“Understanding trauma and that we each respond to it differently will help us be supportive and nonjudgmental toward each other.”
― Stephanie S. Covington,
The Many Shades of Trauma and Loss
In my practice, I see a wide range of clients who are impacted by trauma in different forms: A mother whose baby died in childbirth; a survivor of childhood sexual abuse; a father whose teenage son committed suicide; a special needs mom who is navigating the world of special education; a survivor of 4 miscarriages and 5 failed IVF attempts; a man working in an intolerably toxic work environment; a child who witnessed domestic violence. What these individuals all have in common is the shared experience of trauma and loss. Although their stories are all different, their journeys are similar in that they have survived the unthinkable, and with that, they are working toward healing and recovery.
Response to Trauma
A client’s response to trauma is as unique as the individual. Some may show evidence of PTSD (hypervigilance, numbness, intrusive flashbacks, generalized unease and dread) (DSM-5, 2014), and others still may develop Complex-PTSD (a more severe and pronounced version of PTSD) as a result of exposure to chronic, sustained trauma over a long period of time (Herman, 2015). Even still, some survivors of trauma may not manifest what would be considered a clinical diagnosis in response to trauma; those individuals may be demonstrate resilience and post-traumatic growth, thereby harnessing the power of healing in the face of adversity (Thomadaki, 2017). Most survivors who receive psychotherapeutic treatment for PTSD/complex-PTSD can reach a place of post-traumatic growth as well.
Helpful Self-Care Strategies
In addition to seeking qualified support from a competent and compassionate trauma-informed therapist, a client may benefit from the following strategies to enhance their recovery:
*Basic Physical Self-Care: Strive for at least 5 consecutive hours of sleep per night to restore sleep cycles, thereby lifting the serotonin in the brain and reducing the possibility of developing anxiety/depression. If you are having difficulty with sleep, consult with your general practitioner to discuss potential interventions (such as melatonin, relaxation exercises, etc).
Focus on good nutrition and hydration. Work with your general practitioner to be sure that your body has sufficient vitamins and minerals (stress can deplete vital reserves of these nutrients); rule-out low Vitamin D and also Thyroid Disorder, both of which can mimic symptoms of depression/anxiety. Also discuss supplementation of omega-3 fish oil and it’s benefits for mental health (Kendall-Tackett, 2017). Eliminate caffeine, alcohol and other substances (food coloring, additives).
Get a good exercise program going which incorporates mindfulness meditation, yoga, and hiking if possible. The latter suggestions are all proven through research to benefit the mind and body and restore mental health (WebMD, 2017).
*Establish Safe Community and Support: For survivors of trauma, this may mean joining a support group specific to the trauma (i.e. miscarriage support group). It may mean reaching out to spiritual community at your local church, synagogue, temple, meditation or prayer group. Or it could also involve connecting with known others such as friends and family, who are unconditionally supportive and non-judgmental. For trauma survivors to heal, safe connections with trusted others is essential in restoring a sense of hope for the future.
Self-Care Activities: While incorporating individual and group psychotherapy, self-care strategies for physical health, and reaching out to safe members of one’s community, survivors can also benefit from the following activities:
*Keep a written or visual journal of your experience. Narrating the story and sharing it with a trusted other who can bear witness to the timeline of the experience, helps to validate and lower the intensity charge of the traumatic memory. Image-making can be helpful when words are hard to come by (i.e. magazine photo collage, painting, clay, etc) (Malchiodi, 2010).
*Establish relaxation strategies which incorporate breath work, including mindfulness meditation, yoga, and tai chi. Mindfulness approaches are now evidence-based interventions to lower stress responses (Taylor, 2017).
*Regular attendance at individual and group therapy sessions, including evidence-based and trauma-informed psychotherapy (EMDR, mindfulness based cognitive behavioral restructuring, expressive therapies) (van der Kolk, 2015).
*Know that in time, with competent and compassionate psychotherapeutic care, community support, and excellent self-care, survivors do heal and recover and enter a chapter of thriving, putting their trauma squarely away in the past, where it belongs.
Herman, J. L. (2015). Trauma and recovery: aftermath of violence from domestic abuse to political terror. New York: BasicBooks.
Highlights of Changes From DSM-IV to DSM-5. (n.d.). Diagnostic and Statistical Manual of Mental Disorders, 5th Edition. doi:10.1176/appi.books.9780890425596.388591
How Hiking Is Good for Body and Mind. (n.d.). Retrieved September 04, 2017, from http://www.webmd.com/fitness-exercise/features/hiking-body-mind
Malchiodi, C. A. (2010). The art therapy sourcebook. New York: McGraw-Hill.
Taylor, B. L., Cavanagh, K., & Strauss, C. (n.d.). The Effectiveness of Mindfulness-Based Interventions in the Perinatal Period: A Systematic Review and Meta-Analysis. Retrieved September 04, 2017, from http://journals.plos.org/plosone/article?id=10.1371%2Fjournal.pone.0155720
Thomadaki, O. O. (2017). Bereavement, post-traumatic stress and post-traumatic growth: through the lenses of positive psychology. European Journal of Psychotraumatology, 8(Sup4), 1351220. doi:10.1080/20008198.2017.1351220
Uppitysciencechick. (n.d.). Retrieved September 04, 2017, from http://www.uppitysciencechick.com/
I. (2015). The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma by Bessel van der Kolk, MD | Key Takeaways, Analysis & Review. San Francisco: IDreamBooks Inc.
What is Trauma-Informed Psychotherapy? (n.d.). Retrieved September 04, 2017, from https://blogs.psychcentral.com/savvy-shrink/2017/09/what-is-trauma-informed-psychotherapy/
Photo by Marie in NC