Learn / Resilience in Recovery From Childhood Trauma
Childhood trauma doesn’t just go away. You may continue to feel its effects throughout your adult life. Some people—although certainly not all—develop mental health conditions, like post-traumatic stress disorder (PTSD), as a result of these painful experiences. And because the past can’t be undone, it can be hard to imagine moving forward.
No matter how much you’ve been through, you can learn to carry your memories in a less painful way. There are rehab programs specifically for those struggling with trauma that can help you cope with your symptoms and learn how to move forward. The first step in taking back your personal power is choosing which type of treatment feels right to you.
Whether or not trauma is your primary reason for seeking treatment, you may benefit from choosing a treatment program that offers trauma-informed care. This approach centers each person’s unique experience, creating a safe and respectful environment for healing. With guidance and support, you can become empowered to live a life you love.
Trauma-informed care is an approach, not a therapy. However, many trauma-informed facilities offer therapies with proven success in treating trauma:
Cognitive behavioral therapy (CBT) is a form of talk therapy1 that helps people manage difficult feelings, urges, and behaviors. In conversation with a therapist, you’ll discuss and analyze various aspects of your internal emotional landscape. Your provider will teach you practical strategies you can use to navigate challenging situations.
For example, the American Psychological Association (APA) recommends that therapists “encourage patients to re-evaluate their thinking patterns and assumptions in order to identify unhelpful patterns (often termed ‘distortions’).” By stepping back and assessing your thoughts objectively, you may be able to regulate your emotional response.
Data shows that CBT is a highly effective treatment for PTSD.2 In one study, “92% of participants no longer met criteria for PTSD” after a series of CBT interventions. However, it’s not the only available form of therapy. Also, some clients may benefit from specialized types of CBT, such as prolonged exposure therapy (PE).
Experts strongly encourage the use of prolonged exposure therapy as a treatment for trauma.3 During a PE session, you’ll recount the details of a traumatic event, speaking in the first person and the present tense. For example, instead of just saying “I was in a car accident when I was a kid,” you might begin the story with “I’m 5 years old. I’m in the back seat of my mom’s car. It’s raining, and I can see the drops of water on the window to my right.” Patients describe their memories in as much detail as possible, and reexperience painful emotions within the safe context of a therapy session.
Over time, and with repetition, the goal is for you to move past your most intense reactions to the initial trauma. You may also be assigned homework between sessions, in which you seek out triggering stimuli in order to confront your own responses. To overcome trauma associated with a car accident, for example, you might practice driving or riding in a car on the highway. These exercises ramp up slowly over time, and you’ll process each one in your next therapy session.
Although this form of treatment can be extremely difficult, it’s also highly effective. Multiple studies have demonstrated that PE is an appropriate therapy for adults with a history of trauma.4 Some experts also suggest that combining PE with eye movement desensitization and reprocessing (EMDR)5 may improve patients’ commitment to ongoing treatment.
Somewhat like PE, EMDR invites people to revisit traumatic memories safely,6 with the support of a therapist. During each session, you’ll relate a present-day emotional state to a challenging past experience. For example, you might start by talking about an argument you’re currently having with a friend, and then go on to compare it to a fight you had with a parent during your childhood. Your therapist will instruct you to engage in certain activities, such as repetitive eye movements or tapping on your arms with your hands, while you revisit the memory of a difficult emotion.
EMDR helps you work through unprocessed adverse experiences,7 so you can release the emotions associated with them. Evidence suggests that this therapy might actually change the way traumatic memories are stored in the brain. Specifically, experts posit that EMDR might move those memories “from implicit and episodic memory to explicit and semantic memory systems.” In other words, patients become conscious and aware of thoughts they may never have considered before. “Consequently, the disturbing life experience becomes a source of strength and resilience.”
Contrary to popular belief, inpatient rehab isn’t just for addiction recovery. You can also attend residential treatment for a variety of diagnoses, including trauma-based disorders like PTSD, complex PTSD, and others. By taking time away from your daily life to focus on treatment, you may be able to kickstart the healing process.
Rehabs may employ a variety of therapeutic techniques, including CBT, PE, and EMDR. Some centers also teach life skills, empowering patients to practice self-reliance. Depending on your program, you may also be encouraged to connect with your recovery peers, which lets you practice valuable interpersonal skills. Research shows that community is extremely important during the process of healing from trauma,8 and the act of sharing mutual support may give you insight into your personal history.
Developmental trauma results from adverse childhood experiences, or ACEs. It can sometimes be hard to recognize these events as traumatic until years later. When you’re young, you simply haven’t had the time to encounter diverse ways of living. As a result, it’s difficult to compare your own life to “the norm.” You might take highly distressing circumstances for granted, and not fully understand the harm you experienced until after you reach adulthood.
Whether or not you can identify childhood trauma at the time, it has a lasting impact. You may develop coping mechanisms that help you survive in the short term, but get in the way of living a healthy and meaningful life as an adult. For example, many trauma survivors learn to dissociate9 as a way of protecting themselves from emotional pain. That strategy might help you endure parental abuse, but interfere with later romantic partnerships. The first steps toward healing are understanding what caused your symptoms, and validating your own experience.
Childhood trauma can take many different forms. The CDC defines ACEs as “potentially traumatic events that occur in childhood10 (0-17 years),” such as abuse, neglect, and sexual assault. The list includes experiences that may not be directed toward you specifically, such as living with a person with a severe mental illness, or the loss of a parent through death or divorce.
