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What is trauma?
As a clinician trained in TF-CBT (Trauma-Focused Cognitive Behavioral Therapy), I often view experiences shared with me by others through the lens of trauma. Trauma is a complex topic, and I have seen several different variations in the definition. Without going into depth on the several variations, on a most basic level, the DSM 5 qualifies ‘traumatic’ to include events that a person experiences, witnesses, or learns about that involve actual or threatened death, serious injury, or sexual violence. There are three main types of trauma: acute, chronic, complex.
When working with clients who have experienced trauma, it is often a struggle for the client to acknowledge the impact that it has had on their life. Once the trauma is allowed to be ‘real’, the client instinctively knows that what follows is likely to be a painful process. The brain ‘kicks in’ to protect survivors in a way that provides short-term relief.
How does trauma manifest itself in individuals?
Lisa presented as a capable, articulate, and self-aware young adult, living on her own. When Lisa began sessions with me, she was able to identify some experiences she had as a child in her parent’s home that still greatly affected her. Yet week after week, Lisa continued to question her right and her choice to explore versus ignore her past experiences.
“Was it really that bad? I mean, I know it affected me, but I’m okay now. Well, not okay, but…mostly I’m fine. And other people have gone through much worse.”
Lisa is struggling to figure out if her experience is ‘worth’ exploring. She is attempting to minimize the impact of her past experiences on her day-to-day life, while simultaneously describing emotional and physical symptoms correlated to PTSD (Post-traumatic stress disorder) in our sessions together.
Why is it so difficult for Lisa to accept that she has experienced trauma? Lisa knows what she experienced and she knows how it affected her, and continues to affect her. However, by denying the extent of the trauma, Lisa feels that she can stay safe in the present, without having to make big changes that will threaten family dynamics that have been in place for decades.
The Choice: Ignoring vs. Exploring
“Do I ignore it or explore it?” Lisa considers what kind of boundaries may or may not be helpful. A trauma survivor may deny or avoid their experiences because exploring can bring with it an avalanche of new and seemingly overwhelming feelings and experiences. Inaccurate or unhelpful cognitions will be brought to the surface. Relationships may be challenged by a client seeking to implement boundaries.
Ignoring trauma is unlikely to accompany any lasting feelings of calmness, but may feel like a safer choice in the present moment. Exploring trauma may seem an impossible task, but with the right support team, it can bring immense relief. When clients choose therapy as a means to work through trauma, a strong and trustworthy therapeutic alliance is necessary, since trauma was often experienced as a betrayal of trust by someone who should have been trustworthy. Though it may seem daunting, choosing to explore trauma, and not ignore it, will likely yield longer-lasting, farther-reaching results.
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