Trauma processing is difficult on a number of levels. There is emotional stress when we look at scenes from the past, physical stress because we re-experience some of the stress responses, mental stress because our brain is trying hard to process the memory and figure out the necessary integrative actions and there is stress within the personality system as well, when different parts try to come to terms with what happened. Doing this intense work with another person who then knows about it too can add a relational component of insecurity. We only begin processing when we have the capacity and resources to manage all that stress and when we have time to recover properly.
The ‘processing’ part of trauma processing does not literally happen during the therapy session where we work through the memory with a trauma therapy technique. During the session we shake things loose, establish new connections and we open the door for a new attempt to integrate the memory. It starts the re-processing process but it rarely ever ends there. Integrating the memory is a whole other can of worms. It takes a couple of days where we might feel more vulnerable, experience more memory coming up or an increase of symptoms and where our brain struggles to come to terms. A normal process of integration also includes going through a number of emotions concerning the memory like anger, emotional pain or grief.
It is wise to give ourselves time and allow the process to run its course and (mostly) finish before we turn towards other problems in our life. The time people need to recover will differ from person to person but I would give it at least 3 days and I personally take at least 5 and up to 10 for complex processing with several parts involved. What we do in the days after the trauma processing session matters. We can keep the window of integration open to support ourselves and we can also shut it down when we engage in things that will decrease our capacity. It is possible to sabotage ourselves to the point where the brain will use dissociation again instead of integration. Here are some Do’s and Don’ts.
Don’t:
- use mindless numbing to cope, use grounding resources instead
- add more stress by engaging in stressful activities or with difficult people
- run back to challenging work immediately, take it easy
- expose yourself to more triggers or trauma
- pick up all your responsibilities right away if possible, get help
- …
For some people it is best to process trauma while they are inpatient because that is the only way they can get enough of a break from normal life to give themselves time to finish processing. To do this in private practice we might need to take some time off and we probably need to prepare things in advance and ask other people for support.
DO’s:
Sleep
Sleep as much as you need. Trauma processing is exhausting and it is normal to feel tired, weak and drained.The brain needs sleep to process experiences. There is a bunch of science that supports the idea that sleep is not just ‘being unconscious’, it is a different mode of information processing for the brain that is helpful for us. You don’t have to stick to any schedule, just sleep whenever you have to. Clinics should allow trauma patients to sleep after trauma processing instead of forcing them to take part in scheduled tasks.
Eat well
Energy levels will probably be low and it can get difficult to make meals for ourselves. Unhealthy foods add stress to our body because they are hard to digest while they also don’t provide the kind of energy our body needs. It can help to prepare healthy meals and freeze them ahead of time or order from a place that serves proper food. We need good energy to fuel our body and brain for integration. It helps the body to cope with the challenge and stabilizes our mood.
Walking and Cleaning
While I am not a fan of trauma programs that combine intense trauma exposure with intense workouts, there is a benefit in combining gentle trauma processing with movement. There are studies to show that walking has a positive influence on mental processing. It includes a bilateral activation of the body, right leg, left leg, right leg, which might be part of why it is working so well. It is not supposed to be mindful walking, the mind is allowed to drift. Studies show that there is no difference between walking inside or outside, so if you are not able to go outside, a walking pad or trampoline is just fine. I always make sure to get my 10.000 steps a day during trauma processing phases.
Cleaning has a surprisingly similar effect. It combines vigorous movement with a state where the brain can drift a little. The symbolic action of removing the old and making things look fresh and new adds to the psychological benefits.
Nature
Connecting with nature is deeply grounding. It presents us with a world today that is not TraumaTime. We look around and feel with our senses. It is the opposite of dissociation or numbing. Going outside or engaging with plants at home, opening the window to observe the world outside while getting fresh air, playing with pets, all that will contribute to memory processing. It counters traumatic stress. Even better, we can connect it with a walk. Screens usually have a numbing effect while nature provides grounding. When you are outside, pay attention to the sky. There is something about the third dimension of looking up that is good for the soul. I have had several incidents where younger parts suddenly fully realized that TraumaTime is over when they saw the sky above, the day after processing the memory.
Beauty
Seeing or sensing something beautiful can create a counterbalance for our soul. We have just looked at horrible things in trauma processing. Experiencing something beautiful helps to cope with that and nudges our brain into realizing that the bad things are over. Awe is a feeling that provides a deep emotional impact that often feels healing to people. It is good for a soul that feels raw and vulnerable. It combines well with experiencing nature and going for walks. But looking at art, listening to classical or film music or watching someone dance will have the same effect. There is a reason why people feel good when they come out of a musical performance. This is one of my favorite ones.
Connection
Make sure to check in with the people who support you in your healing journey after you had a processing session. There is no need to go deep or tell anything about it and it doesn’t have to be a long conversation. It is just helpful to know that we are not alone and that others are thinking of us. Clinics who take away means of communication with supportive people are not doing trauma patients a favor. Human connections are a resource that can help us feel grounded and present. It should not become a distraction or a way of numbing the inner experience but hearing human voices while recovering is a good thing.
‘Deep Play’ and Re-Creation
There are activities that combine a physical element, imagination, a certain kind of playfulness and creative thinking or problem solving. That could be
- making music
- creating art
- writing
- cooking
- crafting or needle work
- climbing
- solving puzzles
- certain kinds of intense exercise
- playing games (important: no screens! Computer and video games usually have a numbing effect while chess or an escape adventure do not)
Notice that these are activities that are invigorating instead of numbing. These are the kind of resources that are helpful to use after trauma processing if we are in need of more regulation. Numbing has its place in our tool kit but it will interfere with trauma integration if we use it extensively right after a processing session. Create a list of active, creative activities instead.
If you ask your trauma therapist, they will probably use the exact same activities to help them cope with their work and build up resilience. These are things that help to dissolve stress and they also protect us from the effects of stress if we do them long-term and include them into our life regularly.
There is a connection between the amount of stabilization we have and how difficult trauma processing will feel. The less stability and regulation skills we bring into a processing session the more we will feel the impact afterwards. If energy is very limited I would prioritize activities in the order shown in this article. Sleep and food first. Walks if possible. Everything else is for when it can be done without adding distress by taking up too much energy. Make sure to plan for your recovery after processing and not just for the session itself. Trauma integration needs time. We need to protect that time from disruption. That way we can improve our chances of success.
This article is inspired by ‘Rest’ by Alex Soojung-Kim Pang. The book is more about creative work and burnout prevention