Today’s post is the fifth installment in a series about special needs parenting from the inside out. The series is the result of what I learned while researching Does My Child Have PTSD? What To Do When Your Child Is Hurting from the Inside Out.
The Seven Stages of Trauma Response
Our brains go through seven stages of trauma response when we can’t escape a perceive danger. These seven stages are explained in the Intensive Trauma Response (ITR) model developed by Dr. Louis Tinnin and Linda Gantt, the founders of Intensive Trauma Therapy (ITT), an outpatient trauma clinic located in Morgantown, West Virginia.
These stages are automatic and instinctual for newborns, infants, toddlers, children, adolescents, and adults who go through trauma. This post focuses how each trauma response is experienced in those under age 18. Parents familiar with these seven stages will better equipped to deal with their kids’ behavior during and after traumatic events.
Trauma Response #1: Startle
Startle is the quick, intense response which puts the body on high alert. Baby fingers splay, arms go rigid, and the babies cry. Toddlers, children, and teens tend to jump and gasp. Their hearts pound and their palms turn sweaty about things that adults shake off.
Trauma Response #2: Thwarted Intention
After the initial startle, the body releases a surge of hormones to prepare for fight or flight. When fight or flight aren’t possible, the thwarted intention response kicks in. As kids grow, they become strong enough to hide from perceived danger, to pitch magnificent fits, or to fight back. But babies can’t do any of those things. Therefore, the younger or more helpless children are in any given scary situation, the more like they are to reach the stage of thwarted intention.
Trauma Response #3: Freeze
When intentions are thwarted and there’s no hope of escape, the brain enters the freeze state. The body goes numb and immobile, at least for a moment or two. Children who experience similar, repeated traumas go through the two previous steps so quickly and automatically they may appear to have skipped them completely. They may freeze at the slightest hint of threat. No jump. No gasp. No attempt to fight or run. Their brains freeze and go offline for a while.
Trauma Response #4: Altered State of Consciousness
If the freeze state lasts for more than a few moments, the brain enters an altered state of consciousness. Adults often describe this state as watching a movie of themselves or the feeling of shrinking deep inside their bodies. When threatened, babies disengage and shut out the threat often through gaze aversion. Older children enter this stage by telling themselves, “This can’t be happening. It must be a dream.” Many children escape the situation through daydreaming.
Trauma Response #5: Bodily Sensations
These bodily sensations can be experienced during different stages in the ITR model. All of them are stored as non-verbal memories in the right brain. They remain there as sensations that can’t be put it into words. This step is especially risky from birth to age three because young children have no words. The memories are like terrifying movies playing over and over inside the brain. As children get older, their rational mind can’t explain these sensations, so many adolescents think they’re going crazy.
Trauma Response #6: Automatic Obedience
This instinctual response causes a person to automatically obey a perpetrator’s demands in order to survive the immediate threat. For children in life and death situations, automatic obedience is an appropriate survival response. Therefore, babies undergoing hospital procedures learn to lie quietly when people hurt them. Toddlers surrender when grown-ups touch their private parts. Young children do whatever their parents say to avoid a beating or verbal abuse. Automatic obedience is often the only survival weapon children have until their old enough or big enough to fight back.
Trauma Response #7: Self-Repair
After the threat passes, children tend to the emotional and physical wounds of trauma. Children instinctually seek out a favorite blankie, a stuffed animal or people they trust to comfort them. Sleeping, eating, rocking, going to a quiet place, and washing are other forms of self-repair. Young children revert to sucking their thumbs again or using abottle instead of a sippy cup. Older children regress to baby talk or demand a nightlight at bedtime. These behaviors are attempts to return to a safer, more comfortable time before the trauma happened.
Hope for Traumatized Kids
Keep a few things in mind while reflecting on these seven stages. First, all children face perceived threats and go through these stages. But research shows that children who have a compassionate, calm parent or caregiver to help them process the event are much less likely to experience long term mental health issues. Second, children dealing with unresolved trauma or PTSD that develops from it can be successfully treated by trained trauma treatment professionals.
The next post in this series will look at symptoms of PTSD in children from birth to age 3, ages 4 to 6, 7 to 12, and 13-18. Until then, you can learn more about the seven stages described above in The Instinctual Response and Dual-Brain Dynamics: A Guide for Trauma Therapy by Dr. Louis Tinnin and Linda Gantt, and in Does My Child Have PTSD? What To Do When Your Child Is Hurting from the Inside Out by Jolene Philo.
