Stages of Trauma Recovery
In my last post, I talked about what makes an event traumatic. Remember, this could be one big event, or it could be a period of events that wear the person down, such as prolonged abuse or neglect. As a trauma therapist, I find the recovery process is just as important to understand as being able to identify the trauma. After all, it’s not enough for a doctor to be able to diagnose your symptoms; they have the knowledge for what your recovery can look like with proper treatment.
In her book Trauma and Recovery (2015), Judith Herman lays out three stages of recovery from the effects of trauma. These stages are not necessarily in order for everyone, and people can find themselves in any of the stages at any time. However, I do find using them as a general guide to be helpful in my practice. The stages are: Establishing Safety, Remembering and Mourning, and Reconnection.
Establishing Safety
This stage of recovery is important to calm the nervous system down enough to begin working. In crisis work, basic needs like food, shelter, and safety are placed at the top priority. If someone comes in to an emergency room after a car accident, the first thing a medical team will do is to assess for and stabilize any life-threatening aspects of the patient’s condition. The patient might even have cancer, but if they are bleeding out, cancer treatment won’t help them. The patient will need to be in a stable condition before moving forward with potentially deeper work.
In therapy, people often come when they are in an emotional crisis, usually after an event that signals to them it’s time to get some help. After I assess for basic needs including safety, I start to look at where my client may be emotionally “bleeding out.” Where do they hurt this badly, and how can we work together to get their feet under them for a bit? Establishing safety in therapy focuses on two things: 1) building a relationship of trust between myself and the client, and providing a place for them to feel safe, and 2) helping the client establish safety for themselves outside of session. The first task is through a lot of preparation on my part, including making sure my space is calm and my mental state can be stable and steady as people share their stories with me. I ask for feedback and do check-ins during every session to see how my clients are responding to what we are doing in the moment. The second task is collaborative. We look at self-care and how we can put some new tools in place. I teach breathing techniques, visualization exercises, and provide information about the nervous system and how it works. We decide what it might be wise to take a break from, even for a time to let the nervous system even out for a bit. After all, it would be hard to recover from a car accident if someone keeps going back into the burning car. The goal for this period is to help your nervous system reach a point where you can start sharing what has happened to you without it becoming too overwhelming. It won’t take all of the pain away, but it will make it so you can move through the next stage, Remembering and Mourning.
Remembering and Mourning
This stage of therapy is really important if your trauma keeps popping up in your life. Once you have established safety in yourself and your environment, we begin to process what has happened to you. Some therapists want to hear all of the details of everything in your memories, while others prefer to have you focus on your internal state and body experiences as you remember. This stage can feel overwhelming at times, and might even include all the phases of grief (denial, depression, bargaining, anger, acceptance) about what has happened to you. However, we pull in the tools from the establishing safety phase to keep you engaged enough to process without it overloading your nervous system. If we need to, we can always take a break, learn more tools, and come back to it when you are ready.
There are a couple of key things that happen in therapy to help you process trauma. The first is having someone with you who can be steady while validating your pain. This creates new connections to the part of your brain that senses love and belonging. It tells your brain “You are not alone in this, I am here with you.” Tools like using sound, eye movement, or body movement can keep your senses grounded in the presence enough to keep you from getting totally overwhelmed as you share what has happened to you. When you can face your past without it overwhelming you, you get to decide what you would like to do with it moving forward. This results in moving from a state of fear of the event happening again, to a state of wisdom, where you take what you have learned from the experience into the future. This is where the next phase comes in: Reconnection.
Reconnection
Trauma takes something away from us. It might be a sense of safety, connection with others, or love for the self. The reconnection phase does not mean necessarily reconnecting with people who have harmed you. Instead, we take a look at what was lost in the trauma, and what would you like as you move forward. For some, this means reconnecting with their ability to love themselves, to establish boundaries, and to forgive themselves if they had a part to play in their trauma. For some, it means braving the vulnerability of loving other people genuinely, knowing it might hurt someday but they will get through it. For others, it might mean engaging in advocacy work to prevent similar trauma from happening again, or helping others who have similar experiences. Reconnection can be a lifelong process, where we bravely connect with our mind, body, and soul as we move forward in the world.
One aspect of reconnection I would note is that this is often where the good-intentioned people in our lives want us to start after a traumatic experience. Phrases like “it happened for a reason” and “forgive them, it will set you free” often result in bypassing pain or minimizing the trauma. However, I find people who move through the first two stages are able to connect with concepts like forgiveness and purpose on their own during the third stage. It’s incredible to watch people genuinely forgive (and decide if they want to restore the relationship, because those are two very different things), find purpose and meaning in their past, and love others wisely. Bypassing, especially spiritually, keeps people stuck in their past and in disconnection. However, taking the time to recover well and not rushing the process will often enable people to live in the freedom that we think of with these concepts.
Trauma recovery is not always a linear process. At times you may have to move back into establishing safety, you might reconnect early with pieces that were lost, and memories might come up long after you thought you were done remembering and mourning. However, when you have people in your life who support you, it becomes much easier to face your past.
