brain-speaks

3 Phases of Trauma Recovery

Anyone can be affected by traumatic circumstances when they occur.

In fact statistically over 70% of us in the Western world will experience what it is like to be traumatised during our lifetime.

The good thing, however, is that psychological trauma is something we can fully recover from with appropriate support.

There are many different therapies that a person can choose from when looking for appropriate support; and research is showing us that matching a person to a therapy that is a ‘best fit’ for them is an important factor in achieving recovery.

That said, whilst the specifics of each therapy may be different, what the majority do have in common is they follow 3 key stages in order to support someone as they move from being traumatised to being in recovery.

These 3 key stages are:

 

(1). Establishing safety and stabilisation:

When people are traumatised  they tend to feel unsafe both within themselves, as their body, mind and emotions often no longer feel under control, and in their environment. The latter because the external world previously contained a threat and can do again, and even if that threat does not reappear the world certainly contains triggers that cause a person’s mind and body to react spontaneously, without their conscious instruction. Determining what can be improved almost immediately and where stabilisation can be achieved, in both the external environment and within themselves, is necessary for a person to feel less vulnerable and threatened and more easily able to cope. This is important as in order to begin phase 2 a person needs to feel strong enough within themselves to manage day-to-day and not drop out of therapy.

(2). Processing:

Generally known as the remembering and mourning phase this next stage focuses on processing the trauma, coming to terms with what happened and the impact it has had. During this period a person is expressing their emotions, exploring their memory of what happened and mourning what may have been lost through the impact of the trauma. The therapist helps a person identify where in the traumatic experience their beliefs and values that related to others, the world in general or themselves may have been shattered. The therapist is also helping the person to begin establishing what that now means for them, so new values and beliefs may begin to form. Essentially in ‘telling the story’ we restructure what and how we remember an event to transform and integrate the memories into the story of our life.

(3). Re-integration:

In the final phase of therapy the focus is on supporting a person to develop a new sense of themselves, their world and their future. It is in this stage that we see post-traumatic growth develop. Here people no longer define themselves by what has happened to them but, instead, by the person they are now, having survived the trauma. People usually feel stronger within themselves and have regained a sense of control in their lives. It is from this stage that people often begin making different choices to better support themselves as they continue their life now in recovery.

 

Whilst the majority of trauma-focused approaches follow this 3 stage process, stage 2 is where the actual ‘processing therapy’ can often be changed to suit the client. For example in trauma-focused CBT (tf-CBT) this approach seeks a detailed recalling of events ‘frame-by-frame’, encouraging detailed sensory information. In contrast, integrative psychotherapy is focused on a client led process, where underlying drivers are sought to understand how historical experiences may be contributing to the current trauma response. It also places a focus on the individual and their view of the world, their beliefs, their needs etc. The focus is on facilitating recovery and a ‘wholeness’, so a person is not just carrying a ‘smaller bag of symptoms’ but rather they function better and their mental, physical and emotional health are all improved.

The important thing for anyone considering, or going through, therapy is to ensure they feel safe and that the pace of their progress suits them. It is also vital to remember trauma recovery takes time, and that time is determined by the person recovering and by them moving through each stage at a pace that feels appropriate and safe for them.

 

Gerger, H., Munder, T., Gemperli, A., Nüesch, E., Trelle, S., Jüni, P., & Barth, J. (2014). Integrating fragmented evidence by network meta-analysis: Relative effectiveness of psychological interventions for adults with post-traumatic stress disorder. Psychological Medicine, 44(15), 3151.
Herman, J. (1997). Trauma and recovery. 1992. New York: Basic.

Regel, S., & Joseph, S., (2010). Post-traumatic stress. Oxford: Oxford University Press.

Watts, B. V., Schnurr, P. P., Mayo, L., Young-Xu, Y., Weeks, W. B., & Friedman, M. J. (2013). Meta-analysis of the efficacy of treatments for posttraumatic stress disorder. The Journal of Clinical Psychiatry, 74(6), e541.

Author

Charlotte Copeland

SafeHaven