Do you have insights or questions about the seven stages of the ITR model? Feel free to share them in the comment box.
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Wendy, if your son is not yet seeing a therapist about his trauma issues, you would be wise to find one. A good therapist may have ideas concerning the SPD issues, too. Jolene
I see the last three particularly with my son, he is medically complex and has had many invasive procedures. He is also mild SPD. I am now worried I am not responding correctly to his sensory issues.
Life is like a wild roller coaster ride. It is full of ups and downs, as well as unexpected surprises, both good and bad.
It usually goes a little something like this: You’re at the top of your game, the high point on the roller coaster. Suddenly, you’re thrown forward. You’re quickly gaining speed, flying downward with no end in sight. It’s thrilling. It’s scary. There’s a mix of emotions and feelings.
All in all, these negatives and positives frequently balance each other out.
The universe strives for an energy balance. It’s a constant tug and pulls. All of a sudden, you’re flying back up to the top of that next hill. You’ve forgotten about the last downward spiral. The anticipation and excitement for what is to come have taken over.
Yet sometimes, these positive aspects can be hard to find, especially when your soul has taken a significant hit. Maybe you are healing from a divorce (good or bad – it isn’t easy moving on). Maybe you have recently been fired or laid off from your job. Perhaps you’ve lost someone close to you, by choice or otherwise.
It might feel like someone took your soul and trampled over it. You feel empty, numb, and lost. You’re grasping for direction. There are all types of trauma. This is where the biggest hurdle comes. You can’t seem to move on.
But, you can and you will. Moving on from past trauma is possible. It takes time for your soul to heal, but you’ll get there.
Important Note: If you are really struggling, talk to someone. Find a therapist or a professional that can help you find your path again. Under no circumstances does the following advice replace a qualified therapist who knows you and your situation.
Processing these painful emotions is a challenge. When you are ready, face up to that challenge. Proper mental health care and some soul searching can help get you there.
It’s time to pave the way for healing techniques that will help you address past trauma and guide you toward a better life.
4 Steps to Heal Past Trauma
Step 1: Acknowledge & Accept What Happened
Take the time to recognize what you have been through. Acknowledge that it is causing you emotional pain and distress.
Start simple–say it out loud.
No one has to be in the room, at least not to start. This is for you. Say what happened. Say how you feel. Make the decision and choice to move forward to resolve these feelings.
You could even try a few healing affirmations. Confirm how you feel through them. Then, choose a few to say to empower you. This will help you move on.
And remember, feelings are temporary. They will pass. It takes time to process them. But once you accept them and begin to understand them, things will get better. You can take another step forward and begin the process of moving on.
Step 2: Experience Your Feelings
Acknowledging what happened and accepting it can uproot your previous feelings or intensify them (again, healing affirmations can help you do this!).
Also, talk to someone like a therapist or someone else you trust.
Tell your story. Explain your feelings again and again. Or write about it. Let it all out. Allow this energy space to exist outside of you. It’s the whole “getting it off your chest” idea. And it helps you come to terms with it.
Try engaging in mindfulness every day to soothe your soul and give it that breathing room to finally heal.
Whatever you do, don’t repress your feelings. Bottling it up can lead to a ricochet of emotions and trauma down the road. You deserve better.
Step 3: Take Action
You have let your feelings out. You’ve worked through them. Now comes the hardest part: taking action and shedding the negativity.
Embrace forgiveness. Learn to let go of any resentment. It’s only harming you and holding you back. Write a letter to those who might have helped you through this time and thank them. Help someone else struggling as you once were.
Action takes various forms. Take responsibility for your part in the experience or situation that occurred. Similar to step 2, you can write about it or paint about it.
Step 3 may overlap with step 2 as you work through your feelings and move forward. Healing is complicated. It takes many different tactics and time to work through it.
Each situation is also very different. We all process our emotions differently. Get in tune with yourself and your emotions. Find what works or discuss it with your therapist or friend.
Ask for help when you need it. That’s what a support system is for.
Step 4: Reintegration
Reintegration isn’t just about becoming part of your life again and re-entering society. It’s about becoming a new and improved you. It’s taking this past trauma and accepting that it is part of your past. The best thing you can do is take something from it.
What did you learn? Who were you then compared to who you are now? Next time, what would you do differently?
