Recovery from trauma - help me educate myself?

August 23, 2012 1:50 PM

I was in a traumatic event a few years ago which was followed by shock and near complete amnesia. Recently I've been getting memories back, and, following different triggers, experiencing physical and emotional exhaustion. Help me understand what to expect, and how best to deal with it ? (More specific qs after the cut)

Antidepressants do not agree with me, so I'm just wondering - what (apart from therapy) can I do to deal with the physical and emotional symptoms?
If I go to therapy, what can I expect we will be speaking about (as it will only take a few sessions to cover everything I remember from the event)?
Can I expect therapy will make me emotional (I am pretty numb at the moment)?
Am I at risk of forgetting things again?
If you had a traumatic event - how long did it take you to recover?
If you had a traumatic event- did it help you to get out and about and keep busy, or stay home and take it easy?
Can anyone give me a guesstimate of how long it might take til I am more or less functional again?

Sorry if this is garbled - feel free to ask/memail me if you want more info!

posted by EatMyHat to human relations (11 answers total)

Currently, Cognitive Processing Therapy is the best supported treatment for trauma. It can be a very painful process in therapy, but it's one of the more effective empirical treatments out there. That doesn't necessarily mean a guarantee for you, but it's hopeful. We go through exercises of recalling details, writing about the memories, discussing how what happened relates to deeply held beliefs and ideas that the client has had throughout their lives, and how those ideas of safety have been violated and altered.

I would also recommend mindfulness therapy - there are MBSR or MBCT groups that focus on trauma and that are sensitive specifically to those needs.

Sorry to hear about your trauma - I hope you find help and support you need, and regain a sense of physical and emotional safety.
posted by namesarehard at 2:00 PM on August 23, 2012 [3 favorites]

Some of the major types of therapies for trauma at the moment are: mindfulness, Cognitive Behavioural Therapy (CBT), and Eye-Movement Desensitisation and Reprocessing (EMDR).

EMDR is apparently very successful trauma, although a bit more out-there - it has been found to work very well but why that is is a bit unclear at the moment.

Mindfulness helps significantly when it comes to stress.

CBT is very exercise-based and goal-driven to recalibrate destructive thought patterns (a breaking-the-cycle type thing).

Art therapy is also used as a trauma therapy, if talking is not your thing.
posted by heyjude at 2:16 PM on August 23, 2012 [1 favorite]

I don't feel comfortable necessarily speculating on what your therapy experience will be like, because everyone's experience is different AND it seems our experiences with trauma are quite different.

I can tell you that in my experience, talking about the actual traumatic experience was just the first few sessions. What remains to talk about is how the traumatic event has impacted your life, your relationships and your sense of self. Things I am dealing with in therapy right now: lack of self-control/loss of a sense of control and the personality shift I experienced after the trauma. The trauma itself can be unpacked rather quickly, but if you are years out from it, you may not even be aware of the ways in which it's been affecting your life.

If you had a traumatic event - how long did it take you to recover?

I am currently in therapy. I didn't start therapy until 10 months after the incident; I was in a position where I knew exactly what happened and remembered it, and watched it impact my life but felt helpless to do anything as my life unraveled around me. I can say that therapy has helped me regain a lot of the sense of control and power I felt I had lost. I don't know if recovering from a trauma is the mindset you should have going into therapy. I am not even sure that recovering is the proper term in this situation. You can't un-do the trauma. You just need to learn to process it and live with it.

Good luck.
posted by peacrow at 2:29 PM on August 23, 2012 [2 favorites]

If you go to therapy with a trauma specialist, usually someone who will use a combination of psychodynamic therapy and cognitive behavioral therapy, you will tell your story and then do specific work, including lots of homework, to learn how to identify your symptoms and cope with them. You may learn, for example, that some of your memory loss might be classified by a therapist* as dissociation, which is when we lose reality a little bit to cope with trauma. It lessens with time, and with exposure work, and with doing all your homework. It's good if your homework is something you enjoy, like writing.

No one can tell you how long it will take you to recover from your particular trauma except for a qualified therapist who has heard your whole story. I urge you to look for a trauma specialist with a CBT background: they will work with you to address your specific individual symptoms.

Do you live in or near a major city? The university-affiliated research hospitals in big cities generally have programs (low-cost/sliding scale/all insurance accepted) where these services are offered. If cost is an issue, you could also search for trauma, PTSD, and CBT studies where your treatment could be completely free.

