For this week’s blog I got the opportunity to sit down with Caitlin Weese, LCSW-C, CCTP a trauma specialist in the Frederick Maryland area. We discussed trauma, stigmas, the issues people are facing in today’s society, and much more. Come along with me as we get a deeper look into the world of trauma therapy!
Background and Expertise:
● Can you share a bit about your background and how you got into the field of
mental health?
Absolutely, I started when I was in my junior year of college I saw a presentation about sexual violence and intimate partner violence on campus. I wanted to get involved so I reached out to the person who ran the program and let them know I had an interest and wanted to volunteer in any way. I started working as a peer advocate my senior year of college and with that I saw clients on the University of Maryland campus, not so much for therapy, but for crisis response. If they needed a SAFE exam I would go with them to the hospital or if they needed a protective order I would go with them to court. I would teach them about common responses to trauma and grounding skills, more psychoeducational stuff. I was hired on as an advocate and from there I went on to do crisis response for Baltimore County. Since then I’ve worked for a community mental health agency, an intensive outpatient program (IOP), and a partial hospitalization program (PHP) for dual diagnosis and also group practice focusing on trauma and now I’m here in my own practice.
● What specific areas of mental health do you specialize in, and why are you
passionate about this area?
My specific areas of focus are trauma mostly complex and childhood trauma. A lot of that interest came up in doing that work with the folks at CARE where I was an advocate and just seeing the connections between trauma and the way it impacts the way we see ourselves and our relationships with food and substances. I wanted to learn more from an etiology standpoint on “How does childhood trauma come about?” and also from a preventative standpoint “What can we do in our treatment of trauma to help folks that are experiencing these things early on so they’re not forced to suffer for unspoken amounts of time?”
Approaches and Techniques:
● What therapeutic approaches or techniques do you primarily use in your practice, and how do they benefit your clients?
I would say the main one is probably EMDR. I also like to use a lot of polyvagal theory and internal family systems or ego states interventions. Those are the main ones but I also love DBT. I like teaching some of the distress tolerance skills. I think those can be really helpful and interpersonal effectiveness techniques. In terms of how clients might benefit, I like to focus on teaching clients how to reclaim control over their nervous system or create a more flexible nervous system. After trauma our nervous system can become very regimented or hypervigilant so helping clients to create a more flexible nervous system helps relieve some of that. Then after I like to work with clients to process the trauma so that they see it differently when those triggers do come up.
● Are there any innovative or unique methods you've found particularly effective in
treating certain mental health issues?
I would say one thing that I really enjoy doing within the work is combining different techniques. For example if I am working from a parts perspective a client can say ‘I realize now I’ve always felt bad about myself because of an experience in middle school.’ Then I might use the EMDR to strengthen that neuropathway. I find that has been helpful to clients to cement some insights and help grow that neural network.
Stigma and Advocacy:
● How do you address mental health stigma in your practice, and what steps do you take to create a safe and supportive environment for your clients?
I would say in terms of mental health stigma part of the way that I like to view it is viewing every symptom as an attempt to cope rather than something that is maladaptive. Instead of “what's wrong with this person?” I think “what happened to this person for them to develop this way of being?” Ultimately our brains want us to be healthy and well and all our symptoms are just ways our brain and body are trying to communicate with us that they need something. Or it is a way our brain and body have adapted to things we are experiencing. I like to create a safe and supportive environment through non-judgement. In trauma there can be a deep shame that people hold that could lead them to never share anything about their experiences. Clients have thought “I’m never telling anyone this. I am taking it to the grave. If you knew this about me you would never accept me, or talk to me, you would probably run the other direction.” Knowing this, I try to approach things from a non-judgmental perspective so that clients can feel safe sharing those things in their own time if it feels right for them.
● What do you believe is the most important aspect of mental health advocacy in
Today's society?
I think the biggest thing that I notice is accessibility. From a structural or macro standpoint our society is not set up in a way that clients can get accessible therapy with a competent therapist in a way that does not create burnout and overwhelm for the therapist. There are tons of studies about therapists leaving the field because of the overwhelm and burnout because society does not prioritize mental health in the way that we should. Clients end up losing out because they're not able to get therapy because it's not as accessible. Many therapists are private pay because insurance does not allow them to do the work they need to do. It creates a really terrible cycle for people where there are a lot of people that need services but cannot get them.
Technology and Mental Health Services:
● How do you see technology impacting mental health services and therapy?
Are there specific advancements that have significantly influenced your practice?
I think that a positive technological advancement is the presence of the internet. Websites like YouTube, Instagram, and TikTok are helpful because they make information more accessible to people. However with a huge caveat that not all the information is reliable or from a professional. With trauma especially we can’t think ourselves out of it. We can have all of this great information but that’s not going to actually change what’s going on in our nervous system. I’d say that's probably the biggest influence.
● What are your thoughts on the use of mental health apps or online therapy
Platforms?
