The Healing Crisis

Have you ever had an experience where the “right” choice would make life more difficult? Perhaps it was ending a toxic relationship, stopping an unhealthy coping mechanism, or leaving a job that did not honor your values. Sometimes, the next best step is essential for your health and healing. Sometimes the next best step hurts.

The healing process is not easy. In fact, healing may increase our distress. I first heard the term Healing Crisis from the work of Arielle Schwartz. I learned this term is applied to physiological healing as well as psychological. We use this term to describe the potential distress or worsening of symptoms that can come from the healing process.

Complex trauma survivors are particularly vulnerable to a healing crisis. Complex trauma is not an acute event, it is a series of wounding events that impact multiple systems of functioning—from the belief systems in our cognitive brain to our autonomic nervous system that manages our stress regulation. In complex trauma there is not adequate recovery time or resources to recover from wounding events. The state of nervous system activation (i.e. fight, flight, or freeze) becomes characteristic of daily functioning. Because of the pervasive impact of complex trauma, it influences the individual’s entire identity. A world without trauma may not make sense to someone who can’t remember a time before trauma.

There is a metaphor presented by Ana Gomez that I’ve referred to before and that I will borrow here: Imagine you grew up in Alaska and learned from the beginning of life that you needed a big, heavy coat to survive. Now let’s say you are suddenly uprooted and move to sunny Mexico. You keep the coat on because you learned it’s necessary. But now you are uncomfortable and hot, people don’t understand you, and they tell you to “just take the coat off”. In your mind, however, you would rather be uncomfortable and misunderstood, even isolated, than risk freezing to death.

Taking the coat off feels risky, and to do so may feel like a crisis. For many of individuals, the healing crisis is a scary crossroad in healing. It can impact our identity (causing us to question what our caregivers taught us), our body (wakening uncomfortable sensations we have grown to numb), and our relationships (leading us to acknowledge and walk away from abuse). Here are a few ways one might experience a healing crisis or risks that may lead to a healing crisis:

• Setting boundaries in relationships knowing very well that the boundary may be relationship ending.

• Abstaining from a substance that provides relief from intrusive memories and thoughts. Staying sober when sobriety means feeling uncomfortable sensations and devastating emotions.

• Grief that comes from acknowledging you cannot save or “fix” a broken system or relationship.

• Acknowledging that abuse was not your fault and as a result shifting responsibility to the abuser. This may result in feelings of powerlessness or anger that feels scary, especially if anger was punished by abusers.

• Caring for and feeling the physical body when you have learned that disconnecting, or dissociating from the body is safer than feeling the physical pain of abuse or trauma. “Unfreezing” from dissociation often means feeling the tension and distress related to fight or flight.

• Saying “no” or setting boundaries around resources when you fear it may disappoint others.

• Leaving an abusive relationship when resources are scarce.

• Investing in a new relationship when you have learned that you can have safety or connection, but not both.

• Processing trauma and caring for wounded parts of self when you have distanced yourself from those parts and attempted to “forget” or numb trauma.

If you are experiencing a healing crisis. . .

If you find that you feel stuck, practice compassion for your suffering. Maybe you have taken steps to heal and now it feels overwhelming. Healing is so difficult and scary. Be gentle with yourself here. Allow yourself to grieve the impact of trauma on your life. It is okay to practice gratitude for the ways you have survived, even if it is time to learn new, more adaptive skills. Perhaps you need support and tenderness as you move through the difficulty of healing. Ask for help or seek ongoing support if needed.

If your loved one is experiencing a healing crisis. . .

Maybe it’s not you facing a healing crisis but someone you love. It can be difficult to see them “keep the coat on” when you know there is a better option. It is difficult to see the one’s we love continue in maladaptive patterns. Perhaps they have been on a healing journey but you are confused that they are not “better”. It can be frustrating to witness the complicated nature of healing. Practice self-compassion for your experience. It is allowed to affect you. But I also encourage you to practice compassion for them. Perhaps they are doing their best. Perhaps the risks of change feel overwhelming and complicated. Practice simply being the compassionate witness. Acknowledge what is hard and set boundaries where you need to. This is not easy. You matter and so do they. Take care of you.

If you work with hurting people. . .

Because a healing crisis is an expected experience it is important to address it with compassion (this is a theme here). The window of tolerance is a concept to describe what an individual can tolerate before their survival systems are activated. Work to pace therapeutic work in a way that respects the window of tolerance. Support the difficulty of change without pushing a client to make changes before they are ready. Stage treatment appropriately. Sometimes our work is to stay curious, and fully evaluate barriers or risks to healing. Take time to truly see the client and know their experience. Seek consultation.

Sometimes there is no path without suffering and there is no “right answer”. We must honor the risks required to do healing work and the suffering endured by those doing the very difficult work of healing. Where ever you are in your journey, you matter. Your experience matters and your suffering matters. Stay curious and take care of you.