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.
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.
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
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