Working effectively with people who experience depression, anxiety and trauma has been an aspiration. Years of education and hours upon hours of reading, staying current on best practices has given me some direction. But it has been the experience of being present, witnessing, and taking in the story of each person that has been the foundation for being effective and motivating me to help those who ask. It has been a rewarding journey, sometimes intense, sometimes even frightening, rewarding and always a privilege.
In the early years of my work, I recall most of my trauma cases were children, usually young, some preschool aged. Consistently, these children would enter my office reluctantly, as they knew the purpose of the meeting. Whether it was play therapy, art therapy, family therapy the child or children knew instinctively that their family was either of the verge of crumbling or had already been altered because of the trauma (usually abuse or neglect) and therapy was just another repercussion of having been harmed, deceived, and trust shattered, usually by a previously trusted adult, sometimes a sibling, or someone the parents trusted as a family friend. The dread that these children experienced was palpable. The anxiety, fear and depression had taken a life of it’s own. The shame these children experienced wasn’t always described in words, but could be seen in their poor eye contact, depression, posture, and the way that they distrusted me as another prying stranger.
My job was to give these kids a safe place a couple of hours a week where they would act, talk, eventually stop self-blame, start to heal, and, hopefully learn some skills that will keep them from becoming a victim ever again.
These were the lucky children. The lucky children were those who were believed and supported by their parents and other adults. The unlucky kids didn’t stay in therapy long, because their parents or other adults did not believe their experience. The more fortunate kids had adults that believed that something happened to them, something out of the ordinary, sometimes gut and heart wrenching, and life altering. This group of kids seemed to fare better, begin to heal, and move ahead.
Over time, I became more comfortable with the challenges in working with children’s traumatic experiences, mostly sexual abuse. Adults began to talk to me about their experiences from decades earlier. They described the events, their responses, their caregiver responses as closely guarded family secrets. The secret keeping didn’t make it go away and it didn’t stop being painful. Years of dread, anxiety, fear, depression and discomfort in their own body would come out like a dam breaking. Some of the adults had developed a system of denial, suppression, and managed to function in a way that convinced others that they were not wounded, not different from others. This second group, I noted, were alive and functioning from the neck up. Their feelings and sensations disconnected and they coped by living only in the world of thoughts and mental activities. They could not experience their day-to-day life within their body.
Hopefully, what happens in therapy with adults who have experienced trauma unfolds like the following:
1) A relationship develops of mutual respect and trust. This implies not only the respect of the client from the therapist, but also the client will learn to trust and respect his/herself.
2) As therapy proceeds and safety is clearly established, the therapist will discuss options to assist the client. Development of personal resources to provide support for the client if and when she/he experiences discomfort or overwhelmed.
3) Trauma needs to processed and moved through the body. It is not sufficient for most people to simply rethink the trauma, or to deal with it only with talk. This can be accomplished a number of ways: EMDR, (Eye Movement, Desensitization and Reprocessing), and Mindfulness therapy strategies promote “here and now” experiences and body sensation awareness.
4) In the course of therapy, the client will benefit from developing a coherent narrative of his or her experience. This would be a part of the therapy that relies on talk, writing, and sharing their experience.
5) Before closure, the therapy will shift to focusing on assisting the client to prevent re-victimization. This could include addressing the safety of the client’s children and their possible vulnerability.
People do heal from these wounds. Finding support, getting honest in a place and with a person with whom you feel safe, trusting again and trusting the process move you in the right direction. People who have experienced trauma can find help and get their lives back. It takes time and it is often hard work. As with most things in life that are really worthwhile, hard work is required to make it happen.
For me, hearing the clients’ story is an honor and a privilege. I am being asked to sit with, walk with a person on one of the most challenging journeys that a person has taken. I remember each of the children I worked with all those years ago and hope their journey has been blessed with kindness and kind people.