How Can Intergenerational Trauma Affect Your Ability to Make Decisions?

In the current article I'm discussing how trauma can affect decision-making. 

Intergenerational Trauma and Fear of Making Decisions

What Are Some of the Psychological Factors For Fear of Making Decisions?

If you have this problem with making decisions, it's important to start with compassion.

Developing Self Awareness and Compassion

It's important to look beyond the surface with compassion so you won't be so hard on yourself.

In general, every person who has problems making decisions is unique and has their own set of psychological factors related to decision-making.

Here are some of the most common factors:

• Pessimism and Fear of Change: A negative or pessimistic perspective can lead to only focusing on the potential downside to every possible decision.

• Insecurity: Personal insecurities can lead to someone having difficulty with potential decisions.

• A Problem Solving Identity: Some people like to see themselves as problem solvers for themselves and for others. This helps them to feel useful and needed. However, it can also become a crutch to avoid making decisions.

• Cognitive Dissonance: Some people experience an internal conflict when faced with solutions that challenge their beliefs. This can lead to their challenging every possible solution offered to them to maintain a sense of internal consistency (see my article: Understanding the Negative Impact of Cognitive Dissonance).

Clinical Vignette

The following clinical vignette, which is a composite of many cases, illustrates how a particular type of trauma, intergenerational trauma, an affect making decisions:

Liz

When her boyfriend, Ray, recommended that she seek help in therapy, Liz wasn't open to the idea at first. But when he talked to her about the many times she approached her problems with pessimism and fear of change, she realized she had a problem, so she sought help in therapy.

Anxiety and Fear of Change

When her therapist asked Liz about her family history, Liz revealed that both of her parents had problems making decisions because they usually feared the worst possible outcome.  

Both of Liz's parents experienced intergenerational related to severe poverty. So, even though her parents were now financially secure, whenever they had to make any decision about money, they approached the decision making process with pessimism, anxiety and dread (see my article: What is Intergenerational Trauma?).

The smallest financial decision created so much anxiety that they would find a problem with any possible decision. This lead to procrastination so they made decisions at the last possible moment. This often lead to poor choices in many cases because they weren't able to think about the choices calmly so they made last minute decisions in haste.

Even as a young child, Liz understood that her parents' anxiety and dread were misplaced. She knew that, unlike earlier generations, both of her parents were in high paying professions and they could relax more about money. 

But even though Liz understood it logically, on an emotional level, she took in her parents' fears and anxiety on an unconscious level.  

This created problems between Liz and Ray because whenever they were faced with certain decisions related to spending money, like whether to buy new furniture or whether they could afford to go on vacation, Liz had so much anxiety that she couldn't make a decision.

Logically, Liz knew she and Ray could afford the furniture and a vacation, but whenever he proposed various options, she found reasons to reject everything he proposed.  She couldn't understand why she couldn't reconcile her logical thoughts with her emotions.

After hearing about her family history, Liz's therapist provided her with psychoeducation about intergenerational trauma. 

Although Liz wasn't happy to hear that she was traumatized, her therapist's explanation made sense to her, especially when she heard about the symptoms. 

Some of the symptoms of intergenerational trauma resonated with her, including:

• Persistent anxiety

• Hypervigilance (a constant state of high alert or feeling a sense of threat)

• Problems with emotional regulation

• Shame
  

• Guilt
  

Liz's therapist worked with her to prepare her to do trauma therapy. Since Liz's anxiety was so high, she needed several months of preparation and stabilization before they could start processing her trauma in trauma therapy.

Part of the preparation involved developing self compassion and better coping skills.

When her therapist assessed Liz was ready to work through her trauma, they did a combination of IFS Parts Work Therapy, Somatic Experiencing and EMDR Therapy over a period of several months.

Whenever they discovered an emotional block in the trauma therapy, her therapist used Imaginal Interweaves to help Liz overcome the block (see my article: What Are Imaginal Interweaves in Trauma Therapy?).

Even though the work took over a year until Liz worked through her trauma, she felt incremental relief along the way.

Overcoming Anxiety and Fear of Change

Over time, Liz experienced her emotions as being more in synch with her logical understanding. She was able to modify her emotions and behavior to make decisions without anxiety, pessimism or fear of change.

Whenever she considered possible solutions to problems, she was able to consider each options and make a decision without finding problems with every solution.

Trauma therapy enabled Liz to free herself from a history of intergenerational trauma.

