Trauma Counseling: Mental Health & Trauma Therapy
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For many, it can be a challenge to accept that they need help from others, such as a therapist, when trying to get on track and find their way after traumatic events. It can be humbling to accept letting someone else guide you through therapy to begin feeling healthy and happy again. A traumatic experience can happen to anyone at any time, causing many individuals to develop post-traumatic stress disorder (PTSD).
Seventy percent of adults in the United States have experienced some kind of traumatic event in their life. Sixty percent of men and 50% of women have experienced trauma at least once in their lives. Of those people, as many as 20% of them will develop post-traumatic stress disorder. Ongoing stress associated with traumatic memories or trauma can have long-term negative impacts if left unaddressed.
What is trauma?
Trauma can be anything that happens in your life that has a lasting impact and causes deep distress. Trauma could result from prolonged exposure to psychological trauma such as neglect or more physical trauma like an assault, sexual abuse, or a car accident. It could be childhood trauma that you do not even consciously remember. In such cases, working with a therapist can help you process these experiences through therapy. You could also experience trauma from witnessing a serious or frightening scene, such as the mistreatment of someone else; that trauma memory can affect you for weeks, months, or years to come. Seeking support from therapy may help you heal and build resilience.
Understanding post-traumatic stress disorder
Post-traumatic stress disorder (PTSD) from trauma may also be caused by something like being diagnosed with a serious medical condition such as cancer or heart disease. Trauma is essentially a lasting marker in the brain, resulting in unpredictable emotions, flashbacks, feelings of numbness, moments of dissociation, or even physical symptoms like nausea or headaches. Seeking the support of a therapist and engaging in therapy can help individuals process and heal from the effects of trauma, providing coping strategies and emotional relief.
Trauma and traumatic events can vary
No case of trauma and no person are the same; while the same event may leave a lasting impact on one person, another person who has experienced trauma may not be as deeply impacted. That same person may falter in another situation, as individual resiliency is idiosyncratic and hard to predict. We expect those exposed to a natural disaster, violent attack, or car crash to be traumatized while forgetting that some traumas are more difficult to recognize, like racism, oppression, or discrimination.
Our society has deeply rooted patterns and mechanisms that can lead to the suppression of people based on their gender, race, or ideology. These can be traumatic experiences for individuals. Certain concessions that we encounter daily may not seem abnormal but may also be maladaptive coping mechanisms that we utilize to survive trauma. These things affect us on a deeper level than we may recognize, validating a call for reflection into our existing thought patterns and schemas. Working with a therapist can help uncover these hidden impacts and provide a safe space for exploring the roots of such experiences. Therapy offers individuals tools to reframe maladaptive coping mechanisms and foster healthier thought patterns, promoting healing from trauma.
Causes of post-traumatic stress disorder
Although military combat may be considered an obvious cause of post-traumatic stress disorder, it is not the only cause. There are numerous types of trauma that might encompass a wide range of life events, and any of these may trigger a person to develop mental disorders such as post-traumatic stress disorder (PTSD). Some of the most often reported causes associated with experiencing trauma include:
- Violent physical attack
- Rape or sexual assault
- Serious accidents such as a car or plane crash
- A natural disaster such as a tornado, hurricane, flood, or earthquake
- Abuse, neglect, or bullying
- Racial trauma
- Domestic violence
- Childbirth
- Witnessing or surviving a terrorist attack or other act of violence
- Serious illness
- Losing a loved one
- Fearing for your life for any reason
- Caring for others who are in a traumatic event (such as first responders)
- Substance abuse-related trauma therapy
- Medical trauma requiring intensive therapy
What happens after trauma or a traumatic event
Post-traumatic stress disorder, while often associated with military post-combat, is something that can develop in any individual who has experienced some sort of trauma. Behavior research done in Chicago, Illinois, found that 43% of those patients who visited the Cook County Hospital were experiencing post-traumatic stress disorder, and most of them were gunshot or stabbing victims.
When you encounter a stressor or experience a trauma, your nervous system reacts by releasing certain chemicals that elicit particular survival responses. This is known as the fight or flight response, characterized by the activation of the sympathetic nervous system, which is meant to keep the individual from harm.
