Therapy for Trauma, PTSD, and CPTSD
What is trauma?
Trauma, from a psychological point of view, is the state of being stuck in a past situation or period of time when we felt so extremely overwhelmed and helpless that we had to “cut off” and “lock away” our experience. This cut off experience then periodically or consistently rushes up in our everyday lives – particularly when we are dealing with a person, situation, or place that reminds us of the traumatic event.
What does it feel like when trauma gets triggered?
There will be a rush of internal experiences associated with the trauma:
Where is trauma stored in the body?
This is highly individual. Some of us may feel a constriction all over our body when our trauma gets triggered; for others, it may be a “knot in the stomach,” a migraine, chronic pain in a specific area of our body, or something about our posture and the way we carry ourselves. The process of healing is in many ways about attending to whatever in our body is currently asking for our attention the most.
What are the different types of trauma?
Our traumas may be emotional, physical, sexual, or spiritual. Usually any traumatic experience will have different dimensions to it – for example, instances of physical abuse may have an emotionally paralyzing or spiritually crushing side to them as well.
Another useful way to think about the different types of trauma is to think about how early, prolonged, intense, and complex your trauma was. The higher it was on each of those individual scales, the more tricky and lengthy the healing road will typically be for us and thus the more resilience and wisdom we will emerge with on the other side of healing.
Are trauma and PTSD the same? What is CPTSD?
Although trauma is a more general term than PTSD, these two terms are often used interchangeably. The meaning of PTSD (post-traumatic stress disorder) is that you have been through significant trauma, and the stress of that trauma still lives in your nervous system, making your life challenging.
CPTSD (complex post-traumatic stress disorder) is a diagnosis that is closely related to PTSD. The "complex" part of its name is refers to trauma that was repeated, prolonged, intense and oftentimes early in life as well.
When is trauma triggered?
Trauma gets triggered when we are overwhelmed with stress, or when we come across a person or situation that somehow reminds us of the original traumatic experience. For example, we may feel swamped with work obligations, and the stress from that may at some point start feeling intolerable, which may in turn bring up repressed memories of past intolerable experiences. Or, perhaps, we need to bring up an emotionally challenging topic with an important person in our lives, and that may bring up residue from past experiences of being rejected, dismissed, or attacked for speaking our heart and mind.
How does trauma change you?
Effects on our thoughts, feelings, body, and life in the world.
Trauma constricts our body, our emotions and thoughts, and our ways of being in the world. It makes certain parts of us more tense and rigid than they would otherwise have been.
In the body, trauma can be manifest as chronic tension, pain, or illness. Parts of our body will feel stuck, which then may affect the way we move, sit, or digest our food, for example. The well-researched stress-disease connection comes into play here. Stress leads to constriction, and chronic constriction leads to pain and illness. On the other hand, as we re-inhabit and explore our bodies, the constricted parts of them get a chance to be “flushed” first with our attention and then actually with blood, which gives these parts a chance to be rejuvenated and heal.
In the emotional and cognitive areas of our lives, trauma can be manifest as recurrent feelings and thoughts that we have a hard time “getting away from.” At the same time, we may also have difficulty experiencing certain other feelings or thoughts. For example, we may frequently feel sad or fearful, but rarely or ever feel angry or enthusiastic. Or, our minds may habitually bring up judgmental thoughts about other people while almost never giving us thoughts about the beauty of nature, or things to be grateful for in our lives.
As far as our engagement with the outside world goes, trauma may severely restrict which behaviors we allow ourselves to engage in. We may feel like working hard or taking care of others, for instance, come naturally to us; while relaxing, being playful, adventuring, or receiving care from others feel foreign or even dangerous.
Fight, flight, freeze, fawn responses.
Another important way that trauma changes us is it makes us prone to respond to people and life events in certain habitual, almost compulsive ways. We may frequently find ourselves in a fight mode – feeling powerful anger or rage and becoming emotionally or physically aggressive. We may be overtaken by an instinct to flee – shutting down the conversation, leaving abruptly, or escaping the situation internally through dissociation. We may freeze: i.e., feel “like a deer in the headlights,” paralyzed, helpless. Or we may fawn: try to appease or please the other person, from a position of smallness, fearfulness or helplessness.
How does trauma affect relationships?
To be in a satisfying relationship with another person, we need to see them for who they are. Now, that can never be done perfectly, but there needs to be a critical mass of that in the relationship. If there is a lens of trauma between us and other people, things become much more blurry and confusing, to the degree that we often doubt the legitimacy of our perceptions of other people - and of the world in general, for that matter. It can be quite difficult to tell whether what we feel and think about another person is an accurate, objective representation of that other person or our own, internal material that is getting triggered by that person.
