Yvonne engages in psychotherapy with her patients using a variety of treatment modalities. She has taken numerous workshops and training courses in order to bring the latest research-informed techniques to the treatment of depression, anxiety, trauma, parenting and change of life issues.
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Treatment of Depression and Anxiety
Yvonne takes a complete biopsychosocial history of the patient and administers psychometric evaluation tools to assess the level and areas of depression and anxiety. She then outlines a treatment plan with the patient utilizing a variety of treatment modalities. If warranted, she will refer patients for a medication evaluation and will work with a doctor to ensure the highest level of treatment.
Are you a stressed parent?
Parenting can be rewarding and joyful.
It can give us an opportunity to grow along with our children and become participants in the wonder of childhood. When our children get excited by the beauty of nature or entertainment value of pots and pans we are reminded of how much “magic” exists in our lives.
Except when it isn’t.
However, the day-to-day rushing around from one place to another; the constant balancing of work, family, and personal time can feel more overwhelming than magical. T. Berry Brazelton, M.D. considered a leading authority on child development, characterized the relationship between parent and child as a dance, where each partner must be attuned to the movements and needs of the other. The only problem is that sometimes it feels as though you and your child are either dancing to different beats or just plain stepping on each other’s toes.
What factors contribute to parent-child discord?
Many factors can contribute to discord between parent and child. Factors such as long-term illness in the family, a new job, a recent move, change in financial circumstances or a new addition to the family can all have an effect on the parent-child bond. Often families are so caught up in the moment that it is very difficult for them to re-establish (or in some cases, establish) a feeling of harmony between parents and their children.
All relationships, including the parent-child relationship, have challenges. The most important thing to know is where to get help when one’s ability to discern problems becomes clouded by daily routines and stress. If you find you do not enjoy time spent with your child, or if you feel that you can’t understand your child, or you simply feel that you are stepping on each other’s toes, you may find another perspective helpful.
What can I expect when I see Yvonne?
Yvonne creates a sensitive and respectful environment where parents feel they can be heard. She begins by taking a thorough family history, then she administers the Parent Stress Index (PSI).
These two initial steps provide information about the parent-child relationship. Working together with the parents, Yvonne develops a program tailored to the specific needs of each parent-child relationship. Some aspects of the program may include helping parents become more aware of their child’s individual needs, helping everyone in the family react less emotionally and listen more deeply to one another, and promoting more confidence and understanding in both parents and children.
With the ARC program developed by Dr. Margaret Blaustein and Kristine Kinniburgh, LICSW children and parents are taught techniques to work with each other and begin to really understand what is happening in their lives. This is a flexible program designed to help children and parents with Attachment, Self Regulation and Competency. This program is age appropriate and has differing levels of intervention for each age group.
What is the Parent Stress Inventory (PSI)?
...a psychometric tool designed to help parents distinguish areas in which there may be some need for readjustment in their relationship with their children.The PSI identifies seven characteristic areas of the functioning of typical parents: social isolation, spousal support, sense of competence, restriction of parental role, attachment, depression and general health.
The PSI also identifies and measures characteristic areas of functioning in typical children, as perceived by the parent, in the following areas: adaptability, demandingness, mood, distractibility, hyperactivity, and need for reinforcement. (Richard R. Abidere, EdD, Psychological Assessment Resources, Inc.).
How does the PSI help?
Each of the characteristic areas of functioning on the PSI carries with it implications for the parent-child bond. Once identified, we know where to focus to create positive change.Parenting when parents and/or children are suffering from chronic or debilitating diseases or physical or cognitive challenges.
Trauma Processing and the Timing of Phase-Oriented Treatment
Beginning with Janet (1890’s) the treatment of trauma has involved some type of phase protocol. Research in this area has concluded that patients must first feel safe and secure before they can begin to process the trauma that has taken over their lives. In fact, post 9/11 this type of treatment was put to the test. Talking directly about a trauma before the patient feels safe may be re-traumatizing and may actually harm the patient. Therefore, the course of treatment is very important to the outcome. The first phase of treatment is safety and stabilization. Time is taken to work with the patient and develop resource skills to help with overwhelming feelings and thoughts.
Defenses are identified and explored and new techniques to help patients with their feelings of being overwhelmed are discussed and taught. Ms. Bregman believes that much of the work at this stage is psychoeducation; informing the patient about what is happening in their body and brain and why. Once patients understand why their body is feeling the way it is and how to diminish some of those feelings the patient can begin to look at the second stage of trauma treatment: Treating the Traumatic Memory.Of course careful assessment and diagnosis of the trauma is arrived at by clinical observation, a biopsychosocial history, and psychometric instruments. During the second stage bits of the traumatic material are brought up and processed using a variety of methods, such as Sensorimotor psychotherapy, some cognitive behavioral therapy and other modalities.
