The Technique of Treating Trauma
This past spring, Joanna Filidor was invited up to the Alaska Panhandle by the National Council on Alcohol and Drug Dependence (NCADD), which was educating Juneau-area healthcare professionals along with families affected by drug addiction and wanted key concepts of trauma-informed care to be articulated.
Her enhancements of the Trauma Program at Northbound, which included prioritizing trauma-informed care, have been distinguished by Chief Clinical Officer Ilana Zivkovich for carrying out our stated philosophy on addiction: that it isn’t a moral failing or lack of willpower, but instead a primary, progressive and chronic disease centered in the brain.
As the Trauma Program’s manager, Joanna has used her passion for the neurobiology of trauma as a lens to conceptualize client care and it has been used as the foundation for the current Resiliency Curriculum used for all Northbound clients.
For the newest Staff Spotlight edition, Joanna recently discussed trauma-specific treatments provided to Northbound clients, the trauma-informed care initiative she helped implement and her early exposure to collective trauma growing up in Colombia during one of the country’s most turbulent periods:
Can you elaborate how you prioritize trauma-informed care at Northbound?
Ilana and I both strongly believe in the importance of developing a trauma-informed organization that mirrors the work that we do in the clinical setting to help address each client’s trauma.
In order to achieve this, we’ve trained every single staff member on how they can provide trauma-informed care from their individual roles and departments. Our mission is to ensure that from the moment a client walks through our front door up until the minute they discharge, they have been seen from a trauma lens.
This means our staff has repeatedly asked the question “What has happened to you?” in order to understand the root of their pain. Our Master’s-level trauma therapists also consistently collaborate with drivers and technicians in order to create a safe and contained space for the clients to address their trauma. We focus on addressing the core wound, instead of looking at the client solely on their disruptive and inappropriate behavior. We have created an emotionally and physically safe environment where our clients can focus on their strengths, their autonomy, their resilience.
Joanna with Roy, Northbound’s “Trauma Dog.”
Among the clinical service enhancements you’ve implemented at Northbound are Eye Movement Desensitization and Reprocessing (EMDR) and Cognitive Processing Therapy (CPT). What aspects of these two modalities compelled you to include them here?
It is important for us at Northbound to provide individualized care to each of our clients. This includes ensuring that trauma treatment fits the client’s needs, not the client having to fit into a particular treatment modality. For this reason, we offer not only EMDR and CPT, but also Psychodrama, Experiential Trauma Therapy and Single-Event Trauma Stage Processing.
We chose EMDR as a primary modality due to the plethora of studies showing that by using EMDR, clients can reap the benefits of traditional psychotherapy in a short amount of time. It allows for the brain’s information processing system to organically heal by addressing the core emotional wounds created by trauma. EMDR is based on a three-pronged approach, which involves addressing past disturbing memories and current situations that cause trauma reactions, and it helps develop the necessary skills to create healthy future templates. This fits well with Northbound’s continuum of care because it allows for the trauma treatment process to grow with and accommodate to each client as they move through our innovative In Vivo model.
Cognitive Processing Therapy is used as a treatment modality to address specifically PTSD. It was designed for military service members and later adapted for civilians. My passion to learn about and implement this treatment modality is rooted in both the clinical work I’ve done within the veteran community and my own personal relationship with military life as the wife of an active duty U.S. Navy Corpsman.
While volunteering at the Navy Medical Center in San Diego, I saw firsthand the impact of war on our servicemen and women and their families. This fueled my desire to learn modalities that have proved to be effective in treating these invisible wounds that so many trauma survivors carry.
Joanna (second from right) in Juneau, Alaska the week of NCADD’s addiction and recovery support education event for families. With (from left) Northbound CEO Mike Neatherton, former NCADD Executive Director Kathryn Chapman and Stacy Plaisance, Northbound Seattle’s director of referral relations.
Before moving to the United States at age 12 you spent your childhood in South America — what kind of thoughts occasionally come up about how your career path has been impacted by your experience growing up in Colombia?
