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The concept of “processing” trauma has become ubiquitous; #TraumaProcessing has more than a million views on TikTok, there’s no shortage of trauma-focused therapists sharing coping strategies on Instagram, and chances are you’ve had a friend or family member recommend The Body Keeps the Score, a 2014 book on healing from trauma that soared to the top of the New York Times best-seller list in mid-2020 (where it’s remained for 195 weeks total).
This increased interest in working through trauma makes sense. Most of us have survived a traumatic event or situation of some type—from an emotionally tumultuous childhood to racial discrimination to a harrowing medical emergency or sudden loss of a loved one. The past few years—with the COVID pandemic, the war in Ukraine, a rise in mass shootings, and so many other tragic events—have only added more distress to deal with.
To be clear, not every stressful experience is considered traumatic. While the definition of trauma is evolving in the mental health community, it generally refers to a person’s psychological response to an event (or series of events) that threatens their physical or emotional safety, which can lead to difficulty coping and a slew of long-term mental and physical struggles—including post-traumatic stress disorder (PTSD), as SELF previously reported. Likewise, not everyone who experiences a traumatic event will have lingering effects.
No matter your story, it’s understandable if you’ve recently realized you’re ready to confront your past and the ways in which it’s negatively impacting your current life. But what does “processing” trauma even mean? And what’s the best way to do it? You have more options than ever before, and it’s never too late to get started. Here’s what you need to know.
First, it’s important to understand why you can’t process trauma while it’s happening.
You can’t fully grasp the impact of a traumatic event in the moment because when you’re under immense stress, you go into “survival mode,” Terri Messman, PhD, clinical psychologist and director of the Trauma and Emotional Regulation Laboratory at Miami University, tells SELF. Your sympathetic nervous system, which prepares your body for stressful or dangerous situations, kicks in, and you operate on an evolutionary instinct to either stay and fight, flee to save yourself, or freeze. “In this state, you’re not thinking as much as you’re behaving and responding,” says Dr. Messman.
Later, whether it’s been weeks or months, you can begin to reflect on and process what happened to you—but unless certain factors are in place, you may not be able to fully process, and thus, recover from it. Research suggests that being in a safe and secure environment with plenty of validation and support can help promote trauma recovery—but not everyone is able to do that. A child in an abusive or dysfunctional household, for example, often dissociates or mentally disconnects from their body and the situation they’re in to make it through these early years. “When you’re a little one, you don’t get the choice to process what you’re going through,” Adrienne Heinz, PhD, a trauma and addiction research scientist at Stanford University, tells SELF. “Your brain adapts to survive.”
Adults aren’t always in an ideal situation to process and heal from trauma either, of course. Even if someone has a strong support system to lean on, there are other factors that can impede recovery. People in marginalized communities whose trauma is caused or exacerbated by systemic oppression, for example, have to face that oppression daily, says Dr. Messman. Experts believe your genetics can also play a role in what’s known as intergenerational trauma, as can a personal or family history of mental health disorders.
How can trauma manifest in your mind, body, and life?
“Our biology, our emotions, our thoughts, our relationships—all of that can be disrupted with trauma,” Dr. Messman says. For example, trauma survivors are often flooded with negative thoughts like I’m broken or I don’t deserve to be treated well due to misplaced self-blame, she says. Trauma can also shatter core beliefs, like that the world is safe and that humanity is innately good, research suggests, drowning many survivors in waves of depression and isolation.
While everyone deals with a traumatic experience differently, about 6% of people in the U.S. eventually develop PTSD—a condition characterized by a wide range of distressing symptoms, including intrusive thoughts, sleep disturbances, and constantly assessing potential threats in your environment, among others. That rate jumps closer to 10% for women and as high as 48% for LGBTQ+ folks, according to the National Center for PTSD, largely because these groups are more likely to experience sexual assault and other forms of violence.
Many trauma survivors who don’t meet the criteria for a PTSD diagnosis may still experience lasting physical and psychological issues, including difficulty regulating emotions like sadness and anger, eating disorders, substance use issues, and chronic health conditions such as gastrointestinal, neurological, or musculoskeletal disorders.
In your everyday life, signs that it’s time to reach out for help can look like distancing yourself from loved ones, being physically present but feeling emotionally vacant, or needing that third glass of wine every night to wind down—all of which can be examples of organizing your life around your trauma, according to Dr. Heinz. To determine if this may be the case, she says it can be helpful to ask yourself, How is this limiting me, and is it limiting me so much that I’m not living my life in a way that aligns with my goals and values?
So what does it actually mean to “process” trauma?
