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Do I have to re-live my trauma to overcome it?

answered 10:31 PM EST, Mon January 30, 2012
I was sexually abused as a child. I have a lot of difficulty today forming relationships and with anger control and depression. I have been to therapists in the past but I really do not like talking about what happened to me in the past and talk therapy hasn’t seemed to do much for me anyway. Is there something I could do to get some of these demons out without me having to sit in a chair and explain what happened to me over and over again?

Art Matthews Says...

It can be very difficult to overcome a trauma such as you describe without addressing the trauma itself. It's also very understandable that talking over the incidents of trauma would leave you feeling traumatized again. In your case, you definitely want to stay away from "depth therapy" like psychoanalysis and other psychodynamic approaches. Luckily for you, there are therapeutic approaches that focus on the present rather than the past.

You might want to consider the following present-focused forms of therapy:

Dialectical Behavior Therapy (DBT) - Dialectical behavior therapy (DBT) treatment is a cognitive-behavioral approach that emphasizes the psychosocial aspects of treatment. The theory behind the approach is that some people are prone to react in a more intense and out-of-the-ordinary manner toward certain emotional situations. DBT theory suggests that some people’s arousal levels in such situations can increase far more quickly than the average person’s, attain a higher level of emotional stimulation, and take a significant amount of time to return to baseline arousal levels. The therapy has four components: Mindfulness, Interpersonal Effectiveness, Distress Tolerance and Emotional Regulation.*

Mindfulness-based Cognitive Therapy (MBCT) - For patients with chronic pain, hypertension, heart disease, cancer, and other health issues such as anxiety and depression, mindfulness-based cognitive therapy, or MBCT, is a two-part therapy that aims to reduce stress, manage pain, and embrace the freedom to respond to situations by choice. MCBT blends two disciplines--cognitive therapy and mindfulness. Mindfulness helps by reflecting on moments and thoughts without passing judgment. MBCT patients pay close attention to their feelings to reach an objective mindset, thus viewing and combating life's unpleasant occurrences.**

Rational Emotive Behavior Therapy (REBT) - Rational Emotive Behavioral Therapy was developed by Albert Ellis and was one of the first cognitive-behavioral therapy approaches. RET posits that our emotions result from our beliefs, many of which are irrational, and thus cause us to suffer unnecessarily. The RET therapists will question the client's beliefs to help use her natural ability to think clearly. The therapist will then encourage her to change her actions to align with her new, rational beliefs to relieve her emotional problems. This active approach often includes homework assignments.**

Solution Focused Brief Therapy - Solution-focused therapy, sometimes called "brief therapy," focuses on what clients would like to achieve through therapy rather than on their troubles or mental health issues. The therapist will help the client envision a desirable future, and then map out the small and large changes necessary for the client to undergo to realize her vision. The therapist will seize on any successes the client experiences, to encourage them to build on their strengths rather than dwell on their problems or limitations.**

Gestalt Therapy - Gestalt therapy seeks to integrate the client's behaviors, feelings, and thinking, so that her intentions and actions may be aligned for optimal mental health. The therapist will help the client become more self aware, to live more in the present, and to assume more responsibility for taking care of herself. Techniques of gestalt therapy include confrontation, dream analysis, and role playing.**

Many would suggest EMDR or Eye Movement Desenstitization and Reprogramming; however, this does involve an element of recalling the past and can involve psychodynamic interjection so be wary of jumping into this form of therapy without discussing in detail your expectations with the provider. The benefit to EMDR is that is has been suggested to reach results somewhat faster than many other forms of talk therapy.

It may be possible that the retelling of your experience causes such distress in session because you did not form an effective therapeutic bond with the provider. Perhaps they pushed you too fast or failed to validate the depth of your emotional experience. Obviously I can't critique because I wasn't there. I would suggest that you keep trying because you can recover and move on. But it would be a mistake to think that you will never feel uncomfortable in session. Therapy should be challenging and can be emotionally draining. Be open and honest with your therapist and let them know when you need to take a break or slow things down. A good therapist will listen and work with you to keep you engaged in therapy and shouldn't push to the point of you wanting to leave and never come back.

* Description from PsychCentral.com

** Descriptions from PsychologyToday.com

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Page last updated Jan 31, 2012

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