Tag: Trauma

Posted on

What Is Generational Trauma? Definition, Examples, and Effects

Generational trauma affects a generation’s worldview, mental health, and overall well-being, starting with something that happened to the parents. Their children, and their children’s children, can carry the effects of trauma despite not living through it. 

Generational trauma can be passed down through learned behaviors, parenting styles, and can influence children’s genetics, predisposing them to mental and physical health challenges. 

What Causes Generational Trauma?

Generational trauma is caused by a parent, or both parents, experiencing trauma1 and transmitting it to their children. The parents can be part of a collective group, like Holocaust survivors, or singular survivors of a traumatic event like childhood abuse, disasters, or rape. 

Children with generational trauma don’t experience the trauma directly. Instead, the effects of it pass down from their parents and can leave their children with symptoms and worldviews as if they did directly experience it. Without treatment, generational trauma can pass down through multiple generations.

Examples of Generational Trauma

Generational trauma can affect entire groups and races. For example, Indigenous and minority communities still feel the effects of racism, brutality, and segregation. Survivors of war and Holocaust survivors similarly experience collective generational trauma. 

Since generational traumas often impact a group’s culture and way of life, newer generations may collectively seek out more information about their history and the traumas affecting them in the present day. Some groups and races may not be comfortable with that yet, but many are. Here are a few examples of generational trauma in specific groups/races/communities.

Indigenous Communities

Residential schools in America and Canada housed Indigenous children in an attempt to disseminate their culture, impose religion2, and ultimately force Indigenous children to adopt a Western culture. Malnutrition, racism, violence, genocide, and abuse in and out of residential schools imposed trauma that’s extended over generations.

Indigenous communities bear generational trauma as a collective group, with singular instances of trauma in each unique family and community. Children and grandchildren of those who were in residential schools and victims of colonization can feel the effects of their trauma despite not having gone through it themselves.

Asian Communities

Past wars, immigration, imperialism, and racism can all cause generational trauma in Asian families and their community as a whole. Many Asian Americans also bear the “model minority” label3, where generations are continually expected to behave with gratitude towards America and to forget the trauma in their past (and America’s contribution to it). Thus, silence can prevail between generations, which further distributes generational trauma3. 

Black Communities

Slavery, racism, segregation, and violence impacted black communities from the slave trade and continued racism from it. Black families and communities in America share a haunting past of death, brutality, and inhumanity that still carries into the present. As a result, generational trauma can pass through families and affect generation after generation.

African Americans have been segregated and not seen as equals. Racial violence has been hidden and expected to be forgotten. Even in present-day America, issues like these continue to affect new generations and promote further generational trauma. 

Holocaust Survivors

The men, women, and children who survived the Holocaust (1933-1945) can carry the burden of generational trauma. Murder, assault, racism, and genocide impacted Jewish families and left deep scars in their lineage. Survivors experienced unforgettable horrors and developed post-traumatic stress disorder.

The effects of the trauma passed through generations of Jewish families in and outside Europe. The brutality of the Holocaust continues to shake and affect Germany, European countries, and America despite efforts of justice and healing.

Other Genocide Survivors

Several countries and cultural groups within them have experienced genocide. Rwanda, for example, experienced genocide in 1994. Genocide has also happened in Darfur, Bosnia, Herzegovina, China, Ukraine, Armenia, and more. Murder, violence, theft, and rape were often used as weapons. 

Those who survive genocide are often left with emotional scars. Many women and girls, for example, were raped and mutilated. The communities and cultures who survived genocide bear the weight of it and can pass that down in future generations, especially as groups try to rebuild relationships and reestablish harmony. 

How Is Generational Trauma Passed Down? 

Trauma can pass through parenting styles, imposed worldviews, and, as research recently suggests, genetics. For example, mothers in the Holocaust were found to pass on the genetic changes4 that dysregulated their stress response. That’s because of epigenetics, or how your environment and behaviors affect how your genes work5. Biological and genetic changes can make children more disposed to inherited health and mental health conditions.

Silence can be the catalyst3 for generational trauma. Older generations may not feel comfortable talking about, or at all acknowledging, their trauma. Burying their trauma can inadvertently pass it on to their children, who pick up on their traumatized state and adapt in response. 

Children may adapt by becoming overprotective1 of their parents, by holding onto the trauma and attaching to it, and by taking their parent’s view of the world to maintain their idea of safety. They may see the world as unsafe, unfriendly, and feel isolated by what their parents or grandparents went through. 

How Does Generational Trauma Affect Families?

Families can become disconnected and distant as a result of generational trauma. Parents experiencing PTSD and trauma may struggle to form secure attachments to their kids, affecting their emotional growth and wellness. An unwillingness to talk about obvious trauma can frustrate children and derail their desire to heal. 

Children may also feel the burden of fixing the trauma. They may see how it affects their parents and subconsciously decide perfection can fix their parent’s problems and restore their family. Perfectionism, anxiety, and obsessions can then pass down to their children and extend the original trauma’s effects. 

Ultimately, unacknowledged and untreated generational trauma can forfeit familial closeness and intimacy. Parents and children can then turn to maladaptive coping strategies, like substance use, to cope with the initial trauma and its later effects.

Effects of Generational Trauma

Generational trauma has a few key effects6, including:

  • Fused identity with parents and what they experienced
  • Poor self-esteem
  • Self criticism—”Why am I struggling with this when my parents had to go through ___?”
  • Worrying the initial trauma will happen again
  • Guilt
  • Hypervigilance
  • Mental health conditions, like anxiety and depression

Breaking The Cycle of Generational Trauma

If silence is the catalyst of generational trauma, then conversation is its mediator3. Having open conversations about the traumatic experience educates children, helps older generations process, and can prevent trauma’s effects from passing further. 

In these conversations, emphasizing collective resilience can help survivors3 and their children heal. Collective resilience occurs when a group comes together to get through a challenge, rather than isolating, and recognizes their strength. Facing generational trauma can make future generations more adaptive6 and resilient to future challenges. 

Leaning into tradition and culture can empower old and new generations and instill resilience. Storytelling, traditional activities, and other cultural practices can help survivors acknowledge what happened, its effects, and their efforts toward collective healing.

Parents can also prioritize mental health treatment to improve how they communicate with their kids, how they react to challenges, and how they cope with trauma they experienced without it inadvertently affecting their parenting. 

How to Heal Generational Trauma

Parents and their children—and their children—can also heal from generational trauma through mental health treatment. A mental health professional, like a therapist, psychologist, or counselor, can help those affected by generational trauma process the past and move into the present.

A mental health professional can also help challenge worldviews affected by generational trauma and expose truth. They may use evidence-based therapies like cognitive behavioral therapy (CBT), which challenges unhelpful thought patterns and their resulting behavior. 

Internal family systems (IFS) therapy takes a more creative and engaging approach to identifying generational trauma and equipping your inner Self to heal it. In IFS, generational trauma is identified as an outcast part of yourself that your inner Self can heal. You’ll learn to identify generational trauma and how to realize your innate ability to heal.

Find Help for Trauma

Attending a residential rehab center for trauma can help you take focused time for healing in a safe, non-triggering environment. Browse our list of rehabs that treat trauma to see photos, reviews, insurance information, and more.

Posted on

Healing Trauma, Brain, and Body with Bessel van der Kolk

Dr. Bessel van der Kolk is a psychiatrist, researcher, educator, and author of The Body Keeps the Score. His book, published in 2014, explains how and why trauma stays within—and transforms—the body. Decades of experience and research, much of it outside treatment norms, led Bessel to write his best-selling book, now translated into 43 languages. 

Since publishing, clinicians and the general public alike have used his research and insight to develop new understandings of trauma and its effects on the whole body. We’ll dive into the themes and topics covered in van der Kolk’s momentous novel.

Author’s Background

Dr. Bessel van der Kolk began his career in trauma studies/treatment in one of the first-ever clinical research centers studying people with trauma. He began by studying post-traumatic stress disorder (PTSD) and how mental health medications could affect it. Van der Kolk worked directly with traumatized adults, many of them veterans, to study how trauma works and how people heal. 

Bessel van der Kolk’s research and treatment focuses on creating safe connections to the self and others and becoming aware of inner emotional states. He’s studied various treatments for trauma, including yoga, eye movement desensitization and reprocessing (EMDR), neurofeedback, and psychedelic therapy. 

His book encompasses his years of research, what he discovered about trauma (and narratives he found were false), and what he’s found can help people heal. 

Overview of The Body Keeps the Score

The Body Keeps the Score highlights the connection between trauma and the physical body, emotions, and the truth of certain behaviors (like avoidance, substance use, and rage). Bessel’s direct work and study with PTSD patients informed his conclusions, theories, and proven hypotheses. 

He describes and explains the symptoms of PTSD, why they develop into risky behaviors, and why traumatic stress affects and dictates neuroscience. Bessel led the forefront of the notion that the mind and body connect—and he proved it on many accounts. His book explains his findings, reasons how and why trauma lives in the body, and how traumatized patients can find genuine healing. 

