Can I actually recover from trauma?
I first started working with trauma while in graduate school, and my very first case was with a post-9/11 veteran with PTSD named Eddie (not his real name). Eddie served in the Marine Corps and was deployed to Afghanistan, where, after several months of combat, he was in an IED blast that killed several of his friends. That was ten years before I saw him. When we met, he was out of the military and living in Texas. But mentally and emotionally, he was still in the Middle East.
Eddie didn’t bring up the IED blast at first. He told me he wanted therapy because he was ruining his marriage. He spent his days viewing pornography and refusing to leave the house. His wife had finally given him an ultimatum—change or she was leaving. Only when we started talking about the function of his behavior—remaining isolated and using pornography as an escape from the past—did he finally share the memory he was trying to outrun.
After a clinical evaluation, it was clear Eddie met the criteria for PTSD, along with Major Depression. I remember starting treatment with him, utilizing a gold-standard, evidence-based therapy for PTSD called Cognitive Processing Therapy. I didn’t tell Eddie that I had never done this treatment before. I was learning it at the same time I was providing the treatment (under careful supervision, mind you). Before each session, I noticed my own feelings of anxiety and avoidance. Here was a man asking for my help, deserving of good care. What if I couldn’t provide that?
Weeks progressed, and we started working through the IED blast. Instead of avoiding the memory, we approached it, and I equipped him with tools to begin to identify and challenge some of the beliefs that were fueling his PTSD (such as "I should have been able to prevent it," "I can’t trust anyone," and "I’m worthless"). And then, something miraculous happened—he started to improve. His nightmares gradually reduced in frequency and intensity. He was more willing to leave his house (he even took his wife on a date!) His pornography viewing went from daily to weekly to monthly, and eventually, not at all.
I’d like to take all the credit here, but the truth is, Eddie was doing the real work. I would provide guidance and structure in session, and then Eddie would use it to work through a piece of the traumatic event. I think of it almost like working with a physical trainer; they can show the proper form and exercises, but ultimately, you have to lift the weight.
It’s been years since Eddie and I finished treatment. During that time, I graduated with my Ph.D., wrote a dissertation on trauma, completed my clinical internship, and finished a postdoctoral fellowship focused on PTSD. Eddie was the catalyst that launched me into a specialty I love—working with individuals who have survived traumatic experiences.
Trauma shows up in many forms—not just combat. It may be a sexual assault, medical trauma, a major car wreck, or a natural disaster. I’ve had the privilege to walk alongside folks recovering from traumatic events of all types. Now, when I meet with new clients with a trauma history, I’m not afraid of what they’ve experienced. I’m excited to get to work, and I’m actively hopeful. During the first meeting I emphasize three things with my clients:
Trauma is a real problem. (I believe that what happened to you matters. You’re not making it up. You’re not crazy).
You’re not alone. (Your own traumatic experience is unique, but you are not the only one).
You can get better.
Number three is the one I usually get the most pushback on. Folks will say, "How is that possible?" Many of the stories we hear about trauma suggest that it is final and hopeless. You experienced a traumatic event, you have PTSD, and that’s just the way things are— now and for the rest of your life.
When clients bring this up, I tell them that if that were true, that people never get better from trauma, then I’d have the most depressing job in the world. But the truth is, the reason I love working with trauma is that people do get better. I’ve seen it. Again and again and again.
But what does it mean to get better?
Here’s what it doesn’t mean:
Pretending like what happened was less bad than what it was.
Erasing the memories of what happened (as if that is even possible).
Instead, it means empowering people to live meaningful lives in spite of what they’ve experienced. I usually tell clients, "What happened to you will never be okay, and it will always be a part of your past. But, working together, my goal is to give you the tools and guidance so that it doesn’t have to control your present or future."
And then we get to work.
If you’d like to learn more or be connected for help with trauma and PTSD, please feel free to reach out at info@embarkpsychology.com or call our office at 210-239-7715.
