Trauma Narratives in Mental Health Counseling

We all have events in our past that we’d like to forget. Whether the trauma is “little t” or “big T,” one of the primary tasks of therapists is to help clients process and deal with memories and triggers. Memories from “little t” traumas like a major car accident, bullying, and the loss of a significant relationship may evoke feelings of grief or insufficiency. Cases of severe trauma can cause post-traumatic stress disorder (PTSD), where reminders of the events trigger intolerable memories and associated emotional and physical responses like panic attacks or uncontrollable rage.

Crafting trauma narratives helps clients who have experienced either type of trauma to better manage trauma-related distress. Here’s how trauma narratives can help survivors find their path to recovery and how to assist your clients in developing a trauma narrative.

What is a Trauma Narrative?

People who have lived through trauma often have a need to make sense of those events and the memories, thoughts, feelings, and physical responses connected to them. Crafting a trauma narrative is a psychological technique that helps people make sense of the experiences they suffered. Naturally, most clients try to avoid memories of the events) to stop exposure to their difficult responses. However, this strategy can intensify the pain and can make triggers even more acute, particularly in situations where they can’t be avoided. 

A trauma narrative exposes the person to memories of the experience in a safe environment and helps them reframe the experience so the client can reclaim their power and autonomy. Crafting a trauma narrative helps clients to overcome the painful memories associated with the experience through the power of storytelling. A trauma narrative takes the jumbled mess of sounds, emotions, and images and forms an empowering story that can be told through writing, talking, and even artistic means. 

Benefits of Trauma Narratives

The process of creating the narrative itself helps the client process and reframe their memories. Repeatedly telling the story makes the memories more manageable and helps to diminish the associated painful responses. 

Trauma survivors also benefit from telling their stories because it helps them understand their reactions so they can more effectively manage them. It also gives people hope, which tends to reduce the withdrawal and isolation behaviors that are common with trauma. Additionally, this treatment provides continued support by people who listen to the story without judgment, including their therapist and loved ones. Through the repeated telling of the trauma story,the survivor gains the valuable perspective that the trauma is in the past and they have the power to move forward.

Steps for Using Trauma Narratives in Treatment

Creating a trauma narrative follows a consistent process. However, the speed of progression will vary for each client and their specific situation. You’ll use your professional judgement to determine the pace. 

Psychoeducation

The first step is to help your client create a solid base of understanding about trauma, why it should be treated and not avoided, how the treatment will proceed, and why it will be effective. Psychoeducation is the foundation for treatment. You want your client, and their family if relevant, to understand the basics of exposure therapy and learn coping skills to help them thrive while undergoing therapy (and after therapy). Some key points to bring up in your psychoeducation:

 

  • Trauma is a normal response to some experiences, and each person is unique as to how they react.
  • Avoidance causes symptoms to get worse, although it may feel better to do so at the moment.
  • The strength of traumatic memories will diminish with exposure to them.
  • Discussing trauma can feel uncomfortable, and sessions are a safe space. If the feelings get too intense, it’s ok to stop and come back to it another time. 

Crafting the Narrative

Working with a client to create a trauma narrative will take several sessions. The number of sessions and the speed at which your client progresses will depend on a number of factors, including your client’s comfort level, how much detailed information they share, and your professional judgment. 

 

  • Begin with facts — Invite your client to share the facts of the traumatic experience, and encourage them to include details as to the who, what, where, and when. If this proves too difficult, your client can break down the experience into what happened before, during, and after. Once they feel comfortable enough with the factual details, have them write them down. 

 

  • Add emotions and thoughts — Once the foundational facts of the trauma are written, ask your client to talk about their thoughts and feelings during the traumatic event. Use open questions to invite them to share more. Let them know they can add to the facts as needed as they flush out the details. Don’t dig too deep just yet, but focus on offering encouragement. Then ask them to add these additional thoughts and feelings, as well as any new details, to the story they’ve written so far.

 

  • Sit with discomfort — Once your client becomes more comfortable with telling and writing their story, it’s time to focus on the more uncomfortable parts. Ask your client to dig deeper into the worst moments of their trauma to add as much detail as possible to their trauma narrative. It’s ok to go as slowly as needed. 

 

  • Challenge irrational thoughts — Next, introduce cognitive skills. Review the narrative, challenging any irrational thoughts. Encourage your client to think about how they’re framing the story and to see if they want to revise any sections of the story. 

 

  • Add learnings and growth experiences that have occurred since — Once the story has been updated, ask your client to compare their feelings now relative to when the trauma was happening and then to the time you started therapy. How have their feelings changed? Do they feel stronger as a person? What have they learned? How might they advise someone in the same situation? Focusing on the growth your client has experienced helps them to carve a path forward.

What to Do About Multiple Traumas

Traumatic events aren’t always just a single incident, as in the cases of a long-term abusive relationship, bullying, or being at war. Your client can determine what should be included in their trauma narrative. This can be customized as needed to include a timeline covering multiple incidents and focusing on one or a couple of experiences to work on. 

There’s Hope for Managing Trauma Response

Using trauma narratives in mental health counseling helps clients who have experienced significant trauma to reframe their memories and the resulting thoughts and feelings surrounding them. It can provide significant relief to trauma survivors and continued hope to them and their loved ones.

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