Van der Kolk’s proposed and proven treatments for PTSD veered from pharmacotherapy and traditional therapies, where patients were primarily suggested to talk about their experience until it no longer bothered them. As Bessel and his colleagues found, this could lead to retraumatization, avoidance, and treatment failure as a whole. Somatic approaches, EMDR, psychedelic therapy, and more became his new modes of healing. 

Clinicians, patients, and loved ones alike found Bessel van der Kolk’s delivery to be empowering and educational. Despite his book’s clinical complexities and neurological themes, Bessel makes the information easy to read, insightful, and moving for the general public.

Exploring Trauma and the Brain 

Trauma is more than just a feeling or a thing that happened. It has a definable and proven ability to change the brain, altering the way it works until the trauma is treated. 

In his studies and experiences with patients, Bessel found people would re-experience the sensations of trauma at a neurological level, which would then affect breathing, heart rate, and other physical responses (Van der Kolk, 2014).

This often begins in the amygdala, which signals fight-or-flight (producing adrenaline) and releases stress hormones. For many traumatized people, their bodies don’t stop secreting these hormones because they don’t often feel safe. Their brains and the many parts within it adapt to respond to perceived threats, which can affect physical health, mental health, and your wellness as a whole. 

Neurological Impacts of Trauma

Bessel van der Kolk and colleagues found multiple neurological impacts of trauma. In one instance, they found a traumatized person’s brain activated in the visual cortex, right limbic area, and deactivated in the Broca’s cortex (where language is produced) (Van der Kolk, 2014). Additionally, the “self-sensing” areas of the brain simply did not activate when PTSD patients were asked to sit still and think about nothing, which naturally triggers an awareness of self (Van der Kolk, 2014).

These findings meant patients neurologically responded to the intense emotions of relieving their trauma, as expected, but also went into a state of “speechless horror” (when the Broca’s cortex deactivated). Bessel found this to be the reason why many trauma victims are physically unable to relay what happened to them, and he could see it in real-time on the scan. Many also could not feel a sense of self, instead feeling separated from their body and unaware of sensations like touch.

As long as trauma sensations remain stored in the memory, any activation may trigger the same sensations and feelings; as if the trauma is happening again. Bessel saw this through brain imagery and observing his patients’ reactions to stimuli related to their trauma. 

Neuroplasticity for Recovery

Just as the brain can learn to live in a state of arousal, it can also learn to regulate. The areas of the brain, like the amygdala, can go back to healthy functioning. This ability is called neuroplasticity, or “a process that involves adaptive structural and functional changes2 to the brain.” 

Neuroplasticity offers hope to those with trauma. In the same way their brains adapted to survive, so they can adapt to live fully. 

Trauma’s Manifestation in The Body

Trauma does not go away without treatment. It lingers in sensations, memories, flashbacks, immune diseases, sleep problems, and asthma attacks. Mysterious illnesses without cause may point to the body simply trying to deal with the effects of being in survival mode long after you’ve survived the event. Such strain on the nervous system can eventually lead to mental and physical illness (Van der Kolk, 2014).

The Body Keeps The Score

Somatic symptoms without a clear physical cause commonly affect traumatized adults and children. Examples include:

  1. Autoimmune disorders
  2. Sleep disorders and insomnia
  3. Skeletal/muscular problems
  4. Asthma 
  5. Numbness
  6. Migraine headaches
  7. Fibromyalgia
  8. Chronic fatigue
  9. Irritable bowel syndrome
  10. Chronic back and neck pain

In one example from Van der Kolk’s book, a woman with asthma attacks requiring hospitalization eventually realized she was experiencing a physical manifestation of intense emotions (related to childhood trauma). By focusing on the connection between them and addressing the emotions, she stopped having the attacks and needing hospitalization. This highlights the powerful connection between mind and body. 

Therapeutic Approaches to Recovery

Dr. van der Kolk found and practiced multiple therapeutic approaches for trauma. He initially sought something other than the suggested mode of trauma healing: talking about it until it lost its effect. Bessel found avoidance, retraumatization, “speechless horror”, and other somatic effects of trauma often made this approach ineffective.

Though his patients sometimes reaped benefits from bringing their trauma to light, Bessel rightly thought they needed to do more than just become desensitized to verbalizing it. 

Mindfulness and Somatic Experiencing

To help his patients first feel what was going on in their bodies, as many traumatized people are unable to do, Bessel practiced mindfulness with them (Van der Kolk, 2014). This strengthens the body’s natural ability to notice what’s going on within it. 

You can practice mindfulness in many ways. One of the most simple ways is through breathing exercises—you can count the seconds you breathe in, hold the breath, and exhale. Becoming aware of basic functions like these can help ground you in the moment and experience the present. By connecting his patients into the present, Bessel aimed to tell their brains, “that [the trauma] was then, this is now.” (Van der Kolk, 2014, p. 181).

Similarly, somatic experiencing aims to help patients notice the physical sensations related to traumatic memories (Van der Kolk, 2014). They would then work on calming the body, mitigating hyperarousal, before ever wading into the trauma itself. Doing so offered a safe, stable baseline to begin parsing through memories. If done in a state of panic or arousal, attempting to relive the memories could cause retraumatization.

Eye Movement Desensitization and Reprocessing (EMDR)

Dr. van der Kolk soon adopted EMDR as one of his treatment modalities, though hesitantly at first. It seemed odd—tracking objects (like the therapist’s fingers) back and forth while recalling a traumatic memory allowed people to process it and heal? Bessel van der Kolk soon found that to be the case.

He found EMDR an effective way to orient trauma back to the past, rather than lugging it along into the present. Patients could radically improve in just a few sessions. 

In examples from the book, Bessel guided assault, rape, and other trauma victims through rapid back-and-forth eye movements as they recalled their trauma. Vivid memories and sensations arose almost immediately, but his patients didn’t need to describe them to process them; only notice it. In one example, his patient/fellow student didn’t have to say a word to feel profoundly healed. That’s what Bessel found to be such an intriguing and effective aspect of EMDR: even those plagued by speechless, intolerable horrors could truly heal (Van der Kolk, 2014).

Studies highlighted in The Body Keeps the Score showed EMDR could be a much more effective treatment for PTSD than medications, or therapies like cognitive behavioral therapy (CBT) (Van der Kolk, 2014).

Yoga

Van der Kolk found yoga to be another way his patients could reorient themselves in their present body. It served as a mindfulness tool, a gentle form of exercise, and something his patients could grow an affinity for. 

Poses and breathing techniques helped his patients reconnect to their bodies and feel comfortable being present. Bessel found yoga could be especially helpful for victims of rape and sexual assault as they began to grow more comfortable experiencing physical sensations (Van der Kolk, 2014).

Yoga also helped his patients become more attuned to their emotional states and passing sensations, ultimately helping them separate from past traumas and hold tight to the present.

Many other holistic and alternative therapies were found to alleviate trauma and help patients process it, including theater, psychedelic therapy, neurofeedback, and other forms of creative expression.

Impact on Mental Health Professionals

As one of the pioneers in trauma studies and healing, Bessel van der Kolk influenced many treatment providers and continues to do so. Many found success with their own patients after adopting a mind-body-connection ideology and focusing on helping trauma victims come into the present.  

The revelations found in The Body Keeps the Score ultimately proved what many treatment providers suspected: talking about trauma didn’t cure it; and while prescribed medications could help with symptoms, they weren’t a cure-all either. It also gave them concrete insights and tools into what was found and proven to work. 

Bessel effectively proved how and why traditional therapies didn’t always work for trauma, and how they could even do more harm than good (such as retraumatization). His accumulation of 30 year’s clinical work creates a manual, so to speak, for anyone wanting to deeply understand how people heal. Quotes from appreciative healthcare professionals include:

“With the compelling writing of a good novelist, van der Kolk revisits his fascinating journey of discovery that has challenged established wisdom in psychiatry. … This is a watershed book that will be remembered as tipping the scales within psychiatry and the culture at large towards the recognition of the toll traumatic events and our attempts to deny their impact take on us all.”

-Richard Schwartz, originator of internal family systems (IFS) therapy

“This outstanding volume is absolutely essential reading not only for therapists but for all who seek to understand, prevent, or treat the immense suffering caused by trauma.”

-Pat Ogden, PhD

“This book will provide traumatized individuals with a guide to healing and permanently change how psychologists and psychiatrists think about trauma and recovery.”

-Ruth A. Lanius, MD, PhD

Lighting The Path to a New Future

Books like The Body Keeps the Score effectively help change how society views trauma. As many reviews state, Dr. van der Kolk’s clinical findings have the power to change how the world sees trauma and trauma recovery.
To see rehabs treating trauma, you can browse our collection of trauma treatment providers with photos, reviews, pricing information, and more.

Posted on

Understanding Psychodrama Therapy: Techniques and Benefits

Psychodrama is a therapeutic method that uses dramatic techniques, such as role-playing, to help people understand and resolve their emotional conflicts1. During sessions, patient groups enact scenes from their lives or dreams to gain insights and practice new ways of being in the world2. 

