Reframing Trauma Healing: The Toolbox Approach

There is a question that I have gotten increasingly often over the last few years. It pops up in a couple of different versions, but they all look something like this: Will [insert singular intervention here] fix my trauma? Or: How many sessions of [singular intervention] will it take before I am healed?

That question—in whatever version it comes—reveals two critical mistakes in our thinking about trauma and healing.

The first critical mistake in our thinking is the idea that to be traumatized is to be broken in some way that requires a fix. It is an attempt to render a very complex human experience into something much simpler, like a bone break. To be very clear, traumatic experiences can absolutely leave us with crushing symptoms that can steal our peace.

But to be traumatized is the perfectly right response to certain life experiences. Specifically, those life experiences that we simply cannot bear on our own. It is the symptoms that need healing—recalibrating.

This brings us to our second critical mistake in our thinking about trauma and healing, which is built on the first. When we render our traumatic experiences into broken bones, we naturally assume that there is an arrival point at which we can declare ourselves healed. Ten weeks and the cast comes off, and we can resume our normal lives, correct?

Traumas are not like broken bones, and healing from trauma is not like when you get your cast taken off and move on with your life. Healing from trauma is a long and winding life-long path. And I don’t mean that to be damning—quite the opposite.

Let’s trade metaphors. Healing from trauma is a lot more like building a house that you live in for the rest of your days. What do you need when you are building a house? You need a toolbox. And not just that, you need to know how to use those tools.

Because you could buy all the fanciest tools at Home Depot, but if you don’t know how to use them, well, you’ll end up with not much of a house. If you know how to use those tools, well, you don’t just know how to build but also how to improve and repair. Don’t worry. I’m not just going to leave you with a pretty little metaphor. I will tell you about some of the kinds of tools you will need and why they will help.

Source: Susan Holt Simpson / Unsplash

Retelling Tools

Trauma is, in many ways, a disease of memory. Traumatic experiences cannot be easily integrated into our brain filing systems the way that other experiences can. So, they stick out of the filing cabinets and cause symptoms.

Instead of remembering, we relive. Telling and retelling your experience with someone who can help you organize, categorize, and assign meaning to the memory and help you feel through some of the overwhelm can help your brain put the memory away. This, in turn, can help you stop reliving it. While many of our relationships have therapeutic aspects, this work is best done with a therapist.

In general, look for someone who has a background in trauma and might practice modalities like dialectical behavioral therapy (DBT), cognitive behavioral therapy (DBT), acceptance and commitment therapy (ACT), internal family systems (IFS), or narrative exposure therapy (NET).

While you work with the memory file (or many memory files), another set of tools you can gather and begin learning is those that help you recalibrate your nervous system. Since our bodies are along for the ride, trauma does not restrict itself to our thought processes. A key feature of trauma is a dysregulated nervous system, which leads to the symptoms that we know all too well.

Here’s the good news, though: If we can become aware of our nervous systems and how they work, we can intervene in our dysregulated systems and learn how to regulate them. There are two umbrella categories of nervous system intervention and many tools within each.

Top-Down Regulation Tools

One of the things that leads to dysregulation in the body is an over-active alarm system in the brain. When the amygdala sets off an alarm because it is reliving a trauma, it sends your body into an intense stress response. This is great when you are in danger and really inconvenient when you are just trying to get through a workday. The good news is that you can intervene by manually redirecting your brain function, which in turn slows down the stress response.

There are many ways to do this, but here are two quick tools you can start to use right now:

• Tetris—When the game makes a demand on your visual-spatial system, which is in your prefrontal cortex, blood flow and electrical activity are forced into that area of your brain and away from the alarm system. This effectively turns the alarm system off, sending a message to your body that it’s ok to calm down.
• Expressive Writing—Writing about emotional experiences in a structured way has been shown to have therapeutic benefits by engaging cognitive processing and facilitating emotional regulation. One of the reasons this works is because you are actively engaging the rational parts of your brain while processing emotions. If you’re feeling overwhelmed, take 20 minutes to free-write. Don’t edit, pause, or even read back—just write.

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There are also several therapeutic methods that are based on top-down regulation. Cognitive behavioral therapy (CBT), biofeedback, and mindfulness are a few examples.

Bottom-up Regulation Tools

Bottom-up regulation is when you use the body to regulate the responses in the brain, which can then intervene in the stress response system. The quickest way to do this is to flip the switch from the sympathetic nervous system (responsible for upregulating your system to prepare for danger) to the parasympathetic nervous system (responsible for the rest and digest response).

One of the most reliable ways to activate the rest and digest response is by acti­vating the vagus nerve. The nerve wanders from your brain stem through your abdomen and touches nearly all your major organs on the way down. There are many ways to activate the vagus nerve and trigger a parasympathetic (calming) response in the body. Here are two quick tools you can use right now:

• Diaphragmatic Breathing–One of the places where the vagus nerve is the most sensitive is right in front of your diaphragm. Breathing into it pushes the vagus nerve. To practice diaphragmatic breathing, simply inhale deeply through the nose, pushing the breath into the belly (rather than the top of the chest), allowing the abdomen to expand, and then exhale slowly through pursed lips, constricting the abdomen.
• Cold Water–Cold water activates the vagus nerve through a response known as the mammalian dive reflex. When exposed to cold water, particularly on the face, the body initiates a series of physiological changes to conserve oxygen and energy. The vagus nerve is stimulated, leading to a bradycardic response or a slowing of the heart rate, as well as other autonomic adjustments that promote a state of calm and relaxation. So, splash your face with cold water. If that’s not possible, you can also hold an ice pack to your chest or run your hands under cold water.

There are also many therapeutic tools that are based on bottom-up regulation. Somatic experiencing therapy (SET) prioritizes the bottom-up approach. Some other therapies that also do this are trauma-sensitive yoga (TSY), eye movement desensitization and reprocessing (EMDR), brainspotting (BSP), equine-assisted psychotherapy, and dance and movement therapy.

So, instead of looking for which of these many tools and many interventions will be the cure-all for your trauma, consider adopting a toolbox approach instead because healing from trauma is more like building yourself a house to live out the rest of your days in than it is like mending a broken bone from retelling tools that address the cognitive aspects of trauma to top-down regulation methods like cognitive behavioral therapy and mindfulness, and bottom-up regulation techniques, such as diaphragmatic breathing and cold-water exposure activating the vagus nerve. Each tool does something a little different. Understanding and utilizing this toolbox will not only help you heal from trauma but will also prepare you for other stressors that life may have in store for you.

To find a therapist, visit the Psychology Today Therapy Directory.