caring Communication

Feature
Interview with
dr martha schmitz
R
enowned addiction specialist
Dr Martha Schmitz delivered
a two-day workshop on Seeking
Safety Therapy to staff
in the Alcohol and Drug services and allied
disciplines in Mental Health, homelessness,
Domestic Violence services.
The idea for this workshop originated in HSE
Keltoi Addiction and Trauma Treatment centre
based in the Phoenix Park where clients
undergo an eight-week residential treatment
programme. The centre won the 2015 Health
Management Specialist Care centre of the
Year for their eight-week Emotional Regulation
cours.
The National Addiction Training Programme
has been working to develop resources and
trainings to support staff working with co-occurring
disorders; substance misuse and mental
health issues over a number of years.The
aim of this particular training was to enable
services to become more ‘trauma informed’
so that the co-occurring symptoms of substance
misuse and mental health related to
unresolved trauma could be treated in an integrated
fashion, as trauma is often at the root of
substance misuse/addiction, often perpetuating
the addiction.
Dr Schmitz offers continuing education
workshops and supervision in Post Traumatic
Stress Disorder and substance misuse to
clinicians throughout the United States and
abroad. Dr Schmitz is a Staff Psychologist at
San Francisco - VA Medical Centre and an Assistant
Clinical Professor at UCSF School of
Medicine. She has worked with Lisa Najavits,
author of Seeking Safety, since 2000.
She spoke to Marion Rackard, accredited Addiction
Counsellor (ACI) and Psychotherapist
(IAHIP), chair of the HSE National Addiction
Training Programme which supported the
two-day Seeking Safety Therapy event.
Marion Rackard: What interested
you initially in this field?
Martha Schmitz: That is an interesting question.
There are some intergenerational trauma
issues in my family. Growing up myself, I spent
an extended period of time in the hospital during
infancy which I experienced as traumatic. I
became interested in how people recover and
become resilient.
The resilience of the human spirit for me is
one of the most interesting questions; how
people can grow as a result of trauma and
develop a vision for life beyond it. I decided to
become a clinical psychologist so that I could
help others through the healing process.
Having a hand in someone’s healing is such a
privilege.
MR: What has been the influence
of Lisa Najavits on your clinical
work?
MS: Really, work with Lisa and Seeking
Safety changed my life. Her book was revolutionary
when it came out in 2002. At that time,
trauma and substance abuse treatment were
very separate. Lisa developed an integrated,
cognitive behavioural therapy that addresses
PTSD and substance misuse at the same time.
Up to that point, mental health and addiction
professionals believed that clients needed to
become abstinent before they could engage in
trauma treatment, because they had concerns
that addressing trauma symptoms too early
would cause the client’s symptoms to worsen.
However, the opposite is in fact true; addressing
the trauma symptoms using coping skills in
the present moment helps to provide stability
and recovery from substance misuse.
MR: Tell me about the essence of
the Seeking Safety model
MS: The focus of Seeking Safety is on building
safety, both physically and emotionally,
which is so essential for recovery. People with
histories of trauma and addiction may have
never lived anywhere safe, may not know one
safe person, nor have one safe way of coping
with stress and painful emotions. In Seeking
Safety, clients are encouraged to explore the
connection between trauma symptoms and
substance misuse and to learn skills that help
both conditions. The comprehensiveness of
the model is striking. Through psychoeducation
and coping skills, clients can transform
their lives.
MR: To a client entering substance
misuse treatment, might
it now be too much for them
to consider dealing with both
their substance misuse and their
trauma at the same time?
MS: Seeking Safety is a stabilising, presentfocused
treatment that has been shown to be
helpful for the most traumatised, vulnerable
clients. Rather than destabilizing clients, it
actually strengthens their recoveries from
substance misuse and teaches them the skills
that help both addiction and trauma-related
symptoms. For example, clients with trauma
histories may use substances as a way to
regulate their emotions. Learning coping skills
helps both their trauma-related symptoms
and their substance misuse.
MR: Does Seeking Safety facilitate
a stronger pace of healing?
MS: Yes, people start to build hope for a life
beyond trauma. Research outcomes on Seeking
Safety show that clients not only have
improvement in trauma-related symptoms
and substance misuse, but also in their daily
functioning and quality of life.
MR: How important is it for staff,
clinicians to do their own work
when working with this client
population? One of the participants
at the training mentioned
that “a therapist can only bring
people to where they have gone
themselves”. Do you hold that
view?
MS: I definitely agree. Emotional development
and growth is a life-long process for all
of us. Doing our own inner work is essential in
order to deepen our empathy and understanding
of our clients.
40 | health matters | spring 2016