We don’t need years of formal education in the field of natural sciences to observe that a faster speed normally gets us to our desired destination faster. Speeding up = faster = at destination more quickly. While this law of physics applies widely in the natural sciences, this is not necessarily always so for trauma healing. For trauma healing, and this is often particularly true for complex trauma, we sometimes speed up the healing by slowing down and processing only the right amount at the right time. We “titrate” the process. What is titration in counselling therapy? Let’s explore.
What is Titration in Counselling Therapy?
Titration is a word from the field of chemistry, for which it is define as follows: Titration is “The process, operation, or method of determining the concentration of a substance in solution by adding to it a standard reagent of known concentration in carefully measured amounts until a reaction of definite and known proportion is completed, usually as shown by a color change or by electrical measurement, and then calculating the unknown concentration.”
In chemistry, if you titrate, you start with one substance and then you slowly drip another substance into the first substance. At a certain point there will be a chemical reaction, but because you were measuring everything so carefully and you’re going so slowly, you gain an understanding of what chemical reactions you will have, and you can make carefully measured adjustments to avoid any unwanted chemical reactions, including explosions. This will significantly reduce the risk of damage to you and your surroundings.
What is Titration for Trauma Healing in Counselling
When applying the above concept to emotional and trauma healing, imagine that the trauma healing process is slowed down to a speed that will significantly reduce the risk of you getting flooded and overwhelmed. When we you are flooded and overwhelmed, trauma healing is slowed down at best, because your prefrontal cortex, the part of the brain responsible for cognitive control functions, is partly offline when you are flooded, making it very difficult for you to remain in control of the process.
In chemistry the goal is to avoid a negative reaction, while at the same time slowly, drip by drip, gaining the desired level of chemical reaction and/or mixture. Similarly, for trauma healing, slowing down can sometimes achieve the unlikely outcome of speeding up the healing process.
Let’s Look at What Titration is in Counselling Therapy
Titration in counselling therapy is slowing and portioning. Here are a couple of ways to look at what titration is in counselling therapy for trauma healing:
- Titration is a way of slowing… things… way… down…. For trauma healing, titration is more like “slowing and parsing”, or “slowing and separating.” Or perhaps more like “slowing and portioning.”
- Titration is the process of taking one tiny piece to deal with at one time. A very tiny piece. Slowly. One. Small. Piece. At. One. Time. Always leaving the rest for another time. As you move along, your body becomes the leader for how much you process at one time. The slower speed might help you stay in awareness about whether you are currently overwhelmed or flooded, or feeling safe, calm, and secure. Titration is, therefore, also the needed skill-set to move in and out of doing trauma healing while making sure you are not getting flooded and overwhelmed.
- Titration is an act of slowing down, to a super… slow… level…. how you respond to whatever emotion or physical sensation you can process, at this moment, without any self-judgment. This will allow you to become the director of the pacing of your trauma healing and processing, slowing it down more and more, to whatever speed is just right, for YOU, at THIS TIME. It does not matter what speed you feel you should go, or you feel others go. At another time you may also go at a faster, or slower speed, but today, careful titration allows you to set exactly the right speed for you.
- According to Dr. Peter Levine in Waking The Tiger: Healing Trauma, trauma healing is “… akin to slowly peeling the layers of skin off an onion, carefully revealing the traumatized inner core” (p. 120). Dr. Levine also states, “Because trauma is “too much, too fast, too soon,” we want to counter this in trauma renegotiation,” or titration.
- Slowing down means working with small bits of traumatic and difficult experiences at any given time. It also means pausing and taking time to notice/gain awareness of sensations in the body that correspond with what the body is trying to bring to your awareness—that is, what the body is trying to communicate to you. Thus, slowing down gets you there faster because your prefrontal cortex remains fully online, making it possible for you to hear your body; that is, you understand what your body is trying to communicate to you.
What is Titration in Counselling Sessions
As stated earlier, titrating the process of trauma healing helps in processing the trauma similarly to peeling an onion, or, one layer at one time. This will help the nervous system to move gradually through trauma to safety without overwhelm or flooding.
Titrating to Avoid Re-Traumatization
I believe titration in counselling therapy to be one of the more important parts in trauma healing to avoid re-traumatization. Think of it this way: titration = slowing. If one of the key characteristics of trauma is having too much, too fast, then titration is the exact opposite of what happened during the traumatic experience. That is, you shift from too much too fast to the right amount, at the right speed. It’s a way of telling your body, “you now have all the time you need to process.” Or, “you now have all the time you need to go through your natural process of healing us.”
Slowing and portioning also helps with the helplessness, because you are no longer flooding. You are telling your body, “I will do things at your pace. Your experience is valid and I am paying attention. Your feelings and sensations are understandable and I fully validate you. I promise from now on I will not let anyone or anything override your needs.”
Slowing and portioning also tells cognition: “Your emotions are important. Listen. This is good. I hear you now. There is space for us all here. I am making more space for emotions, too. Listen…. Listen some more. I am listening. I hear you now.”
Titration and Repairing the Past
As you slow things down, little by little, slowing and portioning more and more, titrating… drip by drip, bit by bit, you repair your past. Not by rushing, but by listening. By paying attention. By moving about compassionately towards yourself and towards others.
If you or someone you love would like to explore supports, please do not hesitate to reach out to us any time. We would love to explore how we may be able to help.
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