How do I cope with trauma? Who can help me?
There are many ways to cope with trauma. The medical community is in the beginning phase of understanding trauma. Many of the coping techniques recommended for healing from trauma are based on other ways of coping or understanding the body, not necessarily scientific trials. We do have some studies that suggest what might work. Because trauma is only partially understood by many members of the healthcare team, it may be up to you to start the conversation.
That’s right, it doesn’t seem fair that after all you’ve been through you have to advocate for yourself. Unfortunately, the reality is that many healthcare professionals will never bring up trauma. The good news is that the team will likely listen up and work to help you or find someone who can if you ask about it. Don’t feel discouraged if you need to bring it up more than once or to more than one member of your care team.
How and when do I begin the journey of healing from trauma?
The ironic thing about trauma is that it is a set of adaptations your brain has made to keep you safe. That’s right, trauma is actually one big coping strategy in and of itself! When you went through the big, hard, traumatic things, your mind was taking notes. It was making adaptations to keep you safe. The anxiety you feel was put there by your mind to keep you on alert, to keep you safe.
So the first step in the journey towards healing from trauma is to thank your body. Recognize how hard your body and mind have been working to keep you safe. You aren’t “disordered” or adding another diagnosis to your list. Your body has done exactly what you need it to do in order to keep you safe through a traumatic experience.
Exhale a sigh of relief. You’ve already started your healing journey simply by recognizing that you lived through a traumatic experience. Now the ongoing work involves:
- Staying tuned into what your body is telling you. Avoid going through life on autopilot and letting others convince you everything is fine.
- Identifying patterns that may have helped at one point in your journey, but are now making life harder for you.
- Giving yourself compassion and reassurance. If you are safe, remind yourself of that often. If you are in a place where your physical wellbeing is threatened, ask yourself what you need to feel safer.
- Are you currently facing a life-threatening diagnosis or a recurrence of disease? What would help put your fear into perspective? Do you need to meet with your healthcare team to better understand your prognosis?
- Are you preparing for an upcoming biopsy or scan that is filling you with fear? Explore these tips for coping with scanxiety. Ask your loved ones to support you through these challenging hours, days, weeks.
As you know, coping with trauma is hard work. Healing from trauma is not a straightforward path. It is important to remember that your needs for coping strategies will change over time and depending on how much energy you have.
If you are in the midst of a physical health crisis, you’ll want to focus on coping strategies that are soothing and comfortable. Avoid doing deep emotional trauma work at times when the body’s energy is directed towards an acute (mental or physical) health crisis.
The most important things when picking a strategy for coping with trauma are:
- Does it feel comfortable and safe?
- Is the time commitment, cost, or other investment reasonable and acceptable to you?
Trauma coping techniques should always feel safe. While trauma work is hard and may lead to physical exhaustion and an emotional release, such as crying, it should never feel unsafe. Think about a safe environment and a safe person to be with you on this journey. It isn’t a good idea to work on trauma in a place where you have been traumatized. For example, if you have flashbacks from a time when you were hospitalized, you might not want to see a therapist and talk about your trauma in that same building.
Healing from trauma should be a part of your life; it doesn’t need to become your whole identity. You are a whole person with a life outside of trauma. It’s ok to take breaks from working on your trauma. Healing from trauma shouldn’t cause more stress in the form of time commitments, financial burden, or mental or physical exhaustion.
Let's review some therapies for healing trauma.
TitleCognitive Behavioral Therapy (CBT)
Cognitive behavioral therapy (CBT) is an evidence-based psychotherapy that can be effective in the treatment of many psychological disorders including anxiety, depression, substance use, eating disorders, and even serious mental illness (American Psychological Association 2017).
TitleEye movement desensitization and reprocessing (EMDR)
EMDR is an individual therapy that involves identifying a traumatic event with associated unprocessed emotions. The subject is then asked to focus on the memory of the trauma while being bilaterally stimulated, usually through eye movements. EMDR is associated with a reduction in vivid and distressing emotions associated with the traumatic memory as the body reprocesses the memory in session (American Psychological Association 2017).
TitleEmotional Freedom Technique (EFT) Protocols
This is a sequence of tapping techniques. Tapping may increase focus and reduce distress while speaking affirmations. Tapping is a gentle trauma-treatment modalities for accessing traumatic memories, disturbing images and big emotions.
