Trauma: What Helps?
From the clinicians at Forest Ferns Counseling. Written in the first person by a member of our clinical team.
Trauma is as common as mud. It’s part of the human experience, and not because suffering is unavoidable, but because human beings have the unique capacity to hurt each other psychologically. Sure, trauma can be caused by natural disasters or other such events, but they don’t make up the majority of trauma cases treated by therapists.
Some people have little use for trauma talk, preferring instead to talk about resilience—as if you have to choose between the two. You’ve maybe heard some version of the argument: “I was whipped by my parents and my dad was an alcoholic with anger management problems, but I turned out fine.” But more and more people are becoming aware that their internal struggles (their spikes of intense feeling, their conviction that other people find them despicable, their belief that they’re broken, and maybe even their hard-to-diagnose physical conditions) may have roots in neglect, oppression, abuse, violence, or even less dramatic patterns of suffering.
I read The Body Keeps the Score long before I decided to become a therapist, but it wasn’t until I was actually seeing clients with hefty trauma histories that I understood van der Kolk’s argument. Trauma, he explains, is held in the body. But not in a simple or obvious sense. Your shoulder and back don’t somehow hold your trauma. Instead, trauma is registered through changes to the nervous system and brain. It shows up as a heightened stress response. The brain’s protection systems become sensitized by the original danger, and the body gets stuck in a pattern of predicting danger as if the threat were still present.
A sharp word from your partner might trigger inexplicably strong feelings of rejection. Maybe you find yourself stuck in the loop of crying jags or yelling episodes, or a routine medical examination feels frightening. Maybe you’re beside yourself with fear when your kid rides her bicycle around the block wearing her helmet. Or you notice that you keep trying to soothe and appease anyone you see as an authority figure.
Undoing these patterns takes time. And there’s no single fix, despite what some self-help authors would like you to believe. A number of different interventions can be helpful: meditation, yoga, trauma-focused psychotherapy, and EMDR. If you’re not familiar, EMDR involves moving your eyes in a prescribed way while processing a traumatic memory, and relies on bilateral stimulation, which may help reduce the emotional intensity of traumatic memories. There’s data supporting its efficacy, particularly for PTSD.
When thinking about interventions, though, it’s helpful to consider the hallmarks of trauma: helplessness, fear, and dysregulation. Helplessness involves a sense of powerlessness and being unable to escape. Fear is not just the emotional response the person felt in the past but the chronic expectation of danger in the present. Dysregulation is the activated nervous system misfiring long after the original trauma has passed; this can look like overwhelming experiences of crying, anger, or anxiety, or it can appear less stormy and show up as numbness or dissociation.
When a client feels comfortable and supported, all of these presentations will show up in therapy. With the therapist serving as an unconditionally accepting witness, the client may notice their usual helplessness, fear, and dysregulation quiet down. They can learn to sense and honor their emotional world, and on this foundation build capacities like self-compassion, agency, and meaning.
Reading books about trauma before I went into practice felt like a fascinating intellectual puzzle. But actually working with clients with serious trauma histories can feel grueling. I sometimes feel desperately sad and out of my depth when thinking about what they’ve been through. But if I keep my focus on the person in front of me and the relationship we’re building, I find that I can more easily access hope and purpose.
As humans, we’re easily wounded and we’re resilient. To heal is to reconnect with yourself, with the present moment, and with people who believe your story and support you in reengaging with life.
It’s exactly that easy and that hard.
Clinically reviewed by Mel Whalen, PhD, LP — Licensed Psychologist, Michigan #6301015759.
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