In her book Trauma and Recovery, Judith Herman presents a model for the healing process of people struggling with problems related to abusive, or traumatic experiences in their past.
The problems may include:
1. Difficulty regulating emotions and impulses
2. Emotional numbing
3. Anger and aggression
4. Substance addictions
5. Behavioural addictions (porn, anonymous sex, gambling, etc.)
6. Self-harming behaviours (cutting, burning, etc.)
7. Dissociation (spacing out, blanking out, losing time, etc.)
Judith’s healing process is broken down into three distinct stages of trauma recovery. This week we are focussing on the first part:
Stage One: Safety and Stabilisation
Our goal here is to create a safe space for the young person to experience a sense of security. We do this through building a Therapeutic Alliance. This is achieved by establishing safety and stability in one’s body, one’s relationships, and the rest of one’s life. It is critical here that foster carers support the young person in recognising and developing their own inner strengths, and any other available resources for healing.
We do this by:
1. Learning how to regulate one’s emotions and manage symptoms that cause suffering or make one feel unsafe.
2. Developing and strengthening skills for managing painful and unwanted experiences, and minimizing unhelpful responses to them.
3. Most important, the key to healing from traumatic experiences in childhood is achieving these ‘stage-one’ goals of personal safety, genuine self-care, and healthy emotion-regulation capacities.
Depending on risk, our priorities in supporting stabilisation could be addressing:
1. Problems with alcohol / drugs, depression, eating behaviours, physical health, panic attacks, and/or dissociation (e.g. spacing out, losing time).
2. Taking medication to reduce anxiety and/or depressive symptoms.
3. Referring or seeking a CAMH’s assessment and participating in Cognitive Behaviour Therapy (CBT)* – a treatment for people having serious problems with tolerating and regulating emotions, interpersonal effectiveness, and/or self-harming behaviours.
4. Powerlessness, shame and guilt often linked to a misinformed internal working model.
5. Distrust – particularly of professionals.
6. Re-enacting abusive patterns in current relationships.
Each of the above must be addressed when they are obstacles to safety, self-care, and regulating one’s emotions and behaviour.
*Formal therapy can help with recognising habitual behaviour patterns, beliefs and motivations that maintain self-defeating and self-destructive behaviours outside of conscious awareness or reflection.
During the first stage, the contents of disturbing or disruptive memories may come up. We can look at these in order to better manage these memories and to understand current behaviours. For example they might help us understand why it is hard to care for oneself – perhaps because an abuser had indicated in some way that we were unworthy of care or love.
Our trigger tool is really useful in helping a young person understand how their present environment can trigger various emotions.
Emotional Mapping tool
It is important to note though, that addressing memories is not the primary focus of this stage, rather a means to achieve safety, stability, and greater ability to take care of oneself.
How we process and recover from past trauma will be discussed when we look at Stage Two next week.