Changing Tides, LLC


"The world breaks everyone and afterward many are strong at the broken places"  -  Earnest Hemingway 

The Clinicians at Changing Tides have extensive and specialized training in a number of the most effective treatments for the resolution of complex trauma and dissociation. Among these are included: 

* Eye Movement Desensitization and Reprocessing, levels I, II and Advanced trainings in working with attachment, ego states, dissocation, personality disorders, and children 
* Internal Family Systems Therapy
* Child Centered and Directive Play Therapy
* The use of art in therapy
* Filial Therapy
* Family Systems therapy
* Emotional Freedom Technic
* Clinical hypnosis
* Sensorimotor Therapy
* Bruce Perry's neurosequential model of therapy
* Neurobiology (vis a vi Dan Siegel and Allen Shore)
* Trauma- Informed Cognitive Behavioral Therapy
* Dialectic Behavioral Therapy
* Sandtray therapy
* Psychodynamic psychotherapy
* Understanding Historical Trauma (vis a vi Ed Durran, Maria Yellow Horse Brave Heart, Joe Trimble, Joe Gone and others)
* Specialized training in complex trauma and dissociation from the International Society for the Study of Trauma and Dissociation
* Respect, collaboration, and relationship as the foundation of all therapeutic intervention

Children and adults are diagnosed all the time by therapists, psychiatrists and other individuals who are not trauma-informed, who will see things from a mainly medical or behavioral perspective, and treat from this perspective.  The problem with this is that, when the individual has experienced trauma, especially if that trauma occured in childhood, and was chronic and complex, or when the trauma is also associated with attachment difficulties or dissociation, not addressing the these will result in unsuccessful or simply surfance level compliance without a true psychological change.  Behavioral changes without this deeper context are often temporary, or other behaviors may show up to replace the ones that have ceased.  For true healing to occur, one needs to address the attachment needs, resolve the trauma, and achieve neural integration from a brain based, developmental and relational perspective (see any article written by Daniel Seigel or Bruce Perry).

World wide there is pervasive stigma around mental illness, resulting in a marginalization not only of those who experience serious and chronic mental illnesses, but also those who love, work with, live with, and treat this poplulation.  We are only just beginning to understand the complexities of the mind, the way in which people respond to trauma, and the experiences of healing.  Understanding the connection between early adverse childhood experiences, especially trauma, abuse and neglect has helped us to establish the clear link between these and later mental health difficulties, social problems, relationship issues, substance abuse, self harm, dissociation, and even crime.   

There are many interesting connections between dissociation and psychosis.  In fact, a 2012 National Institute of Mental Health study led by Judith Rappaport found that when trauma was eliminated as a factor, only seven (7) cases of childhood onset schizophrenia could be identified in the entire United States, demonstrating the strong possibility that childhood onset schizophrenia could be a mis-diagnosis or co-diagnosis of dissociation secondary to traumatic events.  In children, severe dissociation is sometimes misdiagnosed as ADHD and in adults, the most common mis-diagnoses of dissociative disorders are borderline personality disorder and BiPolar disorders.  While these can be acurate diagnoses, or co-morbid diagnoses, if there is a childhood history of trauma, dissociation should be assessed.  Dissociation may lead to psychosis at times within people who have dissociative disorders, and those diagnosed with psychosis may demonstrate dissociative processes. Psychosis is also a not infrequent misdiagnosis of Dissociative Disorders, including Dissociative Identity Disorder.  There are valid, reliable measures available to evaluate dissociation in both adults and children.  For therapists wishing to know more, consider taking an on line or in person course through the International Society for the Study of Trauma and Dissociation ( or through Ron Unger's site, Therapy on the Wild Side (  

With significant research we are beginning to understand that the effects of insecure attachments and trauma have been revealed in the glucocorticoid receptors of the hippocampus (McGowan et al., 2009; McGowan & Szyf, 2010).  Some fascinating research has also identified the genetic signature of post-traumatic stress (Yehuda et al., 2009); and early work has begun on examining gene expression in response to psychotherapy (Rossi et al., 2008).  Interpersonal communication, both verbal and non-verbal is highly correlated with the creation and the function of the brain's structure.  As a result, therapy is rapidly changing into a complex and integrative process, one in which science is truly paired with the art and skill of the therapist.