Grow from your experience. Learn from it. And walk through that door into a new stage of your life. Become that new person. You are strong, and you have made it through. You survived. Share your growth. Allow others to learn from it as well.
Recovery & Growth is Coming
You’re stronger than you think.
Trauma can take a slice out of your heart and batter your soul. But you can recover. You can also take on other important mental health care strategies to continue your road of continued personal growth and development.
These strategies could include:
Let those endorphins boost your mood and your confidence.
Getting the right amount of sleep.
Your cognitive abilities don’t function as well on little sleep. You need sleep to think clearly and sort through your emotions. Without it, the trauma may seem even worse. Literally, sleep it off. You’ll feel better, and you’ll be more prepared to get through it.
Try to stick to a positive mindset, even when you don’t want to.
Come up with a list of positive affirmations. Say them every day. Know your worth. Positive beats and tunes can also help you in this regard, so create a playlist for yourself to listen to when needed.
Perhaps life feels much more fragile than before.
Use this and spin it to make your life the best it can be. We all go through emotional trauma. It’s okay to break a little. But fight through it, work through it, and come out stronger and better than you were before.
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“Believing in yourself is really half the battle,” says Krista. Anything is possible and you really can achieve anything you set your mind to, is her motto. Physiotherapist, Piano player, skydiver, yogi, adventure traveler and energetic force of positivity, Krista is herself a (delightful) force to be reckoned with! As. Read More
Gratitude is a funny thing. It doesn’t always come easy for survivors of trauma and abuse. Gratitude is defined as a positive experience of thankfulness. Some people actually wonder why they don’t feel more gratitude after surviving a life threatening event such as a plane accident or being a victim of a crime. Sometime their sense of feeling grateful to “just be alive” is impacted by their day to day PTSD symptoms of unresolved trauma and a sense that it is “not over yet” or that they are “not safe anywhere”. For many trauma survivors fear gets in the way of feeling gratitude and thankfulness. People who have survived trauma have had their joy taken away. In fact, a feature of PTSD is hypervigelence which creates fear in people of being hurt again.
Healing from trauma can happen in multiple ways. Sometimes a gratitude practice can begin the process and other times gratitude can come later after other forms of trauma treatment such as, EMDR therapy has taken place. Knowing what we are grateful for can be something that we think in our heads but don’t quite feel in our hearts. Research shows that gratitude practices don’t always provide a quick fix for survivors of trauma. In fact, some studies show that the positive effects of gratitude increases over time and with practice. This suggests that gratitude needs time in order to help us heal from traumatic life events.
“Not every day is good, but there’s something good in every day.” — Alice Morse Earle
Consider a gratitude practice in your life. Here are some ideas in developing gratitude: a gratitude list or journal, moment to moment gratitude in your thoughts, sharing your gratitude with others such as a partner, spouse or a friend who has agreed to participate with you.
Brene’ Brown, PhD an author and social researcher gathered information on gratitude. She shared in her book, The Gifts of Imperfection, that without a doubt every person that she interviewed who said that they were happy actively practiced gratitude in their lives. Examples of gratitude she came across in her interviews were; doing daily gratitude meditations or prayers, creating gratitude art, and even stopping during their stressful, busy days to actually say these words out loud: “I am grateful for . . .
Gratitude can certainly help with the healing process of trauma as well as create more resiliency to deal with future trauma or stress. So in this season of gratitude take time to reflect on what being thankful means to you and look for small or big ways to incorporate this practice in your life.
The Three Boards Model of trauma healing offers a roadmap to carry us through.
- What Is Trauma?
- Find a therapist to heal from trauma
- Trauma is not a singular event that can be overcome in one sitting; rather, it affects survivors’ lives in almost every way.
- Trauma impacts the body and brain so strongly that it can actually change how we perceive, experience, and react to the world around us.
- Because of this, healing from trauma is a complex and personal journey.
This post was written by Annie Rooks and Albert Wong.
What is trauma?
Trauma, in the body, can be understood as the chronic and persistent dysregulation of the nervous system due to overwhelming events or life circumstances. This reaction in the body occurs when an event happens in a way that the brain considers either “too much and too fast” (too much of something bad) or “too little and too late” (not enough of something good).
These events cause the body and brain to go into either a state of hyperarousal, meaning they get stuck in overdrive (fight/flight), or a state of hypoarousal, meaning they get stuck in nervous system shutdown (freeze).
