You can’t be defined as just one thing. So healing requires looking at all of the things that make you, you. Gestalt therapy shows how all the facets in your life impact you. This approach honors that both you and your environment are always shaping each other. And you can learn how to make this relationship a positive one.
In rehab, gestalt therapy can empower you to move forward from what’s holding you back.
This therapy works by bringing you into the present moment to heal.2 It focuses on the here and now. You can still look at past experiences that you want to work through. But by focusing on what you’re feeling right now, you’re better able to understand and regulate your feelings. Gestalt therapy aims to help you make peace with the past, so you can move on to a brighter future.
This healing journey encourages you to reconnect with and accept buried parts of yourself. It also urges you to be accountable for how you live your life. While we can’t always control our circumstances, learning to adapt to the unpredictable can be hugely empowering.
How It Works
The key to Gestalt therapy is trust: trusting your therapist and trusting yourself. Doing so helps you develop the self-awareness to recognize patterns you want to change.
In session, your therapist focuses on empathizing with you. By giving unconditional acceptance, they’ll provide a safe space for you to heal. They’ll do much more listening than talking.
Gestalt Therapy Exercises
Gestalt therapy takes a hands-on approach to healing. This experiential therapy will have you do more than just talking. In a session, you might do exercises like the following, including some that focus on analyzing body movement:
“I” statements: Instead of “they were mean to me,” for example, you might say: “I feel that they’re being mean to me.” Using this kind of phrasing helps you take responsibility for your thoughts and emotions instead of blaming them on others.
The empty chair: You’ll face an empty chair, representing someone or something, and have an open conversation with it. Here, you’ll work through your unprocessed experiences—what Gestalt therapy refers to as “unfinished business.” The empty chair method3 releases negative feelings, making life more joyful.
The reversal technique: Your therapist will encourage you to act in ways you normally wouldn’t. If you’re normally passive, for example, you might act assertively. This allows you to overcome self-imposed labels and get in touch with your full self.
Top dog vs. underdog: You’ll speak as both the “top dog” and “underdog” of your personality. That is, you’ll speak as your own dominant side versus your submissive side. This exercise reveals internal conflict and empowers you to work toward a middle ground.
Exaggeration: Your therapist will ask you to repeat certain actions, like your leg bouncing or picking your nails, that you do while talking. By doing this action again, you’ll see what emotion it’s tied to. Understanding this mind-body connection is grounding and allows you to develop control of your emotions.
Gestalt therapy is process-oriented,5 unlike many other therapies. This means that it follows the flow of the therapy session and does not have specific rules or a timeline. If you need more structure, Gestalt therapy may not be a fit.
Gestalt Therapy for Mental Health
When you’re in the present moment and self-aware, your mental health benefits. If you’re feeling stuck in old ruts, Gestalt therapy may be able to help you break out of them.
Gestalt Therapy for Trauma and PTSD
Your body stores trauma.6 And Gestalt therapy can help you safely explore it. Focusing on how your body is currently moving or feeling can help you process your past. As trauma expert Dr. Bessel van der Kolk explains:
If you have bodily or sexual trauma, approach Gestalt therapy with caution. Trauma sits differently for everyone, so what may work for others could be triggering for you. Your treatment team can help you decide which modalities are best suited for your goals.
Gestalt Therapy for Trauma Anxiety
Anxiety often starts from stress about your past or about the unknown future. Gestalt therapy can decrease anxiety9 by helping you focus on the now. It can also increase self-love by showing you that all parts of you are worthy. For many, recovery is a lifelong process, and this therapy can support lasting healing.
Addiction and Gestalt Therapy
Addiction might begin as self-medication to cope with stress or other mental health concerns. Learning to accept your life in the present through Gestalt therapy could be a powerful tool for setting yourself free.
Your therapist will look at you as a whole person, instead of just a set of addiction risk factors. Professionals at Monarch Shores explain that the biggest goal in recovery with Gestalt therapy is growth. As you grow to accept your life, you’ll also grow to embrace who you are. And in doing so, you’ll be more motivated to make positive changes.
The fundamental skills Gestalt therapy teaches are also useful for preventing relapse.10
Healing Your Present–and Your Future
You are a collection of every experience in your life. When you learn to love and accept all of the elements that make up who you are, you become a stronger whole. Radically accepting everything you feel can help you focus on the present moment—and find freedom from the past.
Rehab isn’t just for addiction recovery. That’s a common reason to start treatment, but it’s not the only one. You can also go to rehab to heal from trauma.
