Psychological Therapy For Trauma: What It Is And How It Works
Traumas are very shocking and hard experiences that we live through, which end up leaving an important mark on our psyche.
In addition, they also encompass the consequences of said experience. Psychological therapy for trauma is based on two techniques: exposure and cognitive restructuring.
In this article we will learn about the usual symptoms after experiencing a traumatic event, as well as the functioning of psychological therapy focused on treating such traumas. We will analyze the two techniques that make it up, their variants, and how they can be applied in therapy to help the patient.
Before addressing psychological therapy for trauma, we must understand what a trauma is and what implications it entails A trauma is the result of a very shocking event that we experience, and that causes us such stress that it ends up affecting our psychological functioning, interfering with our daily life and decreasing our psychological well-being. The term “trauma”, however, is also used to designate the traumatic event in question.
The consequences of trauma can vary considerably from person to person; However, when we use this term, we generally refer to the onset of PTSD (Post-Traumatic Stress Disorder) or ASD (Acute Stress Disorder). While PTSD lasts at least 1 month, ASD lasts at most 1 month; That is, ASD becomes PTSD when this period of time passes.
Symptoms
Symptoms of a disorder caused by trauma usually encompass physical, psychological, and behavioral manifestations On a physical level, the person may manifest notable psychophysiological symptoms, and also usually re-experiences the traumatic experience, causing the same physical symptoms that he felt at the time of the event.
On a psychological level, you may feel anxious, worried, nervous, irritable or fearful. Finally, behaviorally you may have avoidance behaviors of any details related to the traumatic event; This translates into avoiding talking about it, avoiding going through places close to the event, etc.
As we have seen, suffering from trauma implies considerable suffering for the person, since it stagnates them in many aspects of their life, preventing them from moving forward and developing a normalized life. Although it is true that there are different degrees of affectation depending on the event and the person, as well as different types of trauma, we can speak of PTSD as the main (and most frequent) disorder caused by trauma, as we have already seen.
As a result of the different symptoms that PTSD causes, Psychological therapy for trauma will focus on the patient being able to face, process and integrate what they experienced without repressing anything and working on the aspects that most impacted or overwhelmed him.
It is important that the patient feels comfortable, free and calm to be able to express without fear how they feel and to what extent this event is interfering with their normal functioning.
Psychological therapy for trauma is based on two main techniques: exposure and cognitive restructuring.
1. Exhibition
Trauma exposure is a fundamental part of Psychological Therapy for trauma; This can be behavioral or narrative. A more modern type of exposure therapy has also been used, with promising results: EMDR (Eye movement desensitization and reprocessing). Let’s see what these three types of exposure consist of.
1.1. Behavioral exposure
Behavioral exposure involves exposing the person to stimuli, events or thoughts related to the trauma directly.
1.2. narrative exposition
The narrative exposition, on the other hand, is focused on the patient narrating and describing (or writing) with as much detail as possible, the traumatic experience; That is, explain in your own words what you experienced on the day (or days) of the event, how you felt, what objects or people were there, etc.
1.3. EMDR (Eye movement desensitization and reprocessing)
EMDR, in Spanish “Eye Movement Desensitization and Reprocessing,” is a type of therapy created by Jewish psychologist Francine Shapiro. This therapy, like the previous exposure variants, is used as psychological therapy for trauma. It is used to reduce negative symptoms associated with trauma.
It consists of stimulating the patient bilaterally, through various methods, which can be: eye movements (mainly), sounds or tapping. According to Shapiro and the defenders of the technique, what this stimulation does is stimulate one cerebral hemisphere.
If we analyze EMDR step by step, and in a very summarized way (without going into detail), the first thing the therapist will do is ask the patient to remember the traumatic event, with all possible details (sensations, images, thoughts…). Then the processing phase will begin, where the therapist will ask you to recall the event again while stimulating it.
This will be done through sequences that contain guidelines in between. Afterwards, the therapist will ask the patient about her thoughts. In addition, positive images will be included that the patient must imagine and associate with traumatic memories. In reality, EMDR is made up of various phases (specifically, eight) that the therapist must know in depth to apply this type of technique correctly.
Exhibition Features
On the other hand, it is important to note that exposure should be prolonged and applied gradually. This exposure will be to the patient’s traumatic memories, in relation to the trauma they experienced.
But what is the exhibition for? It is a fundamental part so that the patient gradually processes what he experienced. It is important that the aspects repressed in the unconscious come to light, so that they can be addressed; The objective is for the traumatic experience to be integrated into the patient’s life experience, forming part of it.
We must know that exposure is a very painful process for the patient, since in a certain way it relives very hard and distressing sensations and experiences; In addition, it is common for resistance to appear in the story. That is why the therapist must work from empathy and understanding, validating the patient’s emotions at all times and offering support.
It will also be important for the therapist to give the patient tools so that he can confront the negative thoughts he has, as well as nightmares, intrusive memories, etc.
2. Cognitive restructuring
Cognitive restructuring as part of psychological therapy for trauma is aimed at modifying dysfunctional thought patterns that the patient expresses, to later provide tools that allow him to develop alternative and adaptive thoughts.
This component of therapy is essential since PTSD is often associated with negative alterations in the patient’s cognitions and mood.
In order for the patient who experiences a trauma to assimilate this experience, it is important that they have a space to express themselves without pressure or conditions; Cognitive restructuring is an essential tool to work on the negative thoughts and feelings of guilt that patients who have experienced a particularly painful and shocking experience often have.
This way, It is important that the patient can change his way of perceiving and remembering what he experienced, in the event that it is a maladaptive way On the other hand, behavioral changes, from cognitive-behavioral psychotherapy, are achieved by changing one’s thoughts (and vice versa).
This is why in order for the patient to face the experience, they must work on their aforementioned avoidance behaviors, since the act of avoiding and repressing can end up generating important psychological problems in the future, which end up emerging explosively at any time. moment or in the face of a trigger related to the trauma.
