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11 Things Trauma Survivors Need to Know as They Begin Therapy

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Editor's Note

If you’ve experienced sexual abuse or assault, the following post could be potentially triggering. You can contact The National Sexual Assault Telephone Hotline at 1-800-656-4673.

Therapy is vital to the process of healing and recovery from childhood trauma. It takes commitment, it takes time, and it takes a lot of hard work.

• What is PTSD?

I am a survivor of childhood sexual abuse. I have lived the majority of my life in a dissociated state from the realities of my childhood. In January of 2017, I went into a crisis mode; everything came back, launching what felt like a full-frontal assault and it wept me clean off my feet. 

I went from what felt like a functioning adult to someone with such a debilitating mental illness that taking a shower, grocery shopping and doing laundry was near impossible for me in the beginning months. If I am honest, I still have days like that.

One of the first things I did was find a counselor — two, actually. One for eye movement desensitization and reprocessing (EMDR), one for talk therapy. I saw them both weekly for a year and a half. Now I see my EMDR therapist weekly, my talk therapist every other.

As I near the two-year anniversary of beginning therapy, I realize some hard truths about treatment and recovery that I wish I’d read about in the early stages. Perhaps I would have found my footing a little bit better, in some regards.

1. Finding the right counselor is so important.

If you have started seeing a new counselor and things don’t feel right, it is OK to find someone else to talk to. Therapy needs to be a safe space for survivors to share the most terrifying moments of their lives. If you aren’t comfortable with your counselor, you aren’t going to be successful in your healing and recovery. Trust yourself.

2. Building a safe space isn’t as easy as you may think.

Once you find a counselor you connect with, it will still take time for trust to build. Anxiety is normal in the beginning stages of therapy; you are sharing your story, perhaps for the first time aloud. It makes perfect sense to feel ashamed, anxious, fearful. Just remember: your counselor wants to help you. You will feel safe in time. And if not, see #1. 

3. Therapy is more than sitting and talking for an hour every week.

Therapy is more than a patient lying on a couch, talking to a counselor sat in a chair with a notebook. There will be challenging questions that make you face negative beliefs you hold about yourself. There are goals to set, work toward and celebrate as you achieve. There are coping skills to learn and homework to do.

4. Coping skills are harder to develop and practice than you realize.

Most trauma survivors have no idea what self-care or coping is. Unaware of how to feel and process emotions, the first response to unpleasant stimuli is avoidance or suppression, not coping and self-care. Learning to recognize triggers and heightened emotions related to the past and then manage them is difficult. Being disciplined about self-care can also be a challenge for survivors who are happy they managed a shower. But you will learn, eventually.

5. Reliving the trauma is going to happen, so be prepared.

It really does get worse before it gets better. This is why coping and self-care is so important. All the memories, emotions, the anxiety and fear — it will all become present at you look your realities in the face. There is no sugar coating this; the only way out is through.

6. The five stages of grief is a guideline, not a timeline.

Trauma survivors carry a lot of grief. Trauma is personal, and so is healing. The five stages will cycle in no particular order for every nightmare, flashback, trigger, negative cognition and new memory you take on, and for every new awareness and connection. Do not hold any expectations for how you will grieve your losses or heal your pain. Be patient with yourself, learn who you are and how you feel.

7. The cycling of grief is tiring, and you will long for the comforts of dissociation.

As you transverse the stages of grief, never in the same order – sometimes achieving acceptance, other times getting stuck in anger, denial, depression or bargaining, you may get impatient with yourself. You may feel exhausted from the emotional roller coaster, and unable to get yourself together. You may wish for the comforts of disconnection, the weightlessness of no emotional awareness. Don’t succumb. Stick with it, learn to cope, practice self-care — you will build up your stamina to manage. 

8. It will become the center of your life as you regain your footing.

Suddenly finding yourselves in the throes of mental illness, treatment and recovery is no small thing. It affects all aspects of your life. You will be talking, remembering, feeling, processing, coping – learning to integrate this huge and very ignored piece of who you are, into the life you have. It will become an identifying marker, as it should be, while you heal. It deserves your attention; you deserve to heal. You will get better at finding other joys and connections. Give yourself time. 

9. It will affect all the people in your immediate life.

Husbands, wives, children, friends, co-workers. Whether they know your story or not, the new awarenesses you develop, the heightened sensitivities you will feel – there will be collateral damage. As loved ones struggle to understand and acclimate to you and your new normal, anger, resentment and confusion can manifest. Feelings of neglect can surface from children, spouses and friends who don’t understand why are suddenly sad and withdrawn. Communication is 100 percent a must through the recovery process and your counselor will help you with this. 

10. Acceptance isn’t just about the abuse; it’s also about the lifetime of effects.

Childhood trauma causes physical changes in the brain during it’s earliest and most crucial times of development. Changes that occur as a protection to the child unsure how to cope with such terror. Those physical changes have psychological effects that manifest in your behaviors and your beliefs of self long into adulthood.

11. It’s a long-term commitment, and the time you need depends on you.

There is no time limit or guideline for where you should be by a certain time through therapy. Processing trauma from childhood abuse takes time. Learning to understand, connect to and manage emotions will take practice and trial and error. Recognizing and managing triggers takes patience with yourself. Healing complex trauma is a commitment, and it can have no expectation or time limits.

I hope this has helped you understand a little bit better the journey ahead as you embark on your path towards healing. Learning who you are, how you feel, and understanding and accepting the effects our abuse has on us is the bravest thing we can do as survivors.

That is how we regain control. Good luck, love and support!

Follow this journey on the author’s blog.

Photo by Vlad Bagacian on Unsplash

Originally published: January 22, 2019
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