Is It Possible To Heal From Trauma Without Reliving It?

Trauma affects parts of the brain involved in memory, rational thinking, and decision-making. In some cases, these effects may be chronic, leading to a condition called post-traumatic stress disorder, or PTSD. There are several therapies available to help those living with mental health concerns related to trauma and PTSD. These therapies typically involve working through traumatic memories with a therapist trained in a particular approach to therapy. Below, you will find a guide to evidence-based therapies that may help overcome trauma and PTSD, as well as an overview of why it may be necessary to work through trauma.

What is trauma?

Trauma refers to an emotional or psychological response to a deeply distressing event or experience. It is a neurological reaction to a situation that is perceived as overwhelming, threatening, or harmful. Traumatic events can vary widely and may include situations such as physical or sexual abuse, natural disasters, accidents, combat exposure, violence, or the sudden loss of a loved one. This may cause disorders such as post-traumatic stress disorder and acute stress disorder.

How does trauma affect the brain?

Trauma can have profound and lasting effects on the brain and its functioning. When a traumatic event occurs, the brain's threat response system, located in a part of the brain called the amygdala, goes into overdrive, activating the "fight, flight, or freeze" response. This triggers a flood of stress hormones and neurotransmitters, impacting the brain's typical functioning. 

The prefrontal cortex, responsible for rational thinking and emotional control, may become compromised, leading to difficulties in decision-making, impulse control, and emotional control. The hippocampus, involved in memory formation, can also be affected, resulting in fragmented or intrusive memories. 

These alterations in brain functioning can contribute to the development of acute stress disorder (ACD) and posttraumatic stress disorder (PTSD). Thus, many trauma therapies are aimed at “rewiring” the brain so that it may process trauma in less distressing ways. These therapies often involve recalling or working through traumatic memories, which may be necessary for overcoming PTSD and its associated mental health symptoms.

Acute stress disorder

Acute stress disorder, or ASD, is another psychological condition that can occur in the aftermath of a traumatic event. It is similar to PTSD but with a shorter duration, typically lasting from three days to one month following the traumatic event. ASD is commonly diagnosed in those who have experienced or witnessed trauma such as:

• Injury and disease
• Violence or abuse
• Loss
• Combat or political violence
• Natural disaster
• Institutionalization

ASD produces many of the same symptoms as PTSD but typically resolves within a month. However, when trauma occurs, it may be difficult to gauge the length or severity of the effects. Those with acute stress disorder may benefit from seeking trauma therapy to avoid developing PTSD.

Post–traumatic stress disorder (PTSD)

If ASD is not addressed in the aftermath of a traumatic event, individuals may develop post-traumatic stress disorder (PTSD). PTSD is characterized by a number of psychological and physical symptoms including:

• Irritation, agitation, or hostility
• Intrusive thoughts and memories called flashbacks
• Sleep problems, such as nightmares or insomnia
• Anxiety
• Emotional detachment
• Avoidance of certain people, places, or activities
• Negative changes in thinking and mood
• Hyperarousal and reactivity
• Challenges with impulse control
• Self-destructive behavior
• Social isolation

PTSD may develop in situations where a person who experiences a trauma does not receive mental health treatment. In some cases, individuals may fail to anticipate trauma’s effects or underestimate its severity. In others, getting treatment may be difficult due to a lack of resources or cultural stigmas surrounding mental health. Research has found that more than 80% of people who experience ACS after a trauma develop PTSD within six months; thus, it can be important to seek mental health treatment soon after going through a trauma.

Can you overcome trauma without reliving it?

Some therapeutic techniques may help individuals manage ACS and PTSD symptoms without describing their experiences in detail. These techniques may include mindfulness and meditation, somatic therapies, and expressive arts therapies. However, most evidence-based trauma therapies involve revisiting a traumatic memory with the goal of understanding and processing the trauma. 

Due to the way trauma impacts the brain, it may be necessary to revisit traumatic experiences in therapy. While this process may be uncomfortable at times, therapists are trained to help individuals work through their painful memories in a safe environment while being sensitive to their clients’ needs and preferences. 

Common therapeutic approaches for processing trauma

Processing trauma can be a vital part of healing and recovery, and there are several common approaches that may help those living with PTSD. These approaches are specifically designed to address trauma’s effects, allowing individuals to safely process and integrate their experiences without becoming overwhelmed or retraumatized. 

Eye-movement desensitization and reprocessing (EMDR) therapy

Eye movement desensitization and reprocessing (EMDR) is a type of therapy widely used for helping individuals process and heal from traumatic memories and their associated distress. In EMDR, the individual recalls distressing memories with an EMDR therapist while the brain is stimulated in a rhythmic, left-right pattern. This stimulation, known as bilateral stimulation, may be produced in several ways, including:

• Visual cues (e.g., using a light bar or wand, watching videos)
• Auditory cues (e.g., using headphones to listen to alternating sounds)
• Tactile cues (e.g., using a handheld buzzer, pulser, or tapping device)

The eye movements that occur are thought to activate the brain's natural healing mechanisms, allowing the person to reprocess and integrate the traumatic memories in a more adaptive way. Through repeated sessions, EMDR can reduce the intensity of trauma-related symptoms, decrease emotional distress, and promote a sense of resolution and empowerment. 

