I work with clients that have experienced trauma in their lives. Trauma Therapy is not always quick or easy, but if done safely, can help a client to feel safer and more stable, help in processing and resolving trauma memories and feel more integrated in daily life.
Trauma is deeply disturbing event(s) that infringes upon an individual’s sense of control and may reduce their capacity to integrate the situation or circumstances into their current reality. When most people think about trauma, they tend to think about what we refer to as big "T" traumas which could be exposure to war, combat, natural disasters, physical or sexual abuse, terrorism, and catastrophic accidents. However, a person does not have to undergo an overtly distressing event for it to affect them. An accumulation of smaller “everyday” or less pronounced events, referred to as small "t" traumas, can still be traumatic. This can make day-to-day functioning difficult and interfere with the ability to feel safe and content.
Trauma can develop into Post Traumatic Stress Disorder (PTSD) which results (according to Babette Rothchild - a trauma specialist, trainer and author), "in large part, from loss of the ability to recognise the present as different from the past. It is primarily charactherised by intrusive memories in the form of images (visual, auditory) and distressing body sensations that are reminders of overwhelming, life-and-limb threatening events. These unbidden memories can be so intense (flashbacks) that they can fool the mind and nervous system into believing that the past event is essentially happening again in the present".
Symptoms of trauma
Potentially, traumatic events can be caused by a singular occasion, or from ongoing, relentless stresses. A potentially traumatic event is more prone to leave an individual with longer-lasting emotional and psychological trauma if:
Potentially traumatic events are defined as events that are both powerful and upsetting that intrude into the daily life of the person. Generally speaking, potentially traumatic events involve major threat to one’s psychological and physical well-being. Potentially traumatic events may be life-threatening; to one’s own life or the life of a loved one. These events may have very little impact on one individual but can lead to significant distress in another. The impact of a potentially traumatic event may be related to the mental and physical health of the person, past traumatic experiences, presence of coping skills, and level of social and emotional support at the time of the potentially traumatic event.
Examples of events and situations that can lead to the development of psychological trauma may include:
Commonly overlooked causes of potential emotional and psychological trauma can also include:
Treatment of trauma
Trauma treatment must first and foremost be conducted safely and there is no quick fix. All good trauma therapy should consists of the following phases (based on Pierre Janet's phase oriented structure):
Phase 1: Establishing safety and stabilisation. This can take one session, several sessions or could take much longer. This is the foundation of all good trauma therapy. A client must be able to feel safe and robust enough to cope in daily life. This phase includes establishing daily coping strategies and resources (including mindfulness, stress management, self-care, relaxation tools and grounding), and enlisting a good support network. If this is not done adequately, the client will be unable to cope when the processing of trauma memories take place and could destablise or re-traumatise and the client can get much worse, not better. Some clients only complete this phase of trauma therapy and that is okay. If a client is not willing or ready to face the traumatic memories, the goal of therapy could simply be to feel safer and have more self-control in how they manage day to day.
Phase 2: Involves processing and resolution of trauma memories. I tend to suggest we use EMDR (please click to read more) to work within this phase. This can only take place once a client is stable and resilient enough to tolerate the work, because there will be some challenges doing memory processing, and a client can feel destabilised for a while. Having adequate tools to cope with this is essential and often is overlooked in short-term trauma therapy. For this reason, I prefer to work open-ended with clients to ensure phase 1 is achieved fully before entering phase 2. The aim of phase 2 is to change the effect the past continues to have on the client now and in the future.
Phase 3: Focus on integration, that is, applying what was gained from phase 1 and 2 into the mainstream of daily life. This includes making meaning and applying the learning from the previous phases to leave the trauma in the past and to make a better future.
In addition to my core counselling training, I have done further trauma training. This training includes but is not limited to:
Introductory Certificate in Trauma Therapy (Wealden Institute - Joanna Beazley Richard)
Foundation for the Introductory Certificate in Trauma Therapy
Severe and Complex Trauma and Dissociation
Treating Traumatised Children
Attachment, Attachment Disorder, Trauma and Recovery
NICABM - Treating Trauma Master Series
Online training for therapists on the latest development on trauma by the world's most renowned trauma experts.
EMDR (Eye Movement Desensitisation and Reprocessing) - See more information by clicking here.