Ten Steps to Healing From Trauma
By Martin V. Cohen, Ph.D.
Whether you have been a crime victim, involved in an accident or natural disaster, or were the victim of childhood abuse, the resulting trauma is similar. Pervasive fear and feelings of helplessness are natural reactions to events you probably had little or no control over. “I was totally traumatized,” and “I thought I was going to die,” are among the most often used phrases used to describe such occurrences. Unfortunately, trauma and the stress that follows, is on the rise at the turn of the new millenium in America.
Fortunately, there are ways to overcome the “aftershocks” of traumatic incidents. A cluster of symptoms consisting of (1) Persistently REEXPERIENCING the event (e.g., flashbacks, nightmares, etc.), (2) AVOIDANCE (e.g., avoiding people, places or activities that trigger memories of what happened) and (3) HYPERAROUSAL (e.g., jumpiness, feeling on edge, irritability, etc.) can be treated effectively with the following steps toward healing this condition. In 22 years of practicing psychotherapy, specializing in treating trauma victims, I’ve seen them work.
1.-- Recognize that your symptoms are normal reactions to abnormal circumstances. Although you may feel like you are out of control or “going crazy,” in reality, you are experiencing what are called post-traumatic stress symptoms.
2.-- Talk about your thoughts, feeling and reactions to the events with people you trust. Then, talk about it some more. Keep talking about it until you have no need to talk about it anymore.
3.--Do whatever it takes to create a feeling of safety and tranquility in your immediate environment. Do you need to sleep with a night light on for awhile? Can you develop a discipline of meditation or listening to soothing music?
4.-- As much and as quickly as possible, resume your normal activities and routines. Traumatic events can throw your life into a state of chaos. The sooner you resume these activities and routines, the more normal your life will feel. Structure can provide feelings of security as you etch your way back to stability.
5.-- You are in a recovery process. Give yourself the proper rest, nutrition and exercise. If you were recovering from the flu you would not forget these health tips. Do the same for yourself as you recover from traumatic stress.
6.-- Take an affirmative action on your behalf. For example, if you were a victim of crime, prosecuting the perpetrator may be an empowering experience. If this is not an option for you, write in your journal. Strike out at the perpetrator with words. Take some action on your behalf.
7.-- Become aware of your emotional triggers and learn to cope with them creatively. You may have a flashback to your trauma by engaging in a similar activity, going to a similar place, seeing, hearing, smelling, tasting or feeling something that reminds you of the original trauma. One way to cope with this is to recognize that you are experiencing an emotional trigger and engage in positive self-talk (e.g., “This is frightening but I am safe now.”)
8.--Try to find some deeper meaning in what happened to you. True, you were victimized but you can become a survivor. Survivors often find that changes in their outlook on life are possible, even preferable. What have you learned from your traumatic experience? Record these insights in a journal or voice them in a support group that is sympathetic to your situation.
9.-- Seek therapy. Psychotherapy, particularly with a certified EMDR practitioner who specializes in trauma, is often very effective in helping people overcome the aftermath of trauma. If you can’t stop thinking about what happened; if you are always feeling anxious and on guard; if you find yourself avoiding your normal routines or if you are experiencing some of the other symptoms of post-traumatic stress, you can probably benefit from professional help. The EMDR International Association can give you a referral to a certified EMDR practitioner in your area (www.emdria.org), telephone (512) 451-5200. If you were a crime victim, most states offer victims assistance to pay for psychotherapy. For more information call the National Organization for Victim Assistance at (202) 232-6682.
10.-- Be patient with yourself. Healing takes time. Your recovery will have it’s ups and downs. Follow the guidelines in this article and know that you are in a recovery process that will take time.
Remember, you may have been victimized but you do not have to continue being a victim. In this unfortunate case you were rendered helpless but to continue in that status is very limiting. By following the steps outlined above, you will emerge as a survivor. Your traumatic experience can make you a stronger and wiser person. The potential is there for you to learn and grow in ways you may not have considered had the trauma never occurred.
© 2000 Martin V. Cohen, Ph.D.
Journey to Healing
Your Healing Journey
"There's more than anger, more than sadness, more than terror. There's hope."
— - Sexual assault survivor Edith Horning, Beginning To Heal (2003), by E. Bass and L. Davis
The effects of sexual abuse and sexual assault are difficult to overcome, and the journey toward emotional healing can be a long one. There are many pathways to recovery, yet there is no "right" way. Healing is not a tidy, step-by-step process.
Every survivor's healing journey is like a customized road map, and any action that gives you improved health, greater self-awareness or expanded self-esteem will contribute to your progress. The stages of healing won't occur in the same order or to the same degree for each survivor. Some stages may not even happen at all.
But in general terms, these aspects of healing have been identified as common to many sexual abuse and sexual assault survivors:
Making a decision to heal. The first step is deciding that you want or need to make this change in your life.
Facing the assault. You begin to realize the impacts your experience has made on your life.
Remembering. You recall more details and feelings associated with your sexual assault.
Denying denial. This step involves working through the natural desire to minimize your experience, and to fully accept it as a reality.
Breaking the silence. You talk to someone about what happened to you.
Healing the shame. You come to understand and accept that the sexual assault was not your fault and that you are not responsible for it happening.
Learning to trust yourself. You regain the ability to rely on your perceptions and judgments.
Grief. You feel and mourn the loss of important qualities of your life that were taken away by the assault: innocence, trust, your sense of security.
