Founder of Expat Therapy Barcelona, Isabel Soler is a trained and licensed psychotherapist from the United States specialising in issues surrounding trauma, grief and loss, anxiety, depression and difficulties related to cultural transitions and the expat experience.
Her English and Spanish-speaking practice in Barcelona offers a non-judgemental, professional and confidential space to work through childhood traumas and find a way back to yourself.
Here she shares some of her valuable insights into trauma and trauma-informed therapy, based on over 25 years of experience working in this field.
For the past 20 years, I’ve noticed an increase in our interest in trauma in its many forms and in the way it impacts human functioning in general over time. Because of this rise in interest in this topic, prolific research, investigations and studies have followed. This interest and effort has led to new theories, perspectives and applications that have led to effective treatments for the multilayered impact of trauma on the human experience.
Trauma can be defined by the reaction to a situation, single or continuous, that creates fear and the experience of impending danger, risk and a lack of safety. As you can imagine, there are many factors involved in the shaping of this biophysical and emotional response. The kind of event, the duration, the frequency, the events surrounding it, the outcome, and the emotional/psychological state the person is in all have an impact on how that event is experienced, how it is dealt with and how it is stored.
Countless studies have demonstrated how people who have experienced trauma, especially during childhood (known as developmental trauma), are up to 3 times more likely to develop significant mental and physical health conditions. Some of these symptoms and conditions include anxiety, difficulty with attention span, focus, sleep disruptions, lack of self-esteem, mood dysregulation, symptoms of depression, headaches, fatigue, muscle tension, stomach problems, high blood pressure, heart problems, and learning and performance difficulties.
Trauma, whether acute, chronic or complex, can create default modes in our neurological landscape that lead to nervous system responses and reactive patterns that create significant disruptions in all areas of functioning. Fortunately, the effects of trauma have become an important area of interest across disciplines that will continue to lead to research that in turn results in effective treatment.
All traumatic events can lead to disruptions in our life. But some events have a greater impact due to their nature, significance and level of disruption in our lives. Big T traumatic events, such as environmental disasters, wars, etc, are considered those that have a life-threatening aspect or for others that we care for. Long-lasting abuse, such as domestic violence and/or developmental trauma is also considered a big T trauma due to the generalised impairment it can have on mental and physical health. Little t traumas are those that are disruptive but not life-threatening such as loss of employment, separation, divorce, bankruptcy, etc.
Depending on the type of trauma experienced, the person’s attachment and previous trauma history, trauma will affect us in both subtle and overt ways. Big T trauma will have long-lasting effects and can impact our cognitive, emotional and physical functions and can worsen if left untreated. The impact of little t traumas may be more contained to situations that resembled the traumatic event, but can still significantly impact us in similar ways to Big T trauma.
Trauma-informed therapy refers to a particular perspective and approach to therapy that takes into account the traumatic history of the client. In a therapeutic setting, a non-informed approach to trauma can create more distress and perpetuate the alienation a person who has experienced trauma deals with it daily. Trauma-informed therapy refers to how questions are approached, suggestions are delivered, the tone of the voice as well as mindfulness to non-verbal communication and the way it communicates safety.
There are many ways to deny, avoid, repress or dissociate from traumatic life events and despite these protective efforts (to keep unwanted emotions and memories at bay) it is challenging to “not know” that you’ve experienced childhood trauma. Regardless of what protective devices we utilise to protect us from the past, the weight of trauma seeps through without our ability to control it.
Childhood trauma refers to situations, conditions and parenting styles that create insecure attachment styles with our caregivers and create negative and distorted self-perceptions of ourselves. These negative experiences lead to beliefs of ourselves, our capacity, and our expectations of others and the world that are limiting, restrictive and punitive. Within this state and experience of ourselves, all relationships, performance, and issues surrounding safety, belonging, rejection and abandonment can all trigger a trauma response due to links to past childhood trauma.
Our capacity to adapt and heal is coded into our DNA, our ability to evolve. We wouldn’t have survived on this planet if this wasn’t possible. Our oldest two ‘brains’ (cerebellum and limbic) focus primarily on issues related to survival (keeping our metabolism going, hydration, and sleep as in the case of the cerebellum and issues related to belonging, as in the limbic brain) and prioritise focus on anything perceived as a risk. This is one of the reasons why our mind will default to whatever negative thoughts of possible risk to our survival. We linger on what can hurt us – it’s a way to survive.
Despite this however, we possess a neurological capacity that is ‘plastic,’ meaning our neurology, the way our brain makes connections, creates patterns and directs our response to life is adaptable, this neuroplasticity allows us to undo old patterns that no longer serve and create new ones more relevant to the present. In this way, despite the deep implications of traumatic events, unique ones or continuous developmental trauma, our ability to heal, rewire the pathways shaped by trauma is also part of our genetic predisposition and evolutionary legacy.