The fight or flight response
The fight or flight response, also known as the acute stress response, was discovered by physiologist Walter Cannon while studying the sympathetic nervous systems and stress response of animals during digestion. During the fight or flight response, the heart rate is high, and blood is mobilized toward the arms and legs, leaving less energy to be used for cognitive functions or immunity. This is why your thinking may seem fuzzy or muted during periods of fight or flight or when you experience trauma.
People in this state may make rash decisions that are not based on clear thought. The physical and emotional response caused more frequently by PTSD can lead the individual to experience extreme distress due to an overreactive nervous system, keeping them on edge and expecting a threat even if there may not be an actual threat at that moment. Additionally, trauma can heighten the body's fight or flight response, making it more difficult to return to a state of calm after the perceived danger has passed.
How do you know if you have post-traumatic stress disorder?
Immediate trauma counseling is uncommon, and many people may not know that they are experiencing post-traumatic stress disorder until something happens that causes a noticeable reaction. For example, you may be having nightmares but not connect them to trauma until the nightmares become worse, or you start being unable to go places or talk to people. You may experience a panic attack or overwhelming emotions at work or school without an apparent cause. Here are some of the most common symptoms of PTSD from trauma:
- Nightmares
- Flashbacks (reliving the traumatic incident)
- Terrifying images or thoughts
- Panicking when you see or hear something that reminds you of the traumatic incident
- Aggravation, emotional reactions, or feeling on edge
- Dissociation (not being aware of where you are).Difficulty processing emotions
- Trouble concentrating
- Inability to sleep or stay asleep
- Lack of sexual drive
- Inability to do certain tasks
- Lack of interest in normal activities you usually enjoy
- Trembling, shaking, shivering
- Reckless or self-destructive behavior
- Panic attacks (rapid heart rate, sweating, shaking, nausea, agitation, feeling like you are going to die)
- Avoiding certain places or people that remind you of the traumatic incident
- Depression, feelings of sadness
- Feeling numb or cut off
- Feeling alone or like nobody cares
- Self-medicating with drugs or alcohol
- Inability to have a lasting relationship
- Guilt or hopelessness
- Lack of appetite
- Chronic pain or nausea
- Self-blame for the traumatic incident
- Consistent anger or shame
- Thoughts of self-harm or harming others
You may have trouble keeping a job, having a lasting relationship, and caring for yourself. In addition, continual stress can contribute to physical problems like heart disease or stroke. If you have any of these mental health symptoms or feelings related to post-traumatic stress disorder or trauma, it may be time for you to seek mental health resources to treat trauma and learn healthy coping skills.
It can be helpful to reach out to friends and family for support or speak with a licensed counselor who is specifically trained to provide trauma-informed care. In some cases, it may be beneficial to combine treatment options. A trained professional can help you address memories, find the best treatment plan, and determine if prescription medications like selective serotonin reuptake inhibitors (SSRIs) may be right for you as you heal from trauma.
Trauma counseling for improved mental health
Seeking trauma counseling can be crucial if you’re working to process your feelings following a traumatic event. Generally, trauma-focused treatment involves counseling, whether in-person at an individual practice or online. The following are two common initial trauma counseling methods that may help you after experiencing a trauma:
- Trauma therapy sessions
- Cognitive behavioral therapy for trauma
Trauma informed cognitive behavioral therapy
Treatment for those who have experienced trauma is unique in every case but usually involves some form of trauma-focused cognitive behavioral therapy (CBT) to attempt to recognize and smooth out the existing triggering thought patterns and behaviors and replace them with healthier and less reactive ones.
Cognitive behavioral therapy can be used to address all kinds of mental health disorders, such as depression, trauma, bipolar disorder, and generalized anxiety disorder. CBT trauma counseling works by breaking down the link between the mind (cognition) and the body (behavior). The initial session typically involves the counselor completing an assessment to determine whether you have PTSD and other mental health disorders such as depression, disassociation, and anxiety. From there, you and your counselor will work together to determine avenues and goals for treatment.