This is such an interesting question. I have at times wondered about the effect of growing up in a country whose history is filled with trauma. I was born toward the end of Pablo Escobar’s era. I was young when he was killed. I grew up around the time when it wasn’t unusual for guerrillas and paramilitaries to set off bombs or kidnap people.
One day while my mom was pregnant with me, a bomb went off a mile from where she was standing and my dad was on the 26th floor in a building three blocks from where that explosion emanated. They have shared with me the fear they felt on that day, which sadly wasn’t a foreign experience for them and for millions of Colombians living there during this time. I clearly remember this fear growing up and wondering if a bomb would go off as we walked to the supermarket. I also remember fearing that my family would be kidnapped whenever we drove outside the city. Growing up in an environment like this has most certainly shaped the way I view pain, fear and powerlessness. These are all common themes with anyone who has experienced trauma.
Colombians have experienced a collective trauma for decades. Although I was young and not able to understand the impact that this would have on me later on, I’m now able to look back at these moments and experience a deeply rooted sense of purpose that I am doing exactly what I need to be doing in my life. I’m helping people heal from their darkest and most painful moments.
After coming to the U.S., what was the process for developing an understanding that trauma therapy for addiction was a field where you could thrive in?
During graduate school at the University of San Diego, while studying to become a marriage and family therapist, I had the opportunity to develop my clinical skills in an adolescent outpatient treatment center. Because I’m bilingual, I was assigned to work with first-generation Hispanic families and their adolescents struggling with substance abuse, depression, anxiety and trauma. All of the teenagers I worked with were at-risk youth, most of whom were actively involved in a gang and who lived in areas in San Diego where trauma was a normalized experience. It wasn’t unusual to have 16-year-olds walk into my office after their friend was shot in front of them, or after experiencing physical or sexual abuse in the home.
This opened my eyes to the field of trauma. I realized that to appropriately and effectively treat a population whose main maladaptive skill is abusing substances, it was crucial to address the traumatic experiences that led them to use dysfunctional behavior in the first place. This inculcated a curiosity to understand how trauma affects the brain and the body, which led to my passion for the neurobiology of trauma.
Keeping up with the research on neurobiology is a major fascination of mine. I can’t help but be inspired whenever I go through Janina Fisher’s work and see what other leaders in the field like Bessel Van Der Kolk and Peter Levine are bringing to light in trauma treatment. My passion for this became the driving force in the development of the Resiliency Curriculum at Northbound co-created alongside our chief clinical officer, Ilana Zivkovich. This 12-week curriculum is now used by all residential therapists in order to provide psycho-education to our clients on the effects of trauma on the brain, body and mind.
Joanna and husband Rene at Palace de Versailles in Paris.
Ultimately, through all your assessments, how do you observe the Trauma Program contributing to Northbound’s mission to help clients celebrate one year of continuous sobriety?
Everything we do in the Trauma Program is with that mission in mind. We follow each client through Northbound’s continuum of care so that they are able to address their trauma while they begin to experience life outside of residential care. This allows for comprehensive treatment that addresses not only past disturbing memories, but also explores current experiences at school or at work that trigger trauma responses.
I think too many treatment centers only address one dimension of the person — their maladaptive behaviors. At Northbound, we see these behaviors as a survival mechanism and we encourage our clients to see them as such. Our emphasis on teaching clients about the neurobiology of trauma so they can understand how it affects their brain and their body consistently reduces shame while normalizing each survival mechanism. This increases motivation and reduces fear when processing through trauma, in turn leading to longer treatment episodes. From our many trauma treatment modalities to our comprehensive trauma-informed care trainings, we have created an environment for each client to begin taking the steps needed to achieve one year of continuous sobriety.
Get psychological trauma treatment in Orange County at Northbound
Reactions to traumatic events are always highly individualistic. For more information on the personalized care available in Northbound’s Trauma Program, visit our Trauma Resolution page.