"So often time it happens that we live our lives in chains, and we never even know we have the key" - The Eagles; 'I'm already gone'

Treatment of job-related traumatic symptoms typically takes two or three sessions. I use a technique that I created by combining a variety of treatment techniques (Cognitive therapy, Eye-Movement Desensitization and Reprocessing, visual imagery, Ericksonian hypnosis, Rational-Emotive therapy and NLP) as well as experience gained from treating hundreds of traumatized individuals. I call this technique Multi-sensory Trauma Processing (MTP) and have just completed a book explaining this treatment. MTP is a brief treatment technique designed to treat post traumatic stress disorder (PTSD), partial PTSD, job-related trauma, complicated PTSD and vicarious trauma/compassion fatigue. MTP has also been successful in treating phobias, such as fear of flying. MTP helps to process traumatic memories and flashbacks (move a traumatic memory which is "stuck" in present memory to past memory) and to reduce or eliminate symptoms, such as problems in sleeping and concentrating. For MTP to be successful, the traumatic event(s) must have occurred in the past.

Brief Intense Treatment for Job-Related Trauma of Professionals Living Out of the DC/Virginia/Maryland Area:

Dr. Davis sees numerous professionals who travel from around the United States for treatment. Treatment for these professionals generally can be scheduled to take place in two consecutive days. The first day involve three to five hours of treatment; the second follow-up day involves one to three hours. of treatment. The protocol listed in the explanation of treatment would be compressed, with the review of symptoms, education, taking of a trauma history, and treatment taking place on the first day. On the second day, symptoms are reviewed (including sleep quality on the night following treatment) and traumatic scenes which have not processed, as well as traumatic scenes that were not discussed during the initial session because they were remembered following the initial treatment are treated. Spouses are encouraged to accompany these professionals. Spouses do not sit in on the treatment sessions, however, Dr. Davis educates spouses so that they understand job-related trauma and PTSD. Furthermore, Dr. Davis includes spouses in a portion of the second session in order to teach them techniques that can be used to process the traumatic incidents that their spouse most certainly will encounter in the future. If the professional is already in therapy, Dr. Davis must have the therapist's permission for treatment to take place. Following treatment, Dr. Davis will contact the professional who received treatment by phone and/or e-mail to review symptoms and treatment success. If requested by the professional, Dr. Davis will consult with the professional's therapist. For information and cost of treatment if you do not live in the DC/VA/MD area, call (703-472-3886) or e-mail Dr. Davis at drnancydavis@juno.com.

Unique Treatment of Job-Related Trauma:

The way in which Dr. Davis treats job-related trauma by using MTP is very different from the way in which most therapists work. The first session is 50 minutes in which we review your symptoms, treatment is explained and we decide if I am the one who can best meet your treatment goals. The second session usually lasts from 2.5 to 4 hours. These two sessions include:

1) A review of symptoms: Treatment begins with a review of symptoms using a Symptom Review Checklist. Sleep difficulties are specifically targeted since they particularly interfere with overall life functioning, as well as job performance. The symptoms present at the beginning of treatment are used to determine the success of treatment when they are eliminated and as an indicator of the need for additional sessions, should they return after being eliminated.

3) Taking a trauma history: Experience in treating hundreds of traumatized individuals led me to conclude that traumatic incidents occurring in the life of an individual can be linked or similar. Because of these links, I found that, in many instances, concentrating on one traumatic incident at a time in therapy did not lead to the processing of that event. I also discovered that many people do not know why a specific event was more traumatizing than others and exactly what traumatized them. Therefore, I review your lifetime of traumas in the first session and then treat your reaction and memories of these traumatic events in the same session. Detailed questions are used to help you review traumatic incidents in your past, beginning with incidents that took place during your childhood. Questions are used for the following reasons:

1. Questions seem to assist in retrieval of memories that have been diluted by amnesia or dissociation.
2. Questions help you to organize your trauma memories.
3. Questions take into consideration the impact that the following factors have had on your symptoms: intensity, duration, proximity, support systems, family history, childhood abuse and trauma, sex, physical factors, religion, negative emotions (such as guilt, shame, humiliation, anger and fear), helplessness, sense of control and prior emotional functioning. By discussing and clarifying risk factors, you will be able to provide many important details related to your traumatic experiences that might otherwise be neglected.
4. The interview questions I use were developed from my experience in treating hundreds of traumatized individuals, my recognition that few traumatized individuals were able to articulate important details of their traumatic incidents and that many of these individuals were not consciously aware of the event or specific aspect of a traumatic incident that had been most traumatizing to them. Specific questions have been created for law enforcement trauma and for fire and rescue service trauma, since there are traumatic incidents unique to these jobs.

4) Alternating stimulation in the form of drum sounds, tapping (usually on the shoulders) and, in some instances, eye movement, is a critical technique of MTP treatment. Alternating stimulation accelerates the processing of traumatic memories (moving them into past memory so they no longer are overwhelming or bothersome). In MTP, two or three types of alternating stimulation are used simultaneously in the treatment phase of the session. I use the interview questions and your answers to retell your trauma history; at the same time you will listen to alternating drum sounds on headphones from a stereo tape recorder as I stand behind you (seated in a chair) and alternately tap your shoulders. Although reviewing your traumatic memories (without alternating stimulation) can increase your symptoms and/or the impact and later avoidance of this memory and may be upsetting at the time they are reviewed, by combining alternating stimulation with memory review, the traumatic memory is often processed, moving appropriately into memories associated with past events (traumatic memories seem to be stuck in present memory). Traumatic memories seem to be frozen in the right brain because of the stress hormones your body produced while you were experiencing the event. When memories are stuck in present memory, they continue to cause flashbacks and symptoms. It is unclear exactly why reviewing the traumatic incidents that you have experienced at the same time that you listen to alternating drum sounds and have your shoulders tapped in an alternating fashion processes your traumatic memory. One theory is that this works biologically, perhaps by stimulating both hemispheres of your brain to integrate your traumatic memories. Another theory is that the alternating stimulation distracts the attention you pay to your traumatic memories as they are reviewed, thus changing the way you think about them. The goal of this treatment is to integrate your traumatic memories, (move them into past memory), change in the way you remember these incidents and decrease or eliminate your symptoms, particularly flashbacks and sleep difficulties. The processing of traumatic memories that occurs during MTP can be compared to "de-fragmenting your hard drive".

5) During the treatment phase, I will point out links among traumatic events. MTP recognizes that traumatic incidents are often linked through similarity of events, themes or irrational beliefs (negative self-talk). Traumatic events become linked when the feelings and emotions triggered by one trauma reaches back through time, connecting with the feelings and emotions of an earlier trauma. The linking of two or more traumatic incidents can dramatically increase the impact of traumatic incidents and the symptoms which you experience. This is the reason that you are asked to provide a trauma history, beginning with childhood traumas. I have found that when treatment is focused on a particular traumatic event without recognition of the link that this trauma has to past traumas, the effectiveness of treatment is significantly reduced.

6) During the treatment phase, I will challenge distortions in your thinking, judgment, reasoning and belief systems. Distortions involving shame, guilt and humiliation are particularly targeted, because these emotions have been found to be important elements in the development of symptoms following exposure to traumatic incidents.

7) All brief treatments designed to treat the symptoms caused by exposure to traumatic incidents have found that the success of therapy is increased when you remember the traumatic incident during the treatment session with the same level of intensity, accompanied by same feelings, thoughts, body sensations and visual images as experienced with the original incident. Props (such as video/audio tapes which recorded the event, mementos) which intensify visual and auditory cues, body sensations, feelings, smells, taste and/or thoughts may be used, if necessary, to help you re-create the traumatic incident.

8) During all phases of treatment, I will emphasize your strengths, including accomplishments, survival strengths, positive relationships and job successes.

9) During the treatment phase, I may use visual imagery, metaphors and therapeutic stories as additional techniques to restructure your trauma memories. MTP does not use hypnosis and you are aware of what is happening and can request that treatment stop at any time.

