7 min read

Understanding Trauma II. What Steps Can You Take on the Path to Recovery?

Written by Registered Clinical Counsellor, Eszter Blind.

In our previous post, we discussed the definition, characteristics, types and impacts of trauma. But how can we get out of feeling stuck in repeating patterns? Here you will find information on growth after trauma, effective treatment, elements of therapeutic sessions and steps you can take toward recovery. 

Posttraumatic growth 

Did you know that trauma can be turned into a strength? Not only is there a 50% chance of complete recovery from PTSD within 3 months (WHO, 2019), but experiencing a crisis can also initiate radical positive changes in life. In a study conducted in 2021, up to 70% of people who have had traumatic experiences reported such improvement (Altınsoy & Aypay, 2021)! 

This phenomenon is called Posttraumatic growth (PTG), an experience of positive change, thriving and growth resulting from the struggle with major life crises (Calhoun et al, 2010). 

So, how can we utilize people’s potential for growth after trauma in psychotherapy? 

Effective treatment methods 

The most effective interventions include a trauma-focused approach, and it is suggested to incorporate two or more components of different methods, so that treatment can be flexibly tailored to individual needs, while also taking into account the nature of stressors and types of trauma as well (Cloitre, 2021). For example, besides using a variety of interventions for the different symptoms experienced in CPTSD, a longer course of treatment might be more beneficial, as it is connected to multiple life areas (Karatzias et al, 2017). 

Recommended approaches for treating trauma are (Brewerton, 2007; Crenshaw, 2006):

  • CBT: Cognitive-Behavioural Therapy is one of the most recommended options for trauma-related symptoms. Components to include are prolonged exposure with cognitive reprocessing, stress inoculation training, record keeping and relapse prevention. These techniques help reframe beliefs/views of traumatic events, manage stress, and effectively monitor therapeutic progress. 
  • EMDR: Eye Movement Desensitization and Reprocessing is another widely used modality in trauma treatment. It includes many elements of CBT and can complement it as well. The addition of bilateral stimulation while recalling memories can potentially accelerate the treatment process, and it might not always be necessary to share every triggering detail either. 
  • Pharmacotherapy: since trauma has several neurobiochemical effects, psychopharmacologic interventions can be helpful in symptom reduction (e.g. SSRI medication like fluoxetine or sertraline) – however, it is most efficient in combination with psychotherapy. 
  • DBT: Dialectical Behaviour Therapy, originally developed for treating BPD, has been effective in several other mental health concerns, including PTSD. It is helpful in managing impulse control, affective dysregulation and dissociation in trauma-related concerns. 
  • Psychodynamic therapy: besides symptom management, it allows a deeper emotional healing and helps resolve internal conflicts. It aids in processing the trauma material, exploring the roots of negative experiences, and bringing awareness to how they shape unconscious (e.g. relational) patterns that affect current behaviours. 
  • Indirect techniques: incorporating them into trauma treatment can also be very effective – since trauma has effects even if one does not remember everything, utilizing approaches focusing on physical sensations and experiences, or relying on the creative mind can be useful in addressing concerns without direct verbalization (methods e.g. mind-body integration, breathwork, relaxation, guided imagery, symbols and metaphors). 
  • Additional approaches: they can be effectively integrated and individually tailored as components of trauma treatment (e.g. interpersonal psychotherapy, family therapy, case formulation), paving the way for adaptive coping strategies to effectively deal with deeper concerns without negative consequences. 

What happens in the sessions? 

Taking the first step toward recovery can feel overwhelming. People may have had negative experiences in the past when reaching out, or just not knowing where to start and how to move forward, especially if they are unsure what to expect in the first therapy session. 

The first step is focusing on the connection between therapist and client. Creating a safe, nonjudgmental space allows a strong, trusting alliance, which helps to prepare for understanding concerns and treating them effectively later on. A client can always choose what they prefer, so for a well-informed decision, it is also essential to discuss any emerging questions or to mention available alternative treatment options.

