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How Does Trauma Therapy Work?

Julia Bosson, PhD

Participating in trauma therapy is probably one of the hardest—but most rewarding—things that a trauma survivor can do for him/herself.  It takes a lot of courage to successfully participate in trauma therapy, so that is the first component needed to make the therapy work. Even seeking out therapy after a traumatic experience is a huge step, so courage is something that most trauma survivors bring to the table without even realizing it.

A good relationship between the patient and the therapist is also crucial.  It’s often hard for trauma survivors to trust anyone after the experiences they’ve had, but in order for trauma therapy to work, it’s important that the patient trust the therapist enough to participate fully in the treatment.  This means that the patient needs to be willing to experience some difficult sessions with the knowledge that it’s ultimately for his own benefit.

This idea leads to a third basic component in successful therapy for trauma: a decent understanding of how trauma treatment works and the reasoning behind the things your therapist asks of you. Many patients find it easier to trust the therapist when they understand what her motivation is behind different aspects of treatment, which I’ll describe below.

So those are the first three steps—courage (which you already have if you’ve reached out for help in the first place), a good relationship (which is up to the therapist to develop as much as it is up to the client), and an understanding of how trauma affects people and what works to treat it (which is your therapist’s job to explain).

Beyond that, successful trauma therapy typically unfolds in a fairly systematized way, even though there are some variations among specific treatment approaches. But the theme is always the same—the patient needs to face head-on the very things that have been haunting him and start to change the thoughts he has about those things. This means going out and doing the things you’ve been avoiding (slowly, and at your own pace). It also means facing the memory of what you experienced.

Trauma survivors often work really hard to avoid any memory of their trauma, which means they never get the chance to process what happened to them. By facing the memory of what happened, you can organize and encapsulate it, giving the memory a beginning, middle, and end, and then step back and look at the memory with some perspective. This takes the power out of the memory and puts it back in your hands.

Finally, trauma therapy gives you the chance to examine the thoughts you have about your traumatic experience (and about life in general) that are keeping you stuck. Trauma tends to shake up the way we think about our world, oftentimes leaving survivors with patterns of thinking that make them feel anxiety, despair, guilt, and a host of other negative emotions. Successful trauma therapy helps you acknowledge these thinking traps and reset/eliminate them so you can start feeling better.

Therapy for trauma can’t change the past and certainly doesn’t erase a person’s memory for the bad things that have happened. But it does allow a person to make sense of what (s)he experienced and to go on living and enjoying life—and that is what I love about it.

To learn more about trauma and posttraumatic stress disorder, check out Union Square Practice’s resource page

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