[Editor’s Note: Everyone has mental health experiences on the spectrum between thriving and struggling. Perhaps you (or a friend) are in a season where you need extra mental, social, emotional, spiritual, and physical support. In this #mentalhealth series, we want to balance personal experience/story with input from mental health and medical professionals. We want to also explore, “How does our faith in Jesus relate to our mental health?” Our desire is to support you as you work towards mental well-being.
If you are considering hurting yourself or someone else, or you know someone who is, please contact a mental health emergency hotline. If you need urgent counselling support, Kids Help Phone is also available for young adults up to age 29 for phone calls, Facebook Messenger, or texting conversations.
Today we are sharing our conversation with Alison Buchan (Clinical Social Worker/Therapist, MSW, RSW, CSAT) around mental health, trauma, PTSD, addiction, faith, and healing. Alison has worked as a clinical social worker/therapist for 20 years and runs her practice, The Oaks Counselling Consulting, in Oakville, Ontario. A staff member of Power to Change – Students recorded this interview.]
P2C – Students: Where do you live and work? Do you have a family? How long have you been working as a clinical social worker/therapist? Tell us about yourself.
Alison Buchan: So, I live in Oakville, and I have my own practice called The Oaks Counselling Consulting. It is currently just online because of COVID, which in some ways isn’t great, but anyone can access therapy now, which is good. I have two children, 16 and 12. I’ve been practising in the field of social work for about 20 years. I spent the first 12 in a major hospital, working in addictions and trauma with a medical team alongside psychiatrists, medical doctors, nurses, and addiction therapists. I love the work, and I didn’t want to leave it once the hospital role shifted and changed structurally, so I transitioned to my own private practice.
P2C-S: What led you to pursue being a clinical social worker/therapist?
Alison: I’ve always really loved people, but it started when I lived in a fly-in First Nations community in Northern Ontario called Cat Lake First Nation doing community work with addiction. From that experience, I realized there needs to be change in policy in order to really help people, so I completed a Master’s in social work with a specialty in policy development. Then I ended up doing work on a national project in Canada with HIV-positive youth doing policy change and trying to shift resources. When I had kids, I shifted back to clinical practice working with addiction and concurrent disorder––which is when you have an addiction at the same time as a mental health disorder like the diagnosis of trauma and PTSD (post-traumatic stress disorder).
P2C-S: I’m curious, what interested you in specializing in trauma and PTSD in your work?
Alison: Well, as soon as you land in the world of addictions, trauma and PTSD is what you are going to find. They are so linked. A lot of people have a variety of trauma in their life, but when you come in with an addiction, it’s like a window into their life––when you remove the substance that has been helping them cope, up comes the other traumatic pieces. The first year of addiction recovery looks like getting clean and sober, but then to stay in long-term recovery, you need to do the work that led you to be addicted. A lot of that involves the healing work around their trauma history.
P2C-S: I think it would be helpful to define trauma for those who aren’t familiar with it. What is a basic definition of trauma? When you talk about trauma, what do you mean exactly?
Alison: I’ll give you a few different definitions because there can be so many. One of my favourite books, which is a must-read for anyone who is interested in understanding trauma for themselves or someone else, is called The Body Keeps the Score by Bessel Van Der Kolk, M.D. His definition of trauma is: “Trauma occurs when both internal and external resources are inadequate to cope with the external threat.”
But then the National Child Traumatic Stress Network defines trauma as “an event or series of events that involve a fear of threat.” I like that, because it means your triune brain, which helps manage threat, is flooded and you go into a fight/flight/freeze place. But it’s when even that feels like it’s overwhelmed. So one of the main characteristics of trauma is its power to inspire helplessness and terror.
It’s also really important to say that some variations of trauma for you may have been feeling helpless and terrified with a raging mother, whereas another personality or person may not have experienced that same helplessness. But generally, traumatic events as a series, or one event, can overwhelm your ordinary way of coping.
P2C-S: Right. But how does trauma relate to or impact mental health daily? I’m not sure how many of our readers are familiar with trauma. Are trauma and mental health the same thing, or are they different but related? How do they intersect?
Alison: Great question. There’s something called the DSM5, the Diagnostic Statistical Manual 5th Edition––this is the big book that physicians use to diagnose any mental health issue: depression, bipolar, anxiety, etc. Every mental health diagnosis falls under three or four umbrellas. Two are mood disorders (depression, bipolar) and anxiety (generalized anxiety, social anxiety, phobias, obsessive-compulsive disorder, and PTSD). PTSD is right now the diagnosis for trauma. It has similar symptoms of anxiety––going into hyperarousal, you get flooded. So trauma/PTSD is an actual mental health diagnosis.
