Therapy 101

Trauma therapy techniques

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Trauma therapy techniques

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What is trauma?

Trauma is the result of experiencing something that overwhelms our mind and nervous systems. Living through a disastrous event or a series of prolonged distressing events can have long lasting effects on our mental wellbeing and our ability to cope with everyday challenges. 

Trauma can also be subtler, stemming from a lack of support resulting in increased stress as a child (even very early childhood, before we could verbally communicate). This could be from witnessing a parent go through their own mental health struggles, or having an absent caregiver, as well as more direct stressors like abuse.

Those experiences live on in our bodies and minds and may create unwanted mental or physical symptoms later in life.The severity of these events can vary person-to-person, there is no one-size-fits-all scale for how traumatic an event needs to be for it to negatively affect our mental health.

“Trauma isn't an event, it isn't a thing that happens. It’s what happens inside of you as a response … when a person comes into therapy, their whole life is with them, and I think sometimes we see people as just living in their context right now, but what they’re going through, you know, has a whole history.” - Tanya Kowalenko

Signs and symptoms

It’s normal to need some time to recover from a traumatic event, and everyone recovers at their own pace. Like other mental health issues like anxiety or depression, if symptoms persist for months and are not lessening, it may be time to seek professional help. 

Some of the typical responses to a traumatic experience include:

  • Sadness
  • Anger
  • Fear
  • Shame
  • Insomnia
  • Emotional irregularity
  • Physical symptoms like nausea, headaches or digestive issues
  • Difficulty sleeping
  • Lack of trust

These symptoms could evolve and prevent us from maintaining close or healthy relationships, from functioning at work, or push us to use substances to feel better. 

There are a few types of trauma:

  • Acute trauma: results from a single event or incident.
  • Chronic trauma: repeated or prolonged exposure to stressful events, such as abuse or domestic violence, or bullying. Chronic trauma can also result from unresolved acute trauma.
  • Complex trauma: being exposed to multiple traumatic events, such as childhood sexual, physical or emotional abuse, medical abuse or a long illness, family instability or disputes. These often have interpersonal threads (occurring between two people) or they feel/are more persistent and planned leaving someone feeling trapped.

Chronic and complex trauma emotional responses could reveal themselves years after the event takes place. If there are persistent symptoms like flashbacks or re-experiencing the trauma in a way that is impairing life, it could be a sign of post-traumatic stress disorder (PTSD).

Assessment

A therapist will want to get a sense of the origin of the trauma, the type of trauma, and the degree or severity of it. They’ll likely ask a series of screening questions around your personal history, what kinds of events you remember, and about your current daily habits. Some of these questions may be “yes” and “no” questions only, such as, “did you think your life was in danger?” or “were you seriously injured?”

If you’re having physical systems associated with trauma, you may have a physical exam by a medical professional. 

Treatment

Those who have experienced trauma or are needing help managing the emotional distress following a traumatic event could benefit from therapy techniques such as: cognitive behavioural therapy (CBT), a form of psychotherapy that helps reframe thought patterns for better emotional and behavioural management; dialectical behavioural therapy (DBT), a form of CBT that focuses more on tolerating distress, acknowledging harsh realities and working on self compassion and coping; or exposure therapy, which involves gradually facing the memories of a traumatic event to learn they’re not to be feared and there are no remaining consequences.

Trauma can also have a real impact on our physical selves. We have a natural “fight, flight, freeze” response when our brains perceive danger. This is very helpful when there is real danger present, but not so helpful when we continue through this physical stress cycle at other times. We can hold this stress and tension in our bodies and this can lead to our nervous systems being charged up all the time. Somatic therapy is focused on how our bodies are reacting to stress, and teaches us methods to discharge this and calm our minds and bodies to better cope with new and existing stressors. 

Therapists who are trained to work with clients who are suffering from trauma will likely practice trauma-informed care (TIC). This concept is utilized in the medical community as well. It is not a specific method but an approach to treatment. These therapists will be more aware of how trauma presents itself in their client’s behaviour and they’ll be careful to honour any coping mechanisms they’ve adopted to-date (perhaps the therapist is better able to withstand angry outbursts, or moments of disassociation in a session: aka fight and freeze). They’ll be more careful not to retraumatize someone by having them relive distressing events prematurely. They’ll know it’s about creating a safe environment and motivating empowerment and control for the person in therapy.


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