What Is Trauma? An Introduction to Traumatization and Healing

Feb 24

If you’re finding yourself on this page, you’re probably seeking to learn more about trauma work and what therapy for trauma looks like. Perhaps you’ve sought therapy in the past- perhaps multiple times- and haven’t found that you’ve resolved what you intended to. Whatever the case may be, my goal here is to give a brief overview of some of the background of traumatization and its treatments. There are excellent resources out there for those seeking to learn more and I’ll include the relevant links at the end of this post.

So what is traumatization? There are several definitions, but the one I’ll use here is a state of emotional, psychic and/or bodily dysregulation after experiencing or witnessing an event, in which there was (or was perceived to be) an acute threat, and the dysregulation didn’t subside once the event was over. Let’s break this down. Firstly, some circumstance, or series of circumstances, caused the affected person to be terribly threatened or unsafe. Typically, when we find ourselves in threatening situations, our autonomic nervous system pushes us into fight, flight or freeze (or fawn) mode. In the first two modes, we are overwhelmed with activating hormones, preparing us to either defend ourselves or flee to safety. In the latter mode, an opposite process shuts us down, initiating an almost catatonic state. The reason for these processes is to allow us to either better survive the situation or at least experience less of it.

While it is very much adaptive and positive for our bodies to enter these states in pertinent situations, sometimes we get stuck there. For some, terrifying experiences like combat or encountering a grizzly bear are experienced in the moment, but end when safety is reached. For others, however, even when a traumatic experience is far away in space and time, it’s still held onto by the mind and body. Not, at least most of the time, the “rational” mind, but our deeper, emotional mind. No matter how intelligent or self-aware someone is, there can be parts of them that experience being elsewhere, back in the traumatic situation.

When traumatization occurs, the goal of therapy or other trauma work is to help those impacted reach a place of safety. In some cases, such as the case of someone who is being actively abused, this may mean physical safety. On a deeper level and of equal significance, is the importance of reaching a place of emotional and embodied safety. This means reaching a state in which all of a person’s mind and body are aware that they are no longer living in the traumatic situation.

There are several reasons that certain therapies or therapists aren’t successful with trauma treatment. Of primary importance is the therapeutic relationship. Any intro to psych textbook will tell you all about the importance of the therapeutic relationship and how it is repeatedly shown to be a prerequisite for effective work. While there is truth to this in general, it is especially important for those who are traumatized. Some traumatized people, especially those who have experienced prolonged, repeated, or “Complex” trauma, may not have a reference point for any safe relationship. Even for those who are fortunate enough to have at least one safe relationship, it’s still important that their post traumatic healing takes place in such a relationship. Learning how to be safe or comfortable again, or for the first time, is quite a journey and it’s very difficult to embark without the right person/people and setting to help us establish those qualities.

In the treatment of some issues or disorders, safety and comfortability may be less of a concern. For people experiencing conditions like anxiety or depression or insomnia, in the absence of any significant trauma history, an individual’s internal reference point for safety, comfortability and trust, is often such that even a less than super sensitive therapist will do just fine establishing rapport and relationship. There is also the question of intervention. Many commonly practiced therapies are largely focused on behaviors or surface level cognitions and such purview tends not to require the same level of trust- or vulnerability- from clients.

When it comes to trauma, the question of intervention is a double edged sword, because those interventions that require greater trust and safety also seem to be more effective at treating trauma effectively. One of the most commonly practiced forms of therapy, often referred to as the “gold standard,” is CBT, or Cognitive Behavioral Therapy. While it is often oversimplified in pop psychology, true CBT is a complex tool to master and practice effectively. Nonetheless, while the therapeutic relationship is important as always, the content and focus of CBT tends to be more generic and less personal. Though this approach definitely has its drawbacks, it may also not provoke the same level of distress in clients and consequently, not require the same level of established safety.

On the opposite edge of the sword, an increasingly popular approach among trauma focused therapists, includes interventions like Eye-Movement Desensitization and Reprocessing (EMDR), Internal Family Systems (IFS), Somatic Experiencing or other body-based therapies, mindfulness practices and even ketamine or other psychedelic experiences. While this is quite an array of treatments, each with varying levels of substantiated research or evidence, what they share in common is their depth, lack of pathogenic language and whole-person focus. They definitely ask clients for greater vulnerability, but when practiced properly, they also bring with them the safety and wholeness that traumatized individuals are seeking.

This second approach, and some of these interventions, are the ones I use in my practice. If you’d like to learn more about working together, please fill out the contact form below. If you’d like to learn more about trauma generally, please check out the following resources. The books are true classics in the trauma field and provide significant understanding of traumatization and healing. The website is associated with one of the authors and contains helpful information.

What Is Trauma? An Introduction to Traumatization and Healing

Elliott Blitenthal Therapy

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