Treatment of trauma is not a linear process. Thus, one memory may evoke another memory like a complicated spider’s web. Carefully unraveling the web, will help the patient gain mastery over the distressing symptoms of trauma. The patient gains new insights into how memories are recorded and gains new tools to help manage troubling thoughts.
The last phase of treatment in this approach is: Integration of traumatic material in one’s life. Treatment does not erase traumatic memories, rather it makes them less activating. For example, if prior to treatment any reminder of a traumatic event brought forth overwhelming memories of the incident, this work would help keep the memories in check. You recall that it was not pleasant, but you are not reliving every moment of the memory in terror.
“During flashbacks or re-living of past trauma, integrated cognitive processing is inhibited, and the person temporarily loses the capacity to recognize that the present reality is safe. Instead, he or she identifies the sensations of hyper arousal and the impulse for physical action as indicators of danger. This……Hijacking (Goldman, 1995) is a frequent source of daily life problems and self blame for trauma survivors who have difficulty evaluating the current relevance of sensations of arousal and impulses evoked by reminders of the trauma (Brewing et al.,) They are unable to keep events at a critical distance in order to reflect on them, which engenders a sense of instability, loss of control, psychological incompetence, and a lack of confidence to cope with daily life. “I should be over this” or “I must be crazy” are two common complaints of traumatized patients, stemming from the conviction that they are psychologically inadequate rather than functioning with sensor motor systems that are primed for threat and reacting to danger long since over (Allen, 2001). Ogden, P. “Sensorimotor Psychotherapy Institute: trauma and the Body: A Sensorimotor Approach to Psychotherapy” pg. 22.
Imagine trying to make sense of anything while running away from a lion. Well, that is what your body is experiencing when it is trapped in a trauma “loop”. Every part of your body and brain are screaming “RUN” and you can’t. Instead you remain frozen. This contradiction is a hallmark of trauma. It is the incomplete nature of the resolution of the trauma. Only through work on both the body and the mind can a true sense of resolution be achieved.
Ms. Bregman’s work aims to integrate both cognitive (mind) treatments of trauma with sensory or body treatments. Breathe work, some yoga and sensor motor work, and hypnosis are all elements of the latter. Each treatment protocol is designed to work specifically with the needs of each patient in a research informed and thorough manner.
Change of Life Issues
Contemplating or experiencing a divorce, relocation, change in family structure, bereavement, or change in financial situation can be very difficult to manage individually. Often, it helps to have someone to help with the journey. These life changes can trigger past life difficulties or signal deficiencies in one’s support network. Through a complete evaluation, assessment, and treatment plan work can be done to help patients gain perspective and access inner strengths.
People are often confused and sometimes even frightened by hypnosis. This is not too surprising given the fantastic claims made by some practitioners Hypnosis is a technique that enables people to discover the power within themselves to change. When people have expressed their fears about hypnosis they generally say that they are worried about being “controlled” and will have no memory as to what has happened while they were in a trance. Unfortunately, much of these fears, are only reinforced by the popular media. My response to my patients is that the form of hypnosis I practice is “permissive hypnosis” and that they will never do anything that they don’t want to do while they are in trance or after they come out of trance. Usually, most people remember everything that I say to them. Generally, this is because they are not in a very deep trance.
Still patients can remain fearful about hypnosis because they don’t understand the state of being in a trance. Probably the best way to understand it is to think about times when you have “zoned out”. Perhaps you have found yourself driving along and arrive at your destination and really can’t recall all of the details of driving, but you still got to your destination. This is akin to being in a trance. When you are deeply relaxed and able to shut of the “noise” in your head you are able to focus more deeply on suggestions or questions that the practitioner may pose while you are in a trance. It helps you to sharpen your focus on the matter at hand and not drift off to another subject or concern. This enhanced focus of attention is the hallmark of a trance.
Once my patients understand that they cannot be controlled and that decreasing their awareness of distractions and outside worries or negative beliefs will help them sharpen their focus on their primary concern they become more open to the idea of hypnosis. Another point that should be emphasized is that hypnosis works best on people who really want to change. This underscores the fact that a practitioner cannot force you to change or do something that you really don’t want to do. The very nature of hypnosis is such that it is most successful with people who really want to make the change but need some guidance and focus as to how they can alter unwanted behaviors. All my work with patients who wish to be hypnotized includes some degree of counseling and supportive therapy. The better I know the patient the more tailored the hypnosis sessions can become and when they are more tailored, they tend to be more effective.
“All clinical hypnosis can be viewed as self-hypnosis.” D. Cory Hammond
“Hypnosis is a condition of decreased peripheral awareness and uncritical acceptance that leads in selected subjects to changes in perception, mood, and memory, sufficient to cause significant behavioral, neurobiological, and experiential changes in response to contextual expectancies and verbal suggestions.” D. Brown
Hypnosis is useful for treating: