Estimated reading time: 45 minute(s)
Trauma refers to a disturbing and distressing experience that can overwhelm a person’s ability to cope and move forward. [1] It can bring profound, long-lasting effects on physical health and mental well-being, though these effects may vary from one person to another. The best way to keep trauma and its aftermath under control is by understanding the different stages of trauma along with what recovery may look like. Acquiring this information not only makes it easier for an individual to process their trauma but also achieve mental and physical recovery more quickly and smoothly.
The Basics of Trauma
Experts define trauma as a psychological response to a single or a series of events with bothersome and distressing effects. These events are often severe enough to exceed a person’s ability to cope, leading to fear, emotional distress, and helplessness.
Trauma can manifest in different forms, such as the following:
- Acute Trauma: This type of trauma is secondary to a single, sudden event, such as a natural disaster, car accident, or violent assault.
- Chronic Trauma: This type of trauma results from long-term exposure to a stressful situation, such as ongoing combat, abuse, or captivity.
- Complex Trauma: This type of trauma involves exposure to different traumatic events, typically with interpersonal ties, such as domestic violence, childhood abuse, or neglect.
While trauma can lead to immediate psychological distress, its effects often extend beyond this point. In many people, trauma can dysregulate the stress response, alter brain structures, and lead to various physical and psychological symptoms. Understanding different stages of trauma can equip individuals with the necessary skills to get on the recovery path.
Four Stages of Trauma: An Overview
Mentioned below are the four stages of trauma an individual is likely to go through following trauma exposure:
Stage One: The Impact Stage
This stage immediately follows exposure to a traumatic event and serves as a trigger to the initial psychological reaction. It may include:
- Denial: Some people may deny the severity or reality of the underlying trauma as a coping mechanism. Denial helps such people regulate intense emotions while protecting their psychological stability. [2]
- Disbelief & Shock: Many people may experience disbelief, numbness and shock during the first stage of trauma. These emotions serve as a psychological buffer against the overwhelming feelings, allowing them to process the initial shock more efficiently.
Stage Two: The Intrusive Stage
During this trauma stage, individuals go through heightened emotional arousal along with many intrusive thoughts.
- Hyperarousal: Increased physiological arousal makes a person irritable and hypervigilant while messing with their sleep and concentration. During stage two, many people also exhibit exaggerated startle responses while having an increased sensitivity to potential threats. [3]
- Intrusive Memories: Recurrent distressing memories, flashbacks of the trauma, and nightmares may also occur during the second stage. These intrusive memories and thoughts heighten the underlying emotional distress while interfering with daily functioning.
Stage Three: Avoidance Stage
During the avoidance stage, many people resort to numbing and avoidance as a way to trivialize their underlying trauma.
- Emotional Numbing: Emotional detachment and numbing are standard in this stage, as individuals may use these mechanisms to suppress overwhelming emotions while regaining control.
- Avoidant Behaviors: Avoiding all reminders of trauma, including activities, people, and behaviors associated with the distressing event, is another way to minimize emotional discomfort.
Stage Four: Negative Alteration in Cognition & Mood
This stage primarily includes negative moods and thoughts that force individuals to adopt dysfunctional coping.
- Negative Mood and Thoughts: Traumatized individuals may acquire negative beliefs about themselves, others, and the world. These beliefs often include shame, guilt, sadness, and anger.
- Dysfunctional Coping: Many individuals acquire maladaptive coping techniques, such as self-harm and substance abuse, to struggle with the negative mood and thoughts mentioned above. [4]
Remember that each stage can be a unique phase in a person’s life, and progressing and healing from trauma stages can widely vary based on different factors. These factors may include individual resilience, the nature of trauma, and the social support available.
What are the 5 Stages of Trauma Recovery
Just like trauma has different stages, its recovery process also involves a stepwise process to help individuals slowly manage their traumatic experiences and associated emotions. These trauma recovery stages include the following:
Stage One: Safety & Stabilization
This stage includes the following:
- Establishing Safety: The very first step of PTSD recovery stages includes establishing psychological and physical safety. This may involve isolating from potentially harmful environments, establishing a supportive therapeutic relationship, and taking steps to meet basic needs.
- Acquiring Coping Skills: This step involves learning healthy coping skills, such as stress management, mindfulness practices, and relaxation techniques, to regulate emotions and control hyperarousal symptoms.