Conclusion

If you have unresolved trauma, a good place to start is developing self awareness and compassion.

Most people don't want to create problems for themselves and others when they're trying to solve problems or make decisions, so there's usually a coherent reason. 

If the reason isn't apparent, it's often unconscious (see my article: Making the Unconscious Conscious).

Getting Help in Therapy

A skilled mental health professional who is trained as a trauma therapist can help you to identify the psychological factors involved and work through the problems (see my article: What is a Trauma Therapist?).

If the problems are related to trauma, seeking help from a psychotherapist who is a trauma therapist can help you to overcome the trauma so you can lead a more fulfilling life free from your history of trauma.

About Me

I am a licensed New York psychotherapist, hypnotherapist, EMDR, AEDP, EFT (for couples), Parts Work (IFS and Ego States Therapy), Somatic Experiencing and Certified Sex Therapist.

As a trauma therapist, I have helped many individual adults and couples to work through trauma.

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (917) 742-2624 during business hours or email me.

What Are Imaginal Interweaves in Trauma Therapy?

In prior articles I provided a basic explanation for Imaginal Interweaves in Trauma Therapy (see my articles Imaginal Interweaves - Part 1 and Part 2).

In the current article, I'm taking a deeper dive to explain Imaginal Interweaves, an intervention I often use in trauma therapy.

What Are Imaginal Interweaves in Trauma Therapy?

Imaginal Interweaves are techniques used in trauma therapy.

Imaginal Interweaves in Trauma Therapy

I learned how to do Imaginal Interweaves in an advanced Attachment Focused EMDR Therapy training about 20 years ago from EMDR expert Laurel Parnell, Ph.D.and I have found them to be an effective way to help clients to heal.

Imaginal Interweaves are techniques used in EMDR and other Experiential Therapies where a trauma therapist guides clients to use their imagination to connect with different aspects of themselves (see my article: Why is Experiential Therapy More Effective Than Traditional Talk Therapy?).

This often includes imagining their younger child self (often called "inner child"). This is especially helpful if clients become stuck when they're processing unresolved trauma. 

Examples might be imagining their current adult self:

• Comforting their younger self

• Defending their younger self from someone who was abusive

• Taking their younger self away from an unsafe, abusive environment to a place where their younger self feels safe

Imaginal Interweaves are:

• Specific therapeutic interventions used in trauma therapy, like EMDR therapy, AEDP, Parts Work Therapy and other Experiential Therapies.

• A tool to process trauma when a client gets stuck during the processing

• Guided imagery the therapist facilitates

• A technique for self connection 

Imaginal Interweaves work by:

• Helping a client to develop internal and external resources

• Bridging different perspectives including a gap between a more vulnerable part of a client and a more capable adult self

• Facilitating new emotional responses by using the imagination to work through overwhelming feelings related to trauma

What Are Some Examples of Imaginal Interweaves?

There are many different types of Imaginal Interweaves.

Imaginal Interweaves in Trauma Therapy

Here are examples of a few:

• Adult-Child Interactions: The adult self comforts the child self to provide a sense of present-day safety and reassurance.

• Expressing Anger: The adult self can be imagined as holding the perpetrator so the child self can express anger while feeling safe.

• Direct Communication: After asking the client's permission, the therapist can speak directly to the child self to find out what the child self needs.

Making a Distinction Between What Actually Happened and An Imaginal Interweave

Trauma therapists make the distinction with the client about what actually happened during their trauma and an Imaginal Interweave.

Imaginal Interweaves in Trauma Therapy

In no way would I try to get a client to believe that something different happened from what actually happened.

The purpose of Imaginal Interweaves is to give clients a new embodied experience using their  imagination while continuing to know that what is being imagined didn't actually happen.

An embodied experience means the client experiences a mind-body connection during an Imaginal Interweave which helps with the integration of the new experience.

To help them to experience an embodied experience, I will help the client to have a felt sense where they feel the new imagined experience in their body. 

This serves as an anchor for the experience in an embodied way rather than just being an intellectual process (see my article: The Mind-Body Connection: Developing a Felt Sense of Your Internal Experiences).

Using an embodied approach facilitates healing.

How Can Imaginal Interweaves Help to Free You From Your Traumatic History?

