After a sexual assault or trauma, our brain doesn’t simply “move on” like it does after other events. When you think about what happened, it feels on some level like it’s still happening – your brain hasn’t moved it into long-term memory storage. When triggered, that memory pops right up and our thoughts, body, and feelings will respond as if the event is happening again, right here and now. Our brain needs a little help with understanding that the trauma is over now and we are safe. That’s what trauma processing techniques like EMDR, Sensorimotor Psychotherapy, and Progressive Counting (PC) are used for.
I previously covered how EMDR works here. Now I want to take you through an example of using PC to address untreated trauma.
Let’s meet Jax. (Jax is not a real client). Jax is a 23-year-old, non-binary, law student. Jax recently experienced an uncomfortable sexual experience. They notice that since the experience they have been feeling irritable and lonely. They feel a bit ashamed they can’t just “move on” from it and they think about how other people who have experienced a lot worse seem fine. They feel like there is really something wrong with them.
Here’s how I might work with Jax:
We start with an assessment phase where Jax shares everything they think I should know about them. I ask them a ton of questions about their history, current life, and eventually we create a list together of all of the bad things that have happened to them.
Parent’s divorce when they were 5
Bullying in middle school
Death of a friend from suicide at 16
The uncomfortable sexual experience at 23
In general, before the bad experience, Jax’s life was pretty good. They have normal stressors related to law school. They drink socially but have started drinking a little more since the bad experience. They have some really good friends and are working towards building confidence in dating. They have started going to the gym to try and relieve some stress.
I name all of the factors above because that is a part of our assessment for whether now is the appropriate time for Jax to engage in the hard, stressful work of PC. Life doesn’t have to be going perfectly (and often it isn’t which is why people reach out for help) but if you are struggling with addiction, current abuse, suicidality, or other acute conditions/environmental factors we may need to work through those issues first before tackling the work of processing traumatic material. However, don’t let this be a barrier for reaching out! It just means that we may focus our initial sessions on how to make life a little better for you right now so that you are safe and feel able to do this work.
Back to our example — let’s say Jax seems to be in a good place to do some trauma work and so we discuss using a treatment like PC to process through the experience. We both agree it’s the right time and right circumstances for them.
When we are ready to begin trauma processing, I will take Jax through a “test run”. This means they will use a non-traumatic event while doing PC for the first time so they can learn the process in a relatively low-stress way. If all goes well, we then start to go through the bad things on their list starting from the earliest memory to the most recent.
We always start with the earliest memories because oftentimes a more recent trauma will remind our brains of the previous bad events in our lives. This means it can be difficult for the brain to fully process a recent memory that was actually a retraumatization without first processing the original events that were triggered.
Let’s use Jax’s first memory – their parent’s divorce. We will ask them to identify the first memory they have associated with the divorce. For this example let’s use a moment Jax remembers when their dad told Jax that he and their mom are splitting up. Now with the specific memory in mind I will ask Jax to watch this memory like a movie in their mind. We will have identified a beginning, middle (the memory), and ending to the movie. Jax will “watch” this movie while I count out loud for varying intervals. We will continue until the memory no longer holds any charge to it.
During PC people can feel rather intense emotions and sometimes a surprising (to them) lack of emotion. It’s all “normal”. As the memory starts to feel less and less intense and eventually becomes a 0 people have described to me the feeling:
“it’s like it’s really far away now and I have a hard time picturing it”
“it doesn’t really feel like it happened to me anymore even though I know it did”
“I’ve lost some of the details… it’s like it’s fading”
“It feels like I am seeing the sun for the first time after a really long night”
“It feels really over now”
People do not:
- Forget about it
- Say “it’s ok that happened to me”
- Automatically forgive a person who harmed them
- Feel happy they had the experience (in some cases it may happen that the person feels gratitude for the lessons learned from the event but this is not necessary to healing)
When Jax finishes the memory of their dad telling them about splitting up, we will continue by processing other memories related to the divorce until all of them feel like a “0” (no bad feeling). We then move forward and process all the memories on their list. As the trauma processing phase winds down Jax may experience a sense of grief over what life could have been like if they hadn’t experienced these events. We may spend some time after processing all of the memories working through their grief together. Some people also like to spend time at the end of processing to make meaning of their experiences or acknowledge the ways the events impacted their lives. During this time Jax and I will work together through whatever is coming up for them after processing. We then might anticipate future events that might be stressful or acknowledge ways of avoiding potentially traumatic things.
I will ask Jax to let me know if they experience any traumatic responses (panic attack, nightmares, intrusive thoughts, etc.) so we can assess if there are any memories we may have left out. I always keep my door open to folks and ask them to come back if they experience anything disturbing or continued symptoms.
This process can take anywhere from 3 months to a few years depending on life factors and the number of bad experiences on the list.
PC is an incredibly effective tool for healing trauma. Please don’t hesitate to reach out for a consultation if you think PC might be something that will benefit you.