Kay Gottrich LCPC, RIST, ICST, THTC, a Registered Integrated Sandtray Therapist which is a professional credential that identifies Kay has having completed 50 hours of training, and 15 hours of case consultation in sandtray therapy. Kay specializes in sandtray therapy for clients that suffer from trauma, mood disorders (anxiety, depression, panic disorder, bipolar disorder) adjustment issues, and grief. Sandtray therapy allows clients to access difficult emotions, and difficult events in their life that are stored in the right side of the brain. The left brain rationalizes and reasons things out. Yet, humans heal when we are allowed to work with memories in our right side of our brain.
The right side of our brains processes painful events through images. Kay’s office has shelves of miniatures for clients to choose from to represent feelings and painful events that clients have experienced. Kay may ask adult clients to “build a world in the tray of what failure means to you”, or for a child Kay may ask “ What does it feel like when you are present and mommy and daddy are yelling at each other?”, “What does it feel like to go to school and be bullied?”, “Build a world that describes your anger?”. These questions are called directives, and clients can take the questions in whatever direction they like. The miniatures chosen have meanings that the clients attribute to them, not the therapist. The therapist provides what Daniel Siegel calls “neuroception of safety” which is a safe space in relationship for clients to feel heard and feelings to be validated.
There are many directives a sandtray therapist could ask. Sandtray therapy helps clients work through issues in a way that would take 5-10 sessions to get to with talk therapy. Yet with sandtray therapy we bypass the part of the brain that wants to rationalize or intellectualize.
Not a client sandtray created by Kay Gottrich LCPC RIST
In order for children, teens, and adults to work through traumatic symptoms, the client needs to be able to co-regulate with another person (preferably a person they are attached to). Talk therapy is not successful until a client begins to regulate from the bottom up. Expressive art therapies help clients master co-regulation with another person (preferably a person they are attached to). Kay uses sand tray and play therapy, TF-CBT &EMDR to help clients begin to regulate one’s body and brain. (self-regulation). The goal is to assist clients in decreasing symptoms of hyper-arousal (fight, flight, fidget) and hypoarousal symptoms (fatigue, faint, freeze). When someone is hyperaroused, he/she may experience: quick anger (0-to 100), body shaking, anxiety, fighting with others physically or verbally, being defiant, ,high levels of energy, urges to run away, and/or nightmares.
When someone’s brain and body are hypoaroused (freeze, faint) he/she may experience sadness, difficulty getting out of bed, difficulty concentrating,, fatigue and learning difficulties.
Trauma may be developmental (i.e. childhood, physical, sexual, or emotional abuse or neglect). It may also be situational such as accidents, violence, hospitalization, etc. Powerful tools are available, such as EMDR and experiential approaches, to help heal the emotional impact of the trauma. This frees up energy for the enjoyment of living. As your emotionally focused therapist, it is my role to help you to identify and create solutions that will enable you to walk a positive path toward growth, well-being, and empowerment.
There are 3 windows of tolerance or regulation. Each child, teen and adult have the innate capacity to handle stress. A person’s ability to handle stress is influenced by genetics, attachment style, helpers in their lives, and relationships. For some clients they have experienced many painful stressors early in life, and their body and brain becomes dysregulated over time because they lose the ability to relax, and they may get stuck in the first zone which is called hyperarousal. When a person or child is getting stuck in hyperarousal zone they fidget, fight, and flight. Children can exhibit hyperactivity, quick anger (0-100), temper tantrums, act younger than their age, experience anxiety, get into physical fights, verbal arguments, defiant with authority figures, have difficulty sleeping, have difficulty with transitions, take out their anger on those they love, throw things, ruin property when angry,. Imagine the Avengers character the Hulk, or an angry alligator, or , or hyperarousal 2)Window of Tolerance and 3) hypoarousal.
When people experience big trauma’s and little trauma’s how brain and body become dysregulated. In the window of hyperarousal, children, teens, and adults may exhibit the 3 F’s: fight, flight, fidget. Children, teens and adults that get stuck in hyperarousal have difficulty relaxing, go from 0-100 when angry; may experience difficulty sleeping, may be hyperactive (but do not have ADHD), are impulsive (don’t think about the consequences), defiant with authority, get in physical fights, or verbally aggressive, self-medicate with marijuana, alcohol, and other substances; always for something bad to happen, don’t feel safe, anxious. The hyperaroused person may experience fast heart rate, shortness of breath, stomach aches, headaches, and perceives threat when there is no threat.
Cognitive-behavioral therapy is used to identify and replace thoughts and beliefs that support depression. Clients will learn the connection between feelings, thoughts, and behaviors. Kay will teach conflict resolution skills (active listening skills, I-messages, assertive communication, anger management skills, and self-calming skills).
Apart from those, Kay teaches mindfulness skills to decrease avoidance and to increase awareness of thoughts. Through these skills, clients learn to accept their experiences rather than trying to change or control circumstances. Dialectical behavioral therapy may also be used to help with emotional regulation skills, distress tolerance skills, and mindfulness.
Through cognitive-behavioral therapy, clients learn to identify and challenge fearful self-talk and replace it with positive and empowering self-talk. Kay will help clients learn problem-solving strategies to address anxiety (worries). Clients will learn self-calming skills (progressive muscle relaxation, breathing techniques, visual imagery, body scan, Calm, Safe Place, and mindfulness). EMDR therapy is another option for clients to choose to address triggers.
Cognitive-behavioral therapy is used to assist clients in learning how to decrease pain behaviors as well as how to identify negative thought patterns that maintain feelings of powerlessness and hopelessness. Kay provides psychoeducation on emotional cycles, behavioral cycles, and thought cycles of chronic pain (developed by the Mayo Clinic).
In addition, Kay will teach self-regulation techniques (i.e., progressive muscle relaxation, diaphragmatic breathing, guided imagery, mindfulness, and “Calm Safe Place”). Kay will assist clients in developing a personal plan for difficult days. EMDR is used to reduce pain symptoms as well.
Cognitive-behavioral therapy for insomnia is used to help clients who have difficulty sleeping. Psychoeducation is provided as well as relaxation and calming strategies.