Author: Eric Palmquist

What if you could measure progress while healing from trauma?

When something traumatic happens to you, it stays on your mind. Memories and thoughts of the traumatic event become fused to your consciousness like burnt rice stuck to the bottom of a pot. These thoughts may be painful, confusing, frustrating, and discouraging. Immediately after the traumatic event, it’s all you can think about. Over time, the amount of time you spend thinking about it declines; burnt rice slowly is scraped off the bottom of your pot of consciousness. As we continue to heal, there become larger and larger gaps between thoughts and memories of our trauma. 

Eventually, when the source of trauma is far behind you, you start to wonder when your recovery will be complete. Will your pot of rice ever become clean again? Will you ever stop thinking about a past traumatic event? Can you finally shake that memory out of your consciousness? 

How can you tell that you’re moving on? How do you measure healing?

We can use the length of time between thoughts and memories of trauma to measure the stage of healing that we’re in. The longer we go between these painful thoughts, the more we have healed. Using familiar units of time, we can measure if we are making progress. When we no longer often think about a particular source or instance of past trauma, we have fully recovered. Whether it’s physical, relational, mental, or any other type of trauma, a ten-stage framework can help recognize the progress we are making in healing and be a source of optimism to fuel further healing.

This framework can be explored using any example of trauma, big or small. It works for all types of trauma, too. Breakups, parental relationships, personal failures, and grief all are valid examples to use the ten stages. 

Let’s say, for example, you get into a nasty car crash. You are driving straight through a green light and a driver in the oncoming lane turns left into you, totaling both cars. You are now seriously injured, partially conscious, riding in an ambulance to the hospital, and will require a week-long stay with multiple surgeries. The following ten stages, with their respective car crash examples, describe ten stages of moving on from trauma.

Stage 1: The only thing you can think about. The crash just happened, and you have no idea what’s happening. In shock, you try to gather information about what is going on. You have blood all over you, and an EMT is helping you calm down as you are loaded into the ambulance. You don’t, won’t, and can’t think about anything other than the car crash and its related immediate concerns.

Stage 2: You have your first non-trauma thought. Stage 1 ends maybe 20-30 minutes after the car crash when you have your first thought unrelated to the crash. You realize you’re thirsty and need a drink of water when you get to the emergency room. Congrats! You’re in stage two, and you have already started healing.

Stage 3: You go a minute without thinking about the traumatic event. At some point at the hospital the evening after the crash, you complete a sustained minute of thinking that doesn’t involve anything about the crash. Maybe you have a cordial conversation with your doctor, for example. With this minute, you become one stage closer to healing.

Stage 4: You go an hour without thinking about the traumatic event. At the end of your hospital stay, between surgeries, you are watching your favorite sports team on the TV in your hospital room. As the game comes down to the final play, you realize that you haven’t thought about the crash since halftime.

Stage 5: You go a day without thinking about the traumatic event. You’re four months removed from the accident. The injuries have largely healed, and the insurance paperwork has ended. You’re back at work, getting in your car to leave for the day. You realize that you haven’t had any crash-related thoughts since the previous morning. For the first time, you’ve gone a whole day. At stage five, you’ve already made it halfway through the healing process.

Stage 6: You go a week without thinking about the traumatic event. Stage six is challenging to proceed to and through because during a typical week, you accomplish a wide variety of tasks that put you in many different situations. During healing, it is likely that you encounter one of these situations that will remind you of the crash. However, once you have had your first whole week without thinking about it, you have made excellent progress toward healing.

Stage 7: You go a month without thinking about the traumatic event. You can now drive through the intersection where the accident occurred and not think back to the accident. You’ve since visited the hospital for unrelated appointments without feeling nervous and uncomfortable. Slowly, the world around you has become more distant from the crash, and your thoughts reminding you of that day are becoming more sporadic.

Stage 8: You go a year without thinking about the traumatic event. A major mark of progress is the inevitable realization you’ll have when it has been a year since you thought about the crash. You’re likely a different person with different values and goals, but the trauma you experienced was real. Your healing is accelerating.

Stage 9: You go 3 years or longer without thinking about the traumatic event. While you’re likely decades removed from the crash at this point, you’re healing journey is essentially complete. Perhaps you have forgiven the driver who caused the crash. Maybe you have raised children who have learned to drive themselves. The crash is fully in the rearview mirror; it is no longer a burden you carry.

