Trauma-Informed Psychoeducation in ART

In her book “Come Passion, The Soulful ART of Healing Trauma,” Colleen Clark, RCSW, highlights the importance of delivering Psychoeducation to clients alongside ART sessions. Psychoeducation in trauma therapy involves explaining the client’s mental diagnosis and treatment choices to both the client and their family, helping them understand and cope with the illness by providing useful information and raising awareness.

When therapists and clients use trauma-informed Psychoeducation as part of their treatment plan, it can serve as a helpful map of where to go. In trauma therapy, Psychoeducation helps you recognize commonalities, makes you feel less alone, and reduces the shame you may feel around your trauma symptoms. You become more comfortable discussing your treatment with people in your life.

What are the benefits of Psychoeducation?

In the lens of trauma therapy, psychoeducation equips you with language, knowledge, and skills to discuss your experience with yourself and the people in your life. It also:

Helps you understand your journey: Knowledge is power. Understanding the “whats” and “whys” of trauma treatment increases your adherence to the process. You can see the roadmap and where you’re going.
Reduces shame: When there is an explanation behind your feelings and actions, you feel less judgment toward yourself. You understand that what happened to you is not your fault. What you’re experiencing is often a common and shared response to trauma among other survivors.
Increases hope: When you comprehend that trauma treatment will change your brain and make room for healing, you’re filled with a new-found sense of hope. Colleen states that it’s important for clients to know, “you can move the trauma so that the brain has more space — due to the amygdala being calmed.”
Counters myths with truth: Psychoeducation can reduce stigma and prevent harmful myths about your diagnosis by replacing them with solid information.

How Psychoeducation Helps You Understand Who You Are

Making sense of your symptoms and the effects of trauma is aided by Psychoeducation. Additionally, it unpacks the ways your brain has protected you during trauma and allows you to understand the steps of working through it. Loss, grief, or childhood abuse can influence your adult reactions and relationships. Psychoeducation helps put these experiences into context.

Understanding common symptoms of trauma

Trauma symptoms don’t always show up the same way for each person. However, agitation, recurring flashbacks, and bodily reactions are common impacts of trauma. Impulsivity, avoidance, and strained relationships are also frequent themes in the lives of trauma survivors. These symptoms can dictate how you show up for day-to-day life. When you understand that some of your experiences are symptoms of trauma and not personality flaws, you’re more likely to grant yourself grace.

How the trauma affects each part of the brain

A basic understanding of how trauma can affect parts of your brain can give you further insight toward healing:

The prefrontal cortex helps you make decisions and control your impulses. Trauma might make it harder for you to manage your emotions and behavior.
The brainstem controls essential functions like heart rate and breathing. The stress from trauma might interfere with these functions.
The hippocampus, crucial for memory formation, may shrink under chronic stress, impacting your ability to recall events accurately.
The hypothalamus, involved in regulating stress hormones, can become dysregulated, leading to disruptions in your sleep, appetite, and mood.
The amygdala processes emotions and scans for danger. It is hyperactive during trauma, leading to heightened fear responses.

Phrases of Trauma Healing

Most practitioners agree that trauma-informed treatment comes in three stages:

Stage 1: Safety and stabilization focuses on developing coping skills and establishing a baseline safety for yourself.

Stage 2: Remembrance and mourning focuses on uncovering details of the past while feeling safe in the present. Grief and mourning are common themes in this stage as you explore losses associated with trauma.

Stage 3: Reconnection and integration can focus on the next steps of reconnection with the awareness of how past trauma has affected you. In this stage, you can find meaning beyond the hurt.

When you understand the common goalposts of each stage, you can gently and safely move through your trauma-healing journey without fear of retraumatization.

Impact of ACES

ACEs or Adverse Childhood Experiences are stressful or traumatic events that occur during childhood. These experiences can shape your beliefs, behaviors, and coping mechanisms. As a result, maladaptive behavior patterns or negative self-perceptions can develop. An updated list of common ACEs includes:

Physical abuse
Emotional abuse
Sexual abuse
Physical neglect
Emotional neglect
Alcohol or drug abuse by a parent
Mentally ill parent
Divorce
Incarceration of parent
Childhood Domestic Violence
Systemic Racism
Bullying
Community crime
Foster care
Homelessness
Immigration

During your initial assessment, your therapist will evaluate ACEs’ role in your life and the best way to use this knowledge in sessions.

Understanding who you are is essential for treatment.

Your path to healing is as individual as you are. Your unique combination of beliefs, values, and attachment style can illuminate why you show up as you do in your daily life. When you ask, “What drives you and why?” you have a compass to direct your actions toward healing, treatment, and life.

Attachment styles

Attachment styles, formed in early childhood, influence how you foster connections and deal with emotional distress in adulthood. Here’s a snapshot of how these styles play out:

Secure attachment: Your bonds are healthy, and you feel confident in your relationships. This pattern carries over into adulthood without fear of abandonment.
Anxious-ambivalent attachment: You experience a lack of trust, seek constant approval, and fear abandonment, leading to dependency and feeling unloved by partners.
Avoidant attachment: You expect that your emotional needs will not be met. You experience difficulty expressing and understanding emotions and may avoid intimate relationships.
Disorganized attachment: Blend of avoidant and anxious traits, displaying anger and struggling with emotional control due to unresolved childhood issues.

