The Three Stage Trauma Therapy Model

[Deleted member 1860]

The three stage trauma therapy model is this:

1. stabilizing and managing responses
2. processing and grieving traumatic memories
3. reconnecting with the world

I am wondering if there are PTSD sufferers who have followed this model and have had it work for them.

I was first exposed to this "model" when I was hospitalized in the trauma unit of the Sheppard Pratt psychiatric hospital in Baltimore, MD. It was stressed to me over and over and OVER again that this model was the "right" way to proceed through trauma therapy. I didn't question it because hey, what do I know? I was new to the whole PTSD thing. The social worker stressed to me (and my family) that I would likely be in the "stabilization" period for a long time. I wasn't allowed to talk about my trauma while in the hospital because I was still "stabilizing" and not ready to move on and talk about my trauma. Again, no questioning from me, I was like a sponge just trying to suck up as much information as I could.

Upon discharge I found myself with a new therapist (who coincidentally followed this model as she interned at Sheppard Pratt). I only saw her for a few months, but again, the trauma was not discussed since it was deemed that I was not yet "stable."

Moving on to yet another therapist, this one was trained under Christine Courtois at the Psychiatric Institute of Washington. (I'm sure you've run across her name at some point as she has written books on CPTSD, some geared toward therapists themselves and how they should treat patients.) Anyway, same deal as PIW follows the 3 stage model. Still stabilizing, not talking about the trauma. (This one didn't work out either...)

On to the next therapist...Pretty much the same story as the first therapist above, but by this point I am completely and totally FRUSTRATED at being "silenced" for so long.

Yes, I *do* realize that this model is touted by many so called "experts" in the field of PTSD (Including Judith Herman, the author of "Trauma and Recovery" in which she proposed a separate CPTSD diagnosis), and is pushed by many psych trauma hospitals. However, I feel completely INVALIDATED in that for over 25 years I kept the abuse to myself, and now I have professionals telling me that I am NOT ready to talk about it?!? Is there any wonder as to why I started telling anybody and everybody my life story? People I just met, strangers on the internet, you name it. I needed a voice!

My other beef with this trauma model is that it saves "reconnecting with the world" until last. Why? Is it because at this point we should be "fixed" and therefore more presentable to society? Whereas before this point we are too symptomatic to function with the rest of the world? Meh, it just served to heap more piles of shame upon me.

So yes, this is my little vent. Yes, I realize that we are each responsible for our own treatment and finding out what is best for us. However, when you finally receive a correct diagnosis after years of misdiagnosis', you instantly want to find the "best" way to heal, am I right? You look toward the "experts" in the field and see what they suggest. So when you stumble upon this model over and over and over again, you think "hey, this must be the right way." I continued to follow the model because for some strange reason, I continued to believe in it even after it failed me time and time again.

It wasn't until things reached a breaking point with my third therapist did I realize that I needed to start seeking out alternative therapies. And thank God I did! I am now working with a neurotherapist who works extensively with meditation and EFT. She is the first "trauma" therapist who actually makes me feel validated, simply because I am finally allowed to deal with the trauma itself, as she does not follow this 3 stage model. She understands my particular trust issues as she specializes in treating attachment disorders (Still a little puzzled as to why none of my other therapists would touch the trust issue with a ten foot pole. Last time I checked, trust issues were pretty central to CPTSD, and they *did* claim this as their specialty. Ahh, but I digress.)

Anyway, if anyone else has had success with this model, please share. It was an epic FAIL for me, but hey, we all experience this disorder a little bit differently, and I have no doubt that we all heal a little bit differently. I've finally found something that is working for me, and if this model works for you, all the more power to you. (Although, as you can tell, it has left a bitter taste in my mouth! I say beware of anyone who tells you THE way to heal.)

Hugs,
SOL

 

[PerfectEmpire]

For me, the three stages occur naturally, in a somewhat overlapping way. But nobody ever told me about this. It just happens. And it repeats itself (multiple traumas). I've just accepted that this is the way my mind works and plan my life around that. I go through periods of craziness, then isolation, then reconnecting. It's a beautiful cycle, really.

It's not that the model "works"; it's that people tend to fall into that pattern. It's pretty backwards to try to make people "use" a pattern that is meant to merely describe how things tend to fall into place. It's useful as a descriptor, but by no means should they try to stuff people into those parameters. But that's what the mental health industry does: stuff people into parameters.

I'm glad you got away from those therapists! A good therapist usually takes a model like the "Three Stages" into account, but would never force their patient to fit into it. A good therapist considers You to be the only expert on You!

 

[Sterre]

Hi ScaredOfLonely, I am verry happy with youre little vent about the three stages!

Were I live they started a new trauma centre ( it's actually the only one in the country that puts its focus on CPTSD) and they follow these three stages. The programm takes three years to finish. I am not sure if it's not allowed to talk about trauma in the first year, but if it is like that I would likely get very frustrated.

Good for you that you followed your instinct on this!

 

[kers]

It's unfortunate that your former treatment providers took the role of deciding what you could talk about. I know my therapist is familiar with this model (it's described in varying terms by most professionals in the field, I think), but we have gone back and forth between the phases. Different phases are accentuated at different times in my healing.

For example, when I first started therapy, after a few sessions I blurted out my trauma and tried to talk about it, but I freaked out and was very scared, dissociate, etc. So he gently suggested that my reaction was because I had shared too much...so we started a tenuous process of me sharing, connecting with him, sharing too much, withdrawing, then reaching out again. I've done work in all three "stages" I think. So sometimes my counselor will suggest we attend to something else, but he would never (or has never) stopped me, denied me, from doing work that I thought was important.

I'm glad you've found someone to work with you like and trust.

 

[jaerc]

My first find on Sheppard Pratt ... so you did not find the program helpful ScaredOfLonely? it doesn't sound as great as everyone (professionals) tout it to be. I am not gung ho on any inpatient programs, period.

I've done the mental ward 3 times now; I'm good! however my therapist has gotten me into SP. I said fine, go for getting me in back in June because I od'd... I was miserable and upset and wanted OUT of the psych ward here in S. Texas. I would have agreed to anything. Plus, dc is my home base.

Thoughts on SP's IP Trauma unit would be greatly appreciated. Thanks.