What happened to you in the past does not have the final say in who you become. For some people, trauma and its effects can heal on its own, after a period of time. For others, the healing process may require professional treatment. Recovery from trauma requires access to the conditions that promote healing. If an individual who has experienced trauma doesn’t have access to recovery-supportive conditions, the effects of trauma may continue indefinitely, and may even worsen.
Become familiar with emotional regulation and distress tolerance and skills
Allow yourself to feel what you feel when you feel it. Acknowledge your feelings about the trauma as they arise and accept them. The terms emotional regulation and distress tolerance skills come from Dialectical Behavior Therapy (DBT).
Emotional regulation is related to mindfulness practice. It relates to identifying the emotions that are being felt in the moment, and observing them without being overwhelmed by them. Emotional regulation skills include self-soothing activities that provide a calming effect and help to reduce emotional intensity such as the relaxation and stress reduction practices mentioned above, as well as listening to music you enjoy, taking a walk, reading something pleasurable or spiritual, singing a favorite song, exercising, visualizing a comforting/relaxing image, journaling, etc. Emotional regulation is aimed at modulating feelings in order to strengthen the capacity to manage impulses so as to not behave in reactive, self-defeating, and destructive ways.
Accepting your feelings is part of the grieving process and is necessary for healing from trauma. Learning how to be OK with uncomfortable emotions and allowing yourself to feel them is known as distress tolerance.
Distress tolerance is about enduring and accepting discomfort, learning to bear pain skillfully. Distress tolerance skills are an outgrowth of mindfulness practices, and involve the ability to nonjudgmentally accept both oneself and the current situation in spite of the emotional and physical distress experienced.
It is important to clarify that acceptance does not equal approval. We can learn to tolerate thoughts, emotions, physical sensations, and situations that we don’t like at all, and may even deeply dislike. Distress tolerance enhances coping capacity by strengthening resiliency—the ability to adjust to change.
Trauma Self-Help Healing and Recovery Tips
Recovering from trauma takes time. It’s so important to give yourself time to heal and to mourn the losses you’ve experienced related to your trauma. It’s never helpful to try to force the healing process. Do the best you can to try to be patient with the pace of your healing and recovery. Try to simply be consciously aware of your thoughts and feelings, and allow yourself to feel whatever comes up for without judgment or guilt or shame.
Minimize isolation by connecting with others
Following a trauma, and especially when you are experiencing its effects, you may want to withdraw from others, but isolation tends to makes things worse. Connecting with others can help you heal, so make an effort to maintain your relationships and avoid spending too much time alone.
Seek out support
It’s important to talk about your thoughts and feelings, and ask for the help you need. Turn to a trusted family member, friend, counselor, or clergyman. Support from family and friends can have a huge positive impact on coping with the trauma. It is often helpful to share thoughts and feelings with those loved ones and friends.
The twelve-step programs of recovery are among the most therapeutic sources of support available. If you a member of a twelve-step program, it may be extremely helpful for you to increase your involvement by attending more meetings, speaking with your sponsor more frequently, and making greater use of your twelve-step support system. If you don’t participate in a twelve-step program of recovery, now may be an excellent time to connect with one.
It may be helpful to consider joining a support group for trauma survivors. Being with others who are facing the same problems can help reduce your sense of isolation through mutual identification and support. You may find that you have a need to talk about the trauma over and over again. That’s not uncommon, especially in the days and weeks after a traumatic event. That said, if others try to talk with you about the trauma you've experienced but you find you are uncomfortable or simply prefer not to, you have every right to gently refuse them.
Participate in social activities, even if you don’t feel like it
Try to continue with or resume your usual activities whether those are with others or by yourself. If you’ve retreated from activities or relationships that were once important to you, make the effort to reconnect with them. Schedule time for activities that bring you joy—favorite hobbies or activities with friends, for example.
Consider volunteering. As well as helping others, volunteering can be a great way to reconnect with people and challenge the sense of helplessness that often accompanies trauma.
Being of service by helping others in your family, your neighborhood or community, or a 12-step program is a very effective way of taking the focus off of yourself while serving as a reminder of your abilities and strengths. It can also help you reclaim a sense of competence and personal power.
Minimize self-blame and judgment
Trauma survivors are not to blame for the situation they find themselves in—you are not to blame for what happened to you. Instead of being angry with yourself, allowing yourself to be mired in guilt and/or shame, or blaming yourself for what happened to you or for your behavior during and after the traumatic event, try to be kind, compassionate, and forgiving toward yourself.
Although reactions such as anger, guilt, anxiety, and depression are completely normal after trauma, blaming yourself will only make things more difficult. In the event that you feel guilt, anger, or sadness, sharing these feelings with others may help you release them and give you access to the perspective of others.
Compassion means recognizing the pain of others and experiencing a desire to help to reduce their suffering—for example, offering understanding and kindness to others when they struggle, make mistakes, or fail. Expressing compassion is a spiritual experience that spreads outward whenever we can connect with another through shared experience. This can take many forms, including the awareness that pain, suffering, failure, and imperfection are universal to the experience of being human.
Self-compassion consists of responding the same way toward yourself when you have a difficult time, experience pain, make mistakes, or experience something you don’t like about yourself. Instead of harshly judging and criticizing yourself for your inadequacies, try to be kind and understanding with yourself. Having compassion for yourself means that you honor your humanness by accepting yourself when you struggle with challenges—including the effects of traumatic experiences—and fall short of your ideals.
Work on staying grounded in the here and now
In order to maximize your ability to stay grounded—maintaining mental and emotional stability—after a trauma, it helps to have the consistency and predictability of a structured schedule to follow. As much as you can, maintain a daily routine (ideally the same schedule/routine you had prior to the trauma, assuming that still fits your needs), with regular times for waking up, sleeping, eating, working, and exercising. Make sure to schedule time for relaxing and social activities, too.
