When we think of “trauma” we often think of an event, a natural disaster, attack to our person, or sometimes a motor vehicle accident or sudden death of a loved one. In counseling, trauma is any deeply distressing or disturbing event to which the response overwhelms an individual's ability to cope. Trauma causes feelings of helplessness, diminishes a person’s sense of self and their ability to feel a full range of emotions and experiences- regardless of “what” the event actually was.
Research shows traumatic experiences really change the brain and can:
Cause emotional dysregulation of many kinds
Cause anxiety
Lead to depression if untreated
Did you know, there are different types of traumas?… And they are all valid. There are three main types of trauma: Acute, Chronic, and Complex. Acute trauma results from a single incident, like we stated above- a disaster, attack or the like. Usually feelings of overwhelm and anxiety occur within six months of the event. Chronic trauma is repeated and prolonged such as intimate partner violence or childhood abuse or bullying, and the effects are often long ranging.
Complex trauma is exposure to varied and multiple traumatic events, often of an invasive, interpersonal nature.
I have heard about PTSD- what is that about?
All three types of traumas are real and can benefit from several types of counseling. You DO NOT have to have a Posttraumatic Stress Disorder diagnosis to benefit from counseling for your experience.
In order to be diagnosed with a trauma related disorder, a traumatic event is one in which a person's life was threatened, or they witnessed another person's life being threatened. However, any event such as childhood bullying or emotional abuse is considered to be trauma which could benefit from counseling if the person’s response is overwhelming their coping skills. Around 70% of adults in the United States have experienced at least one trauma in their lives. Not everyone will have lasting effects, but 6% of U.S. adults develop post-traumatic stress disorder (PTSD). Others will have multiple ranges of responses and can benefit from several types of evidenced based, “or best” therapies.
Specific types of counseling that are better for trauma are all related to Cognitive Behavioral Therapy.
If you’ve been following our blog posts, you’ll remember, Cognitive Behavioral Therapy, or CBT, is based on the idea that your thoughts, feelings, actions are all connected.
Another way to explain this is sometimes called the “cognitive triangle” of Thoughts, Feelings, and Actions. Whichever way you choose to view this triangle of thinking, each corner of the triangle, effects the other, and vice versa, allowing for lots of ways to change and grow at each point.
A therapist trained in CBT will help you begin to recognize your thoughts, feelings, and actions, as well as point out where you can change and grow for relief of trauma related symptoms. Some specific therapies include Solution Focused CBT, and Trauma Focused CBT. Both of these not only work to challenge and change our unhelpful beliefs, they focus specifically on how we can change in the “here and now,” and identify the beliefs keeping you “stuck” in your truama. Let’s break it down….
A Brief rundown of Trauma Focused CBT…
Trauma-focused CBT (TF-CBT) therapy is a cognitive behavioral treatment mainly used when our trauma (or chronic or complex traumas) began in childhood, where we often get “stuck” not understanding how to figure them out. TF-CBT’s goal is to help us recognize false beliefs, such as who to blame for abuse, correct unhealthy behavior patterns which may have developed to cope with long term abuse, and develop new ways to cope, such as self-soothing and expressing our emotions.
Using TF-CBT your therapist will help you identify unhelpful beliefs about yourself, or the world around you which stem from your trauma. Then, you can work together to form more neutral thoughts, and then slowly more positive thoughts about yourself and the world around you. TF-CBT will also help identify unhealthy coping skills we may develop in response to truama such as overeating, numbing with substances, avoidance, and/or failing to advocate for our wants and needs. Once you and your therapist identify areas for work, you can begin to practice new behavior patterns. We cannot act our way to feeling better, therefore, thought work comes first in TF-CBT.
What will my therapist and I DO in TF-CBT sessions for my trauma?
Some common techniques in TF-CBT include guided discovery and relaxation techniques.
Guided discovery involves your therapist getting acquainted with how you currently view, or think, about your world. Then they’ll ask questions designed to challenge your beliefs and broaden your thinking. You might be asked to share examples which support your automatic thoughts, views, and often assumptions, as well as evidence that does not. Through this process, you’ll learn to see things from other perspectives, especially ones that you may not have considered before. This can help you choose a more helpful path.
