Trauma is an increasingly popular field in psychology, psychotherapy, and the world in general. Through countless studies in interpersonal neurobiology and social psychology, we now understand trauma more than ever before, and have many approaches to help resolve trauma when it causes problems. I’ve found all the ones I’ve studied to be useful and effective.

What’s not widely understood about trauma is the fact that addressing/healing/integrating trauma tends to proceed through stages, with different challenges and tasks at each stage. For instance, when initially dealing with trauma it is important to identify the symptoms, allow the feelings, and focus on traumatic memories/meanings maintaining tolerable levels of emotional arousal, while in later stages of trauma treatment the agenda is to notice the beginning of a trauma trigger and focus away from the traumatic events/meanings onto other, more positive memories and images.

Such differences can be confusing for clients and therapists. Transforming trauma into transcendence involves literally changing the emotional charges and existential meanings of trauma from self-denying and self-denigrating to self-affirming and self-enhancing, and I’ve found that the healing journey proceeds through different stages with different people. That being said, people are wildly different, so any stage can occur at any time of treatment or life, and when it does the focus of attention needs to support the current stage that’s arising.

In general though, what I’ve noticed in dealing with trauma over the last 48 years is that trauma work tends to progress through four stages, with each stage having different principles, demands, and goals. Briefly, those four stages are:

1: Face trauma. Initial awareness that unresolved traumas might be a problem often comes from people experiencing negative emotional surges, painful perspectives on self and others distorted towards the negative, and reflexive destructive behaviors. They might ask, “Where are these distressing feelings/perspectives/behaviors coming from? What can I do about them?” With help, we can follow triggered distressed feelings, behaviors, and memories to their roots in traumatic experiences, and learn how to consider traumatic memories and meanings in affectively tolerable doses.

2: Adjust your life story. Once we can consider traumatic events and meanings without becoming overwhelmed, we need to fit the experiences into positive, coherent, autonomous autobiographical narratives. A traumatic event is what it was, but the meaning of the experience changes over time, and we can powerfully affect the meanings of all experiences. The Hero’s Journey finds meaning, purpose, and identity in trauma and crises as well as in triumphs and successes.

3: Change habits of attention from negative to positive. When past experiences—implicit memories, explicit memories, traumatic restimulations—or habits of negative association and obsession intrude, they create unwanted painful states of consciousness. If we have processed memories and meanings to the point of self-acceptance and a positive narrative, then further focus on them often reflects habits of obsessive thoughts, images, and meanings leading to unnecessary suffering. This has less to do with trauma and more to do with negative habits of consciousness—habits of obsession and reaction. In such cases we can choose to direct our attention to memories, images, intentions, or beliefs that instantiate preferrable positive states having pleasurable emotions and positive, self-affirming beliefs. This is the central process in CBT’s exposure and response prevention (ERP), and is used to address negative thoughts, OCD (including both behavioral and cognitive OCD), phobias, and painful habits of consciousness. The process at this stage becomes:

• Notice the bad habit as it occurs.
• Refuse to indulge the focus on painful feeling and meaning.
• Focus instead on more honest, positive, and life affirming memories/images/processes yielding preferable states.

This practice creates better habits of consciousness which, through repetition, eventually include and transcend old bad habits. Activating these more complex neuronetworks by focusing on preferable thoughts and behaviors causes the brain to myelinate and strengthen them.

4: Use traumas to enhance personal evolution. Often the first three steps yield relief and post traumatic growth, but not always. When steps 1, 2, and 3 leave a client still feeling in the grips of some kind of toxic programing, a useful therapeutic approach is to focus back on the traumatic memory/feeling/belief looking for what we’re resisting, or what negative beliefs or self-identifications we still cling to. This often leads to finding deeper personal meanings associated with traumatic memories and calls to action from those deeper meanings. Usually this work involves identifying beliefs, habits, experiences, or traits that we have resisted owning, normalizing, and integrating into a more whole and healthy self. In other words, parts of us where we resist self-awareness and block radical self-acceptance need to be recognized and integrated. Lack of satisfying resolutions can also indicate:

• Further episodes that need attention via step #1.
• Kinks or dissociated parts of our autobiographical narrative that need to be addressed and integrated via step #2.
• Habits of consciousness driven by the human negativity bias that need focused attention to be included and transcended into new habits via step #3.
• The need to embrace a new worldview/sense-of-self that we have been on the verge of becoming, but have resisted. I’ve observed this resistance to stepping through into a new sense of self and the world in transitions from egocentric to conformist worldviews, conformist to rational worldviews, rational to pluralistic worldviews, pluralistic to Integral worldviews, and beyond. Other such transitions are from Warrior to Man of Wisdom, and from student/practitioner/lover/mother/artist/healer to Woman of Wisdom.

Personal work can take us to the threshold of a new sense of self, but often we need to consciously step through that threshold into our next level of awareness, consciousness, self-identification, and personal responsibility. This is sometimes surprisingly difficult, but often necessary as we support our ongoing evolution.

—Dr. Keith