My orientation as a trauma therapist
Trauma is different to normal stress. Even major stress and profound grief form an essential part of life itself, and our minds and bodies have evolved to respond to these predictable life challenges in some fairly predictable ways. If given adequate support, we can generally recover fully over time without any need for specific therapy. This becomes less likely however when actual "trauma" has also been experienced...
"Trauma" means any overwhelmingly stressful experience that, at the time, produced so much shock that it was impossible to fully integrate into the psyche. Trauma therapy can prove invaluable when the shock of traumatic stress or traumatic grief has intercepted the normal recovery processes of the body and mind. It is when this natural recovery process has been overwhelmed or blocked in some way that trauma therapy can help.
While not all grief is traumatic, trauma and grief tend to be interwoven, as most trauma involves some profound loss in addition to a significant shock. Sometimes this loss is obvious, as in a loss of home in a bushfire, or a loss of full physical functioning after a car accident. Less obvious is the profound loss involved in any betrayal trauma, including a loss of safe, trusting relationships. Trauma healing for survivors of domestic violence or child abuse involves not only healing from complex traumatic stress, but also grieving these losses. Child abuse survivors often need to grieve the loss of childhood itself.
Western culture still tends to perpetuate a strong denial that horrific things can happen to innocent people. The prevalence of child abuse, rape, political torture and domestic violence is typically minimised, and trauma survivors disbelieved, pathologised and marginalised. One of the worst offenders has been "psychology" (my own profession), which should provide consistent recognition, powerful advocacy, and effective help for survivors of trauma.
Traumatic experiences can shatter a person's core sense of safety and stability, and have long-term impact on emotional well-being, physical functioning, and information processing. Many different traumatic experiences are likely to leave this legacy, imprinted deep within the mind and body, that can then rob a person of their full potential in later life. Victims of rape or other violent crime, for example, often continue to re-experience sensations associated with the original assault as if it were recurring long after any physical injuries have healed. Without informed help, any sudden bereavement leaving traumatic images or a strong sense of personal responsibility may remain like an open wound, hidden from view yet unhealed throughout life. Likewise, any trauma involving the betrayal of trust or the exploitation of power within a relationship, as in domestic violence or child abuse, may call for specific containment, processing and resolution within the safety of a healing relationship.
Multiple, unresolved trauma and grief tend to have a cumulative effect on a person's experience of life, especially when traumatic stress first occurred in childhood. This is because it is in childhood that the brain is most readily "wired" in adaptation to the environment.
For background reading in this area, please see the BOOK LIST section on trauma research
Regardless of how traumatised a person may be, deep-level healing is not only possible but can be as predictable as trauma's original imprint. Healing is inevitably promoted when clients are able to use their own inner resources by experiencing competent trauma therapy within the safe boundaries of a therapeutic relationship. The therapy relationship provides the safe context within which specific trauma therapy can then provide a sound structure to facilitate the person's natural healing processes. Over time, the person is supported to employ their own inner resources to effectively process the trauma itself, together with it's associated (or dissociated) emotions, beliefs, and memories (including sensory memories of trauma). This enables trauma's subsequent impact on current life experiences to also be effectively addressed.
Recent advances in trauma research indicate that, when people heal from trauma, they are making changes that involve actually re-forming particular neural connections.* Without these unique changes in healing the neurological imprint of the original trauma/s, merely thinking differently (or behaving differently) is probably insufficient for true long term trauma healing. (Incidentally, for other therapists reading, this implies that despite the current popularity of CBT within psychology practice, cognitive behaviour therapy is not, in itself, trauma therapy, regardless of how useful it may sometimes prove in symptom management). This is because memories of trauma are generally encoded and stored much deeper than the cerebral cortex, where logical thought processes occur. For example, without trauma therapy it is quite common for survivors of child abuse to "know" superficially that they were innocent and are now safe, (a valuable cognition) while younger levels of the psyche remain unconvinced by adult logic, and traumatic images, emotions and sensations persist indefinitely. As all trauma tends to produce some disconnection between logical thought processes and traumatic memory storage, it is vital that trauma therapy not increase this split. Simplistic old or new-age approaches that merely encourage or exhort trauma survivors to think/perceive differently, behave differently, or feel differently may do more harm than good when people then find deeply imprinted, automated responses returning. Likewise, merely "reexperiencing" the trauma/s generally only re-traumatises the person and impedes their subsequent efforts to heal (especially if abreaction has been pushed in some way). If this has happened to you, please do not give up hope. Healing is always more than possible.