The goal of psychodrama is for patients to gain mental clarity so they can learn new ways of thinking and cope with their feelings surrounding the event. Through these exercises, patients may see improved social skills, a boost in self-esteem, or a positive attitude shift3. Psychodrama can teach adaptive coping strategies, leading to resilience4. 

Incorporating psychodrama into your recovery plan can offer a new perspective on healing and a deeper understanding of yourself.

Origins and Development

Jacob Levy Moreno, a Romanian psychiatrist and psychoanalyst, invented psychodrama in 19215. Moreno studied the power of relationships and group interactions, seeing a person become the healing agent for another. His creation was inspired by improvisation theater and the rise of the psychoanalytic movement led by Sigmund Freud. It became the first form of group psychotherapy.

Moreno quickly developed one of the fundamental concepts, role theory, which shows how social roles shape behavior6. People take on different roles in their lives, and exploring these roles in a therapeutic setting can lead to insights and personal growth.

In the 1940s-60s, interest grew in psychodrama, and it became a therapeutic practice. Psychodrama was applied not only in clinical settings but also in educational and community settings. Today, psychodrama can be applied to family therapy, trauma work, and addiction treatment. It’s even being discussed as an alternative method of education in schools. 

Core Principles of Psychodrama

Psychodrama therapy is guided by several core principles. Moreno defined these principles7 as:

  1. Warming up: A process that creates an appropriate environment for spontaneity. This may look like physically shaking your body to loosen up, clearing any doubts, and having silly conversation. 
  2. Spontaneity: By being in the present moment, you can react to things without any preconceived notions. This can benefit role play.
  3. Creativity: Spontaneity helps catalyze creativity—it is born by reacting the way you normally would, a true-to-self reaction. When you are rooted in the here and now, there’s more opportunity for play, creativity, and new ways of thinking.
  4. Encounter: Meeting another person where they are at and mentally viewing the event from their perspective.
  5. Tele: Sensing the feeling/bond between 2+ people. During the first encounter between a group, the tele should be neutral. Then, a positive or negative feeling forms over time and between interactions.
  6. Co-conscious vs co-unconscious: These are states shared between 2+ people. A co-conscious state is when a particular feeling in a group is voiced or acted out, so it is known. A co-unconscious state occurs when 2+ people who are closely existing develop a normal atmosphere amongst themselves. This is created through shared and unshared feelings, actions, and beliefs, but it is not outrightly stated.
  7. Role: An identity that someone takes on in the moment, depending on the context. For example, the eldest sibling may assume the role of parent if the younger sibling is in distress and the parent is not nearby.
  8. Role vs ego: The ego is a concept that helps us balance between societal norms and our true desires. In psychodrama, the ego actively explores roles, emotions, and conflicts. It aims to strengthen ego function.
  9. Role reversal: Changing from your current role to the other person’s. This can help you gain insight.

Looking at all these principles, we can form the inner workings of psychodrama. Focusing on spontaneity and creativity while role-playing allows you to develop a new perspective on past events, feelings, and behaviors. 

Key Roles in Psychodrama

There are 3 key characters in a psychodrama session: the protagonist, auxiliary egos, and the director.

The protagonist takes center stage during a psychodrama session. They are the main focus and typically present an issue or situation they want to explore and work through. The protagonist enacts personal situations, bringing them to life through role-playing.

Auxiliary egos are people in the group who play roles within the protagonist’s enacted scenario. They may portray significant people, objects, or aspects of the protagonist’s internal world. Auxiliary egos offer alternative perspectives for the protagonist.

The director is the therapist or facilitator guiding the session. They set the stage, facilitate interactions, and ensure a supportive environment. The director leads warm-up activities, and they may intervene or suggest things to facilitate exploration and resolution.

Techniques and Processes: How It Works

In a psychodrama session, you may participate in various techniques to find the best for your healing. At the core, you will be role-playing as the protagonist or acting out specific roles or situations to explore emotions, thoughts, and behaviors. 

From there, you could practice mirroring, where the auxiliary egos copy your behaviors, emotions, or body language—this can foster self-awareness.

Another group member may practice doubling, voicing your thoughts and opinions for you. Speaking your internal feelings aloud can help deepen your understanding of the event. 

You may role reverse with another person, allowing you to experience the situation from a new perspective. 

Sometimes, you, as the protagonist, talk through your inner thoughts, providing insight into your internal dialogue and expressed emotions. This is called soliloquy.

Practices such as these can strengthen your emotional awareness. The director (your therapist) will ensure that the sociometry of the group is healthy and balanced, meaning the auxiliary egos are well suited to support the protagonist. As group dynamics grow, these techniques will become easier and easier, making room for deeper exploration.

The Role of Action and Enactment

Physically acting out past experiences is what sets psychodrama apart from traditional talk therapy. This approach is immersive and engaging, and activating all the senses can help patients work through buried feelings. Psychodrama pulls patients out of their internal world and allows them to experience emotions, thoughts, and behaviors directly.

Psychodrama can be particularly effective for patients who feel limited by traditional talk therapy. Reenacting certain events can provide insights and much needed emotional release.

Applications of Psychodrama

Psychodrama is commonly done in group therapy, although it can be used in individual and family therapy, as well. In a group or family setting, other participants in the group would help set the scene, while individual therapy usually involves the counselor and the patient engaging in this practice.

Psychodrama can be beneficial for specific conditions, such as trauma. Trauma affects both the brain and the body8, and it can be hard to find words to describe trauma (because Broca’s area, the part of the brain responsible for language, is less active when remembering trauma9), making it difficult to process in traditional talk therapy. Psychodrama provides an alternative way to connect the mind and body to work through trauma.

As this approach aims to boost self-esteem and self-sufficiency, psychodrama can improve depression and anxiety symptoms10. It can also aid addiction recovery. Role playing a patient’s addictive behaviors helps them understand the roots of their substance use and develop healthier coping strategies.

Any patient can benefit from psychodrama—it’s not only for self-proclaiming “creative” people. With the right guidance, engaging in these practices can improve communication, self-awareness, and promote healing.

Integrating Psychodrama with Other Therapies

Psychodrama can be integrated with other therapeutic modalities to create a well-rounded treatment plan. 

Cognitive behavioral therapy (CBT), one of the most common and effective therapies for addiction11 and mental health disorders, can combine with elements of psychodrama. Your therapist may use role-play or family of origin imagery12 (exploring mental images, memories, and perceptions of your family and childhood) in addition to CBT techniques that replace unhealthy thought patterns with more positive ones.

Psychodrama can also work in conjunction with Gestalt therapy. This therapy takes a “whole person” approach to healing and looks at many aspects of someone’s life that may have contributed to their struggles instead of just one event or trauma. Gestalt therapists can use role reversal and the empty chair method13 (similar to role-playing with an auxiliary ego, but instead, you interact with an empty chair) in addition to Gestalt techniques such as “I” statements.

Dialectical behavioral therapy (DBT) compliments psychodrama, as well. DBT has similar processes to CBT; however, there is an emphasis on mindfulness and healing in the present moment. While engaging in role play and other psychodrama practices, focusing on mindful words and movements can increase spontaneity and creativity—thus facilitating exploration and recovery breakthroughs. 

Questions to Ask Your Provider About Psychodrama

Before beginning psychodrama sessions, you may consider asking your provider a few questions, such as 

  1. How do you act as the director of the group? Can you give examples of how you mediate sessions?
  2. How do you determine who would be a good auxiliary ego for my role-playing session?
  3. How would you evaluate my progress in the sessions?
  4. Are there follow-up sessions to break down what we’ve learned in the psychodrama sessions?

Training and Certification

As a therapist, proper psychodrama training can ensure that your patients get the most out of your sessions. You can receive training through many organizations; some are in person, while others are virtual. At the American Board of Psychodrama14, you can learn the theory, master the techniques, and understand group dynamics to facilitate your patients’ healing.

If you’re seeking out a psychodrama therapist, ensure that they have this certification and proper experience and education—this should be a Master’s degree or higher, and their credentials can look like Psy.D., M.S.W., and L.M.H.C. Ask them questions such as

  1. What does a typical psychodrama session look like?
  2. How do you integrate psychodrama practices into other therapies?
  3. How will you manage the group dynamics?

To find more resources to support your recovery journey, visit our Resources Hub.

Posted on

Strengths-Based Approach to Trauma Treatment

A strengths-based approach focuses on a person’s behaviors, ways of thinking, and values that promote health1, instead of focusing on symptoms that can cause poor mental well-being. By emphasizing unique positive characteristics, patients’ recovery aligns with what will best help them heal. 

For example, a patient who expresses their emotions freely through art may receive more art therapy sessions to play to their strengths. Another client may bond and open up to peers, so they would attend more peer support groups. If a trauma patient responds well to eye movement therapy, then they might add in 2 more sessions weekly.

Trauma is highly specific to each patients’ experience, environment, and personality. A strengths-based approach acknowledges that people who have experienced trauma can access innate strengths to promote healing.  