You can have a PTSD diagnosis alongside other diagnoses, like depression and PTSD. In fact, PTSD is sometimes misdiagnosed as bipolar, because if you are triggered you can get hyper-aroused, like fight or flight, or hypo-aroused, which is freeze, or a low mood. In addictions, once you remove the substance or behaviour, you get all of these symptoms. And if you have these symptoms without an addiction and you go to your doctor, often what is diagnosed first is depression, because it often immobilizes us first. But then sometimes the doctor will see these symptoms of being hyper-aroused, and this is where the misdiagnosis can happen.
Being able to see a doctor or professional consistently who can understand your story is critical, because they can tease out if you’re experiencing PTSD or something else.
P2C-S: If a person experiences trauma in their childhood, how does it impact their life years or decades later? Does it “go away,” or does it influence them in adulthood?
Alison: So trauma actually impacts your brain, and it disrupts your ability to attach to other people in a way that is consistent and stable. Even as an adult––if in my mind and body I keep returning to traumatic events, I may be re-enacting things that may have kept me safe as a child (which is really resilient and creative), but it may not work so well in an adult relationship.
As children, we need to feel four things to securely attach: seen, soothed (feeling emotions and staying present), safe, and secure (like no one will harm us). We just need each of these in some measure, it doesn’t need to be perfect––then we are able to securely attach. We don’t even need a ton of people. What every child needs to thrive is one adult who is absolutely crazy about them.
P2C-S: Students often encounter struggles in relationships or in their family dynamics with parents. It’s so overwhelming to unpack or try to understand what’s going on because they struggle to function in their current reality.
Alison: I think one of the big barriers for many is that they love their parents. They may feel that in talking about their childhood struggles, they may have to cut their parents off, or maybe change their relationship. It may even feel like betrayal to talk to someone else (even a professional) about them. So it’s really important to know that it’s possible to have continued loving relationships but be able to process how they have impacted you. Sometimes I say to clients, “If you can imagine, when we’re talking about the parent or whoever it is, let’s protect them and keep them really safe, even metaphorically in this room. Because we don’t want to disrupt that attachment. But we need to talk about the impact, kind of what’s playing out for you now.”
P2C-S: It’s possible that I may have experienced something that my parents never desired, and they still love me, but the impact has been damaging. It’s important to work through that, so I hopefully don’t continue to pass that on to my spouse, my friendships, my church community, or my children.
Alison: You know what, I often say to people, you can see a therapist like three times and do as much work as you want to do and leave there. You don’t have to make commitments to stay for years to figure it out. And as an aside, if you choose the pathway of seeing a therapist, it’s important to find someone who you can really connect with.
P2C-S: What are some common examples of trauma that people may face?
Alison: Some common things that would cause trauma would be physical, sexual, or emotional abuse, domestic violence, and/or community violence. That would be what you’ve seen at home or in your community (like gangs, chronic bullying, neglect, emotional neglect, or physical neglect). Even if your parents or caretakers had significant mental health issues like chronic depression, suicidality, institutionalization, addiction, and maybe incarceration, there would have been some limitations that could have impacted you.
Other forms of trauma can come from natural disasters, a sudden death or violent death of a loved one, or a death you weren’t expecting. Even a death that you were expecting can be traumatic, and seeing someone die, witnessing war, those kinds of things. Trauma can be a single event or it can be a recurring experience––that on its own may not have been traumatizing, but after a certain amount of time, it becomes traumatic. It’s super complex.
P2C-S: What then is the healing process like for someone with trauma––who may have experienced one or even several of the things you just described?
Alison: In the healing process, there are a few things you need. The first one is connecting in a healthy relationship. That might be with a therapist, or with a loved one. Someone who can pay attention to you without judgment and with compassion––especially if you’re having triggers or you’re feeling flooded. Someone who can help you process what’s going on for you.
The second part of healing is to find new ways to regulate your CNS (central nervous system). Your CNS goes up your spine to your brain, and it’s what tells your brain to fight-flight-freeze. Some ways to calm and regulate your CNS can involve mindful breathing, prayer, meditation, and using your five senses to keep you in the present rather than being flooded back to the past (it helps ground you). When your CNS is regulated, it allows you to feel, helping you process something through to the end rather than continuing to keep it exiled or contained.
The third thing would be probably to tend to really basic things like making sure you get enough sleep, eat well, avoiding drugs and alcohol, and doing exercise (which gives you dopamine, allowing you to feel better). With any kind of exercise like walking or running, you’re actually bilaterally stimulating by going back and forth with your feet, stimulating your brain. I don’t know if you’ve ever experienced this, where you’re kind of ticked at someone, you go for a run or walk, and afterward you feel relief––and even know what you’re going to do in the situation. So to reduce stress, you want to do movement, but it also can help you actually process in the moment when you’re feeling hard feelings, rather than going back to old patterns of coping.
