The term “trauma” may feel like a buzzword in society today, but trauma and its effects are real and can result in changes to the brain and body that leave one feeling helpless, isolated, and disconnected from self and others. Trauma leaves the body and mind in a prolonged state of hypervigilance and fear. This can have profound negative effects on a person’s sense of self, relationships with others, and ability to feel joy and meaning in life.
Understanding Trauma
Trauma can come in many different forms, such as psychological, emotional, or physical trauma and can be acute, chronic, or complex. Common types of acute traumas include being exposed to an overwhelming event, like a natural disaster, experiencing a robbery or assault, or getting into a car accident. Chronic trauma is prolonged exposure to a traumatic situation, like fighting in combat, living in a war-torn country, or growing up in a household where abuse and/or neglect was the norm. Complex trauma occurs when an individual has been exposed to multiple traumatic events throughout their life and often has a relational component involved, meaning the individual experienced trauma at the hands of caregivers, intimate partners, friends, or family members.
Trauma can have both short-term and long-term psychological effects, such as PTSD, CPTSD, depression, anxiety, substance use disorders, difficulties with relationships and intimacy, impaired memory and concentration, decreased impulse control, and problems with emotion regulation. There can also be acute and chronic physical impacts of trauma, including chronic pain, headaches or migraines, digestive issues, cardiovascular problems, a weakened immune system, chronic fatigue, and autoimmune responses.
Core Tenets of Trauma Recovery
Judith Herman is a pioneer in the field of trauma and outlined three core principles of trauma recovery that are essential to understanding how the healing process works. Taken together, these principles act as a guide map to help trauma survivors regain control and safety in their lives, rebuild relationships with themselves and others, and achieve a feeling of empowerment and wholeness.
- Establishing Safety: The first stage involves establishing both physical and emotional safety. Individuals who have experienced trauma often perceive the environment as threatening and their nervous systems are in a constant state of hypervigilance. Establishing ways to calm the nervous system is essential to trauma healing. Establishing physical safety may mean ensuring the person is no longer in an environment where they could be harmed. Emotional safety entails helping the person find ways to find safety internally, such as by practicing strategies to manage anxiety, panic, or dissociation. Ensuring the person has skills to manage distress is a critical step before the person is ready to process the trauma they’ve experienced. Another important component of safety is establishing safety in the therapeutic relationship. This could mean creating a space that feels welcoming and comforting to the client and giving the client permission to decline talking about topics they are not ready to talk about.
- Remembrance and Mourning: This stage involves the trauma survivor processing the traumatic event(s) they have experienced and reintegrating these events into their broader life narrative. This can be done using a variety of evidence-based treatment approaches that will be discussed below. Processing involves feeling the emotions associated with the trauma while in the presence of a supportive other. This often frees up space for the client to reframe beliefs they hold about their trauma (i.e., self-blame) and establish new, more adaptive ways to view the trauma as part of their life story that is in the past. The therapist will also help the client mourn what was lost due to the trauma, including losses like trust, time, safety, or childhood.
- Reconnection: Trauma is often accompanied by a deep feeling of isolation. This last trauma recovery principle is reconnection which entails reconnecting to self, their community, and the broader world. A person’s identity can be wrapped up largely focused on the trauma the person has experienced. When the client begins to process the trauma, they may feel lost and unsure of who they are. In this stage, the client may explore what gives their life purpose and meaning, rebuild relationships, and discover activities or interests that bring about feelings of enjoyment.
Evidence-Based Treatments for Trauma
There are many evidence-based treatments for trauma that map onto Judith Herman’s three stages of trauma recovery. Finding a therapist who is trained in one of these modalities is recommended to ensure you are receiving quality care from a professional who can support you on your recovery journey.
- Eye Movement Desensitization and Reprocessing (EMDR): Eye movement desensitization and reprocessing therapy (EMDR) is different from traditional talk therapy. It uses bilateral stimulation to help the brain reprocess traumatic events. Bilateral stimulation entails getting both sides of the brain talking to one another, such as by moving the eyes back and forth in a rhythmic pattern or using vibrating tappers that alternate between the left and right hands. Bilateral stimulation decreases activity in the prefrontal cortex, which is the brain area that helps clients rationalize the trauma, get caught in cycles of self-blame, or avoid thinking about the trauma. Alternatively, bilateral stimulation activates other brain areas, like the limbic system, where the emotions and details of the trauma have gotten stuck and therefore maintain symptoms of PTSD. EMDR helps clients reprocess traumatic memories which lessens the impact these memories have on the person’s life.
