How to Avoid Retraumatization in Therapy: The Benefits of Inpatient Treatment

People who have experienced intense trauma in the past can get caught in a loop of reliving the terrible distress. Even in therapy, retraumatization is possible and can impede the recovery process. A client can lose trust in their therapist and the treatment journey unless retraumatization can be redirected by an experienced clinician and an empowering treatment environment.

Andy was seeing a therapist every week for seven months to process his feelings and painful memories of being physically and emotionally abused as a child years ago. This wasn’t the first therapist he’d seen, but she was the first person he felt could really understand him and what he was going through. Still, it always seemed as if he’d sit down for a weekly session and spend the first 50 minutes getting settled and reconnecting with the trust he felt in their dynamic. Only the last 10 minutes or so would be extremely productive before they had to wrap up and set the discussion aside until the next week.

This imbalance of slow, gradual reconnection and brief, intense productivity is familiar for a lot of people starting out in outpatient therapy scenarios. But it is especially common for people with trauma disorders who have trouble trusting others in general—let alone trusting others enough to reveal and share their very personal experiences of trauma. Still, this is a positive case scenario when a productive relationship can be established over time between a client and a clinician. In some cases, clinicians are not as aware of or experienced with trauma disorders to handle them with complete understanding, awareness, and careful action. The healthiest treatment setting is one that avoids harmful retraumatization in therapy and instead works to restructure the experience of triggers and trauma for long-term recovery outcomes.

What Are the Dangers of Retraumatization in Therapy?

Retraumatization is a natural process when someone suffers from a trauma disorder. Triggers may be conspicuous and expected, such as a news story about a similar experience, a movie or TV show, or a person or place associated with the original trauma. Or triggers may be inconspicuous and unexpected, such as certain scents, sounds, textures, or other stimuli that remind someone of the original traumatic event. When a trauma disorder is untreated and retraumatization is left to follow its own course, the symptoms of post-traumatic stress can be incredibly distressing.

If you have a friend or family member who suffers from a trauma disorder, it’s important to understand just how serious retraumatization can be. When someone is triggered to recall the original traumatic event, this reexperiencing can be as terrifying as it was in the first place. Retraumatization can lead to:

  • Negativity
  • Mistrust
  • Intensification of flashbacks and nightmares
  • Paranoia
  • Psychosis
  • Self-harm
  • Heightened stress on the nervous system
  • Substance use disorders
  • Major depression
  • Other anxiety disorders
  • Eating disorders

Treatment is necessary for someone to navigate the recovery journey from trauma. But treatment can also be a trigger in and of itself for retraumatization because clients may be asked to explore their feelings and memories as they work to heal them. This is where an important difference comes into play between a clinician who is experienced with trauma versus one who is inexperienced, a treatment setting that is immersive and supportive versus one that is brief and impersonal, and a course of treatment that is consistent and extended versus one that is short and infrequent.

Not only is retraumatization in therapy terribly distressing for a client, but it can also set them back on their treatment journey and inspire fear and doubt about trusting the recovery process at large. This can be a major setback for people who really need to discover the light on the journey ahead, a reliable support system, and their own self-compassion.

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How Can Retraumatization in Therapy Be Avoided?

In general, a treatment environment is the best and most important place for someone with PTSD or other trauma disorder to be, but even treatment experiences can feel threatening and unsafe if triggers are reinitiating the powerful echoes of trauma. Hence, the particular circumstances of the therapeutic setting and the traits and techniques of the clinician can make an enormous difference to the client’s success and whether they experience disturbing retraumatization in therapy.

The Client Needs to Develop a Trusting Relationship with Their Clinician

Many people with a history of trauma and retraumatization have found it challenging to trust others and to develop strong relationships that last long enough to affect the healing process. It takes time and persistence on both sides to develop a working dynamic in therapy. The best chance for this crucial relationship to develop is in a long-term residential setting where a client can focus entirely on their healing journey, their interactions with their clinician are frequent and immersive, and they can make progress gradually and cautiously.

The Recovery Journey Must Progress at the Client’s Own Pace

Especially in the case of trauma, there are myriad layers of pain and distress to wade through and heal in treatment. With patience and compassion and a strong therapeutic relationship, this healing absolutely can happen. But if the journey involves pressure—due to brief and inadequate therapy sessions, a clinician who is ill-equipped to help manage trauma, or repeated exposure to regressive triggers—retraumatization can continue and set an individual’s progress back in a most distressing way. The quickest route to recovery is actually through a PTSD residential treatment program that offers more therapeutic exposure with less pressure and, ultimately, fewer setbacks from retraumatization. When a client has an open-ended timeframe, they can develop a trusting relationship with a therapist at their own pace and begin to feel comfortable with the idea of treatment.

The Attending Clinicians and Staff Must Be Knowledgeable and Experienced with Trauma

An accurate diagnosis is an absolutely critical early step if someone is to find appropriate treatment and recovery from a trauma disorder. If the clinician attending to a client is not familiar enough with trauma to help ease their distress and restructure their relationship to the trauma, they will stay stuck in the loop of retraumatization in therapy and in their daily life. A clinician who is confident and ready to help in these cases knows that pain and trauma will come up when it’s ready; the process and conversations about trauma cannot be forced.

An ideal treatment environment with expert therapists and staff does not rule out the risk of retraumatization in therapy. Rather, when triggers and trauma begin to surface, in this setting a client has comprehensive and compassionate support to minimize distressing symptoms of underlying trauma while simultaneously developing coping mechanisms to relate and react to trauma differently. In other words, there is a difference between retraumatization and successful reprocessing of trauma as it arises. Through fully supportive and immersive treatment, a client is stepping into a new sense of strength and hope for approaching triggers during and after treatment without being overpowered. In this way, a life not weighed down by fear is possible.

BrightQuest offers comprehensive inpatient psychiatric treatment for people struggling with mental health illnesses and co-occurring. Contact us to learn more about our renowned program and how we can help you or your loved one start the journey toward recovery.