Guilt is a powerful emotion that does not like to be disobeyed. It is often quite loud, slippery, insidious, and overwhelming—yet it is not always right. Emotion experts believe that guilt is a social emotion, which arises when we behave in a way that goes against social rules, morals, or expectations. Since we are a highly social species that depends upon the social pack for survival, it makes sense that an intensely undesirable emotion arises when we break from the guidelines of the pack; in fact, the intensity and undesirableness of guilt is designed to get us to make a U-turn, align our behaviors with the guidelines of the social group, and resume our membership within it.

Understanding this gives you an avenue by which to determine whether listening to your guilt is wise. Rather than using the intensity of your guilt to determine whether to listen to it, you can look at the societal guidelines the guilt is in reaction to and determine whether abiding by these guidelines is wise.

Identify what societal guidelines your guilt is rooted in and spend some time deciphering what exactly you feel guilty about. Once you have a sense of the guidelines your guilt is in reaction to, weigh these against the guidelines you are basing your decision to separate on. From my perspective, your decision to separate from your spouse is rooted in a belief that you have a right to safety and to live free from abuse. The right to live a life without abuse is a human right, a constitutional right. Do the guidelines that are fueling your guilt outweigh your moral and legal rights to an abuse-free life?

I hope that engaging in this exercise can help you understand that your guilt, although strong, is not based on guidelines that are safe for you to abide by. While understanding this will most likely not make your guilt go away, it can provide you with a perspective that can help you tolerate the guilt, allowing you to ride it out.

Keep in mind that you do not need to get rid of the guilt, even though it would be lovely if it did go away; it is possible to have the guilt and not do what it says. Imagine your guilt to be a toddler who is having a massive temper tantrum in the grocery store—you need to be like the savvy parent who holds the child’s hand and proceeds to continue with the shopping trip, wailing child in tow. Your guilt can act up, be strong, powerful, and horrible, but you do not need to do what it says, nor do you need to focus on it.

One last tip is that all emotions pass. Hang on to this fact when your guilt is really powerful, and feel free to engage in activities that produce other emotions, such as peace, calm, and empowerment.

Finally, due to the violence that has been in your relationship, I recommend that you discuss the details of your separation with a therapist—be it your individual therapist or your spouse’s therapist—and that your spouse’s therapist is kept informed. A trained therapist who knows the details of the situation and is actively working with your spouse can help him through the transition. While it is your responsibility is to treat your spouse with kindness, respect, and genuineness, it is not appropriate for you to sacrifice your safety or well-being in order to make the transition easy. All the best to you, and keep in mind that standing up against abuse is vital in order for healing to begin.

Kind regards,
Susanne

All too often, compromised energy levels are a lingering impact of traumatic experiences, particularly ongoing or frequent traumatic events in childhood.

Compromised energy means that you simply do not have enough energy to tackle certain tasks. In addition, traumatic experiences often prevent people from learning how to manage their energy levels. This encompasses everything from recognizing when you are running low on energy to knowing how to build an energy reservoir and stamina.

Understanding Energy

Take a quick moment and think about all the energy it took to get through today. Think about the physical energy, as well as emotional and mental energy. Of these three types of energy, physical energy is possibly the most obvious. We have all experienced times when we were simply too tired to engage in a task because our physical energy was just not up to it. Many factors, including sleep, nutrition, exercise, medications, and substance use, can impact your physical energy level.

These factors also impact your emotional and mental energy levels. Emotional energy is used when you interact with emotions, whether in a productive or unhealthy manner. You use emotional energy when you identify an emotion, express it, act on it, calm it, understand it, and so on. Mental energy is the energy you use when thinking, planning, making logical decisions, and following through with your decisions and plans.

When traumatic life events have “stunted” your development of energy management tools, it is important to include learning these skills in your healing work. Broadly speaking, there are three categories of skills you will want to learn for each of the types of energy: the skills necessary for monitoring your energy level, those needed in order to manage your energy, and those that will increase the staying power of your energy.

Monitoring Your Energy Levels

How aware are you of your physical, emotional, and mental energies? Is there one type of energy that you are more aware of? Do you recognize when these energy levels are full and geared up for action, when they are at their midpoint, or when you are close to being empty? Or do you only become aware of your energy level when you are past empty and burnt out? Becoming aware of energy levels before you hit burnout will allow you to refuel before you run out of energy.

Physical energy can be a great one to start practicing these skills with. Take some time throughout the day—maybe every hour or two—and check in with yourself. How awake or tired are you? How full or hungry?