Trauma counseling treatment typically, but not always, takes about five to 15 sessions that last between 30 and 60 minutes, depending on the cause and severity of the post-traumatic stress disorder. The premise behind cognitive behavioral therapy is to develop healthy coping skills that target traumatic stress symptoms and thought patterns, bolstering positive thought patterns in the brain through attended repeated exercises.
How online trauma counseling can improve mental health after a traumatic event
Although finding the right mental health services can be intimidating, the internet has allowed for the emergence of online interfaces like BetterHelp, which remotely connects those in need of help with appropriate licensed mental health professionals such as a skilled trauma counselor.
Online counseling may be especially helpful for people who are experiencing post-traumatic stress disorder, which might make it difficult to leave the house. Online trauma counseling can be conducted via video conferencing, texting, email, telephone, and instant messages. By identifying and working through our traumas and how they affect us, we can find ways to cope and live a more satisfying and comfortable life. Affordable online counseling options may also make it easier for people to find a counselor within their budget.
Online counseling is just as effective as in-person counseling for a variety of conditions and concerns, including PTSD and trauma-focused therapies. In a 2020 meta-analysis, medical reviewers evaluated 15 studies conducted on the efficacy of online counseling for PTSD treatment. This analysis found that quality of care, patient satisfaction, and reduction of PTSD symptoms with online counseling were all comparable to those of in-person therapy.
Trauma-informed therapy for longstanding PTSD
For those who have experienced a traumatic event in the past and are currently experiencing symptoms of PTSD, there are some practices of trauma-informed counseling that are used to help manage symptoms and decrease the emotional impact of the experience over time. According to the National Center for PTSD, cognitive processing therapy (CPT), eye movement desensitization and reprocessing (EMDR), and prolonged exposure (PE) work best as trauma-focused treatments.
- Cognitive processing therapy (CPT) as trauma therapy
- Eye movement desensitization and reprocessing (EMDR) therapy
- Prolonged exposure therapy
- Group therapy for trauma survivors
EMDR
Eye movement desensitization and reprocessing (EDMR) is an interactive form of trauma-focused therapy that uses specific eye movements along with talk counseling to help process a client’s trauma story, such as a sexual assault or other violent attack. Eye movement desensitization and reprocessing therapy targets the memory of the experience and uses bilateral stimulation to decrease the physical and mental impacts of that memory to improve mental health. The desensitization and processing of one’s memory of a traumatic event can help them better cope, making eye movement desensitization and reprocessing therapy one of the most effective forms of trauma counseling. This counseling process may also be conducted online. It can be difficult, though, to find a practitioner who provides eye movement desensitization and reprocessing therapy online.
CPT
Cognitive processing therapy (CPT) is a specific type of cognitive behavioral therapy. It is different than eye movement desensitization and reprocessing because instead of focusing on the traumatic experience itself, it guides trauma survivors through the emotions connected to the experience. With cognitive processing therapy, a trauma counselor offers strategies to analyze and challenge thoughts surrounding the trauma to attempt a new perspective. Like CBT, CPT can be done either in person or online.
Exposure therapy
This form of trauma treatment to treat PTSD encourages patients to confront their fears in a safe environment to break the pattern of avoidance and fear. Like EDMR, it is trauma-focused. For example, if a client experienced a deadly tornado, their counselor may slowly incorporate photos and live footage of natural disasters into their sessions. Virtual reality, visualization, and real-life exposure may also be used to help people recover from their trauma responses. Some forms of exposure therapy are tailored for in-person sessions, though other forms may be done online as well.
In summary, the following methods are used to treat PTSD and trauma:
- Eye movement desensitization and reprocessing (EMDR) therapy
- Cognitive processing therapy (CPT)
- Exposure therapy
- Art therapy for trauma
- Music therapy for PTSD
Takeaway
Anyone can experience trauma and post-traumatic stress disorder (PTSD), regardless of age, gender, economic status, race, sexual orientation, or religion. Trauma can be difficult to recognize in ourselves and is often a humbling experience to work through, at least partially because it can often require asking for help from others. We cannot, nor should we, try to work through and fix everything on our own.
