Why Is Trauma Therapy So Hard? Challenges and Recovery Road

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Mental health therapist specializing in EMDR and trauma therapy. Experience with working with children, adolescents, adults and groups. Supervision and clinical director experience. Considerable experience working with addictions.
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Why Is Trauma Therapy So Hard? Challenges and Recovery Road

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Experiencing Trauma and its Impact on the Mind

Complex trauma is caused by prolonged or repeated exposure to traumatic events, particularly during childhood or early adulthood. These events often involve:

  • Physical or sexual abuse
  • Neglect
  • Abandonment 

The effects of complex trauma can be severe and long-lasting. Research has shown that complex trauma impacts the brain and body in several ways.

  • Perry and Pollard (1997) found that individuals who experienced chronic childhood trauma had decreased activity in the prefrontal cortex. This area of the brain is responsible for [A]: Executive functioning
  • Decision-making
  • Emotion regulation (control of impulsive behaviors) 

Studies have shown that complex trauma can also have a significant impact on brain development. This is so particularly in the areas of the:

  • Prefrontal cortex
  • Hippocampus
  • Amygdala

These regions of the brain are responsible for a wide range of cognitive and emotional processes, including:

  • Memory
  • Attention
  • Emotion regulation
  • Stress response 

Additionally, the hippocampus, an area of the brain responsible for memory consolidation and retrieval, was found to be smaller in individuals who experienced complex trauma. These changes in brain structure and function can lead to difficulties with:

  • Attention
  • Memory
  • Emotional regulation

Cognitions and Trauma

Various types of cognitive or thought-process changes can occur in the mind in response to traumatic stress, including [B]:

  • Cognitive errors: Interpreting a current situation as dangerous because it resembles a past traumatic event
  • Excessive or inappropriate guilt: Often called “survivor’s guilt”, a person who has experienced trauma and survived, tries to make sense cognitively and control a traumatic experience by assuming responsibility for the event because others did not survive.
  • Idealization: Having inaccurate rationalizations, idealizations or justifications of the perpetrator of abuse’s behavior, especially if they were a caregiver. 
  • Trauma-induced hallucinations or delusions: Having these, that although biological in origin, contain thoughts that map to the trauma content (e.g. believing that someone on a bus is their abusive father, because they wore the same shoes)
  • Intrusive thoughts and memories: Experiencing, without warning or desire, thoughts and memories associated with a trauma. These may easily trigger powerful emotional and behavioral reactions, as if the trauma was recurring.

Understanding Trauma Therapy

Traumatic stress reactions are normal reactions to abnormal circumstances. Specialized effective treatment approaches for complex trauma involve a combination of evidence-based psychotherapies [B]. 

The following therapies are designed to help individuals address the negative impact of trauma on their mental and physical well-being.

  • Eye Movement Desensitization and Reprocessing (EMDR)
  • Accelerated Resolution Therapy (ART)
  • Cognitive Processing Therapy (CPT)
  • Mindfulness practices 

EMDR

EMDR is an 8 phases-based psychotherapy approach that was specifically developed to treat trauma-related disorders. It involves the use of bilateral stimulation, such as eye movements or taps, while the individual recalls traumatic memories. The goal of EMDR is to:

  • Reprocess traumatic memories
  • Reduce their emotional intensity
  • Replace negative beliefs with positive ones 

A meta-analysis of 26 randomized controlled trials found that EMDR was an effective treatment for post traumatic stress disorder (PTSD) and that the benefits were sustained over time (Bisson et al., 2013) [C].

ART 

This is another evidence-based psychotherapy that was developed to treat trauma-related disorders. ART combines elements of cognitive-behavioral therapy, exposure therapy, and eye movement desensitization and reprocessing (EMDR). ART uses rapid eye movements to help the individual reprocess traumatic memories and replace negative beliefs with positive ones. A randomized controlled trial found that ART was an effective treatment for PTSD and depression, and that the benefits were sustained over time (Kip et al., 2017) [D].

CPT

CPT is a cognitive-behavioral therapy that focuses on changing negative thoughts and beliefs that result from traumatic experiences. CPT involves identifying and challenging negative thoughts and beliefs and replacing them with positive ones. A meta-analysis of 18 randomized controlled trials found that CPT was an effective treatment for PTSD, and that the benefits were sustained over time (Chard et al., 2010) [E].