*which I am not. I am definitely not any kind of therapist. But I am a trauma survivor, and a CBT veteran, and I will say the structured treatment helped me immensely.
posted by brina at 2:31 PM on August 23, 2012 [1 favorite]

EMDR admittedly sounds like woo, but has been shown to work well in a variety of situations. My husband had great success with it.

However, the best therapy or other solution for you will involve finding a clinician whom you can trust, so don't limit your search to one methodology or another.
posted by Madamina at 3:10 PM on August 23, 2012 [1 favorite]

I think that shopping for a therapist who focuses on trauma (and with whom you have a good rappart) is far more important than whether he or she is expert in some particular modality that any given Mefite favors.

FWIW, my experience with therapy following a traumatic event had virtually no "homework."

What to expect at therapy?
I think it is fair to expect that you will get emotional at therapy. However, part of the point of processing your trauma with a professional (rather than with your mom or your buddy or other non-trained person) is to work through your feelings, memories, etc in manageable chunks.
Your therapist might also spend some time helping you train yourself to identify and manage your level of emotional "activation".

I don't think anyone can predict how long it will take for *you* to make progress or feel better. And, actually, that's another thing you might expect to work on while you are in therapy: accepting that your response is what it is, and that it will evolve on whatever schedule it is going to.
posted by janell at 3:42 PM on August 23, 2012 [1 favorite]

I can answer your last four questions based on my own traumatic experience. Background: I was in a serious accident caused by an earthquake. I lost time for about 4 hours, I was conscious during that time, but by my memory was permanently erased until I reached a hospital.

Afterwards, I did not have any problems with memory, just that four-hour gap. Although I did not consciously remember the events, somewhere in me it registered, and I developed ptsd-ish symptoms that were related to the disaster. I became very frightened of flying, and any shaking of a building, even a truck going by, sent me into distress. These symptoms started gradually and built over time, at their peak, I started doing visualizations to calm the anxiety, and they disappeared. Perhaps it wasn't the visualization, maybe just the passage of time.

It helped me to get out and be busy, to just resume normal activities as soon as possible, I went back to school and got back to my work, that felt really helpful. It also just felt like a very natural thing for me to do, not forced, I would say do what feels like the best thing for you.

It took me about 3 years to recover, to the point where it was not affecting very much of my daily life anymore.
posted by nanook at 4:58 PM on August 23, 2012 [1 favorite]

what (apart from therapy) can I do to deal with the physical and emotional symptoms?

Try grounding yourself. If you look around, you can find other techniques, like imagining the sensation/memory is a texture and washing it with warm light. Sounds kooky, but it works for me.

If I go to therapy, what can I expect we will be speaking about (as it will only take a few sessions to cover everything I remember from the event)?

Your counsellor will work with you to set goals. The length of the event has little to do with a timeline for healing (which is very personal). S/he will help you re-integrate the trauma, as parts of it have possibly split off, preventing the trauma from being integrating with your normal experience. You may be dissociating. (I am not a doctor or counsellor.)

Can I expect therapy will make me emotional (I am pretty numb at the moment)?
Yes, I think that's a reasonable expectation. But your internal system will help you manage the level of that emotion. (Numbing is a defence mechanism.0 A good counsellor will help too.

Am I at risk of forgetting things again?
Maybe, but through processing the trauma, I think you have a reasonable likelihood of possibly reintegrating your experiences.

If you had a traumatic event - how long did it take you to recover?
I have complex trauma from multiple experiences. Someone with one-time PTSD might be in a better position to answer.

If you had a traumatic event- did it help you to get out and about and keep busy, or stay home and take it easy?
Both. Sometimes I needed to get out. I find work soothing. Othertimes, I would be too traumatized to work. Sometimes I needed to sleep or watch TV or surf online. Other times, I needed to be out with people, doing activities or something of the like.

Can anyone give me a guesstimate of how long it might take til I am more or less functional again?
I don't know you or what you experienced. Everyone is unique. But if you are not getting results from therapy within 5 sessions, it might make sense to try a new counsellor. If your counsellor helps you set goals, you should both have an idea of whether you are progressing. (This might be measured by you being able to use some self regulating techniques, for example. You won't be "healed" but you may have improved. But it's like driving up the ramp of the parking garage. Sometimes you're back in the same place, but on a different level. And sometimes you might go back a bit before you go forward.)

I'm not an expert. Just someone who's been through extreme traumas.