Both hyperarousal and hypoarousal can cause wide and far-ranging mental and physiological side effects. Physical changes in the body due to trauma are known as somatic symptoms and are the basis of the Three Boards Model (Price, 1996).
To understand the Three Boards Model, it is important to first understand the window of tolerance (Siegel, 1999). The window of tolerance is a frame of reference for what is considered normal in the body and what is considered traumatic. Its purpose is to graph the average arousal-cycle, which will typically look like a bell-curve, with the peak of the curve being the highest point of anxiety and/or stress a person is feeling.
Trauma occurs when the peak of the arousal cycle is above the person’s threshold, meaning that they are no longer within the window of tolerance. When this happens, different aspects of a person’s reality begin to fragment off and disconnect from one another (discussed further in “Why You Can’t Think Your Way Out of Trauma”).
So how do we fix this? With a model that can be adjusted to suit each individual’s needs and allow them to work at their own pace. This is where the Three Boards Model comes in.
The Three Boards Model
The Three Boards model emerges out of the oral tradition from the Esalen Institute (Price, 1996) and outlines three different approaches to somatic healing, all using some sort of “board” in their practices. Each approach also correlates with a different stage of the trauma healing process and aims to help people better understand their trauma and regain control over their lives.
This framework to understanding trauma and the recovery process is effective because it helps restore a person’s agency, which can be incredibly empowering, and because it also gives them a roadmap on the way to healing. Here is a basic summary of each of the “boards”:
- “The Surfboard” looks at the graph in the window of tolerance as a wave. This means the person and their surfboard both rise and fall with the wave. However, sometimes the wave is too big, and the person gets thrown off of their surfboard and ends up stuck outside the window of tolerance. This stage is focused on resourcing (finding resources to help get back inside the window of tolerance).
- “The Keyboard” compares different components of lived experience to different notes on a keyboard. In this framework, there are multiple constituents of experience (sensation, images, behavior, affect and meaning), but they are not always readily available to us (Levine, 2010). The “Keyboard” stage of the work invites us to ask the following questions: How accessible are these different channels of experience? Can they all be “played”? Are some stuck? This stage of the work is focused on examining the constituents of experience and determining what we have access to—and what we don’t.
- “The Boardroom” reflects the importance of listening to every inner voice and welcoming all thoughts, images, sensations, and feelings. This stage of therapeutic work is focused on letting each part of our experience be heard, seen, valued, and felt, which—with luck—allows us to complete the arousal cycle (come down from the peak of the stress to a place of calm).
In the blog posts to come, we will be exploring each of these “boards” in more depth. Stay tuned.
Annie Rooks is a sophomore psychology major at Chapman University. Currently, she works as an intern at Somatopia, an online educational platform dedicated to creating an embodied world. She plans to attend graduate school and become a child psychologist. Rooks is passionate about making information and resources accessible. She hopes to write children’s books that teach coping methods for mental disorders.
- What Is Trauma?
- Find a therapist to heal from trauma
Quincee Lark is a senior psychology major at Lewis & Clark College in Portland, Oregon. Aside from pursuing her degree and freelance painting and illustration, Quincee works as an intern at Somatopia under the supervision of Dr. Albert Wong.
Price, C. (1996). Gestalt Awareness Practice. Workshop conducted for Extended Students at the Esalen Institute.
Levine, P. (2010). In an Unspoken Voice: How the Body Releases Trauma and Restores Goodness. Berkeley, CA: North Atlantic Books.
By Carly Herbert , posted 07.20.2021
How to Heal From Trauma
70% of U.S. adults have been into some traumatic experience at least once in their lives. Notably, extremely stressful events that make you feel helpless, destroy your sense of security in an unsafe world result in emotional and psychological trauma. Let us take an example of the pandemic Covid-19. It traumatized most part of the world, adversely affecting people from across the globe physically, emotionally, and financially as well. The good news is you can heal from trauma. Here are several useful tips in this blog but know that everyone’s journey will be different.
What Is Trauma?
When defining trauma, it is an emotional response to a terrible event such as rape, accident, or natural disaster, according to the American Psychological Association (APA). Adding to it, a Traumatic experience can also include life experiences such as death, divorce, and illness. After trauma, you feel denial and shock typically. As far as its long-term effects are concerned, you possibly suffer from physical symptoms, e.g., fatigue, headaches, and nausea. The long-term traumatic effects also include volatile emotions and flashbacks.
What Are the Effects of Trauma on the Body?