The more different types of adversity you experienced as a child, the higher your ACE score. If you have a history of trauma in only one of the defined areas, you could be said to have a low ACE score—even if that type of trauma happened repeatedly. People with higher ACE scores are at a greater risk of ongoing health and behavioral concerns. For example, research shows that people with high scores are more vulnerable to addiction, depression, and heart disease. However, that risk is just one part of the story.
Experts caution against thinking of ACE scores as the only predictors of wellness. Jack Shonkoff, Director of the Center on the Developing Child at Harvard University, explains that “there are people with high ACE scores11 who do remarkably well.” Certain protective factors, like trauma-informed therapy, may mitigate the health risks associated with trauma. And not every type of trauma has the same effect.
Every person grows up with a unique set of risk and protective factors for the development of mental health issues. Based on your unique combination of experiences, a traumatic event may or may not cause you to have trauma-related symptoms.12 And it can be extremely difficult to predict exactly which experiences will have long-term effects.
Mental health professionals distinguish between traumatic experiences in a number of ways. For example, some experts categorize these events as either “big T” or “small t” traumas. Examples of big-T traumas are listed as the “exposure to actual or threatened death, serious injury, or sexual violence,” while small-t traumas may include parental neglect or humiliation.
However, these terms can be misleading. At first glance, it might sound like big-T traumas are more serious, while small-t traumas can be easily dismissed. For some patients, the exact opposite is true. Research shows that survivors of interpersonal trauma usually exhibit more severe PTSD symptoms than survivors of non-interpersonal trauma. And many types of small-t trauma are interpersonal.
Unfortunately, it’s quite common for trauma survivors to feel guilt and shame about what happened to them. This can make it difficult to accept the magnitude of an event’s impact. And as a result, you may delay getting the help you need.
Preliminary research has found that many people minimize the effects of their trauma.13 More data is needed to understand why and how this happens, and how it can interfere with the recovery process. But even without that data, this tendency is widely recognized within established support systems for trauma survivors.
Sexual Assault Survivors Anonymous (SASA), for example, has published resources that describe the phases of processing trauma after sexual assault.14 In what they term the “Outward Adjustment Phase,” the survivor goes about their apparently “normal” life despite emotional dysregulation. SASA lists 5 primary coping mechanisms to watch out for during this time. The first of these is minimization, in which you might pretend “‘that ‘everything is fine’ or that ‘it could have been worse.’”
And yes, of course it could have been worse. Here you are, reading this article, with the emotional resources to think about healing. Not everyone gets this far. That doesn’t mean what happened to you was okay. Your feelings are valid, and you deserve to get support while you heal. That’s true for everyone who lived through developmental trauma—even if you blame yourself, even if you feel ashamed, and even if you can’t clearly remember what happened.
Traumatic events can directly affect brain function15 and structure. One study found that people with PTSD may present with changes to the amygdala, hippocampus, and prefrontal cortex. Researchers say that “these brain areas play an important role in the stress response. They also play a critical role in memory, highlighting the important interplay between memory and the traumatic stress response.”
As a result, trauma survivors may struggle to trust their own memories.16 According to experts at the International Society for Traumatic Stress Studies (ISTSS), multiple scientific studies have “demonstrated a connection between childhood trauma and amnesia.” Some survivors repress their memories as a defense mechanism, even if it is “established fact that the traumatic events occurred.”
Over time, you may or may not remember the details of what happened to you. In some cases, rediscovering those memories can inspire people to begin recovery in earnest, finally seeking out the support they need. Others may never remember the specifics of their trauma, even if they’re actively engaged in therapy. Healing is always possible, whether or not you remember exactly what happened in your childhood.
Kati Morton, LMFT, explains how it’s possible to heal from trauma even if you don’t clearly remember it.17 Even people who have repressed their worst memories are likely to have a noticeable response when confronted with triggers. Morton puts the most likely responses into 2 categories:
According to Morton, “identifying and understanding” these responses helps people “find better ways to manage them.” During treatment, your therapist can help you learn how to respond to triggers in a more effective way, without engaging in unhealthy behavior. This is especially important for people who have a history of both trauma and addiction.
A wealth of research links childhood trauma with addiction during adulthood.18 Multiple studies have found “extraordinarily high percentages of childhood trauma of various sorts, including physical, sexual and emotional abuse” among people with a history of substance abuse.
Perhaps because of this connection, some of the same techniques can be used to treat either or both of these diagnoses. In particular, prolonged exposure therapy can effectively treat both PTSD and addiction.19 If you’d like to address the 2 conditions at once, you might benefit from attending a rehab program for people with co-occurring disorders.
It’s also important to note that addiction itself can cause additional trauma.20 If you experienced trauma as a child, this can quickly become a vicious cycle: getting triggered can make you want to take drugs, and the situations that arise because of your drug use can be even more triggering. Many people need professional support in order to break free of this pattern.
Healing from trauma isn’t easy, simple, or fast. If you remember what happened to you, those memories probably won’t just disappear. And even after completing treatment, you may continue to face triggering situations. Recovery can’t undo the past—but it can help you imagine a better future.
Learn more about programs that can help, and see reviews, therapies offered, virtual tours, and more, in our searchable directory of trauma rehabs.
Reviewed by Rajnandini Rathod
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