By processing unresolved trauma using Imaginal Interweaves, you can free yourself from your traumatic history by:

• Overcoming unresolved trauma that keeps you stuck in your current life

• Overcoming false negative beliefs you have about yourself

• Connecting you to your inner resources

• Integrating various internal parts of yourself to achieve improved mental health

• Gaining self confidence to cope with past, current and future challenges

Getting Help in Trauma Therapy

Traditional talk therapy can help you to gain insight into your problems, but it doesn't always help you to heal from trauma.

Experiential Therapy that includes Imaginal Interweaves provides you with a mind-body oriented experience that is a more holistic way to heal.

Rather than struggling on your own, seek help in Experiential Therapy so you can heal and live a more fulfilling life.

About Me

I am a licensed New York psychotherapist, hypnotherapist, EMDR, AEDP, EFT (for couples), Parts Work (IFS and Ego States Therapy), Somatic Experiencing and Certified Sex Therapist.

As a trauma therapist, I have helped many individual adults and couples to work through unresolved trauma.

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (917) 742-2624 during business hours or email me.

 

What is the Purpose of the Preparation and Stabilization Phase in EMDR Therapy?

In the past I've written other articles about EMDR therapy including:

• What is EMDR Therapy? 

• EMDR and the Brain: How Does EMDR Therapy Work?

• Overcoming Trauma With EMDR Therapy

• EMDR Therapy - When Traditional Psychotherapy Isn't Enough

• EMDR Therapy Helps to Achieve Emotional Breakthroughs

In the current article I want to focus on Phase 2 of EMDR Therapy: The Preparation and Stabilization Phase.

Before focusing on Phase 2, let's review the eight stages of EMDR therapy.

The Preparation and Stabilization Phase of EMDR Therapy

What Are the 8 Phases of EMDR Therapy?

The eight phases of EMDR Therapy:

Phase 1: History Taking and Treatment Planning: 

• Taking a thorough family history
• Taking a history of the problem
• Establishing a rapport with the client
• Selecting target memories to process with EMDR

Phase 2: Preparation and Stabilization:

• Teaching the client about EMDR processing
• Helping the client to develop the necessary coping and relaxation skills to process the trauma with EMDR
• Ensuring the client is ready to process the trauma with EMDR

Phase 3: Assessment:

• Identifying the client's negative belief
• Identifying the images related to the traumatic memory to be processed
• Helping the client to identify their level of disturbance about the memory (Subjective Unit of Disturbance or SUD)
• Rating the level of disturbance (SUD)

Phase 4: Desensitization:

• Using bilateral stimulation (tapping, eye movements or tones) while the client focuses on the traumatic memory
• Reducing the client's disturbance (SUD) to a manageable level

Phase 5: Installation:

• Helping the client to identify and integrate a positive belief that contradicts the client's negative belief
• Strengthening the client's positive belief with bilateral stimulation

Phase 6: Body Scan:

• Helping the client to recognize any residual body sensations associated with the trauma
• Addressing any residual discomfort client has with regard to the trauma

Phase 7: Closure:

• Helping the client to develop a calm and grounded state
• Providing strategies so that the client can manage any future triggers

Phase 8: Reevaluation:

• Assessing the client's progress and revisiting the traumatic memory
• Deciding whether any further processing of the traumatic memory is needed

What is the Purpose of the Preparation and Stabilization Phase of EMDR Therapy?

Phase 2, known as the Preparation and Stabilization phase of EMDR, is essential because it:

• Builds Resources: The EMDR therapist helps the client to identify and strengthen internal resources  and external resources as well adaptive memory networks to support the client in processing the trauma.

• Helps to Build Coping Skills: The client learns various coping skills such as a breathing exercise, a container exercise, imagery, and grounding techniques to manage any intense emotions so the client can remain stable.

• Establishes a Relaxing Place Imagery: The client creates a mental image of a relaxing or safe place that they can return to if the processing feels overwhelming or between EMDR sessions.

• Increases Trust and Safety: This phase helps the client to develop trust and a sense of safety as well as enhance the therapeutic alliance between the client and therapist.

• Provides Psychoeducation: The therapist educates the client about trauma, the processing of trauma and what to expect in EMDR therapy. 

• Assesses the Client's Readiness to Start EMDR Processing: The therapist assesses the client's readiness to do EMDR therapy, determining if the client is sufficiently stabilized to proceed with the processing of trauma or if the client needs additional resources or more attention to stabilization. 

Why is the Preparation and Stabilization Phase Important in EMDR Therapy?

Without the necessary preparation and stabilization phase of EMDR, a client can become overwhelmed or retraumatized. 