The inconvenient thing about trauma is that its symptoms come at all times of the day and night, rarely do they wait until the therapy appointment you scheduled for a week from Tuesday at 3pm! So it can be helpful to have a few techniques you can use to help cope with trauma at home. First, it's important to realize that trauma is really the thing that happened to you. It isn’t one specific feeling or symptom itself. Trauma is experienced in the mind and in the body as:
- Depressed Mood
The good news is that by calming the nervous system, you can relieve several of these symptoms by learning a few techniques. Here are three examples of coping techniques you can learn and use at home: Acupressure, Emotional Freedom Technique, and Progressive Muscle Relaxation.
What is Acupressure?
You may have heard of acupuncture. Acupressure utilizes the same medical theory used in acupuncture. In acupressure, you apply gentle pressure to specific locations on the body called acupoints, instead of the insertion of an acupuncture needle. You can apply pressure with the fingers, hands, elbows, or special acupressure tools. In some clinical settings, other tools such as magnets, lasers, or tuning forks may be used to stimulate acupoints.
How does it work?
Acupoints are locations on the skin that are sensitive to and conduct the body’s bioelectrical impulses. Pressure on these points stimulates the nervous system, releases endorphins, increases blood flow and tissue oxygenation, and releases muscular tension, which in turn promotes an innate healing response. In addition to these physical responses, acupressure is known to help soothe emotional tension and promote relaxation.
What does the science say?
Acupressure has been studied for a variety of symptoms. One study of breast cancer survivors showed that acupressure helped relieve fatigue. The same study also concluded that relaxation acupressure sequences improved quality of life in cancer survivors (Zick, Sen, Wyatt, Murphy, Arnedt). A study of lung cancer patients also concluded that acupressure was helpful with fatigue (Lin, Zhang, Qian, Xu, Xia, Dong, Tian).
In a study that included post surgery patients, acupressure decreased anxiety and improved sleep quality (Aygin, Sen).
These are just a few examples. Hundreds of articles have been published showing the benefit of acupressure over the last five years. Many of them focused on the following symptoms in cancer survivors: pain, constipation, nausea, insomnia, fatigue, and quality of life.
What’s to like about acupressure?
It’s easy to learn and practice at home. Read more about Acupressure for Self Care.
You don’t have to think about trauma to benefit from acupressure. Choose from any of the Acupressure for Wellbeing Sequences and simply focus on what might make you feel better in the moment.If you like acupressure, you may want to try acupuncture and learn more about this powerful medicine from a licensed acupuncturist
TitleEmotional Freedom Technique (EFT)
What is EFT?
EFT is a gentle tapping technique and is sometimes just referred to as tapping. It uses elements of three well known techniques:
- Exposure Therapy
- Cognitive Behavioral Therapy (CBT)
- Somatic Stimulation (tapping) on acupressure points
How does it work?
The basic recipe for EFT is to think of a distressing time (exposing yourself to the trauma), reframe the thoughts you have around that time into a more positive self-accepting thought (CBT), and stimulate powerful points on your body (acupressure) while doing so.
- Even though I have this diagnosis of _____, I am willing to hold myself in compassion.
- Even though it is hard and painful to go through biopsies and treatments, I am willing to hold myself in compassion.
- Even though this disease makes me look different than I used to, I am willing to hold myself in compassion.
What does the science say?
EFT has gained popularity over the last ten years. There are more and more studies that support its effectiveness. One study combined the results of 14 other studies and the experience of a total of 658 people to understand that power of EFT. The results showed that EFT led to a significant reduction in anxiety. (Clond)
What’s to like about EFT?
- Easy to do.
- Can be done in your own home.
- Takes only a few minutes.
TitleProgressive Muscle Relaxation (PMR)
What is PMR?
PMR is an approach that involves tensing and relaxing specific muscle groups to down
Regulate, or calm, the nervous system and induce the relaxation response. Stress, anxiety, and trauma are often held in the body which leads to muscle tension and discomfort. Through PMR you can learn to control your response to stressors. PMR is particularly beneficial in stressful situations like the days leading up to a medical appointment, or time spent waiting for a medical procedure to begin. PMR is also used for insomnia, chronic stress management, and anxiety.
