Phase One: Stabilization
Experts have come to an agreement that trauma therapy, no matter what kind of therapy is used, should occur in three phases. This is sometimes called the Tri-Phasic treatment model. The first phase of trauma therapy is stabilization. In this phase, the person with the trauma is learning skills to help with emotional regulation. This phase could also include a more stable living arrangement, such as getting free from an abusive partner. In the case of Dissociative Identity Disorder, this phase would also include learning about DID and developing communication with members of the system. For some people with the most severe cases of DID, trauma therapy may never go beyond this phase as they continue to work on stabilization. Some people choose to stop after this phase because they feel like the improvements they have made are enough to get by in life.
Phase Two: Memory Processing
Phase two is what people often think of when they think about trauma therapy. In this phase, the work is focused on processing the traumatic memories. This comes second because the person needs the emotion regulation skills to be able to cope with the emotions that this trauma processing can bring up. Without those skills, the person would likely become overwhelmed and further traumatized. If you start therapy with someone who wants to immediately jump into memory processing without making sure you have the skills for regulating your emotions, please find another therapist.
Phase Three: Adjusting to a Life No Longer Dominated by Trauma
Phase three is often overlooked by people. By this point, they have dealt with their traumatic memories. Those memories no longer haunt them. So many people feel like this is enough and leave therapy at this time. And, truthfully, people have been in therapy for quite a while at this point. Some people are just ready to be done, which is very understandable.
Phase three, for those who continue on, is focused on gaining the skills and experiences that you didn’t get at the usual time developmentally. It is also focused on helping you adjust to your world as a person who is no longer actively haunted by memories of trauma. The old ways you dealt with the world, the ways that protected you from trauma, no longer fit and you need to find new and healthy ways to deal with the world and its challenges. That’s also the focus of this phase. Another component of this phase can be processing the grief and sadness that can arise as you heal and realize what you missed out on growing up and what the traumatic past has cost you.
Treatment Cycles Through the Phases Repeatedly
These phases as I’ve described them sound very linear and very clear cut. First we do phase one, then phase two, and perhaps then phase three. In actual practice, it’s not like this. During the work of phase one, a particular traumatic memory might come to the surface and need to be processed so that it is not blocking progress. And sometimes in phase two, the therapist and client will realize that some additional skills building could be helpful for healing. This can happen in phase three, as well, where a memory suddenly makes itself known and needs to be processed or more skills need to be developed. So in actuality, treatment for trauma is moving from one phase to another as needed but overall the work is centered in one phase at a time.