Imagine your energy levels as a gas gauge with marks at full, ¾ full, ½ full, ¼ full, and empty. When you check in with each of these physical experiences, determine where you fit on that scale.  Are you past the point of energy, but not quite tired? Are you not full but not hungry? By figuring out where you’re at, you can determine what you need to do to manage your energy and satiation levels: take a nap, go on a walk, eat a snack, say no to the offer of a snack, or whatever works for you.

Managing Your Energy

Once you can identify your energy levels, you can determine what you need to do to keep your energy at workable and beneficial levels. Let’s look at emotional energy. Say your emotional energy is still at the ¾ full mark, despite it being late in the day. Maybe now would be a good time to call a friend and extend support. Maybe you can take time to reflect on, process, or journal about a recent upsetting experience.

If you notice that your emotional energy is close to empty, but you still have a few emotionally taxing tasks to do,  it would be wise to carve out a bit of time to refuel yourself. Reach out to an emotionally supportive friend, take a break and head to an emotionally restorative place in nature (even if it is just smelling the neighbor’s roses), or take a few moments to breathe deeply, read an encouraging piece of prose or poetry, and so on. If you become aware that you have experienced several days on empty, you may want to consider dedicating your weekend to replenishing, rather than extending, your emotional energy.

Building Energy Reserves and Stamina

If learning how to replenish your energy reserves is one side of a coin, then building stamina is the other. This skill requires a great deal of gentleness and care: many survivors of trauma push themselves to have too much stamina, not allowing themselves to honor their limits.

With this in mind, building your stamina is nonetheless an important pursuit. Just like building physical stamina, developing a deeper mental energy reservoir requires practice in small increments. When you notice that you are approaching empty, but not quite there yet—somewhere just less than ¼ full—gather your mental energy and sustain your focus and effort for another 10 to 15 minutes. Rather than exiting the activity to replenish your energy level, stay engaged and practice hanging in there. If you simply do not have enough mental energy to stay with your current task, try switching to a less demanding activity that still engages your mental energy.

Use Energy to Bring Healing to Your Life

Feel free to play with these ideas and apply the ones that resonate with you. Practice each type of skill (monitoring, replenishing, and building stamina) with each type of energy (physical, emotional, and mental). Be as creative as you can be and brainstorm additional ways to grow these skills. In so doing, you reclaim crucial abilities and further your healing.

Practice these skills in a safe environment and in a manner that can only benefit you. Never do anything in the name of healing that could actually bring damage to you. As always, keep in mind that you do not need to heal on your own. Reach out to support groups, loving friends, supportive family, and trained professionals. We are all here to help you grow.

GoodTherapy | Learning to Accept Love After Experiencing TraumaLove is one of the most elemental of emotions. It is a building block of some of our deepest relationships and a component in many of our happiest days. Yet the ability to freely give and receive love is a fragile skill, which traumatic experiences can all too easily dent or damage.

Learning how to be loved is a vital part of your healing. Here are a few things to think about as you regain your ability to accept someone’s care, concern, and nurturing.

Part of learning how to be loved again is learning how to interact with people who express kindness, care, concern, nurture, and attention. Because you have experienced a traumatic experience, you have learned that people are capable of great cruelty. To avoid experiencing cruelty again, a part of your mind may have decided to ensure that you will never be hurt again. One of the ways that your mind tries to protect you from future cruelty is to assume that people are dangerous. This assumption in turn results in you leaning towards mistrust, avoiding vulnerability, and shying away from emotional intimacy.

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One way to practice opening yourself up to love is to practice opening yourself up to trust, vulnerability, and intimacy. But you have to make sure that you are practicing this with a safe person: someone who will not be cruel, let alone abusive, to you.

First, assess the level of vulnerability you open yourself up to if you take in the token of love.

Once you assess the level of vulnerability, take a moment and decide if this is a level of vulnerability you are safe with. If the vulnerability exceeds your level of healing, claim your right to do what is wisest for you, and back off or decline the token of love.

Consider the giver’s genuineness and accuracy. Is this someone with whom you have enough history to know their usual level of genuineness and accuracy? If you’re not sure, consider only accepting an expression of love that is low on your level of vulnerability. If you do have enough history with this person, then let their history of genuineness and accuracy help you decide whether to take in the expression of care, concern, or love. Someone who has proven to be genuine, truthful, and accurate is most likely extending an expression of love that is worthy of trust.

