Trauma in a person’s life has many possible causes, and many toxic effects. There is one word that never applies to trauma, however: “superficial.”
Trauma is deeply rooted and lasting. That is why psychologists have developed a complex array of trauma therapies, and devote substantial time and energy to researching new techniques.
Trauma is like memory,” writes Sandro Galea, M.D., the Robert A. Knox professor and dean of the Boston University School of Public Health. “It stays with us through the years, undermining our mental health long after precipitating events.”
Dr. Galea witnessed the long-lasting effects first-hand when he conducted a comprehensive study of a region of Liberia that had experienced a prolonged civil war. He discovered how easily trauma can become woven into the fabric of a person or population: “We found that not only was the prevalence of PTSD among the population high, at 48.3 percent, but also that the geographic patterns of present-day PTSD mapped on to where the primary conflict had occurred two decades before.”
Shelley Behr, a Vancouver-area family therapist, has seen this in her own practice. Behr witnesses civil and uncivil wars on a much smaller scale when helping families cope with aspects of divorce. These conflicts won’t make the news or change the geopolitical balance in the world, but the trauma they channel and generate can be just as lasting, for parents and children alike.
“Trauma puts survivors on constant high alert, a survival response useful to protect against additional trauma,” writes integrative trauma therapist Odelya Gertel Kraybill, Ph.D. “But this sense of alertness also blocks access to the deep roots of trauma in the body. Traumatic memories reside as frozen experiences within. They take away spontaneity, one of the most important resources for survivors in moving on.”
Because traumatic experiences become so deeply rooted, effective trauma therapy is much more extensive than a series of conversations about past events. “Traumatic memories are not stored in a way that they can be deeply accessed by verbal interactions based on cognitive or logical processes,” she explains. “Careful preliminary work with other strategies needs to take place before working with the trauma story itself. … If we begin therapy by focusing on the trauma story itself, the risk is high that we will add to the injury and pain. Early work should focus instead on restoring a sense of safety, on helping the survivor to discover and draw on their resources, and on self-regulation.”
Family therapist Shelley Behr agrees. “Each patient in trauma therapy requires the benefit of two key variables: a uniquely tailored approach — and the time to make it work. Traumatic events live on in memories that are sometimes vivid and often repressed. Therapy must address both the fear and anxiety so clearly present on the surface, as well as the not-quite-forgotten memories buried in the subconscious.”
In treating trauma, Behr applies a range of techniques, including cognitive behavioural theory, energy psychology, family systems theory and solution focused therapy. For children who have experienced trauma, often as a result of parents divorcing, she finds that art and play therapy is effective in many cases.
The best trauma therapy imparts hope and understanding to a patient — understanding of root causes and hope that traumatic memories can be managed.
As psychologist Seth J. Gillihan, Ph.D. has written: “After a trauma it can feel like we have 99 problems — I’m scared, I can’t sleep, I’m on edge, I’m angry, etc.—and recognizing that all of these problems are tied to the trauma can make them feel more manageable: Maybe what I’m experiencing is one problem with many faces. It can also be useful to realize that as the recovery process unfolds, these experiences are likely to improve, which can instill hope.”