Healing Trauma Takes Time

Like the brain impacts of substance use disorders (aka substance abuse or addiction), most people do not understand the brain impacts of trauma.

Trauma takes many forms: neglect, sexual assault, physical abuse, emotional abuse, parental divorce, and growing up with a parent who has an untreated substance use disorder or mental illness, to name a few. Thanks to the CDC-Kaiser ACE Study, there is now solid research to help us understand the brain impacts of trauma (aka adverse childhood experiences), which in turn helps us better understand the physical impacts of trauma, as well. These brain impacts are related to toxic stress and how toxic stress changes how the brain works, wires, and maps. The physical and emotional ailments and quality of life outcomes of toxic stress include: anxiety, depression, stomach ailments, skin disorders, sleep problems, neck/back/shoulder pain, and inflammatory diseases, to name a few. Check out the American Academy of Pediatrics’ article,“Adverse Childhood Experiences and the Lifelong Consequences of Trauma.

Healing Trauma Takes Time

Healing Trauma Takes Time

Healing trauma takes time because of its toxic stress impacts on the brain.

Thus understanding the impacts of trauma and what it takes to heal those impacts is critical, which is what prompted me to share and comment on Jonathan Shedler, Ph.D.’s article, “Selling Bad Therapy to Trauma Victims.” Dr. Shedler, Clinical Associate Professor at the University of Colorado School of Medicine, opened his article with, “The American Psychological Association (APA) just issued guidelines for treating trauma. Patients and therapists would be wise to ignore them.” He goes on to write,

“Psychotherapy takes time. Psychotherapy follows a ‘dose-response’ curve. It takes more than 20 sessions, or about six months of weekly therapy, before 50 percent of patients show clinically meaningful improvement. It takes more than 40 sessions before 75 percent of patients show meaningful improvement.1 These findings, based on the scientific study of more than 10,000 therapy cases, dovetail with what therapists report about successful treatments2 and what patients report about their own therapy experiences.3,4 
The RCTs [randomized controlled trials] behind the [APA’s] trauma treatment guidelines studied only therapies of 16 sessions or less. Many were eight sessions or less. In other words, the guidelines considered only therapies that are inadequate. Read his article here.

As someone who spent three years in cognitive behavioral therapy to overcome a number of traumatic events (read my story, here) and as someone who has spent a great deal of time studying current brain research, I cannot help but agree that trauma cannot be healed in 16 sessions or less. Why? Because of the complexity of the human brain — complexity influenced by all the factors that contribute to how an individual’s brain wires, develops and maps from birth and across a lifetime.

As importantly, the impacts of trauma left untreated (whether it occurred before the age of 18, which is the basis of trauma measured in the ACE Study, or later in life, perhaps the death of a loved one, PTSD, living with someone who has a severe substance use disorder) do not go away until the trauma is treated. And until it’s treated, a person will continue to experience the toxic stress-related physical and mental health issues caused by the untreated trauma. For more on this concept, please check out two of my articles chronicling my experiences, “When Recovering From ACEs is Recovering from Secondhand Drinking and Visa Versa” and “The Legacy of Untreated ACEs.”

 

Lisa Frederiksen

Lisa Frederiksen

Author | Speaker | Consultant | Founder at BreakingTheCycles.com
Lisa is the author of hundreds of articles and 11 books, including "If You Loved Me, You'd Stop!," "Addiction Recovery: What Helps, What Doesn't," and "Secondhand Drinking: the Phenomenon That Affects Millions." She is a national keynote speaker with over 25 years speaking experience, consultant, and founder of BreakingTheCycles.com. She has spent more than 14 years studying 21st century brain research in order to write, speak, and consult on substance use disorders prevention, intervention and treatment; mental disorders; addiction (aka substance use disorders) as a brain disease; adolescent addiction treatment vs adult addiction treatment; effective treatment for co-occurring disorders (having both a substance use and mental disorder); secondhand drinking | drugging; help for the family; and related subjects. In 2015, she founded SHD Prevention, providing training and consulting to companies, public agencies, unions, nonprofits and other entities to address the workplace impacts of employee secondhand drinking and alcohol misuse.

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  1. My therapist used the Brain Mapping technique on me this week and though I was skeptical that it would do anything, it did something that years of talking didn’t. I can’t even explain it – but the brain is a fascinating thing! Thanks again Lisa for digging deeper and deeper.

    • Oh my gosh, how exciting, Diane!! I continue to find it amazing how deeply, deeply groved some of my old, unhealthy brain maps are. However, this understanding of how they wire (are triggered) and the CBT and other tools I’ve learned over the years, helps me re-wire, yet another that no longer serves me (or at least recognize it for what it is 🙂 ). Thanks for sharing your experience!

  2. Thank-you so much for this reminder, that healing takes time! It’s so easy to forget when you’re in the throes of recovery, and it feels like you’re standing still on some emotional issue which was based on a traumatic event. If only just knowledge of the event was enough to get rid of the associated pain!! Yet another lesson to be kind to myself and to just put the time in.