So trauma isn’t all just based on fear?? Shame has been increasingly recognized as a key component of PTSD reactions for many individuals. Research has found that it can even play a major role in many aspects of PTSD and how it develops over time. So what options are there for shame and trauma treatment?
Shame can also be a pretty difficult obstacle for clients to overcome. It can even sometimes pose a barrier to effective treatment. Good news for us, there are multiple good methods to learn to help support patients and provide treatment of trauma and shame!
Shame from trauma is actually very amenable to cognitive processing therapy (CPT). CPT directly targets beliefs about one’s role in a traumatic event(s) that contribute to shame and moral injury. There is a good training on CPT from one of its developers. There is also an excellent podcast that can take you or your client right through the process.
Shame-based PTSD is not always cut and dry, though. Or clients can have understandably very difficult reactions to exploring it. Alternative methods may be helpful to approach client shame or to compliment approaches you may already use. The NICABM has a good series of trainings with some pretty big names to help with other practical strategies.
Pros. Both the CPT and practical strategies trainings provide concrete research-based strategies clients can learn. CPT in particular has extensive research support since the 1990s. Strategies from both trainings come in addition to helpful ways to talk clients through their experience in session. Highly respected researchers who have done a lot of work related to difficulties conduct these trainings.
Limits. Most (but not all) of the researchers in the practical strategies training (the second mentioned above) do not appear to be experts in trauma, specifically. So those trainings to not appear to cover the nuances of how shame in particular interacts with trauma (only how to deal with each individually). This does not mean it is not a good training, however. Like all trainings, these cannot guarantee 100% success with any client, but do appear to have some very helpful approaches.
Shame that arises from PTSD can be a tough experience for someone to navigate. It’s no wonder we want to do the best we can to support our clients through those experiences. Targeted trainings can help us fulfill that exact mission!