Key Components of the Strengths-Based Approach

Some trauma treatment approaches use deficit or pathology-based methods, meaning they focus on addressing the negative symptoms; however, a strengths-based approach builds on existing strengths, resilience, and coping mechanisms to recover. 

Trauma-Informed Care

Notably, a strengths-based approach incorporates trauma-informed care principles,  which seek to address the effects of trauma and promote safety, self-regulation, and empowerment2. It recognizes and adheres treatment to the impact of trauma and creates a safe and supportive environment that fosters healing. Other methods might risk re-traumatizing the patient by treating trauma symptoms without sensitivity.

Therapists using a strengths-based approach, such as Judy Crane3, tend to have specialized trauma training and incorporate the idea of the Trauma Egg into their practice. The Trauma Egg offers a visual framework to view how trauma affects a patient’s life4, and it aims to promote personal reflection and healing. Using this concept, patients can “talk” to and peel back each separate component that their traumatic experience has given them. Adopting practices like these into a strengths-based approach can help the patient feel in control of their recovery.

Collaborative Decision Making

A strengths-based approach encourages collaborative decision-making between patients and their treatment team. It actively involves patients in their recovery process, respecting their autonomy and choices. By building on a patient’s independence, this approach can help them flourish in recovery with strength, growth, and resilience.

Empowerment

A strengths-based approach bolsters a patient’s natural positive coping skills, emphasizing their ability to adapt in the face of adversity. This approach views patients as inherently capable of their own recovery and in control of their lives, particularly in the context of trauma. 

Benefits of Strengths-Based Trauma Recovery

Patients participating in a strengths-based recovery can gain control and build a new mindset of creating and rebuilding, rather than being broken. 

Patients learn how to set goals, develop healthy coping skills to foster growth, and confront rather than avoid challenges. Their strengths and newfound resilience can then improve their personal, family, and community well-being5. It also builds self-esteem and competence in recovery and their daily lives.

While a strengths-based approach has many positives, it’s also important to find and address personal weaknesses5. Ignoring these could lead to a less effective recovery.

Find Treatment for Trauma

Using your strengths, you can find healing from your trauma. Browse treatment centers providing trauma-specific care with pricing, insurance, and photos.

Posted on

Understanding the Roles of Victim, Rescuer, and Persecutor: A Guide to Empowerment

Have you ever felt stuck in a relationship where power plays seem endless? Maybe you blame others for your struggles, use tactics to avoid accepting blame, or swoop in to fix things only to end up feeling drained and resentful.

The Drama Triangle is a psychological and social model that describes 3 common roles people often unconsciously play in dysfunctional relationships. This victim-rescuer-persecutor cycle isn’t just relationship drama; it’s a deeply felt dynamic that’s woven into mental health struggles. 

Recognizing these roles isn’t about pointing fingers; it’s about understanding the disempowering patterns that keep us spinning our gears. Breaking free from these scripts paves the way for personal growth, better boundaries, and stronger relationships. 

These insights and strategies can help you shed these roles and step into your personal power. 

The Victim Role

Within the victim-rescuer-persecutor dynamic, also known as the Drama Triangle,1 the victim perceives themselves as powerless. They believe external forces control their circumstances, leading to these behaviors:

  • Externalizing blame: Attributing personal struggles to factors beyond their control, neglecting individual agency and responsibility
  • Helplessness: Believing they’re unable to improve their situation, leading to despair and hopelessness
  • Exaggerated vulnerability: Constantly seeking external support and validation, often presenting themselves as fragile and incapable

The victim mindset limits your ability to grow your own resilience and keeps you feeling stuck in life. It can also make you feel more isolated, anxious, and depressed.

The first step to breaking free of these limitations is to recognize the signs of victimhood:2 

  • A negative outlook; feeling like you were dealt a bad hand
  • Asking “why me?”
  • Ruminating on past hurts or injustices
  • Feeling like nothing ever works out for you 
  • Having a low opinion of yourself; believing you don’t deserve good things 
  • Being jealous of others’ successes 
  • Minimizing your own strengths and achievements
  • Giving up when you’re overwhelmed by challenges 

Psychiatrist Dr. Tracey Marks points out, 

Setbacks and disappointments and hurts, they’re all part of the uncertainty of life. How you respond to these setbacks determines how satisfied you are or will be with your life. You can’t control your circumstances, but you can control your response to them.

The Rescuer Role

Driven by a need to “fix” others and alleviate suffering, the rescuer often doesn’t realize their behaviors are disempowering:

  • Excessive responsibility: Taking on the burdens of others, often neglecting their own needs and well-being
  • Compulsive helpfulness: Offering unsolicited advice and solutions, overlooking others’ agency and growth potential
  • Enabling: Encouraging dependence by doing for others what they can do for themselves

While rescuers are well-intentioned, their role has significant pitfalls. By focusing solely on others, they neglect their own boundaries and needs, leading to resentment, burnout, and emotional exhaustion. Some describe this as an addiction to helping.3

Recognizing the need for healthy boundaries and self-care is crucial for rescuers to move from codependency to empowerment. This can look like:

  • Setting clear limits on support and responsibility
  • Encouraging others to find their own solutions and build agency
  • Prioritizing your own mental health

Stepping back from the hero complex allows rescuers to offer genuine support that doesn’t encourage dependency.

The Persecutor Role

Persecutor behaviors are often more destructive and obvious:

  • Manipulation and control: Using guilt, blame, or emotional leverage to maintain power and influence over others
  • Minimizing and denial: Dismissing the needs and experiences of others, refusing to take responsibility for their actions
  • Self-centeredness: Prioritizing their own needs and desires at the expense of others

The persecutor’s behavior damages relationships by eroding trust and fostering anxiety and fear. Their actions undermine personal growth and recovery, perpetuating unhealthy dynamics and cycles of dependence.

In more severe cases, persecutor behavior can become emotionally, psychologically, or physically abusive. If you feel unsafe in your relationship, contact the National Domestic Violence hotline to identify abuse, get help, and plan for safety.

Persecutor behaviors usually stem from deeply held insecurities and learned patterns of manipulation that have roots in childhood trauma. It’s well known that, usually, abusers were once victims themselves.4 Just like victims and rescuers, their patterns are the result of unhealed wounds. 

It’s important to remember that while this may explain why someone behaves the way they do, abuse is never okay. If you feel unsafe in your relationship, seek the support you need to leave the situation and heal.

The Dynamics of the Triangle

The victim-rescuer-persecutor model isn’t about who’s better or worse. It’s a framework for understanding the power dynamics that can play out in unhealthy relationships, including those impacted by addiction and mental health struggles.

These roles aren’t static. Most people move between them, but have one role they gravitate toward the most.

Ultimately, the goal is to step off of this triangle completely.5 Empowering yourself starts with owning your feelings and actions.

Empowerment Strategies

Unlearning disempowerment takes a proactive approach. Here are some key strategies to cultivate your personal power:

1. Develop Self-Awareness

These roles are often automatic, so challenge your assumptions. Observe your thoughts, feelings, and reactions. Are you slipping into victim, rescuer, or persecutor mode? Recognizing this is the first step toward change. 

2. Learn How to Set Boundaries

Healthy boundaries are the shield that protects your well-being. Learn to say “no” and limit your engagement in toxic dynamics. Clearly communicating your needs, and meeting them yourself, makes it less likely that you’ll become resentful or passive-aggressive. Remember: setting boundaries isn’t selfish, it’s self-protective. 

3. Cultivate a Growth Mindest

Instead of seeing yourself as a victim of your circumstances, you can view challenges as opportunities to learn, grow, and get stronger. You have agency in shaping your journey, and you have the ability to improve your life skills, confidence, and independence. 

These strategies aren’t quick fixes, but a continuous practice. As you show up for yourself consistently, you’ll gradually rewrite your own script. Eventually, you’ll find yourself less likely to get caught in toxic patterns and better prepared to handle relationships with integrity and self-respect.

Clearing Misconceptions

This dynamic is often shrouded in misunderstanding. Let’s shed light on some common myths:

Myth: Roles are fixed.

Reality: People may move between roles depending on the context and their emotional state. A rescuer, burnt out from constant fixing, might shift to the victim stance. Similarly, a persecutor may wear a rescuer mask in other contexts.

Myth: Blame the persecutor.

Reality: Solely blaming the persecutor solely doesn’t address the complex interplay of roles and their impact on each person. Instead, focus on understanding the motivations behind your behaviors to break free from the cycle.

Myth: Change is impossible.

Reality: With dedicated effort and consistent self-awareness, changing patterns is absolutely possible. By cultivating a growth mindset, setting healthy boundaries, and communicating effectively, you can choose more empowered relationships.

The journey out of disempowerment is about reclaiming your voice and taking charge of your own path. It’s not about assigning blame or achieving perfection, but about fostering healthy dynamics that are in the best interest of all.

Healing and Transformation

Healing from the victim-rescuer-persecutor cycle is a vulnerable and deeply personal journey. Showing up authentically and being honest about what you’re working on can help you have more authentic relationships. 