Let's say, as an example, that I was often and harshly criticized by my parents when I was growing up. Now, years later, when I interact with my boss at work, I may frequently find myself feeling hurt and angry, and thinking that they are being too critical or too harsh, or maybe even abusive. Yet, when these thoughts and feelings do come up for me, it may not be clear at all to me whether they mean that my boss is actually being unfair or abusive, or whether they are just my own feelings left over from my past.
Even after we learn to recognize that we engage in certain trauma-based feelings or behaviors around a particular person, we can still feel pulled to habitually and automatically feel or behave in those ways.
Does trauma attract trauma?
At first, usually yes - especially if we are unaware of our trauma. We will tend to attract and be attracted to people with certain characteristics which are related to our trauma. We, may unconsciously want to have a corrective experience with the other person to “fix” our past trauma; or we may just be used to certain negative or hurtful behaviors in other people and thus will tolerate it in our significant other.
For instance, if a woman’s father was emotionally absent when she was a child, she may feel a particular pull to date men who tend to shut her off emotionally. For one thing, this will feel familiar to her, and thus safe. But also unconsciously a part of her may feel motivated to try to change the man she is with, to “open him up” and thus have a corrective experience that would repair the pain and loneliness of her past experiences with her father.
How I can help.
The way to help our traumas get unstuck, change, and heal is to slowly, at our own pace, begin to open up the “closed doors” it's hidden behind, and then witness and re-integrate those feelings, memories and energies. In my practice, I first help folks learn to better ground themselves in a state of safety and mindfulness. You will learn to re-inhabit the stuck parts of your body, build mindfulness skills in order to more effectively tolerate inner discomfort, and explore what it is like to share challenging past and present experiences with another person. This will also be an opportunity for us to lay the foundation for a trusting, collaborative therapeutic relationship.
This process is not always as clear-cut as I described it above. People vary greatly in what they need at each stage of trauma work. Some may need to first explore their relationship with me, to make sure that I am trustworthy or that I am caring or skilled enough to help them. Others prefer to start exploring their trauma internally - that is, more directly - soon after starting their sessions with me. Yet others may need to spend quite a bit of time just sharing their story, feeling understood and not alone. In our work, we will both stay attuned to what is needed for your healing process at the moment.
Trauma, from a psychological point of view, is the state of being stuck in a past situation or period of time when we felt so extremely overwhelmed and helpless that we had to “cut off” and “lock away” our experience. This cut off experience then periodically or consistently rushes up in our everyday lives – particularly when we are dealing with a person, situation, or place that reminds us of the traumatic event.
What does it feel like when trauma gets triggered?
There will be a rush of internal experiences associated with the trauma:
- body sensations (tension, pain, heaviness, a “whoosh of energy”)
- feelings (terror, rage, shame, guilt, an impulse to run away, an impulse to please the other person)
- thoughts (“I am bad,” “This is too much,” “F. you!” “I am going to die”)
Where is trauma stored in the body?
This is highly individual. Some of us may feel a constriction all over our body when our trauma gets triggered; for others, it may be a “knot in the stomach,” a migraine, chronic pain in a specific area of our body, or something about our posture and the way we carry ourselves. The process of healing is in many ways about attending to whatever in our body is currently asking for our attention the most.
What are the different types of trauma?
Our traumas may be emotional, physical, sexual, or spiritual. Usually any traumatic experience will have different dimensions to it – for example, instances of physical abuse may have an emotionally paralyzing or spiritually crushing side to them as well.
Another useful way to think about the different types of trauma is to think about how early, prolonged, intense, and complex your trauma was. The higher it was on each of those individual scales, the more tricky and lengthy the healing road will typically be for us and thus the more resilience and wisdom we will emerge with on the other side of healing.
Are trauma and PTSD the same? What is CPTSD?
Although trauma is a more general term than PTSD, these two terms are often used interchangeably. The meaning of PTSD (post-traumatic stress disorder) is that you have been through significant trauma, and the stress of that trauma still lives in your nervous system, making your life challenging.
CPTSD (complex post-traumatic stress disorder) is a diagnosis that is closely related to PTSD. The "complex" part of its name is refers to trauma that was repeated, prolonged, intense and oftentimes early in life as well.
When is trauma triggered?
Trauma gets triggered when we are overwhelmed with stress, or when we come across a person or situation that somehow reminds us of the original traumatic experience. For example, we may feel swamped with work obligations, and the stress from that may at some point start feeling intolerable, which may in turn bring up repressed memories of past intolerable experiences. Or, perhaps, we need to bring up an emotionally challenging topic with an important person in our lives, and that may bring up residue from past experiences of being rejected, dismissed, or attacked for speaking our heart and mind.