I definitely think that online therapy can be very helpful to increase accessibility. I provide online therapy. As a therapist that understands how those platforms work I definitely have a lot of concerns about them for a lot of different reasons. They're not necessarily good or bad. I think like with a lot of new technology there is a lack of regulation. That lack of regulation inherently brings with it an increased risk to consumers.
Self-Care and Well-being:
● How do you encourage clients to incorporate self-care into their routines?
What are some effective self-care practices you recommend?
One thing I would say is that I really try to end most of my sessions by asking clients “What is one thing you can do for self care between now and next time?” I want to try to get their brains to think about self care. Not just self care in the sense of face masks and taking baths I love all those things, they're great but self care can look like a lot of different things. I am trying to get their brains to think about it and then also introduce and encourage micro self care practices. It might not be realistic or accessible for somebody to go get a massage or take 20 minutes to meditate, instead it could be taking 30 seconds halfway through your day to take a deep breath and notice what that’s like.
● In your opinion, what role does lifestyle play in maintaining good mental health?
It plays a huge role because ultimately traditional therapy is 50 minutes once a week. There are so many other hours that we are without our therapists. Supporting our mental health
Through our lifestyle is key because our brain and our body are so connected.
Mental Health Challenges:
● What do you perceive as the most common mental health challenge people face
today, and how can individuals begin to address them?
A big one that I notice is chronic loneliness or loneliness being an epidemic. I think despite social media and having more ways than ever to be connected we as a society are less connected than we’ve ever been in a deep sense. We don’t have communities and neighborhoods in the ways we used to where you knew your neighbors and community. It’s a lot less common now. That loneliness and isolation is really dangerous. A study I came across said that loneliness is as impactful on your health as smoking a pack of cigarettes. It has a real impact on not just our mental health but our physical health. I would encourage people to look for opportunities for connections that you might not otherwise notice. Whether that's in your workplace, your kid’s sports teams, or your neighborhood. Just trying to notice those opportunities and taking small steps to put yourself out there while keeping in mind not everyone is going to be a good fit for you and that’s okay but you can always try. Sometimes communicating with people around you more, even in a way that isn't deep, can build more connections. Things like “Hey I like your shoes!” or “Wow! That’s a nice dress!” to a person you’ve never spoken to but know from an exercise class creates an opportunity for connection.
● Are there any misconceptions about mental health that you often encounter in
your practice?
One misconception is that mental health is treated like physical health. Oftentimes clients come in thinking that it's going to be similar to going to a doctor's appointment. They expect to come in and say here's what's wrong with me and the doctor listens and sends them home with a pill to fix it. Physical health is a pretty short term intervention while mental health is not like that at all. It’s not going to be a quick fix and the results are not going to be as black and white with physical health. With physical health you can take a pill and say hey I feel better! With mental health it’s more of a gray area things are not going to be as easily measurable as with physical health.
Workplace Mental Health:
● What advice do you have for individuals struggling with mental health issues in
the workplace?
Employees struggling should take a look and see if their workplace offers any benefits with mental health. Some employers offer EAPS that can be beneficial for mental health. It's also important to remember that ultimately a job is a job and your mental health is worth more than whatever money you’re making. This is easier said than done. You may not be able to quit your job because you have bills but maybe you can create better boundaries at work so that you aren’t allowing the work to seep into your personal life.
● How can one balance the demands of work and mental health effectively?
With all balance it’s adjusting and readjusting. If you think of yoga during a tree pose the muscles in your feet and legs are adjusting and readjusting multiple times. This idea of finding balance one time and being able to set it and forget it isn’t realistic. We’re gonna have to adjust and readjust. It could look like deciding what the non-negotiables for your mental health are and how you can work those into the work that you do.
Preventive Mental Health Practices:
● What are some preventive measures individuals can take to support their mental
health before issues arise?
Some good places to start might be mindfulness or meditation. Take time to scan your body, check in with your breathing. That regulates your nervous system and helps other areas of your brain function. It will help you be less likely to go to those places of anxiety and overwhelm. Alongside that is getting in touch with your feelings, noticing what you're feeling, and having someone you can talk to about it. Also knowing what the yellow flags are that come before you get to the red flags. What are the signs for you that things are feeling more unmanageable and having a plan in place about what to do if you start to notice those.
● Are there specific habits or practices you encourage for maintaining good mental health on a day-to-day basis?
Mindfulness and meditation are big ones. It can be hard to keep up with but even if it’s just for a minute or two a day it will help you start to become more aware of your body and your emotions and help you regulate your nervous system. Also, I’m biased because I am a yoga instructor, but I think yoga is a great tool to use because it gives you an opportunity to get in touch with your body and your breath.
Resources and Advice:
Finally, could you recommend some reliable resources, books, or online platforms for individuals seeking further information or support regarding mental health.
NAMI.org is great for free support groups for different mental health struggles
For trauma focused information the books “What Happened to You” and “Waking the Tiger” are really good and there are workbooks that go along with them.
Ariel Schwartz Complex PTSD Workbook
Reach out to local community agencies for more information on support groups offered in your area.