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Trauma Work - what it is and how to do it

This article is a . This article uses the word "Parts" as defined in Emotional Fragment Recovery New and the term "headmate" for entities, people & person-like-parts, while "system member" can cover all of the above.

Also see Healing Trauma for an older article with some suggestions.

What is Trauma Work?

Any attempt to bring up trapped emotions, memories, parts, qualities, or traumatized headmates from where they are lost/stuck into the Here & Now, and reunite them with the co-conscious now-time system.

Trauma can come into the Here & Now in many guises, for example flashbacks (visual/auditory/spacial) or emotional flashbacks (feelings that are trapped and well up), with or without the ability to resolve the trauma. Painful feelings, anxiety, panic attacks, panic reactions New. And traumas can be held by headmates that are only partially co-conscious, or operating beyond amnesiac boundaries. These are just some of the styes and combinations that we have seen trauma in. There's certainly more.

Resolving these issues so that the undesirable aspects of traumatic memories aren't distressing, painful or disabling is the main goal of trauma work.

Most trauma work is probably seeking Memory Reconsolidation New and understanding that process may help trauma work, regardless of modality, to move forward with more consistent results.

When is a good time to start trauma work?

Trauma can be compelling. We may either be motivated to run away and hide from it, or we might upend everything and tear the whole place apart trying to root it out and eradicate it. What's really hard to do is tell when we're actually ready to work on it.

It's not possible to be objective when we have trauma. We might seem level headed and think we're ready. We might not be. Or we might be as ready as we'll ever be and get avoidant and put it off anyway. Not that anyone else really can be sure whether we're ready either. There my not be a "good time" to work on trauma.

You likely want some moments of stability, hope, and to be able to handle at least some adversity in your life before doing any trauma work. This means practicing presence skills and learning some emotional regulation. It's possible to do traumawork without this though.

In part, the type of trauma work you're going to do will affect the skills you need to be able to handle it. Some techniques are incredibly gentle, can work from wherever you are without pushing or digging and are therefore easier to handle. Others try to dig into memories and the past in order to work on specific memories.

When headmates seek out lost & stuck parts they can be triggered into dissociative episodes, or traumatized headmates can be triggered front, and they may not be aware of current events or assured that your life is safe. (Also be sure to read about flooding in the timing section.)

Why is it usually done in Therapy? Can you do trauma work without a therapist?

While trauma work is usually done in therapy it can be done without a therapist. The reason it's usually done in therapy is because a knowledgeable therapist can teach stabilization skills, help monitor dissociative symptoms and help orient the client to the Here & Now before they leave the office.

The best way we can think of to do trauma work is as an empowered client assisted by a skilled and observant therapist. Trauma work should be a client-led process, and the ability to speak up and state what you want and are ready to do is important (cf our presentation on Achieving Healthy Multiplicity: The case for 5 steps). The client should set the pace of trauma work, with advice from their therapist who might caution them against moving too fast or choosing to work on "big" traumas before working on some of the smaller ones to get a sense of how the process works for them.

The therapist should monitor it and help you stabilize. Y'all can take the lead and pick & choose what to work on, and when. This gives y'all back power & control at a time when learning how to handle yourselves is very important.

Folk have done trauma work in closely trusted partnerships and small teams. Folk have done trauma work alone. We don't advise that you do trauma work without a therapist, we acknowledge that there's not always the ability to hire or acquire a therapist and that there may be some traumas that are necessary to process regardless in order to continue to stabilize or achieve other life goals or necessities.

Do acquaint yourselves of the cautions and possible hazards of doing your own trauma work so that you can plan (not predict or play what ifs) around them.

The Importance of Timing: Preventing Flooding & Crisis

Impatience is not a virtue in trauma work. Busting internal walls, blowing away the inner world, rushing into memories snatching up traumaholders and relocate them in the present headspace, or diving into the biggest worst baddest traumatic memory you can think of are not a matter of you being strong enough or skilled enough. The question isn't you at all, if you can concieve of these things. Your mind isn't yours alone, you share it with others, and they may not be ready for that much change and activity all at once, and it may make them feel destabilized and unsafe.

Therapists sometimes rush, and when they rush they can destabilize their client — and once unstable the client's system is more susceptible to what's called "flooding". This is when amnesiac barriers cannot hold back a tide of (any type of) memory fragments, and folk who are co-conscious get buffeted in a storm of (various sensory) flashbacks. Like a tsunami or tidal wave of repressed stuff all comes up and assaults them at the same time.

If this were a good thing, we wouldn't be talking about it. This is not a healing event. This is a retraumatization event. Recovering and processing memories is good. Recovering an unprocess-able tidal wave of memories is not and can lead the system to crisis, self-harm, and hospitalization.

Going faster doesn't have to end up like this. But it can. And many therapists won't chance it and choose to go slower, and ensure that their client is stabilized before going on to more trauma.

This is also important to know for folk who are working on trauma on their own; you can still trigger traumaholders, unleash the floodgates, and end up flooding your system. So making sure that you have the skills to do the work, and taking the trauma work slowly and only after you have established stabilization skills is equally if not more important, as you won't necessarily have the skilled therapist safety net.

Stabilization before Trauma Work

In terms of therapy, some trauma work happens in order to stabilize a system in stage 1 but the bulk of trauma work is put off until stage 2 (see our analysis of the ISSTD 2011 guidelines New, this may change when new guidelines are released) when the system is already stabilized and capable of self-regulation to some degree.

The idea is that the system should have built up skills in how to regain presence in the Here & Now, alliances of headmates who are confident in each other's abilities and who trust each other to care for the shared life, emotional regulation & other coping skills, and hopefully a stable external home environment that will support them between sessions.

