Ups and Downs of Healing from Trauma

Many of us imagine that healing from the emotional effects of trauma is like healing from a physical wound. Each day, a healing wound is a little smaller and less tender, until it disappears. If a physical wound grows bigger or more tender at some point during the process, it is considered a setback, and a sign for concern.

Stuck in the closet
By contrast, healing from trauma is more like slowly moving out of a cramped, crowded closet. During the traumatic event, the small enclosed breathless space feels life-saving. After the emergency is over, however, it can feel like a limiting, unending entrapment, where change is impossible and self-blame is very loud.

A physical state
There are physical changes in both brain function and hormonal activity that correspond to life in the trauma-reaction closet. The nervous system is in a highly agitated state, leading to restlessness, powerful anxiety, and self-critical, racing thoughts. Several key parts of the brain shut down, including the section responsible for perceiving the passage of time, and the part that allows for self-reflection. Meanwhile, adrenaline causes shallow breathing, rapid heartbeat, and increased blood flow to major muscle groups. While the closet does not have physical walls, it is nevertheless a physical state.

Gradually reconnecting
Healing comes from gradually, gently reconnecting with the experiences that were overwhelming and/or unacceptable while they were happening, so that the body can realize that the emergency is over.

Brief reprieves
As emotional healing begins, there are short visits outside the closet. The constant agitation of an over-stressed nervous system quiets down. Breathing expands all the way into the belly, and sighs out gently. The world sparkles with renewed color and detail. Hope arises for steady improvement.

Back in the closet after the short excursion is over, nothing has changed, including the feeling that nothing will ever change. The brief reprieve feels like an unrepeatable fluke, with the added despair of “backsliding.”

A turning point
As emotional healing continues, the excursions lengthen and happen more frequently. A turning point comes when, back in the closet with feelings of timeless entrapment, the memory of being outside the closet is also present. Eventually, a brief stint in the closet becomes a reminder of how much healing has occurred, and how much better life usually is nowadays.

Practicing the transition
When recovering from trauma, the goal is to remember how to make the transition from agitation to calm, rather than achieving a state of calm and never leaving it again. From that perspective, each sojourn in the closet, as uncomfortable as it is, gives an opportunity to practice the transition back into a more comfortable, calm state.

To make the closet more bearable:

• Remember that experiencing the closet does not represent a failure, nor a life sentence. It is a perfectly normal response to traumatic stress, and it will change with time.
• Give yourself permission to heal slowly, with a lot of back and forth between feeling better, and feeling just as bad as you did before.
• Celebrate your strengths. List all the things you did to survive the original trauma, and all the things you’re doing now to survive the difficult time you’re going through.
• Keep a mood log to help you track the changes you’re going through. It can be on the computer or on paper, brief phrases or extended journaling. Read it over when it feels like nothing will ever change.
• Anxiety is often a big part of the closet experience. Make a list of all the ways you’ve learned to manage anxiety and bring peace into your life. Post your list in a prominent place, and refer to it often.
• Some people find help through medications. For people with sensitive systems, homeopathic remedies such as Bach’s Rescue Remedy tincture or ointment can be helpful.
• Seek out support. Notice the people, events, and activities that help you feel calmer, and seek them out. Stay aware of the difference between calmness and numbness or dissociation. Numbness can give you a welcome break from feeling awful, but it won’t help you re-learn how to become calm.
• If you notice over time that you’re still stuck in the closet as often as before, consider getting trained assistance in gently and gradually re-negotiating the trauma. EMDR (Eye Movement Desensitization and Reprocessing), Somatic Experiencing, and neurofeedback have been shown to be effective techniques.

Give yourself time
As much as you can, observe the ups and downs of your healing process with gentle curiosity. Luxuriate in the reprieves, endure the hard times, and above all honor yourself for surviving and healing from a traumatic experience.

Learn more
Dr. Bessel van der Kolk, Founder and Medical Director of the Trauma Center in Boston, describes some of the physical changes in brain function and hormonal activity during trauma responses in his article Clinical Implications of Neuroscience Research in PTSD (pdf) .