How does it work?
The goal of Progressive Muscle Relaxation (PMR) is to down regulate the nervous system from a state of sympathetic activation to a parasympathetic state of relaxation.
With a little practice, you can learn how to shift into a relaxation mode. When done successfully, the relaxation response increases alpha brain wave activity and lowers blood pressure, pulse, respiration rate, metabolic rate, oxygen consumption, and anxiety, and produces a greater sense of wellbeing. Over time, you can develop the ability to shift into a more relaxed state in the midst of stressful situations. Having awareness of where you store stress in your body is an important part of stress resilience. Learning how to release tension in your body is part of PMR.
Finding a Practitioner or Therapist to Help with Trauma
There are three main categories of professionals who might be helpful depending on your individual journey with trauma. You may create a team with one, two, or all three of these types of professionals. You may work with your team continuously, or you may keep them on standby for tough times.
Mental Health Therapists
A mental health therapist is a good idea for guiding this process. You can find a mental health therapist with special training in trauma by searching the internet, checking with your insurance company’s list of in network mental health providers, or even just searching the internet. In Minnesota, we have a resource called the MN Trauma Project, which allows you to search for trauma specialists in the state. You may also ask your healthcare team for a referral to someone in your area. Consider working with someone who is licensed in your state. Mental health therapists can be licensed in many ways, and it varies from state to state. Here are some credentials you might look for. Most mental health therapists should hold a masters or doctoral degree in their specialty area as well as a state license.
- Licensed Clinical Social Worker
- Licensed Marriage and Family Therapist
- Licensed Professional Clinical Counselor
- Licensed Psychologist
Though there are no medications to “treat trauma,” there are medications that can be used to manage the side effects you might be experiencing as a result of your trauma. Sometimes these can be prescribed by your main medical team if they feel comfortable treating trauma. Most often, they will want to refer you to a mental health provider who can prescribe medications. There are three main types of mental health medication prescribers in most states.
- Licensed Psychiatrist with the credential MD or DO
- Licensed Advanced Practice Nurse with the credential PMHNP or PMHCNS
- Licensed Physician Assistant or Associate with the credential PA
Integrative Health Providers
Finally, if you are looking for more guidance on how to use integrative therapies to manage the symptoms of trauma, you might consider working closely with a provider of an integrative therapy. Though there are many, here are a few to consider. Licensure, certification, and training vary widely depending on the specialty area. A member of your healthcare team or your mental health therapist may be able to make a referral or help you understand a practitioner's level of training and credentials. Often practitioners who are certified but not licensed are not covered by insurance. Check with the practitioner to see if they work with your insurance before scheduling your first appointment.
- Licensed Acupuncturist with the credential LA-C
- Certified Yoga Therapist with the credential C-IAYT
- Certified Music Therapist with the credential MT-BC
- Certified Art Therapist with the credential ATR-BC (In some states, art therapists are licensed mental health therapists, in other states, they may be required to have two credentials to practice independently. You can read more about each state’s requirements here.)
- Certified Dance Movement Therapist with the credential R-DMT
Check out these national organizations for help finding someone in your area:
Aygin, D.; Sen, S. (2019). Acupressure on Anxiety and Sleep Quality After Cardiac Surgery: A Randomized Controlled Trial. Journal of PeriAnesthesia Nursing. 34(6):1222-1231.
Clond M. Emotional Freedom Techniques for Anxiety: A Systematic Review With Meta-analysis. J Nerv Ment Dis. 2016 May;204(5):388-95. doi: 10.1097/NMD.0000000000000483. PMID: 26894319.
Lin, L.; Zhang, Y.; Qian, H. Y.; Xu, J. L.; Xie, C. Y.; Dong, B.; Tian, L. (2019). Auricular acupressure for cancer-related fatigue during lung cancer chemotherapy: a randomised trial. BMJ supportive & palliative care.
Zick, S. M.; Sen, A.; Wyatt, G. K.; Murphy, S. L.; Arnedt, J. T.; Harris, R. E. (2016). Investigation of 2 Types of Self-administered Acupressure for Persistent Cancer-Related Fatigue in Breast Cancer Survivors: A Randomized Clinical Trial. JAMA Oncology. 2(11):1470-1476.