Stage 10: You’ve thought about it for the last time: Chances are, you’ll never truly forget a severe car crash. But, at a certain point in time, your trauma from this event does not occupy any part of your consciousness in regular day-to-day life. At stage ten, you’ve healed as much as you can and will. The journey is complete. You’ve had your last traumatic thought. Congrats!

These are the ten stages to pay attention to when you are healing from trauma, whether that is physical, mental, social, relational, or a combination of any or all of them. To measure your progress in healing, recognize the gaps between the difficult thoughts and reminders you have of your trauma.

Additionally, this framework is useful for separating and healing from multiple intersecting and complex traumas. While one aspect may be at stage 6, another may be at stage 3. Splitting out these different sources of trauma can help digest each more effectively and appropriately

Trauma is an inevitable part of life, and healing from trauma takes time. However, these ten stages provide a framework for knowing where you are in the healing journey. As you advance through the stages, recognize and celebrate the progress you make. Healing is attainable and constant.

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There are a few reasonable caveats to this ten-stage framework that are worth mentioning.

• This is from the perspective of someone who wants to stop thinking about their trauma. Perhaps they have fully processed their pain and would like to get past it. Maybe someone’s trauma is not particularly painful, but it is confusing, and they would like to untangle it. I recognize that consciously thinking about trauma does have practical purposes. 
• I will acknowledge that this framework only works for conscious thoughts of past trauma. Unconscious changes in our brain occurring as we process trauma are too complex and hard to measure. This tool is meant to help overcome the conscious parts of trauma that we are most familiar with.
• You will likely hold some sources of trauma until you die. In this case, we never reach stage ten. With these, we can still use the ten stages as a measuring stick to indicate progress over time. Realizing that you have moved from one stage to the next is valuable, no matter if the healing journey is lifelong.
• Progress in healing isn’t linear. You may make it to stage 6 (week) before getting stuck back in stage 4 (hour). However, stage 7 will one day be attainable.

8/17-9/15 – South Salt Lake, Utah and Salt Lake City, Utah

When you’re tired, pay attention to what you think about. In particular, pay attention to the thoughts you only have when you’re tired. They are probably sad, frustrating, or scary thoughts. Explore those thoughts, cry about those thoughts, and write those thoughts down, but don’t try to resolve them then. Return to your written “tired thoughts” when you have the energy you need to work on them.

What is stuck in your head when you are exhausted? What internal conflicts do you struggle to resolve? What do you regret or feel shame for? What do you feel self-conscious about? What deeply confuses you? Are there people that you think about? Are there relationships that have fallen apart? Are there goals that have been missed? Are there things you wish you could say to someone at that moment, but you can’t?

These are thoughts that always exist at some level in our brains and require significant mental resources to keep at bay. Consciously holding and managing these thoughts hurts, but we usually have the cognitive defenses on guard to remain emotionally safe and stable by avoiding these thoughts. When we have plentiful mental energy, we don’t dwell on these thoughts because they are buried beneath an unconscious layer of mental armor.  However, when we are tired, we lack the mental energy to maintain our defenses and suppress negative thoughts. So, we think tired thoughts. 

Of all the problems that we all have, our tired thoughts are the most important to resolve. Mental fatigue uniquely opens a window to see exactly what is eating away at us, all the time. Unresolved thoughts burden our cognitive capacity, requiring mental energy to keep them suppressed or managed. This causes a constant drain on our cognitive resources, even when we are not actively thinking about these issues. The mental energy we perpetually spend to sequester tired thoughts is energy we are unable to access in our work, relationships, goals, and personal lives. Tired thoughts are like the unnecessary background applications on a computer, constantly sucking battery and computational power away from every other task we try to accomplish. They prevent us from making the most of our lives.

So, when you are tired, write down your thoughts, feelings, and emotions. When you have the energy, try to resolve them. That way, you can take back space in your brain and your heart that tired thoughts once occupied. Resolving tired thoughts will lead to personal growth via a greater capacity to progress and develop. While it will require significant intentionality, time, and effort, resolving tired thoughts may be the most freeing thing we can do for ourselves.

7/14/2024 – Salt Lake City, Utah