These are often short-term reactions in the immediate aftermath of the event. But for some people, they become ongoing symptoms. If that’s the case, you can ask your doctor to evaluate you for PTSD.
Post-traumatic Stress Disorder
PTSD is a prolonged reaction4 to a finite traumatic experience. This could be a single event, like a car accident, or a period of time, like a tour of duty in the military. Symptoms of PTSD include the following:
Flashbacks
Sleep problems like nightmares
Avoidance, where you stay away from reminders of your trauma
Feeling tense
Angry outbursts
Loss of interest in your passions
To fit the criteria for PTSD, these symptoms need to last for more than a month and interfere with your quality of life.
In addition to the symptoms of classic PTSD, people with c-PTSD may also experience the following:
Dysregulated emotions
A negative self-image
Difficulty forming and maintain healthy relationships
While treatment for these diagnoses is similar, c-PTSD can cause additional challenges.
Co-occurring Trauma and Addiction
Studies indicate a strong link between addiction and traumatic experiences.6 There are several reasons for this. Drugs and alcohol can offer a temporary distraction from the pain of trauma. Or, you might decide to self-medicate in order to manage your symptoms.
It’s all too easy to get caught in a cycle of trauma and addiction. That’s true for a few reasons. First, drug and alcohol use can make your mental health worse. And second, addiction itself can be traumatic. You might find yourself in dangerous situations because of the way you obtain or take drugs. Those experiences can compound your trauma. But without support, drug use might be the only way you know how to manage your symptoms.
What Happens in Rehab for Trauma?
If you’re having a hard time healing on your own, you might benefit from residential treatment. There, you’ll have the time and space to focus on healing, instead of just surviving.
What is Trauma-Informed Care?
Trauma-informed rehab programs provide treatment in a safe and empowering way. Clinicians are sensitive to your concerns, and may have special training in trauma recovery.
Trauma symptoms can put you on high alert,7 even if there isn’t any danger. The tranquility of a trauma-informed treatment center can help you stay centered. For example, you might attend therapy in a soundproof room, so there’s a lower chance of loud noises. Or, your massage therapist might ask for consent before starting every session.
This type of care accommodates your needs, but it won’t insulate you from all your triggers. Instead, you’ll learn how to navigate them while keeping yourself safe. Rehab gives you the chance to practice new coping skills before you reenter a less curated environment.
A Framework for Recovery
While you can heal from your trauma in an outpatient setting, going to residential treatment offers unique benefits. For example, keeping a consistent schedule helps people with PTSD feel safe.8 And when you attend inpatient treatment, your days will have a set routine. It’s common for people to feel overwhelmed after trauma,9 so taking a break from making certain decisions can be a relief. That way, you can focus on your recovery, instead of what you’re going to have for dinner.
A Calming Environment
It’s much harder to heal in the same place where you got hurt. If your trauma happened close to home, a change of scenery might be necessary for recovery. Studies even show that changing your environment can improve your mood.10
Everyone’s healing process is different. That’s why so many luxury rehabs offer personalized care. During inpatient treatment for trauma, you can access several different types of therapy in the same program. This empowers patients to take control of the healing process, under the expert guidance of their care team.
Cognitive Behavioral Therapy
Cognitive behavioral therapy (CBT) is a popular treatment for trauma symptoms.15 In session, patients learn to recognize and work through thought patterns that no longer serve them. This is easiest to understand with triggers. For example, after an accident, you might feel intense fear about getting into a car. CBT can help you put that feeling in context. Instead of avoiding cars altogether, you could learn how to calmly assess whether it’s safe to drive. And then, additional CBT skills can help you stay centered while you’re on the road.
Prolonged Exposure Therapy
Prolonged exposure therapy (PE)16 is a type of CBT. In PE, you’ll confront your trauma head-on. Patients do this by recounting their most painful memories in great detail. As you tell the story of what happened, your therapist may encourage you to engage your 5 senses. What did the room smell like? What noises did you hear? How did your body feel?
PE isn’t easy. The goal is to trigger yourself, purposely causing an intense emotional response. But as you return to the same memory over and over again, you’ll become desensitized to it. Eventually, you’ll be able to think about what happened without feeling triggered at all.
If you’re healing from complex trauma, you may need to repeat this process with a few different memories. Over time, PE helps patients regulate their feelings in and outside of sessions.
