Complex trauma treatment involves a series of stages of therapy. Each stage ensures the client is ready to progress to the next, and although these are not perfectly linear, and sometimes overlap or repeat, it is vital not to skip or try to take short cuts. Doing so will cause actual delays and sometimes actual harm.

While the specific stages and terminology might vary depending on the therapeutic approach, here’s a general outline of the stages involved in trauma therapy:

1. Safety and Stabilization:

• Establishing Safety: The initial focus is on creating a safe and trusting therapeutic relationship and environment. This involves building rapport with the therapist, establishing clear boundaries, and ensuring the individual feels comfortable and secure.
• Symptom Reduction: The therapist helps the individual identify and manage overwhelming emotions and distressing symptoms, such as anxiety, flashbacks, nightmares, and hypervigilance. This may involve teaching coping skills like grounding techniques, relaxation exercises, and mindfulness practices.
• Developing Resources: This stage involves identifying and strengthening internal and external resources that can support the individual’s healing journey. This might include connecting with supportive friends and family, engaging in self-care activities, and building a sense of self-efficacy.

2. Remembrance and Mourning:

• Trauma Processing: In this stage, the individual begins to process their traumatic experiences in a safe and controlled manner. This may involve revisiting memories, exploring emotions, and making sense of what happened.
• Emotional Expression: The therapist provides a safe space for the individual to express and work through a wide range of emotions related to the trauma, including fear, anger, sadness, and shame.
• Challenging Negative Beliefs: The therapist helps the individual identify and challenge negative thoughts and beliefs about themselves, the world, and others that may have developed as a result of the trauma.

3. Reconnection and Integration:

• Rebuilding Connections: The focus shifts towards reconnecting with oneself, others, and the world. This may involve rebuilding trust, improving communication skills, and developing healthier relationships.
• Finding Meaning: The individual explores ways to find meaning and purpose in their experiences and to integrate the trauma into their life narrative.
• Developing New Skills: The therapist helps the individual develop new skills and strategies to manage triggers, cope with challenges, and prevent re-traumatization.

4. Consolidation and Resolution:

• Strengthening Resilience: The individual continues to build resilience and develop coping mechanisms to navigate future challenges.
• Moving Forward: The focus is on consolidating the gains made in therapy and moving forward with a renewed sense of hope and purpose.
• Self-Care and Growth: The individual prioritizes self-care, continues to develop healthy habits, and focuses on personal growth and well-being.

It’s important to remember that the stages of trauma therapy are not always linear. Individuals may move back and forth between stages as they process their experiences and develop coping skills. The duration of each stage can also vary depending on the individual’s needs and the complexity of their trauma.

Narrative Therapy in Trauma Therapy

Narrative therapy is a form of psychotherapy that focuses on the stories we tell ourselves about our lives and experiences. It views people as the experts on their own lives and sees problems as separate from the individual, rather than as a part of them. In trauma therapy, narrative therapy can be a powerful tool to help individuals reframe their experiences and reclaim their stories.  

Here’s how narrative therapy can be used in trauma therapy:

1. Separating the Problem from the Person:

• Externalizing the problem: Narrative therapy helps individuals externalize the problem, viewing it as something separate from their identity. This can help reduce feelings of shame, guilt, or self-blame that often accompany trauma.  
• Naming the problem: Giving the problem a name can help individuals gain a sense of control and agency over it.  

2. Re-authoring the Narrative:

• Identifying alternative stories: Trauma can lead to dominant narratives that focus on negativity, helplessness, or victimhood. Narrative therapy helps individuals identify alternative stories that highlight their strengths, resilience, and agency.  
• Reclaiming the story: By exploring alternative narratives, individuals can begin to reclaim their stories and create new meanings from their experiences.  

3. Thickening the Plot:

• Exploring unique outcomes: Narrative therapy encourages individuals to identify “unique outcomes,” which are moments when the problem did not have control over their lives. This helps challenge the dominant narrative and create space for alternative possibilities.  
• Finding new meanings: By focusing on unique outcomes and alternative stories, individuals can find new meanings in their experiences and develop a more hopeful outlook.  

4. Witnessing and Re-membering:

• Therapeutic witnessing: The therapist acts as a witness to the individual’s story, providing validation and support.
• Re-membering: Narrative therapy can help individuals “re-member” their lives by connecting with forgotten or marginalized aspects of their identity and experiences.  