Because these roles are so unconscious and ingrained, breaking the cycle takes effort and time. That’s where professional support can be hugely helpful. A qualified therapist can help you untangle these dynamics, identify their root causes, and implement strategies for change. 

Search our collection of mental health treatment centers to find a program that meets your needs, and reach out to an admissions counselor today.

Posted on

Internal Family Systems Therapy and Legacy Burdens

Internal Family Systems (IFS) therapy is a relatively recent therapeutic approach developed by Richard Schwartz. It describes the psyche as having multiple parts with a centralized Self—or, your core essence. Within the Self are Parts, each with its own unique characteristics, emotions, and motivations. These Parts can be in conflict with each other, leading to inner turmoil and psychological distress.

Dr. Schwartz created IFS to identify Parts of the self1 and change how those Parts interact; it’s used in interpersonal psychotherapy and in group settings. Healing damaged Parts and addressing self-protectors can identify trauma, legacy burdens, and deep pains. Then, the client and therapist work together to soothe the Parts and create a sense of safety that allows clients to heal their parts on their own. 

IFS and other forms of therapy can also address deep-seeded legacy burdens, which are conscious or subconscious burdens from generational trauma, family legacies, and family expectations that affect your life.

What Is Internal Family Systems Therapy (IFS)?

IFS therapy offers a comprehensive framework for understanding and addressing the complexities of the human psyche, both at an individual and systemic level.

IFS is based on the idea that each person’s mind is made of “Parts”2 that form around a traumatic experience. The Parts compensate for trauma and strive to protect Exiles, which are the isolated Parts carrying hurt and trauma. 

Managers and Firefighters, the other 2 Parts, both work to keep Exiles hidden and safe. 

Your Firefighter Part is responsible for behaviors like drinking, drug use, and self-harm. These behaviors arise to control the Exiles’ feelings (terror, rage, grief, fear). Manager Parts find control through carefully evaluating situations, caretaking, and controlling. By staying in control, Managers think they can protect you from further pain and rejection.

Healing The Parts in IFS

In IFS, you’ll learn to hold space for the vulnerable Parts and meet them with compassion, a core part of the Self. IFS therapy helps you create a safe internal environment to confront your protective and vulnerable Parts and engage your compassionate Self. This safe internal environment can help you process traumatic memories and release legacy burdens without retraumatization.

IFS also connects your mind and body to increase mindfulness. You’ll become more aware of what you’re feeling and why, and where it may hold itself in your body. 

Ultimately, IFS draws on “the inherent wisdom of the Self2” to rework cognitive distortions from childhood trauma, legacy burdens, and negative views of self. It’s done compassionately and without judgment, allowing the Parts to accept healing and back away from their maladaptive coping strategies. 

Therapists are trained to provide IFS therapy. Not all therapists will offer IFS, and some will be more experienced than others. Check with your provider to see if they’re trained in IFS and their level of experience. 

IFS for Trauma and PTSD

IFS can help those with trauma and PTSD become “compassionate witnesses”2 to their traumatic experiences without feeling overwhelmed or retraumatized. Patients use mindfulness to separate from the emotions, sensations, and images of their trauma. That mindful separation can strengthen their ability to reflect on their experiences as caring, compassionate observers. 

For example, a patient may have residual shame after childhood abuse. IFS would help them step away from the shame, address the Part responsible for it, and allow their Self to replace the shame with self-compassion. Releasing the shame and allowing self-compassion can then reduce the hold of the traumatic experience and help the patient step into the present (and feel safe doing it).

Legacy Burdens: What They Are and Their Effects

A legacy burden leaves an imprint on future generations’ worldview and wellness. It can stem from one person or exist across a generation of people groups as generational trauma. 

A single-person legacy burden could be caused by a belief carried down. For example, one of your grandparents or a parent may impose a belief on you and others in your family. The belief could be that you need to earn a lot of money, stay in a particular religion, or have a specific relationship. Even if you don’t necessarily believe their beliefs, the internal burden of their beliefs and expectations can still affect you.

Generational Trauma and Legacy Burdens

Generational trauma also leaves a legacy burden3. Indigenous and marginalized groups often carry trauma from generations of gentrification, colonialism, and brutality. 

Stress and trauma can pass between generations through genetic changes3. Environmental stress can molecularly affect how a parent’s genes function, which then pass down to their child. Parents may also recreate their trauma and traumatize their children in turn. Generational trauma can pass down through a combination of the 2 as well. 

The generations who didn’t experience the trauma firsthand may still experience the residual effects through their parents. Distant parenting, witnessing parents suffer from trauma, and avoiding the topic can strain relationships and create unhealthy attachment patterns. Some also feel the need to hold onto the trauma to honor those who directly went through it and bring awareness.

Interestingly, positive change commonly occurs in the third generation3. Grandparents, for example, may be more willing to share their experience with their grandchildren. It could be because enough time has passed, and because the third generation is more likely to seek growth and healing. This, in turn, can help the first and second generations heal. 

Generational trauma can also create resiliency. Some children may see the burden carried in their lineage and actively pursue healing for themselves and others—which can turn into a sort of legacy burden itself. But, having a legacy burden doesn’t automatically entail generations of suffering. Individuals and groups can end the cycle, sometimes through IFS therapy.

IFS as a Healing Tool for Legacy Burdens

IFS can address the Parts carrying legacy burdens, allowing the Self to heal and prevent the trauma from extending. For some, their Exile may need healing. Others may need to heal a Firefighter or Manager to learn new coping tools.

Once the Part with the legacy burden feels safe and heard, the Self can bring in compassion and perspective, allowing you to detach from the burden. Continued IFS sessions and homework from your IFS therapist can help you maintain this release and continue forward. 

Your legacy burden may surprise you once you identify it, or it could be an obvious burden carried through your family (like alcoholism or racism). In either case, IFS and other therapies can help you identify the burden and use your natural capabilities to heal.

Posted on

Mind Control and Complex Trauma

Children, young adults, and adults can suffer mind control and complex trauma. Mind control can also be a broad phenomenon experienced by people groups, organizations, and countries. Other times, it can be used as a directed form of psychological abuse. 

Complex trauma is the cumulation of “multiple interpersonal threats”1 or abuse during childhood. It may come as the result of mind control or other abuses. Dr. Karol Darsa—psychologist, author, and creator of RITTM (Reconnect Integrative Trauma Treatment Model)—offers insight into healing.

Understanding Mind Control

Mind control compromises a person or group2’s freedom of choice by altering their perception, motivations, and behavior. Some mind control techniques aren’t done maliciously; for example, most advertising involves pushing emotions for a desired outcome (buying their product). 

Malicious mind control aims to control another person (or group) through fear, deprivation, and confusion. For example, research found people in controlled environments with sensory stimulation removed (like visuals, smells, sounds, and other sensations) moved into a malleable emotional state. The process worked by only allowing select information to the sensory-deprived person. In that state, new ideas or beliefs could be implanted and believed3. 

As an example, the only stimulation provided to someone could be a repeated fact of any sort. With nothing else to occupy or influence their thoughts, it can be easier to believe and act upon whatever information is provided. 

Similar emotional states could be achieved through abuse and trauma, where stress and abuse return the brain to its primal, animalistic survival functions. In its worn-down state, the victim’s brain could accept and believe almost anything about themselves or the world around them. 

Mind control as a form of abuse could lead to complex trauma and complex post-traumatic stress disorder (c-PTSD), especially if it occurs in childhood. 

An adult with c-PTSD caused by mind control may struggle to trust others, themselves, and their reality. Sometimes, they may not even know why they don’t trust; just that they don’t. 

Complex Trauma and Its Prolonged Impact

C-PTSD usually occurs due to childhood trauma. Complex trauma can have more severe consequences2 than non-complex trauma. It can also cause the onset of depression, anxiety, PTSD, substance use disorder, and dissociative identity disorder (DID). 

C-PTSD can have more long-lasting effects2 because it occurs after repeated, inescapable traumatic events. It’s more common to experience in childhood, but it can happen at any time of your life. PTSD, in comparison, occurs as a single instance (like a rape, tornado, or car accident). Staying in activated stress states and experiencing them often, especially in childhood, can cause the more severe psychopathy and cognitive deficits associated with c-PTSD. 

That means that children with c-PTSD are more likely to grow into adults with major depressive disorder, anxiety, psychotic symptoms, and addiction. Children with c-PTSD were also found to have lower IQ scores2 and poorer executive function as adults. 

Psychopathy4, lower IQ scores, and poor executive functioning can have prolonged effects in adulthood. When caused by c-PTSD, these effects occur independent of other variables like genetic disposition, motivation, and effort.

Recognizing Signs of Mind Control and Complex Trauma

You or someone else could be experiencing mind control if you recognize these tactics:

  • A person or group uses terror, threats, and manipulation to mold the brain into its more primal survival mode. Escape feels impossible, either physically, mentally, or socially.
  • You or someone else believes the perpetrator and whatever truths they tell about you, someone else, or the world.
  • You comply with their wishes and demands to survive. You’ll believe or do anything they ask out of forced trust and the need to survive. In a state of survival, your brain struggles to process information logically, which is why you may continually trust and believe the perpetrator. Doing what they say often feels like the only way to stay safe.  

