Traumatic Memories: Do we have to process them or is it enough to regulate our bodies?
This year as I have taught more about dissociation than ever throughout the Chicagoland community, this question comes up in almost every training. “Do we have to process trauma memories. Do we have to talk about them, feel them, think about them. Can we just learn to ground and calm the body?” My belief, after 15 years of working with CPTSD←→DID, studying about trauma, and learning from experts in dissociation, my answer is yes, we do need to help our clients process their memories in order to heal the brain, body, and soul that are hijacked by painful, unprocessed injuries. I also believe that learning somatic grounding and regulation is a huge piece of treatment as well. We need to help our clients with both and I do both as a trauma specialist.
I work on teams for my more complicated cases and know that I cannot provide everything my client needs alone, to heal from trauma. Since I’ve been asked so many times, I wanted to dig deeper into the question. Why do clinicians keep asking this question over and over? What’s wrong with the way we are teaching new learners about traumatic memories? Why do some practitioners disagree with this idea and believe that somatic regulation is enough? What does this question say about us? I attempt to address some of these questions below.
There are simply not enough providers doing complex trauma and dissociative work, not enough therapists are trained in it, and not enough providers seek on-going consultation for complex cases when they land on their caseload. We simply cannot learn how to treat complex trauma simply, quickly, or without the help of the elders in the field. Additionally, some providers feel scared of doing memory work and other providers feel too eager to do memory work too quickly. To me, this is an issue of access to support, training, and learning how to pace memory work with each unique survivor sitting with you. It doesn’t mean we should avoid it.
Like our clients, we too can want to avoid going back to look at the harms we face, especially if there is a betrayal, terror, or abandonment involved. When complex trauma is happening to children, everything in the mind is about protection and moving forward. Safety is about moving away from knowing how bad things really are. It’s an evolutionary mandate, to keep hold of our attachments, to our family and to our community. We must sacrifice knowing what really happen for survival. All of this energy makes it terribly difficult, as adults, to want to return to something we have been fleeing for so long. I can defintely validate how much avoidance is embedded in our traumatic experiences. That’s why I believe we should only go back with someone where there is enough safety in the therapy-attachment relationship.
Would you ever ask a doctor to not remove the cancer cells, or a tumor and instead just have him teach his clients how to regulate the pain of having cancer? Would you ever tell someone in a car accident to not set the bones right, remove the dirt and glass in the skin, and just to treat the skin and got to PT instead? No. You would attempt to do it all. Why are we asking people to avoid remembering and working through the biggest injuries of their lives when it’s the cause of continual distress? Survivors will often both need to practice regulating for the rest of their lives and somethings regulate fully after processing a traumatic memory.
The question itself shows a lack of understanding of neurobiology and about where and how traumatic memories are stored. Intrusive thoughts, chronic nightmares, numbing, and a deep lack of internal attachment safety do not let our survivors locate themselves safely in the here and now. Learning basic regulation tools such as nervous system regulation do not remove these deeper agitants of trauma.
Trauma is stored in a different part of the brain than regular memories. They are often invisible and protected very deeply. They can be highly emotional and somatic, causing intense pain. They can’t be accessed through plain talk therapy that focuses on cognition. They also won’t leave you alone until they come up and out with a safe person. They cause so much memory dysfunction, body pain, anxiety, and fear. If left untreated, the survivors reactions and feelings towards self and other remain de-contextualized. Shame, self-blame, isolation, and self-hate remain without this work.
I actually think the term “memory processing” isn’t that helpful. What it feels like is happening is that we are grounding memories in the here and now. These memories are dislocated from time, space, and context. The survivor is stuck in them and struggles to make sense of them. It doesn’t feel like time has passed even though the injuries happened decades ago. When we do memory work, we are bringing the memory from the place of dislocation to the hear and now where we can observe it, have compassion, and see the child as they were - completely innocent. This helps free our clients from deep seated shame and pain.
Trauma survivors will need to be safe enough attachment relationship to their provider to regulate long term and to change traumatized pathways and systems in the body. The human body consists of 11 major organ systems that work together to maintain life, including the nervous, cardiovascular, respiratory, digestive, musculoskeletal, endocrine, etc. Survivors will need help regulating all of these over time. We can’t achieve that with just somatic regulation. We must work in tandem with parts/memories, internal systems, and somatics.
As trauma therapists we need to be systemic, treating a multitude of issues and that forces us to look at some hard issues:
Many individuals do not have enough money or good enough insurance coverage to do long term trauma work. This work can be hard on therapists and often we need to work as a team with multiple practitioners. Not everyone can afford that kind of care.
Sometimes talk therapy really doesn’t help. In fact, if the therapist isn’t trained somatically, emotionally, and relationally, someone can talk for years without resolving anything, left feeling completely hopeless and lost in their pursuit of healing.
People in the wellness industry are constantly trying to seperate the mind and body instead of looking at it systemically, and then marketing products based on one part of the body (nervous system) and claiming that focusing on one part will bring pain relief. We are constantly told we should regulate, feel calm, be happy. In a society that truly diminishes the value of human’s physical and mental health, we can’t trust these messages. The systems in power do not invest in our wellbeing. We have to pay to be well. What happens to the people that can’t pay? They are offered quick fixes, brief treatments, an endless list of products with empty promises, or nothing at all.
We all have a deep feeling of fear and trepidation when we think about returning to painful memories. But we aren’t told how to do it safely and in community, we simply cannot do some of this healing work alone. Therapists need to obtain a level of skill in helping survivors process memories safely, slowly, and with the wisdom of the client’s parts.
We’ve normalized toxic societal abuse and intergenerational abuse in family and societal systems so much, that most people don’t even understand how traumatized they really were/are during childhood, and therefore many people do not present with buried or dissociated trauma and don’t even know what is causing them so much pain and dysregualtion. That leads them searching for answers for many, many years.
If I could speed up this process for people, find an easier way to correct the 18+ years worth of laying down traumatized neural pathways, find immediate and long lasting ways of reducing pain, I would. If I could shorten the 7-30 years of trauma therapy that complex survivors need, I would. It all seems so unfair. Living through hell as a child and then needing many years of healing as an adult. Pain relief and regulation is a part of the trauma therapy package, but it often can’t be achieved quickly. It doesn’t mean we shouldn’t try to reduce pain and create calm through different modalities. However, we also need to help people discharge the energy that dissociated memories are robbing them of, but we also need to take our time doing so. We can’t pretend this is simple or easy, and we don’t serve traumatized people well by hiding this from them.
Blog and image created by Tovah Means, LMFT