Understanding your present-day attachment can shed light on your relationship with your caretakers and also show any patterns in your adult relationships.

Distorted Thoughts

Cognitive restructuring is a common practice in Cognitive Behavioral Therapy (CBT). In Cognitive Restructuring, you become aware of unhelpful, unsupportive thoughts and replace them with more helpful ones. You can identify specific patterns as you become familiar with watching your thoughts. Further examination may often show that the unhelpful thoughts are unfounded and not based on facts.

Noting the 3’s of Cognitive Reappraisal may help:

Catch it- Noticing the thought example: I’m ashamed that I must get therapy. I’ll always be a mental patient.

Check it—Is this helpful or true? This thought makes me feel bad and puts me in a box.

Change it- How could I view this instead? People are many different things. Therapy helps me reach my goals.

Becoming more aware of common thought distortions and how they present themselves helps you recognize that not all thoughts are facts and can be changed.

Core Beliefs

Most everyone suffers from negative, destructive core beliefs on some level. Beliefs about ourselves and the world were formed at a young age before the reasoning portion of our brain was fully developed. At their center, core beliefs are your working model of the world designed to keep you safe. People who suffer from trauma may experience a more significant number of core beliefs, such as “I’m unlovable,” “I’m at fault for everything,” and “I’m not good enough.”

Psychoeducation can help you pinpoint and identify your core beliefs. Once you understand their role in your life, you can easily see how they shape your actions and experiences.

Understand your Window of Tolerance

Your ‘window of tolerance‘ is the comfort zone where you can function effectively without feeling overwhelmed. When you know and can manage your emotions within this window, you’ll likely maintain your cool even under stress. As you educate yourself on your stress limits, you can become more familiar with how to exist in each moment.

“The Window of tolerance concept helps us to think about our roles and how we manage during stressful times. This neuro-scientific model illustrates the best place to be or the best state of arousal in which each of us can thrive. Imagine a river running through an open stretch of land, and the riverbanks being a bit precarious — a bit of chaos on either side of that river. On one side hyper-arousal, and on the other, hypo-arousal. Within the width of that river, we can manage ourselves — it’s like we’re in a zone of thriving, even when there are turns and the current is choppy. But if we move closer to the edges of the river — the riverbanks — or that wavy line each side of our zone of thriving, we can become hyper-aroused or hypo-aroused.

We each have our own Window of tolerance, which can change daily — within a reasonable range.” – Come Passion: The Soulful ART of Healing Trauma, Colleen Clark RCSW

Tools and Coping Strategies

Your therapist will provide you with tools and coping strategies to handle challenging moments that may arise. These may often center around deep breathing exercises, grounding, and mindfulness. There are many different techniques, and their effectiveness depends on your personality and preference. Some popular coping strategies include:

Muscle relaxation exercises
Breathing exercises
Meditation
Yoga
Listening to quiet music
Spending time in nature

Developing a “Feel Good List” as part of your Psychoeducation is an excellent tool to keep in your back pocket on days when you feel hyperaroused and distressed.

Mindful-Self Compassion

People suffering from trauma often develop rigid, harsh thoughts toward themselves. Practicing mindful self-compassion helps to catch these thoughts. It is helpful to remember that you have done the best you can to protect yourself. The author of the book Self Compassion, Kristin Neff, explains the importance of “unconditional regard” for yourself as it lays the stage for healing. Self-compassion allows emotions to soften, calming the fear centers of the brain. Positive decision-making practices can occur from this newly regulated spot.

“The goal of therapy is to change the suffering into healing, and we do that through compassion. ” Come Passion: The Soulful ART of Healing Trauma, Colleen Clark RCSW

Communicating and Practicing Boundaries

A final part of Psychoeducation in trauma therapy is centered around how you communicate with others in the aftermath of trauma. You may wish to share specific details about your diagnosis and symptoms with people who feel safe. Your therapist may help you by providing the best resources and techniques to share. Additionally, communicating your boundaries, comfort level and expectations with people in your life will be crucial. Honing your boundaries makes you more assertive, helps you practice self-care, and communicates more authentically. If you have a trauma history, it’s common to feel as though you trust everyone or no one. In light of this, you will discover the right balance as you develop awareness around your boundary setting and trust level.

The role of Psychoeducation in ART therapy

Accelerated Resolution Therapy is known for its efficiency, often working its magic in one to five sessions. By integrating Psychoeducation, you gain a better understanding of your mental health patterns, and you recognize that your trauma responses are natural rather than a source of shame. Psychoeducation can help to deepen the impact of ART and extend its benefits.

As you grasp your diagnosis, symptoms, and behaviors, you can actively participate in the rescripting process of ART. This therapy, known for its collaboration between you and your therapist, gives you a voice in shaping your session journey as an informed and engaged participant. This process teaches you to dismantle your old, troubling patterns and discover how to build new, healthier thought processes and behaviors. This transformation enhances your overall therapy journey.