Feeling Worse After Trauma Therapy Is Normal. Here's Why
Mission Harbor Behavioral Health describes trauma therapy as "a form of talk therapy aimed at treating the emotional and mental health consequences of trauma." For people who have been through trauma and have dealt with the lasting effects, this therapy can offer relief to the victims. With the importance and benefits of therapy becoming so widely known, many people seeking help may be startled to find that it's only making things worse when they start off. It can be confusing and alarming when this happens, as it often feels like you're somehow failing at therapy. Don't worry; that's not the case, and you're not alone in feeling this way.
When beginning any type of therapy, many people report they feel worse to begin with, and trauma therapy certainly takes the cake when it comes to putting you through the wringer. Even after attending trauma therapy sessions for a long time, you still may feel like you've finished a grueling marathon after each appointment. So many people swear by trauma therapy, and it can be frustrating and demoralizing to feel like you're just aggravating the problem or managing to fail at therapy somehow. The good news is that you can identify why you're feeling this way and strategize how to push through to get to the benefits of your trauma therapy.
If you or someone you know is struggling with mental health, please contact the Crisis Text Line by texting HOME to 741741, call the National Alliance on Mental Illness helpline at 1-800-950-NAMI (6264), or visit the National Institute of Mental Health website.
It gets worse before it gets better
Fixing anything in life may often reveal an even deeper problem in the beginning, whether it's sorting out issues with your partner, cleaning a messy room, or, in this case, working on your mental health. Salene W. M. Jones, Ph.D., writes that this is often due to avoidance. "Approaching a problem leads to a temporary increase in anxiety but avoidance can lead to long term anxiety," Jones explains (via Psychology Today).
But what is avoidance, and why does it temporarily make us feel worse when we face a problem? Jones writes that "'Avoidance' is when someone does not engage with a problem, situation, or person. Avoidance can be behavioral, where the person physically disengages, or it can be cognitive, which involves attempts to not think about the problem or situation." A natural response, when you think about it. If you touch a hot stove, you get hurt, so you learn to avoid touching it. Forcing yourself to do something you've found to be painful, even in small measures, can be extremely stressful. So, why is breaking the pattern of avoidance necessary?
"Avoiding these things too often means we don't learn how to face these problems or situations and don't learn our own strengths. This means we accrue less evidence that we can face these problems and more anxiety the next time the problem comes up," Jones reports. "Over time, as a person copes with a problem and learns they do have the strength and skills, the anxiety and sadness fade. But that temporary increase can be difficult to overcome, even when avoidance leads to more anxiety and sadness long term."
The problem may be worse than you thought
When going through therapy, many people find that the initial surface problem is hiding many deeper issues that we tend to suppress and ignore. Northwestern University found that "some stressful experiences — such as chronic childhood abuse — are so overwhelming and traumatic, the memories hide like a shadow in the brain." Part of trauma therapy may include uncovering traumatic memories and suppressed emotions, bringing even heavier issues to light.
It may also be the case that things you may have thought of as normal and commonplace may come to light as having been traumatizing. For example, many people who experience trauma in their childhood or in a first relationship have no basis for the events that they went through and may think that it's completely normal. They may even feel guilty for having any complicated or negative feelings about what transpired. It's only as we get older, gain perspective, or speak with a professional who is trained to look for signs of trauma that we may discover what we thought of as something everyone went through may have actually been traumatic. Discovering that the problem is worse than you initially thought can make you feel even worse, as it seems your problem has only grown and gotten worse instead of getting better — the reason you're attending therapy to begin with.
Heavy emotions are physically draining
Ever notice how you feel like you need to take a long nap after you've cried? Trauma therapy is like that, but worse. Even an hour of dredging up these heavy and complicated emotions can leave you physically exhausted for a day or two. Emma Seppälä, Ph.D., writes of high-intensity emotions: "Our heart rate increases, our sweat glands activate, and we startle easily. Because it activates the body's stress response, excitement can deplete our system when sustained over longer periods — chronic stress compromises our immunity, memory, and attention span" (via the Harvard Business Review).