EMDR is a recognized and evidence-based treatment for trauma. In addition to helping individuals cope with trauma and PTSD, EMDR treatment has also been shown to benefit those experiencing anxiety disorders, depression, chronic pain, and phobias. 

Prolonged exposure therapy

Prolonged exposure (PE) therapy is another highly effective treatment for posttraumatic stress disorder (PTSD) that aims to help individuals overcome the debilitating effects of trauma. In PE therapy, individuals gradually and systematically confront their traumatic memories. Through repeated exposure to these memories, either through imaginal exposure or in vivo experiences, individuals can learn to process and integrate the traumatic events more effectively. 

This process allows them to reduce avoidance behaviors and the associated distress, ultimately leading to a reduction in PTSD symptoms. Additionally, PE therapy incorporates cognitive restructuring techniques to challenge and modify maladaptive thoughts and beliefs related to the trauma.

Cognitive processing therapy

Cognitive processing therapy (CPT) is an evidence-based therapy approach that focuses on the cognitive aspects of trauma. In CPT, a therapist helps the individual identify and challenge the negative thoughts and beliefs that may have developed because of trauma using a process called cognitive restructuring. This may make it possible to reframe and replace unhelpful thoughts with more accurate and adaptive ones. This type of therapy also incorporates education about trauma reactions and the connection between thoughts, emotions, and behaviors. 

By addressing cognitive distortions, it may be possible to develop a more balanced understanding of one’s experiences. The structured nature of CPT, along with the use of written exercises and homework assignments, helps individuals actively engage in the therapeutic process and apply the skills learned in therapy to their daily lives.

Trauma-focused cognitive behavioral therapy (CBT)

Trauma-focused cognitive behavioral therapy (TF-CBT) is an evidence-based therapeutic approach specifically designed for children and adolescents. It combines cognitive-behavioral techniques with trauma-sensitive interventions to address the unique needs of young people who have experienced trauma. 

TF-CBT focuses on several key components including:

• Psychoeducation about trauma and its impact
• Relaxation and stress management skills
• Cognitive restructuring to challenge negative beliefs
• Gradual exposure to trauma-related memories

This form of therapy also typically incorporates elements of family therapy aimed at enhancing communication, strengthening relationships, and maintaining a nurturing support system. TF-CBT has been shown to be effective in reducing trauma-related symptoms, improving coping skills, and promoting post-traumatic growth in children and adolescents.

Narrative exposure therapy

Narrative exposure therapy (NET) is another type of therapy designed to address the impact of traumatic experiences. It is often used with individuals who have experienced multiple or complex traumas, such as war, political violence, or prolonged interpersonal violence. NET integrates principles of cognitive-behavioral therapy and storytelling to help individuals process traumatic memories.

In NET, the individual is guided to create a chronological narrative of their life, focusing on traumatic events and significant life experiences. The therapist helps the individual construct a detailed account of their trauma history, paying attention to thoughts, emotions, and sensory details associated with each event. They then repeatedly recount the narrative in therapy, which may help the individual make connections between past events and their current experiences. 

NET has been shown to offer lasting benefits for individuals living with the effects of trauma and PTSD. Therapists may also employ cognitive-behavioral and exposure techniques to address trauma-related symptoms. 

Group therapy

In addition to individual therapy with a licensed therapist, group therapy has been shown to be beneficial for trauma recovery. In a group therapy setting, a trained therapist or facilitator guides a small group through meaningful discussions about trauma. Some group therapies specialize in a particular type of therapy, such as those outlined above. Attending a group setting may lessen feelings of isolation and provide a safe environment in which individuals can tell their experiences and learn from others. 

Some trauma therapy groups may serve individuals who have experienced a certain type of trauma, while others may be intended for anyone experiencing the effects of trauma or PTSD. Trauma therapy groups are often offered through community centers, faith organizations, non-profits, and online therapy platforms. 

Finding a therapist for overcoming trauma

If you have gone through a trauma and are experiencing mental health symptoms, you may benefit from seeking the help of a licensed therapist specializing in trauma therapy and recovery. Therapists may employ different techniques to treat their clients, and it can be important to find an approach that feels comfortable for you. 

In some cases, online trauma therapy may be preferable to traditional face-to-face therapy, particularly if your symptoms make it difficult to meet with a therapist in person. Virtual therapy offers an affordable and convenient way to receive mental health treatment from the comfort and safety of your home. Therapy platforms such as BetterHelp offer weekly sessions that can be through phone calls, video chats, or in-app messaging. Online therapy may be particularly helpful in cases where it’s difficult to find a local therapist specializing in your chosen form of trauma therapy.

The efficacy of online therapy for trauma recovery

Research into PTSD has found that trauma-focused therapies can be effective in lessening the frequency and severity of its symptoms, whether individuals utilize in-person or online therapy. While these therapies typically involve directly addressing traumatic memories, a trained therapist can offer empathy, understanding, and comfort as individuals confront their difficult experiences. In one study, researchers assessed the efficacy of an online cognitive-behavioral therapy intervention for those who had survived intimate partner violence. They found that those participating experienced statistically significant reductions in their symptoms of PTSD, depression, and anxiety, as well as improvements in their quality of life.