Benefits of Narrative Therapy in Trauma Therapy:

• Reduces shame and self-blame: Helps individuals separate the problem from their identity and reduce feelings of shame or guilt.  
• Empowerment: Empowers individuals to reclaim their stories and take control of their lives.  
• New perspectives: Offers new perspectives on traumatic experiences, helping individuals find meaning and hope.  
• Improved coping skills: Provides tools and strategies to manage the effects of trauma and navigate challenges.  
• Enhanced relationships: Can improve relationships by helping individuals communicate their experiences and needs more effectively.  

If you are interested in exploring narrative therapy for trauma, it is important to find a qualified therapist who is trained in this approach. They can guide you through the process of exploring your story, externalizing the problem, and creating new meanings from your experiences.

Forms of Narrative Therapy

While narrative therapy is often considered a single approach, it actually encompasses various types and techniques that can be tailored to individual needs and goals. Here are some of the different types of narrative therapy:  

1. Externalizing Conversations:

• Focus: This type of narrative therapy emphasizes separating the problem from the person, helping individuals view their problems as external entities rather than internal flaws.  
• Techniques:
  • Naming the problem: Giving the problem a name helps externalize it and reduce its power over the individual.  
  • Mapping the influence: Exploring how the problem has influenced the individual’s life and relationships.  
  • Identifying unique outcomes: Finding moments when the problem did not have control, highlighting the individual’s strengths and resilience.  

2. Re-authoring Conversations:

• Focus: This type of narrative therapy focuses on re-writing or re-storying the individual’s narrative to create alternative and more empowering stories.
• Techniques:
  • Identifying alternative stories: Exploring alternative narratives that highlight the individual’s strengths, values, and agency.  
  • Thickening the plot: Adding details and complexities to the alternative stories to make them more compelling and believable.
  • Re-membering: Reconnecting with forgotten or marginalized aspects of the individual’s identity and experiences.  

3. Definitional Ceremony:

• Focus: This type of narrative therapy involves creating a ritual or ceremony to mark a significant shift in the individual’s narrative or identity.
• Techniques:
  • Telling the story to an audience: The individual shares their re-authored story with a supportive audience, such as friends, family, or other therapists.
  • Creating a tangible representation: The individual may create a physical representation of their new narrative, such as a letter, artwork, or performance.  
  • Celebrating the change: The ceremony provides a space to acknowledge and celebrate the individual’s progress and new identity.

4. Therapeutic Documents:

• Focus: This type of narrative therapy utilizes written documents, such as letters or certificates, to help solidify and reinforce the re-authored narrative.  
• Techniques:
  • Letters of invitation: The therapist may write letters inviting the individual to step into their new narrative.
  • Letters of prediction: The therapist may write letters predicting the individual’s future success based on their strengths and resilience.
  • Certificates of accomplishment: Certificates can be used to acknowledge and celebrate the individual’s progress and achievements.

5. Narrative Exposure Therapy (NET):

• Focus: This type of narrative therapy is specifically designed for individuals who have experienced trauma. It involves creating a detailed chronological narrative of the traumatic experiences to help process and integrate them.
• Techniques:
  • Constructing a lifeline: The individual creates a visual representation of their life, including both positive and negative events.  
  • Recalling traumatic memories: The individual recounts their traumatic memories in detail, while the therapist provides support and grounding.
  • Reframing the narrative: The therapist helps the individual reframe their narrative to create a more coherent and empowering story.

6. Tree of Life Therapy:

• Focus: This type of narrative therapy uses the metaphor of a tree to help individuals explore their strengths, resources, and connections.
• Techniques:
  • Drawing a tree: The individual draws a tree, with the roots representing their past, the trunk representing their present, and the branches representing their future.  
  • Exploring the tree: The therapist and individual discuss the different parts of the tree, exploring the individual’s strengths, challenges, and hopes.
  • Creating a new narrative: The tree metaphor can help individuals create a new narrative that emphasizes their resilience and potential for growth.  

These are just a few examples of the different types of narrative therapy. The specific approach used will depend on the individual’s needs and goals, as well as the therapist’s training and expertise.

Narrative in Hypnosis based Therapy

Storytelling hypnosis is a technique that uses the power of stories to induce a hypnotic trance and create positive change in the listener. It combines the art of storytelling with the principles of hypnosis to engage the imagination, bypass the critical conscious mind, and access the subconscious mind where deep-seated beliefs and behaviors reside.