Overproduction of Stress Hormones:
When in trauma, your body stimulates overproduction of stress hormones named cortisol. Noticeably, your body remains in a state of high alert due to the activation of stress hormones in case you are reliving a traumatic experience constantly. Triggers might include an exaggerated startle response or trembling, occurring due to the things reminding you of a traumatic event.
Fight or Flight Mode:
Whenever you feel triggered, your body will step into the flight, fight, or freeze mode. To put it simply, you will either: Defend yourself against the trigger or Feel paralyzed. You might also feel difficulty sleeping and the need to avoid situations or people that you believe threatening.
Psychological and Emotional Distress:
Trauma put an impact on three areas of the brain, including the hippocampus, the amygdala, and the prefrontal cortex. This can cause lasting changes in all three areas. Post-traumatic stress disorder (PTSD) can cause impaired functioning of the brain and make significant changes in its size as per some animal studies. Moreover, post-traumatic stress leads to fight or flight response that further causes overproduction of cortisol. If so happens, rewiring of your brain’s circuitry will take place, bringing about emotional and psychological distress.
How to Heal from Trauma?
You can start healing from trauma by following these useful tips:
Limit Media Exposure:
Avoid watching disturbing footage and social media before bed. Also, if you are watching the news and feel triggered, turn it off and do something pleasant.
Accept What You Feel:
In this regard, you need to process painful emotions in the following ways:
Giving yourself time to get through your feels and mourn any loss you have encountered.
Seek a therapist
Preparing yourself for volatile emotions.
Learning to reconnect with uncomfortable emotions.
Be Physically Active:
Being physically active is a helpful way of releasing endorphins, i.e., the feel-good hormone that will boost your mood.
You can do the following for staying physically active:
Indulge in rhythmic exercises, e.g., running, walking, dancing, basketball, or swimming.
Practice mindfulness by participating in rock climbing, martial arts, weight training, or boxing.
Increase your exercise timing over time.
Have a Healthy Diet and Get Quality Sleep:
Having a well-balanced diet is extremely important. In fact, you can cope with traumatic feels better by having a healthy diet, including lots of fresh fruits and vegetables, complex carbs, omega-3 and omega-6 fats, and high-quality protein. As well as that, getting quality sleep is also necessary for coping with trauma. To accomplish this purposefully, avoid caffeine, make your bedroom dark, soothing, and quiet and go to sleep at the same time.
An inside look at the traumatized brain, and how you can start to heal.
- The brain is plastic, growing and evolving throughout life. Trauma survivors can capitalize on this plasticity to heal.
- A traumatized brain tends to experience excessive activation in areas related to fear, and reduced activation in “thinking” areas.
- Psychotherapy and mindfulness training can reduce activation in the fear center and allow for healthy emotional expression.
Approximately 50 percent of the population will experience a traumatic event at some point in their lives. While reactions to trauma can vary widely, and not everyone will develop post-traumatic stress disorder (PTSD), trauma can change the brain in some predictable ways that everyone should be aware of, especially if you or someone close to you is struggling to cope after trauma. With increased awareness, you can seek treatment to address your symptoms and learn skills that could actually rewire your brain for recovery.
Additionally, knowing what’s going on can be immensely helpful because it may help you realize that you’re not crazy, irreversibly damaged, or a bad person. Instead, you can think of a traumatized brain as one that functions differently as a result of traumatic events. And just as your brain changed in response to your past experiences with the world, it can also change in response to your future experiences. In other words, the brain is “plastic,” and you can change it.
3 Areas to Know
Trauma can alter brain functioning in many ways, but three of the most important changes appear to occur in the following areas:
- The prefrontal cortex (PFC), known as the “Thinking Center”
- The anterior cingulate cortex (ACC), known as the “Emotion Regulation Center”
- The amygdala, known as the “Fear Center”
The PFC, or thinking center, is located near the top of your head, behind your forehead. It’s responsible for abilities including rational thought, problem-solving, personality, planning, empathy, and awareness of ourselves and others. When this area of the brain is strong, we are able to think clearly, make good decisions, and be aware of ourselves and others.
The ACC, or emotion regulation center, is located next to the prefrontal cortex, but is deeper inside the brain. This area is responsible (in part) for regulating emotion, and (ideally) has a close working relationship with the thinking center. When this region is strong, we are able to manage difficult thoughts and emotions without being totally overwhelmed by them. While we might want to send a snarky email to a coworker, the emotion regulation center reminds us that this is not a good idea, and helps us manage our emotions so that we don’t do things we regret.