Cognitive Processing Therapy
Cognitive processing therapy (CPT)17 helps you address the emotional fallout of trauma. With a therapist’s guidance, you’ll explore the way you feel about what happened. Early in treatment, you’ll write a trauma impact statement.18 There, you’ll describe why you think your trauma happened, and list its lasting effects on your life. Then, you’ll recount a traumatic experience and talk through the way it makes you feel.
While this process is a lot like PE, the goal is a little different. Instead of desensitizing yourself, you’ll work to understand why you feel the way you do. For example, self-blame is a common response to trauma.19 If you feel guilty about what happened, you might practice self-compassion during CPT. You’ll also learn how to cope with the triggers you encounter in daily life.
Eye Movement Desensitization and Reprocessing
Eye movement desensitization and reprocessing (EMDR)20 uses visual or audio cues to help you process your trauma. First, you’ll learn more about trauma and coping skills. Then, you’ll identify a “target” traumatic event. For about 30 seconds, you’ll focus on that target as you pay attention to an external cue.
Studies indicate that EMDR helps patients reduce anxiety and other PTSD symptoms. But it can also be emotionally taxing to concentrate on your trauma. You might feel triggered or vulnerable after a session. But in residential treatment, you won’t have to jump right back into other tasks after EMDR.
These methods aren’t replacements for talk therapy, but they can work well as complementary therapies. In rehab, you can combine holistic treatments with more traditional techniques.
What Are the Stages of Trauma Recovery?
No matter what therapy you use, it still takes time to heal from trauma. And healing is nonlinear. As you grow and change, your feelings about what happened might change, too. For example, some people have trauma from romantic relationships. They might feel completely healed—while they’re single. But then new triggers might come up when they start dating again.
While everyone’s process is different, experts describe 5 distinct stages of trauma recovery.23 You might progress through these in order, or all at once. You might even revisit some stages more than once. But as you heal, it’s likely that you’ll touch on these different perspectives.
Trauma Processing and Reexamination
Processing your trauma is an important part of recovery. Therapies like CBT and PE help you understand the effects of what happened to you. By working through your past triggers, you can focus on the present, and start to build a meaningful future. Living on-site in a rehab program helps you focus on healing, without the distractions of daily life.
Managing Negative States
During rehab, you’ll learn more sustainable coping strategies. And when you encounter triggers, your care team will likely be on hand to help you practice them. As you develop those skills, you can let go of any behavior—like addiction—that doesn’t support your growth.
Rebuilding the Self After Trauma
Trauma can make you feel disconnected24 from yourself. During rehab, you can rebuild your confidence and self-esteem. There are several ways to work toward that goal. Holistic therapies, for instance, can help you reintegrate different parts of your identity.
Connecting With Others
Trauma affects the way you relate to other people.25 And no one exists in a vacuum. On the contrary, healthy relationships are vital to recovery. There are countless ways to approach this part of healing. You might connect with other patients, or join a support group. But those options don’t work for everyone. Some high-profile clients, for instance, may need confidentiality during rehab. If privacy is a priority, you might consider family therapy with your closest loved ones.
Regaining Hope and Power
After you survive trauma, serious danger stops being theoretical. You know from personal experience that getting hurt is a real possibility. It’s happened before, and it might happen again. Recovery means learning to live a rich, beautiful life in the face of that uncertainty. Treatment can help you regain your power and hope for the future.
Compare luxury rehabs that treat trauma and reach out to them directly to learn how you can get started on your healing journey.
Trauma can be an isolating experience. When you go through something so painful that it changes you, it’s natural to feel like no one else can understand your new reality. You may have trouble connecting with the people around you, or no longer enjoy activities you once found meaningful. No matter how hard it is at first, remember: this is not the end of your story. You can always create a new beginning.
By going to rehab, you can get help from experts in trauma, PTSD, and CPTSD. The simple fact that these experts exist is proof that trauma is extremely common. You may feel isolated, but you’re certainly not alone. Depending on your program, you can also spend time in rehab building community with people who have life experiences like your own.
Diagnosis After Trauma: PTSD and CPTSD
This process can teach you a great deal about your own perspective. There are countless kinds of trauma, and everyone’s response to it is unique. For the most part, however, people whose mental health has been severely impacted by trauma are diagnosed with PTSD and/or CPTSD.
PTSD
Post-Traumatic Stress Disorder1 (PTSD) normally develops in response to trauma that occurred in a discrete, specific amount of time. It’s often diagnosed in veterans and survivors of sexual assault. This condition is characterized by many symptoms, including but not limited to the following:
recurring, involuntary, and intrusive memories of the traumatic event
flashbacks and/or dissociation
avoidance of reminders of the traumatic event
dissociative amnesia
persistent negative beliefs and/or self-blame
feelings of alienation
PTSD can be overwhelming. You may have the sense that one moment, or one brief period of time, permanently changed your emotional capacity. And that might even be true. But it doesn’t mean you’ll always be in pain.
