Trauma therapy: how do you take the first step?

[bellbird]

So far with my trauma T we've been building a strong foundation of trust, and also getting me at a baseline where I'm able to start trauma therapy.
We've been doing a lot of parts work, too, trying to encourage cooperation between my parts especially heading into dealing with trauma stuff.

We're now at the point where we're more ready to start working on trauma stuff.
Yesterday T suggested we start by bringing up a less-bad memory from the Abuse Years for just 3 seconds, and then come back into the room.

I told her in my head it feels a lot like I'm standing in front of a door in a room. With T asking me to just open the door slightly for 3 seconds and then we close it again.

Thing is, I can't even bring myself to touch the door handle.

I used this analogy with T and she found it really useful. She suggested I ask on the forum how others took that first step with doing actual trauma therapy/EMDR?
So, for those of you that have done it, how did you take that first step? How did you manage to put your hand on the door handle and crack the door open?

It seems utterly impossible.

 

[MrMoonlight]

It's really hard for me too...recently I was able to verbally say out loud to her, or 'walk her through' much of my main trauma when we were doing EMDR. I just make myself go there but will sometimes stop or disassociate...my body starts jerking, just typing time is making me jerk because I was thinking about one of my main mental scenes.

You can baby step it Bell, just touch the doorknob...then turn it, then peek in the room through a small crack in the door and quickly close it, then hold it open a moment longer...etc. ?

ETA: having a really strong and accessible "safe place" to go is really important. Sometimes in EMDR I will be going through some shit and find myself floating in my safe place to escape EMDR. She will know by my body language that I've gone there. I also go there after every EMDR session.

 

[Wendell_R]

Good question!

I really agree with @MrMoonlight ! Find & make safe spaces. I had to create a space that was safe from noise and people coming in. Looking back, since some of my trauma was being surrounded by sexuality and alcohol, making that safe space was trauma work.

I put pictures in my journal book that I was a little afraid of, then made a construction paper door that covered the picture. Open the flap, look at the picture, close the flap. That was like looking at something that just reminded me of the trauma, and not the trauma itself.

I also did a lot of EMDR "resources" where we did EMDR, but our focus was on bringing in safe people/safe places. Learning how to bring in those safe people when I feel threatened.

Here's another one. Little Wendell is afraid to ask for anything, so he asked for something in the therapist's office. Even though that's a safe place, it seemed so dangerous to him. Same message--find something that reminds you of the trauma, and learn that that is safe in your therapists office.

 

[Sideways]

I don’t know if this helps at all?

But since my main trauma involved me literally opening a door and walking into a room as the first part of every traumatic incident?

We didn’t open the door at all straight away. I described where I was. What it looked like, what the handle was like, the bike leaning against the wall beside me, the temperature, what I was wearing, what I could hear, what time it was, day of the week, why I was there...

After that? I described the layout of the room that I would see after I opened the door. Like, “There’s going to be grey, commercial carpet, an almost floor-to-ceiling window on the far wall...etc”. Layout, as though the room was empty of people.

That’s how I started. Not the actual trauma itself, but a whole lot about the place and the circumstances.

ETA We also talked a lot about my interactions with my abuser that weren’t traumatic, a lot, and what I thought of him, etc. We focused on that a lot, and kept coming back to it between describing individual traumatic events.

 

[Freida]

baby steps.

You may just need to stand at the door until you get bored with standing there. Seriously! It might take several sessions where all you are doing is standing in front of it before you can move on to touching the handle. Then that may be another run of sessions. Therapy runs on YOUR timeline - not anyone elses. So some things will come easily and some not so much. You may even need to find something less impactful than the door to be able to take those first steps. Like maybe a hallway leading to the door? Not as scary but still something that you need to do before you enter the room?

Are you doing emdr along with it?

The safe space is the biggie. The idea is to have somewhere to go or something to hold on to that can give you safety and get you back into the present. It's not something I was able to create so we used the elephants instead because they reminded me of a specific time in my life.

 

[MyWillow]

I think it’s different for everyone. I’m kinda still in denial after 2.5 years. Successful professional that I am. I don’t have clear memories to explain my responses. Lots of flashbacks. But it MUST start with safety. And I struggle to define that - because I really like my psychologist but I spent 6 months not remembering sessions and another 6 months of panic attacks and dissociation with her. She referred me to a psychiatrist (who specialises in child psychology) - she took me on for weekly therapy before she quietly suggested medication. She has an uncanny ability to know how to bring out honesty in me. Part of it is that she doesn’t judge me nor does she permit me to judge myself. She asks open ended questions and nails my energy levels or wariness. She apologises for triggering me but says she was glad to be there with me during the experience. She asks when she’s not sure. She doesn’t encourage dependence but teaches me to be kinder to myself. She always asks what would help if I’m triggered (happens a lot) and if I can’t think of something because I’m too frozen she will suggest a couple of options. If I’m really in a bad way she will take charge. She never asks me to explore memories. We generally talk about what happened during the week - triggers, recognising them, accepting them, taking the time to recover from them. She doesn’t allow me to get away with generalisations or humour aka avoidance. But when I’ve had enough and talk about my animals she respects that. Memories and flashbacks pop up when I’m ready to deal with them I suspect. I still see my psychologist but we do equine work which is very different. I generally don’t tell her something that I haven’t raised with my psydoc first.

