Psychotrauma & Psychoneuroimmunology
Expressive Trauma Integration™ (ETI) is an integrative therapeutic approach that utilizes cutting-edge research on Biohacking Dysregulation (PTSD), and the impact of trauma on all aspects of wellness. ETI integrates recent findings and practices from various fields of study, including neuroscience, attachment and developmental psychology, expressive and body-oriented therapies, cognitive reframing, behavioral modification, mindfulness, nutritional psychology, and psychoneuroimmunology.
Personal reflections by Odelya
I was first introduced to trauma therapy as a student and client trying to live with my struggles as a trauma survivor. My journey continues as a clinician, scholar, and teacher of sustainable trauma integration.
From many years of observing and working on my own dynamics and working with clients on four continents, I've come to see how important it is to view mental health symptoms in the context of underlying root causes.
Clinicians may be technically correct in diagnosing such clients as having depression, anxiety, bipolar disorder, personality disorders, RAD, DMDD, ADHD, OCD, addictions, eating disorders, and so forth. However, when a dysregulated nervous system lies at the core of symptoms, such a diagnosis can harm more than it helps.
Diagnostic labels can be deeply misleading to both survivors and clinicians by riveting attention to a narrow set of issues that deserve consideration but only in the context of a much larger journey.
Trauma integration is a complex emotional, cognitive, physical, spiritual, and social journey. A single strategy approach doesn't go very far in this journey.
My core training and primary tools for interacting with clients come from attachment-based psychotherapy, neuroscience, and expressive therapies. In response to the insights above, I've also invested much effort and time studying nutritional and integrative psychology for over a decade to augment my core training.
Working with clients with severe complexities has led me to work like a private investigator, searching for root causes. I conducted an in-depth investigation into biohacking dysregulation (PTSD).
Biohacking involves using knowledge and practices from biology, genetics, neuroscience, and nutrition, translating to "Do-It-Yourself practices."
These practices tailor the core of the sustainability plan, which is crucial, especially in complex circumstances where clients do not respond to therapies and need a more comprehensive strategy to establish sustainability.
My work has led me to a specific focus on the interactions between emotional states, nervous system function, and the immune system. This interdisciplinary field, Psychoneuroimmunology, is the missing link for a complex set of neurological and neuropsychiatric symptoms that often do not respond to standard therapies.
My personal and extensive clinical experience in this area allows me to provide a unique and effective approach to these challenging cases.
The process of trauma integration takes time and requires an in-depth investigation of all root causes. Some trauma survivors suffer from lingering underlying infections that show up in the form of autoimmune and inflammation disorders, psychological conditions such as depression, anxiety, OCD, self-regulation problems, attention or sensory difficulties, or chronic ill health. Unless we address all aspects of wellness simultaneously, no treatment will help for long.
Stress affects the body and can instigate chronic fatigue, IBS and IBD, chronic nerve and muscle pain, and other conditions. Such conditions will not improve without addressing the dysregulated nervous system.
By the time they came to me, many clients had tried a variety of modalities with several therapists. Typically, they report temporary good results with one modality or another that eventually prove unsustainable. For such clients, targeting all aspects of wellness is essential.
That doesn't mean we have to deal with everything at once. However, we do need to plan a strategy that considers all aspects of wellness. These include:
(1) Emotional – dealing with first-line emotions such as fear and anger and second-line emotions such as shame, guilt, and pain. An important goal is to expand the ability to endure pain and enhance joy;
(2) Cognitive – the way we process thoughts, how we focus attention and retention of information;
(3) Physical – the way we manage nutrition and nourishment, sleep, movement and exercise;
(4) Spiritual – our worldview - the framework we use to find meaning and purpose in life;
(5) Social – relationships with spouses, family, friends, colleagues, and strangers.
More About the ETI Approach
The Expressive Trauma Integration™ (ETI) approach originated by Dr. Odelya Gertel Kraybill is based on two decades of extensive research and clinical work with different populations in the Middle East, United States, Africa, and Asia. A modular approach suitable for both psychosocial and trauma therapy interventions, ETI is an integrative framework that draws on recent research and practice from the fields of neuroscience, attachment and developmental psychology, expressive therapies, experiential and body-oriented therapies, cognitive processing, behavioral modifications, mindfulness, nutritional psychology and psychoneuroimmunology.