So, you may not just be mentally exhausted; physically, you may end up just as drained. Seppälä says the result of these high-intensity emotions is that "you tire easily. Whether you're getting amped up with anxiety or with excitement, you are draining yourself of your most important resource: energy." So, if you feel like you need to tap out and take a while to rest and recuperate after your therapy sessions, listen to your body! It's highly likely that you really do need that rest, even if you keep telling yourself that all you did was sit in a chair for an hour. Your body doesn't know the difference; it may think it just ran a marathon.
Stressors can compound quickly
If you're like many other people out there seeking trauma therapy, chances are you haven't booked yourself a month-long vacation on a calming beachfront to go through your therapy. You probably already have to deal with the everyday stresses of life, job, money, and relationships, and now you have the hovering stress of your therapy appointments to boot. Medical News Today notes that stress is entirely different for different people. Various different events or triggers can stress individuals out, and the degrees to which they become stresses out vary, too. For some, this stress might be acute, possibly just in relation to therapy. For others, this could be an issue of chronic stress, which trauma therapy might be compounding upon. This stress can be caused by re-living your trauma, putting too many expectations on yourself, or even just the healing process.
The short of it is that the more stressful situations you put yourself through, the worse your stress will be. It seems incredibly simple when you put it that way, but the reality is that stress can make you feel a bit like you're stuck in a loop of feeling awful. The good news is that stress is absurdly common, so there are many proven ways to navigate and reduce it, the first of which might just be acknowledging it.
You see trauma everywhere now
Once you become aware of the events that lead to your trauma, you start to recognize those same triggers in life around you. It can be hard to go through life, let alone therapy, while constantly being reminded of your trauma, and feeling like you're still experiencing your trauma is even worse. This often manifests in the form of triggers, or things that remind you of your trauma and force you into remembering it or experiencing a flight or flight response. Recognizing what triggers you may be something you discuss in your therapy sessions, but there are other things that you may become aware of that make you feel worse in your day-to-day.
The way people interact with you is just one example. While at one time you may have been somewhat annoyed but otherwise indifferent to the way a certain coworker treated you, you may now recognize patterns of manipulation or abuse. You may start to wonder why you're suddenly seeing trauma everywhere. Is it just me — am I making a big deal out of nothing? A huge part of healing is identifying other areas of your life that are still causing you trauma, and while this is a taxing process, it may make for a better life in the end. In some areas, such as dealing with a coworker, it may be impossible to cut the bad out–hence why you might feel worse about the situation. In others, you may find yourself empowered by being able to recognize what you are dealing with isn't your fault; you may be experiencing active trauma or abuse, and thanks to therapy, you may know how to respond to it.
Trauma therapy affects your hormones
Anything that throws your hormones off-balance is bound to leave you feeling worse. Clinical psychologist Forest Talley, Ph.D., tells Shape that trauma therapy can result in increased levels of cortisol, and catecholamines, which can lead to a whole slew of side effects. Cortisol is colloquially referred to as the stress hormone, while catecholamines are linked to things like adrenaline; an imbalance in either makes itself known. Either of these can result in feeling like you're constantly on edge or give you a sense of anxiety.
We often forget that mental health has real connections to the brain and body, so a hormone change is something that many people wouldn't even think of. All you may know is that you feel bad, but without any idea as to why. Even for women, including those who track their regular hormonal cycle throughout the month, this may be something that blindsides them. Men might be even more susceptible to forgetting about taking their hormones into account when they feel off and may even disregard hormones as a possibility when it is suggested (via Psychology Today). But why does this happen? As is often the case with hormones, any kind of stress may trigger the change, and trauma therapy certainly isn't a walk in the park.