Consider whether there could be an ulterior motive. How would the giver of this token of love benefit from you accepting it? Could this benefit be damaging to you? When accepting an expression of love that makes you beholden or indebted to someone, think long and hard whether there could be an ulterior motive on the behalf of the giver.

If the expression of care is within your range of vulnerability, and is from a genuine and accurate person who does not have a damaging ulterior motive, then take in the love. Practice taking a deep breath while reminding yourself that you are actively healing one of the most fundamental of skills. Recognize that this is a moment in which you are being cared for, loved, and nurtured. Try not to miss these moments of kindness and care.

If you can believe the giver’s statements of friendship, respect, or love, then rejoice in the fact that someone believes these positive things about you. If believing these messages of love is out of your reach right now, then simply practice listening. Avoid disagreeing and don’t rebut the person’s opinions of you. Give voice to your gratitude, and express your thankfulness for this token of love.

If you are working on your healing with a therapist, try using that relationship to practice accepting care. I hope you have experienced your therapist to be the kind of genuine, accurate person with whom it will be safe to practice accepting love. Those questions about how you are, how your week was, and so on, are not just the standard questions of therapy: they are also tiny moments when therapeutic care and concern are being expressed. If nothing else, practice listening to these statements of care without disagreeing. I encourage you to take in the warmth of your therapist.

Thank you for these fantastic questions. I am going to answer each question individually, as you bring up quite important issues; but before I get to your questions, I’m going to ask you one. Does your therapist have specialized training in working with survivors of trauma?

This is a critical question for you to find the answer to and here’s why. The vast majority of therapists are competent, capable and genuinely caring individuals but not every therapist knows how to work with trauma. Unfortunately, it is possible to have a wonderful and generally effective therapist make unintentional and damaging mistakes with regards to a survivor of trauma.

Therefore, my recommendation would be to ask your therapist if she/he has training in working with trauma, is knowledgeable about this type of healing, etc…. When asking this it is appropriate to share that you are a survivor of trauma and would like to work on this aspect of yourself. If your therapist does not have a high level of specialized knowledge regarding trauma, then feel free to talk with your therapist about your desire to find someone who does have this expertise. Keep in mind that your therapist wants what is best for you and will not be upset, angered or disappointed if you need to connect with an alternate therapist for awhile or for good. Therapists recognize that we are only one piece of someone’s healing journey. We tend to be grateful for the segment of the journey that we share with our clients and trust that our clients will find other healers and avenues for healing as they journey through life.

So, assuming that you are working with a therapist who has specialized knowledge in trauma, here are some of my thoughts.

“How can you tell if it is a good idea to bring up trauma with your therapist?”
You own your life story and this includes the trauma(s). You and you alone have the right to set the agenda of your healing. If you feel safe with your therapist, trust him/her and desire to share about your life having trauma, then by all means feel free to do so. If on the other hand you would prefer not to share this, then know you also have the right keep this information private. You also have the right to bring up the fact of trauma and express your desire to not delve into the healing. A trauma therapist will understand that you are not being resistant, evasive or avoidant and will honor the courage it took to share as well as the trust you are showing by sharing.

“How long should I wait?”
This is 100% up to you. I have had clients who have told me about trauma in the first session. I have had clients who waited months and I have had everything in between. Once again, you have the right to claim your history – your therapist understands that the choice to disclose is your choice and a part of your healing. Your therapist will not be offended if you wait a long time to share and your therapist will not be overwhelmed if you share early on.

“I don’t want her to think that’s all I am.”
A key principle in psychology is that people are complex, more than meets the eye, and not equal to one life event or type of experience. Your therapist understands that you are a multifaceted individual and will try and define you based on your experience of trauma(s).

“I also am worried what if I get upset if I tell her.”
It is understandable to be worried about becoming upset, but rest assured that being upset in therapy is totally normal and to be expected. Your therapist will know how to help you soothe and calm your upset. If your therapist does not help you soothe and calm, then talk about this with your therapist. You have every right to require that the therapist you work with knows how to effectively handle emotions and knows how to teach you to navigate your emotions.

“What if I had a flashback while I was there?”
Pacing and timing are two important issues when healing from traumatic life events. Here’s an analogy, if you were to run a marathon, your pace would be how quickly you run each section of the race while your timing would be when within your training regime you actually run the race. In terms of healing (healing being the marathon), pacing has to do with how quickly and deeply you share about the trauma(s) while timing has to do with when you share. If you were preparing for a marathon, you and your coaches(s) would jointly make decisions about pacing and timing so that you push your body to achieve its potential while maintaining safe and achievable expectations. Once again, the analogy is apt – with regards to healing, you and your therapist jointly make decisions about pacing and timing. It is your therapist’s job to help you pace your disclosure so to minimize the chances of a flashback and if one does occur it is your therapist’s job to help you get out of the flashback as quickly as possible. The ability to recognize and manage a flashback are part of a trauma specialists skill set and makes this one of the prime reasons why working with a trauma specialist is vital.

