Creating a Trauma Account

In the last few years, I’ve had some traumatic experiences that had a significant impact on my life overall. In terms of how I conceptualize trauma responses, what matters the most is how the mind/brain processes the trauma. That processing can range from adaptive to disordered (i.e. PTSD).

While I don’t have PTSD, I still haven’t fully processed the trauma-related memories. I was reminded of this when I got triggered a couple of weeks ago, and all of that emotion came rushing back. I realized that I’ve been engaging in some serious avoidance, and that means there’s a lot of shit that I haven’t dealt with.

Cognitive processing therapy (CPT)

In some of the continuing education I’ve done on PTSD for professional reasons, one of the things that interested me was cognitive processing therapy (CPT), which is an adaptation of cognitive behavioural therapy. One of the elements of this type of therapy is creating a trauma account, which accomplishes a couple of things. Creating a trauma narrative helps the brain to change how it encodes emotionally and sensory-charged trauma memories, and writing, re-writing, reading, and re-reading also acts as a type of exposure therapy. I decided to give this a try.

The first trauma account involves writing out the traumatic events, including as many memories and sensory details as possible. A second trauma account is then written, including any more details that come up as well as the thoughts and feelings that arise while re-writing it. Thinking stuck points are then identified and challenged, and the trauma account is read regularly to provide exposure and regularly challenge the stuck points.

Starting the trauma account

After deciding to do the trauma account, I kept putting it off. I didn’t want to do it. I recognized, though, that this avoidance was exactly why I needed to do it in the first place. So I put it on my calendar for yesterday morning, knowing I would be able to go to yoga class afterward to relax. I created a little safety zone for myself:  soothing aromatherapy, a cup of tea, wrapped in a cozy blanket, and with my favourite stuffed animal plus my guinea pig who loves her mama the most tucked in at my side. And I started writing.

I wrote for 45 minutes. It was hard, and it was tiring. I tried to observe how my body was responding: the tension, the stomach ache, the shallow breathing. But I did it. I’ve still got a lot left to do, but I’m glad I’ve started the process. What stands out to me is that I’m now able to name the emotions that before were too raw and twisted in thick snarls to tease apart. Something that came up repeatedly was “I feel worthless. More than worthless.” I hadn’t realized that was such an issue.

I’m going to stick with this approach of scheduling and making a safety zone. I’m going to keep writing until it’s all down on paper, and then I’m going to highlight and footnote until it makes sense, and then hopefully I’ll feel more ready to move on and escape from the prison of the past.

Finishing the first account

While the CPT protocol used by the sources I worked from focused the trauma account on the single most traumatic event, the things that I need to work through were more spread out, so I just went with that.

It took me 7 writing sessions, each lasting about an hour. Initially, I kept coming up with excuses to avoid the writing sessions that I’d scheduled on my calendar. But I was able to get into a routine of doing writing sessions twice a week, with soothing aromatherapy going, a cup of tea on one side, and a guinea pig or two on the other side.

I would begin each writing session by writing a few sentences about what was forefront in my thoughts, feelings, and bodily sensations. Then I would take up where I’d left off the last session and write until I was exhausted. At that point, I’d close with a wrap-up of where I was at in terms of thoughts, feelings, and body.

I found with more recent events that have happened in the past year or so, it was harder to construct a coherent narrative because I just didn’t have clear memories. I’m not sure if that’s because I was extremely depressed at the time these things were happening, or if it’s because I’ve been avoiding those memories as if they were poisonous. Quite possibly some of both.

What came up

What arose the most often in my trauma account was getting the message that I am worthless. I’m not sure why I wasn’t expecting that to be what would stand out; I guess because I generally have reasonably good self-esteem. But it kept coming up over and over. I guess moving forward, I face the challenge of internalizing the quote “Your value doesn’t decrease based on someone’s inability to see your worth.”

Next week I’m going to begin writing the second version of the trauma account. It feels like a less daunting task than dredging all of it up for the first version. It remains to be seen how much this will really help, but it’s certainly worth a try.

P.S. from 3 years later

I would say that doing the trauma account helped a lot. It helped to create distance both from the memories themselves and the emotions associated with them. It’s certainly something I’m glad that I did.

Want to learn more about CPT?

The US Veterans Affairs Center for Deployment Psychology has some interesting info in their online mini-course Cognitive Processing Therapy (CPT) for PTSD in Veterans and Military Personnel. Yes, it’s aimed at therapists and focused on veterans, but it’s still a really good source of information.

The Medical University of South Carolina/Navy Medicine has another good online course.  

You may also be interested in the post Big-T Trauma, Little-t trauma, and Mental Health Cutlery.