Do you have clients who when asked about traumatic experiences tend to get into a lot of detail and emotional activation when describing these experiences? Do they tend to talk about these events each time they meet with you? Whether you are doing trauma therapy with them or not? If so, they are probably retraumatizing themselves and need some help to stop doing this.
Just What Is Retraumatization?
Retraumatization happens when someone who has suffered trauma re-experiences the event by recalling it in vivid detail (that is the norm for people who’ve suffered from these kinds of experiences) or engaging in behaviors that mimic the original trauma or expose them to similar conditions that the original trauma happened in. It risks reopening old wounds and ingrains the old emotional reactions that happened at the time of the original trauma.
Why Is It Bad for Clients
The reason it’s harmful for clients is that they already have a tendency to relive these events. This is due to the flashback symptom of PTSD. When they consciously expose themselves to more experiences of the same nature, including retelling it in super-vivid detail, the same grooves in their brain and nervous system get activated. This further ingrains the trauma and worsens the harm to the brain and nervous system that has been already harmed enough. It primarily acts on the parts of the brain stem that are already too active for people who suffer from trauma.
What Can You Do to Counter Retraumatization?
One thing you can do is to help your client learn to not get into ‘all the gory details’ of their trauma by spilling their guts about these events, especially in the first few sessions of their work with you. In my experience, that is almost a guarantee they will discontinue therapy and decrease their inclination to seek further treatment. You can do the following instead:
Use psychoeducation
Tell them you want to know about these hugely important events. But want to do so in a way that won’t make a bad thing worse. You can talk to them about how trauma affects the brain and nervous system. And that getting into great detail will only serve to worsen things.
Use containment
Identify a receptacle of sorts in your office that you show clients who suffer from trauma. Tell them that if they are tempted to relive events in between sessions or otherwise retraumatize themselves they are to figuratively send the key image related to these events or experiences into the container. I have used this with many clients and it can help to give them permission to not dwell on traumatic events in between sessions. It also is a conscious way for them to use healthy compartmentalization that teaches them that these events are not to be wrestled with on one’s own, but with the help of a skilled professional.
Use systematic relaxation
Teach your clients how to use some means of systematic relaxation. It can either be deep relaxing breathing, or mindfulness meditations. Yoga, or some other form of relaxation can also help calm the nervous system down after becoming activated. Most people who suffer from trauma are used to living ‘from the neck up’ as Bessel Van der Kolk, MD, has said, and using the body to help aid in dealing with trauma can be very helpful.
Appreciate the Struggle of These Clients
Finally, it is important to be aware that these clients are not consciously retraumatizing themselves. If they knew what they were doing, they’d certainly stop doing it. This is primarily an unconscious attempt to somehow ‘solve’ the issue. It is being done by a brain that has already been seriously hampered by the event or experience that kicked it off. You as a clinician can have so much empathy for their plight. You can offer them a way out of the conundrum they have become trapped in. The fight is not only to redeem the past. But to help them have a present and a future as well.
Scott Kampschaefer, LCSW is a private practice therapist in Austin, Texas. He has an extensive background in working with depression, anxiety, and bipolar disorder at a clinic for older adults with these disorders in Austin. He now works with adults and adolescents of all ages in private practice.