Relaxation techniques include deep breathing, which you will practice in session with your therapist. Your therapist will also teach progressive muscle relaxation, a systematic way to help your physical sense feel more at ease, which can help you generate more positive, less reactive ways of thinking. Another relaxation technique is guided imagery- where your therapist will play a story or tape, similar to listening to an audio book, to help you discover your thinking patterns, emotions, and new responses- kind of like a choose your own adventure book!
Solution Focused Cognitive Behavioral Therapy (SF-CBT), in a nutshell:
SF-CBT is based upon the view we have our own ideas of how we want our life to look, and what would be different in our preferred vision of the future. SF-CBT is helpful for truama residuals because you cannot change your past and what you have been through, but you can change your future. Your therapist will encourage you to create and describe your vision of a desired future and then to think about how you can work together to strengthen your current abilities in order to reach your desired outcomes.
Using SF-CBT your therapist will guide you in identifying what works well for you now, or what has worked in the past for similar challenges. At times, new approaches to problems are encouraged as a way to experiment with possible responses to new challenging circumstances.
What will my therapist and I DO in SF-CBT sessions for my trauma?
In SF- CBT common techniques are breaks, and compliments- and who doesn’t like those?
A common technique in SF-CBT is to take a break during the second half of each session and review what has been discussed so far. Shortly before the break, before the break, your therapist will ask for any more information you want to provide. During the break, you are left alone for a few minutes to reflect on what was already said. Upon returning, your therapist will offer an encouraging and therapeutic message about your ability to accomplish your goals.
Coping skills and ‘coping questions’ are often a focus of treatment, so that therapist and client can identify, change, and improve responses to trauma. Your therapist may often compliment how you are handling current situations which are challenging, to further bolster your resolve and steps already taken towards healing from trauma.
When it comes to truama, your therapist can use a lot of cool “add-ins” to bolster therapy to make it even better!
Art, music, reading, known as biblio-therapy, writing, journaling, and body movement, may all be suggested and explored in sessions. Art therapy is considered very helpful in truama treatment because the subconscious mind will often reveal our thoughts, fears, and anxieties which we cannot express in words. Music therapy- either listening, composing, playing or exploring types and genres of music, can help us release pent up emotions and identify themes to our coping skills and thinking, which we may not have previously realized. Bibliotherapy, if you enjoy reading, can become a way to feel less alone by focusing on characters who may have overcome similar challenges, or by exploring coping tools in non-fiction works. Writing and journaling – either with prompts from your therapist or free writing which you share in sessions- is often helpful to ensure between sessions your world and thoughts are accurately captured to discuss, as well as providing you some distance from your thoughts and emotion. Many people find, once they are on paper, the thoughts and feelings are not so scary. Body movement, either through dance or yoga may not be practiced, but the ideas can be explored in your session for you to practice on your own. Body movement of many kinds, dance, yoga, even simply walking are all highly encouraged to release trauma stored in your body.
How long will it take before I feel better?
Like most cognitive behavioral approaches, TF-CBT and SF-CBT are short term- aimed at helping to ease depressive thinking, anxiety and patterns of trauma responses as quickly as possible. Weekly to bi-weekly meetings with your therapist are recommended for the best outcomes. SF-CBT can last as few as six weeks or go about 4 months long. Another way to think of it is in terms of “sessions” or “meetings” with your therapist, which usually range between 5 to 20 sessions.
Reaching out for help when you have experienced a trauma or traumas is covered by insurances, Medicaid, and there are some free grants and programs as well for those who lack insurance. Do not hesitate to ask for help for fear you cannot afford it.
We have experienced group and individual counselors who can help you learn to use Cognitive Behavioral approaches, TF-CBT and /or SF-CBT to help you heal from your truama. Please reach out to us at A Helping Hand Of Wilmington today to start feeling better as soon as possible!