A Stages Model

The most common approach to thinking/feeling about the process of recovery from trauma or abuse is to conceptualize it as working through a series of stages. Herman summaries several such models in a helpful table (Judith L. Herman, Trauma and Recovery, BasicBooks, 1991, p 156]

Syndrome Stage One Stage Two Stage Three
Hysteria(Janet 1889) Stabilization, sympton-oriented treatment Exploration of traumatic memories Personality reintegration, rehabilitation
Combat trauma(Scurfield 1985) Trust, stress management, education Reexperiencing trauma Integration of trauma
Complicated post-traumatic stress disorder (Brown & Fromm 1986) Stabilization Integration of memories Development of self, drive integration
Multiple personality disorder (Putnam 1989) Diagnosis, stabiliation, communication cooperation Metabolism of trauma Resolution, integration, development of postresolution coping skills
Traumatic disorders (Herman, 1992) Safety Remembrance and mourning Reconnection

 

Others have produced models involving many more ‘stages.’ For example, Bass and Davis suggest the following 14 stage model: (Ellen Bass and Laura Davis, The Courage to Heal, Harper and Row 1988 pp 58-59)

1. The Decision to Heal. Once you recognize the effects of sexual abuse in your life, you need to make an active commitment to heal. Deep healing happens only when you choose it and are willing to change yourself.

2. The Emergency Stage. Beginning to deal with memories and suppressed feelings can throw your life into utter turmoil. Remember, this is only a stage. It won’t last forever.

3. Remembering. Many survivors suppress all memories of what happened to them as children. Those who do not forget the actual incidents often forget how it felt at the time. Remembering is the process of getting back both memory and feeling.

4. Believing it Happened. Survivors often doubt their own perceptions. Coming to believe that the abuse really happened, and that it really hurt you, is a vital part of the healing process.

5. Breaking Silence. Most adult survivors kept the abuse a secret in childhood. Telling another human being about what happened to you is a powerful healing force that can dispel the shame of being a victim.

6. Understanding That It Wasn’t Your Fault. Children usually believe the abuse is their fault. Adult survivors must place the blame where it belongs – directly on the shoulders of the abusers.

7. Making Contact With the Child Within. Many survivors have lost touch with their own vulnerability. Getting in touch with the child within can help you feel compassion for yourself, more anger at your abuser and greater intimacy with others.

8. Trusting Yourself. The best guide for healing is your own inner voice. Learning to trust your own perceptions, feelings and intuitions forms a new basis for action in the world.

9. Grieving and Mourning. As children being abused, and later as adults struggling to survive, most survivors haven’t felt their losses. Grieving is a way to honor your pain, let go, and move into the present.

10. Anger. The Backbone of Healing Anger is a powerful and liberating force. Whether you need to get in touch with it or have always have had plenty to spare, directing your rage squarely at your abuser, and at those who didn’t protect you, is pivotal to healing.

11. Disclosures and Confrontations. Directly confronting your abuser and/or your family is not for every survivor, but it can be a dramatic, cleansing tool.

12. Forgiveness? Forgiveness of the abuser is not an essential part of the healing process, although it tends to be the one most recommended. The only essential forgiveness is for yourself.

13. Spirituality. Having a sense of a power greater than yourself can be a real asset in the healing process. Spirituality is a uniquely personal experience. You might find it through traditional religion, meditation, nature or your support group.

14. Resolution and Moving. On As you move through these stages again and again, you will reach a point of integration. Your feelings and perspectives will stabilize. You will come to terms with your abuser and other family members. While you won’t erase your history, you will make deep and lasting changes in your life. Having gained awareness, compassion and power through healing, you will have the opportunity to work toward a better world.

The whole concept of ‘stages’ implies that the process of recovery has texture — something that is helpful at one stage of the process may not be helpful (or as helpful) at another stage. For example, the kind of group process that is helpful in the earliest stages of recovery may not be optimal in later stages. This will have very significant implications for any ministry strategy.

It is important to emphasize that most people who conceptualize recovery as a series of stages do not think of recovery process as linear. The work that needs to be done in one stage may need to be revisited as part of later work. The process may need to be repeated multiple times. The boundaries between stages may be quite fluid. Many other kinds of complications are possible. It is also important to emphasize that ‘stages’ does not imply a gradual movement from ‘easier’ stages to ‘difficult’ stages. All the stages are demanding, challenging.

My instincts are that the three-stage model has some advantages. Longer lists may provide a more comprehensive list of the tasks that need to be done — but they don’t usually help much in figuring out which things are best done first and which things might be better to do later.

6 Responses to “A Stages Model”

Read below or add a comment...

