Resumen de Building Skills, Not Stories: Chronic Trauma and Resilience-Building
Trauma studies tend to focus on traumatic narratives - the telling and re-telling of trauma stories. Current evidence-based trauma therapies work almost exclusively with trauma narratives, and assume a basic level of client safety. When clients continue to live in unsafe and unstable environments, however, working towards a trauma narrative can be ineffective and even harmful. This chapter will look at the critical question of how clinicians provide effective trauma therapy even in an environment with limited resources. We will explore how to identify and strengthen existing coping skills; assist with limited and contained processing; and enhance client resilience. Our chapter will discuss differences between acute and chronic trauma, and highlight major theories and evidence-based trauma practices. We will then look at limitations and risks of current modalities when working with clients still living in chronically traumatizing and/or stressful environments. We highlight the danger of focusing solely on the traumatic experience when the client remains in an unsafe environment, arguing it can emphasize the fragmentation of the person and potentially reinforce cognitive distortions. We will share our adaptations of trauma therapies, which combine existing evidence-based trauma practices with insights from the harm-reduction framework common in addiction counselling. We will show how working with chronically traumatized clients requires a strongly relational approach for maximum efficacy. Our model can also be used when there are other significant constraints, such as limited or sporadic access to therapy. Our approach highlights working collaboratively with the client towards a goal of increased resiliency and skill-building, rather than the cessation of most or all symptoms. We will show how this approach can later be used as a foundation for traumatic processing if / when the client’s environment becomes more stable.
