How Trauma Narratives Can Help Clients Heal

There are a lot of different ways trauma can manifest itself, and no two clients will experience trauma the same way. Whether your client experienced sustained trauma over a long period of time in their life or went through an isolated traumatic event, it can be uncomfortable and overwhelming for them to remember—or relive—those memories. 

Because of how uniquely trauma impacts different people, there are a lot of different ways you can go about treating it in therapy. Determining which treatment method is the right fit for a particular client will rely heavily on your clinical judgment and what your client feels comfortable trying as well. Based on your judgment and your client’s comfort level, one treatment method you can try is crafting a trauma narrative with your client. 

What Is a Trauma Narrative?

Simply put, a trauma narrative is a psychological technique used to help survivors of trauma make sense of their experiences. 

A trauma narrative is a collaborative counseling method designed to help clients objectify their past trauma, and view themselves as a whole person separate from that event. 

Crafting a trauma narrative in therapy allows clients to be the expert in their own lives, and helps them face their problems in a larger context, and as something separate from themselves. 

Are Trauma Narratives Part of Effective Treatment for Trauma?

Evidence suggests that developing and processing a trauma narrative in therapy can be helpful in the treatment of trauma in adults and children, depending on the client and the nature of their specific trauma. 

Often, past trauma can feel too intense to think about on its own, so creating a narrative around it can help externalize the event, making it easier for clients to look back on it with more clarity and less discomfort. 

How to Create Trauma Narratives in Mental Health Counseling

To create trauma narratives in mental health counseling with your clients, first start by educating your clients on what a trauma narrative is, and discuss with them if they think it would be something they’d want to try. By opening this discussion with your client, you’ll help them feel like they have autonomy in their treatment process—and you’ll also have the chance to let them know the potential pros and cons of a trauma narrative as a treatment option. 

If and when you and your client decide that creating a trauma narrative is the right choice, then you can jump into actually crafting your client’s story. 

Step 1: Get the facts down first

In this step, have your client write down (or dictate to you, if you choose) the objective facts of what happened to them. Go through the who, what, where, when, and why. It’s important to note that this stage may be especially painful to think about, so make sure you go slowly. If you’re working in a larger framework of trauma care, such as TF-CBT or NET, these offer useful guidance and context for managing direct discussions of the client’s traumatic experience.

Step 2: Layer in emotions and thoughts

Once you and your client have the basics of what happened, it’s time to go back and add in how your client was feeling and what they were thinking before, during, and after their trauma. This gives your client a chance to reflect and perhaps put language to any emotions or thoughts that they couldn’t name at the time. 

Step 3: Recognize discomfort

In the process of writing down or saying out loud their trauma narrative, your client may naturally begin to feel more comfortable talking about their trauma. Once they’re in a place where they can speak about their narrative with relative ease, then it’s time to encourage them to think about the parts that are still painful or uncomfortable to talk about, so they can eventually become more comfortable with those parts of their trauma narrative as well. 

You may need to go more slowly in this step too, and that’s okay. Make sure your client knows that you’ll go at their pace, and that you’ll help them explore all the parts of their narrative as they’re ready. 

Step 4: Challenge irrational thoughts

One of the benefits of a trauma narrative is it allows your clients the time and space to reflect on their trauma, and use that distance to recognize which thoughts at the time may have been irrational, and how they can change their mindsets going forward. 

It may take a while for your client to be comfortable reading or talking through the entirety of their trauma narrative, and that’s okay. As they reach that level of comfort, look back through their narrative together, and see if there are irrational thoughts there that you can challenge. You can use a CBT thought record, for example, to help your client challenge irrational or dysfunctional thoughts that may have come up during their trauma, and reframe those thoughts into a more functional or regulated mindset.

It may be helpful to remind clients here that the word “irrational” is used without judgment or negative connotation. “Irrational” thoughts are often the natural, sensible responses to a person being in a situation of great distress and working to survive it. Applying this term in retrospect doesn’t mean that the client made a mistake or did something wrong in the moment. It just means that what may have been useful (from a survival perspective) in the midst of a traumatic experience is often not useful in other contexts.  

Step 5: Reflect on growth

After your client’s trauma narrative is completed and they feel confident talking about it, ask them to take a step back. How have their feelings or thoughts about their trauma changed since the event occurred, and even since they started coming to therapy?

By encouraging your client to focus on how far they’ve come since experiencing their trauma, you can help them see that their trauma didn’t define them. Focusing on growth can also help clients feel more hopeful for the future, and you can use that to help them plan how they’d like to continue to heal going forward. 

Trauma Narrative Example

Here is a trauma narrative example to show you how the different steps can take shape.

Step 1: Get the facts down first

It was a Thursday night and I was getting ready to go to dinner with my partner. I took a shower and got dressed, and then I texted my partner that I was on my way. I got in my car to drive to their house. 

I had been driving for about 10 minutes when a black car cut in front of me. I slammed on my brakes, but I couldn’t stop in time, and the side of their car crashed into the front of mine. 

My car flipped over, and the other driver sped away. I was stuck in my car for a long time before help arrived. The paramedics were able to get my car open and pull me out. Then they rushed me to the hospital in an ambulance. I don’t remember much of the ride to the hospital, but I vaguely remember the paramedics talking and trying to stabilize me. 

Step 2: Add in thoughts and feelings

It was a Thursday night and I was getting ready to go to dinner with my partner. I was feeling really excited to see them because they had been away for a few days for work, and we hadn’t seen each other for a few days. I took a shower and got dressed, and texted them that I was on my way. I was running a little bit late, so I felt a little bit rushed. Then I got in my car to drive to their house. 

I had been driving for about 10 minutes when a black car cut in front of me. I remember jumping and my body tensing up when I saw it happen. My first reaction was to slam on my brakes, but I didn’t react in time. The side of their car crashed into the front of mine. 

My car flipped over and the other driver sped away. I remember feeling really mad that they left without stopping to check on me or exchange information. I was stuck in my car for what felt like a really long time before help arrived, and I was so scared that no one would stop or call for help for me. The paramedics finally arrived and were able to get my car open and pull me out. I was crying the whole time and even though I was still really scared, I was super relieved that they had arrived. 

They took me to the hospital in an ambulance. I had never been in an ambulance and was really freaked out. I don’t remember too much of the ride to the hospital, but I do remember the paramedics talking and trying to stay calm while they stabilized me. 

Step 3: Recognize discomfort

When the car first cut in front of me, I had a moment where I wondered if I could have avoided the accident, or if it was somehow my fault. After the accident when I was recovering, people asked me a lot of questions, and even though none of them directly asked me if I could have done anything differently, I felt like that’s what they were getting at under the surface. It made me feel really self-conscious and I doubted myself a lot. 

When I was in my car waiting for help, I wasn’t sure what would happen to me. I was scared no one would call for help and I would be stuck for hours, and I kept thinking about what my partner would think when I didn’t show up for dinner. I was also scared because I didn’t know how badly I was hurt, or how long it would take me to physically recover. 

Step 4 and 5: Challenge irrational thoughts and reflect on growth

Now I’m able to recognize that the accident wasn’t my fault. It was just that—an accident. It’s taken me some time to accept this, but I’m working on showing myself more grace, and it’s getting easier. 

I still sometimes feel anxious when I drive or ride in a car, but I know with time that’ll get easier too. I have good tools and resources to help me stay calm and grounded, and I know I’m doing everything I reasonably can to keep myself safe while still living the life I want. 

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