Cognitive Processing Therapy and “Stuck Points” that prevent healing from Trauma

Trauma survivors sometimes get stuck in their recovery.

When sudden, dangerous, and uncontrollable events threaten us, our basic beliefs can be shattered, leaving us with ideas and habits that keep us feeling “safe.” Over time however, those coping strategies may not be as helpful as originally intended, and can keep us stuck in a toxic cycle of avoidance and distress. We call those beliefs and ideas “stuck points.”

What are Stuck Points?

Stuck points are statements about yourself, others, or the world at large that are exaggerated, extreme, and often negative. They tend to focus on the five themes covered in Cognitive Processing Therapy (CPT) treatment, which are safety, trust, power/control, esteem, and intimacy.

It is critical to note that stuck points are not behaviors, feelings, facts, questions or moral statements. Much of recovery from trauma is readjusting how we relate to the world, and seeing how stuck points skew reality in a way that is harmful in the long run.

How do Stuck Points prevent recovery from Trauma?

Stuck points lead us to think in extreme terms, which give us the perception that we are in control, and able to prevent trauma from reoccurring. However, in reality, they skew our view of ourselves, other people, and the world in an unhealthy way.

We may start to believe that we can never feel safe in the world, that all people fundamentally intend to harm us, that we are powerless over getting hurt again, and thus, withdraw from people, places, and things that feel associated with threat.

Important truths that stuck points can prevent us from seeing include:

• We may be safer than we fear
• Not all people hurt us intentionally
• We have more control over some aspects of our lives than others
• Some people do want to be close to us in healthy ways
• Some people are decent and do commit altruistic acts
• Some people can be trusted
• We can learn who is trustworthy and healthy to have in our lives

How are Stuck Points processed?

CPT involves using worksheets specifically designed to process each stuck point, and illustrate how such beliefs may:

• Be true, or not, based on actual evidence
• Be exaggerated
• Be based on habit or emotions – rather than facts
• Overgeneralize to other unrelated areas of life
• Overlook important aspects of the trauma that occurred
• Be black or white (dismissing gray areas)
• Magnify one piece of information
• Focus on one source of information that may not be reliable
• Confuse what is possible with what is likely
• Focus on details that are irrelevant

The end result of this reexamination is changes in how a person thinks about oneself and others in relation to the five core themes affected by trauma (internal link).

For example, someone may believe “I am entirely at fault for being sexually assaulted” because of having flirted with the perpetrator prior to the assault. However, through further processing the therapist can help the client recognize how:

• Flirting is not an invitation to be assaulted
• There was no intention on the client’s part to be assaulted, and
• The perpetrator is entirely to blame

This insight can then open the door to recognize that flirting, in and of itself, is safe since it alone does not lead to assaults in other intimate settings. One can also be assisted in seeing how past flirtatious encounters did not end in assault, to help re-develop trust in one’s own judgment when considering other intimate encounters in the future.

Treatment in CPT starts by identifying stuck points to address through the process. A successful outcome typically results in regaining flexible beliefs in a way that contributes to more healthy coping strategies and an improved sense of well-being.

For more information on Cognitive Processing Therapy, visit the website CPTforPTSD.com.

Melody Jazeb, LCSW is a Diplomate with the Academy of Cognitive Therapy, and specializes in providing Cognitive Behavior Therapy for people dealing with Anxiety Disorders, Obsessive-Compulsive Disorder (OCD), and Posttraumatic Stress Disorder (PTSD).