Before applying any technique of the therapeutic approaches listed above, a comprehensive assessment is essential for an appropriate treatment plan. It is important that the practitioner fully understands the client’s experience. Traditionally, this is aided by an interview, in which past and present experiences, as well as other related concerns, are thoroughly explored. Depending on the modality and the concern, additional assessment instruments (e.g. brief scales, self-report measures) may be used during the first few sessions. However, in cases of trauma, careful attention is needed, as it might feel difficult to open up and talk about triggering experiences at first. To allow a more comfortable, gentle pace, the evaluation of trauma history can be revisited periodically (Brewerton, 2007). 

Reprocessing emotions tied to traumatic experiences is also a key element of trauma recovery, e.g. embracing the “4A-s” – authenticity, agency, anger, acceptance (Fogleman, 2024). For a deeper transformation, essential steps are important to take in therapy, which means focusing on adaptive coping and communication strategies, ways of self-soothing and regulating emotions, reconnecting to the present, repairing the sense of self and identity, building on and reinforcing strengths, positive traits and unique talents, as well as finding meaning and a positive perspective for the future (Crenshaw, 2006). These elements all help to facilitate therapeutic progress and to prepare for navigating life challenges with more ease and confidence afterwards. 

What steps can you take on your journey? 

If you are seeking solutions for concerns related to any of the areas mentioned above, a holistic approach is key. As mind, body and soul are interconnected, finding a practitioner who provides trauma-informed care could make the difference! It is essential to find the right match, so feel free to take your time to look around for a mental health professional who not only provides effective treatment options but also resonates with you. Your recovery process and treatment need to adjust to your pace, goals, values, specific needs, choices and preferences (Cloitre, 2015; Crenshaw, 2006).

In the meantime, you can get back in control by taking effective steps in the right direction. Engaging in meaningful activities can assist you in recovering from trauma (Crenshaw, 2006): 

  • Stimulating the body: movement, physical exercise (yoga, dance, martial arts, etc.), massage 
  • Creativity: arts, painting, collage, music 
  • Connection: focusing on experiences here and now, taking in the present moment 
  • Perspectives: picturing a positive future (What would it look like? How do you see yourself in it? How does it make you feel?) 

It might also be beneficial to take a moment to acknowledge your resilience and strength that have helped you along this path of growth. If you decide you do not want to carry the weight of trauma any further, and you wish to create a meaningful change in your life, any moment can be taken to start your journey. Trauma does not define who you are, and change can occur, whenever you are ready for it. 

References: 

Altınsoy, F. & Aypay, A. (2021). Development of traumatic experiences screening form (large T): an investigation for university students. Osmangazi Journal of Educational Research, 8 (1), 168-192. 

Brewerton, T. D. (2007). Eating Disorders, Trauma, and Comorbidity: Focus on PTSD. Eating Disorders, 15 (4), 285-304. 

Calhoun, L. G., Cann, A. & Tedeschi, R. G. (2010). The Posttraumatic Growth Model: Sociocultural considerations. In: Weiss, T. & Berger, R. (2010). Posttraumatic growth and culturally competent practice: Lessons learned from around the globe. John Wiley& Sons, Inc., 1-14. 

Cloitre, M. (2015). The “one size fits all” approach to trauma treatment: should we be satisfied? European Journal of Psychotraumatology, 6: 27344. 

Cloitre, M. (2021) Complex PTSD: assessment and treatment. European Journal of Psychotraumatology, 12 (1), 1866423. 

Crenshaw, D. (2006). Neuroscience and trauma treatment: Implications for creative arts therapists. In: Carey, L. (2006). Expressive and creative arts methods for trauma survivors. Jessica Kingsley Publishers, 21-38. 

Fogleman, C. D. (2024). The Myth of Normal: Trauma, illness, and healing in a toxic culture. Family Medicine, 56 (1), 58-59. 

Karatzias, T. et al. (2017). Evidence of distinct profiles of Posttraumatic Stress Disorder (PTSD) and Complex Posttraumatic Stress Disorder (CPTSD) based on the new ICD-11 Trauma Questionnaire (ICD-TQ). Journal of Affective Disorders, 207, 181-187.

World Health Organization (2019). International statistical classification of diseases and related health problems (11th ed.). https://icd.who.int/