They might be unable to stay in the present moment during the processing of the trauma or between sessions.

The Preparation and Stabilization Phase of EMDR Therapy

Preparation and stabilization ensures the client has the necessary internal stability and resources to safely process trauma using EMDR therapy.

This phase also helps to reduce the risk of negative experiences and to a better overall outcome for the client.

Clinical Vignette

The following clinical vignette, which is a composite of many different cases to protect confidentiality, illustrates the importance of the EMDR Preparation and Stabilization Phase:

Tom

As a US veteran who experienced significant trauma during the Iraq war, Tom suffered with Posttraumatic Stress Disorder, which is also known as PTSD (see my article: What is the Difference Between Trauma and PTSD (Posttraumatic Stress Disorder)?

After he heard about EMDR therapy, he had consultations with a few EMDR therapists in his area.

When the therapists spoke to Tom about the need for preparation and stabilization before processing his traumatic memories, he felt discouraged about the time this would take. Understandably, he wanted to get rid of his PTSD symptoms and he wanted it now. 

One of his friends, John, an unlicensed mental health intern, told Tom that he had read books about EMDR therapy.  Even though he had no formal training in EMDR, John felt he could help Tom to overcome his trauma, so he offered to do EMDR for Tom.

Aside from John not being a licensed mental health professional and having no training in doing EMDR, Tom jumped right into Phase 4 of EMDR (Desensitization) by skipping Phases 1-3.

Within minutes of processing the trauma, Tom went into a dissociated state and believed he was back in the battlefield. He had no awareness of the present moment with John. He began shaking, crying and cowering on the floor. It was obvious to John that Tom was being retraumatized.

Panicked and not knowing what else to do, John called 911 and the Emergency Medical Technicians were there with 10 minutes. They helped to stabilize and calm Tom so that he became aware of his current surroundings.  They also suggested he contact his primary care physician.

In addition, the EMTs told John that, as an unlicensed intern, it was unethical and dangerous for him to undertake doing any type of therapy.

A few weeks later, Tom's primary care doctor referred him to a licensed mental health professional who had advanced training in EMDR therapy.

Although the therapy took longer than Tom would have liked, by the time his therapist prepared him for EMDR processing, he felt safe enough with her and prepared to do EMDR.

The work was not quick or easy, but by the time Tom completed EMDR therapy, he was relieved of his trauma symptoms and he felt ready to move on with his life.

Conclusion

EMDR is a safe and effective therapy to process and overcome trauma when done responsibly by a licensed mental health professional who has advanced EMDR training.

This article seeks to explain the importance of the Preparation and Stabilization Phase of EMDR (also known as Phase 2).

The Preparation and Stabilization Phase of EMDR Therapy

All the phases in EMDR therapy are important, however, as illustrated in the clinical vignette above, it's important not to skip any of the phases, including Phase 2, because of the risk of  experiencing negative mental health consequences, including retraumatization.

Some clients who seek help in EMDR therapy are initially disappointed that they cannot immediately start processing their trauma on Day1 in therapy.

They might seek help from unlicensed and untrained people because they think it will be quicker, but many of these individuals become retraumatized and in a worse state than they were originally.

Only seek help in EMDR therapy with a licensed mental health professional who has advanced training in EMDR.

About Me

I am a licensed New York psychotherapist, hypnotherapist, EMDR, AEDP, EFT (for couples), Somatic Experiencing and Certified Sex Therapist.

I work with individual adults and couples.

One of my specialties, as a trauma therapist, is helping clients to process and overcome trauma (see my article: What is a Trauma Therapist?).

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (917) 742-2624 during business hours or email me.

How Does Somatic Experiencing Heal Trauma?

As a psychotherapist who specializes in helping clients to overcome trauma, I have been using Somatic Experiencing (SE) regularly for 15 years and I have found it to be a highly effective therapy to heal trauma (see my article: What is a Trauma Therapist?).

Somatic Experiencing Can Heal Trauma

How Does Somatic Experiencing Heal Trauma?

Somatic Experiencing, which is an experiential therapy, helps to shift the body's autonomic physical responses by allowing clients to process and discharge "stuck" energy associated with trauma's fight, flight and freeze responses (see my article: Somatic Experiencing: A Mind-Body Oriented Therapy For Overcoming Trauma).

Examples of this include changes in heart rate, blood pressure, digestion, breathing, which are all part of the body's autonomic response system.

