The Process of Resolving Trauma with Therapy
So, you might be ready to talk about what happened...
Maybe it was one thing or a lot of different things. Maybe you can’t even pinpoint how many times it happened, but you know it has stuck with you. You’ve gone to therapy and every time you get ready to talk about it you don’t show up again. You feel a little bad for ghosting your therapist but cannot bear the thought of actually working on what you need to. We get it, we’re used to it. Not surprisingly, it takes time to get ready just to face what you’ve put away.
It can be a “little T” or a “big T.”
It can be a bunch of “little T’s” that led up to one big T. A little T is a trauma that most people will not necessarily deem “traumatic” like a divorce or emotional invalidation by family. A big T is an event most people would deem traumatic like a car accident or natural disaster. Even if you have not survived what others think is traumatic, those little T’s can lead to developing complex trauma (C-PTSD), personality disorders, depression, anxiety, eating disorders, and addictions.
So, you’re ready to finally talk about it.
Or, maybe you think you are but you’re terrified because you have no idea what to expect and talking about something to personal to a stranger is really scary. Or, you’re not sure if you’re ready to go back there again because your last experience talking about actually made you feel worse. Every therapist’s approach is different, but here is typical to what you can expect.
You schedule an appointment after looking for a therapist. Maybe you’re burned out just from searching or you’re so motivated you found one on that same day. Either way, this can be a difficult time and just booking the appointment is a major step!
2. Showing up
You go in for your first appointment. Your therapist will go over informed consent – which is basically the caveats to counseling like the potential for difficult emotions to come back up and limits to confidentiality that keep you and others safe.
3. The intake assessment
Maybe you spend some time getting to know each other and ask questions or you get right into it. Your therapist will ask a bunch of questions and some might not feel all that important or maybe even invasive. Some might be very difficult to answer. These questions help the therapist get a whole picture of what is going on to start putting puzzle pieces together on how to best help you or potentially refer you to someone who can help you better. This can feel like a rejection, but oftentimes it is because the therapist just does not have the right skills or resources to best assist you.
4. The intake assessment, continued
Because there are so many questions your therapist might need a couple sessions to ask them all. Again, it’s to get a whole picture. Your therapist might even come up with a crisis plan together and identify what helps you during low moments to help keep you safe during the process of therapy. Since therapy can bring up some big emotions and revelations, along with difficult topics and memories brought to the surface this is especially important.
5. The beginnings of therapy
In the beginning, your therapist might begin to teach you some skills to help with the difficult emotions that are coming up and potentially will come up. DBT skills are especially helpful. Dialectical Behavior Therapy (DBT) is based on the premise of two opposing forces – acceptance and change. The skills focus on interpersonal effectiveness, mindfulness, emotional regulation, and distress tolerance. These skills help you during moments when your emotions are running so high the rational part of your brain shuts down. The easy to remember acronyms can help you during moments of distress with practice. Another helpful modality is Cognitive Behavioral Therapy (CBT). CBT helps retrain your brain from automatically thinking negative cognitive distortions that oftentimes are a result of what has happened to us. TF-CBT, which is trauma informed CBT, helps change the distortions around the trauma. One of the most helpful aspects of CBT is identifying negative core beliefs. These beliefs are often shaped in childhood or a negative experience and find ways to reinforce how we see the world in a negative way. CBT helps us find evidence to counteract those beliefs and find ways to question them so we can change our emotions and in turn our behaviors to help break the negative thought-emotion-behavior cycle. Perhaps your therapist uses Acceptance and Commitment Therapy (ACT) to help work on accepting what happened and how you will make positive change from it with skills like psychological flexibility, recognizing that feelings are not facts, and identifying and applying your values. There are many other modalities, but these are ones I often use with clients because they can be incredibly helpful.
6. Getting into it
When you have resources in your toolkit, you might be ready to get into what happened and make positive changes in your life. Maybe your therapist uses eye movement desensitization and reprocessing (EMDR) with you. EMDR helps identify triggers for the trauma and helps you make a positive belief out of a negative one. For example, because you were in a house fire that occurred during a lightning storm, you associate lightning storms with the traumatic event. This is a completely understandable response and yet you don’t want to live the rest of your life feeling panic every time it begins to rain. EMDR can help you change the belief from “I am not safe when there is bad weather” to “there is bad weather right now but that does not mean a fire will happen again.” After these sessions, your therapist will ask you to imagine stuffing what was brought up into a container. Even if EMDR is not used, containment is an effective skill to use after talking about what happened. I like to tell clients that when discussing the trauma to remember that it is not happening right now. It is over, it’s already happened, and now we are retelling your story to make the effects of what happened less impactful. It’s important to remember during this time you can always say to your therapist “I’m not ready to talk about that” or “I don’t feel comfortable talking about this.” You deserve to let your concerns be heard and hopefully have the therapeutic relationship where you feel safe telling your therapist your concerns.
The hardest part of recovering from trauma is accepting it happened. It is a long, difficult journey and you will be so thankful you did it. You can finally get to a place where your triggers are not as debilitating and you have compassion for yourself for doing what you could to get through it, even if hindsight previously told you otherwise. I cannot guarantee you will be totally over what happened, but you will finally have a way to make it a smaller piece of your life. Your life will not revolve around what happened to you, but instead on how you can continue to thrive and make progress with everything you have learned. Remember, the resilience, the strength, and the drive to get better all comes from you. It does not from what happened to you or who hurt you. You had it in you all along and something outside your control happened to you along the way. The hard work will be worth it.
Meet the Author
Kayte believes that people are experts of themselves and greatly honors the privilege of walking alongside others on their healing journeys.