Complex trauma has several distinct signs5, too. 

  • Re-experiencing the trauma through flashbacks
  • Dissociation
  • Interpersonal challenges with relationships
  • Self-destructive behaviors (like substance use)
  • Irritability and hyperarousal, or emotional numbness
  • Social withdrawal
  • Hostility 

You may notice these signs in yourself or someone else as a child, young adult, or adult who’s experiencing c-PTSD.

Karol Darsa’s Treatment for Trauma and c-PTSD

Trauma psychologist Karol Darsa created the Reconnect Integrative Trauma Treatment Model (RITTM)6 to treat trauma. RITTM is comprehensive and body-based, which means it’s designed to heal and reconnect the mind and body. 

RITTM integrates eye movement desensitization and reprocessing (EMDR) therapy, brainspotting, somatic experiencing, gestalt therapy, energy psychology, and mindfulness. The result is a whole-person approach to treatment that can help adults with c-PTSD heal their trauma and the conditions associated with it. 

RITTM occurs in individual settings and stresses a positive therapeutic alliance. Rather than following strict protocols and regimes, RITTM can flex to individual needs and types of trauma. It’s been found to help with single-event and complex trauma. 

Dr. Darsa’s 20 years of experience led her to write a guide on trauma healing, found a treatment center, and educate other professionals on trauma healing. She’s been featured as an expert on ABC, CBS, and more. She also lectures on trauma at universities like UCLA, Cal Lutheran, and the University of Southern California. 

Other Therapies for Trauma and c-PTSD

Other forms of trauma treatment may fit your needs. Some aspects of RITTM may suit you better if they’re pulled out and focused.

EMDR can help reduce your reaction to traumatic memories7 by using eye tracking as you recall your trauma. Doing both at the same time can desensitize you to the effects of the memories and help you process your trauma. 

Prolonged exposure therapy (PET)8 exposes you to an imagined scenario of your trauma or to real-life stimuli associated with it. Doing so can help reduce reactions to the experience and help you process and heal. PET may be too triggering for some; your treatment team can help you decide if this may work for you.

Trauma-focused cognitive behavioral therapy (TF-CBT)9 uses CBT to specifically focus on trauma. It can be especially helpful for children and their families. TF-CBT aims to reduce shame, guilt, and thought distortions related to trauma by identifying inaccurate beliefs and developing adaptive responses to trauma. Practitioners gradually expose patients to reminders and places to reduce their distress and reactions to trauma. 

Many other trauma therapies can help you recover from complex trauma and mind control. Your doctor, therapist, or psychologist can help you find the best fit for your needs. 

Finding Help for You or a Loved One

Attending a rehab for trauma, setting up therapy sessions, and actively pursuing healing can help you or a loved one heal from complex trauma and mind control.
Rehab provides a residential setting to focus on treatment and healing. There, you can experience EMDR therapy, Karol Darsa’s RITTM therapy, and other trauma therapies uniquely designed for healing.

Posted on

What Is Complex Trauma?: Causes, Signs, and Treatment

Complex trauma, sometimes called complex post-traumatic stress disorder (c-PTSD), is caused by prolonged exposure to traumatic events and has subsequent effects on psychosocial functioning and neurodevelopment. It differs from PTSD, which is typically associated with a singular traumatic event. Complex trauma accumulates over time with repeated activation of the stress response during sensitive developmental periods1, creating a web of emotional and psychological challenges. 

Usually, but not always, complex trauma forms in childhood. Professionals defined adverse childhood experiences (ACEs) as a set of potentially traumatic events that can happen during childhood2 and are linked to negative long-term health and well-being. The more ACEs a child has, the more likely they are to develop complex trauma. ACEs can negatively impact education and job opportunities and are associated with chronic health problems, mental health disorders, and substance use problems. 

However, complex trauma can form in any stage of life through various circumstances.

Causes of Complex Trauma

Complex trauma comes in many shapes and forms, as it can develop during any sensitive time period, especially for vulnerable populations. 

Childhood abuse: Complex trauma often stems from childhood abuse or neglect, including physical, emotional, or sexual abuse. This abuse can be caused by family or caregivers, disrupting a child’s sense of safety, attachment, and self-worth.

Domestic violence: Long-term exposure to domestic violence, where one partner emotionally, physically, or sexually abuses the other, can lead to complex trauma. Children who witness domestic violence within their family may also experience this form of trauma.

War and conflict: People living in areas affected by ongoing conflict and violence can develop complex trauma. This includes combat trauma, displacement, and loss of loved ones.

Human trafficking: Victims of human trafficking, whether for sexual exploitation or forced labor, endure captivity, manipulation, and violence, contributing to complex trauma.

Institutionalized abuse: Incarceration in prisons or detention centers with violence, isolation, and harsh conditions can cause complex trauma. Additionally, people who have been involved in cults or religious sects that use manipulation and emotional abuse can experience this type of trauma.

Chronic medical trauma: People with chronic or life-threatening medical conditions who undergo multiple surgeries, treatments, or hospitalizations may experience complex trauma from the ongoing stress and pain associated with their illness.

Symptoms and Effects

Complex trauma can significantly impact psychological and emotional well-being. Often, it can mirror or result in the onset of other mental health conditions3 such as PTSD, eating disorders, and personality disorders like borderline personality disorder. People with complex trauma are also more likely to turn to drugs or alcohol4 to self-medicate and cope with emotional pain.

In addition to mental health disorder symptoms, someone with complex trauma can have self-regulatory disturbances3, which can manifest as difficulties in emotion regulation and impulsivity. Complex trauma patients may also experience intrusive thoughts and dissociation, which is a disconnection from one’s thoughts, feelings, or surroundings. Physically, it can cause insomnia, gastrointestinal issues, headaches, and cardiovascular problems from the prolonged stress5. 

Long-term, complex trauma can greatly hinder a person’s ability to trust and form close relationships because a lack of safety leads to hypervigilance to potential threats. They may experience challenges developing healthy and secure attachment patterns. Someone with complex trauma may also have low self-esteem and intense shame or guilt. 

Trauma-Informed Care

Trauma-informed care6 is an all-encompassing approach to providing services and support that accounts for the unique experiences of people with complex trauma history. Healthcare professionals take patients’ past traumatic events into consideration when asking questions, creating a treatment plan, and executing therapies. It creates an environment that is sensitive to the needs of those who have experienced trauma and aims to promote trust and empowerment. This helps the patient feel safe and supported throughout their recovery.

Trauma-informed care aims to avoid retraumatization during recovery, which is key for complex trauma patients. To achieve this, healthcare providers will conduct an evaluation to screen for trauma history. Then, they can appropriately care for your needs though enforcing safety during treatment, avoiding triggering situations, and practicing crisis intervention. A cornerstone in treatment will also be trauma-informed therapy.

Trauma-Informed Care Principles

Trauma-informed care is based on several key principles7, as defined by The Center for Disease Control (CDC) and the Substance Abuse and Mental Health Services Administration (SAMHSA). Providers should strive to incorporate these ideas into their practices. 

First, it emphasizes that trauma is prevalent, and many people seeking treatment have experienced trauma. This recognition helps create a non-judgmental environment for patients to share their experiences without retraumatization.

This approach emphasizes the importance of trustworthiness and transparency between patients and providers. It involves building trust through clear communication, consistency, and reliability.

Trauma-informed care is based on a holistic understanding of traumatic experiences. Physical, mental, and emotional well-being are interconnected, so it takes into account the patient’s unique strengths, needs, and cultural background.

Trauma-informed care highlights collaboration and empowerment by actively involving patients in the decision-making process and providing them with opportunities for autonomy. This approach helps to restore a sense of control that may have been lost due to trauma.

Therapeutic Approaches for Complex Trauma

Recovering from complex trauma often requires talk therapy. These therapies allow you to practice emotional regulation and learn coping skills.

Trauma-focused cognitive-behavioral therapy (TF-CBT) is an evidence-based therapy designed to help patients process and manage the impact of trauma. It focuses on identifying and changing negative thought patterns and managing uncomfortable emotions. This approach often includes techniques like exposure therapy, cognitive restructuring, and stress management.

Eye Movement Desensitization and Reprocessing (EMDR) is a specialized therapy for trauma. It incorporates bilateral stimulation, such as rapid eye movements or taps, to help patients process and integrate traumatic experiences, reducing their emotional charge.

Many trauma-informed programs also integrate holistic and experiential therapies. Somatic experiencing emphasizes the mind-body connection in trauma and releases related physical tension and stress responses. You will also likely practice mindfulness techniques to develop greater self-awareness, emotional regulation, and stress reduction.

Resilience and Post-Traumatic Growth

Complex trauma could potentially lead to personal growth and positive changes8, also called post-traumatic growth (PTG). You may even look at the positive consequences in parallel with the negative, as opposed to its own separate island. 