"Stuck" or "trapped" energy means the body's instinctive survival response (flight, flight, freeze) to a dangerous event doesn't complete, which leaves excess energy and heightened nervous system arousal stuck in the body. 

This unresolved survival energy can take the form of ongoing health and mental health problems including (but not limited to):

• chronic pain

• anxiety

• emotional numbing 

• muscle tension

• fatigue

• hypervigilance 

• problems with self regulation

Changes in SE are often subtle responses like feeling warmth, tingling or vibrations which indicate the release of trapped trauma-related energy.

A Somatic Experiencing therapist helps to guide clients to notice and track these felt sensations (see my article: What is the Felt Sense?).

Somatic Experiencing therapists also use pendulation to help clients shift their awareness from challenging emotions to a sense of calm so they can gradually process and integrate traumatic experiences (see my article: Coping With Emotional Distress By Using Pendulation in SE).

Understanding interoceptive and proprioceptive sensations is also part of the skill building clients learns in SE.

Interoceptive sensations are the sensations within your body, like the sensations mentioned above: heart beating, muscles tensing or feeling hungry or thirsty. As part of a traumatic experience, these sensations can become hyperactivated which leads to constant anxiety or discomfort.

Proprioceptive sensations is your body's sense of where its different parts are in space and how they are moving. Trauma can disrupt proprioceptive sensations which can make you feel disconnected from certain parts of your body.

SE can change these trauma-related disruptions to restore the natural rhythms of your nervous system that became dysregulated by the trauma.  

Along the way, you learn embodied awareness so you feel more connected to your body and bodily sensations instead of feeling overwhelmed by them. This can lead to the transformation of intense and distressing sensations to a greater sense of well-being and safety.

What Are the Benefits of Somatic Experiencing?

As an experiential therapyp, Somatic Experiencing integrates body awareness into the therapeutic process which makes it unique compared to other non-experiential therapies like regular talk therapy (see my article: Why is Experiential Therapy More Effective Than Regular Talk Therapy to Overcome Trauma?).

Somatic Experiencing Can Heal Trauma

As mentioned above, Somatic Experiencing can help to release trauma which can bring the body back into a regulated state.

Somatic Experiencing can be used as a primary therapy or it can be integrated with other forms of experiential therapy including:

• EMDR

• AEDP

• Hypnotherapy

• Parts Work Therapy, like IFS and Ego States Therapy 

    See my article: Integrating EMDR and Somatic Experiencing

Getting Help in Therapy to Overcome Trauma

As a trauma therapist, Somatic Experiencing is one modality I use either alone or in combination with other types of experiential therapy (see my article: Why Experiential Therapy is More Effective Than Regular Talk Therapy).

I work in a collaborative way with clients to help them to decide which modality or combination of modalities would be best for their particular needs.

Getting Help in Therapy to Overcome Trauma

If you have been struggling with unresolved trauma, you could benefit from seeking help from a Somatic Experiencing therapist.

Freeing yourself from your traumatic history can help you to lead a more fulfilling life.

About Me

I am a licensed New York psychotherapist, hypnotherapist, EMDR, AEDP, Somatic Experiencing and Certified Sex Therapist.

I work with individual adults and couples.

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (917) 742-2624 during business hours or email me.

What is Trauma-Related Masking?

Masking is a trauma-related response where individuals hide their true personality, feelings or behavior and mimic others as a maladaptive coping strategy to present a false self.

Trauma-Related Masking

One of the problems with masking, which is also known as social camouflage, is that it creates a disconnect from an individual's true self or genuine self. 

Another problem is that it doesn't allow for genuine connections with others.

Why Causes Trauma Masking?

Childhood trauma can create deeply rooted feelings of:

• Fear
• Shame
  
• Guilt
• A sense of being unworthy or being unlovable

Masking these and other feelings temporarily helps individuals to deal with social situations where they feel too much stress and anxiety to be themselves. 

What Does Masking Look Like?

Masking can include some or all of the following:

• Suppressing feelings
• Hiding aspects of one's personality
• Trying to mimic other people to act in a way that they think is acceptable to others

Clinical Vignette

The following clinical vignette, which is a composite of many cases, illustrates how an individual with a traumatic history uses masking and how trauma therapy can help.

Jane

When Jane left her parents' home to go to college, she felt anxious about meeting new people in college.

Throughout elementary school, middle school and junior high school, Jane only had one or two friends who made an effort to befriend her. She never invited any of these friends home because her father was usually drunk and her mother was depressed so Jane felt too ashamed to allow anyone into her home.

