Informed Approach for Couples Who Want to End Abuse In Their Relationship Read More »