Trauma

"Traumatized people suffer damage to the basic structures of the self. . . .Their self-esteem is assaulted by experiences of humiliation, guilt, and helplessness. Their capacity for intimacy is compromised by intense and contradictory feelings of need and fear."

Judith Herman

What is trauma, and how might it affect you?

There is a growing awareness of trauma and its effects on the psyche. Trauma comes in many forms, and it is impossible to describe them all here. A single incident - such as a car accident - can be traumatic and lead to severe anxiety, flashbacks, nightmares, and other symptoms that make daily life difficult. Being physically attacked or sexually assaulted can leave you with anxiety, shame, and difficulty trusting others. A prolonged period of being belittled, put down, ignored, humiliated, or gaslit by someone in your life can be traumatic. Witnessing another person’s trauma or its aftermath can be traumatic in itself. A sudden, shocking experience of loss or betrayal can lead to trauma symptoms.

Most profound are the effects of trauma in childhood. A child needs to feel that they are safe, that they are loved and worthy of love, that they are important to their primary caregivers, and that their caregivers are able to take care of them. If you did not have this experience, you might have continuous struggles with self-worth, shame, and identity. You might have recurring problems with relationships and communication. You might have trouble taking good care of yourself and managing your emotions in non-harmful ways. Your mind might have learned to “shut down” when overwhelmed - making it difficult to stay present and remember things.

How do you treat trauma?

Every client is different, but I generally follow the three stage model described by Judith Herman, M.D., in her classic book, Trauma and Recovery. These stages, and my approach to them, are described below:

1. Safety and Stabilization: In this stage, we address your most urgent concerns and create a solid foundation for trauma work. This includes taking the time to develop trust and comfort in the therapeutic relationship. This stage might also include:

   • reducing suicidal thoughts, self-harm urges or behavior, substance use, risky sexual behavior, and other symptoms that put you at risk of harm

   • working to meet basic needs (e.g., financial resources, safety from abuse)

   • understanding emotions and building skills to manage emotions

   • managing depression and anxiety symptoms

2. Remembrance and Mourning: This is when we work on "processing the trauma." This is challenging, painful work, and we will not rush into it before you are ready. This work will help reduce the power that these traumatic events hold over your life and your emotions. This stage involves:

   • sharing your story - usually by talking about it in session, but you may use writing, art, or another method if you prefer

   • organizing memories into a coherent story

   • understanding your symptoms as survival mechanisms

   • finding ways to express how the trauma affected you

   • grieving the things you lost, or never had, as a result of your trauma

   • working on self-compassion and self-acceptance

   • practicing using skills to calm and soothe yourself when remembering trauma

3. Reconnection: This is the work of moving forward. With a deeper understanding of the role that trauma has played in your life, we return our focus to present-day concerns. This might include:

   • exploring your identity and values

   • working on long-term goals related to relationships, work, education, health, or other areas of life

   • practicing new skills and behaviors

If this sounds helpful to you, visit the Contact page to schedule an appointment. I would be honored to work with you.