The Best Way to Treat Trauma: One Therapist's Perspective

Most days, somewhere between six and eight people perch on my purple couch to tell me their stories. A significant percentage of these individuals have been reached by dark waters of trauma ranging from a single betrayal to repeated abuse. We don't always call it that. It's not always discussed right away. Disclosure could be something akin to a quiet, shaky confession of having been a "bad kid" before detailing abuse, judgment, rejection, and pain. Other times, people feel more comfortable talking about their trauma. They might disclose having escaped a fire or natural disaster in the first session.

I lean in, seeking to envision these accounts through their eyes. I thank them for their trust. Sometimes, we do EMDR.

Among the leading topics of training for psychotherapists is trauma treatment. Protocols are designed and tested. We gather in summits and conferences to discuss how to help people make peace with their past.

Still, often, I wonder, what if the events that caused the aftermath had never happened?

The Impact of Trauma

Mental health professionals can rattle off the statistics. Children who have experienced abuse are at high risk of low self-worth, depression, anxiety, and substance use as adults (Downey and Crummy, 2022). Trauma increases the odds of most mental disorders (Hogg et al., 2023), and the greater the number of traumatic experiences a person has had, the more likely they are to develop a mental health condition (Mckay et al., 2021).

This is not to say that trauma causes these problems. Yet, from a perspective of stress diathesis where a combination of sufficient stress and genetic vulnerability pave the way to psychological suffering, it's conceivable that traumatic experiences could serve as a trigger.

A Wicked Problem

Still, it is far less often that I hear of initiatives to prevent trauma, particularly childhood trauma. Adult survivors of abuse can seek therapy, but often, children experiencing abuse are fearful to tell their stories to anyone. Older children are aware of mandated reporting laws and the risk of being separated from family if they share. In families where abuse occurs, circumstances are usually not always "bad," and there is still often love between parents and children.

Emotional abuse is not reportable in all states, and when it is reported, effective interventions can be sparse.

Family distrust, limited resources, and understaffing are just a few of the endless obstacles facing social service workers intervening in cases of abuse and neglect. Removing youth from the home and even the investigative process can unintentionally cast most trauma.

A Lot of Questions, Not a Lot of Answers

I won't pretend to have an answer to these questions. Still, I wonder, "What if we refocused more resources toward decreasing social stress, supporting families, and providing early, compassionate intervention for all kinds of childhood trauma?" Regardless, I believe that the best way to treat trauma would be to prevent it.

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