Healing Trauma
When you hear the word “trauma”, what do you think of? According to the APA (2021), Trauma is defined as “an emotional response to a terrible event like an accident, crime, natural disaster, physical or emotional abuse, neglect, experiencing or witnessing violence, death of a loved one, war, and more”. In my education, trauma was broken down into three pieces: the traumatic event, the individuals experience of the trauma, and the individual’s response to the trauma. In therapy, the focus is often on the combination of the individuals experience of trauma and their response to the trauma. Identifying the way the traumatic event(s) have impacted this individual’s view of themselves and the world around them.
Based on the model created by Judith Herman, trauma recovery is broken down into three stages or phases. It is important to note that these stages are not linear, however, that we always begin at stage one (The Three Stages of Trauma Recovery, n.d.).
3 Phase Process to healing trauma through processing:
Education, Stabilization and Safety
The first step to all successful therapies is building a relationship between client and therapist. Especially in trauma therapy, it is important to have a safe and trusting relationship in order to feel safe enough to explore traumas. If you are more interested on the importance of the relationship in therapy, read THIS.
Through this process you will also receive education regarding trauma. Learning how it impacts your nervous system, starting to see how it may be impacting your relationships or other aspects of your life and education on how trauma impacts the nervous system and brain. Normalizing and recognizing that these responses, although maybe unhelpful outside of the traumatic event/happening, are normal and expected responses to these types of events.
You will also work with your therapist to build skills that can help stabilize. These may include the typical coping skills, such as deep breathing, mindfulness, grounding, etc. These also include other skills that can help us be more stable and successful in life, including communication skills, attachment skills, crisis management skills, relationships skills, etc.
In the process of learning new skills, you will also work to decrease unhelpful or risky skills that were previously developed. These could include things like suicidality, self-harm, substance use or any other things that could pose a risk for the re-processing. It is common for things to become challenging during the re-processing stage and having safe and reliable coping skills to utilize during this is of the utmost importance, before beginning the second phase.
Re-Processing
There are MANY different modalities that can be used to process and re-process trauma. Below, I will review some of the most common:
Cognitive Processing Therapy (CPT): CPT is a type of Cognitive Behavior Therapy (CBT) that is used for trauma. This starts with recognizing the automatic thoughts that are related to the trauma and increasing the PTSD related symptoms (thoughts that increase anxiety, panic, hopelessness, etc.). The client then writes a detailed account of the traumatic experience and reads this in session. The goal is to work on breaking the pattern of avoiding thoughts and feelings related to the trauma to teach the brain and body that the trauma is over (the threat is not currently present). Together with the therapist, they will begin to question unhelpful thoughts about the trauma and begin to develop more adaptive thinking patterns. Once able to challenge the previous thinking about the traumatic event, the client works on bringing these adaptive strategies outside of the treatment (Re-integration).
Prolonged Exposure (PE): PE is another form of Cognitive Behavior Therapy that focuses on confronting fears. This teaches clients to gradually approach trauma related memories, feelings and situations in order to decrease the PTSD symptoms. PE is centered around the idea that fears are reinforced when avoiding, so by learning to face these fears the related symptoms can be reduced overtime.
Eye Movement Desensitization and Reprocessing (EMDR): EMDR has gained notoriety over the last years, despite being initially developed in 1987. Unlike other treatments that focus directly on altering emotions, thoughts or responses resulting from trauma, EMDR focuses directly on the memory. EMDR is intended to change the way the memory is stored in the brain as a way to reduce or eliminate problematic symptoms. With the use of bilateral stimulation, clients will focus on the memory and the vividness and emotion of the memory are reduced.
Accelerated Resolution Therapy (ART): ART is a newer form of therapy for trauma. ART involves rapidly addressing distressing or troubling memories with specific techniques designed to rescript the memories and provide relief from trauma symptoms. ART borrows from EMDR by aiming to reprocess the traumatic event, however, ART focuses on replacing disturbing images with positive ones.
This is not an exhaustive list of trauma therapies. These descriptions are meant to provide a brief overview, however, if you are interested in trauma processing services it is best to talk to a licensed provider to find the best option for your individualized care.
Re-Integration
This is the stage where we begin to adapt what changed in the re-processing to life outside of therapy. Identifying faulty coping mechanisms and thoughts/beliefs that were created from the trauma that can now be altered.
This is starting to think about what does life after trauma look like? Focusing on reconnecting with people and identifying what will create a fulfilled and happy lifestyle for the individual. This will often also explore finding a new sense of self, no longer allowing the traumatic experience to dictate who you are as a person or who you want to be moving forward.
With a focus on self-actualization and empowerment, you can start to find lifelong recovery, that will look different for every single individual.
Recovering from trauma does not mean you will be completely free from any traumatic impacts, however, that you have reclaimed your life, skills and sense of self moving forward.
If you are interested in trauma services or want to begin your own individual counseling, click HERE. You will receive an email 1-2 business days after you submit this form to obtain access to the online client portal and to schedule your first appointment. If you are located outside of South Dakota, searching for a licensed therapist on PsychologyToday can be a great first step.
Sources:
American Psychological Association. (2017, July 31). Cognitive processing therapy (CPT). Https://Www.apa.org. https://www.apa.org/ptsd-guideline/treatments/cognitive-processing-therapy
American Psychological Association. (2017). Eye movement desensitization and reprocessing (EMDR) therapy. American Psychological Association. https://www.apa.org/ptsd-guideline/treatments/eye-movement-reprocessing
American Psychological Association. (2017, July 31). Prolonged Exposure (PE). Https://Www.apa.org. https://www.apa.org/ptsd-guideline/treatments/prolonged-exposure