Therapeutic Approaches, What is the Baseline?
Humans are made to communicate and be in community. Using words is how we make connections, learn, express our feelings and needs, how we reveal our fears, and how any form of healing from trauma can begin.
While there are multitudes of approaches to choose from and each trauma victims will have individual needs (and therefore individual plans to adjust their healing process) talking, specially talk therapy, is pivotal and foundational to any healing.
That said, it can be argued that talk therapy could be used as the baseline or a supplemental to other therapeutic approaches. At times talk therapy may need to be used alone, but it can also be used in conjunction with other therapeutic approaches in order to bring the fullest healing to a victim. (Fritscher, 2018). It may be best to take a deeper look into talk therapy to grasp how it can integrated or supplemental to other forms of therapy and yet completely necessary for healing.
To begin, author Van Deer Kolk (2014) offers this quote: “nobody can ‘treat’ a war, or abuse, rape, molestation, or any other horrendous event, for that matter; what has happened cannot be undone. But what can be dealt with are the imprints of trauma on body, mind, and soul” (p. 205). However, “the challenge of recovery is to reestablish ownership of your body and your mind – of yourself” (p. 205).
Due to the challenge of recovery those in the mental health field have developed numerous ways of attempting to assist victims in establishing ownership of themselves. One to the foundational remedy developments, and what I believe to be the most effective, is analytical talk therapy.
Van Der Kolk (2014) insists that therapists have an undying faith in the capacity of talk to resolve trauma (p. 233). While not easy, talking and communicating about an event is one of the most healing things a person can do. This can be said because no one can heal from anything until they name it. Meaning, no one can heal from trauma until the know what they need healing from. Analytic talk therapy can accomplish this.
It accomplishes the above goals by helping clients “break the silence” (Van Der Kolk, 2014, p. 235). Trauma and traumatic events present a difficult task when it comes to communication, though, they are almost impossible to put into words. Therapist can and will attempt to help clients break their silence through a few avenues.
One way is that a therapist will help, ask, and enable clients to become aware of their bodies while speaking or listening. The therapist will ask the client to tell them their stories or experiences and tell them to be aware of visceral sensations while talking or being asked questions. Being aware of these sensations is the key emotional awareness (Van Der Kolk, 2014, p. 240). Once emotional awareness is achieved, clients can begin to put words to what they are feeling and discover what made them feel this way. Once this is identified with words, a story can be pieced together that can offer an object to blame and give words to pain, which can effectively reduce the effects of trauma
A second method is asking clients to write to themselves. This is one of the most effective ways to access your inner world of feeling (Van Der Kolk, 2014, p. 240). One of the specific exercises therapists will engage clients with is the practice of free writing. This is where a client will use any object as their own “Rorschach test” and begin writing the first things that come to mind as they look at the object. The client then continues to write without stopping or rereading and soon finds that there is a string of memories, thoughts, and associations that are uniquely theirs (Van Der Kolk, 2014, p. 241). Using this exercise gets the clients into conversation with him or herself and positively reinforces the use of words to discover themselves and find healing from trauma.
To show how effective analytical talk therapy is we can look at the first systematic test of the use of language and talk therapy done by James Pennebaker in 1986. Pennebaker was a professor at the University of Texas and turned one of his classes into a experiment. He asked students to think about a deeply traumatizing event in their lives and divided the class into three groups.
One would write about what was currently going on in their lives, another would write about the details of the traumatic event, and the third would write about the facts of event, their feelings/emotions about it, and what impact they felt it had on their lives. The students wrote continuously for 15 minutes on four consecutive days. As time went on the students would reveal secrets they had never verbalized, were emotional as they wrote and all of the students agreed that it increased their self-awareness and ability to articulate their pain (Van Der Kolk, 2014, p. 242).
One specific thing that is interesting to note is that the group that wrote about both the facts of the experience, their feelings/emotions about it, and how they thought it was affecting their lives were said to benefit the most. Van Der Kolk (2014) explained that those who wrote about their deepest thoughts and feelings about their trauma had improved moods, a more optimistic outlook on life, and even better physical health (p. 242).
The study above reveals that talk therapy is effective because it uses the body as a bridge to overcome the inability to put words to trauma. It provides a passage for understanding ourselves and enables us the ability to express how we feel. When we are able to express this we can then begin to piece together the timeline of our experiences and bring the chaos into focus. Once this can happen, healing can take its full effect.
Hence, talk therapy can be seen as necessary for any healing (Fritscher, 2018) and as such, a need to incorporate this into any therapeutic approach may not only be possible but may be necessary.
For instance, Cognitive Behavioral Therapy or CBT would not be possible without talking and analyzing through why an individual perceives a certain traumatic event and how it may govern how they feel or act (Rousseau, 2018, p. 13). A client must become aware of how they act or feel in certain situations and connect it to why they perceive the traumatizing event as they do. How is this done? Through talking and naming their trauma and their feelings/actions. This could not be done without incorporating analytic talk therapy tactics with CBT.
Even using medications as a therapeutic approach needs talk therapy. Here it may be best to use it after a medical diagnosis for medication is used. Once the correct medication is found and a victim expresses interest in further healing, talk therapy may be the next best step.
The examples of the necessity and baseline of talk therapy could go on and on. The need for basic human interaction and communication is necessary for any therapeutic approach to fully work (Fritscher, 2018).
Hence, the power of words and speaking out fears, alienations, perceptions, feelings, confusion, victories, and praises can make or break a therapeutic approach. Without talk therapy and its foundational practices, most therapeutic approaches run the risk of falling short in the quest to heal trauma victims.
As the post began with a quote, let it end with another relevant insight from Van Der Kolk (2014). Even though trauma can keep us “dumbfounded, the path out of it is paved with words, carefully assembled, piece by piece, until the whole story can be revealed” and thus healing from traumatic events takes place (p. 234).
Reference:
Fritscher, L. (2018). Talk Therapy. New York, NY: Well Mind.
Rousseau, D. PhD. (2018). Trauma and Crisis Intervention. Boston, MA: Boston University.
Van Der Kolk, B. M.D. (2014) The Body Keeps the Score: The Brain, Mind, and Body In the
Healing of Trauma. New York, NY: Penguin Books.