What if she cried or something?
For many survivors of trauma, there is a deep fear that they are toxic, damaging and will inflict intolerable pain on those they share their histories with. Generally, the fear of one’s therapist crying is rooted in this fear. Due to your therapist’s training in trauma, she/he will know how to express compassion, nurture and healing in a way that teaches you that you are not damaging, toxic or the inflictor of intolerable pain. If your therapist does cry and this does overwhelm you, know that you can talk about this with your therapist.

Finally, feel free to bring up each and every one of these questions with your therapist. I know I speak on behalf of countless therapists when I say that we welcome your concerns, thoughts and worries – we believe that you are important and therefore believe that your questions are important too.

Kind regards,
Susanne

Since I don’t know you or the details of your life, I am going to answer your question using what I have learned from my clients who have felt and expressed similar questions.

Most of the individuals I work with who have felt as if they are not human have endured rather painful and cruel experiences. Oftentimes, these experiences were ongoing and occurred in relationships or situations from which the individual could not easily exit. While I don’t know if you have had experiences like this, I am going to talk a bit about how I help these individuals heal.

The first piece of this healing has to do with educating my clients that their experience of being ‘un-human’ is understandable and explainable, and the outcome of what once was an effective coping skill. Here is what I like to teach my clients:

  1. You, as a human, are built to survive, and if you cannot physically exit painful and cruel experiences, then you will do the next best thing and learn how to distance yourself from your own feelings, thoughts and sensations connected and related to the unavoidable experiences.
  2. Unfortunately, the human experience functions a bit on an all-or-nothing principle, meaning that if you cut out one part of your human experience you lose access to most of the other parts. Disowning your pain might mean you don’t hurt, but over time, it also means you don’t feel joy, happiness, meaning, etc…
  3. Eventually, the more parts of yourself that you disconnect from, the more you will begin to disconnect from your inherent sense of humanness, and your sense of belonging to the human collective will begin to fade.
  4. While effective in the short run, (i.e. you don’t feel pain), the overall ‘price tag’ of this coping strategy is just too much. So, learning how to let go of this coping strategy in favor of alternate coping strategies is critical.

Thankfully, therapy is just the place to engage in this type of learning, and the good news is that it is not the specific type of therapy, but rather the specific therapist that is most important. By connecting with your therapist, your therapist can teach you how to reconnect with yourself, and this reconnection with yourself allows you to regain your sense of connection with your humanness.

The big question then becomes, what type of therapist should you be looking for? You will want to connect with a therapist who embodies, i.e. lives, the following key attributes:

  1. Warmth. You want a therapist who expresses and displays warmth towards you, has genuine compassion for you, enjoys working with you and possesses enthusiasm to be your therapist.
  2. Understanding. You need to have the sense that your therapist gets you, that your therapist can understand who you are and how you tick. In addition, you want this understanding to be linked with acceptance – that your therapist accepts you just as you are and welcomes you to engage in the therapy process just as you are.
  3. Genuineness. You should link up with a therapist that you perceive to be genuine with you. Someone who will be authentic with you and someone you can be real with. This genuineness will allow you to build trust in your therapist, so that you can be open, honest and share 100% of who you are.
  4. Even though these traits are the most essential part of your therapist search, here are a few buzz words you might want to ask about: attachment theory, and a client-centered approach. You will want a therapist who agrees with these concepts and at a minimum lines her/his work up with the overall spirit of these approaches. Finally, if there are traumatic experiences in your past, then you need a therapist who has specific training in working with trauma.
  5. Ultimately, you will need to locate a therapist who creates a space where these approaches come alive and are embodied and applied to your therapy. I applaud you for reaching out with your question, and I encourage you to locate a therapist that can help you reconnect with yourself. Don’t worry if the first therapist isn’t the best match – it sometimes takes a few tries. Just don’t give up: You deserve to feel human, and you have the inherent ability to do so.

Kind regards,
Susanne

painting white heart on wallMost people would agree that having a compassionate stance towards oneself is desirable. But how do you cultivate self-compassion?