Reconnecting. You're able to explore your deepest feelings about what happened to you, including your anger.
Spiritual growth. You develop a greater sense of self through art, music, religion or other fulfilling means.
Resolution. You achieve a degree of inner peace that enables you to return to previous stages of your healing journey if desired, but with less pain and greater self-awareness.
Survivor's Measure of Growth*
Use the checklist below to measure your recovery, to set goals for yourself, and to help you develop your own list of goals.
___ I acknowledge that something terrible happened to me.
___ I am beginning to deal with my feelings about the assault.
___ I am angry about what was done to me but recognize that my anger is not a constant part of my feelings. It intrudes into other parts of my life in a negative way.
___ I can talk about the assault experience with a counselor or a therapist.
___ I am beginning to understand my feelings about the assault.
___ I can give responsibility for the assault to the person who attacked me. It is not mine to accept.
___ I could not have prevented the assault and I recognize that I did the best I could to get through it.
___ I am developing a sense of my own self-value and increasing my self-esteem.
___ I am comfortable with choices I make for myself.
___ I am developing a sense of being at ease with the subject of my assault.
___ I recognize that I have a choice about whether or not to forgive my assailant(s).
___ I recognize that I have begun to get back control in my life, that the assailant does not have power over me.
___ I recognize that I have the right to regain control of my life.
* From the New York City Task Force Against Sexual Assault.
Stages of the Healing Process
This stage can last anywhere from hours to weeks or months. Typical reactions might include saying "I can't feel anything" or "I can't think clearly." Disorientation and high levels of anxiety are common.
The two biggest things under this category are: that the event even happened and that even if it did, it didn't "bother" the victim. The stages of shock and denial can take severe mental and emotional tolls on victims. The psychological destruction, types of traumatic reactions and the long-term effects and syndromes impacting victims are many. The severity or length of the incident or incidents doesn't seem to have any impact on how deeply a victim is harmed - the victim of a date rape with minor physical injuries doesn't suffer less than a victim who is raped repeatedly and receives more severe physical injuries.
Most blaming is typically directed at the self. Victims may focus on thoughts such as: "If only I didn't...", or "I should have...", or "I shouldn't have...” Making matters worse, this self-blame is easily exacerbated by supporters like friends, family or investigators with comments such as "what were you thinking - wearing that short skirt to that seedy place" or other such comments which only serve to place the blame for the attack on the victim, instead of on the attacker who chose to take actions against the victim.
Pain usually covers two issues: avoiding and feeling. Attempts to avoid feeling physical and emotional pains resulting from an attack might include depression, acting out or self-medicating with alcohol or other "numbing" medications or drugs. When the pain gets through, sadness, fearfulness and confusion come to the forefront.
At some point, for most people, pain demands a reaction. For victims of sexual assault, this reaction is usually anger. The anger might be directed at the self - seen when the victim is intensely focused on their own behaviors (self-injury and substance abuse are common), or might be focused on others - either the attacker in particular, or directed at anyone/anything that can become the focus of the feelings, even innocent bystanders like spouses, family members or friends.
The time, effort, and method of reaching this stage differ with each individual. There's no "schedule" for when a person "should be over it." The unfortunate fact is that many victims don't reach this stage - and certainly those who don't seek assistance have even smaller chances for leading healthy, fruitful lives after sexual assault. For those who get here, this stage includes the ability to put the event behind them (which is NOT the same as forgetting it!) and start identifying and doing new behaviors. This might be going back to school or work, going out with friends again, doing volunteer work, getting involved in outreach activities, or getting to a place where they are ready to resume, renew, or initiate an intimate
Thus the stages and roles are:
Role: Victim Survivor Hero/Heroine
Separate from the trauma Being with the trauma Moved on from the trauma
Stages: Shock Pain Integrating
Denial Anger Accepting
Approaches to Healing
There are many different ways to recover from the trauma of sexual abuse and sexual assault, and no two people will follow exactly the same path. A trained counsellor may help you to manage the impacts your experience has caused in your life, and there are other things that may be useful to you:
Learning and practicing good self-care
Reading books about sexual violence and the healing process
Exploring audio or video materials designed to boost your self-esteem and belief in your potential
Expressing your creativity by any means: painting, writing, crafting, making music, cooking, gardening or whatever inspires you
Building a strong support network for yourself
Keeping a journal or diary
Expanding your horizons: taking courses, trying new things, seeing new places
Learning or improving life skills that may have been damaged by the assault or abuse: assertiveness, parenting, communicating, etc.
Adopting a regular spiritual practice such as daily prayer, meditation, yoga, tai-chi or whatever fits your own beliefs
Doing nothing: giving yourself permission for a time-out to simply "stop and smell the roses"
Reaching for help in hard times by connecting with a Sexual Assault or Rape Crisis Center in your area.
You're the one who's in charge of your own healing journey. With encouragement from people who love and care, you can create your own unique pathway to take to there.
What happened to you is not your Fault.
You did not choose to have this happen to you. Sexual abuse and assault is never the fault of the person it happens to.
It doesn't matter where you were or how you were behaving. It doesn't matter what you were wearing or saying. It doesn't even matter whether you were drinking or using drugs. You did not deserve to be assaulted or abused. Nobody does.
It's NOT your fault. The person who did this to you is entirely responsible for what has happened. That person has committed a crime.