What Techniques Help Patients Deal With Trauma?

Trauma is one of those terms that many people hear—on television, on social media, in conversations amongst friends and coworkers—yet very few have an accurate understanding of what trauma really is. Simply put, trauma occurs when an overwhelming event happens that causes a person to experience tremendous distress. This distress then affects the person's experience of their everyday life in school, work, everyday activities, and in their relationships. In some situations, trauma may occur multiple times in a person's life, and sadly, a person may experience being 're-traumatized.' Therapy can be exceptionally helpful in teaching a person to understand their trauma—gaining the understanding that awareness allows for change. When we achieve awareness as to our trauma, that's when positive change can happen.

Trauma-Focused Cognitive-Behavioral Therapy offers various techniques; my favorite being helping a person to understand the connection between emotions, cognitions, and behaviors. A TF-CBT clinician will help a person to identify negative thoughts and emotions that lead to patterns of negative behaviors that occur as a result of the trauma(s). This helps a person to feel empowered to understand themselves and to make consistent changes that interrupt dysfunctional patterns so that the person can experience a greater sense of calm and well-being.

Although there are many evidence-based trauma therapies that are effective in reducing the impact of trauma, I believe that before a person dives into their trauma, the therapeutic space needs to feel safe. Safety looks different for everyone, but my first step when working with clients to hopefully reduce the likelihood of retraumatization is cultivating a safe therapeutic space where they feel comfortable enough to share their trauma. Cultivating safety may look like validating one's lived experiences, making them feel heard, or teaching clients coping skills to regulate their nervous system.

Additionally, I tell my clients I will never force them to talk about an aspect of their trauma that they are not ready to discuss, as forcing someone to discuss trauma too early reduces their feelings of safety and may increase the risk of retraumatizing them.

In the field of psychology, there isn't a single technique universally applied to help patients cope with trauma; instead, approaches tend to be highly tailored to each individual client. However, key components often include prioritizing safety, which entails establishing a secure environment for clients to engage with their emotions, and emphasizing transparency. Therapists should maintain honesty and openness in their sessions, fostering trust that is essential for effective therapeutic work.

One technique I often employ to assist patients with trauma without retraumatizing them is gradual exposure therapy. This involves introducing the traumatic memories or situations in a controlled and incremental manner, allowing individuals to confront their fears at a pace they can manage. Through this approach, we work collaboratively to establish a hierarchy of triggers or distressing memories, starting with those that are least distressing and progressively moving towards more challenging ones. Building resilience through cognitive restructuring techniques also plays a significant role, helping individuals reframe negative thought patterns and develop a sense of mastery over their trauma-related symptoms.

One of the key techniques that I like to use with clients who have experienced trauma is first to help them with emotional and nervous system regulation through grounding techniques, such as progressive muscle relaxation. Since trauma can dysregulate the autonomic nervous system, leading to a constant state of 'fight or flight' in clients, progressive muscle relaxation can be a technique that helps activate the parasympathetic nervous system, which is responsible for relaxation, helping to counteract the physiological arousal associated with trauma. By focusing first on techniques like progressive muscle relaxation before diving into specifics around the client's trauma, one can create a safe space for them to work on trauma with minimal risk of retraumatization.

The most crucial aspect of processing trauma is ensuring the client's nervous system can handle the traumatic material without becoming overwhelmed or shutting down. The initial step in this process is to develop resources that enable the client to regulate their nervous system activation level. For instance, if they are feeling highly anxious or, conversely, numbed out, we will have a set of established tools to help them manage their stress response. It's a delicate balancing act; I aim for enough activation to metabolize the traumatic material but not so much that it becomes unmanageable.

During processing, one of my go-to interventions is titration. During this process, I guide the client to mindfully access a fragment of the traumatic material for a brief moment, then shift their focus to something positive or neutral. This approach allows the client to 'dip a toe' into the traumatic material without becoming overwhelmed. My ultimate goal is for the client to feel in control throughout the entire process.