Let’s quickly define the term. In this article, “compassion” means tenderhearted recognition of pain or distress, coupled with a desire to alleviate it. Each component of this definition—recognition, tenderheartedness, and a desire to alleviate distress—offers opportunities for cultivating compassion. This article will look at how the skill of “recognition” can help you grow self-compassion.

The ability to recognize your pain or distress requires that you embrace your limits. Each of us has inherent human limits, as well as personal limits that are rooted in our personalities, life experiences, knowledge, skill levels, and more.

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For example, one obvious human limit is that everyone needs sleep on a regular and consistent basis. A less obvious human limit is that everyone needs some amount of play. Other examples may include the amount of money you need in your savings account in order to feel prepared for a “rainy day,” your tolerance for grumpy individuals, the patience you have for slow drivers, and more.

Some people have a difficult time accepting these human and personal limits. This desire to have no limits stems from a variety of sources. One common reason is that people confuse limits, which are neutral facts, with weaknesses. To put it another way, some people (falsely) believe that if they have limits, they are somehow flawed, weak, insufficient, or not capable of great things—therefore, they deny the reality of their limits. Denying your limits does not enhance your worth or value, but does block you from having genuine self-compassion.

By recognizing that you have limits, you can notice when you have been pushed beyond them, and then deem your ensuing emotions as legitimate. For example, if you know one of your limits is that you need a break every three or four hours of work, and you have to work a full day without breaks, you will know it is legitimate to feel exhausted.

Understanding this emotional distress as legitimate sets you up for the next component of compassion, which is tenderheartedness. In order for you to have compassion towards your distress, you must recognize your distress as legitimate: worth noticing, worth caring about, worth turning towards, and worth alleviating. It is by acknowledging, accepting, and allowing your limits to exist that you bestow legitimacy onto your distress.

Another piece of “recognition” is granting yourself permission to accept your limits as they are in the here and now. Your limits are not what you desire them to be or think they should be. Some limits, such as how much sleep you need, cannot be changed. Other limits, like patience for slow drivers, can be changed—but regardless of the flexibility of the limit in question, if you’ve exceeded your limit, you are beyond it.

While it is entirely appropriate, and a sign of maturity, to work on expanding limits, you can’t do that by denying that you have exceeded a limit. Instead, practice noticing when you have passed a limit and acknowledging it, instead of judging yourself harshly for having it in the first place. Rather than berating yourself for being exhausted at the end of a work day that had no breaks, recognize that you are bone-tired not because you are incompetent, but because you eclipsed your work-break limit.

Self-compassion is grounded in the ability to recognize that you are in pain or distress and that this pain or distress deserves and requires attention. Recognizing your limits as they are in this moment in time, personally and as a human being, allows you to acknowledge the legitimacy of your pain and the ensuing need to attend to your distress. You are entirely capable of growing into a person with more self-compassion, and I encourage you in this work. If you desire or need the guidance of a trained professional, do not hesitate to reach out.

Simply put, when it comes to traumatic experiences, there is no hierarchy of pain. Many survivors believe—or want to believe—that trauma is scalable and therefore more or less extreme than that of someone else. While this belief is understandable and does offer some benefits, it is ultimately more flawed than accurate.

For many life events as well as emotions, it is possible to create a hierarchy and use it to determine if event/emotion A is more or less than event/emotion B. One can look at happiness and stress to see how this scaling occurs. For example many would agree that receiving the perfect gift on your birthday falls below the happiness you feel on your wedding day, while the stress you go through on your wedding day exceeds the stress you have on your birthday. This scalability can add perspective, meaning, and depth to happenings that are within the realm of ordinary, expected, and standard.

Yet trauma lies at the utmost extreme of human experience; for the individual, there is nothing ordinary, expected, or standard about it. The severity of trauma, the danger, horror, and fear involved cannot be compared—regardless of what the content of the traumatic occurrence was. Regardless of how much or how little was endured, all traumatic experiences lie within the category of utmost extreme. Therefore, creating a hierarchy of traumas is not possible, since every trauma is an extreme life event. Once something is extreme, ranking its extremeness is a futile exercise.

Phrased another way, trauma is trauma; how you sustained a traumatic event does not alter the fact of the trauma. Imagine for a moment, a gorgeous glass vase, which becomes shattered; how this vase shattered—by wind gusting through an open window, a child bumping the table the vase sat on, or you dropping it while changing out the flowers—is of no import to the shattered vase.