How does trauma change you?
Effects on our thoughts, feelings, body, and life in the world.
Trauma constricts our body, our emotions and thoughts, and our ways of being in the world. It makes certain parts of us more tense and rigid than they would otherwise have been.
In the body, trauma can be manifest as chronic tension, pain, or illness. Parts of our body will feel stuck, which then may affect the way we move, sit, or digest our food, for example. The well-researched stress-disease connection comes into play here. Stress leads to constriction, and chronic constriction leads to pain and illness. On the other hand, as we re-inhabit and explore our bodies, the constricted parts of them get a chance to be “flushed” first with our attention and then actually with blood, which gives these parts a chance to be rejuvenated and heal.
In the emotional and cognitive areas of our lives, trauma can be manifest as recurrent feelings and thoughts that we have a hard time “getting away from.” At the same time, we may also have difficulty experiencing certain other feelings or thoughts. For example, we may frequently feel sad or fearful, but rarely or ever feel angry or enthusiastic. Or, our minds may habitually bring up judgmental thoughts about other people while almost never giving us thoughts about the beauty of nature, or things to be grateful for in our lives.
As far as our engagement with the outside world goes, trauma may severely restrict which behaviors we allow ourselves to engage in. We may feel like working hard or taking care of others, for instance, come naturally to us; while relaxing, being playful, adventuring, or receiving care from others feel foreign or even dangerous.
Fight, flight, freeze, fawn responses.
Another important way that trauma changes us is it makes us prone to respond to people and life events in certain habitual, almost compulsive ways. We may frequently find ourselves in a fight mode – feeling powerful anger or rage and becoming emotionally or physically aggressive. We may be overtaken by an instinct to flee – shutting down the conversation, leaving abruptly, or escaping the situation internally through dissociation. We may freeze: i.e., feel “like a deer in the headlights,” paralyzed, helpless. Or we may fawn: try to appease or please the other person, from a position of smallness, fearfulness or helplessness.
How does trauma affect relationships?
To be in a satisfying relationship with another person, we need to see them for who they are. Now, that can never be done perfectly, but there needs to be a critical mass of that in the relationship. If there is a lens of trauma between us and other people, things become much more blurry and confusing, to the degree that we often doubt the legitimacy of our perceptions of other people - and of the world in general, for that matter. It can be quite difficult to tell whether what we feel and think about another person is an accurate, objective representation of that other person or our own, internal material that is getting triggered by that person.
Let's say, as an example, that I was often and harshly criticized by my parents when I was growing up. Now, years later, when I interact with my boss at work, I may frequently find myself feeling hurt and angry, and thinking that they are being too critical or too harsh, or maybe even abusive. Yet, when these thoughts and feelings do come up for me, it may not be clear at all to me whether they mean that my boss is actually being unfair or abusive, or whether they are just my own feelings left over from my past.
Even after we learn to recognize that we engage in certain trauma-based feelings or behaviors around a particular person, we can still feel pulled to habitually and automatically feel or behave in those ways.
Does trauma attract trauma?
At first, usually yes - especially if we are unaware of our trauma. We will tend to attract and be attracted to people with certain characteristics which are related to our trauma. We, may unconsciously want to have a corrective experience with the other person to “fix” our past trauma; or we may just be used to certain negative or hurtful behaviors in other people and thus will tolerate it in our significant other.
For instance, if a woman’s father was emotionally absent when she was a child, she may feel a particular pull to date men who tend to shut her off emotionally. For one thing, this will feel familiar to her, and thus safe. But also unconsciously a part of her may feel motivated to try to change the man she is with, to “open him up” and thus have a corrective experience that would repair the pain and loneliness of her past experiences with her father.
How I can help.
The way to help our traumas get unstuck, change, and heal is to slowly, at our own pace, begin to open up the “closed doors” it's hidden behind, and then witness and re-integrate those feelings, memories and energies. In my practice, I first help folks learn to better ground themselves in a state of safety and mindfulness. You will learn to re-inhabit the stuck parts of your body, build mindfulness skills in order to more effectively tolerate inner discomfort, and explore what it is like to share challenging past and present experiences with another person. This will also be an opportunity for us to lay the foundation for a trusting, collaborative therapeutic relationship.
This process is not always as clear-cut as I described it above. People vary greatly in what they need at each stage of trauma work. Some may need to first explore their relationship with me, to make sure that I am trustworthy or that I am caring or skilled enough to help them. Others prefer to start exploring their trauma internally - that is, more directly - soon after starting their sessions with me. Yet others may need to spend quite a bit of time just sharing their story, feeling understood and not alone. In our work, we will both stay attuned to what is needed for your healing process at the moment.