Even with all that, it's recommended that (regardless of the tools used) the client alternate between sessions that dig up and examine trauma versus sessions for reorienting in the present with any new information that has come up, or assisting new system members (parts, fragments, headmates…) in stabilizing themselves. So basically just because the co-conscious system members have been through the stage 1 stabilization phase, it doesn't mean that the things/parts/people/emotions/memories etc. that are being recovered have done so. We call this process Onboarding New (that's a podcast episode, or see also the article on Stuck Residents New).

So care should be taken during stage 2 trauma work to help a client regain their sense of equilibrium, confidence, competency, presence, while assisting new parts &/or headmates to adjust to their new life.

Tools for stabilization & preventing flooding:

How do you do Trauma Work?

Trauma work is not an exact science, it's going to vary on a system-by-system basis depending on where y'all are stuck and what is trapped (sensory issues, memories, fragments, alters/headmates, etc.). We often use the example of recovering lost innocence: this is not really a headmate, a memory, or an emotion — it's actually a fragment or part of yourself, and you may be co-conscious but still stuck at some level until this fragment is recovered and returns to you. See Emotional Fragment Recovery New for one style of "simple" self-help style trauma work.

Here's some ideas that might help you understand how diverse but also maybe "easy" (as in easily overlooked) this vague wishy-washy idea of "bringing up trauma to work on" can be.

  • Bring your triggers or memories to sessions: start to keep a log or journal of past triggers, or memory snippets that come up so that y'all can decide which ones to work on in sessions.
  • Create a life timeline, look for gaps, listen for headmates' ideas of what is missing or what they're asking you to add to the timeline.
  • Look through childhood photos or documents (cf the Emotional Fragment Recovery New article), keepsakes or memorabilia.
  • Make headmaps and look for headmates who are still stuck/lost in traumatime.
  • Go through old diaries or journals, notebooks, planners, etc.
  • Allow traumaholders or system kids to draw art about things they need to talk about or process.
  • Think about things you've avoided. You may have been avoiding certain things almost by habit or instinct at this point, but they may speak to issues and traumas. For us Crisses, Dr. Who is a biggie. We can't watch it, it's like nails on a chalkboard if people talk about it. Obviously something big is going on around Dr. Who, right? What would happen if we tried watching the original series, we wonder. Bet that would bring something up.

Trauma Work Tips

  • Don't do these all at the same time. We know you're amazing, but have compassion for your companions.
  • If things start coming up, if y'all go down memory lane, please make sure y’all can find the way back to the here & now: You might have a friend to contact who knows some positive triggers for coconscious headmates to help them come back to the Here & Now. You could have a playlist or 3 ready to use if you feel like you're dissociating.
  • It's very important to remember to restabilize after doing a session of trauma work. Work on something, then come back to the present and reconvene back into your routines, exercise emotional regulation techniques, welcome the emotions you're processing, track how you're all doing, have internal meetings and consider what's happened, etc.

That's kinda some of what trauma work can look like.

Community Trauma Work

There are some methods that either are very specific to plural systems, or that are particularly well-suited to C-PTSD, BPD & DID which have come up through grass-roots or other methods into the community-at-large.

  • Rescue Missions New - this is generally inner world work that seems to naturally flow from situations in which specific headmates are stuck, separated, or suffering and can use assistance either coming into the Here & Now, or coming towards whatever one's system considers the co-conscious &/or more front-facing portions of one's inner world.
  • Decording is a way to remove undesirable attachments from people or things and replace them with at least placeholders while one repairs one's boundary system.
  • A donated article, for one style: Tentative Process for Healing Trauma in Splintered Souls
  • Re-parenting is a slow trauma work process of helping (usually younger) headmates with unmet attachment needs to get their needs met safely in-system.

We will keep working to identify ways that community tools can affect trauma reactions or help us process trauma.

Other Trauma Processing Tools

  • Subjective Units of Disturbance Scale (SUDS) New - a self-rating instrument that can help give a before/after snapshot and help rate whether you have cleared any particular trauma reactions &/or activation regarding specific memories or triggers.
  • Memory Reconsolidation New - an important overall format, regardless of modality, for achieving the resolution of trauma pathways
  • Consider EFT (Emotional Freedom Technique New) which is a partially somatic self-help technique that may help with processing specific traumatic issues held in the autonomic nervous system.
  • Folks who may have very early childhood attachment traumas may want to look into The Ideal Parent Figure Protocol (IPFP) New.
  • Four Blinks New - this is a therapist-developed trauma processing tool meant to process one trauma memory (recent memories of being activated are fine! No need to dig up the past!!) with the lowest activation level possible i.e. without being retraumatized. It's been put out as uncopyrighted and free to use — but do approach it with caution and try it out with someone with experience of any sort first before trying the solo instructions.
  • The Rewind Technique New - A technique invented to inactivate repetitive intrusive imagery of traumatic events, with some modifications for plural systems.

Therapists may have additional Trauma Tools!

If a therapist has additional treatment modalities New like Modified EMDR New, ART (Accelerated Resolution Therapy), somatic processing, polyvagal theory New, etc. it can help. But they're just tools, regardless of the tools the changes are happening in our brains & bodies.

Do you have to do Trauma work?

If you& (all of y'all in the system) are happy where y'all are, trauma work is always only optional. You& don't have to do trauma work for trauma work's sake. The issue is when y'all are not happy, safe, functional, unstressed, etc. and it is trauma that's in the way.

For example: if you want to achieve unification New, you need to find everyone in your system (that's already a tall order) and lower amnesiac boundaries between headmates. This usually also requires trauma work and sharing memories. Amnesiac boundaries will prevent headmates from achieving fusion.

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