Part of trauma therapy is to address unhelpful thoughts and beliefs. They keep us stuck in painful emotions or disrupt our relationships with ourselves or others. What we believe shows in how we live and what choices we make. Often there cannot be change unless we change the way we think.
Standard approach
In CBT our Ts will teach us about cognitive errors to help us change set beliefs. Knowing these will create awareness for extremes we might be stuck in. Here is an overview of the common cognitive errors:
- Catastrophic predictions: We believe that everything will end badly, things will go wrong, people will leave, we will fail…
- Mind reading: we make up stories about what is going on in other people’s heads or hearts although they never actually expressed any of it
- Overgeneralization: because of one experience we think we know that there is nothing else, it will all be just the same everywhere and every time with everyone
- Mental filtering: we focus on one detail and lose sight of the big picture. It means losing context that could balance the experience. Our brain does this automatically when stressed.
- Magnification: we make an issue bigger than it is, especially when we failed somewhere, and imagine huge consequences when it really isn’t a big deal
- Premature conclusions: we think we know exactly what is going on even though we lack important information. Assumptions fill the gaps according to personal beliefs.
- All-or-nothing/ black-or-white thinking: we jump from one extreme to the other. If things don’t work out perfectly then we quit altogether or don’t see the point in making an effort anymore.
- Emotional reasoning: we let our emotions define our reality. When it feels that way it has to be that way, even if it isn’t grounded in reality.
- ‘Should have’ statements: we tell ourselves all the things we should have done differently but it isn’t getting us anywhere because we didn’t and it is over now.
What is called emotional hijacking can sometimes be driven by cognitive errors.When painful emotions don’t decrease with time we are probably feeding them with dysfunctional thoughts. It keeps us stuck in suffering. Then it is time for relentless reality checking, specifically, searching for these cognitive errors.
Sometimes we are so used to this kind of thinking that it needs a T to point out the errors. They have become so much part of our experience that we might be blind for them.
Once we recognize an error we can come up with alternative beliefs that are less extreme and exchange an old belief for a new one. It helps to seek experiences that prove the old belief wrong. That can feel scary, but experience is more effective in changing beliefs than reflection alone.
When the standards fail
It is not rare for traumatized people to struggle with the simple CBT solution. Trauma-related thoughts and beliefs aren’t changed so easily. One fundamental reason is structural dissociation. The parts who have the corrective experience are not the same parts as those who hold the painful belief. We can end up having corrective experiences every day and not realizing that it is happening. It helps a lot to make sure that the right parts notice the new experience. And then we can still be stuck. Here are some options to try:
Bottom-up instead of top-down
A chronically dysregulated body sends feedback to our brain and that can have a deep impact on what we are able to believe. We cannot believe things that the body doesn’t believe through experience. That is why the phrase ‘felt sense’ has become so important in trauma therapy. If a body is stuck in a state that is shut down and disconnected from the social engagement system, the body will produce thoughts of being abandoned/alone in the world, of being a failure and of wanting to die.
Chronic hyperarousal will result in mistrust and suspicion, judgemental thoughts or the conviction that nothing is safe. It is what the body is telling us about the world when we are in flight or fight states. To change the glasses that tint our world we need to get out of chronic dysregulation. Our thoughts might change automatically once we are more regulated and connected.
Coping strategies
Often core beliefs were part of our coping strategies during TraumaTime. Holding on to certain beliefs protected us from the blunt force of the trauma and made it more bearable (Example). We can often find that sets of core beliefs were dissociated together with parts that hold them and they are resisting change like their life depends on it. It will make sense once we look at it in the context of the specific trauma. The mind often has to twist itself into seemingly irrational shapes but they do make sense. We are not crazy or stupid to hold on to thoughts that get in our way so badly. (more about survival logic)
You can’t just approach a traumatized part and take away their coping strategy. They might see it as their identity and their only way to survive.
Changing a belief like that starts with really good grounding. Parts need to know that past experiences are over and that the world looks different today. They also need to realize that the people of the past aren’t in control anymore and that new people are different than the old ones. It can take time, testing and new experiences to notice the differences. Sometimes that is enough to change their mind.
Other times it is still too difficult to let go because change is scary and there is still a sense of needing the belief. That is when we use Radical Openness tools. The idea is not to have all the answers why it is impossible to change and instead find good questions to ask ourselves.
Some questions we find helpful:
- how does holding on to this belief serve me?
- what truth would I have to face if I gave up that thought?
- how is this belief keeping me safe ?
- how does this belief protect me?
- why was this belief useful during trauma time?
- who does this belief make me as a person/part within my family/system?
- how does this belief make me better than other people/parts?
- how would changing this thought put me at risk in the future?
- how does this belief help me to feel safe in my relationships?
- what does this belief keep me from knowing that would be painful?
- ….
I would recommend focussing on finding the question that resonates and not trying too hard to answer it. Usually we intuitively know the answer. It just needs a realization that this is what we are actually doing: we are somehow using the belief for an understandable reason. Parts of us are still trying to keep us safe from trauma and the world we grew up in. Trauma-related thought patterns used to serve a purpose and we need to understand the purpose to move on. This can jump-start another round of reality checking, a key skill that is vastly underestimated.
Negotiating truths
Parts might be deeply invested in their beliefs. Sometimes their whole world is built on it and shaking that foundation would be too difficult for them to cope with. Instead of trying to convince them that their thought is wrong and they need to believe something different, we work well with the concept of parallel truths. They can be right and then there is also another option that could also be true at the same time. What abusers said could be true. And it could also be true that they had their own agenda with what they said. When we introduce a second truth it doesn’t threaten the part’s convictions, it just co-exists for a while and they can get more familiar with that thought. Over time it can become more important and might replace the old belief. Parallel Truths is the most gentle way to introduce other options. We are not taking away anything, just adding.
One of these usually works, at least in a given situation that causes distress. Some core beliefs, like a deep inability to trust people because they are not trustworthy enough, can take a long time to change. Even if we can find some arguments in one situation it will probably be an issue again in the next. If cPTSD was so easy to overcome nobody would struggle with it. You aren’t too stupid to change. Therapy simply doesn’t have any better tools yet and there are limits to what reflection can change. We can do our best by adding trauma-focussed techniques to regular CBT but there is no miracle solution.
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