  1. gina says:

    Thanks for the article, I wanted to find information on the process that I am familiar with as I am going through it now. It is definitely true that telling others is healing, its powerful. I wish the healing process was easy but its not. It takes so much effort, work and support from yourself and others. It takes the true desire to be free, alive and in the moment (back to our natural selves) … I think probably the most difficult thing would be to confront my abuser, you might need to put him in a cage this way I can’t punch him in the face! I am angry, and id like to get that out in a good way. The way that I am able to forgive is to visualize my abuser being punched, or slapped around, belittled and abused as a child by his caretakers… it helps me have a sense of compassion and understanding… and realization that he is more wounded than he could ever be punched in the face by me a trillion times. But, its tough because as I said I get angry now and feeling a lot at this stage. I mourn both the parents I never had. Feel upset and sad for things they did and as a child didn’t understand were wrong. I am going on and on, but I just feel good to write about it. Again thanks for the article because I can see the stages and all the processes you go through, in no particular order and glad to see that I have been doing them and on the right path.

  2. Ellie says:

    Wow. Thats cool. I am recovering, and although it still hurts inside, I have become a much stronger Christian.
    The biggest turning point for me was telling someone. She supports me, and never put me down, which means so much to me. Now I have someone to go to, who knows they could never understand the pain of the verbal abuse, but can be there to tell me to not put the blame on myself. In a way, she boosts confidence, and keeps me in line with God. I learned instead of it bothering me, go pray, because Jesus knows pain.

  3. Lara says:

    One of the hardest parts I find about healing is that society allows this kind of abomination and destruction to occur. The hardest part is facing a culture of widespread denial. It reinforces my own fears that we live in a world where the most vulnerable beings are openly exploited, ie, the fact that there are sex trades of women and children. Even in the context of maintaining ongoing employment, people can smell vulnerability in others. There will always be people who seek to manipulate and alienate the vulnerable, leading to ongoing unemployment, poverty and alienation. It’s a vicious cycle. How many men are out there campaigning for legislative changes to protect women and children. I wonder how many more millions of children will have to suffer because conservative political forces believe that they will profit by their inactivity? Because of what I’ve been through, I will never bring children into this world. I believe that I’d be acting irresponsibly to do so. Besides falling into poverty, not being well enough to bring a child into the world is just one of many experiences of loss that I have to, but am struggling to come to terms with. What’s been done to me hurts so much that I often feel overwhelmed by the internal sense of chaos that being incestually abused has left me with. I have days when I believe that I’d at least have some peace if I was dead. I’m struggling to find forgiveness because I am reminded each day by not having a job or a family that my past represents an ongoing series of reinforcing beliefs; that I am a failure. It hurts so much to have no feelings of internal and external safety. Many elements in society have no understanding of this, nor do they want to help in anyway, when I feel that I’m beyond finding redemption. Sorry for the pessimism. It just feels very real right now.

  4. Nisha says:

    Lara-
    reading your post reminded me so much of how I have felt over the years. For so long I have believed myself irreperably damaged by my past. That voice that tells us we are failures– it’s not us–it’s the voice of pain, a pain that will not stop until it is acknowledged and released…it’s not the pain of the wounded you, but the pain of the REAL you, somewhere inside. When you start listening to her, you will finally see that there is something deep within each of us that will always remain whole, no matter what it is we have experienced. You have to have the courage to strip yourself down to this core, through the layers and layers of pain, in order to rebuild your life. But you CAN.
    therapy helps, and medication, to ease the depression…
    Good luck, and don’t stop trying…
    Nisha

  5. KC says:

    I can’t agree more to this…I see I’m on track…been through a lot and confronting..hmm…that’s something I’m dying to do, but not ready. I could of this past week, but the person(ex-friend) wasn’t around as I bumped into her significant other at a coffee shop.
    The pain is there and it hurts. It hurts so bad that I wish it never happened. I think the best feeling I had was punching the person in my dream…it felt good when I woke up!
    Forgiving is another issue I’m dealing with. Does she really deserve my forgiveness whom she took advantage. Anyway…it just hurts at times…getting stronger, but ya, it hurts. I did not know that when you tell people it makes it stronger. I never saw that before. I was close to tell her husband, but I don’t think he would believe me much but then it would set her off and I would be in trouble. So, I left it the way it is. There was verbal, emotional, a bit of physical abuse. Toxic friendship (she was a mother figure too, which hurts more) then…anyway…how long does it take for it to pass, the feelings and the healing? I mean, I’ve been going to therapy since January. There are days where I’m fine, and then there are days where I am not. It hurts a lot. I’m guessing it is normal.
    Someone told me that its also a grieving stage too, and if I need to cry I should just let it out. Its hard, even when you are at work, but I have managed.
    Anyway…I see that I am on track though…it is tough too…

  6. one of the best things to incorporate with Stress Management is meditation and deep breating exercises.`;*

Leave A Comment...

*