Therapy for Trauma
When trauma occurs, it can leave us feel broken or shattered. Those wounds, however, can also be how the light gets in.
Too Much, Too Soon, Too Fast
The Roots and the Fruits
A more technical definition of a traumatic event is that it involves directly or indirectly experiencing “actual or threatened death, serious injury, or sexual violence" (NIMH, DSM-5). Different people can respond differently to the same potentially traumatic event. Some people will not develop long-term difficulties related to the potentially traumatic event, whereas other people will experience traumatization. Some people who are traumatized will meet the full criteria for Post-Traumatic Stress Disorder (PTSD), whereas others will have various levels of post-traumatic stress but their experience is more accurately captured by diagnoses such as Major Depression, Panic Disorder, Social Anxiety Disorder, OCD, or another mental health disorder. This is a trauma-informed view of diagnosis and treatment.Regardless of whether someone meets the full criteria for PTSD or not, post-traumatic stress can exact a tremendous toll on your body, soul, and spirit. There are currently four main categories of PTSD symptoms:
- Re-experiencing: flashbacks, nightmares, unwanted memories or disturbing thoughts
- Avoidance: avoiding people, places, objects related to the event; avoiding thoughts and feelings related to the event
- Arousal and Reactivity: being "on edge" or easily startled; having difficulty sleeping
- Cognition and Mood: thinking negatively about oneself and the world; experiencing undue guilt or self-blame; trouble remembering aspects of the event
How Can Therapy Help?
- Psychoeducation: learning about trauma and how it affects people
- Parenting: learning parenting strategies for traumatized youth
- Relaxation: learning how to relax in your own unique way
- Affect Regulation: learning about feelings, their varying degrees of intensity, and how to cope with them
- Cognitive Coping: connecting thoughts, feelings, and actions; modifying thoughts so that they are more accurate and helpful
- Trauma Narrative: creating a story of how the trauma happened
- In Vivo Exposure: overcoming any feared or avoided situations related to the trauma
- Conjoint Session: sharing the story with a parent or caregiver
- Enhancing Future Safety: learning to stay safe into the future
When working with young adults who've experienced trauma, I tend to blend those components of TF-CBT with another approach such as Cognitive Processing Therapy (CPT). This involves learning about trauma and post-traumatic stress, writing out the story of the trauma, learning to challenge thoughts about the trauma, and exploring themes related to the trauma (safety, trust, power and control, esteem, and intimacy).
Trauma is not a life sentence, and it doesn't define who we are. Therapy helps you get unstuck and redeems the most painful aspects of your experience so that they can become infused with new meaning, purpose and beauty. Imagine living life with more freedom from the damages of trauma, with the pain becoming less and less over time, having discovered that the trauma can be contextualized into the broader vision and meaning of your life story.