Trauma Therapy

I think there was a thread about this a while back, so sorry if I'm recycling an old subject.

I was wondering what Trauma Therapy is about. Is it, in some cases, a matter of seeking out a therapist who lists as one of their specialties trauma because this is something you mostly struggle with? Or in other cases, do you really want the focus of your therapy to be almost exclusively trauma?

I've been curious about this, because I feel like if it were me, I would feel 'pressure' to only talk about trauma. This is in part why I ask, because it's my impression, but I imagine the reality is different.

I've certainly talked about past trauma with my therapist. But, for better or worse, I tend to only touch on it relatively briefly here and there, and then circle back to it at a later date, usually if something going on in my life has reminded me of it/if it's affecting me a great deal at a certain point in time. Though often times when I go through very bad periods like this, we will talk about what is going on now, even though we both know that this is about past stuff. I guess I prefer to keep the causes in the background. At least for now...

So, for me, really small doses -I don't think I could, or would want, to do it any other way.

So what is trauma therapy? Do you talk about other things? Do you feel pressured to talk about trauma most of the time? What do you do once you feel like you've worked through the trauma -I mean at that point do you need to look for a new therapist, or can your trauma therapist make that transition with you to beyond trauma?

And what do -all of you- think are the differences between talking about trauma with a non-specialist (or not as the focus of therapy) versus what it would be like to talk about it in the context of trauma therapy?

When you're in trauma therapy, do you feel it helps you with other (maybe unrelated) issues you have? Or do you feel that in working through the trauma, it will necessarily help you with other issues?

As usual, lots of questions!!

Thanks!

Personally I am in therapy with someone who knows about / has experience with trauma but am not focusing solely on that. Small doses, like you. We talk about whatever comes up. I wouldn't want to work on trauma and only trauma and then have to change T.

For me personally, it's important to be with a T who is willing to work on trust rupture and repair over and over and over. I'm never going to just trust him, end of, as I have complex PTSD and I need him to go round in circles with me. It's also important for me to feel he can handle anything and not freak out.

So I'm not specifically in trauma therapy and that works for me.

It sounds like he's a good fit for you. Thanks for your reply!

I guess I think of it more as "Difficulty" therapy? One generally decides to go to therapy because whatever they're doing now isn't working for them. In therapy, depending on the approach, one may learn that most of "now" has roots in "then" when there was difficulty or trauma that was not adequately addressed. Some therapies stick with "now" and what one is thinking or doing now and go with that, not paying a whole lot of attention to feelings and where they may have come from.

I think trauma therapy is part of the former, now-has-roots-in-then (NHRIT :-) types of therapy but one cannot just talk about "then" all the time or getting to what's going wrong now will take too much time? I guess I think of the various traumas as gashes in one's hide and therapy goes back and forth in time stitching them up (after cleaning them well, of course)?

I'm interested to know this too.

I've had a lot of past trauma, and I've also seen therapist's who specialized in trauma and those who don't. What I've found is that the therapists who did not have a lot of training in dealing with trauma didn't know how to help me, and some of them even made things a lot worse. I no longer feel comfortable going to a therapist who doesn't specialize in dealing with trauma. I've been told by my current T that working with trauma is very complex and I agree. If I just look at the variety and complexity of my own issues and what we deal with in there, training in that is a must for me. Does that mean all we talk about is trauma? Absolutely not. We have barely gotten into specifics in 5 years. I think she has a general idea what's happened and we have talked about specifics as needed. But we talk about whatever comes up. We work a lot on fears and trust and relationships. We talk about whatever day to day problems I'm having. But when I'm being triggered a lot by something in the past, we can focus on that as much as I need to as well. Generally what happens is I will work on connecting and relationships and my fear of abandonment in the here and now for awhile...I'll specifically focus on something like calling someone when I need help, or sharing a feeling with a friend, or something like that. It will trigger past experiences and feelings. We'll talk about those feelings, and if I need to, the experiences. That will settle down the triggers and memories, and I'll try again to work on something specific in the here and now. For me, it's a lot of revisiting and working on the same core issues in lots of different ways, and the best way for me to deal with them is to focus on how they are playing out in the here and now, and work on any connection to my past that comes up with it and doesn't shift. We don't just focus on the trauma...it's more about working on the effects of the trauma. That does for me involve some telling what happened, but that's not the majority of my work. Hopefully that makes sense.

One way to look at is that all therapy is actually trauma therapy. If we were to look deep enough, we would find that trauma is behind most if not everything that is a concern in therapy. Trauma therapy includes understanding how trauma has affected you and made you who you are, but not faster than you are ready, so for someone beginning trauma therapy, the focus should be on establishing safety and security, and should be at your own pace. Only after you feel safe can you deal directly with the trauma. After addressing trauma, you still need to be able to reconnect and live in the present, which is also part of trauma therapy. These three stages are actually pretty general and your needs will probably jump back and forth from one to another and back again, and that is normal and expected. There are a lot of different ways to do trauma therapy.