PTG doesn’t deny the pain and challenges of complex trauma but acknowledges that growth can occur alongside suffering. Through professional and personal healing, you can discover a sunnier outlook on life, leading to increased resilience, confidence, and improved relationships. It’s a testament to your strength and the capacity for positive change, even in the aftermath of severe adversity.

So, how can you achieve PTG?—By making your healing a priority. Reach out for help from mental health professionals and trusted friends and family. Attend therapies that fit your needs, and openly communicate about your experiences. Work on developing healthy coping mechanisms for dealing with stress and emotional distress. And take time to do some deep self-reflection. Evaluate what’s truly important to you and your path to move forward by writing down recovery goals. 

Support and Resources

To find a trauma-informed provider, ask your primary care physician for referrals. They can guide you to a specialized professional or clinic that can address your specific needs. Look for professionals with relevant credentials and specializations, such as Licensed Clinical Social Workers (LCSWs), Psychologists (Ph.D. or Psy.D.), or Psychiatrists (MD). Additionally, check if they have certifications or training in trauma-focused therapies like eye movement therapy or trauma-focused cognitive-behavioral therapy.

After an evaluation, talk through your treatment options. Consider asking questions such as:

  1. Are there specific trauma-focused therapies you recommend?
  2. What qualifications should my treatment providers have?
  3. How can I actively participate in treatment and advocate for my needs throughout the process?
  4. Where can I reach out for support in case of a crisis?
  5. Are there coping skills I can practice outside of therapy? 
  6. Do you recommend any medications to manage my symptoms? 
  7. Do you recommend family therapy or couples therapy if complex trauma has affected my relationships?

Peer support can allow you to share experiences, learn coping strategies, and connect with others who have faced similar challenges. CPTSD Community Safe Group9 offers private online support groups and resources to those in recovery. There may also be in person support groups in your area, and you can find those by asking your primary care physician.
For assistance finding a provider near you, call SAMHSA’s National Helpline at 1-800-662-HELP (4357)10, or text your zip code to 435748.

Posted on

What Is Post-Traumatic Growth?

Post-traumatic growth (PTG) is a positive and ongoing inner change after trauma or a highly distressing situation. PTG can occur simultaneously with post-traumatic stress disorder (PTSD). One does not negate or invalidate the other.

PTG can positively change your outlook on life and place you on a more bright, resilient path. This offers hope to those who may feel discouraged by what they’ve gone through and how it affects their place in the world. 

Stages of Post-Traumatic Growth

You likely won’t feel positive changes immediately after a traumatic event. Most who do recognize PTG notice it after they’ve put space between their trauma1 and had some time to heal, which is part of the 5 stages of PTG. 

  1. Crisis or Trauma

A singular traumatic event or recurrent trauma prime you for post-traumatic growth. Though the experience will likely cause distress, it’s a necessary aspect of PTG. 

A variety of traumas can eventually connect to PTG. The Substance Abuse and Mental Health Services Administration (SAMHSA) defines trauma as2

  • Physical or emotional harm
  • Any threat to your life

Traumatic situations will impact your mental, physical, and emotional health. A non-exclusive list of trauma examples include

  1. Growth Awareness

Reflecting on how you’ve changed since your trauma can prompt post-traumatic growth. You may not gravitate towards reflection naturally, especially if your memories still cause pain. A therapist, spouse, or friend may notice it first. 

You may sit on this awareness for days, weeks, or months. Even if you don’t act on the awareness right away, realizing you’ve grown from something terrible can offer encouragement and hope.

  1. Growth Exploration

Next, you can see where you’ve grown. You may identify your growth by yourself, with a therapist, or a loved one. You can take a deeper look at the areas you’ve grown in and find encouragement from the positive changes.

For example, you may notice you’ve become more sure of yourself and your identity1. Or, you may notice you have a greater appreciation for your life and your loved ones. You may also be more aware of what you want out of life. 

  1. Developing New Beliefs

Your trauma may have left you with negative beliefs about yourself and the world. As you heal, your beliefs may change—maybe without you noticing. When you become aware of your growth and explore it, you can also see what beliefs align with your new growth. 

For example, you may believe you’re more equipped to handle hardships because you’ve survived one and grown. This can reinforce your self-efficacy. 

  1. Integration of Growth

Once you’ve become aware of your growth, explored it, and developed new beliefs based upon it, you can then integrate your growth into your daily life. Your growth may make you more confident, more empathetic, and more resilient. Those qualities may direct you to a new line of work, a volunteering opportunity, or creative outlet.

You may feel drawn to supporting others. With your strengths and insights, you could help others in similar situations and inspire hope. While that’s in no way a requirement, some trauma survivors feel highly fulfilled doing so.  

Signs of Post-Traumatic Growth

You can look for the signs of PTG3 in yourself and those you love.

Valuing Life More Than Before

Getting through a crisis or traumatic experience can make you value the life you have, especially if your trauma was life-threatening. Or, you may simply feel grateful for positive experiences after enduring such negativity. 

For example, if you survived a car crash, you may feel more thankful for your life and what you can make of it. 

Easier to Relate to Others

Trauma survivors sometimes develop a “sixth-sense”, where they become more attuned to the emotions and behaviors of others. Their experiences can help them relate to others4 and develop a strong sense of empathy. 

A Change in Priorities

A change in priorities is a strong sign of post-traumatic growth4. For example, you may unwaveringly prioritize family time after a traumatic event. 

In another example, a traumatic experience may awaken you to your true passions. Perhaps you suddenly realize your corporate job can’t compare to the fulfillment of painting. As you experience PTG, you may pursue a painting career to prioritize fulfillment. 

Increased Self-Confidence

Post-traumatic growth typically involves an increase in your personal strength1 and self-confidence. Those with PTG are more confident in their abilities to overcome challenges and make difficult decisions. 

Approaches Promoting Post Traumatic Growth

Several approaches to healing promote PTG. While interpersonal factors and characteristics of the trauma influence PTG5 too, the ways you heal play a large role in PTG. The following approaches are just a few that can promote PTG.

EMDR Therapy

Eye movement desensitization and reprocessing (EMDR) therapy helps trauma survivors safely process trauma. Processing the trauma can lead to quicker healing and a shorter path to post-traumatic growth.    

In an EMDR session, your therapist will have you track an object back and forth as you quietly or verbally recall traumatic memories. Eye movement helps you focus on something other than the strong emotions associated with the memories and process the trauma faster.

Cognitive-Behavioral Conjoint Therapy (CBCT)

CBCT is “a trauma-focused conjoint therapy1 that has a session specifically devoted to PTG.” Therapists use it to treat PTSD and trauma, though it can also improve depressive and anxious symptoms.

CBCT, like cognitive behavioral therapy (CBT), addresses thoughts and behaviors with a focus on trauma symptoms6 (numbing, avoidance). 

CBCT can help you cope with the cognitive and emotional effects of trauma and promote the growth associated with PTG.

Prolonged Exposure (PE) Therapy

PE works by exposing you to memories or other stimuli7 that “cognitively restructures beliefs about [your] sense of safety”, especially if and when you encounter the trauma again outside a therapeutic environment. 

You may imagine the stimulus or confront it in the real world, sometimes as a “homework assignment” after therapy. Therapists tailor the type and amount of exposure to avoid distress and facilitate healing.

As you become desensitized to the stimuli and more confident in your safety, your PTG can blossom. 

Cognitive Processing Therapy (CPT)

CPT addresses trauma and helps patients reconstruct beliefs7 about themselves, others, and the world. It encourages reflection on positive changes since starting treatment.

Doing so, you can change your internal narrative and stimulate PTG.

Challenges And Obstacles in Achieving Post-Traumatic Growth

Negative emotions after trauma (shame, guilt, depression) can hinder PTG3. These emotions can prevent someone from seeking treatment, as they may feel addressing their trauma is too painful. 

Fear, avoidance, and hypersensitivity–all symptoms of PTSD–can make treatment seem daunting as well. Negative feedback from friends and family can also hinder treatment and PTG.

Participants in one study said PTG began once they had an internal need for change3. Until that need is realized, PTG may not begin and may never take effect. 

Feeling forced or expected to have positive growth after a terrible event can add undue pressure8 and hinder PTG. 

Overcoming Obstacles to PTG

Support from friends and family and professional help from a mental health professional can help you overcome obstacles to PTG3. They can help you see a need for change by looking through their eyes and seeing your situation from another perspective. 

You can also reflect on your present life and how you would like to grow. This can encourage ambition and a strong desire for change that ends with PTG.

PTG can also be presented as a positive, but optional, aspect of trauma healing—not something that must happen. Rather than expecting PTG, providers and patients can instead be aware of it and accept it if it comes. 