Paracelsus Recovery in Zurich, Switzerland takes developmental trauma into account when addressing mental health and addiction issues.
CPTSD
Complex Post-Traumatic Stress Disorder2 (Complex PTSD or CPTSD) is similar but not identical to PTSD. This describes people who have experienced prolonged trauma, such as long-term domestic abuse or long-term childhood trauma. While many veterans who served only one tour have PTSD, those who spent years in active service, and especially those who were detained in Prisoner of War camps, may in fact have CPTSD. The term may also apply to people who grew up in violent neighborhoods or spent time in prison.
CPTSD is not yet officially classified as a diagnosis by the DSM-V (the American Psychiatric Association’s manual for assessing and diagnosing mental health conditions). However, many clinicians use it as a framework for discussing their clients’ experience. The term has been in use since at least 1988, when Dr. Judith Hartman of Harvard University suggested that the symptoms of long-term trauma may require a different kind of treatment than those of PTSD. She referred to a number of specific symptoms:
self-destructive behavior, such as impulsivity and substance misuse
emotional difficulties, including rage, depression, and panic
chaotic personal relationships
dissociation and personality changes
Although CPTSD is not yet classified as a medical diagnosis, a growing number of healthcare providers use the concept as a therapeutic tool. It may very well be included in a future version of the DSM. Even now, many people in recovery identify with the term. Like any diagnosis, this is not only meant as a way of explaining ineffective or damaging behavior. Instead, it can help you define your experience in order to chart a path away from destructive patterns.
What Is Trauma-Informed Care?
“Trauma-informed care“3 refers to a variety of healthcare practices that take into account the unique experiences of people with a history of trauma. Providers may be experts in treating PTSD and CPTSD, and they may offer special accommodations for certain clients. For example, when a survivor of assault sees a massage therapist who offers trauma-informed care, the therapist might make it a point to ask for verbal consent before touching any new area of their body. The provider’s goal is to treat the client with respect, making sure they feel as safe as possible throughout the healing process.
Trauma-informed care takes the client’s past, present, and future into account. It’s not productive or even possible to ignore the original traumatic event while trying to move forward. Jan Garber, the CEO of Paracelsus Recovery, explains:
“When we’re looking at trauma, we often look at family of origin to understand how people were shaped and how that then informs how they react in life and how they relate to others.”
He adds, “If someone’s coming to us, most of the time they’ve identified a set of symptoms that’s saying, ‘Hey, stuff in life isn’t well, or it’s not working the way it could.’ So that’s the smoke, and where there’s smoke, there’s fire. So we want to really look at where that fire is and how the fire started.”
Looking at the root cause of trauma is not about assigning blame. It’s unlikely that you caused your own trauma, and it’s certainly not true that you’re responsible for other people’s behavior. You did not make this mess; or at least, you didn’t make it alone. Whatever or whomever the source of your pain may be, though, healing is your responsibility. That can feel very daunting, especially for people who experienced childhood trauma. Remember that you are not the first person to feel this way. There is a great deal of research that can guide you through PTSD and CPTSD, and your healthcare providers are there to help you navigate it.
McLean Fernside in Princeton, Massachusetts recognizes clients’ need for trauma treatment as an essential part of recovery.
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.
Camino Recovery in Vélez-Málaga, Spain uses EMDR to help clients reduce the impact of traumatic memories.
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.
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.
Frequently Asked Questions About Trauma-Informed Care in Rehab
What is trauma-informed care in rehab?
Trauma-informed care in rehab is an approach to treatment that recognizes the impact of past traumatic experiences on an individual’s mental, physical, and emotional health. It focuses on creating a safe and supportive environment for healing and recovery.
What are the key principles of trauma-informed care in rehab?
The key principles of trauma-informed care in rehab include safety, trustworthiness, choice, collaboration, empowerment, and cultural sensitivity. These principles inform every aspect of treatment, from the initial assessment to ongoing support after leaving rehab.
What are the benefits of trauma-informed care in rehab?
Trauma-informed care in rehab benefits individuals by taking their experiences and trauma into account to provide a safe and supportive environment for recovery. This can foster a sense of empowerment and autonomy, which may lead to improved mental health outcomes.