Here’s how storytelling hypnosis works:

• Engaging the Imagination: The therapist uses vivid imagery, metaphors, and sensory details to create a captivating story that draws the listener in and stimulates their imagination.
• Bypassing the Critical Mind: The story acts as a vehicle to bypass the critical conscious mind, which often resists direct suggestions. The listener becomes absorbed in the narrative, allowing the hypnotic suggestions to be received more readily by the subconscious mind.
• Accessing the Subconscious: Once the listener is in a relaxed and receptive state, the therapist can weave in hypnotic suggestions and metaphors that align with the listener’s goals and intentions. These suggestions can target specific issues, such as anxiety, fears, or unwanted habits, or they can promote positive change, such as increased confidence, motivation, or self-esteem.
• Therapeutic Metaphors: The story itself can be a metaphor for the listener’s own life and challenges. The characters and events in the story can represent different aspects of the listener’s internal world, and the resolution of the story can provide a symbolic representation of the desired change or outcome.

Benefits of Storytelling Hypnosis:

• Enhanced Relaxation: The immersive nature of storytelling can induce deep relaxation and reduce stress.
• Increased Suggestibility: The hypnotic trance created through storytelling can make the listener more receptive to positive suggestions.
• Bypassing Resistance: The use of stories can bypass the critical conscious mind, which may be resistant to direct suggestions.
• Emotional Engagement: Stories can evoke powerful emotions and create a deeper connection with the listener’s subconscious mind.
• Creative Problem-Solving: Metaphors and symbolism in stories can stimulate creative problem-solving and new perspectives.

Applications of Storytelling Hypnosis:

• Anxiety and Stress Reduction: Stories can create a calming and relaxing experience, reducing anxiety and promoting a sense of peace.
• Phobias and Fears: Metaphors and visualizations in stories can help individuals overcome phobias and fears.
• Habit Change: Stories can support individuals in changing unwanted habits, such as smoking or overeating.
• Personal Development: Stories can inspire personal growth, self-discovery, and positive change.
• Trauma Recovery: Stories can help individuals process traumatic experiences and reframe their narratives.

Using Humour to reframe and create new images

While it may seem counterintuitive, humor can be a valuable tool in trauma therapy when used appropriately and sensitively. It can offer a sense of relief, empowerment, and connection for individuals who have experienced trauma.

Here’s how humor can be beneficial in trauma therapy:

• Creating Distance and Perspective: Humor can provide a temporary break from the intensity of trauma work, allowing individuals to step back and gain a new perspective on their experiences. It can help create a sense of distance from the trauma, making it feel less overwhelming.  
• Releasing Tension and Promoting Relaxation: Laughter can release endorphins, which have mood-boosting and pain-reducing effects. Humor can help reduce tension and promote relaxation, creating a more conducive environment for processing trauma.  
• Empowerment and Reclaiming Control: Humor can be a way for individuals to reclaim a sense of control after experiencing a traumatic event that often leaves them feeling powerless. By finding humor in their experiences, they can begin to reassert their agency and challenge the narrative of victimhood.  
• Building Rapport and Connection: Sharing laughter and humor can strengthen the therapeutic relationship and foster a sense of connection between the therapist and the individual. This can increase trust and create a more comfortable space for exploring difficult emotions and experiences.  
• Challenging Negative Thoughts: Humor can be used to challenge negative or distorted thoughts that may have developed as a result of trauma. By reframing experiences in a humorous light, individuals can begin to shift their perspectives and create new meanings.  

Important Considerations:

• Timing and Sensitivity: It’s crucial to use humor at appropriate times and with sensitivity to the individual’s experiences and cultural background. Humor should never be used to minimize or dismiss the trauma.
• Individual Preferences: Not everyone finds humor helpful in the context of trauma therapy. The therapist should be attuned to the individual’s preferences and adjust their approach accordingly.
• Types of Humor: Different types of humor can have varying effects. It’s important to use humor that is affiliative (connecting) and self-enhancing, rather than aggressive or self-defeating.
• Trauma-Informed Approach: The use of humor should always be embedded within a trauma-informed approach that prioritizes safety, empowerment, and respect for the individual’s experiences.

In summary, humor can be a valuable tool in trauma therapy when used thoughtfully and sensitively. It can offer a sense of relief, empowerment, and connection for individuals who have experienced trauma, helping them to process their experiences, reframe their narratives, and move forward with greater resilience and hope.

Stuart uses humour, metaphor and narrative based therapy at various stages of the trauma therapy process according to the needs of his client. Full competencies and qualifications HERE