Many survivors of traumatic life experience(s) find comfort and protection in maintaining the belief that because he or she did or did not experience certain components in the traumatic event(s), then the trauma is less than someone else’s. And, if it is less, it is a minor, even inconsequential moment in time that does not need to be acknowledged, let alone healed through. Despite the apparent protection that this belief brings, sustaining it prevents you from engaging in your healing, and healing is the only means by which to detoxify trauma.

In addition to blocking your healing journey, this belief robs you of self-compassion. The reason this belief precludes compassion, is that compassion requires reckoning. This belief prevents you from truly acknowledging and owning your hurt, pain, and suffering. It is only after acknowledgment has arisen that the second component of compassion can come forth: turning toward distress. This turning toward allows you to potentially alleviate your pain. Self-compassion not only validates your wounds, but it also opens a deep reservoir of gentleness. Holding and extending gentleness toward yourself, as well as regarding yourself through a compassionate lens, provides you with unshakeable stamina to engage in as well as endure your development into a thriving post-trauma individual.

Believing in a hierarchy of human suffering and pain seems to grant you peace as well as protection, but in the end it shortchanges you out of the health and wellbeing you have an inherent right to. Feel free to slowly begin letting go of this belief and replacing it with a more accurate acknowledgment of your past, and while you do this, aim to grow compassion as well as gentleness within yourself. If you want or need a compassionate guide to help you through, know that there are many qualified professionals who believe in your inherent right to compassion, gentleness, healing, and growth who can and will assist in this undertaking.

Woman with curly hair sitting on therapist's couch with head leaned on hand. Sitting next to her, a female therapist in a grey coat is listening and taking notes on a clipboard.Learning about the stages of healing can be distressing, motivating, upsetting, or uplifting. No matter how you feel, your reaction is not wrong. Acknowledging your emotional response to the stages of healing can allow you to harness your emotions’ energy and reach out to a trained therapist.

When looking for a therapist, it is vital to keep in mind that, regardless of what type of psychotherapy you pursue, your therapist should empower you and welcome you as a collaborator in your therapy, not attempt to impose control over you. Studies have found that individuals who are active participants in their therapy are more satisfied with the therapy. In addition, it is crucial that you feel safe in your therapeutic relationship.

There is no magical treatment that will heal you overnight, nor is there one form of psychotherapy that is right for everyone, but you should be able to find a therapist, as well as a therapeutic approach, that works for you. Healing is like a marathon. It requires preparation, repeated practice, courage, determination, and the support of others—including that of a professional coach or therapist.

While there are numerous therapy approaches, the purpose of all trauma-focused therapy is to integrate the traumatic event into your life, not subtract it. This article discusses the most common forms of trauma therapy. Each approach is described in its most pure form, but keep in mind that many therapists combine different types of therapies.

Pharmacotherapy

Pharmacotherapy is the use of medications to manage disruptive trauma reactions. Medications have been shown to be helpful with the following classes of reactions/symptoms:

Taking medication does not make one’s trauma reactions and pain evaporate. Medications can only help make the symptoms less intense and more manageable.

If you decide to use medications, consult a psychiatrist and continue working with that psychiatrist for as long as you take the medications. Inform the psychiatrist of how the medications are impacting you. Some medications have side effects that may or may not be tolerable to you, and some people do not respond favorably to medications. Medications are most effective when individuals pursue therapy concurrently.

Behavior Therapy

The most common form of behavior therapy is exposure. In exposure therapy, one gradually faces one’s fears–for example, the memories of a traumatic event–without the feared consequence occurring. Often, this exposure results in the individual learning that the fear or negative emotion is unwarranted, which in turn allows the fear to decrease.

Exposure therapy has been found to reduce anxiety and depression, improve social adjustment, and organize the trauma memory. There are various forms of exposure therapy:

Exposure therapy is a highly effective treatment for posttraumatic stress (PTSD).

Another form of behavior therapy is Stress Inoculation Training (SIT), also known as relaxation training. Stress Inoculation Training teaches individuals to manage stress and anxiety.

Cognitive Behavioral Therapy

Cognitive behavioral therapy (CBT) is grounded in the idea that an individual must correct and change incorrect thoughts and increase knowledge and skills. Common elements of cognitive behavioral therapy trauma therapy include:

Eye Movement Desensitization and Reprocessing (EMDR)

Therapists who perform EMDR first receive specialized training from an association such as the EMDR Institute or the EMDR International Association. An EMDR session follows a preset sequence of 8 steps, or phases. Treatment involves the person in therapy mentally focusing on the traumatic experience or negative thought while visually tracking a moving light or the therapist’s moving finger. Auditory tones may also be used in some cases. Debate regarding whether eye movements are truly necessary exists within the field of psychology, but the treatment has been shown to be highly effective for the alleviation and elimination of symptoms of trauma and other distress.

