When Healing From Trauma Doesn't Help

Many people with borderline personality disorder (BPD) have experienced traumatic events. Recently, my therapist and I decided to work on some of the trauma I've faced in my life. Short version: it didn't go well. I began having horrific flashbacks, strong urges to self-injure, and was irritable. We agreed that we should stop talking about the trauma for a while and focus on mastering coping skills.

It took me a while to realize it's not a failure on my part. Sometimes, the healing process can do more harm than good.

When repression is helpful

"If you have been severely or repeatedly traumatized or are currently coping with a great deal of stress, the healing process described in this book and certain forms of counseling may not be advisable," writes Dr. Aphrodite Matsakis in I Can't Get Over It: A Handbook for Trauma Survivors.

"In most cases, counseling is helpful," Matsakis writes. "However, in some cases it has been shown to increase symptoms and depression. ... Although it is natural and normal for you to experience distress upon trying to follow the healing suggestions in this book, keep in mind the warning signs listed in the 'Cautions' section of the introduction to this book (suicidal or homicidal thoughts, disorientation, hyperventilation, shaking, irregular heartbeat, and so on). If you experience any of these signs, seek professional help immediately."

Focusing on the trauma is not always a good thing. If you are not ready to confront your past, then doing so may be harmful. It's okay not to be ready.

Where do I fall?

Matsakis describes four different categories of trauma survivors who can't immediately face the trauma: those who should never attempt to remember the past but should focus on symptom management, those who are so stressed that they should address the trauma later in life, those who need some other form of counseling before facing the trauma, and those who need to be in a safe and controlled environment before facing the trauma.

You may fall into one or more of the categories. That's okay. Discuss with your therapist where you think you are. It is also possible that you may move from one category to another. That's okay. Healing is not a linear process.

Some people have experienced multiple traumatic events, myself included. This can further confuse the healing process. You may be ready to face one traumatic event but not another. That's okay. Different events affect people in different ways.

Don't give up

While it may not be advisable to focus on traumas, it is important to stay in counseling. It's like staying on your medication: feeling better does not mean you should quit. The relief may be from counseling or medication, and quitting either one can cause you to fall apart all over again.

"The pain is not dead," writes Matsakis. "If you drop out of counseling prematurely, you are only postponing dealing with the problem. If you are truly a trauma survivor, the pain, numbing, anger, or self-destructive behavior will resurrect itself again and again, until circumstances force you to look at it."

There are times, however, when you may have to drop out. For example, I fired one psychiatrist for telling me it was my fault I was sexually assaulted. However, it is important to stay in counseling, even if you have to change counselors.

Counseling is vital to recovery. However, it does not mean you have to face the trauma or traumas directly. It's okay to wait and work on coping skills. Inability to face the trauma or traumas is not a failure on your part; it simply means you need to work on something else for a while. It's okay to wait.