Finally, the amygdala, a tiny structure deep inside our brain, serves as its fear center. This subcortical area is outside of our conscious awareness or control, and its primary job is to receive all incoming information—everything you see, hear, touch, smell, and taste—and answer one question: “Is this a threat?” If it detects that a dangerous threat is present, it produces fear in us. When this area is activated, we feel afraid, reactive, and vigilant.
What’s Going on in a Traumatized Brain
Traumatized brains look different from non-traumatized brains in three predictable ways:
- The Thinking Center is underactivated.
- The Emotion Regulation Center is underactivated.
- The Fear Center is overactivated.
What these activations indicate is that, often, a traumatized brain is “bottom-heavy,” meaning that activations of lower, more primitive areas, including the fear center, are high, while higher areas of the brain (also known as cortical areas) are underactivated. In other words, if you are traumatized, you may experience chronic stress, vigilance, fear, and irritation. You may also have a hard time feeling safe, calming down, or sleeping. These symptoms are all the result of a hyperactive amygdala.
At the same time, individuals who are traumatized may notice difficulties with concentration and attention, and often report they can’t think clearly. This, not surprisingly, is due to the thinking center being underactivated.
Finally, survivors of trauma will sometimes complain that they feel incapable of managing their emotions. For example, if someone spooks them as a prank, they may experience a rapid heart rate long after the joke is up, or may have a hard time “just letting go” of minor annoyances. Even when they want to calm down and feel better, they just can’t. This is in large part due to a weakened emotion regulation center.
What You Can Do Now
Changing the brain takes effort, repetition, and time. The best gift you can give yourself toward this goal is psychotherapy. If you’re ready to start that journey, look for a psychologist who specializes in trauma and PTSD, and who uses evidence-based methods that change the brain by working with both the body and the mind.
Also, consider adding a body-based or mindfulness-based technique to your daily routine, to help begin deactivating the fear center. This is a vital first step to healing, as when we are able to quiet the fear center, we are better able to work on strengthening and activating the thinking center and emotion regulation center. Two such exercises include diaphragmatic breathing and autogenic training. (Access free, guided practices of these techniques HERE.) The recommendation is to practice these techniques, or similar ones, for short periods of time multiple times per day. Remember, practice makes progress.
LinkedIn Image Credit: tommaso79/Shutterstock
- Phases of Trauma Recovery
- Taking Care of Your Spiritual Self
- Cultural and Healing Practices
- Culture and Healing Videos
- Building a Support System
- Supporting Family and Friends Affected by Trauma
“The first goal of trauma recovery should and must be to improve your quality of life on a daily basis” (Rothschild, 2010)
For an overview of the recovery process please view the video below:
Recovery is the primary goal for people who have experienced trauma, their families, and their care providers. Recovery does not necessarily mean complete freedom from post-traumatic affects. Recovery is an individual experience and will be and look different for everyone. In general recovery is the ability to live in the present without being overwhelmed by the thoughts and feelings of the past.
Central to the experience of trauma is helplessness, isolation and the loss of power and control. The guiding principles of trauma recovery are the restoration of safety and empowerment. Recovery does not necessarily mean complete freedom from post traumatic affects but generally it is the ability to live in the present without being overwhelmed by the thoughts and feelings of the past.
There is a vigorous debate in the field of traumatic stress as to whether revisiting traumatic memories is necessary for healing or whether it may in fact even be harmful. Obviously this is an individual matter; many may find it beneficial to tell and retell their experiences of trauma where others may find that destructive to their well being.
Trauma recovery is best to be looked upon as a process that is worked on over time and in intentional stages. The re-establishing of safety is the first and most central step in recovery separate and apart from whether the details of the trauma are ever spoken of or not.
Dr. Pierre Janet conceived of a phased framework of trauma recovery in the late 1800’s with Dr. Judith Herman making it more readily known in her seminal work, Trauma and Recovery (1992).
- Phase I
- Phase II
- Phase III
Safety and Stabilization
People affected by trauma tend to feel unsafe in their bodies and in their relationships with others. Regaining a sense of safety may take days to weeks with acutely traumatized individuals or months to years with individuals who have experienced ongoing/chronic abuse. Figuring out what areas of life need to be stabilized and how that will be accomplished will be helpful in moving toward recovery. For example:
- A person who has experienced trauma may struggle with regulating or soothing difficult emotions in everyday life which they might not associate directly to the trauma.