Hypnotherapy

There is no one guiding principal for hypnotherapy. In general, a hypnotherapist guides the individual in therapy into a hypnotic state, then engages the person in conversation or speaks to the person about certain key issue. Most hypnotherapists believe that the emotions and thoughts that an individual comes into contact with while under hypnosis are crucial to healing.

Psychodynamic Therapy

The goal of psychodynamic trauma therapy is to identify which phase of the traumatic response the individual is stuck in. Once this is discerned, the therapist can determine which aspects of the traumatic event interfere with the processing and integration of the trauma. Common elements of psychodynamic therapy include:

Group Therapy

There are a variety of different groups for trauma survivors. Some groups are led by therapists, others by peers. Some are educational, some focus on giving support, and other groups are therapeutic in nature. Groups are most effective when they occur in addition to individual therapy. It is important for a trauma survivor to choose a group that is in line with where one is in the healing journey:

Any therapist, regardless of which type of therapy she or he works from, desires to help you grow and heal through your traumatic experience.

Together, you and your therapist will strive to acknowledge and identify:

As always, reach out for help and know that you do not need to go it alone.

Reference:

  1. What is the actual EMDR Therapy session like? (n.d.). Retrieved from http://www.emdrresearchfoundation.org/for-the-public/what-is-the-actual-emdr-therapy-session-like

GoodTherapy | From Victim to Survivor to ThriverOne way to understand the healing journey is to think of growing from a place of victimization to survival, and ultimately, to thriving. While a person has had no choice about being victimized, he or she does have a choice about growing through these stages.

Regardless of what the traumatic event was, where or when it occurred, there was a period of time when victimization occurred. This victimization is not something one should feel guilt or shame about, rather it is a factual reality to understand, accept, and grow through. When an individual cannot or does not grow through the period of victimization, one can think of this person as being stuck within the victim stage.

An individual in the victim stage feels as though he or she is still in the trauma—no matter how long ago the actual traumatic incident(s) occurred. The sense of being in that moment of time permeates the person’s feelings, thoughts, and behaviors and even his or her sense of self. It is common for an individual in this stage to avoid many emotions while experiencing in abundance feelings of helplessness, vulnerability, fragility, self-pity, numbness, defeat, shame, self-hatred, and discouragement. The person might feel out of control or angry, want to hide and hope to be rescued. The individual often believes he or she lacks choices and has few possibilities and a shortened future. This combination of thoughts leads to little planning for the future and a preoccupation with the past.

In addition, the individual may feel plagued by memories of the event, particularly if he or she is struggling with flashbacks. Common behaviors that arise out of these thoughts and feelings are self-destructive ones such as addictions or a pervasive passivity. While most individuals, even those who have been stuck within this stage for quite some time, do not desire to be within the victimization stage, some individuals do experience secondary gains (such as love, support, attention, assistance) from being within this victim stage.

[fat_widget_trauma_ptsd_left]These benefits can also become intertwined with the individual’s way of life and identity, making it all the more difficult to grow through this phase. Just as some individuals struggle with leaving this stage, some individuals struggle with being in this stage and try to avoid acknowledging the truth of the victimization. Neither approach is healthy, because true recovery can only occur when ones has dwelt within and then healed out of this stage.

Once a person has grown through the victim stage, he or she enters into the survivor stage, which is the time when one begins to feel strong and confident and to truly believe that there are resources and choices. A key realization of this stage is that an individual has gotten through the trauma intact, or mostly intact, and is indeed outside of it. This understanding allows the person to begin integrating the trauma into his or her life story, to take control of life, and to recognize potential for change and growth.

For many, a sense of satisfaction accompanies this realization as does a shift into an emotional state that has less suffering, less pain, less guilt, and definitely less depression. Many of the difficult emotions decrease, and though this is not necessarily a happy phase of life, moments of happiness will start to occur more often. As one progresses through this stage, living one day at a time increasingly becomes a primary focus. Coping from day to day and acting upon a commitment to healing, trusting, and restoring relationships becomes the essence of healing.

