Between Therapy Sessions: 3 Handy Coping Skills for Trauma

Woman thinking While it’s true that working with a good trauma therapist enhances healing, not all trauma work happens in the therapy room. Even when a person regularly sees a therapist, the trauma work does not stop because a therapy session has ended. On the contrary, the brain keeps working and sorting through traumatic material in an effort to heal and move forward.

The brain is incredible in its resiliency and natural tendency toward healing. The brain wants to heal, but in doing so, sometimes distress happens. For example, when the brain has nightmares or flashbacks after experiencing a traumatic event, it is in fact attempting to heal by trying to bring forth information related to the trauma. But the distress and anxiety from experiencing these intrusions and related trauma symptoms can cause a person to want to (understandably) push away the memories and other intrusive symptoms related to the trauma.

It is not uncommon for intrusive symptoms to sometimes increase at the beginning of trauma therapy. As much as trauma therapy helps, it can also cause discomfort and intense emotions as a person faces and works through the traumatic memories. Therefore, having effective coping skills to use between therapy sessions is imperative. Below are three skills that can be used in or out of therapy sessions.

1. Body Scan

The body often tenses as it prepares to fight, flee, or freeze due to continued trauma symptoms, even long after the traumatic event has ended. The body holds onto trauma, which can cause it stay on “high alert” status. This is exhausting and can take a toll on your health. Body scan is an exercise during which you pay attention to parts of your body without changing anything you notice. The objective of this exercise is not to relax. It is simply to be aware of what is happening in a particular moment.

Why doesn’t the body scan encourage relaxing the tension or pain you find? Because sometimes just noticing the tension you find is enough. Also, releasing any expectation of what is supposed to happen during the exercise can relieve anxiety about the exercise itself and make it more effective. If you have the expectation that you are supposed to feel relaxed during the exercise and that is not what you experience, negative thoughts about “not doing it right” may come up, which can cause distress.

During this exercise, you can start at the head, feet, or any other part of the body, and then pay attention to each part or section of the body at a time, noticing any sensations that come up. You may notice tension, itching, discomfort, or no sensation at all. The key is to just pay attention and to be aware. If you get distracted, simply notice that you got distracted without criticizing yourself, and gently redirect your attention back to the part of your body you were focused on.

2. Containment

Containment is one of the skills I was taught early in my EMDR training and it has become one of the stabilization skills I teach most frequently. This exercise is effective in utilizing the brain’s natural ability to contain material. It involves imagery of a container of some type that can hold onto material that is distressing or disturbing, until the time you feel better able and prepared to deal with it.

To utilize this exercise, imagine a container of some type: a box, safe, vault, trunk, etc. Whatever the container is, it should have a door or lid that you can open and close as you please. The container needs to be big enough and strong enough to hold anything that is causing distress. When something distressing comes up and it is not possible or optimal to address whatever is coming up in that moment, imagine letting the traumatic material go into the container temporarily, until it can be addressed at a later time.

The objective of this exercise is not to disregard or ignore the important information that the brain is trying to communicate. Rather, it is meant to allow the brain to set aside distressing information for the time that it is optimal to address the material. This helps to prevent becoming too overwhelmed by trauma symptoms, which often include intrusive thoughts, images, and memories. It is beneficial to discuss with your therapist the thoughts/images/memories/etc. you contain between sessions so that he or she can help you sort through the material in the container, a little at a time.

3. Body Movement

Sometimes the body is our most underutilized resource. Recent research by Bessel van der Kolk, et al. (2013) found that a yoga practice as a supplementary treatment for posttraumatic stress (PTSD) dramatically decreased symptoms of PTSD in participants. The researchers in this study theorize that yoga practice may help individuals with trauma to learn to more effectively tolerate and cope with body and sensory sensations, in addition to helping them to learn to tolerate intense emotion.

It is my belief and experience that, whether it is yoga or some other form of exercise, moving the body has major benefits and enhances trauma healing. The exercise or body movement you choose does not have to take a great deal of time or money. Some people report that simply walking and stretching has positive benefits on their ability to cope between sessions. People often report that engaging in some form of exercise or body movement also is helpful in gaining self-appreciation and the ability to self-soothe and nurture.