 

[grit]

I feel you are getting a lot of really great feedback and I will just echo some of them. IMHO, one should not work on trauma until a lot of the foundational parts are integrated and strong to handle crisis (from trauma work and from everyday life) between therapy. There is absolutely no reason why one would ever risk of break in the self cohesion just to work on trauma.

With that all being said and not particularly knowing how long you were in therapy, I think move like a turtle. You do not only need strong alliance with the therapist but also you need to have a goal - to feel what safety which means viscerally (not just cognitively or emotionally)...it has to be a super felt experience that you simply honestly cannot easily switch back to feeling unsafe. In my opinion, the whole point (the ultimate goal of therapy being successful) is that you feel so safe that only an extraordinary experience can make you lose it not a memory from trauma or triggering...so focusing on finding safe space or feeling safe is a great goal but it is destination...
What the therapist can help you to build that is coping mechanism and you will need one other person in your life to be there for you in between therapy. How can you hold yourself up in between therapy? This I cannot understate.

The gist, move like a snail. No rush to get there if limping along the way. You want to walk not sprint.

 

[somerandomguy]

For me, the first step looked entirely different. I don't know if I can even describe what my first step even was. I had no problem talking about my traumatic events - none whatsoever. I could talk about them all day. But I couldn't FEEL anything about them.

Then I got massively triggered. I spent an entire day dissociating and crying, but went back to whatever my version of "normal" was and didn't really talk much about it. Then it happened again, and suddenly I couldn't STOP feeling. Years of feelings overwhelmed me for weeks and weeks.

After my second trigger and in the midst of being overwhelmed, I made a list of all the things I needed to process with my T and started getting down to actual trauma work.

I'm not sure how helpful that is because it seems like you and I are just coming from completely different places, @bellbird. Mine was from a place of almost complete ignorance of the process, whereas you've been aware of every step. I did spend over a year with my T just talking about nothing before starting the trauma work, but in that time she built a foundation of trust and non-judgment with me. I couldn't even have started if that foundation hadn't been there.

 

[BrownLea12]

Sometimes I find holding onto my necklace from my dear friend and mentor gives me strength. That tangible representation of love and support in physical form helps me to open the door so to speak.

 

[Karolina12]

I’ve been thinking about this question ever since you posted it and I kept coming back to see if any responses would help me.

Going with your analogy, my issue is I don’t control the opening and closing of the doors. So touching the handle is pointless for me—the door is locked.

Then, at other times, door opens and closes on its own.

I have yet to find a consistent predictable pattern but I wonder if the same things that cause the door to open for me would help you feel comfortable touching the handle. And vice versa.

Some things I think may have helped me open the door:
-processing the body sensation first (e.g., the one that is associated w/ what is stopping you from touching the door handle)
-making sure you are opening one door only, being sure you are opening the door to a closet or room rather than front door of a house (I.e., identifying and focusing on something specific)
-thinking “about” the door and what is behind it rather than walking or looking “in”
-trying and failing—getting stuck... and then it opens easily later or next session
-accessing it through another part... for example, activate it by connecting to an emotion (any)

 

[Skywatcher]

Maybe try a different analogy. We have done watching yourself watching a tiny movie screen that is showing your trauma. And you can stand far away from you watching a far away tiny screen.

I have one trauma that I kept in a glass cube with thick wavy glass walls. I’m on the outside and the image isn’t really clear and the sounds are muffled.

My therapist said you could have your trauma on a train that zooms by you. I couldn’t catch on well to that since that trauma had happened in a building near an actual train.

We did a library where you store different traumas in different books. You can open and peek in. Then you decide where you will store or shelve them. Most of my traumas are kept in the horror section.

My most effective one was to hold the trauma in a strong box that you design. You create a safe space (mine is a beach that I love). When you are comfortably walking in your safe space, you open the lid and peek in the box and then close it really fast. My therapist would guide me on when to open and close the box. Because I’m in my safe spot and my therapist is there with me I feel safe enough to look. Also, it’s an emdr thing, so we can stop any time we want.

 

[MrMoonlight]

EMDR for me it's not linear. I kinda 'pop' around my traumas, finding myself in different places. I may start EMDR in one trauma location and find myself confronting another in a different time and place. Traumas are stored in the same place so they can mix, if you touch one you may inadvertently stir up another.