Phases of Trauma Recovery
“The first goal of trauma recovery should and must be to improve your quality of life on a daily basis” (Rothschild, 2010)
For an overview of the recovery process please view the video below:
Recovery is the primary goal for people who have experienced trauma, their families, and their care providers. Recovery does not necessarily mean complete freedom from post-traumatic affects. Recovery is an individual experience and will be and look different for everyone. In general recovery is the ability to live in the present without being overwhelmed by the thoughts and feelings of the past.
Central to the experience of trauma is helplessness, isolation and the loss of power and control. The guiding principles of trauma recovery are the restoration of safety and empowerment. Recovery does not necessarily mean complete freedom from post traumatic affects but generally it is the ability to live in the present without being overwhelmed by the thoughts and feelings of the past.
There is a vigorous debate in the field of traumatic stress as to whether revisiting traumatic memories is necessary for healing or whether it may in fact even be harmful. Obviously this is an individual matter; many may find it beneficial to tell and retell their experiences of trauma where others may find that destructive to their well being.
Trauma recovery is best to be looked upon as a process that is worked on over time and in intentional stages. The re-establishing of safety is the first and most central step in recovery separate and apart from whether the details of the trauma are ever spoken of or not.
Dr. Pierre Janet conceived of a phased framework of trauma recovery in the late 1800’s with Dr. Judith Herman making it more readily known in her seminal work, Trauma and Recovery (1992).
Phase I
Safety and Stabilization
People affected by trauma tend to feel unsafe in their bodies and in their relationships with others. Regaining a sense of safety may take days to weeks with acutely traumatized individuals or months to years with individuals who have experienced ongoing/chronic abuse. Figuring out what areas of life need to be stabilized and how that will be accomplished will be helpful in moving toward recovery. For example:
- A person who has experienced trauma may struggle with regulating or soothing difficult emotions in everyday life which they might not associate directly to the trauma.
- Learning how to regulate and manage these difficult/overwhelming emotions.
- Some people who experienced trauma, particularly complex trauma, may find that speaking about their experiences emotionally overwhelming. Recently, both therapists and researchers have been exploring nonverbal ways to foster emotional regulation. Several studies have suggested that Mindfulness Based Stress Reduction (MBSR) groups and the use of acupuncture for clients with Post-Traumatic Stress Disorder (PTSD) reduces negative emotions and promotes a more calm appraisal of life situations (Hollifield, 2007 and Davidson et al, 2003). There are other types of self soothing practices such as meditation, deep breathing yoga, Chi Qong as well as other spiritual and cultural practices and ceremonies that have been shown to be effective in soothing the nervous system. Refer to the topic on Mindfulness and other related topic areas. These practices work well with more traditional talk therapies allowing greater stability throughout recovery. Auricular Acupuncture has the added advantage of reducing cravings for alcohol and drugs as well as promoting better sleep and clearer thinking among clients who receive it regularly (Stuyt, 2005). It is also well suited for supporting work with refugees and immigrants in that it is nonverbal and closer to the methods of traditional medicines found in a variety of cultures.
Metaphor for creating safety:
The experience of emotional overwhelm is similar to that of a shaken bottle of soda. Inside the bottle is a tremendous amount of pressure. The safest way to release the pressure is to open and close the cap in a slow, cautious and intentional manner so as to prevent an explosion. (Rothschild, 2010)
Phase II
Remembrance and Mourning
This task shifts to processing the trauma, putting words and emotions to it and making meaning of it. This process is usually undertaken with a counselor or therapist in group and/or individual therapy. It might not be necessary or required to spend a lot of time in this phase. It is however necessary to be continuing to attend to safety and stability during this phase. Attending to safety allows the persona affected by trauma to move through this phase in a way that integrates the story of the trauma rather than reacts to it in a fight, flight or freeze response.
Pacing and timing are crucial during this phase. If the person affected by trauma becomes quickly overwhelmed and emotionally flooded when talking about their trauma memories, safety and stability must be regained before moving further on with the story. The point is not to “re-live” the trauma but nor is it to tell the story with no emotions attached.
This phase involves the important task of exploring and mourning the losses associated with the trauma and providing space to grieve and express their emotions.
Phase III
Reconnection and Integration
In this phase there must now be a creation a new sense of self and a new future. This final task involves redefining oneself in the context of meaningful relationships. Through this process, the trauma no longer is a defining and organizing principle is someone’s life. The trauma becomes integrated into their life story but is not the only story that defines them.
In this third stage of recovery, the person affected by trauma recognizes the impact of the victimization but are now ready to take concrete steps towards empowerment and self determined living.
In some instances, people who have experienc ed trauma find a mission through which they can continue to heal and grow, such as talking to youth, or peer mentoring. Successful resolution of the effects of trauma is a powerful testament to the resiliency of the human spirit.
Recovery is an individual process and will look different for everyone. There is an intense desire to feel well quickly and individuals can feel that the process is taking too long or they are not doing it “right”. Recovery is not defined by complete absence of thoughts or feelings about the traumatic experience but being able to live with it in a way that it isn’t in control of your life. It is important to gentle, patient and compassionate with yourself as you move through this healing process.