I have found with the people I work with in therapy that, when used consistently, the above skills help to move trauma work forward as they begin to feel more confident in their ability to tolerate intense emotion and distress. Contact a qualified trauma therapist if you think you might benefit from some guidance.

Reference:

Van der Kolk, B. A., Stone, L., West, J., Rhodes, A., Emerson, D., Suvak, M., and Spinazzola, J. (2013). Yoga as an adjunctive treatment for posttraumatic stress disorder: A randomized controlled trail. Journal of Clinical Psychiatry, 75, e1-e7. Retreived from http://www.traumacenter.org/products/pdf_files/Yoga_Adjunctive_Treatment_PTSD_V0001.pdf

© Copyright 2015 GoodTherapy.org. All rights reserved. Permission to publish granted by Anastasia Pollock, LCMHC, therapist in Midvale, Utah

The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by GoodTherapy.org. Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

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  • val

    val

    March 5th, 2015 at 10:18 AM

    funny how many of us think that the work is over when we leave our therapy sessions
    when in actuality that is when the real work usually begins!

  • Andrew

    Andrew

    March 5th, 2015 at 12:04 PM

    Doing a body scan sounds like a great way to get in touch with what you are feeling without letting those feelings take over. It can simply help you be more aware of what you are experiencing but in a way that is non threatening.

  • Mark B

    Mark B

    March 7th, 2015 at 4:03 AM

    I wish that I did have the ability to practice containment as mentioned.
    I would like to leave certain things in different compartments until the time comes when I am better ready to deal with it.
    I am guessing that this takes quite a bit of discipline to be able to effectively do this.

  • carlotta

    carlotta

    March 9th, 2015 at 5:45 AM

    Thank you so much for sharing these options. I think that many of us are afraid of going to therapy, not because of what happens during therapy, but then thinking about what we should do after the sessions are over and we have to start to manage this on our own.

    These are useful tools that I think that with a little time and practice most of us could manage to work into our lives to help control some of the anxiety that talking about what we have experienced could naturally bring to the surface.

  • Greg

    Greg

    March 14th, 2015 at 8:34 AM

    I have not considered how exhausting to the body it can be to hold onto this sort of trauma and how it can play such a tole in your physical health too. You know I think that most of us only consider the mental toll without fully appreciating that this can do damage to us on a physical level as well. Thanks for pointing that out and giving us some options for how to turn this around and remedy those situations when they come up.

  • Emotional

    Emotional

    March 20th, 2015 at 7:35 PM

    Migraines go away. Tears welling up slot since my last therapy session. Dr adjusted my meds. Just want to cry in someone’s arms. If only my therapust would so I can feel comforted. Flashbacks started this. Numbed myself from the pain since I was a child. My therapist was able to break off a small chip off my wall. I can’t live like this with all these raw emotions that I’ve kept bottled up. How do I get past them

  • my sprained brain

    my sprained brain

    April 26th, 2015 at 3:39 PM

    Emotional, curl up in a big chair, hug a pillow and let yourself cry. Cry until the sobbing stops and you are down to the hiccups, cry until the spark of joy comes like the sun comes out after a big thunderstorm.
    Make sure you have a big box of triple layer soft tissues, a big glass of water and a waste basket beside you. Put up a do not disturb sign and make sure you have nothing else planned for the rest of the day. You will be emotionally worn out and will need a nap afterwards.
    Have a notebook and pen close by so you can journal your thoughts afterwards and do not censor anything in any way. Just write and let it all out.
    You can also imagine holding the young, emotionally hurt you in your arms like you would hold a small child and rock them like you do a child who is hurt, afraid and needs consoling. Console yourself, love and respect yourself and allow yourself to receive that love and healing. Ask for and receive forgiveness for anything that comes up and needs it. Be kind to yourself and love yourself.
    When you are ready get up from your chair go have a nice warm shower, something light to eat a warm herbal tea and curl up for a good nap. After your nap go for a walk in the woods if you can or a walk through a quiet neighborhood. Being gentle with your body and your mind – this is a healing time.
    Crying is a gift that humans have. It helps us to heal emotional wounds. Tears are saline ad they seem to wash the wounds in a way that helps them to heal if we allow it. Our society has turned away from the true use of tears and out of fear says it is a sign of weakness. Being able to cry shows someone who is very strong and in tune with themselves and others.
    Try crying,it is like surfing waves after the sorrow comes the joy. Hope this is helpful for you, it has been very helpful for me on my healing journey.

