If you have not read our article overviewing all three stages of trauma recovery, you can find it here. We have also posted a more in depth article on the first stage of recovery, Establishing Safety, and you can find that here.  Both are helpful reads in preparation for the following article which will focus on the second stage of recovery, Remembrance and Mourning. Below is a segment (with some minor edits) from The Stages of Trauma Recovery which provides a general review of what occurs within this second stage.

In the second stage of trauma recovery, survivors may begin to tell the story of their trauma. Survivors choose when they are ready for this step (remember, empowerment and control are key to recovery) as it usually involves recalling the trauma in detail to a mental health provider. Within the safety of the therapeutic alliance, survivors share their trauma and their emotional responses to their trauma. This process can be very intense and at times, terrifying, but it is important to process the trauma in order to move on to the next stage. However, given the delicate nature of this step, safety has to be maintained and if things begin to feel extremely unsafe again, it might be necessary to shift back into stage one. Recovery is NOT linear. Once the challenging work of sharing the trauma has happened, there may be a process of grief and mourning. Survivors often have to mourn the many things, people, and experiences they have lost. Ultimately, this grief and mourning leads to acceptance and in many ways, liberation.

How does trauma processing work?

Through trauma processing, survivors are meant to explore their trauma in as much detail as possible. Though group work can be crucial to the healing process and is a core part of the treatment process at Sanctuary, survivors do not share the details of their trauma with other survivors. Because these details might be triggering and harmful for other survivors to hear, this step happens individually with a therapist. A therapist might ask the survivor to write out a narrative account of their trauma followed by clarifying questions so that there can be a clear understanding of what happened. These methods, and the process of working through the survivor’s emotional response to the trauma are part of a specific type of therapy called Cognitive Processing Therapy or CPT. Though these steps may be taken using other modalities as well.

Facing the reality of the trauma can be extremely difficult and it is normal for survivors to go back and forth on some of the details while they are reconstructing the events of their trauma. Dr. Judith Herman, from whose work much of this information is drawn, acknowledges that “acceptance of the full reality seems beyond what any human being can bear.” For this reason, all involved with the healing process must get comfortable with uncertainty — it may take time to work through all the facts of the trauma and still there may be gaps in memory and pieces of the story that will never be recovered.

Guilt and shame usually also come up during trauma processing. The survivor may reflect on the narrative and feel “stuck” in the belief that they are to blame for what happened to them. These are challenging and painful feelings to work through but they must be addressed so that ultimately the survivor can come to a place of acceptance that they were not responsible for, nor deserving of, their trauma. Addressing these so-called “stuck points” is another aspect of CPT — and part of the work that happens at Sanctuary.

Mourning what has been lost.

Dr. Herman describes the inevitable “descent into grief” that comes with trauma processing as something that is “dreaded.” Once grief is let into the room, it often feels like it is taking up all the space. As anyone who has ever experienced bereavement can attest, there is often a feeling that the grief will never end once it has started; it can feel suffocating. Survivors may be grieving the loss of a safe and happy childhood, the ability to trust others, comfort with intimacy — these are things they did not choose to lose but rather things that were taken from them. Some of these losses are things that can never be recovered, like childhood, while others, like trust and intimacy, can return with time.

This article, though not specifically addressing trauma, does offer some meaningful insight on the process of mourning imperfect caregivers and an imperfect childhood. It illustrates experiences that everyone can relate to whether they have experienced trauma or not.

Though it is sometimes difficult to accept, there are trauma survivors who have harmed others; this is something that will have to be mourned as well —  the mourning of choices that cannot be undone. It is important that therapists help survivors take accountability for their actions while also naming the extreme circumstances under which these actions may have been motivated.

The mourning stage is extremely painful, emotional, and often time consuming.

It can sometimes lead to increased thoughts of suicide and self-harm — this may sound discouraging but it is a reality that needs to be mentioned. Trauma recovery is hard work; survivors often have to march into a dark forest of uncertainties on their way to the clearing on the other side. It is so hard but so rewarding.

“Recovery is NOT linear” 

This bears repeating. Recovery (any kind of recovery) is messy and imperfect and never happens in a clean straight line. Just as a substance user in recovery may relapse, trauma survivors can experience their symptoms in cycles or waves that come and go. Sometimes, a survivor may move onto the second stage of recovery feeling prepared to open up about their trauma and dig into their painful past. However, one session in or six sessions in, or years into this process, the safety may be disrupted and may need to be reestablished by shifting back to the first stage of recovery. This is part of the long hard work of healing and it is okay. Establishing safety is part of protecting and caring for yourself so that you can continue the work of processing and move on to the third stage of recovery: Reconnection with Ordinary Life. This final stage, perhaps best personified as a big, beautiful, meditative breath, is the space where survivors find themselves after the hard labor of trauma processing. More on reconnection and all that comes with it in the next post.

Mackenzie McBride, Recovery Coach
Sanctuary Healing NYC    

 

Sources

What is Cognitive Processing Therapy? (CPT) – 2MIN Video

 

Grieving a Lost Childhood by Robin Berman, M.D.

 

Herman, J. L. (1998). Recovery from psychological trauma. Psychiatry and Clinical Neurosciences, 52(S1), S98–S103

Trauma and Recovery: The Aftermath of Violence — from domestic abuse to political terror by Judith Herman, M.D.
Sanctuary Healing Levels of Support
Sanctuary Treatment Modalities

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