Trauma Counseling: Helping Others Heal Beyond the Hurt
Trauma counseling is a specialized form of mental health treatment that helps a person heal from the emotional, psychological, physiological, and social impact of traumatic experiences. This process is a crucial step in alleviating the painful and enduring impacts of living through adverse experiences.
Trauma therapy is often said to target the root cause of symptoms. This is done by helping individuals process their experiences, learn coping strategies, and manage or change negative feelings, thoughts, and behaviors.
According to the Centers for Disease Control and Prevention (CDC), a traumatic event is a highly stressful event or series of events usually involving a sense of horror, helplessness, pain, injury, or threat. Trauma can be a result of directly experiencing the event, witnessing the event as it occurred to others, learning the event happened to a close family member or loved one, or repeated and extreme exposure to aversive details of the traumatic events.
These events may be a natural disaster, sexual assault, accident, war, injury, child abuse, serious illness, loss of a loved one, displacement, bullying, harassment, loss of a job or financial stability, neglect, abandonment, and other highly stressful and painful events. It is important to note that the effect, severity, and duration of trauma may vary from person to person. What may be traumatic to one may not be traumatic to another.
Trauma can be acute, chronic, or complex. Acute trauma occurs after a single incident, such as an accident, sexual assault, or loss of a loved one. Chronic trauma is repeated and prolonged, such as domestic violence or abuse. Complex trauma is exposure to varied and multiple traumatic events, often interpersonal in nature.
Individuals who have experienced trauma report a broad range of reactions and experiences. In many instances, two people who have experienced the same traumatic experience can have completely different responses.
Symptoms of Trauma
Shortly after experiencing a trauma, you may feel a sense of shock, numbness, or disbelief. You may also feel disconnected, fearful, anxious, panicked, confused, hopeless, powerless, irritable, or withdrawn. You may struggle to relax or feel safe, and experience physiological symptoms such as increased heart rate, rapid breathing, tension, headaches, nausea, increased perspiration, gastrointestinal problems, and a high level of alertness. For a majority of people, these symptoms subside within a few weeks or months. Others may not experience symptoms until weeks, months, or even years after the traumatic event. Some experience persistent symptoms lasting for several months or years, that impair their daily functioning and cause significant distress.
If these symptoms do not resolve or improve within a few weeks or months, it is important to speak with a mental health professional, who can determine if these symptoms are attributable to posttraumatic stress disorder (PTSD). PTSD can have a substantial impact on a person's everyday functioning, relationships, and general well-being.
Persons experiencing PTSD report the presence of recurrent, involuntary, and distressing memories, dreams, or flashbacks of the event, or physiological and psychological reactions to reminders of the event.
This contributes to persistent avoidance of these reminders, memories, thoughts, or feelings. Alterations in thought and mood are present, such as an inability to remember the event, negative beliefs about oneself, others, or the world, unhelpful thoughts about the cause of consequences of the event, constant negative emotional state, disinterest or nonparticipation in your usual activities, feelings of detachment or estrangement, and inability to experience positive emotions.
It is common to experience irritable behavior or anger outbursts, reckless and self-destructive behavior, heightened alertness and sensitivity to your surroundings, exaggerated startle response, problems with concentration, and sleep issues.
In 2018 the World Health Organization (WHO) began to recognize a new type of posttraumatic stress disorder, known as complex posttraumatic stress disorder (CPTSD). This disorder is marked by experiences of repeated traumas, that last for months or years at a time. While recognized by many American mental health care professionals, it is not often diagnosed, as it has not yet been included in the diagnostic manual (DSM5) used by American mental health professionals.
Encompassing many of the symptoms of PTSD, persons with CPTSD may experience additional challenges with emotional regulation and interpersonal relationships. Many of the treatments indicated for PTSD have also been studied and applied to CPTSD in other countries.
Professional intervention and treatment, such as counseling and medication, are often required to help individuals manage their symptoms and move toward healing and recovery. These treatments are highly researched and effective when offered by a trained professional. Those who have undergone these treatments often report they are transformational and incredibly helpful at restoring their wellness.
The Role of a Trauma Counselor
People who have experienced trauma require and deserve a safe, confidential, and neutral space to feel supported, understood, and helped. A trauma counselor, therefore, should be able to establish trust and rapport with trauma survivors to help them successfully go through the therapy process.
Here are the key responsibilities of a trauma counselor:
Creating a Safe Space
This means establishing a supportive and comfortable environment, where one can share their experiences and be heard without judgment.
Assessing and Diagnosing
A trained professional can evaluate the impact of traumatic experiences on one’s mental health. Receiving an accurate diagnosis of PTSD indicates to a professional what treatments may be helpful for you and allow you to receive services that are covered by most health insurance companies.
A trauma counselor educates the individual about the implications of trauma, the healing process, and available treatments.
Developing Coping Strategies
Trauma counselors must also teach individuals healthy coping and adaptive mechanisms. These can include relaxation techniques, grounding exercises, therapeutic activities, and other practical skills that support emotional regulation, promotion of self-care, and enhanced quality of life.
A knowledgeable provider will help individuals find wellness again through evidence-based approaches. These approaches include trauma-focused cognitive-behavioral therapy (TF-CBT), prolonged exposure (PE), eye movement desensitization and reprocessing (EMDR), Somatic Experiencing (SE), and Brainspotting among others.