By the way, EMDR sounds like total quackery. I thought it was woo. But then I tried it. OMG, my life changed. Seriously. Now I tell everyone to try it. And I'm the person who thinks poorly of anything woo. I decided to give it a go because my counsellor said that I didn't have to believe in why it works to see if it works. Honestly, I think it's a bit like exposure therapy with a bunch of other techniques wrapped into it.

Also, if you're someone who tends to intellectualize or split off from your emotions, CBT may make the trauma split off more. That's why my counsellor wanted me to do EMDR. I thought it would be useless, but it's the most useful therapy I have tried.
posted by Chaussette and the Pussy Cats at 5:41 PM on August 23, 2012 [1 favorite]

Just for reference, there are medications that are not antidepressants that I understand can be used for ptsd. You may not need any medication at all but it's nice to know there might be an option if needed.
posted by St. Alia of the Bunnies at 5:44 PM on August 23, 2012 [1 favorite]

One of the things that I've read about post trauma recovery is that it doesn't matter too much what therapy you choose, as long as you are talking about it with someone and working on it. It is sort of like desensitization, in that by talking about it, you give the trauma a "place" in your memory and timeline so it has somewhere to go. Rather than being this monster that you keep hidden until something triggers you.
posted by gjc at 6:30 PM on August 23, 2012 [1 favorite]

Indeed, the type of therapy matters less than the rapport you have with your therapist (find one you trust) and feeling that the therapeutic space is indeed therapeutic for you. I say "feeling" because it is indeed the emotion itself that's important; it and trust are what will allow you to heal. As another anecdote, I've been in psychoanalysis, which has helped me immensely. Not quite traditional psychoanalysis, but not following any particular methodology either. (It is part of a school of thought, but one that tries to strike a balance between open-endedness and direction. MeMail me if you're curious to know, I just don't specify here because really, the type matters less than the fit for you personally.) This fits well for me because I've never been a methodical or goals-oriented person. Yes – I went into therapy without any goal other than an increased awareness. This runs so counter to contemporary discourse that maybe I should point out, I have a relatively successful life that a lot of people assume, on first blush, has to do with being a perfectionist who sets strict objectives, to the point where, for instance, it took my managers years to understand that I wasn't actually, in reality I'm pretty much a dreamer who loves things. Everyone's different.

Antidepressants do not agree with me, so I'm just wondering - what (apart from therapy) can I do to deal with the physical and emotional symptoms?

Have a space that is physically, temporally, and emotionally safe. For instance your home or a room in it, a set time of day you're there, and in a way that you're not likely to be interrupted by anything/anyone non-urgent. (This is also something therapy does.) In that space, allow yourself to feel and be without judgment, without consciously amplifying emotions but recognizing them and what they're related to (meditation, in a sense). If you panic, for instance, you can recognize that it's a memory because you are in your safe space, and that knowledge alone will help you process it gradually. You're no longer in that trauma, you're somewhere that you're able to heal from it. Also, if you have activities you love for whatever reason, do those as much as possible. Even if you can only manage doing something you love for a few minutes, it helps counterbalance the rough emotions and flashbacks.

If I go to therapy, what can I expect we will be speaking about (as it will only take a few sessions to cover everything I remember from the event)?

Others have covered this pretty well, my experiences have been similar to peacrow's.

Can I expect therapy will make me emotional (I am pretty numb at the moment)?

If all goes well you will get emotional at some point, yes. A large part of therapy is on feeling and recognizing emotions, then analyzing them (for lack of a better word; it's complex).

Am I at risk of forgetting things again?

I've not experienced that myself. I did have some repressed memories that I didn't realize were repressed. My therapist had no idea either, she's not the "I bet you have repressed memories" sort, so it didn't come from any outside suggestion. They arose spontaneously and were able to be corroborated (throws you for a loop when that happens...). I've not forgotten them; on that count, journalling helps. You do occasionally forget certain progresses in therapy, but sometimes that's positive too. Going over realizations again brings up things you hadn't noticed the first time, which helps anchor them.

If you had a traumatic event- did it help you to get out and about and keep busy, or stay home and take it easy?

It all depends on what makes you feel most comfortable. For me it was definitely being at home, in that safe space as described. But I am an introvert, while there are people whose "safe spaces" can also be with friends or even in public spaces, or being busy with something. As long as it's what *you* feel comfortable with.

As for time, I wouldn't know what to say; I've had multiple traumas. It's gotten much, much better over the past two years of therapy/analysis. It's pretty tough to be triggered now, and when I am, I have awareness built through therapy that guides me in how to deal with those instances.
posted by fraula at 2:00 AM on August 24, 2012 [1 favorite]