The Three Stages of Healing Trauma and Abuse
This model is borrowed from Judith Herman’s stages of trauma healing as well as EMDR best practice.
Stage One of Healing Trauma – Education, Stabilization, Safety.
Depending on the severity of complex trauma a person can remain in this stage for a while.
Education helps normalize what you’re experiencing. It helps you know you’re not crazy. What’s happening is your nervous system and brain are responding exactly the way they were designed to respond after having survived repeated traumatic experiences.
Stabilization helps you learn ways to manage urges to abuse substances, alcohol and to self-harm, like cutting and suicide attempts. Find a therapist that understands trauma treatment and doesn’t just treat substance abuse or mental health issues.
In this stage it’s important to learn skills to contain and manage distressing emotions. This is called learning to self-soothe.
Safety is about feeling safe with your therapist. This is very important for healing to happen. It’s also about getting supports to help with crisis situations. This can be a therapist, a local crisis line, and creating a support plan. This includes phone numbers of people you will call and services you will reach out to if you are feeling suicidal.
In some cases medications can be helpful. These medications are meant to be temporary and work best when combined with therapy.
Stage Two of Healing Trauma – Remembering and Mourning.
This stage of recovery is about making sense of what happened.
In fact, once the first stage of recovery has provided a good enough foundation, some people realize that thinking and talking about painful memories is not necessary to achieve their goals, at least in the short term. Some find that the memories are no longer disrupting their life and no longer of much interest to them. (And sometimes people need to teach their therapists about this!)
For those who choose to work on disturbing memories, because those memories are still disrupting their lives, several ‘memory processing’ methods can be used during this stage.
Evidence Based Treatments for this stage are:
- EMDR – Francine Shapiro – This method can transform traumatic memories into memories that no longer create the distress that you have become used to. You don’t have to talk about them in order for this therapy to work.
- Blue Knot Foundation’s Best Practice Guidelines – for trauma-informed service delivery
- Somatic Experiencing – Peter Levine
- RET – Laurie McKinnon
- CBT Trauma Focused Treatment
The main work of stage Two involves:
- Recognizing that the abuse is not who you are (you are a worthwhile being) but rather what happened to you.
- De-constructing and letting go of shame, guilt and disgust that is often passed on from the perpetrator to you. Knowing who you are (a unique being) not what the perpetrator told you who you were.
- Mourning the loss of a happy childhood/relationship that you didn’t get.
- Choosing with your therapist to get help with distressing memories that may be affecting your quality of life, i.e, sleep disturbances, night terrors, flashbacks, ruminations, dissociation, and hyper vigilance.
- Working with a therapist who is trained to deal with dissociative disorders.
Stage Three of Healing Trauma – Meaning and Re-connection
This involves making sense of your past, present and future through exploring meaning. It’s also about reconnecting to others in meaningful and healthy relationships – friends, partners, family and work. For some people this also involves spirituality or religion. For others it may be using philosophy or mythology to make sense of existential questions such as “Why did this happen?” “Why am I here?” and “What does it all mean for me?”
This stage is also about reconnecting to your community. For some people it’s about giving back in some way or focusing on dreams and goals for the future. Now that you feel lighter, moving forward with your goals and dreams is possible.
Remember that recovery is not linear. Your journey will probably not follow a straight line, but instead might be circular, moving in and out of stages until you feel you are ready to move forward and reconnect with your goals and dreams.