ETI has been field-tested and revised in trainings provided to social and community workers, therapists, first responders, and students, in Lesotho, S. Africa, S. Korea, Philippines, US, Canada, Israel, Japan and China. The ETI training model was formally accepted by the Philippines Department of Health in 2014 as one of their key modules of response to communal trauma after crisis.
ETI Pillars
Experiential Psychoeducation about dysregulation and trauma is education about the cognitive, physical, emotional, spiritual and social effects of dysregulation and trauma on survivors and families (individual trauma) and communities (communal trauma).
The Six Stage Trauma Integration Roadmap provides a clear conceptual framework for understanding and responding to trauma. The ETI approach helps survivors describe their experience in stages of: 1-Routine, 2-Event, 3-Withdrawal, 4-Awareness, 5-Action, 6-Integration. Survivors locate what they are experiencing on this map and in the safety of a therapeutic setting, use it to guide exploration of further steps towards trauma integration.
Secure Attunement Framework. Attunement is a nonverbal process of being with another person in a way that attends fully and responsively to that person. A key aspect of attunement is that it is a joint activity, experienced in interaction with a caregiver. In therapy, the therapist attunes to the client with a goal to become a “co-regulator” with the client's responses. Over time, the client is able to transfer the sense of being co-regulated, to self-regulation outside of the therapy room, in everyday life. Through attuned relationship, clients lean to expand their capacity to endure the pain and loss of trauma and its aftermath.
Biohacking Dysregulation (PTSD involves controlling one's sensory reactions and increasing the ability to respond appropriately to situations emotionally and cognitively. Research indicates that traumatic memories are stored in areas of the brain that cognitive methods cannot reach. Addressing embodied memories (the body's dysregulation response to traumatic memories and triggers) requires targeting the lower parts of the brain.
Whereas talk-based and cognitive approaches work top-down and enlist higher parts of the brain in calming the more primordial functions of the lower brain, nonverbal approaches work bottom-upwards. They engage directly with the lower parts of the brain and expand from there until the client is ready to engage in top-down narrative processing and trauma integration.
The ETI approach utilizes tools and techniques to enhance body awareness (grounding and embodiment), improve sensory and bilateral integration, strengthen vagal tone, and promote neuroplasticity (reorganization and formation of brain responses)—all of which together establish sustainable regulation.
Individualized Sustainability Plan (ISP). Setbacks are common for trauma survivors, often after encouraging progress. An ISP is an individual plan designed to assist the continuity of progress. It contains techniques and practices tailored to a client's unique situation and preferences and addresses all aspects of wellness, including emotional, cognitive, physical, spiritual, and social aspects.
Sustainability plans are tailored using cutting-edge research on biohacking dysregulation (PTSD). Biohacking involves applying knowledge and practices from biology, genetics, neuroscience, and nutrition, leading to "Do-It-Yourself" practices.
These practices were demonstrated to be effective in mitigating nervous system dysregulation and enhancing the capacity to experience joy. These include mindfulness and simplified self-compassion, mindlessness (spontaneity and play), sensory and bilateral integration, sport and movement, (top-down) cognitive reframing and behavioral modifications, expressive arts, brain-training neurofeedback and individualized nutrition.
When developing a sustainability plan, it's important to consider the interactions between emotional states, nervous system function, and the immune system, also known as Psychoneuroimmunology. This field of study helps identify the root cause of complex neurological and neuropsychiatric symptoms that don't respond to standard treatments. By understanding these interactions, we can design sustainable solutions that address the underlying issues.
REVIEWS
I really appreciate how much you put into each training. Having been a trainer I know it takes an enormous amount of presence to hold a group our size and to keep us engaged like you do.
I feel like I have a new and much more expanded understanding of trauma and now have some tools to help to hold the people I work with much more tenderly and with more knowledge. I thank you for sharing the depth of your wisdom and the exquisite care you hold those with you are working.
ETI Series I workshop participant
The workshop was amazing. The experiential activities keep things engaging. I used the Squared Breathing technique to assist clients in a mindfulness activity and even used some of the grounding exercises. It was an extremely useful workshop. I am definitely going to take some more to build on the techniques and understanding until I have integrated them into everyday practice.
Leah Reed LCPC Participant in ETI Series I workshop
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