“Across all the different trauma-healing approaches and strategies, the unifying theme is that you do have to go back to the trauma in some way,” Dr. Heinz says. “You have to walk through it to get past it.” Ultimately, in most cases, processing trauma means getting in touch with trauma-related emotions, thoughts, and conclusions you’ve drawn about yourself and the world. It’s allowing yourself the space to integrate a traumatic experience into your life story, grieve what you’ve lost, and move forward in a meaningful way.
However, that doesn’t necessarily mean you need to delve into traumatic memories or rehash all the terrible things that happened to you if you’re not ready to (or simply don’t want to) do that. In some types of therapy, such as certain forms of cognitive behavioral therapy (CBT), you don’t even need to talk about the details of your trauma at all. The emphasis, instead, is on exploring how trauma causes problems in your current life and learning coping skills that can help you regain control. (We’ll get more into this below.)
Because trauma is so individualized, all of the experts we talked to recommended seeking out a therapist who specializes in trauma, if you’re able, to guide you in this process. A trauma-informed therapist can understand how your history maps onto your present, identify signs that you’re overwhelmed, and set the pace for successful treatment, Dr. Messman says. Our guide to getting trauma-informed mental health support, as well as these tips for finding an affordable therapist, can aid you in your search for the right person.
What types of therapy can help you process and heal from trauma?
If you can connect with a mental health professional one-on-one, there are plenty of research-backed trauma-focused therapies to choose from. These are some of the most common options, depending on your goals.
- You want to reclaim what trauma’s taken away from you. Prolonged exposure (PE) helps you take back pieces of your life, like getting behind the wheel again after a horrific car accident, by talking out your fears and gradually exposing yourself to what you’ve been avoiding.
- You want to recover your self-esteem, hope, or ability to connect with other people. Cognitive processing therapy (CPT) gives you the space to challenge negative thoughts or black-and-white beliefs about yourself and the world that are keeping you down or limiting your opportunities so you can rewrite your script with a more nuanced perspective.
- You want to process a traumatic memory that’s still haunting you. Eye movement desensitization and reprocessing (EMDR) involves going back and remembering the traumatic event in order to give yourself the opportunity to process the memory in a safe environment as you focus on a sound, buzzers in your palms, or an image that ping-pongs back and forth on a screen.
- You don’t feel ready to open the Pandora’s box that is your troubling past. Trauma-informed cognitive behavioral therapy (CBT) can help you cope with flashbacks and other manifestations of trauma through grounding techniques, learning how to relax again, and practicing positive self-talk without delving into the specifics of what you’ve been through.
Group therapy can also help you work through trauma.
Interpersonal traumas such as childhood sexual abuse or sexual assault can feel so deeply individual, but group therapy can show you that others have been through similar situations and is generally more affordable than individual therapy. You can exchange coping skills, begin to build supportive relationships, and feel the power of healing together.
“Peer support groups serve a similar purpose to group therapy, often with a strong emphasis on shared wisdom, compassionate mentorship, and personal growth in the wake of trauma and adversity,” says Dr. Heinz. If the stereotypical circle of folding chairs in a church basement doesn’t speak to you, know that there are a lot more options to choose from these days—from virtual meetings to groups that connect people with similar cultural backgrounds to “indigenized therapy,” which uses traditional practices to help Indigenous folks heal from intergenerational trauma together, as SELF previously reported. You can find a certified group therapist with the American Group Psychotherapy Association’s directory and learn more about peer support groups and how to join one in your area via the National Center for PTSD.
There’s no set timeline for processing trauma, but you’ll know you’re in a good place when your life no longer revolves around it.
Although you might fear that opening the door to your past could mean a lifetime of therapy, processing trauma doesn’t have to take forever—some therapies, including those listed above, can be effective in as little as five to twelve sessions, Jessica B. Stern, PhD, a trauma-trained clinical psychologist at NYU Langone Psychiatry Associates, tells SELF. But no matter how long it takes, working through trauma doesn’t mean you no longer have triggers or that other challenges like anxiety or depression just go away. Lingering mental health symptoms are common after trauma therapy, but they can be treated as well, she says.
The goal of trauma processing is to develop the skills to deal with the ways trauma still manifests in your life so that the waves of panic, fear, or despair may begin to strike less often. You’ll also know that you’ve made significant progress when your life is no longer organized so tightly around what happened to you, Dr. Heinz says.
“You’re still going to have bad days,” she says. “You’re still going to be reminded of how difficult those times were, but you will be empowered to not let them impair you—you can still go live your life and serve your purpose.”
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