- Prolonged Exposure Therapy (PE): Prolonged exposure (PE) is based in emotional processing theory which states that PTSD symptoms arise from cognitive and behavioral avoidance of trauma-related thoughts, feelings, and events. During prolonged exposure, the client will re-experience the traumatic event by constructing a trauma narrative and exposing themselves to this narrative by re-reading or imaging the trauma in the presence of a supportive therapist. Exposure helps desensitize the individual to the trauma, meaning their distress levels decrease upon repeated exposure. The therapist will help the client gain a new, more adaptive perspective of the trauma.
- Cognitive Processing Therapy (CPT): Cognitive processing therapy (CPT) is a type of cognitive behavioral therapy (CBT) specifically designed for individuals with PTSD. CPT helps clients reframe negative thoughts related to the trauma and that are thought to maintain symptoms of PTSD. CPT involves providing psychoeducation on PTSD symptoms as well as on how thoughts and beliefs impact one’s emotions and behaviors. Clients will then explore the thoughts, feelings, and behaviors associated with their trauma. They will work with a therapist to learn ways to challenge and reframe these thoughts and beliefs. This approach often involves writing assignments between sessions for clients to practice the skills they are learning in therapy.
- Acceptance and Commitment Therapy (ACT): Acceptance and Commitment Therapy (ACT) focused on helping clients accept distressing thoughts and feelings related to the aftermath of trauma rather than avoiding these thoughts and feelings. This approach can help trauma survivors understand and explore the function of their emotions, increase awareness of emotions without trying to change them, and decrease avoidance. ACT seeks to help clients gain mindfulness skills, live according to their values, and develop a more flexible as opposed to rigid way of thinking which can lessen the impact of PTSD symptoms.
Other Approaches for Trauma Healing
Research on trauma recovery is rapidly growing and different approaches to trauma recovery are emerging in the field. Trauma not only affects the brain, but the body as well. Trauma survivors often feel disconnected from their bodies following a traumatic event. There are several approaches to healing that aim to help clients release trauma stored in the body:
- Trauma-Sensitive Yoga: Trauma-sensitive yoga is an approach that uses yoga to help trauma survivors reconnect with their bodies and process trauma in a safe and supportive environment. Instructors aim to promote compassion, patience, and acceptance. This approach helps clients become non-judgmentally aware of their bodies and their emotions in the present moment while moving through different yoga poses. Different stretches and poses can also help release stored tension in the body that maintains bodily symptoms of trauma. Clients will also discover what it feels like to reconnect with their bodies through grounding techniques and breathing exercises. Emerging research shows positive results for TSY in reducing symptoms of PTSD and depression, releasing stored tension in the body, and enhancing overall well-being and quality of life.
- Somatic Experiencing: Somatic experiencing focuses on healing the body and the nervous system rather than only verbally processing traumatic memories. Somatic experiencing aims to help clients release stored tension in the body associated with the traumatic experience. Clients will focus on the body sensations associated with the trauma, learn and restore what safety feels like in their bodies, and become more aware of what they are feeling in their body in the present moment. This approach has been shown to help reduce symptoms of PTSD, release physical tension, improve emotion regulation, and restore body awareness.
While trauma comes in all different forms, the effects of trauma often leave a survivor feeling alone, isolated, and in a prolonged state of fear. Finding a professional who is trained in trauma recovery is essential in healing from trauma. Healing in the presence of a safe and supportive individual can make a world of difference in the healing process. Trauma recovery ultimately aims to lessen the impact of past traumatic memories, help the survivor process the emotions, body sensations, and beliefs associated with the trauma, and mourn the losses that accompany all kinds of trauma. Recovery looks like a survivor who feels empowered, is connected to their body, able to regulate their emotions, has regained a sense of purpose, and who has meaningful relationships with others.
At Integrated Care Clinic, our team of mental health professionals specialize in the treatment of trauma. If you are ready to begin the healing journey, reach out today.
