Trauma-Informed Care: How Rehab Can Support Post-Traumatic Growth 

Learning From Triggers

Trauma-informed care is sensitive to triggers. This word has been co opted and even denigrated in recent years, so it’s important to define it in this context. 

A trigger is an inciting event that elicits a strong emotional reaction which may be disproportionate to the present moment, but is a reasonable response to the past trauma you’ve experienced.

It is not true that being triggered means you are weak, or fragile, or maladjusted. On the contrary, triggers exist for good reason. The extreme emotional reactions they cause used to serve you well. With time, effort, and therapy, many people can overcome these disproportionate reactions. 

Triggers are unique to everyone. Some are very common; for example, many survivors of physical violence have trouble looking at gorey images. However, they can also be hard to predict. A bouncy pop song might be triggering if it was playing when you got in a terrible car accident. If you struggle with your family of origin, you may be triggered by a funny sitcom about a happy family.

Simply avoiding triggers is both impractical and ineffective. Even if you never play the radio in your home, that same bouncy pop song might come on the speakers while you’re at a grocery store. Isolating yourself from situations in which you might be triggered can prevent you from living the life you want. The long-term goal of trauma-informed care is not to protect you from triggers—although that may be a useful short-term strategy. You will instead learn how to regulate your emotions and tolerate difficult situations.

The first step toward building habits is to acknowledge your current patterns. From there, you can decide which of them are still helpful. The skills that got you to this point served an important purpose, but they may not be the skills you need to build a better life. 

Trauma, Addiction, and Mental Health

When you experience trauma, it’s natural to develop coping mechanisms that are appropriate to use in emergencies. These strategies are very important; they are designed to help you survive and ultimately escape. But life isn’t always an emergency. Some of these habits can become harmful if you keep using them after the danger has passed. For example, a person who grew up in a violent home might have learned to mistrust their family members. That skill was probably a very important defense mechanism during their childhood. In adulthood, however, that same skill has the potential to damage a romantic partnership. 

If you’re living in an unsafe situation, it’s normal to want to escape. If physical escape is not an option, you may turn to other means of escape, such as substance use. Researchers have found “that there is high comorbidity between PTSD with substance abuse disorders⁴ and other mental disorders.” Because of this well-understood connection, many rehab centers are well-equipped to offer trauma-informed care. 

“Even if the person doesn’t define for themselves that they have trauma history, we assume that they do,” says Dr. Monika Kolodziej, Program Director of McLean Fernside. She describes their trauma-informed approach:

“What that means is being very respectful of space. It means being a clear communicator. It means not overstepping boundaries. And it means introducing the possibility that treatment for trauma might be an important part of their recovery. So in addition to being sensitive and interacting with the person in a way that’s respectful, that doesn’t overstep boundaries or is not aggressive or confrontational, it also means providing treatment and skills.”

PTSD and CPTSD can also co-exist with or even cause other diagnoses, such as anxiety and depression. Scholars have also suggested a link between CPTSD and Borderline Personality Disorder (BPD);⁵ some even suggest that we stop differentiating between these two conditions.⁶ If you’re living through ongoing trauma, and develop an additional mental health issue as a result, it can be even harder to get out of danger. And once you do arrive at a safer place, these conditions can complicate the healing process. 

Trauma-informed care takes these many complexities into account. Rehab is a place to not only move past substance use, but also learn to cope with the underlying cause that led you to use substances in the first place.

Trauma-Informed Behavioral Health Services

Rehab is designed to be a safe, protected environment in which you can begin healing from trauma. You’ll have access to experts who can help you process your past experiences and learn new skills to use in the future. Without the added responsibilities of work, school, or caring for your family, you’re free to focus on yourself. This dynamic is especially important for people with a history of domestic violence, and anyone whose trauma has caused them to struggle with interpersonal dynamics. 

PTSD and CPTSD can be extremely isolating, both during and after the original trauma. That isolation can even be a key indicator of whether or not you’ll develop one of these conditions in the first place. For instance, if a person gets in a car accident and then has to wait for hours before an ambulance arrives, that waiting period might be just as emotionally damaging as the accident itself. After that traumatic event, it could also be hard for them to explain why they’re triggered by sitting quietly at the side of a road.

Rehab offers clients the opportunity to inhabit a safe and protected environment, without isolating them from care. By connecting with your cohort and your team of providers, you can learn how it feels to simultaneously exist in a private space and benefit from community support. 

Various rehab facilities offer different types of therapy for people with a history of trauma. Behavioral therapy is a particularly effective treatment. This approach provides clients with very specific tactics for navigating difficult situations, coping with triggers and urges, and living in accordance with their personal values. Some common styles of therapy for healing from trauma⁷ include cognitive-behavioral therapy (CBT), exposure therapy, and eye movement desensitization and reprocessing (EMDR). 

Each of these kinds of therapy looks at trauma from a slightly different vantage point, and it’s important to choose the one that’s right for you. EMDR, for example, aims to restructure the way memories are stored in the brain. Meena Lavender, Family Therapist and EMDR Practitioner at Camino Recovery, explains:

“If you had a filing system in your brain, it would house traumas in different sections of your brain. What EMDR does is access it one by one and processes that to eliminate the emotional charge it has.”

EMDR is just one example of trauma-informed care that simultaneously treats the mind and the body. This holistic approach can be helpful for clients who experience physical symptoms as a result of their emotional experience. In some cases, these symptoms can be extreme: panic attacks can be mistaken for heart attacks, and dissociative episodes can put a person at risk of physical harm. Ryan Soave, Director of Program Development at All Points North Lodge, states: 

“We hold trauma in our body, and stress is really the symptom of trauma. we can start working some of that stress out of the body, utilizing things like yoga, breath work, meditation, massage, the sensory deprivation tank, exercise and other types of functional movement, then when that stress is released from the body, it makes it easier to deal with the stressors that are going to come on a daily basis.”

The Ball, the Box, and the Button: A Metaphor for Healing

Imagine that, at the moment you originally experienced trauma, someone handed you a box. Inside it, you find a bouncy ball and a big red button, which is mounted on one of the sides. Whenever the ball hits the button, you’re reminded of your painful experience. That may mean you get triggered, feel anxious, and/or have the urge to engage in destructive behavior. 

At first, the ball and the box are almost the same size. The ball is constantly pressing down on the button, and you spend most of your time feeling the effects of what you’ve been through. This acute phase of healing from trauma can be very overwhelming. Without effective tools to regulate your emotions, it’s unfortunately easy to fall back on unhealthy coping mechanisms.

Over time, though, you learn. You grow. The box gets bigger, and the ball has room to bounce around. It spends less and less time pressing on the button. Your feelings may still be intense every time the button gets pushed, but you’ll have some space to breathe in between those moments. You’ll develop skills to manage your own reactions, and be better prepared for the next time the ball hits. 

This metaphor was originally developed to describe grief. And the process of healing from trauma is not unlike the process of grieving.⁸ Often, though, what you’re grieving is a version of yourself. As painful as that is, there is a well-charted path forward. 

Trauma-informed care offers people the space they need to get to know themselves again. This is your opportunity to redefine yourself, your life, and your values. Healing is a-linear, and there will always be good days and bad days. This process is intended to help you navigate them both. 

To learn more about your options for care, see our collection of residential rehabs offering trauma treatment here. 

Frequently Asked Questions About Trauma-Informed Care in Rehab