Stage Two: Remembrance & Mourning
The following are the two components of this trauma recovery stage:
- Processing Trauma: Individuals can use therapy to confront and process traumatic memories and emotions slowly. This technique helps them integrate their fragmented memories into a more coherent narrative.
- Grieving Losses: Many individuals mourn their losses associated with trauma, such as a loss of trust, safety, and sense of control. Grieving these losses is essential for emotional healing and optimizing recovery.
Stage Three: Reconnection & Integration
This stage includes the following steps:
- Rebuilding Relationships: Individuals slowly reconnect with others to re-establish trust, particularly in relational trauma. Social support is also beneficial in this particular stage of trauma recovery,
- Integration of Experience: This involves integrating trauma into a person’s life and identity and using it for personal growth. This experience is particularly beneficial for promoting post-traumatic growth and resilience. Â
Stage Four: Post-Traumatic Growth
This stage includes the following:
- Finding Meaning: Individuals try to make sense of their traumas and find meaning or purpose in the experience for psychological well-being and resilience.
- Positive Psychological Changes: Many individuals undergo post-traumatic growth, leading to deeper relationships, better personal development, and a greater appreciation for meaning and purpose in life.
Stage Five: Growth & Maintenance
The last stage of trauma recovery involves the following:
- Ongoing Healing: Trauma recovery is usually non-linear and includes many ups and downs. Seeking a continued therapeutic approach with frequent self-reflection can support continuing healing and growth.
- Continued Self-Care: Experts advise maintaining healthy coping strategies and including more self-care practices in daily life to sustain trauma recovery and minimize relapses.
Facilitating Healing From Trauma Stages
Treating trauma and supporting recovery is possible through a range of various therapeutic approaches tailored to the complex emotional and psychological impact secondary to trauma. Planning an effective treatment plan helps individuals process trauma and develop skills to rebuild trust and safety.
Following are some therapeutic modalities to facilitate individuals to pass through different stages of trauma to achieve healing.
Cognitive Behavioral Therapy
This evidence-based therapeutic approach is widely recognized for trauma healing and recovery. CBT involves identifying and changing negative behaviors and thought patterns contributing to stress. When it comes to trauma, CBT can help people understand how their thoughts impact their behaviors and emotions related to traumatic experiences. It uses behavioral activation, exposure therapy, and cognitive restructuring to reduce trauma symptoms, manage associated anxiety, and improve coping skills.
Dialectical Behavior Therapy (DBT)
Dialectical behavioral therapy combines mindfulness with cognitive behavioral techniques to help trauma survivors manage stress, regulate emotions, and improve interpersonal relationships. It is particularly beneficial for those struggling with intense emotions or using self-destructive or impulsive behaviors to cope with trauma. DBT focuses on distress tolerance, interpersonal effectiveness, emotional regulation, and mindfulness, providing practical tools to navigate these challenges.
Eye Movement Desensitization and Reprocessing (EMDR)
This specialized therapy has been designed to control stress associated with traumatic memories. Using structured protocols, individuals recall their traumatic memories while focusing on external stimuli, such as auditory tones or eye movements. This dual attention aids in reprocessing traumatic memories while reducing their emotional intensity. [5]
Trauma-Focused Cognitive Behavioral Therapy (TF-CBT)
This therapy has been designed mainly for adolescents and children who navigate different stages of healing from childhood trauma. The treatment combines trauma-sensitive approaches with cognitive behavioral techniques to help the young ones process their traumas and manage the associated distressing symptoms. TF-CBT involves both children and their caregivers to support their family system. [6]
Psychodynamic Therapy
This therapy helps individuals explore how past traumas impact and shape their current behaviors, feelings, and thoughts. It mainly focuses on unmasking the patterns of unresolved conflicts that may contribute to stress. By understanding the dynamics of underlying trauma, psychodynamic therapy helps individuals develop a better understanding of their relationship with trauma and promote growth.
Mindfulness-Based Therapies
These therapies include mindfulness-based cognitive behavioral therapy and mindfulness-based stress reduction therapy, which promotes awareness in the present moment. These therapies also support individuals in accepting their traumatic experiences without any judgment and developing skills to regulate their emotions, build resilience, and reduce stress. Mindfulness-based therapies also promote trauma recovery stages, mainly when used in conjunction with other therapeutic approaches.