  • teea

    teea

    August 29th, 2015 at 6:23 PM

    My sorained brain, thats lovely advice

  • Angie

    Angie

    April 18th, 2015 at 12:58 PM

    A very helpful and validating article. Thank you.

  • Lisa

    Lisa

    April 25th, 2015 at 12:18 PM

    thank you these are very helpful tools. I just started with s grief counselor being referred by my regular counselor I’ve been seeing for 3 1/2 years due to my husbands suicide in 2007. After seeing many I found her to be the easiest to talk to but there was nothing more she could do for me. Also I had a traumatic childhood and have been diagnosed with Lifetime Abandonment and serous grief. So in between sessions these should help me I must add they are painful also dealing with PTSD. Thank you very much.

  • Melle

    Melle

    April 26th, 2015 at 3:22 PM

    In Big T Trauma cases of PTSD..esp cases where huge stress or Trauma began before school age ..most of the time the person will continue to Have the anxieties from it unless able to get Off All Psychoactives (meds..drugs..Nutrasweet..Antihistamines..Sleep meds..Adhd meds..antidepressants..then Complete EMDR or Rapid Trauma Resolution Sessions with Level 2 Therapist or higher- Only these 2 New School type Hypnotherapies can Move Aside Pains of the past..over from emotional part of brain To thw Logical part- Its fast healing ..with life turned around- These highly trained Trauma Therapists are Not to be confused with Old School Trauma Therapists who expect Meds & forever Talk Therapy to remain part of the ptsd persons life- EMDR or RTR puts an end to the pains once sessions completed- also..these new school Trauma Therapies have No Need for the person to bring out every detail of every painful event in the past..bc the trauma therapist only needs to know enough about the pains & heartaches..in order to start & handle the sessions…as All in that Type of Trauma in that certain span of time Gets Moved Aside while the person is in A safe Daydream type state..nothing like stage hypnosis.. One therapist who brags about being saved by Rapid Trauma Resolution..& who now has a PhD..tells of Old,School Trauma Therapy having worsened her all thru growing up..with multiple labels on her..& sadly labeled a,Borderline until she reached adulthood & found RTR- Where she works right now only helps Males& EMDR is whats recommended & given there- she boldly says..I NEVER WAS MENTALLY ILL..DEFINATELY NOT A BORDERLINE..& I AM A THERAPIST TODAY..SO I KNOW FIRST HAND ABOUT EMDR & RTR TRAUMA THERAPISTS NOT WANTING TO SEE PRIOR EVALUATION RESULTS..WHEN THE DIAGNOSES WERE DONE WITHOUT THE PTSD PERSON HAVING HAD A CHANCE TO COMPLETE SESSIONS OF EMDR OR RTR

  • Elizabeth

    Elizabeth

    June 10th, 2015 at 9:24 AM

    Mellie-sounds like you may have learned some things from Dr Bill Tollefson- his RRT work? Good comments

  • munsif

    munsif

    April 30th, 2015 at 11:39 AM

    very handy tips and practical to apply.

  • Karen C.

    Karen C.

    June 7th, 2015 at 2:15 PM

    I completley agree with this article! I see a therapist a couple of times a week for my PTSD and working through trauma work for years now, and I have come through a lot of hard hard break-thru’s in therapy, and believe it or not, a huge percent of my work is done outside therapy. I use what my therapist and I talk about in session and apply that to life outside of healing and a lot of my break-thrus have been done on my own.

    The one thing I know and write about in my blog (website above) is that therapy doesn’t heal you, YOU heal YOU! its the guidance in therapy and the support you get from your therapist that helps the steps you need to take. No one can heal you but you.. you just need the support to help you along the way.

    I have an amazing therapist.. been working with him for 8 years now and I wouldn’t be where I would be without his wisdom, but its me who got me here not him.

    Another thing I learned is “it takes time!” healing takes time, no rushing it or time line, you heal in phases and you deserve the time needed to heal the way you need to heal.

    I write about my healing on my blog and that also has helped the process ..

  • Valerie

    Valerie

    June 8th, 2015 at 8:31 AM

    I agree that the body scan is an effective tool in trauma therapy. My therapist sent me an audio clip of her voice going through the body scan, which allows me to focus on the sensations step-by-step. Her voice seems to help too since it’s familiar.