Trauma-related issues affect our mind and body in a variety of ways and can worsen if not properly addressed and worked through, which is why it is important to seek treatment and mental health support. Trauma counseling can help you learn coping skills, find spiritual well-being, and experience many other benefits — as can reaching out to family or other loved ones, going to support groups, journaling, and practicing meditation.How do mental health counselors treat trauma?
There may be a variety of ways that mental health counselors administer trauma treatment, and it could depend on the type of trauma and the severity of the individual’s trauma-related symptoms. Some common trauma counseling techniques include cognitive behavioral therapy, dialectical behavior therapy, eye movement desensitization and reprocessing, prolonged exposure, and mentalization-based therapy. Many mental health counselors assume people have experienced trauma and use a trauma-informed approach to every therapy session, whether or not it is trauma-focused.
Below are examples of specific trauma-focused therapies:
- Trauma-focused cognitive behavioral therapy
- EMDR therapy
- Exposure therapy
- Narrative therapy for trauma
Why is trauma-informed counseling and trauma therapy important?
Most people will experience at least one trauma in their lives. For example, many people may be adult survivors of child abuse or victims of intergenerational trauma. Since trauma is so widespread in our society, both of these therapeutic approaches are vital. To understand the importance of trauma counseling and trauma therapy, it may be necessary to understand the difference between the two. The distinction may lie in the different treatment targets. While trauma-informed counseling is sensitive to past trauma, it may focus on other, unrelated mental health conditions or challenges. Trauma counseling, on the other hand, focuses on the traumatic event to help the individual process the trauma.It may also seek to treat any related conditions such as post-traumatic stress disorder, complex trauma, mood disorders, or acute stress disorder.
What are the first priorities for helping someone after a traumatic event?
Safety is the first priority for helping a trauma survivor. It’s important to get them to a safe space and ensure they are physically unharmed or get medical attention if necessary. Afterward, you can listen to the person’s concerns and encourage them to seek professional support.
How do you comfort someone after trauma?
A trauma survivor may want to be comforted, and there are various ways you may be able to provide this comfort. For example, you can let the person know you’re there to provide support and listen to them if they want to talk. If you notice any unhealthy behavior patterns such as substance misuse (formerly substance abuse), you may encourage the person to speak to a mental health professional.
Which intervention helps the person who has experienced a difficult event?
Some mental health clinicians consider trauma-focused cognitive behavioral therapy to be the most effective intervention for someone who has experienced a difficult or traumatic event.
How do you overcome trauma triggers?
There may be various ways to overcome trauma triggers associated with a past traumatic event. For example, you can undergo exposure therapy with a trauma-informed counselor to become gradually desensitized to the trigger. You can also use relaxation techniques and mindfulness practices to control your emotional response to trauma reminders.
Can I heal trauma on my own?
It depends. Everyone is different and it may depend on the nature of the trauma and the severity of any trauma-related symptoms. Some people may require the assistance of a mental health professional to properly process the trauma and learn effective coping strategies.
How do you heal trauma without talking about it?
Some people find it difficult to speak about past trauma, and that’s understandable. There are some ways to reduce trauma symptoms like trauma stress or relieve trauma-related conditions without verbal communication. Some of these might include breathwork, yoga, journaling, art therapy, and music therapy.
What does emotional shock feel like?
Emotional shock might feel different for different people. Even so, some common reactions could include confusion, disbelief, numbness, trembling, or panic.
What is daily life like for someone with PTSD?
According to the Diagnostic and Statistical Manual of Mental Disorders, someone who has persistent trauma-related symptoms that last at least a month after the traumatic event can be diagnosed with PTSD. Someone with post-traumatic stress disorder might have difficulty functioning in everyday life, but symptoms can vary depending on the individual. Common symptoms include bouts of anger, irritability, flashbacks, and social withdrawal for example. These symptoms may occur as a result of trauma-related memories or they could be present even in non- trauma-related situations. Since symptoms overlap, PTSD is sometimes misdiagnosed as borderline personality disorder or other personality disorders. Treating PTSD may include a combination of counseling and medication.
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