I do feel like talking about the trauma has helped me with other issues, because a lot of my issues now stem from the messages and beliefs I internalized because of the trauma then. Working through the trauma is allowing me to try to change some of those belief systems and hence is allowing me to change my life now. I have certainly tried to make changes now and avoid anything from the past, but that didn't work for me. Talking about trauma gives it less power over me too. It's "out there" instead of something I'm hiding. Sorry for the long posts. These are great questions and ones I've thought a lot about. I told my T on friday for the 5385953312765th time that I don't want to talk about what's happened, but this thread is making me realize why I need to.

I've never encountered therapy for trauma that was its own distinct method different from other kinds of therapy, so I kind of assume many different therapy modalities can be used to work with trauma issues.

My current T does a remarkable job with trauma, but he doesn't refer to himself as a "trauma specialist"; not sure what that would mean. Is there some kind of special certification for such? Not that I've ever heard of anyway.

His approach is to as much as possible start from wherever I am right now. We delve into history/trauma as it becomes apparent that the here and now and the then and there are connected.

The one thing he strongly believes is that working through those old traumas should not be retraumatizing. If it is, he doesn't believe he is doing his job right because he does not ever want to serve the purpose of causing me more harm. I have suffered enough. He is very attuned to my responses/reactions/dissociation, etc. and is very careful to not take me past a point that I can tolerate. If he sees I'm getting beyond that point, his focus shifts to helping me feel safe and present and grounded.

He says there was/and still is a theory of thought that a patient had to re-experience/relive the old traumas over and over again in the therapy room to recover from them. He personally and professionally feels that to be dangerous and more harmful than helpful in most cases, and he refuses to take that approach (thank goodness).

If and when we do delve into the memories, it is in very small doses, always with the constant reassurance that I am safe and in the here and now, always with the goal that I remain entirely present in the room and the process, and always with the goal that looking at the past only serves the purpose of understanding myself in the here and now. I don't have to go back there and get lost in my past. I've done enough of that all my life already.

How has his approach worked? Well, for the most part, I really do find that my past is just a string of memories now, and I can think and talk about those memories now if need be without them being too terribly upsetting. They don't drive my life like they used to. I still hold a PTSD diagnosis, but the symptoms very rarely come into play anymore. Where I used to have nearly constant flashbacks, I rarely have one now and it takes a really huge current trauma to bring one on. Where I used to almost live in a constant state of dissociation, I rarely dissociate now and when I do it is not nearly to the degree I used to.

I've been in therapy for 2 years. 6 months with my current t but we talk mostly about the here and now. the 1 1/2years with xT...the highlighted above is what I really needed (didn't know how to put that in words)... is there a term for that ?

Lots of good questions.

I *think* I am in trauma-focused therapy with a therapist who has a decent amount of training beyond T-school with trauma, and 30 years of experience working with trauma survivors. He specializes in trauma and a few other things.

I personally would not see a T who did not have training and experience in trauma. I don't have some litmus test or amount of training or experience fixed in my head, though, and I wouldn't care if they listed it as one of their specialties or not.

But I don't necessarily talk about trauma, as in details of experiences or their dynamics or the specific aftereffects that connect the dots from my traumatic background, very often. My T does not direct me to speak about trauma, or anything else. He is very nondirective-- and he is also a believer of the theory that therapists should not impose their agendas on clients in terms of trauma or anything else. So he doesn't say, for example, "let's explore more that time that you dad did ___." He thinks of it as important not to be "coercive" about sharing details of trauma, although he emphasizes repeatedly that he's willing and able to hear whatever I tell him.

I don't know if there's an official term, trust repair maybe.

I imagine trauma therapy may be a short term form, done straight after a traumatic event...!?!

some people's traumatic events went on for years. Years.

Not really. My initial trauma was about about age 5, but I didn't begin working with it at all until I was 35 (and only a wee bit then). The serious work with that trauma didn't start until about 6 years ago which would have been age 43-ish.

I think this is one form of trauma therapy, most common as an intervention soon after any traumatic experience.

But most people have the experience of trauma manifesting many years later in other areas of their lives. I think many therapy modalities can address trauma--while there may be some general principles common to all trauma, there's no magic formula for dealing with its consequences because everyone's experience is different.

I think it's more likely that there are some Ts who choose to focus on modalities that do not address trauma, and I would hope that they are up-front about that, or refer out clients who need to process trauma.

My trauma = the first 25 years of my life.

A therapist specializing or trained in trauma therapy is just that. They have a different skill set that they can use to help you when you do discuss your trauma. The therapist I see is a trauma therapist, trained in EMDR but is also a marriage/couples counselor and does general, individual therapy.

The benefit I see from this type of therapist is that I can talk to him about non-trauma stuff, my marriage, and past traumas, and he can (and has) handled all of it very well. Trauma specialists are trained in helping the client remain safe when they have extensive flashbacks, triggers, dissociation, or other issues related to their trauma that come up in therapy.

I definitely do not talk about my trauma all the time...there have been many sessions in a row where I talked about nothing but my marriage. Then there are times when I do focus on my trauma. It all depends on what I feel like talking about that day.