10) At the end of this long treatment session, I will check to determine if you have processed your traumatic memories.

Following this initial treatment session, I’ll contact you to determine how you are doing, particularly reviewing the symptoms that you indicated were a problem for you. The first night following the treatment session, you may find that sleep is interrupted by memories that seem to be processing. Most people indicate that after that night, they sleep very well. Traumatic memories seem to be processed for days following the initial session, as if a dam has been removed in your brain, and your brain is restructuring your memories.

The elimination of your symptoms is the measure of success of treatment, particularly sleep problems and flashbacks. Many of the symptoms related to PTSD may be the result of sleep deprivation and will decrease or disappear when normal sleep patterns are restored. You may find that two sessions are all you need to eliminate the symptoms that cause you problems. You determine the number of sessions you need after this point. Some individuals want further sessions to deal with other problems that have arisen in their lives. Although no promises can be given as to the success of this treatment in your particular case, MTP has been highly successful in helping many individuals process their traumatic memories, especially with job-related traumas. When treatment is unsuccessful, it is often due to undiscovered links between traumatic events or the part of the event which was the most traumatizing has not been pinpointed. Alcohol or drug abuse also interferes with treatment success. In some cases, a particular r job assignment may become so traumatizing (such as investigating child abuse) that reassignment to a different job may be recommended to you for maximum reduction of symptoms.

Because life is filled with traumatic incidents, especially if you are a law enforcement officer or work for the fire and rescue service, symptoms may disappear following treatment only to re-occur in the future. This may happen when an event triggers old symptoms or additional traumatic events occur. For example, symptoms from working a particularly gruesome plane crash may be processed until working a second plane crash scene re-triggers old flashbacks and symptoms. Generally, an additional short session eliminates these new symptoms. Treatment of your job-related trauma is on an as-needed basis…you determine the need. In particular, you should use deep and restful sleep, flashbacks, and an increased use of alcohol as indicators of whether you are experiencing job-related trauma. The goal of MTP is to return you to the level of functioning you experienced when you started your job and to make you as productive and high functioning as possible.

MTP can be used when secret or confidential information related to employment cannot be revealed, although it is more difficult to identify the most important details of a traumatic incident, the links among a series of incidents and any unique characteristics of the incident which have caused it to be traumatizing to you. I do not want you to violate any rules related to your employment, nor is this necessary for treatment success. So, when secret or confidential details cannot be revealed, I will educate you in a much more detailed fashion as to the traumatizing aspects of particular incidents, the ways in which traumas can link and unique characteristics of job-related traumatic incidents which can lead to symptoms. I may have you read material to increase your understanding. Prior to my retelling your trauma history story, I will have you give me neutral cues t9o include in this story which will bring up your memory of the incident. In this way, during the treatment phase, rather than my recounting of the details of the traumatic event, I will say the neutral cues and you can silently review the traumatic event in your mind. I have found that these cues allow you to process your traumatic memory without my knowing the details.

You can request, in writing, that all notes detailing your trauma history be destroyed following the first or second session. I provide this option because the success of MTP depends on our discussing many details of all traumatic incidents in your background and my discovering of any links among them. I take extensive notes during the first session, as you answer questions. If important details are not revealed because you do not want a written record of these incidents or because of your fear that management might gain access to them, despite the limits of confidentiality, treatment will not be as effective. Although treatment notes are confidential, there are, of course, ways that others can gain access to these notes, if they exist. If you choose to have your treatment notes destroyed, you will have to remind me of your trauma history if you return for additional sessions. Furthermore, you should understand that I would not be able to accurately recall the details of your trauma history without these notes, if you found the need to have them for Workman’s Compensation or other such reasons. Therefore, if you request that these notes be destroyed. However, the "Consent for Treatment", "Patient Intake Information Form", "Notice of Privacy Practices Authorization form", and information related to insurance or Workman’s Compensation cannot be destroyed and will be kept as permanent records; these forms do not contain the specific details provided in treatment sessions of your traumatic incidents.