When she met her roommates at college, Jane felt too self conscious to allow her guard down so she tried to imitate their way of speaking and behaving because she believed this is what she had to do to be accepted.

Trauma-Related Masking

Then, one day one of the roommates, Rita, told Jane she realized that Jane was uncomfortable. She told Jane she wanted to have a genuine friendship with her, but she felt Jane wasn't being herself and she encouraged her to be herself.

At first, Jane pretended she didn't know what Rita was talking about. But a couple of weeks later, Jane confided in Rita that she had been pretending and she felt disconnected from herself for so long that she wasn't even sure who she was anymore. 

Soon after that Jane decided to see one of the counselors in the student counseling unit and the counselor was able to help Jane to cope with her anxiety and shame.  She also helped Jane to get help from a trauma therapist off campus.

The trauma therapist got a detailed family history from Jane and asked her about her goals for therapy. Jane told her that she was tired of trying to hide who she was and she wanted to learn to feel comfortable with herself.

Her therapist explained the concept of masking and this explanation resonated with Jane.  She realized she had been pretending to be someone else her whole life because she was afraid people wouldn't like her. 

Her therapist worked with Jane by helping her to feel emotionally safe in therapy and they didn't start to process Jane's traumatic history until Jane felt prepared to do the work (see my article: Why Establishing Emotional Safety is Essential in Trauma Therapy).

When Jane was ready, she and her therapist used EMDR Therapy and Somatic Experiencing to help Jane to process her traumatic history.

The work wasn't quick or easy but, over time, Jane began to feel like herself. She no longer felt the need to pretend to be someone else. She gradually let her guard down and she realized that people liked her for who she really was and not who she was pretending to be. 

Even more important, Jane accepted herself for who she really was and she felt good about it.

How to Overcome Trauma-Related Masking

• Self Awareness: Self awareness is the first step to overcoming trauma-related masking (see my article: What is Self Reflective Awareness?).

Overcoming Trauma-Related Masking

• Self Compassion and Self Acceptance: Self compassion can be challenging due to shame, fear and guilt, but it's a necessary step on the way to healing trauma (see my article: Acceptance and Self Compassion).

• Trauma Therapy: Trauma-related masking is difficult to overcome on your own, so getting help in trauma therapy is an important part of healing.

Getting Help in Trauma Therapy

Hiding behind a mask can be emotionally exhausting and lonely.

As mentioned earlier, you're not just emotionally disconnected from others, you become emotionally disconnected from yourself.

Getting Help in Trauma Therapy

A skilled trauma therapist can help you to work through unresolved trauma so you no longer feel the need to mask your true self.

Rather than struggling on your own, seek help from a licensed mental health professional to free yourself from your traumatic history and live a meaningful life.

About Me

I am a licensed New York psychotherapist, hypnotherapist, EMDR, AEDP, EFT (for couples), Somatic Experiencing and Certified Sex Therapist.

I have over 20 years of experiencing helping individual adults and couples.

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (917) 742-2624 during business hours or email me.

How Do You Know If You're Ready to Seek Help in Trauma Therapy?

Many people procrastinate getting help in therapy to deal with unresolved trauma (see my article: What is a Trauma Therapist?).

One the one hand, it's understandable that people want to think carefully before beginning trauma therapy because it's a commitment. 

Getting Help in Trauma Therapy

On the other hand, it's possible to procrastinate and overthink it to the point where years go by and you're still dealing with the impact of unresolved trauma.

How Do You Know If You're Ready to Seek Help in Trauma Therapy?

Here are some characteristics that would be helpful:

• Some Awareness and Curiosity of the Impact of the Trauma: You have some awareness that traumatic circumstances in your life have had a negative impact on you. You might not understand the full impact, but you have a sense that your traumatic history is creating problems in your present life (see my article: Why is Past Trauma Affecting You Now?).

Getting Help in Trauma Therapy

• A Desire and Willingness to Change: In addition to being aware of the problem, you have a desire and willingness to change. This includes realizing that working through trauma isn't a quick fix process (see my article: Developing Internal Motivation to Change).

• Feeling Emotionally Ready to Start the Process: You are at a point in your life when you feel ready emotionally to begin the process. Your trauma therapist will help you develop the necessary tools and skills to prepare for processing the trauma. The length of time for the preparation phase of trauma therapy varies depending upon a client's particular circumstances.