Mindfulness

Mindfulness practices, such as meditation and yoga, have also been found to be effective in treating the symptoms of complex trauma. Mindfulness practices help individuals develop awareness and acceptance of their thoughts and emotions, which can reduce the impact of trauma-related symptoms. 

A randomized controlled trial found that a mindfulness-based stress reduction program was an effective treatment for PTSD (Niles et al., 2012) [F].

Challenges in Trauma Therapy

Because of the complexity of trauma responses, there are many challenges in trauma therapy. How an event affects a person depends on many factors, including:

  • Characteristics of the individual
  • The type and characteristics of the events
  • Developmental processes
  • The meaning of the trauma
  • Sociocultural factors

As a result, determining the appropriate types of therapy is an important step in the healing process.

Goals of Trauma Therapy

Despite the significant challenges associated with complex trauma, there is hope for recovery. Research has shown that the above evidence-based treatments can be effective in helping individuals to heal from the effects of complex trauma. These treatments focus on helping individuals to:

  • Process their traumatic experiences
  • Develop coping skills
  • Build resilience

Recovery Timeline

Trauma affects everyone differently, whether they be one-time, multiple or long-lasting repetitive events. Some may clearly show symptoms of Post Traumatic Stress Disorder (PTSD) and complex trauma while many more will show resilient responses or brief symptoms.The impact of trauma can be subtle, insidious or destructive [B]. 

As a result, there is no one timeline that fits all. Some people may feel better and back to normal in weeks, others months or some not for years.

The Corner Canyon Solution

Treatment is available in Utah. Are you or a loved one looking for a compassionate space to heal from trauma and mental health issues? Our licensed professional therapists and counselors can provide compassionate help. 

We offer a variety of types of therapy including Trauma-Focused Cognitive Behavioral Therapy (TF-CBT), Somatic Experiencing (SE), Eye Movement Desensitization and Reprocessing (EMDR) and Accelerated Resolution therapy (ART)  to heal from the effects of complex trauma. In addition, mindfulness practices such as meditation and yoga, can also help promote relaxation and stress reduction.

Reach out to our Admissions team now at Corner Canyon Health Centers. We’re in a peaceful setting bordered by the beautiful Wasatch Mountains.

Sources

[A] Perry, BD and Pollard, D. 1997. Altered brain development following global neglect in early childhood. Society For Neuroscience: Proceedings from Annual Meeting, New Orleans.

[B] Center for Substance Abuse Treatment (US). Trauma-Informed Care in Behavioral Health Services. Substance Abuse and Mental Health Services Administration (US); 2014. (Treatment Improvement Protocol (TIP) Series, No. 57.) Chapter 3, Understanding the Impact of Trauma

van der Kolk, B. A. (2014). The body keeps the score: Brain, mind, and body in the healing of trauma. Viking.

[C] Bisson, J. et al.  2013. Psychological therapies for chronic post-traumatic stress disorder (PTSD) in adults. Cochrane Database Syst Rev. Dec 13;2013(12):CD003388. doi: 10.1002/14651858.CD003388.pub4.

[D] Kip H. et al. 2017. Accelerated Resolution Therapy (ART): a Review and Research to Date. Military Mental Health (CH Warner, Section Editor). Published: 13 March 2017. Volume 19, article number 18, (2017).

[E] Chard, K. et al. 2010. Dissemination and experience with cognitive processing therapy. Veterans Affairs. JRRD. Volume 49, Number 5, 2012

[F] Niles, B. et al. 2012. Comparing mindfulness and psychoeducation treatments for combat-related PTSD using a telehealth approach. Psychological Trauma: Theory, Research, Practice, and Policy, 4(5), 538–547. https://doi.org/10.1037/a0026161

Clinical Director
Mental health therapist specializing in EMDR and trauma therapy. Experience with working with children, adolescents, adults and groups. Supervision and clinical director experience. Considerable experience working with addictions.
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Liz Lund, MPA

Liz is originally from lush green Washington State. She is a life enthusiast and a huge fan of people. Liz has always loved learning why people are the way they are. She moved to UT in 2013 and completed her bachelors degree in Psychology in 2016. After college Liz worked at a residential treatment center and found that she was not only passionate about people, but also administration. Liz is recently finished her MPA in April 2022. Liz loves serving people and is excited and looking forward to learning about; and from our clients here at Corner Canyon.
When Liz is not busy working she love being outdoors, eating ice cream, taking naps, and spending time with her precious baby girl and sweet husband.