What is Trauma Processing?
Written by: Kally Doyle
Many of us have heard or used the phrase “I want to process my trauma” when it comes to therapy. As a therapist, it’s usually one of the first explanations I hear when I ask what brings them into my office, and as a client myself it was one of the first things I remember telling my therapist that I wanted out of therapy.
Despite it being such a common phrase, I have found the meaning behind it remains rather ambiguous. Clients often name “processing trauma” as a therapy goal, but often tell me they aren’t actually too sure what this entails. In this article, I aim to explore why that is and I also hope to provide more clarity for those beginning their therapy journey.
Trauma by nature is ambiguous. If you think about it, an experience would not be considered traumatic if it made complete sense, followed logic, and was always easy to identify. Instead, we often find it takes several months or years for us to identify that an experience we endured was indeed traumatic for us.
An example of this ambiguity in trauma is that many of us who had childhoods where a parent was unsupportive, emotionally unavailable, mentally unstable, and verbally demeaning and/or abusive grow up believing to some extent that this is a normal family dynamic. This is often reinforced by factors such as the other parent not seeing it as problematic, having various family members who refuse to discuss it or avoid the topic altogether, having limited knowledge and understanding of what a parent should be providing emotionally to a child, and more. Because the child’s reality of not having their emotional needs met was never validated, the child then grows into a young adult who likely struggles with relationships, feels insecure in themselves, has trouble with emotional regulation or anger issues, and feels anxious and/or depressed. By the time they begin to realize this pattern, and that something may not be right, they may be well into their 20s. It may be only after several failed relationships, several episodes of depression and anxiety, or other difficult experiences that they begin to realize the reason for these patterns in their life. Even after the realization that trauma may have occurred, it often takes much more personal work and self-reflection to truly see their childhood experience for what it was or was not.
I provide this example to help lead into my next point: defining what “processing trauma” means will vary from person to person, as well as from therapist to therapist.
This is because 1) everyone does not put the same amount of emphasis on their trauma history 2) people express their feelings and inner worlds differently and one style of expression may not be beneficial for every person and 3) there are many different theoretical orientations, or styles of therapy, that exist. Different styles of therapy approach processing trauma in different ways based on the fundamental beliefs about human behavior and psychology that form that type of therapy.
Using my previous example of an individual who has a history of childhood relational trauma, here are some very brief descriptions of how a clinician using the following types of therapy may approach trauma processing with this client:
Psychodynamic therapy
A psychodynamic therapist believes that the past influences and shapes the present. They also believe that the unconscious mind of an individual should be explored in therapy in order to bring about more self-awareness and insight into one’s current problems. With the client example of relational trauma provided above, the clinician will likely explore the client’s childhood and family relationships through talk therapy. As the clinician picks up on unconscious cues, behaviors, feelings, or beliefs expressed by the client, interpretations are made and explored together in therapy. Processing trauma will consist of this exploration of therapist and client interpretations and shedding light on the unconscious mind.
Somatic Experiencing
SE believes that energy becomes trapped within the body during a traumatic experience. It is because this energy is not able to be expelled in those times that the person becomes traumatized. SE works to process trauma through helping the client get more in touch with their body and the language that it speaks; this is done through movement and through learning to recognize physical sensations within the body. SE places less emphasis on the story itself, and more on what the body needs and wants to express. In the example of our client above, an SE therapist would likely help the client learn about what has been held in their body because of their childhood trauma and would work to help the client express this trapped energy.
Attachment Theory
Attachment theory believes that individuals form different styles of attachment to other people based on their initial experiences with their caregivers as an infant and child. Attachment theory believes that trauma can be caused by interruptions in attachment, which can occur because of reasons such as a parent unwilling or unable to meet a child’s emotional needs, or a parent struggling to correctly identify their child’s emotional needs. Lack of secure attachment means an individual does not feel safe. Not feeling safe is a core piece of trauma. Some attachment therapists will also use Polyvagal Theory to help their clients learn how the nervous system responds to threats in the environment. Simply put, polyvagal theory describes how the nervous system responds to trauma and it states that connection equals safety. An attachment therapist may focus on building a safe, supportive, and reliable relationship with the client mentioned above; this relationship-building would be of the utmost importance and would actually be directly and indirectly influencing the client’s attachment style and working to improve their relationship with them-self and others.
Trauma-Focused Cognitive Behavioral Therapy
TF-CBT is a type of Cognitive Behavioral therapy that specifically focuses on trauma processing. It is typically used with children and teens, though it can be used with some adults. It has 3 stages: establishing safety for the client/stabilizing the client, gradually exposing the client to triggers through telling their story, and then consolidating what has been learned and working with the client and family members to ensure a continued sense of safety and healthy coping.
Dialectical Behavioral Therapy
DBT therapy can be highly effective for those whose trauma has led to emotional dysregulation. Emotional dysregulation includes trouble keeping a consistent mood, having emotional outbursts, quickly switching moods, and trouble expressing emotions in a healthy way. A DBT therapist will coach clients on the practice of mindfulness in order to help them learn they are not their thoughts, and feelings, which can lead to an increased sense of control within the client. DBT also usually includes group therapy that teaches clients various emotional regulation and distress tolerance skills. Interpersonal effectiveness skills (healthy communication skills) are also taught. DBT often involves homework assignments and in-session exercises. A DBT therapist may approach processing trauma by coaching these skills and helping the client work towards an increased sense of autonomy and emotional regulation (control). It is through learning these skills that the client is able to manage their trauma reactions in healthier ways.
EMDR
Eye Movement Desitization and Reprocessing therapy is a structured style of therapy with 8 phases. EMDR is similar to exposure therapy in that it has the client recall traumatic experiences in pieces while the therapist helps keep the client calm and relaxed. It uses something called “bilateral stimulation” of the brain to help a CL reduce the intensity of their trauma symptoms while being guided by the therapist to use their eyes to track a certain type of back-and-forth movement. This is a very oversimplified explanation of EMDR, but overall it can be helpful in reducing the pain our example client feels when they recall memories of their childhood.
Please note this is nowhere near an exhaustive list of available and practiced therapies. I chose to list these particular ones because they are often the most common ones I see used among colleagues and other practitioners today in the treatment of trauma. Also, please note that just because a therapist states they practice with one of these therapies does not mean this is exactly how trauma processing will unfold in therapy. Many clinicians use a few theoretical orientations to help shape how they conduct therapy and help their clients process trauma. Additionally, therapists tailor treatment to fit your particular needs.
Overall, you can likely see now why “processing trauma” can be a very vague therapy goal. It will look different based on the type of trauma in your history, how deeply you feel this trauma has affected you, your personal style of expressing yourself, and the type of therapy you choose to pursue. Processing trauma may occur in structured steps, such as in TF-CBT, EMDR, and DBT, or it may occur freely and depend more on what you as the client bring to session each day (such as in Psychodynamic). It may involve physical movement or it may be conducted via talk therapy.
I encourage you to do your own research and seek out a therapist that practices a style of therapy that feels closest in-line with who you are and what you hope to get out of therapy. If one style of processing trauma does not feel effective, try another. Your connection with the therapist is also highly influential in the success of your treatment as well, so feel free to try a few different therapists out too.