- Learning how to regulate and manage these difficult/overwhelming emotions.
- Some people who experienced trauma, particularly complex trauma, may find that speaking about their experiences emotionally overwhelming. Recently, both therapists and researchers have been exploring nonverbal ways to foster emotional regulation. Several studies have suggested that Mindfulness Based Stress Reduction (MBSR) groups and the use of acupuncture for clients with Post-Traumatic Stress Disorder (PTSD) reduces negative emotions and promotes a more calm appraisal of life situations (Hollifield, 2007 and Davidson et al, 2003). There are other types of self soothing practices such as meditation, deep breathing yoga, Chi Qong as well as other spiritual and cultural practices and ceremonies that have been shown to be effective in soothing the nervous system. Refer to the topic on Mindfulness and other related topic areas. These practices work well with more traditional talk therapies allowing greater stability throughout recovery. Auricular Acupuncture has the added advantage of reducing cravings for alcohol and drugs as well as promoting better sleep and clearer thinking among clients who receive it regularly (Stuyt, 2005). It is also well suited for supporting work with refugees and immigrants in that it is nonverbal and closer to the methods of traditional medicines found in a variety of cultures.
Metaphor for creating safety:
The experience of emotional overwhelm is similar to that of a shaken bottle of soda. Inside the bottle is a tremendous amount of pressure. The safest way to release the pressure is to open and close the cap in a slow, cautious and intentional manner so as to prevent an explosion. (Rothschild, 2010)
Remembrance and Mourning
This task shifts to processing the trauma, putting words and emotions to it and making meaning of it. This process is usually undertaken with a counselor or therapist in group and/or individual therapy. It might not be necessary or required to spend a lot of time in this phase. It is however necessary to be continuing to attend to safety and stability during this phase. Attending to safety allows the persona affected by trauma to move through this phase in a way that integrates the story of the trauma rather than reacts to it in a fight, flight or freeze response.
Pacing and timing are crucial during this phase. If the person affected by trauma becomes quickly overwhelmed and emotionally flooded when talking about their trauma memories, safety and stability must be regained before moving further on with the story. The point is not to “re-live” the trauma but nor is it to tell the story with no emotions attached.
This phase involves the important task of exploring and mourning the losses associated with the trauma and providing space to grieve and express their emotions.
Reconnection and Integration
In this phase there must now be a creation a new sense of self and a new future. This final task involves redefining oneself in the context of meaningful relationships. Through this process, the trauma no longer is a defining and organizing principle is someone’s life. The trauma becomes integrated into their life story but is not the only story that defines them.
In this third stage of recovery, the person affected by trauma recognizes the impact of the victimization but are now ready to take concrete steps towards empowerment and self determined living.
In some instances, people who have experienced trauma find a mission through which they can continue to heal and grow, such as talking to youth, or peer mentoring. Successful resolution of the effects of trauma is a powerful testament to the resiliency of the human spirit.
Recovery is an individual process and will look different for everyone. There is an intense desire to feel well quickly and individuals can feel that the process is taking too long or they are not doing it “right”. Recovery is not defined by complete absence of thoughts or feelings about the traumatic experience but being able to live with it in a way that it isn’t in control of your life. It is important to gentle, patient and compassionate with yourself as you move through this healing process.
Not everyone who endures a traumatic experience is scarred. But recovering requires that painful emotions be thoroughly processed.
By Ellen McGrath published November 1, 2001 – last reviewed on June 9, 2016
Whatever inner resources people need to mobilize for recovery, they still can not accomplish the task alone. Depression and trauma are disconnective disorders. They do not improve in isolation. To fix them you have to be connected to others.
Direct experience with disasters ranging from war and terrorism to hurricanes and earthquakes has taught me that there are four basic stages in recovering from a profound stress. Progression through all four stages is essential to recovery.
Stage One: Circuit-breaking
If you overload an electrical system with too much energy and too much stimulation, the circuit breaker activates and shuts everything down. The human nervous system is also an electrical system, and when it is overloaded with too much stimulation and too much danger, as in trauma, it also shuts down to just basics. People describe it as feeling numb, in shock or dead inside.
The juice turns off. Intellectually, you lose from 50 to 90 percent of brain capacity, which is why you should never make a decision when you’re “in the trauma zone.” Emotionally you don’t feel anything. Spiritually you’re disconnected, you have a spiritual crisis or it doesn’t mean anything to you at all.
