How Therapy Works

Our minds and bodies are brilliant.  When we experience situations that overwhelm us, our minds protect us by helping us not know what we actually do know.  It’s hard to make sense of these difficult experiences, and so we create narratives to explain why these things happened to us.

Good therapy offers experiences that help us get back in touch with what we actually know.  This can only happen once we feel safe enough to go there, by building trust with a therapist who understands how to help us through this process.  (Notice that I say “safe enough,” because safety is relative rather than absolute.)

The Five Stages

In her seminal book, Trauma and Recovery: The Aftermath of Violence – From Domestic Abuse to Political Terror, Judith Herman emphasizes the parallels between interpersonal violence and social violence.  Her healing paradigm lays out five stages toward integration of traumatic events.

1. Healing Relationship – This means establishing a therapeutic bond with someone who can be trusted enough to get therapy started – the “good enough” relationship.  The therapeutic contract is clear, and it’s important that the survivor has choice and impact on the relationship from the beginning.
2. Safe Environment – We create a safe internal and external environment in which therapy can occur, which includes using effective coping and containment skills.  This stage involves naming and normalizing what is happening.  Within this framework, we can start to feel a sense of control and mastery in managing our environments and protecting ourselves.
3. Remembering and Mourning – Name the trauma and grieve the losses associated with it – both what was lost and also what will not happen because of its effects.  This is an important step, because telling the story can transform the traumatic memory.  What is shareable is bearable.  As with each of these stages, I will empower you to move at your own pace.
4. Reconnection to Community – We begin to connect to our communities and reduce the isolation and fear that may have existed because of the trauma.  Herman talks about the importance of letting go of old ways in this stage, and allowing ourselves to reinvent ourselves without our trauma identity.  This can feel like entering a new country and learning new ways of seeing, interacting and understanding.  While this might be a challenging process, we will commit to maintaining the safety and productive grieving established during the previous stages.
5. Commonalities with Others – This is when we step into a new role, building bonds with other people, including trauma survivors, that rework old wounds.  This lessens the profound isolation and disconnection of the trauma, and invites social engagement to soothe our fear and anxiety.

Of course, our healing paths are all unique, and we may pass through these stages multiple times or in a different sequence according to our own needs and personal journeys.  I like to offer this model as a potential road map, because seeing the big picture of where we are and where we’re heading can contextualize the tough moments, when it seems like things are getting worse rather than better.

Feeling It

The short and skinny is that you may feel worse before you feel better.  Predicting this from the start helps us maintain hope and the long-view vision.  Because our mind-bodies have done such a good job of protecting us from overwhelming experiences, going back in means feeling them in a new way.  I won’t sugarcoat it: sometimes that really sucks.  But if we’re honest, open and willing to stay in this process, we will get to a place where the trauma experiences lose their power over us.  To me, this freedom is worth the journey.

“The art of life is not controlling what happens to us, but using what happens to us.” – Gloria Steinem