When a person wants to start therapy, we always start off by asking what their therapy goals are. Why do they want therapy and what are they hoping to gain from attending therapy? Most people respond by saying they want to feel better. For trauma therapy specifically, the client wants to feel relief from the trauma symptoms and trauma triggers that he/she experiences.
What does trauma mean?
Trauma is defined as a deeply distressing or disturbing experience. Trauma also refers to the emotional responses we have to the negative experience. The important thing to remember is that not everyone reacts to events in the same way. Something that feels like no big deal to you, may be very difficult for someone else to go through.
Why do I need to process the trauma I’ve experienced?
After going through a traumatic event, it’s common to have unhelpful thoughts about yourself and the world. You may experience common symptoms such as depression, anxiety, fear, difficulty sleeping, self-blame or a sense of helplessness. Various stimuli such as a physical object, a song, a place, a feeling or an interpersonal situation might remind you of the trauma, and therefore provoke an emotional response or belief. These reminders are known as trauma triggers.
A metaphor we often use with clients is a football field that was built on top of a landfill. Instead of clearing away the garbage before building the football field, they pushed the garbage into the dirt, added more dirt on top to level it out and then built the sports field. For a few years it seemed like everything was fine. But then the football players started to trip. Upon inspection, they found holes and mounds and even garbage coming up from the ground. The field’s past started to show itself and get in the way of its present. This is the same with our trauma. If we try to bury our past or avoid talking about our traumatic experiences, it might seem like we’re doing okay as time passes by. But eventually, our past will show up in the form of a trauma trigger, bringing back to the surface those feelings of fear or that belief that we don’t deserve happiness. The triggers and symptoms we experience usually do not diminish 100% without participating in some form of therapeutic treatment.
How does it work?
Engaging in trauma therapy includes looking at our trauma from different perspectives, considering new information and helping our brain make sense of the experiences we’ve had. Trauma therapies examine our thoughts, feelings, body sensations and actions. We learn to challenge the unhelpful beliefs that are commonly formed in our heads and hearts after going through a trauma. And we learn to tell a new story about ourselves and our history. We also focus on where the trauma is stuck in the body to help unlock that somatic memory.
What types of therapy can help me process my trauma history?
At Genesis, we provide trauma therapy to women and children. The three trauma-informed modalities we use the most are Eye Movement Desensitization and Reprocessing (EMDR), Cognitive Processing Therapy (CPT) and Trauma-Informed Cognitive Behavioral Therapy (TF-CBT). There are several other therapies designed to aid survivors of trauma in lowering their Post-Traumatic Stress (PTS) symptoms. The National Center for PTSD at the U.S. Department of Veterans Affairs endorses EMDR, CPT and Prolonged Exposure (PE). PE involves helping you face your negative feelings by talking about your trauma and engaging in activities you’ve tried to avoid since that trauma. Dialectical Behavior Therapy (DBT) is another common trauma therapy where you learn to regulate your emotions and utilize healthy coping skills to help you live in the moment and improve your relationships with other people. If you like to write, you may want to explore Narrative Exposure Therapy (NET) and Narrative Therapy (NT). Both encourage you to reframe the way you see your life experiences. NET is conditionally endorsed by the American Psychological Association, meaning it’s recommended but not a first choice.
Additionally, because we know that trauma can get trapped inside our bodies (commonly causing stomach aches, headaches or asthma), there is research to suggest that body-based therapies are helpful in reducing symptoms. Somatic Experiencing (SE) and Neurosequential Model of Therapeutics (NMT) are two ways to use the body and movement to get at what’s underneath our thoughts and feelings associated with the trauma. Finally, the National Child Traumatic Stress Network lists over 30 trauma-informed modalities to use with children, including TF-CBT, which is a short-term intervention targeting a child’s thoughts and behaviors around the traumatic experience.
How do I know which type of trauma therapy would be right for me?
It’s hard to know which trauma therapy will work for each person. Our best advice is to learn about a couple different options, talk to a therapist about their experiences using those therapies, and consider your current circumstances. For example, CPT involves doing daily homework. If you live with an abusive partner, it will be important to have a safety plan around when and how you can complete that homework without your partner finding it. Effective EMDR sessions involve bringing up images in your mind. So if you have difficulty with visual imagery, EMDR might not be the best modality for you. While it’s best practice to stick to one form of therapy, if you start one type and see that it isn’t working well for you, talk to your therapist about other options.
How will I know when I’m done processing my trauma?
Trauma processing is different for each person. The timeline depends on the amount of trauma you’ve experienced, the amount of healthy people in your life, and your current level of safety. Our hope is that through therapy, you will be able to talk about your trauma history without experiencing an emotional response. The stimuli that once provoked tears, anger, embarrassment or the thought that you aren’t lovable will no longer hold power over you. You will recognize that you are not to blame for another person’s actions. And you will feel empowered to face life’s challenges and successes.
Written by Ruth Guerreiro, Senior Director of Clinical and Non-Residential Services at Genesis Women’s Shelter & Support