Post-Traumatic Growth Examples

PTG will look different for each person, but a few examples include

  • Changing jobs to pursue a dream or passion. 
  • Taking time off work to travel and pursue new experiences. 
  • Committing to charity work.
  • Helping others who’ve experienced trauma similar to yours, perhaps by becoming a speaker or through contributions to studies and articles. 
  • Fostering stronger relationships with family and loved ones. Parents may feel an especially strong desire to grow closer to their children.
  • Deepening your faith in God or becoming more spiritual, even if you’re not part of an organized religion.
  • Leaning into your creative side and feeling deep fulfillment. You may enjoy forms of art, writing music, or crafting stories.

Find Help For Trauma

Trauma changes those who experience it. Sometimes, the changes can be positive. Even so, trauma can be a heavy weight to hold. Professional treatment can help you manage its effects and facilitate post-traumatic growth. 
Rehabs for trauma provide intensive care and support for your recovery. Browse our list of trauma rehabs to learn about their approaches to trauma treatment, see photos, and verify your insurance.

Posted on

Celebrity Recovery Stories

Celebrity recovery has long found itself in an unsavory spotlight. Magazines, paparazzi, and the general public place intense focus on the plight of suffering celebrities, often with an air of mockery. 

Celebrities coming forward with their addiction and recovery have started changing the lens of celebrity recovery stories. This is a far cry from old reports of a new celebrity in rehab suggesting culpability, shame, and judgment. 

Instead of making life unwaveringly easy, celebrity addiction stories suggest fame and fortune were not the cures to pain the general public may first assume. Despite the public scrutiny, many celebrities have recovered and inspired thousands on the way.

Elizabeth Taylor

Elizabeth Taylor was one of the first celebrities who acknowledged their addiction and advocated for recovery. She became addicted to prescription painkillers after a spinal surgery. She also struggled with alcohol addiction. 

Elizabeth Taylor decided to publicly announce her admittance to Betty Ford Center in 1983, Betty Ford’s first treatment center. By doing so, Elizabeth helped normalize the need for addiction treatment when such news was scarcely discussed, even in private.  

Though her famous career and life have since come to an end, Elizabeth showed many what living in recovery looks like—and that it’s achievable, even as a celebrity. A quote from ElizabethTaylor.com1 reads,

“Her willingness to remain open and honest, while under intense scrutiny, brought millions of people out of the darkness of shame and into the brilliance of healing.”

Jamie Lee Curtis

Jamie Lee Curtis nursed a secret addiction to alcohol and prescription drugs. She was prescribed Vicodin after a minor plastic surgery2, which she then took for years.

A friend finally caught her taking the pills and encouraged getting help. Jamie also stole Vicodin from her sister, who supported her in getting into treatment. 

Jamie has been sober since 1999; she revealed this to the public two years after gaining sobriety. She’s attended recovery meetings since her sobriety, sometimes hosting them herself in her set trailer. 

She was at first nervous she’d lose sponsorships and acting roles, but that was far from the case. Even in the earlier days of outspoken addiction recovery, her story was still widely well-received. 

Her public journey and commitment to the sober community have made her an encouragement to celebrities and non-celebrities in recovery.

Bradley Cooper

Bradley Cooper used alcohol, drugs, and “mean humor”3 to fit into the environment of Los Angeles actors. Despite his efforts, he realized he hadn’t made progress in becoming more popular—and was even doing the opposite.

In 2004, Bradley’s friend, Will Arnett, held an intervention to help him see the scope of his addiction and the harm it caused (forgetting to let his dog out all day after being on cocaine, for example). Cooper focused on his sobriety from that moment on and has been sober for almost 20 years.

Treatment also helped him grow his self-esteem and become confident without using substances to fit in. Now, he’s known to be generous, charming, and kind.  

Robert Downey Jr 

Robert Downey Jr’s experience with drugs began at age 64, when his father offered him marijuana. They used various substances together throughout his childhood. Downey Jr, like many others, was soon caught in the cycle of using to self-soothe and hide from the negative effects his addiction had on his life.

Robert Downey Jr has been arrested multiple times for drug use5 and spent a year in prison. After his third arrest, he checked himself into rehab and has stayed sober. A recent documentary featuring his late father details his recovery and history with addiction.

After becoming sober, Robert Downey Jr went on to have a wildly successful career. He speaks about his addiction and recovery to highlight the sobriety journey and offer his real-life success story.

Daniel Radcliffe

Daniel Radcliffe, best known for his role as Harry Potter, used alcohol to cope with the scrutiny and pressure6 of such a monumental role. He’s said his way of dealing with it was “just to drink more or get more drunk, so I did a lot of that for a few years.”

He would drink to forget he was being watched, then drink more to forget they were watching the “boy wizard” get drunk. As the movies drew to a close, Daniel continued to use alcohol to distance himself from the end and from figuring out who he was outside the role. 

With support from friends, he started his sobriety in 2010. He’s been sober since and enjoying new roles outside the wizarding world. 

Lindsay Lohan

Lindsay Lohan has a successful acting career freckled with jail time, arrests, and rehab. She described alcohol as a gateway drug for her, and she dabbled in cocaine to fit in with the party scene. 

She received her first DUI at age 207 and was in court for various drug/alcohol-related convictions 20 times from 2007-2012. A judge ordered her to go to court-ordered drug rehab in 2012. She credits that as what turned her life around. 

After regaining sobriety, Lindsay Lohan moved to the United Arab Emirates for a quieter, more anonymous life. She’s since gotten back into acting and helping others along their sobriety journeys.

Drew Barrymore

Drew Barrymore’s struggles with drugs and alcohol began as young as 9 years old. She attended rehab twice by age 128 and was hospitalized for 18 months following a suicide attempt and continued substance use. Her public struggles with addiction and mental health at first made it difficult to find roles. 

After her hospital stay, Drew emancipated from her parents. She eventually found success in acting again and married. She then divorced and married again later, having two children before a second divorce.

Her second divorce in 2016 drove her to alcohol use9. She says, “It was just trying to numb the pain and feel good—and alcohol totally did that for me.” An unnamed rehab facility and her daughters helped her recover.

Now, Drew Barrymore inspires other celebrities to talk about mental health and addiction on her talk show The Drew Barrymore Show and beyond.

Ben Affleck

Ben Affleck rose to fame in the early 90s. He went to rehab for alcoholism10 and a reset in 2001, then again in 2017 and 2018. 

A divorce in 2016 exacerbated his drinking. He went to rehab again, regained sobriety, and has since had relapses—some of which were famously documented. But he didn’t let that derail his recovery. 

Ben has become strong in his 12-Step program and, more generally, as a celebrity in recovery. He’s been quoted to say11, 

“It doesn’t really bother me to talk about alcoholism and being an alcoholic. It’s part of my life. It’s something that I deal with. It doesn’t have to sort of subsume my whole identity and be everything, but it is something that, you know, you have to work at.”

Demi Lovato

Demi’s first experience with drugs came when she was 13 and prescribed opioids after a car accident. Bullying and an early rise to fame led her to start cocaine in 2009, at age 17.

A sexual assault, and the coping skills she used after, eventually led her to treatment for self-harm and an eating disorder in 2010. There, she was diagnosed with bipolar disorder12. Demi checked into a sober home shortly after, in 2013.

Demi stayed sober for 6 years after years of heavy drinking and drug use (mainly cocaine). She highlighted her eating disorder recovery in 2017. But in July of 2018, she suffered a near-fatal heroin overdose13. After a 2-week hospital stay, Demi was released. 

She later relapsed on heroin, which served as another wake-up call. Demi got back into treatment and adopted a California sober approach to recovery, which meant she still used weed and alcohol in moderation. In the last couple years, she’s changed her approach to sober-sober14, or not drinking and using drugs in any amount.  

Now, Demi continues to take her journey day-by-day with an attitude of humility and hope.

John Mulaney

As one might expect, comedian John Mulaney describes his addiction with a unique level of hilarity. He first went to rehab in December 202015 after initially getting sober in his early twenties.

He became addicted to cocaine and prescription pain pills, which he kept on hand through shady (or clever) routes. One included buying and pawning a watch to purchase drugs with the cash. In other schemes, he went to low-rated doctors who he knew wouldn’t turn down the prescription requests of any new patient. 

At first, he feared the public’s response to his addiction and how it went against his public-facing demeanor. However, many received the news with little to no judgment, instead feeling glad he sought help. This highlights the upward swing in the public’s perception of addiction. 

He credits his friends and their intervention as what got him to get help. Reflecting on his 3-year sobriety, he says, “​​I used to care what everyone thought about me so much…And I don’t anymore. Because I can honestly say, ‘What is someone gonna do to me that’s worse than what I would do to myself?'”

Start Your Recovery Journey

Time has shown the deep humanity of celebrities, despite what the media might have us believe. Their stardom doesn’t save them from suffering; but it can make them excellent advocates for recovery. Money and fame didn’t make them recover. Their own personal choices and efforts did. 

Whether or not you’re a famous actor, comedian, or other celebrity, you have resources for your recovery. Celebrity addiction stories highlight that truth. A residential rehab could provide the safe, structured environment you need to begin, and maintain, your recovery.
You can browse our list of rehabs to see photos, reviews, insurance information, and more all in one place.