Like many people who have experienced trauma, Eva had a strategy of trying not to think about the thing that had happened to her. When she contacted me, she wanted to connect with a therapist who could give her techniques to suppress the thoughts and images she had about the day her best friend had died.
Eva was surprised to learn that therapy for trauma involves doing the exact opposite of what many people want to do; instead of learning how to not think about the trauma, I told Eva that the way forward was to talk about it, write about it, and let her thoughts and feelings about the trauma come to the surface. This idea scared Eva, but deep down she suspected that this is what she had avoided doing for a long time and needed to do to get better.
Eva’s friend had died at a party where a group of friends were drinking and playing a board game. Everyone was trying to talk over everyone else, and Eva’s friend choked on a piece of snack food. Panic broke out as the group took steps to help her, but in the end, despite doing all the right things, Eva’s friend died as they waited for emergency services to arrive.
Images of that night had haunted Eva for years. She knew she had done everything possible, but still felt she had failed her friend. Eva had developed panic attacks and had gradually stopped leaving her house. She couldn’t work and was living on savings. She had food delivered, and knew she was spending way too much on this. She struggled to sleep at night and had nightmares. Sometimes she felt like she was losing her mind. It seemed as if the day her friend died, part of Eva had died too.
At the outset of our work together, I told Eva that trauma therapy often feels like ripping off a band-aid. It was going to be intense, but probably relief would come relatively quickly. In therapy, we would talk very specifically about what happened the day Eva’s friend had died, all the sights, sounds, and experiences frame by frame, as if Eva was describing a movie. I would also ask Eva to write out a detailed account of the day from start to finish, and then to read the account aloud for us to discuss. I told her I would also ask her to read this account to herself at home every day for 2-3 weeks.
When I first told Eva that we were going to be doing these exercises, she thought they were going to be awful, and she wasn’t sure she would be able to do them. She thought about not coming back to therapy, or delaying it for a future time in her life. I told her this was a common reaction, and encouraged her to keep with the process, and to not flee the emotions that were going to get opened up. In the opening days, Eva felt that she was white-knuckling it to complete the prescribed exercises, but the process began to become easier relatively quickly. Within three weeks, it was dramatically easier to discuss the death of her friend and all the circumstances surrounding it.
Eva began to make peace with the fact that she and her friends had done everything possible to save her friend, and that she bore no responsibility for her death. Locked-up grief spilled out, and we spent time talking about how much she missed her friend and the importance that she had played in her life for so many years. Her friend would always carry a special place in Eva‘s heart. It was a void that could not be filled, and yet the rest of life would move forward with new experiences and people coming into it, and Eva concluded that this was what her friend would have wanted for her. She did not need to feel guilty about having a life.
Four months into therapy, Eva no longer had panic attacks, and her nightmares had stopped. She began to think about looking for a part-time job. She still missed her friend terribly, but the day of her death existed on a timeline that was in the past. Eva could emotionally separate that time from the present. It had been a horrible day, but one that Eva could now reflect on when she needed to, while still opening up a psychological path for a future where she went on living.
The following story is a composite inspired by my work. Details have been altered to protect privacy, while the process remains true to the therapeutic experience.