Medication
In some cases, experts may use medications to alleviate trauma-related symptoms, such as anxiety, depression, and sleep disturbances. Antidepressants, such as selective serotonin reuptake inhibitors (SSRIs), are typically the drug of choice to manage symptoms while supporting individuals in their healing journey. Combining medication with therapy is the most commonly used combination to address psychological and biological aspects of trauma recovery. [7]
Supporting Someone in Trauma Recovery Stages
Supporting someone undergoing trauma recovery requires patience, understanding, and empathy. Following are some tips to make this journey more accessible for them.
Learn about Trauma
Understanding trauma and its effects on psychological and physical health is the first and the most crucial step to providing informed support to a loved one. Learn more about trauma, common reactions to trauma, and challenges it can lead to. This knowledge helps individuals empathize with their loved ones experiencing trauma in a much more supportive way.
Listen Actively
Create a safe space for a trauma survivor to express their feelings and thoughts without judgment or fear. Active listening involves validating emotions, paying full attention, and avoiding offering advice or opinions. It also involves allowing a trauma survivor to share at their own pace.
Validate Their Experience
Validate their experiences and feelings while avoiding trivialization and comparisons with other people’s experiences. Remember that each person has a different journey through trauma stages, and healing and validating their journey and experience can affirm their feelings of distress while promoting acceptance.
Offer Practical Support
Practical assistance can reduce stress while helping trauma survivors focus on healing and recovering. Practical support may include running errands, preparing meals, or offering them transport to appointments. These simple acts of kindness demonstrate support and care during difficult times and help a trauma survivor navigate them more easily.
Respect Boundaries & Choices
Respecting a person’s decisions and autonomy is essential to support recovery. Do not pressure them to confront or discuss their traumatic memories if they are not ready. Respect their boundaries and give them space to set the pace for healing.
Practice Patience and Persistence
Trauma recovery is a gradual process that takes time to unfold. Be patient and understand the fluctuations and setbacks that are likely to occur in a trauma survivor’s emotional journey. Offer them support and reassurance even when the progress appears nonlinear or slow.
Provide Emotional Stability
Create a predictable and stable environment to promote emotional safety. Minimize volatility and unpredictability, as it can cause more anxiety and stress for a trauma survivor. Offer them stability and reassurance by being present and dependable.
Learn About Support Resources
Research local support resources, such as support groups, crisis hotlines, and trauma-informed professionals. Provide this information to loved ones and encourage them to contact these resources if needed. It is also beneficial to offer them company appointments or assistance finding a suitable service.
Invest in Self-Care
Supporting a person undergoing trauma recovery is an emotionally challenging task. Hence, prioritize self-care and protect your well-being by seeking support, setting boundaries, and taking time for personal joy. Maintaining emotional resilience is essential to support trauma survivors in a better way.
Conclusion
Understanding the different stages of trauma and recovery is crucial for supporting trauma survivors more effectively. By recognizing the complex emotional journeys these individuals undergo, from the initial impact to recovery, it becomes easier to establish resilience and promote healing. Using a holistic approach that includes a blend of therapy, medications, and mindfulness can also help people struggling with trauma to navigate the trauma stages and recover more smoothly for quicker healing.
FAQs
How long do stages of trauma generally last?
The duration of each trauma stage may vary depending on factors like the nature of underlying trauma, personal resilience, and the support systems available. Some people progress through these stages more quickly, while others may require more time.
Are there any therapies to support healing from trauma stages?
Fortunately, many therapeutic stages are available to facilitate a person going through various trauma recovery stages. Some of these therapies include dialectical behavioral therapy, eye movement desensitization and reprocessing therapy, cognitive behavioral therapy, and other trauma-focused therapies.
Does everyone experience post-traumatic growth?
Post-traumatic phenomenon is not universal, as only some individuals with background trauma will experience it. Factors like coping strategies, social support, the ability to find meaning in the traumatic experience, and resilience contribute to the possibility of experiencing this growth.
How can I support someone going through different stages of trauma?
The best way to support a loved one through trauma recovery stages involves listening to their concerns, offering practical assistance in carrying out day-to-day chores, encouraging them to seek professional help, and being non-judgmental and patient. Remember that if extended rightly, support from loved ones can make a profound positive impact on trauma recovery.