As much as you can, break large jobs into smaller, more manageable tasks. Focus on taking pleasure from the accomplishment of even small achievements. Find activities that make you feel better and keep your mind occupied (reading, taking a class, cooking, playing with your kids or pets), so you’re not dedicating all your energy and attention to focusing on the traumatic experience.
Develop self-grounding skills through practice
If the effects of your trauma include feeling fearful, anxious, rageful, depressed, disoriented, or confused, it can be helpful to practice the following exercises.
- Sit in a chair with both feet on the ground and your hands on your thighs or in your lap. Feel your feet on the ground. Feel your hands on your thighs or lap. Feel your butt on the seat and your back against the chair.
- Look around you and pick out six objects in the room and name them out loud. This will help you to feel centered in the present, anchored in your body, and more grounded. When you do this, notice how your breathing begins to become smoother and deeper.
- You may want to go outdoors and find a peaceful place to sit. As you do, feel how your body can be held and supported by the ground. Notice the environment around you—the sky, the trees, the grass or other ground cover, and name them out loud.
- Wherever you are, take a look around. Don’t look for anything particular or in a specific direction because you need to go someplace. Just look to see what is. Let your thoughts slow down as you name to yourself what you see. Start with the big picture. If you’re inside: desk, walls, floor, ceiling, windows, furniture (chairs, tables, bookshelf, computer, bed, nightstand, etc.) Then begin to take in smaller details: your own hands, your fingers, what they’re touching. Take in the different shades of color and light. Use your other senses, too. For instance, what do you hear? Do you hear the sounds of traffic, dogs barking, or birds outside?
Coping with flashbacks
As noted in a preceding blog post, flashbacks are a vivid and powerful re-experiencing of the traumatic event as if it were happening in the here and now. Not everyone that has trauma has flashbacks, but for those who do they can be especially scary and upsetting because they seem so real. In the event that you find yourself experiencing a flashback, you can be consciously aware of this. You can tell yourself you are having a flashback, and that this is OK and normal in people who have experienced trauma.
Remind yourself that the worst is over—it happened in the past, but it is not happening now, even if you are re-experiencing some of it. “That was then, and this is now.” However uncomfortable and upset you may feel, you survived then, which means you can get through what you are experiencing now.
Ground yourself by becoming more aware of your environment in the present: stand up, stamp your feet, jump up and down, dance about, clap your hands. See where you are right now. Look around the room and notice the colors, the people, and the various objects. Make it more real. Notice and listen to the sounds around you: the traffic, voices, washing machine, music, etc. Notice the sensations in your body, the boundary of your skin, your clothes, the chair or floor underneath you. Pinch yourself or snap a rubber band on your wrist as a way of reinforcing the present and that the things you are re-experiencing occurred in the past.
Take care of your breathing and breathe intentionally. Imagine you have a balloon in your stomach, inflating it as you breathe in, and deflating it as you breathe out. When we are anxious, scared, or stressed, our breathing automatically becomes more rapid and shallow. Sometimes this contributes to a sense of panic, as our body is not getting enough oxygen. This causes shakiness, light-headedness, and more panic. Breathing more slowly and deeply will help interrupt this process.
Get support if you would like it. Let people close to you know about flashbacks so they can help if you want them to. That might mean holding you, talking to you, helping you to reconnect with the present, and to remember you are safe and cared for now.
Flashbacks are powerful experiences, which drain your energy. Take time to look after yourself when you have had a flashback. You could have a warm, relaxing bath or a nap, a warm drink, play some soothing music, or just take some quiet time for yourself. When you feel ready, write down all you can remember about the flashback, and how you got through it. This will help you to remember information for your healing, and to remind you that you did get through it (and can again).
Professional Trauma Treatment
Healing from trauma frequently benefits from professional treatment. The ultimate purpose of treatment is to help free the individual from the grip of the effects of trauma and to help him or her begin to again live in the here and now, with an enhanced sense of safety, competence, and personal responsibility. Recovering from trauma that has progressed to Post-Traumatic Stress Disorder (PTSD) generally requires professional assistance.
In general, professional trauma treatment has three fundamental phases as defined by Judith Herman, M.D., in her landmark book, Trauma and Recovery (1992).
- Safety and Stabilization—creating a sense of safety, reducing symptoms, and increasing competencies by helping the individual learn and practice skills related to emotion regulation, distress tolerance, mindfulness, cognitive restructuring, cognitive diffusion, and relaxation.
- Remembrance and Mourning—processing the trauma by putting words and emotions to it, and mourning the losses associated with it.
- Reconnection and Integration—consolidating new meaning and gains made through the application of awareness and skills, wherein the traumatic experience(s) become something that happened to the individual but no longer define him or her.
There are currently three primary trauma treatment modalities. In exposure therapy people re-experience and talk through the traumatic event in guided circumstances designed to maximize emotional safety over and over until the event is no longer activating. Eye Movement Desensitization and Reprocessing (EMDR) involves techniques that help people reexamine, reprocess, and integrate traumatic memories and events. Somatic Therapies emphasize the use of the body to process trauma and facilitate the integration of traumatic memories and experiences. The most notable of these are Somatic Experiencing and Sensorimotor Psychotherapy.
Trauma recovery is a highly individualized process that takes place over time, not overnight. What’s most important is to find the type and level of resource(s)—be they self-help, mutual-aid, professional, or a combination thereof—that best fit your needs and which can most effectively facilitate your healing.
As indicated above, this is the fourth and final of a four-part series.
Copyright 2016 Dan Mager, MSW, all rights reserved.