In this article, I discuss one of the most important and most overlooked ways to heal from a traumatic event—noticing specific signs of healing.
For some of the clients I see in my work as a Calgary psychologist and a Cochrane psychologist, their main concern is negative events from their pasts. Examples include being exposed to physical, verbal, emotional and sexual abuse along with bullying and experiencing or witnessing a traumatic event like a robbery or a car accident. My work in trauma counselling (or post-traumatic stress disorder counselling) to address the impact of these events often focuses on helping my clients talk about these events to lessen the intensity of their emotional impact and develop more favourable thoughts about themselves in relation to the events.
However, as important as this ‘processing’ of the events themselves can be in helping the person to heal from their negative effects, I’ve also found healing to be facilitated by a different strategy. This strategy focuses on the client’s present and future in order to lessen the negative impact of an event from their past. It involves helping the client track signs of healing from the negative impact of the event. Please note that this strategy may be a helpful one for you to use in addressing many issues including those in depression counselling, anxiety counselling, anger management counselling, self-esteem counselling, eating disorders counselling, addiction counselling and stress management counselling.
Why tracking signs of healing is important
When someone experiences or witnesses a traumatic event, there is typically a double-barreled negative effect. First, the event will usually result in the person experiencing negative emotions and negative thoughts or beliefs at the time of the event and, in some instances, long after. For example, someone who has been sexually abused may experience emotions such as anxiety and shame and have thoughts such as ‘I am worthless’, ‘I’m not safe’ and ‘People can’t be trusted’. The second part of the double-barreled negative effect of a traumatic event is the individual’s belief that the event not only impacted on them negatively at the time, but is continuing to do so and will interfere with their life indefinitely.
Tracking signs of healing can help the person address this second part of the double-barreled negative impact of the event. That is, by tracking signs of healing the person can move toward the view that, despite the negative impact of the event on them at the time it occurred, it is no longer interfering with their life in significant ways. This shift in belief can often be a critical factor leading the person to be able to put the event in their past while they move forward with their life.
An example of the benefits of tracking signs of healing—sexual abuse
I became aware of the importance of tracking signs of healing thanks to the work of renowned therapist Yvonne Dolan. In her book, Resolving Sexual Abuse, Ms. Dolan states that early in therapy she invites clients to notice specific signs of healing from the sexual abuse they have suffered. She says doing so helps instill a sense of hope and optimism in her clients. Specific signs of healing appear in a questionnaire in her book which Dolan created based on her experience working with many clients who have been victims of sexual abuse. It is called the ‘solution-focused recovery scale for survivors of sexual abuse’. The client is asked to rate the extent to which they have achieved each of the specific signs of healing using the response format ‘not at all,’ ‘just a little’ ‘pretty much’ and ‘very much’. The items include signs of healing such as ‘able to think and talk about the trauma,’ ‘able to think and talk about things other than the trauma’, ‘engages in social activities outside the home’ and ‘enjoys lovemaking’.
Like Ms. Dolan, I have found that my clients experience a significant improvement in their outlook and mood following the completion of the scale. Many of them remark that they had not realized they had made such progress in healing until they tracked their healing by using the items on the scale. Clients are typically so uplifted by completing the scale that they look forward to between-session homework in which they are asked to notice continued signs of healing.
Tracking signs of healing from other traumatic events
The same benefits of tracking signs of healing from sexual abuse occur for clients who have suffered other types of traumatic events. When working with these clients, I adapt Dolan’s solution-focused recovery scale for sexual abuse to each client’s particular trauma. In doing so, I first work with the client to identify items from Dolan’s scale which would constitute signs of healing for the client from his or her traumatic event. Such healing signs which typically cut across various forms of trauma include ‘able to think and talk about the trauma’, ‘able to think and talk about things other than the trauma’ and ‘goes to work’. We then add items to the scale which are specific signs of healing for this client from his or her trauma. For example, if the client’s traumatic event was a car accident, we might add an item such as, ‘able to drive on the freeway’.
How tracking signs of healing fits in with counselling for healing from traumatic events
I help my clients notice and track their signs of healing throughout their time in counselling with me. It is one of the best indicators of their progress. Accompanying this tracking during therapy will often be work on ‘processing the trauma’ in which the client will, at their own pace, be encouraged to express in words and emotions the details of their traumatic experience. Although this processing work is not easy, if done consistently and with proper pacing it will lead the client to address the first part of the double-barreled negative effect of the traumatic event to which I previously alluded. That is, discussing the event and experiencing the emotions related to it will help the client reduce the intensity of the negative emotions he or she experiences when thinking about or discussing event. With the help of a skilled therapist, doing so will also help the client gradually change the negative thoughts and beliefs he or she experiences when thinking about or discussing the event. Tracking signs of healing can help the client recognize that the difficult work they are doing by processing the event is paying off in helping them achieve specific signs of healing from the event.
How to get started on tracking your signs of healing
The first step in tracking your signs of healing is to come up with a list of several specific ways in which a person who has suffered from your kind of traumatic event would be expected to heal. A good method of thinking of these signs of healing is to first think of the specific ways the event would be expected to impact negatively on the person. For example, if you first consider that someone who has been bullied would be expected to suffer low self-esteem as a result, then ‘having a positive view of oneself’ could be listed as a sign of healing from this event. As I mentioned, many of the signs of healing listed on Dolan’s scale for recovery from sexual abuse may apply to other types of trauma including perhaps the one you may be addressing.
Once you have listed several specific signs of healing, list the degree to which you have healed using the scale I discussed. Then take time to reflect on what you’ve learned from your responses. If the experience with my clients is an indicator, you should be pleasantly surprised by what you learn. You should then monitor on a regular basis (weekly or biweekly is fine) your progress on healing for each item on your scale. Sometimes you can even set goals to ‘move up the scale’ on certain items by working to achieve the sign of healing related to that item. For example, if ‘able to look friends in the eye’ is a sign of healing which you are tracking and you rated yourself, ‘just a little’ on this item, you could set a goal to look friends in the eye more frequently over the next week.
Do not hesitate to work with a psychologist or other therapist to help you track your signs of healing. Not only can they help you with this task, they will also be invaluable in helping you process the events from which you are attempting to heal. Tracking your signs of healing along with processing the events should result in your experiencing a ‘double-barreled positive effect’ of your work in counselling.
May you get your healing on the right track,
-Dr. Pat
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