Packing for a journey: tools and skills

     Healing from trauma is a long process and a substantial journey. As any big trip it requires preparation and right gear. For some journeys we need clothes and a sleeping bag for others we need tools and skills. This post will help you understand a broader picture of what you may need to support your healing journey. The posts that follow will expand on each category and teach you specific skills.

     Very often when trauma is over, we find ourselves behaving in self-destructive ways, such as abusing alcohol or drugs, cutting self, taking unjustified risks, engaging in unsafe sex and so forth. This happens not because we really want to hurt ourselves but because we are reaching for what is available and quick to relieve our emotional pain. A couple of drinks can really take the edge off in this moment. A one night stand can temporarily relieve loneliness and create a moment of pleasure.  

     The truth is we want to cope. We want to feel better. But we don’t know of lasting and effective ways to bring relief. Nobody teaches us in school or college the skills we might need if we get traumatized. Good news is that we can obtain what we need at any age by understanding common emotional needs of trauma survivors and learning specific ways to address them. So, let’s get to the bottom of it. The table below  summarizes common emotional needs and issues of trauma survivors and suggests different tools and skills that can be helpful in dealing with each one of those. 

Common emotional concerns of survivors	Focus of learning	Skills & Techniques
Mood & affect instability	How to tolerate distress and pain without falling apart; How to improve mood	Distraction Self-soothing Mind-body techniques Containment
Anxiety, hyperarousal, stress and tension	How to tolerate anxiety; How to reduce anxiety	Mind-body techniques Imagery techniques, i.e. Safe Place
Relieving past traumatic experiences: flashbacks, obsessive thoughts, sudden intense emotions	How to be in and return to the present moment	Grounding Mind-body techniques Containment Safe Place Visualization
Difficulty communicating with or relating to others	How to express self effectively; How to listen to others efficiently	Expressing your thoughts and feelings Asking for what you need Effective use of “no”
Non-specific difficulties functioning at the “normal” level	How to take good care of self	Basic  self-care: sleeping, eating, exercising
Negative self-image & shame	How to focus on the core goodness; How to focus on the positive aspects of self	Loving kindness meditation Positive self-talk & affirmations Discovering anger
Persistent feelings of guilt		Loving kindness meditation Forgiveness practice
Intense anger	Validation & safe expression of emotions	Coping affirmations Time out Safe expressions of anger
Suicidal thoughts, impulses to self-harm, homicidal thoughts	Understanding the nature of the thoughts/impulses	Survival kit/box

     In the next several posts I will describe the skills summarized in the table above in detail. Each post will focus on the specific emotional concern (left column of the table) and teach you skills to address or cope with this concern. Some of the skills or concerns have been described in the previous posts. You will find links to those posts in the table.
     As a conclusion, healing from trauma is a long process that takes courage, perseverance, time, and multiple resources. It is a long journey. As any successful journey, it has to be planned and prepared for. Think of learning and practicing coping skills as a very important preparation step.You need those tools in order to cross the "oceans" and "desserts" that you will meet on your way and to reach the oasis of  healed and whole self. So, do not regret time and energy you spend at this step of the process. It will serve you very well once you delve into reprocessing traumatic memories, the most painful part of the .journey.

Dealing with shame

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     Shame is a common consequence of trauma, especially interpersonal injury or stressful events that lasted for a while. When we are treated cruelly, when we are abused by other people, it leaves us feeling like we are bad and not deserving love. Because why else would we be subjected to violence? Trauma survivors may experience shame as ranging from nagging background feeling of not being good enough to the full-blown self-hatred and desire to kill themselves as they are not good.

     Shame maybe defined as a painful emotion caused by a strong sense of embarrassment, unworthiness, or disgrace. Feeling of shame is profound. It affects the way we perceive ourselves. It tells us that we are bad, incompetent, and unlovable. Shame is a toxic emotion, especially when it is experienced on the regular basis. People tend to hide shame, because nobody wants to seem inadequate or bad. As a result, shame is an emotion that is very difficult to express. It loves dark places. It tends to thrive in hiding. Because of the aforementioned qualities, shame is very difficult to deal with.

     I am going to discuss several approaches that compliment each other and can be used together to alleviate painful effects of shame.

     Developing a sense of worthiness and self-acceptance is a potent antidote to shame. There are many ways to work on that. I particularly like two practices described below. When exercised daily over several months to a year period of time, they may lead to dramatic positive change in the level of self-acceptance.

