Although the DSM-V criteria for Borderline Personality Disorder does not include trauma, it is a common thread in those with the disorder. On Twitter I see tweets starting with "TW" (trigger warning) before something that may be triggering. It's a shared boundary for many in the mental health community. In DBT skills class we strictly enforce the rules about refraining from saying things that can be triggering. Sharing something triggering is rarely intentional. Sometimes those who don't have trauma don't realize how upsetting what they say can be or if someone is disconnected from their trauma, they may not understand how someone could be hurt by what they are saying.
This week myself and a client came to the conclusion that talking about her trauma only continues to hurt her more than help her. Creating a boundary became necessary since other clients continued to push her to speak about the trauma thinking that, like them, she needs to "get it out and give it away." In group, she announced this decision and the overall look was puzzlement, so we decided to allow questions as this appeared to go against everything they have been taught since being in therapy. The questions were in 3 categories; 1) doesn't keeping it in keep us sick? 2) How does talking about it make it worse? 3) So what are you going to talk about then? The group decided to respect her boundary, although they were skeptical. The end question was then "Ms. Paz, how is she going to work on her trauma issues without talking about it?" I spoke about how working on how the trauma affects you now; relationship issues, boundaries, PTSD symptoms and focusing on coping skills and grounding techniques instead of living in the past. The group was still unsure about this plan as it goes against what they have (thought) they have known for most their life.
Here are some ways to work on your trauma flashbacks without talking about the trauma itself [source]
Tell yourself that you are having a flashback when it's happening.
Remind yourself that the worst is over. The feelings and sensations you are experiencing are memories of the past. The actual event has already occurred and you survived. Now it is the time to let out the terror, rage, hurt, and/or panic. Now is the time to honor your experience.
Get grounded. This means stamping your feet on the ground to remind yourself that you have feet and can get away now if you need to. (There may have been times before when you could not get away, now you can.) Being aware of all five senses can also help you ground yourself.
Breathe. When we get scared we stop normal breathing. As a result our body begins to panic from the lack of oxygen. Lack of oxygen in itself causes a great deal of panic feelings; pounding in the head, tightness, sweating, feeling faint, shakiness, and dizziness. When we breathe deeply enough, a lot of the panic feeling can decrease. Breathing deeply means putting your hand on your diaphragm, pushing against your hand, and then exhaling so the diaphragm goes in.
Reorient to the present. Begin to use your five senses in the present. Look around and see the colors in the room, the shapes of things, the people near, etc. Listen to the sounds in the room: your breathing, traffic, birds, people, cars, etc. Feel your body and what is touching it: your clothes, your own arms and hands, the chair, or the floor supporting you.
Get in touch with your need for boundaries. Sometimes when we are having a flashback we lose the sense of where we leave off and the world begins; as if we do not have skin. Wrap yourself in a blanket, hold a pillow or stuffed animal, go to bed, sit in a closet, any way that you can feel yourself truly protected from the outside.
Get support. Depending on your situation you may need to be alone or may want someone near you. In either case it is important that your close ones know about flashbacks so they can help with the process, whether that means letting you be by yourself or being there.
Take the time to recover. Sometimes flashbacks are very powerful. Give yourself time to make the transition form this powerful experience. Don't expect yourself to jump into adult activities right away. Take a nap, a warm bath, or some quiet time. Be kind and gentle with yourself. Do not beat yourself up for having a flashback.
Honor your experience. Appreciate yourself for having survived that horrible time. Respect your body's need to experience a full range of feelings.
Be patient. It takes time to heal the past. It takes time to learn appropriate ways of taking care of yourself, of being an adult who has feelings, and developing effective ways of coping in the here and now.
Take Care,
Alicia