It is important to discuss your treatment options with your provider, as some treatments may be more appropriate than others, given your circumstances. A skilled provider can help you consider your options, and offer a referral to a different provider if they are untrained in the treatment you request or require.
Emotional Support and Validation
Trauma counselors provide a safe and non-judgmental environment where individuals can talk about their feelings and concerns. The professional also provides support, compassion, understanding, and empathy while validating the client’s emotions throughout the process.
Building and Reinforcing Resilience
The counselor makes it a point to help individuals bounce back as well as find meaning and growth after the trauma. This is done by helping them find their strengths and regain their sense of control in their lives. They assist with not just healing but helping the individual gain a sense of renewal so they can make a fresh start and take advantage of opportunities to thrive.
Because trauma-related symptoms encompass emotional, mental, and physical aspects, counselors often work as part of a multi-disciplinary team of medical doctors, social workers, psychiatrists, and psychologists to provide a more comprehensive treatment approach.
Approaches and Techniques Used in Trauma Counseling
There are several evidence-based approaches and techniques that trauma counselors use in therapy. Below are a few common approaches, though this list is not comprehensive.
Trauma-Focused Cognitive-Behavioral Therapy
This is a combined parent-child or caregiver-child treatment that utilizes cognitive-behavioral principles and exposure techniques to identify and change trauma-related negative thought patterns and behaviors. It has been proven effective for children and adolescents aged 3 to 18 years who suffer from the emotional impact of a single or series of traumatic experiences.
Eye Movement Desensitization and Reprocessing (EMDR)
EMDR is a psychotherapy treatment originally designed to alleviate trauma-related distress. It involves recalling traumatic memories using eye movements and other bilateral stimulation that help process these memories with less negative impact. Its objective is to bring trauma to an adaptive resolution and alleviate distress, rewire negative beliefs, and reduce physiological arousal.
Prolonged Exposure Therapy (PE)
Prolonged Exposure is a type of cognitive behavioral therapy. PE teaches individuals to approach traumatic memories, feelings, and situations, through various types of exposures. This exposure often includes audio recording a detailed account of the trauma and repeatedly listening to the audio recording between sessions, while practicing breathing techniques. Exposure may also include facing things you have begun to avoid.
Somatic Experiencing (SE)
SE is a type of body-based trauma therapy, rooted in scientific research on the intersection of physiology, psychology, ethology, biology, neuroscience, indigenous healing practices, and medical biophysics. SE helps to resolve symptoms of trauma that accumulate in our bodies (e.g. changes in the biological stress response). Through various body-based exercises, somatic experiencing has helped many heal from trauma.
Rooted in neurobiological research, Brainspotting is a trauma treatment introduced in 2003. Brainspotting works by identifying, processing, and releasing sources of emotional and body pain while relieving other challenging symptoms. Its name stems from the concept of a Brainspot, which is a fixed eye position that activates a traumatic or emotionally charged issue in the brain. Through holding this eye position and other techniques, traumas can be processed and resolved.
Grounding Techniques and Stress Reduction Strategies
These involve multi-sensory experiences to ground the individual to the present moment and manage overwhelming emotions. These exercises help temper heightened responses to distressing thoughts and emotions. Some examples are deep breathing exercises, muscle relaxation techniques, mindfulness meditation, and guided imagery. These techniques are often included in a variety of evidence-based treatments.
Art Therapy and Other Creative Modalities
While many of the treatments mentioned above do not require vocalizing or describing the details of traumatic experience (SE, EMDR, Brainspotting), art therapy can be particularly helpful for those that do not wish to do this type of processing. Various art forms like painting, drawing, writing, or music can help them explore and express their emotions, gain insights, and help them move toward healing and recovery.
Ethical Considerations in Trauma Counseling
Trauma often disrupts a person's sense of trust and safety with others. This often shows up in the therapeutic relationship. It is therefore imperative for trauma counseling professionals to practice confidentiality, create safe boundaries, and prepare clients with coping skills for therapeutic interventions that pose the risk of causing discomfort or distress.
There should also be cultural sensitivity and awareness. This empowers professionals to understand that trauma survivors come from diverse cultural backgrounds, beliefs, practices, and values that may influence their experiences, ways of coping, and healing processes. A trauma counselor with this level of sensitivity and awareness should never shame or stigmatize you for the symptoms you’re experiencing. Rather, they should recognize that symptoms are often a normal reaction to abnormal events.
It is also important for trauma counselors to have a genuine desire to help, a commitment to educating themselves on scientific research and evidence-based techniques, and the ability to adjust treatment plans when treatment is not working or causing too much distress.
In the journey towards healing from trauma, counseling, and the available trauma treatments offer considerable hope. Trauma counselors can help guide individuals through the process of recovery through compassion and evidence-based support.
While the road to healing can appear challenging, it is important to remember seeking help is an act of courage, strength, and resilience. The progress made in trauma counseling research and practice over the years underscores the message that healing is possible, and a brighter future is within reach.
If you or someone you know is grappling with the aftermath of trauma, know that you are not alone. The path to recovery is ahead of you. With the power of your own inner resilience, the innate capacity for humans to heal, and the right professional, you can overcome this adversity. There is a community of skilled and empathic professionals ready to walk alongside you, who can empower you, and help you embrace a future marked by hope, growth, and vitality.