Therapy changes your body
The stress of trauma can change your very DNA through epigenetic modifications, which change your gene expression, per research published in the Annual Review of Anthropology. Trauma therapy somewhat makes you re-live this stress, which can cause physical symptoms such as changes in your skin, gastrointestinal issues, headaches, migraines, body aches, fatigue, flu-like symptoms, and general body pain and weakness. It can be difficult to imagine that even re-living stress can have so many physical effects on the body when nothing is physically harming us at the moment. While trauma therapy may not cause this to happen so much as the trauma itself does, therapy can re-open old wounds and temporarily exacerbate the problem; once again, it gets worse before it gets better. Adding the stress of bodily side effects to mental ones often amplifies general discomfort as well.
In one way, this sort of reaction is almost validating; so many people put their mental health on the back burner because it's "all in their head," but the reality is anything but that. Mental health has a huge connection to the physical body, and much like the side effects that come with medication when you get sick or injured, treatment for your mental trauma can have just as many caveats. The trick is to remember that going through the struggles of therapy's acute stress on your body now is likely saving you from further long-term stress-related damage, as chronic stress can lead to ailments as serious as cardiovascular disease, according to Dr. Tracy Gapin.
Change is incredibly difficult
Even though you know it's for the best, it can be hard to change life-long habits and patterns. You may feel a loss for old activities or people, even if they only negatively affected you–and not all things you have to change will be purely negative, either.
It takes three to six months to implement actual changes in our lives, which is a long time to keep anything up, but most especially something as strenuous as therapy. While it does get easy over time, it's still difficult to let go of the past. Trauma therapy will ask you to change all sorts of things in your life; the way you see yourself, the way you react to things both in and out of your control, your habits, your routine, and thousands of other things we take for granted.
Some of these things are easier to drop than others; limiting contact with a toxic person might be easier than giving up heavy drinking, for example. But in the same example, some of these changes will be more difficult to implement because they're not just a negative force in your life. Drinking perhaps comes as a part of being social, dating, or joining an after-work networking session. Letting go of the good with the bad may make you feel like it's one bad thing after another with therapy. Keep your chin up; once you're on the other side, you'll find that it was all worth it, no matter how hard it was.
You haven't properly prepared for your appointments
When it comes to other vigorous activities, it seems like a no-brainer to prepare yourself. You'd stretch before doing serious exercise, but how are you supposed to warm up your brain and body for the rigors of therapy? Urim Recovery suggests research, managing expectations, a good atmosphere, and help, whether it be from aides like journals and planners or having someone with you for support. Getting the practical things out of the way, such as paperwork or outside distractions, can also massively impact the ease of your sessions and cut down on the stress of an appointment.
Urim Recovery also notes that people's expectations when joining therapy don't always align with what their body is ready for. In fact, their mind might not be ready, either. It's easy to go into therapy with the idea that you're going to tackle therapy head-on, but you have to be prepared for all of the hard things you're going to encounter. So, make sure you take time to center yourself, check in with your body and mind's needs, and, above all, don't force it. Healing takes time, preparation, and a lot of effort.
You're being too hard on yourself
When it comes to things like broken bones or a tough bout of the flu, it seems easy to give yourself a break. When it comes to anything mental, though, so many people criticize themselves and grow frustrated when they don't just "get over it." When it comes to trauma, the healing process is even more difficult than getting back on your feet after a physical injury, so give yourself some credit, and don't beat yourself up for not healing right away.
Don't rush it. Everyone's recovery is different, and getting better isn't always linear; some people may relapse, even multiple times, and some will feel like each day is better and better only to hit a point where they may not make progress for months. There will be days when you feel like you're all the way back at square one, but that's okay, and you're certainly not alone in this experience. Treat yourself with the same kindness and respect you would to anyone else going through trauma, and don't expect to beat it like it's a bug.
You're worth the time and effort it takes to recover, and you deserve to be happy. So give yourself a break! Don't make yourself feel even worse after your sessions by critiquing yourself or finding more reasons to be upset. It's all in the process, and you're amazing for even beginning your journey to recovery.
If you or someone you know is struggling with mental health, please contact the Crisis Text Line by texting HOME to 741741, call the National Alliance on Mental Illness helpline at 1-800-950-NAMI (6264), or visit the National Institute of Mental Health website.