    The body scan isn’t exactly easy, though. The clip sent to me is about 25 minutes long. I recommend practice before really using it as a skill, and be sure to have privacy! It’s awkward when someone walks in.

  • Virginia

    Virginia

    June 16th, 2015 at 7:01 PM

    these are great techniques and good for you to put them in a statement anyone can follow. We use these in EMDR therapy all the time and encourage clients to use them as you have described. EMDR also has a light stream technique that is similarly used.

    I cannot understand anyone being in therapy several times a week or for 8 years. I’ve been a therapist for 25 years and even working with the SPMI clients this is not seen.

    I agree that EMDR is the go to therapy for trauma. I have used it with adults with very severe cases of childhood ritualistic abuse, witnesses to suicides, veterans and many many first responders who accumulate truama upon trauma. The most severe case I have ever dealt with I saw weekly for one year but that is not the norm. The average client with trauma using EMDR might be 6-10 sessions. Some people process very quickly and what you might think would take several sessions they are at a zero level in 3/4.

  • Tina H

    Tina H

    August 31st, 2015 at 12:33 PM

    I don’t disagree with you totally , but stating ‘ I don’t understand how anyone can be I therapy so long’ etc. could be felt as judgemental by some clients. It’s true that managing trauma techniques can be learnt relatively quickly, but managing the all the other things that may have come out of a traumatic early life for example can take time to process in therapy . extreme trauma where a client has dissociated constantly as a means to survive means they may not have completed childhood developmental phases and these need space and time and for clients to go at their own pace, and not to be made to feel as if ‘they should be doing better than this by now’ .

  • Blanche

    Blanche

    December 19th, 2015 at 10:39 AM

    I agree with Tina. As a therapist who has also been a client, I can say that some people need more time than others (i.e. those with multiple traumas, long term traumas,limited support system, etc.). Great article! Thanks for sharing!

  • Tina H

    Tina H

    August 31st, 2015 at 12:33 PM

    Brilliant article by the way!!

  • Donna B.

    Donna B.

    January 2nd, 2016 at 11:48 AM

    I was on 16 years of psych meds which I took faithfully. Finally I sought counseling for a relationship crisis. Instead of fixing the relationship which there was no fix for, I found all sorts of tools and skills in the next 5 years with the help of the therapist. Now after almost 5 years free of any meds, I begin the work of healing more of my life long trauma with EMDR. I am 60 years old. I am grateful for all the new brain science and mindfulness skills. Many of us our being able to increase the quality of our life’s. We have suffered as the ACE studies revealed. I worked with a neuro-psychologist for awhile too. I got neuro-feedback and he directed me to a home unit. This past summer I was traumatized by a nearby forest fire while volunteering. With simple feedback from my previous counselor that I was not breathing, then I slowly realized that I was triggered again. I started yoga and meditation 3 times a week in a really small group where I knew the teacher. I was able to focus on my belly breath to release the contraction, over and over. Along with daily use of my David Delight, Mind Alive unit I continue to provide my brain and central nervous system with a calmness without any drugs. All of this is such a miracle to me. I am so very grateful. There is such hope and healing. The quality of my life has so increased. Never ever give up!!

  • Mac

    Mac

    August 9th, 2016 at 2:50 PM

    I’ve been in therapy most of my adult life due to a terrifying childhood in which my mother was verbally/physically abused for as long as I can remember. I am 70 now, and am still dealing with this trauma. of my childhood.

  • Helene E. Goble, MFT

    Helene E. Goble, MFT

    November 25th, 2016 at 5:30 PM

    Thank you for the excellent article. In addition, many benefit from brain-body work such as EMDR, Brainspotting, or some type of Somatic work. An excellent book to understand how the body holds trauma is Peter Levine’s “Waking the Tiger.” Relief from trauma is possible and life changing!

  • Jo

    Jo

    November 26th, 2016 at 2:19 AM

    wow Mac, much respect to you, its worth doing, reclaiming ourselves, thats how it seems to me. And Tina H great points there thankyou, that represents me too. It is unlikely to live a life without trauma and as someone said its how we react to that that defines us, though of course if one is wounded and not fully functioning then its completely unfair to expect more than what there is. Though like seeing a good physio or accupunture its amazing how much better we can be. best wishes everyone

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