Traumatic events such as abuse not only have a devastating effect on a person at the time of their occurrence, they can also significantly interfere with a person’s enjoyment of life long after. In many instances, the impact of the events is so negative that the person suffers from post-traumatic stress disorder (PTSD). In my work as a Calgary psychologist and a Cochrane psychologist, I follow a research-supported, cognitive-behavioural approach to help my clients heal from traumatic events so that they can put these events in their pasts and start living enjoyable lives. Some of the traumatic events I have helped my clients to heal from include abuse (physical, sexual, emotional), bullying, car accidents, and assaults. Strategies I employ in trauma counselling to help my clients heal include the following:
TRACKING SIGNS OF HEALING
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. I help my clients track signs of healing to address this second part of the double-barreled negative impact of the event. That is, by helping my clients track signs of healing they 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 my clients to be able to put the negative events in their pasts while they move forward with their lives.
PROCESSING THE TRAUMA TO FACILITATE HEALING
In addition to helping my clients track their healing, I also help them to ‘process’ their trauma to facilitate healing. In this processing, I encourage my clients to express in words and emotions the details of their traumatic experience at a pace which is gradual and not overwhelming. Although this processing work is not easy, if done consistently and with proper pacing it leads my clients 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 helps my clients reduce the intensity of the negative emotions they experience when thinking about or discussing event. I also help my clients gradually change the negative thoughts and beliefs he or she experiences when thinking about or discussing the event by allowing them to examine the event in proper perspective. Encouraging my clients to track signs of healing helps them recognize that the difficult work they are doing by processing the event is paying off in helping them recover from the event.
OVERCOMING RUMINATION AND AVOIDANCE
Two behaviours which prolong recovery from a traumatic event are rumination and avoidance. Avoidance involves going to great lengths to avoid thinking about or talking about the trauma. Rumination involves ‘beating oneself up’ by going over negative thoughts about the trauma–often negative thoughts about oneself. Although both avoidance and rumination are natural responses to a traumatic event, persisting in these behaviours interferes with healing. I work with my clients to help them decrease and discontinue these unhelpful behaviours. That is, I work with my clients on overcoming avoidance by gradually helping them think about and talk about the traumatic event. I help my clients stop ruminating on the trauma by giving them alternatives to ruminating and by helping them change negative thoughts about themselves and other aspects of the trauma on which they tend to ruminate.
DEALING WITH TRIGGERS OF MEMORIES OF THE TRAUMATIC EVENT
One of the biggest challenges for people suffering from traumatic events is encountering ‘triggers’–people, events and other stimuli which remind them of the traumatic event. These triggers can cause the person to experience the negative emotions and thoughts they experienced at the time of the traumatic event. Being triggered in this manner can significantly interfere with a person’s ability to function effectively at work, in relationships, in recreational activities, and at sleep, to name just a few areas. I help my clients deal with these triggers so that their negative impact decreases. One way I do this is by helping my clients interpret the triggers in a more positive light. That is, I help my clients view triggers as their body and mind’s attempt to heal rather than as a sign that they will never heal. I also help my clients notice when triggers tend to occur and in what settings. This greater predictability helps my clients feel less startled when they encounter triggers. I also help my clients notice differences between the stimuli which triggered their emotional reaction and the stimuli which were present at the time of their trauma. Noticing these differences helps my clients realize that the traumatic events are not recurring when they encounter these stimuli. Finally, by helping my clients think about and talk about their traumas I allow them to take the ‘sting’ out of stimuli reminding them of the negative events as they will have already experienced these events when discussing them in their counselling sessions with me.
USING EMDR AS A TECHNIQUE TO FACILITATE HEALING
I am trained in Eye Movement Desensitization and Reprocessing (EMDR), a technique which was created to help people heal from traumatic events. Although it is not essential in post-traumatic stress disorder counselling to use EMDR to heal from these events, many of my clients in PTSD counselling have found this technique to be a beneficial part of the healing process.