If you have attempted to work on these issues on your own, kudos to you, because that requires a great deal of courage. The odds are, though, that your therapist didn’t encourage this or didn’t provide you with tools and techniques to do so. Healing can be done at home, and I will often recommend that people use various techniques such as cognitive exercises or writing letters to help themselves when they are not in session. While the typical Cognitive Behavior (CBT) therapist will assign you homework to complete (e.g., thought records, behavioral interventions, and various worksheets), remember that it’s not simply the amount of time you spend on healing, but how you spend the time. Working to heal through remembering, feeling, expressing, releasing, and reframing are critical, active techniques, and so using these techniques is far more important than spending huge amount of times doing less critical activities.
•How has the emotional trauma you suffered affected your life negatively? Has it negatively affected you in terms of careers, relationships, moods, or your ability to enjoy life? Has therapy helped you deal successfully with any of these problems, especially in the long-term?
There are subtle ways and then there are obvious ways that experiencing trauma can impact one’s life. Working too much, as Jim did, is an example of an obvious response to his trauma. More subtly, he lost his enjoyment of life because his mind was anchored in the past. Therapeutic treatment is designed to address and permanently resolve these issues. Anything less is ineffective treatment.
Many people are dissatisfied with their emotional trauma treatment; and people who have stopped treatment or never bothered with it may grit their teeth and try to muddle through life with all the burdens that trauma creates.
It doesn’t have to be this way. To help make the case for an effective alternative and a model for trauma treatment, let me share six different approaches that have contributed to my model on healing from emotional trauma. In this way, I think you’ll start to understand the roots of trauma and how it might respond to the right treatment protocols.
Six Contributions to My Understanding and Treatment of Emotional Trauma
Before introducing my model for treating trauma, let’s explore trauma from six distinct perspectives: those of stress response, neuroscience, cognitive behavioral theory, Gestalt Theory, Freudian psychoanalysis, and religious training. Each of these topics will provide insight into the method I use and why it is so effective in the treatment of all types of emotional trauma.
The Stress Response
In 1956, Dr. Hans Selye at the University of Montreal described in his book a three-step response to challenges, which he called the stress response5. More specifically, he coined the term General Adaptation Syndrome6 (GAS) to illustrate a three-step progression of what happens to an organism (including you, the human) when stressed. Selye noted that stress is a specific, predictable, internal response to a non-specific stimulus or threat. In other words, whatever threatens you, be it a subpoena, an IRS audit, or an episode of Real Housewives of New Jersey, evokes a predictable physiological response: secretion of stress hormones like norepinephrine and cortisol, accelerated heart rate and respiration, shutdown of digestion and sexuality, and increased blood flow to the major muscle groups, including the chest, back, arms, and legs, all of which prepares the organism for “fight or flight.”
This first stage is called the alarm reaction, and it is entirely normal and appropriate. The extra fuel you receive from norepinephrine, for instance, aids you in staying up all night for the final exam or rescuing a child from a burning house. When the threat is over, the body returns to homeostasis.
The second stage of the GAS is the “resistance stage.” Here, the stressor is ongoing, so your nervous system remains in high gear. For example, your high-conflict marriage becomes a high-conflict divorce, your financial woes worsen, or your child’s hyperactivity continues unabated. This stage lasts as the perceived stressor goes on—or until the body’s coping mechanisms give way to the third stage, “exhaustion.”
Exhaustion is exactly what you think it is, a breakdown of the nervous system resulting in fatigue, dysphoria (low mood), anhedonia (an inability to experience pleasure from previously rewarding activities), free-floating anxiety, insulin spikes, panic attacks, infections of all kinds (since your immune system no longer fights off intruders), muscle cramping and aching, every one of your least favorite gastrointestinal symptoms, and so much more. People in the third stage are hospitalized or suffer from “nervous breakdowns,” depressive episodes, psychotic breaks, or panic attacks. Our coping mechanisms are temporarily defeated and require help.
So what does this have to do with treatment of trauma? Unresolved trauma causes the stress response to be left in the “on” position, or perhaps it is like a faucet that is continually running. A primary goal of treatment is to shut off the stress response, return it to the “off” position, or shut off the faucet, whatever analogy you prefer.
And how is that done? The mind must believe that there is no longer a threat (or that it is manageable) and that all is “okay.” It’s that simple. And yet meeting this condition is imperative for turning off the stress response. In reality, there are a thousand ways to get to “okay.” For instance, the surgeon looks down at you in the recovery room, smiles, and says, “We got it all, you will recover completely,” and you believe her. Likewise, the insurance guy calls and says, “We’ve reviewed your case, and we are going to pay for 100 percent of the flood damage,” and you believe him. Your wife says the affair is over and she only wants to be with you, and you believe her. The nanny says she will forgive your children for tying her up in the playroom and will not resign after all, and you believe her.
Again, the mind must conclude that somehow all is okay once again for the stress response to be shut down. So you, the trauma sufferer, need to believe that whatever the trauma—rape, betrayal, financial loss, death of a loved one, abandonment, the sounds and images that form the experience of combat, etc.—there is hope, and you and it will be okay. For Jim to resolve his issue, he will have to believe that despite the loss of his two sons, he can recover and live a meaningful life. All will be okay.
Neuroscience
Trauma can quite literally change your brain7. Various neurological studies and research conducted since Selye’s discovery of the stress response have further illuminated the impact that trauma can have on brain structure.8 9 Thanks to modern neuroimaging, we can now observe some of the fascinating complexities of the brain. For instance, the hippocampus is the structure responsible for memory. More specifically, it creates new memories, storing them away for later, and also retrieves memories in the brain. If I ask you to recall the name of your third-grade teacher, more than likely, you would be calling upon your hippocampus to do the dirty work. But as Bremner (2006) notes, it appears trauma is responsible for reducing the volume or size of the hippocampus.7
Why does size matter? Since we routinely call upon our memory center thousands of times in the course of a day, shrinkage would create confusion and compromise your capacity for recall. Additionally, a smaller hippocampal unit would make it more difficult to decipher which things were threatening to you and which not. Your judgment would also be reduced, and the stress response would be triggered far too often by non-threatening stimuli.
After a particularly bad auto accident, the hippocampus may be impacted. As such, deciphering what driving conditions are normal and which ones are dangerous may be extremely difficult. Hence, all driving on crowded roads and highways might be perceived as very threatening and compromise the driver’s willingness or confidence in his/her ability to drive. Again, this may contribute to your stress response being left in the “on” position for no good reason.
The limbic system, the area of the brain most responsible for emotions, contains the amygdala, which is thought to be responsible for emotional processing and the acquisition of fear responses. Your amygdala attempts to determine what a given stimulus is and whether or not to react emotionally to the stimulus. When adversely impacted by trauma, this structure in the brain is