·        Loving kindness meditation is an ancient practice with its roots in Buddhism. The full practice has practitioner wishing wellness, health, love, and so forth to him or herself first, then to a friend, a neutral person, an enemy, and finally all humans. For our purposes, I suggest using only the first part of meditation, which is wishing yourself well.
Here are the instructions: Choose the phrases that you will be working with (repeating) that start with “May I” and focus on wishing yourself well. Usually, meditation consists of  3-4 phrases repeated over and over again. If you find it difficult to come up with those phrases, here is my suggestion:
- May I be well
-May I love myself no matter what
- May I accept myself just the way I am
- May I be content
After you identified and wrote down the phrases you are going to use, find a quiet place, where you will not be disturbed by anyone or anything. Sit in a comfortable position, such as with your legs crossed on a cushion or in the chair or on the sofa. Close your eyes and focus on your breathing for a few moments. Notice how you breathe air in and how you breathe it out. Then visualize yourself surrounded by white or yellow light. Feel the warmth of light on your skin. Enjoy the sensations. Now start saying the phrases that you identified out loud or silently in your mind. Pause after each sentence and connect to the wish it contains. Maintain awareness of your breathing and picture of yourself surrounded by white light. Spend 3-5 minutes repeating the phrases. Repeat this practice daily.
Note that for the first couple of months wishing yourself love and acceptance may feel false or wrong. Some parts of you may think that you don’t deserve all of those things. It’s OK. You don’t have to believe in what you are saying to get positive results. Additionally, the more often you practice this meditation the more you will feel and believe in your worthiness.

·        Affirmations, when used many times a day and especially during the times you feel unworthy or evil, are a great tool for reducing shame. Affirmation is a positive statement about yourself in the present tense. For example, I am wonderful just the way I am. The more specific and relevant  a statement is to the specific thoughts associated with shame the more effective it would be. I suggest working with 1-3 affirmations at a time. To develop helpful affirmation notice what thoughts come up for you when you feel inadequate. Then create a sentence that describes you as a complete opposite of that. So, if you think “I am unlovable”, the appropriate affirmation will be “I am lovable”. If you think “I am a bad person, who does not deserve to live”, a helpful statement will be “I am a good person, and I deserve a good life”. I hope you got the concept. Once you develop one to three affirmations, start using them multiple times a day. I suggest repeating them several times right upon awakening, when you feel ashamed, inadequate or bad, and right before you go to sleep.

      Properly directing and expressing your anger is another powerful technique for combating shame. The theory behind it is that trauma survivors often couldn’t feel anger at their abusers at all or to the full extent, because it was very dangerous at the time and could have prolonged violence. So, substantial part of this anger was directed at self. It was an essential survival tool that helped survivors come out of trauma with minimal possible injuries (even if they were substantial, they would have been worse if a survivor expressed full extent of his or her anger at the perpetrator). If trauma is over at this point, anger can be reconsidered and directed properly.
     So, anytime you feel shame, ask yourself “Who am I angry at right now other than myself?” After you identify a person or situation you are angry at in the moment, find a way to safely express your anger. Some options include journaling about it, aerobic exercise, talking to a safe person about your feelings, singing or yelling in the shower. In some situations it may help to tell the person you are angry at how you are feeling. However, it is not advisable if your anger is too intense or if the person has a potential to become or has been violent in the past.  

          Talking to trusted others about your shame and experiences that caused it is one of the best ways to reduce or eliminate it. Remember that shame loves dark places and hiding. When you shed light on it by talking about it, shame runs away. There are several crucial considerations factoring into decision to open up to someone else. First, it is important to choose a person you trust. Ideally it should be someone, who is able to listen and understand difficult experiences, who is open about their own challenges and difficulties, and who responds with compassion to pain of other people. Second, be aware that initiating and having this conversation, especially for the first time, will not be a comfortable experience for you. And, it’s OK. Just prepare yourself for a challenge. Also, first couple of times you talk to others, shame may increase. Let the person you talk to know about that and ask for what you need from them whether it’s a hug or reassurance that they accept you or something else.

     Working on reducing or eliminating shame is a long-term process. Please, be patient with yourself. However, if the aforementioned techniques don’t make any difference in how you feel within a couple of months, seek professional help from a mental health professional.

     As always, I am interested in your feedback, questions, and comments. Please, share them on the blog page if at all possible.