The thriver stage crystallizes the growth of the survivor stage and takes one’s healing to the point where he or she has general satisfaction with life as well as a sense that ordinary life is both interesting and enjoyable. Commitment to moving forward, to taking care of one’s physical health, to investing in one’s career, relationships, and love and life allow these gains to occur. On an emotional level, feelings of strength, empowerment, compassion, resilience, and self-determination eclipse the emotions experienced within the victim stage. In addition a renewed sense of joy, peace, and happiness arises because one has grown, despite the traumatic experience, and is living well.

It is within this thriver stage that a person’s thinking becomes less pessimistic; he or she begins to think and believe that that there are long-term options, that there is a point to planning for the future, and he or she begins to recognize and embrace new possibilities. This living well is also exemplified in an ability to connect with others who are suffering, to accept imperfections in loved ones, and to reach out to others. Life is once again rich in meaningful relationships which help the person find a sense of meaning and purpose. If any symptoms of posttraumatic stress or other issues remain, the individual has learned how to effectively cope with these symptoms. Ultimately, he or she perceives him- or herself as more than a victim. One recognizes him- or herself as a valuable individual who, though tempered by tragedy, has risen and moved beyond the trauma.

This article is part II of a three-part series. Part I introduced the first phase of healing, the safety phase.

Woman looking sad mourningAs you pass out of the first phase of healing, you may feel as though you have a new lease on life and want to step out of your healing journey.

While you have more than every right to do this, the first phase is ultimately not sufficient to bring whole and complete healing. The real and perceived safety that you established within the first phase of healing—within yourself, with the people in your life, and in your physical environment—becomes the foundation that allows you to grow into the second phase of healing. In this second phase of healing, the actual traumatic experience is grappled with through remembering and mourning.

Integrating Traumatic Events into Your Personal History

Remembering allows you to address your trauma story by placing the event, or events, into your life history. This is giving your memories temporal dimensions. Due to the physiological processes that are “online” during a traumatic experience, the subsequent memories can seem to float outside of time and space rather than being rooted in the timeline of your life. To truly heal and integrate the reality of your traumatic event, the experience needs to settle into your life history.

To achieve this, a therapist can work with you to review your life before the traumatic event, the circumstances that led up to the trauma, and life after the trauma. Such a life review includes looking at others’ reactions, as well as acknowledging and healing from secondary wounding experiences.

By engaging in this emotional work, you transform the traumatic event from something that was done to you into something that is a part of your life experience. Rooting the traumatic event into your collective life history enables you to reclaim yourself—not the trauma—as the main character in your life, and allows your personal meaning of the trauma to come to the surface.

Reconstructing Trauma Memories

Once the experience of trauma is rooted as a part of your life experience—as an event that has a sense of time and space—the next step is to reconstruct the traumatic event. This is not memory recovery work: no memory is created where there is none. Instead, your therapist will work with whatever memory you have, regardless of length or detail. The purpose is to transform the trauma memory from a frozen moment of terror into a memory that reveals your feelings about and interpretation of the event.

This work is done one small piece at a time, with the guidance, support, and assistance of a competent professional. Despite the therapist being “the expert,” you, the survivor, have the final say about the pace of this work. The end result for most survivors is that their trauma story is no longer one of humiliation and shame, but rather one of virtue and dignity.

Remembering the traumatic event or events and connecting them to words and emotions enables you to mourn what you have lost. While trauma may or may not result in physical loss, it always results in psychological losses. Emotionally connecting with your losses is a courageous act. It can feel scary or even terrifying, because this acknowledgment can confirm the finality of the losses.

Moving Beyond the Second Phase

For many, the work of remembering, mourning, and grieving feels endless, regardless of the actual amount of time this phase encompasses.  Keep in mind that there is no set time limit to this phase. Every survivor spends a different amount of time in this second phase of healing, but it cannot be skipped nor rushed.

Survivors will know that they are nearing the end of the second phase of healing when, as Dr. Judith Herman states, “It occurs to the survivor that perhaps the trauma is not the most important, or even the most interesting, part of her life story…when the patient reclaims her own history and feels renewed hope and energy for engagement with life. Time starts to move again…the traumatic experience truly belongs to the past. At this point, the survivor faces the tasks of rebuilding her life in the present and pursuing her aspirations for the future.”

Important Notice

GoodTherapy is not intended to be a substitute for professional advice, diagnosis, medical treatment, or therapy. Always seek the advice of your physician or qualified mental health provider with any questions you may have regarding any mental health symptom or medical condition. Never disregard professional psychological or medical advice nor delay in seeking professional advice or treatment because of something you have read on GoodTherapy.