Physically all your systems shut down and you run on basics. What is so intriguing is that physical symptoms that were previously prominent often disappear during this time. Back pain, migraines, arthritis, even acne often clear up. Then, when recovery from trauma is complete, the physical symptoms return.
When the system starts to recover and can handle a bit more stimulation and energy—and the human system is destined to try to recover, to seek equilibrium—feelings begin to return.
Stage Two: Return of Feelings
Most people have not experienced so much primary trauma that they must see a professional counselor; they can work through their feelings by involving the people they are close to. They do it by telling their story—a hundred times. They need to talk talk talk, recount the gory details. That is the means by which they begin to dispel the feelings of distress attached to their memories.
The more that feelings can be encouraged, the better. The more you feel the more you heal.
The expression of feelings can take many forms. For most people it may be easiest to talk. But others may need to write. Or draw. However they tell their stories, the rest of us have an obligation to listen.
It is often helpful to actually revisit the scene of destruction. That allows someone who has been impacted directly to emotionally experience the event and grasp the reality of it. That direct experience can stimulate the return of feeling. Visiting the site is not for everybody, however. For some it is too disturbing. Others may need the support of loved ones to revisit the scene.
There are four broad patterns of expression of feelings that people employ in response to a crisis. Call them feeling styles. Some people consistently maintain one style; others exhibit all four styles at different times.
It is important to recognize which style of emotional expression is characteristic of your response, and which patterns your loved ones display. Each one demands a different approach.
The Trickle Effect
Feelings flow in little trickles, slow but steady. Tricklers have feelings at a low or medium level most of the time.
Hit and Run Feelings
Some people hit an emotion, experience it intensely, then find it so scary they run away from it. They avoid it and may not talk about it for days, weeks or even months. Then they hit the feeling again, it blows up and they run away from it again.
Many people go up and down emotionally. They are in touch with their feelings but their feelings are all over the place. Like a roller coaster, however, they can go very quickly through the feeling stage.
Emotions come in tidal waves that are so big, comprehensive and overwhelming that those who get them feel like they’re going to drown. They flail about, and then the wave recedes; they discover that they’re still alive and they feel better. Tsunamis usually occur because people repress their feelings of pain.
Stage Three: Constructive Action
People need to take action and make a difference even in the smallest ways. Taking action restores a sense of control and directly counteracts the sense of powerlessness that is the identifying mark of trauma.
The ways of action are many. You can write a letter to the rescue workers. You can give blood. You can make a card for those who lost loved ones. You can hang a flag if that means something to you, or donate to the Red Cross. You can feed rescue workers or collect needed supplies for them from your community. You can take in children whose families can’t reach them. You can help a person who is out of control to get more grounded during the crisis.
You do whatever you can and never assume that any gesture is too small. In a situation that is overwhelming, you don’t go for the big picture. You go for what is closest to you and where you can make a difference. Constructive action might be writing about the catastrophe or creating some work of art about it. It also encompasses getting back to work so that you can contribute something.
Stage Two and Stage Three go hand in hand. To go forward you feel and you act. You can’t do one or the other. Acting and feeling become an engine that propels you forward.
Stage Four: Reintegration
In the wake of crisis it is possible to learn and grow at rates 100 times faster than at any other time, because there is a door of opportunity. Growth can go at warp speed in every domain of life.
You can learn much that is deep and profound. You do this by interacting and by working together on the meaning of the difficult experience. Those who have the courage to become part of the trauma tribe, to experience and share their pain, or to help them overcome their pain, also have the opportunity to share their growth.
Everyone who goes through this process ends up better, stronger, smarter, deeper, and more connected. They would say so and everyone who comes in contact with them recognizes the change. It is like having a broken bone. If it heals properly, it is stronger in the spot where it fractured than it was before the injury.
Traumatic experiences are broken bones of the soul. If you engage in the process of recovery, you get stronger. If you don’t, the bones remain porous, with permanent holes inside, and you are considerably weaker.
In this stage of recovery, you reintegrate your self and your values in a new way. You incorporate meaning in your life. You integrate deeper and more authentic ways of communicating.
People at this stage may experience a new sense of the preciousness of life, a clarification of goals and renewed commitment to them, and new understanding of the value of ties to others. But to get to stage four you have to go through the first three stages.