Lastly, getting some professional help is important if you try everything else and you’re still having trouble functioning.
P2C-S: Outlining those four elements of healing is helpful. I’m interested though, is it possible to “overcome” trauma? Do the effects ever go away completely? Or is it always something we have to deal with, and mitigate the impacts of PTSD or trauma in our lives?
Alison: Actually yes, we can overcome trauma. As adults, we can develop what’s called secure attachment in a relationship––feeling safe, secure, soothed, and seen. But even in healing and secure attachment, there may be moments or days where you have triggers or struggle with reacting to something well. Because your natural response is very deeply embedded in your neural pathways, in how you likely coped in that traumatic situation or abusive relationship.
But the good news is, though, over time, doing something different over and over (like forming secure attachment, or staying present in the moment without being flooded) develops new neural plasticity, new neural networks in your brain, which over time become the norm. It’s like crossing your arms the same way every single time, and then learning to cross them the opposite way. The first few times, it’s awkward and weird, and you have to think about it. But over time, you would start doing that naturally. As humans, we’re very resilient. God is so good in the way he created our brains to adapt and grow.
P2C-S: It’s so fascinating that healing from trauma involves reprogramming our brains and neural pathways. How then can we see the role of God working alongside the role of therapy to bring healing? How does your faith influence your work, and how you view something like trauma? How do those things relate?
Alison: They’re so intertwined. It is talked about, especially in addictions work like AA (Alcoholics Anonymous), that when someone has a sense of a higher power or something inside themselves, they actually have a greater likelihood for healing. When we are broken-hearted and feel crushed, knowing that God is bigger can help us heal––it allows us to have trust in the healing process. Even for those people who never attended church. As someone who knows Christ, I wouldn’t say I’m a Christian counselor, but I’m trained as a clinical social worker. But I do know that God is close to the broken-hearted, and that allows me to honestly trust that, no matter what, God is able to heal.
The piece that is interesting for me to navigate is that I believe God is so much bigger than even myself. That means that I never have to do this work alone, which actually means, to be honest, I’m not burning out. I don’t think I will burn out. Because it’s not about me. Right? I actually think that it gives me the ability to relinquish what isn’t mine and know that God is bigger.
The other piece that I am constantly straddling is my faith and my profession. I don’t tell clients that I’m Christian, because sometimes, as soon as the word “Christian” comes into the therapy field, that can actually mess up the interaction. There can be so much baggage around what the church was for that person. I don’t want to become the projection of the belief system or values that someone held in their life, when I don’t necessarily hold those things true. So there’s this weird line of knowing what is spiritual truth for me, and being able to help and see some people actually come to God themselves.
P2C-S: In ministry, students can easily struggle with burnout, and how we respond is so important. I don’t want them to go away feeling, “Wow, another bad experience,” because they shared something vulnerable and I squashed it, or I said the wrong thing.
Alison: Yet I think, if someone who is struggling discloses things or shares with you, and you walk away thinking, “I missed them, or I started talking about myself, or I said the wrong thing,” you can go back. You can say, “Hey, I totally missed you there. Please tell me more. Right? Or maybe I spoke too much about myself and maybe it was really unhelpful. Can we talk a bit more about that thing that you were saying?”
P2C-S: As we wrap up here, Alison, some of our readers may read this conversation and wonder if maybe they have experienced some level of trauma. What are their options? What should they do?
Alison: Well, if they have a safe person in their life, try to put words around some of what they’re thinking and feeling. If they can’t do that, they can speak to a family doctor about what they’re noticing. They could go online and check out local therapists, or speak to yourself or someone else who’s in ministry who might be able to refer them to a professional.
Also, often in the health centres at universities and colleges, they have social workers who are very skilled. There are also groups they can attend. If they’re noticing they are using sex, alcohol, or a prescription medication (not the way it’s prescribed), it’s important to tell someone. It’s not about judgment, but understanding what’s going on for them and taking those initial steps towards health.
It’s also important if the person is able to hold compassion for themselves. It always makes sense why they’re doing what they’re doing. To understand your story and untangle some of it, to make sense of why you might be engaging in relationships or behaviours in certain ways. And finding someone to help you make sense of it.
P2C-S: I love that self-compassion piece. There are many times where we feel like we’re at the bottom of a barrel. Thinking, “Wow, I couldn’t go any lower, I don’t even know how to climb to the top.” But that’s not where it has to end, you know? God’s not done with you. There is hope, there is opportunity––and it can still be very scary. But God also promises his presence and Holy Spirit to empower and help us take those steps of faith towards healing. God also gives us people in our lives to help us. Sometimes we just need to pay attention, look around, and ask, “Who has God given me? Who can help me?”
Did you enjoy this article? We encourage you to check out more articles in our #mentalhealth series.