• Having the Time to Commit to the Process: You understand that trauma therapy involves a commitment of time and you can commit to once-a-week trauma therapy to work through yout traumatic history.

• A Willingness to Confront the Problem: Although you know it will be challenging, you are willing to confront the problem with help and support from your therapist. 

• An Openness to Emotional Vulnerability: You understand working on the problem will involve opening up emotionally to traumatic events from the past, but that you're in charge of deciding when you're ready to start processing the trauma and your therapist will assess with you the timing of the processing.

Clinical Vignette

The following clinical vignette is a composite of many cases (to protect confidentiality) and illustrates one possible pathway for the decision-making process:

Anna

A few years after Anna graduated college, she was aware she was having problems connecting on an emotional and sexual level with men.  

She watched videos, listened to podcasts and read articles about psychological trauma, so she had some awareness that there was something in her history that was affecting her in her present life.

Initially, she was afraid to seek help in therapy because she was feared therapy would be too overwhelming, so she thought about it for a several years and kept putting it off. But when she heard about a close friend's experience with trauma therapy, she became curious for herself.

Getting Help in Trauma Therapy

Her friend, Carol, told Anna she was also scared to start trauma therapy at first, but she felt motivated to get help because her relationship with John was getting serious and she realized she was worrying she might create the same tumultuous relationship her parents and she really didn't want to that.

Carol told Anna that, after talking to another friend about trauma therapy, she got curious to find out what it was about. So, she had an hourlong consultation with a trauma therapist who described the process to her and she realized the therapist would go at Carol's pace. She also realized she felt comfortable with this therapist.

Carol also told Anna her therapist prepared her to process her traumatic family history using EMDR Therapy. Carol said the therapist also used Parts Work Therapy. 

Carol said she learned so much about herself and, even though she was still processing the trauma, she was beginning to feel like a weight was being lifted from her. 

She also began to realize she wouldn't repeat her parents' dysfunctional patterns and it was possible for her to have a healthy relationship with John.

Anna trusted Carol. She also knew she wanted to be more open emotionally and sexually so she could eventually get into a relationship. So she set up a consultation with another trauma therapist who was recommended to her.

During the consultation, the trauma therapist asked her what she wanted to work on in therapy. In addition, the therapist explained the different types of trauma therapy she did including:

• EMDR Therapy (Eye Movement Desensitization and Reprocessing)

• AEDP (Accelerated Experiential Dynamic Processing)

• Parts Work Therapy

• Somatic Experiencing

• Hypnotherapy (also known as Clinical Hypnosis)

She also explained the preparation phase of trauma therapy and that it would be Anna's decision when she felt ready to go on to the next stage, processing the trauma.

After her initial consultation, her trauma therapist helped Anna to develop the skills and tools she needed to process her trauma. 

When both Anna and her therapist felt she was ready, they began working on processing her trauma keeping in mind Anna's goal of becoming more emotionally and sexually open.

Over time, Anna noticed small positive changes in herself where she began to feel more open and curious about opening up emotionally and sexually.

Her therapist told her that setbacks are a normal part of the therapy process on the road to healing, so Anna wasn't surprised when she had a minor setback.

Getting Help in Trauma Therapy

When Anna began dating Bill, she felt more comfortable with him than she had ever felt in the past with other men. He was willing to take things slowly until they dated for a while.  

Over time, as she continued to process her childhood history in trauma therapy, Anna was able to open up to be more vulnerable with Bill.

She also enjoyed her therapy sessions, even though she had to process difficult memories, because she was learning about herself and she was opening up to new possibilities in her life.

Getting Help in Trauma Therapy

If you have been on the fence for a while about getting help in therapy, you can start by contacting a therapist for a consultation.

Use the time in the consultation to ask about the therapy process, how the therapist works and any other questions you might have about trauma therapy.

Getting Help in Trauma Therapy

You might need to have more than one appointment to tell if you feel comfortable with the therapist or you might need to see a few therapists before you know which one to choose (see my article: How to Choose a Therapist).

Freeing yourself from your traumatic history can lead a more fulfilling life.

About Me

I am a licensed New York psychotherapist, hypnotherapist, EMDR, AEDP, EFT (for couples), Somatic Experiencing and  Certified Sex Therapist.

I have over 20 years of experience as a trauma therapist helping individual adults and couples to overcome traumatic experiences.

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (917) 742-2624 during business hours or email me.