As far as ‘totally’ healing from trauma I’d like to add that we can never ‘totally’ return to a previous state, or age for that matter. Life shapes us without permission. This doesn’t mean however that despite the challenges and traumas we may experience in life, with effective and appropriate attention to our healing, compassionate action towards our journey, we can’t come out stronger, wiser and kinder than we ever were.
I’ve been interested in trauma since the onset of my psychotherapeutic career. Particularly our persistent resilience in the face of such pain and grief. My very first entry into the field was at a long-term shelter for sexually abused girls. Trauma was just gaining attention during that time but it was to be almost another decade before techniques such as EMDR, IFS, Inner Child Work (which can be applied within many different approaches), Neurofeedback (something I’ll start training in late January), Trauma Informed Yoga, Somatic Experiencing Practices, Breath Work, Mindfulness, Meditation and Polyvagal Practices would all be recognised as evidenced-based practices.
Within the last 15 to 20 years, countless studies have substantiated the benefits of these practices. These techniques are particularly effective for the treatment of trauma due to their ability to engage the body in the process of healing, and in particular the limbic brain. The mammalian brain focuses on belonging, and protecting from abandonment and is also the seat of the alarm centres for the nervous system and our memory network.
These practices all share the understanding that our ability to redirect our focus (through countless different approaches) and create awareness around the beliefs we carry about ourselves, the emotions and sensations in our bodies associated with these beliefs and to meet whatever is there with safety, can rewire an activated nervous system to become a calmer and more receptive one. This allows us to be more proactive and clearer in our understanding of what’s going on with us. Talking therapy, particularly traditional psychotherapies, such as psychoanalytic and cognitive therapy is of course useful, but in the case of trauma, it has many, many limitations.
Each person is unique and each of us is neurodivergent in our own way. Every person’s life is unique and we all have histories that have shaped us in particular ways. Despite our uniqueness, we share very similar operating systems, created through millions of years of evolution and responding to life in very similar ways. Embedded in each person’s fears, sorrows, grief and sadness is the answer to what’s needed.
As a therapist, I feel that the most important piece is to listen, deeply, and to let the story unfold. In particular, listening to what is not being said, what was needed and wasn’t there. What was there that wasn’t needed and so many different ways the person experienced their life and that continues to shape them today. Once this story is clearer, my own understanding of different theories, practices and intuitive wisdom, which I value greatly, will guide the way forward towards treatment.
This is such a personal moment for us. Today I’m glad there’s much less stigma around participating in therapy than there was in the past. I guess we become ‘ready’ for therapy when we realise that we can use someone else’s expertise to help us see more clearly, maybe undo some old patterns and help us see what’s needed moving forward.
There are many ways to do this; through nature, community, art, dance, music, plant medicine, shamanic practices, meditation, etc. Western therapy is just one way. It has come a long way though and I do believe it can help us to understand ourselves better, and create more compassion and trust in ourselves, which is at the centre of any healing journey.
Being an expat, like all other conditions and situations we find ourselves in carries with it unique challenges. Essentially at the core, it activates the same themes we have dealt with throughout our lives: belonging, rejection, connection, acceptance and safety.
Whenever our environment changes, whether intentionally or unintentionally (although this has so many more consequences and challenges around integration), our identity, stability and the meaning we’ve assigned to ourselves, become destabilised.
When this happens, it can activate other past experiences and unprocessed wounds around these same issues of belonging, safety, etc, creating grief, sadness, shame and feelings of loneliness.
Of course, there is a wide spectrum of how we experience the transitions inherent in the experience of relocation and it’s also important to keep in mind the impact of our own past history and the way that it will shape our interpretation of our present.
Whether it’s your first time seeking someone to speak to about current concerns, or you’ve decided to continue growing within a supportive therapeutic relationship, I welcome you to Expat Therapy Barcelona.
Therapy is an active process that is grounded in respect, honest communication and trust. This combination is the key to working and growing towards the change you seek.
Here are some things to expect from our initial session and subsequent sessions:
The therapeutic relationship is one of the most influential factors in creating change so this is why is so important to work with a therapist with whom you feel heard, seen, understood and also can relate to your values.
Of course, it is very important to choose someone who has knowledge and experience with the issues you are seeking to address. I would always recommend finding someone who can offer unconditional respect and compassion.
There are endless ways to build support and stability. As I mentioned before, spending time in nature, engaging in community activities with groups that you feel connected with, exercising, finding ways to meditate, doing breath work, journalling, dancing, art, music, practices that create inspirational rituals, creating boundaries and prioritising your time and activities.
Here is a List of Tools for a Daily Practice in which there are strategies for regulating the body, mind and emotions. There are links to practices across the spectrum that could help bring more stability and integration to the nervous system.
It’s ok to be nervous, as it is a mechanism designed to protect us, and also to let that part of you that’s nervous know that you can proceed along with it and promise this part of you that you will listen to it, that it has a place and also to trust you as you find ways to create more lightness and integration.