With each passing month after beginning counseling, I fought against the shame around my slow progress. I feared I would never “be better”. I was successful in all other areas of my life…so how was I “failing” at therapy?!
That’s how it felt to go slow in therapy – like failure!
I had 3 degrees, an impressive career, and so many awards and achievements. I spent years running multi-million-dollar projects for a Fortune 100 corporation. And I worked hard at therapy – doing all the right things! Always an over-achiever, I could not come to terms with the reality that there wasn’t a damn thing I could do to make my healing process go any faster!
I frequently apologized to my husband for all the money I was spending on therapy. I admitted my humiliation to my friend, believing she was annoyed with supporting me through this long process. I emailed my therapist between sessions letting her know I was making progress, always worried she was close to giving up on me for taking so long. Clearly, I must be treatment-resistant, right?
There are endless reasons why we cannot control the pace of therapy, too many to fit into one post. So this will be the first of a few posts touching on the various aspects of why trauma therapy takes so long and simply cannot be rushed.
Trauma Memory is Stored Without Language
Unlike other types of memories that fully engage and can be recalled via the prefrontal cortex, traumatic memory is encoded quite differently and involves many different brain areas. The brain’s prefrontal cortex (with logic and language in Broca’s area) is inhibited during traumatic experiences. It essentially moves out of the way to allow for instinctive action and threat response to occur without the hindrance of words or logic. It is imperative to understand that the prefrontal cortex could not properly witness the experience at the time of the trauma. This includes the experiences after a traumatic event when attempting to heal without enough support or internal resources.
If the prefrontal cortex (with its capability for words) was not involved, we would be left without any clear story or even an accurate sequence of what happened. Is it any wonder we think we are weird or crazy as we try to make sense of our internal experiences!?
Trauma survivors are attempting to use one part of the brain (the prefrontal cortex which was shut down during the trauma) to put words to the memories that are fragmented and stored in other brain regions. It simply doesn’t work that way!
As clients, we believe (or perhaps your therapist believes) that we should sit and talk about the trauma in order to heal. We spend session after session trying to narrate experiences only to find that very little relief is found through talking.
The Memories of Trauma are Body Symptoms
The answer to why therapy takes so long is complex, but maybe the simplest summary is that unprocessed trauma modifies our whole nervous system. Trauma memories are stored as fragments in multiple areas of the brain. They are stored as implicit memory and activated through the body via triggers.
Without any concise narratives to provide to other humans (like our therapists), our traumatic memories are visceral and overwhelming.
The limbic system is highly activated during trauma, yet it holds no language or cognitive abilities like the prefrontal cortex. We naturally want to put words to the shame and turmoil within us (or others expect this of us), but we have no words.
Instead, trauma memories are fragmented, body-based, and stored in multiple areas rather than having a nice clean narrative through language. After 8 months of working with a therapist who specialized in CBT for trauma, I cried to my friend, “I’ve already SAID the worst stuff! Now how do I get it out of my body?!” At this time I knew nothing of the way trauma memories were stored, yet I knew my body was still incredibly distressed – probably worse than when I began therapy. I feared this would never improve and sunk deeper into depression.
A 2001 study by Bessel van der Kolk found that even after a survivor of trauma verbalizes the experience (i.e. talk therapy), they continued to be triggered, causing them to repeatedly re-experience the trauma. These triggers occur through such channels as visual, affective, tactile, olfactory, and auditory sensations (Fisher, 2013).
This and further research has demonstrated that traumatic memories are stored implicity throughout different brain regions and throughout the nervous system, rather than stored and recalled explicitly like other types of memories.
Symptoms, body reactions, and triggers are actually memories – they are the way the nervous system remembers the experiences. We need help not only with our emotions but with our somatic experiences.
Healing trauma must be SLOW because we are not simply working on the way we think or patterns of behavior. That will never be enough for trauma healing! I am asking my entire nervous system to make the changes necessary to bring safety into my body!
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