The Truth About Trauma Therapy

Trauma therapy, also known as trauma-focused therapy, has its roots in the mid-20th century when mental health professionals started recognising the profound impact of traumatic experiences on individuals' psychological well-being.

Early pioneers like Sigmund Freud and Pierre Janet laid the foundation by exploring the effects of traumatic events on the human psyche. Freud's theories on psychoanalysis highlighted the significance of unresolved trauma in the development of various mental disorders.

However, it was not until the 20th century's latter half that trauma therapy began to evolve as a specialised field. The identification of post-traumatic stress disorder (PTSD) diagnosis after World War II provided a framework for understanding trauma's enduring effects. In the 1970s, Vietnam War veterans' experiences further emphasized the need for targeted therapeutic interventions.

Traditional models of trauma therapy involve the intentional triggering of traumatic memories & content, with the goal of assisting in processing & integrating of those memories. By nature, trauma therapy is triggering. It involves discussing highly distressing experiences over & over again.

More modern forms of trauma-focused therapy may use different techniques to trigger & work with trauma memories, but they share the core focus of treatment as exploring past trauma.

This brings us to a common problems with trauma therapy & why caution should be exercised when deciding on the right treatment for you or your loved one.

Here is a summary of the 3 most common problems people can find when engaging in trauma- focused therapy:

Problem 1: Sessions are highly distressing & unpleasant.

If therapy sessions are highly distressing & unpleasant, many people will simply stop going. This makes sense! Why would anyone repeatedly do something that makes them feel terrible?!?

In the worst cases, people can find therapy sessions so distressing that they find themselves engaging in MORE problem behaviours to deal with the increased distressed, for example drug/ alcohol abuse; self harm; isolating from others.

Therapy is not always nice or enjoyable, but it should not leave you feeling worse every time you go! If you find yourself wanting to drop out of therapy because it's so upsetting, you may want to consider a different therapeutic approach where trauma is not the focus of treatment.

Problem 2: Increased problem behaviours following sessions.

The 'therapeutic window' is a term used to describe the ideal target for effective therapeutic processing. Too little activation of distressing content means people may not make effective gains. Too much activation of distressing content can lead to increase in problem behaviours &/or dropping out of therapy.

For some people, just coming into therapy can be activating & distressing enough, without even talking about traumatic memories.

This is especially the case for people who have experienced complex trauma (eg. childhood trauma & multiple traumas of an interpersonal nature). Interpersonal trauma is when someone is hurt by someone they are close to & trust. This type of trauma is often triggered in relationships with others, & can often also be triggered in therapeutic relationships.

If you find you are engaging in more problem behaviours following sessions, consider switching to another model of therapy with focus on building emotion regulation & distress tolerance skills (such as dialectical behavioural therapy).

Problem 3: Misaligned goals

Some people come to therapy with the goal of making day-to-day life better, including emotion management, relationships & functioning. Processing & integrating past trauma may not be high on someone's priority list, which is completely understandable.

If this is the case, it doesn't make sense to jump into trauma- focused therapy (& it could even be harmful). Instead, it may be more suitable to choose a therapy that focuses on improving quality of life rather than past trauma.

Try This Instead...

If you have tried trauma therapy before & found you experienced any of the above problems, that's a good indication that you should try a different approach.

Likewise, if you relate to the above problems, try an alternative form of therapy BEFORE you try trauma-focused therapy. It is much safer to delay trauma-focused therapy until other psychological skills can be established & grown.

Try a therapy model that focuses on the following:

- Increasing distress tolerance

- Improving emotion regulation skills

- Improving relationship skills

- Improving your relationship with yourself

- Building acceptance skills

Dialectical behavioural therapy focuses on all these areas, plus more. If you would like more info about DBT, drop us a line at Mindful Recovery Services & we'd be happy to chat more about whether DBT might be a good fit for you:)

Alex.