>> For more information see for e.g. The Neuroscience of Psychotherapy in the BOOK LIST
Until recently within the history of psychological research there was relative neglect of the study of trauma, it's effects and recovery. Despite this neglect, or perhaps partly because of it, many different techniques are now proliferating which have increasingly inspired practitioners and their clients to have confidence in specifically addressing aspects of trauma. Psychological researchers are currently attempting to investigate the effectiveness of some of these (often with no small degree of bias!). Overall, the jury is still out, particularly regarding some of the newest techniques which may lack face validity and defy common sense. Neither do we yet know for certain what the "active ingredients" are when techniques do seem to "work". However, we do know that something clients accomplish internally for themselves is pivotal. *
>> If interested, click here for some theorising regarding the healing process...
From research into the neuropsychology of memory, we also know, that typically trauma memories are stored differently to other kinds of memories, and are not initially stored in narrative (verbal) form. Non-verbal aspects of trauma memories can include physical sensations, emotions, images, behaviours and subconscious beliefs, which often become disconnected from verbal memory. The emerging consensus from trauma research seems to be that a wide variety of different kinds of therapies which help integrate nonverbal and verbal processing can prove useful to clients in reworking trauma induced emotions, beliefs, and body memories etc.
Many widely differing methods or techniques may be found to be highly useful for at least some people some of the time (such as TIR, EMDR, NLP, EFT etc). It too often happens, though, that the technique itself seems to be given credit for the client's healing (or even the practitioner who uses the technique!), rather than the client ever fully realising their own power in their healing process. It is my view that, although sometimes useful in facilitating client's own processing, techniques as such never actually heal trauma, any moreso than techniques could be claimed to "cure" grief. If relied upon to "treat trauma", techniques can be experienced as intrusive and disrespectful of people's own processes. Trauma and grief are closely related, and it is absolutely vital that people's natural healing processes are honoured and respectfully facilitated in both.
I use the term "client-centred therapy" to differentiate this from therapy which is technique centred or which is focused on a particular therapist agenda for the client (rather than using this term in a strictly Rogerian sense).
Experience has confirmed for me that effective trauma therapy needs to be as individual as each client is unique. Although common general principles apply, specific techniques that may facilitate one client's process may impede another's. Within my own practice, I sometimes offer different processing modalities much as one might offer an array of painting brushes or ceramic tools to an artist, but it is always the client, and the client alone, who remains the artist creating the inner changes for their own healing.
It seems increasingly common to hear therapists claim to "treat trauma" just as some doctors might claim to cure disease. Yet even within the medical model of physical illness it needs to be acknowledged that the best medical "treatment" ultimately enables the body to heal itself. Therapists and therapies may facilitate a person's healing but only the client has the power of healing.
During almost 20 years of working with many severely traumatised clients of widely varying ages, I have often found myself in awe of people's inherent ability to recover their own dignity and self-respect, to find true inner peace and to reclaim their joy in life... It is this which continually strengthens my motivation in working with trauma survivors.
You are invited to read:
- You can expect your safety to be held as paramount at all times. This means, for example, that your therapist needs to know how to prevent trauma processing from being retraumatising for you. It also means that your emotional boundaries need to be completely honoured, just as your physical boundaries are protected.
- You can expect to be respected as the best expert on your own healing process, while not being abandoned to an experience of utter helplessness. All trauma involves a frightening loss of power and control, and it is vital that therapy helps you feel able to maintain a sense of control over the process and pacing of your own healing.
- You can expect your therapist to have cultivated skill and experience in applying the fundamental principles of trauma therapy and to keep up with developments in understanding trauma itself, it's effects, and it's resolution, while never losing sight of your own uniquely individual experiences and processes. You can expect your therapist to maintain an open mind regarding the many different paths that you may possibly find useful to your healing.
- There is much more that you have a right to expect in trauma therapy. Whenever people have been abused within core relationships, the therapy relationship itself tends to take on an extra significance in the healing process (more so than with, for example, a car accident or bushfire trauma)
For an example of an established therapy which I sometimes offer for it's potential usefulness in trauma processing and healing, please see: