Treating Girls & Trauma in the Wilderness

Grace Larson Therapist

by Grace Larson, Clinical Wilderness Therapist

It’s a hard time to be a teenage girl, and the pressures only seem to be accumulating. The drowning buzz of social media and social comparison, the unrealistic expectations our society puts on girls for thinness and beauty, and an increasingly competitive academic environment; combine that with the normative difficulties of adolescence, and you’ve got a crockpot full of struggle. While struggle, at times, can be motivating and the path to growth, for many teenagers, it is simply too much. This competitive, demanding, and at times, very unsafe environment our girls live in breed the most dangerous thing of all; a mentality of disempowerment. A mentality where women feel valued for only their physical attributes and accomplishments, rather than their genuine self, their values, their quirks, strengths and passions. They feel afraid and insecure of not being good enough, valued, capable and safe. It becomes easy for these girls to want to quit; to give up on the struggle, to succumb to the easiest or most available way out; be it drugs, sex, self-harming, isolating, or living in a tortured perfectionism. These are the girls I work with every day in wilderness therapy. Parents seem to struggle just as much in watching their daughters; wanting nothing more than for their daughters to be safe, to live up to their potential, and to see the beauty in themselves that they, as parents, see in them every day. It is hard for parents not knowing the right combination of boundaries, warmth, restrictions, and asking for outside help to guide their daughters through this complex and at times traumatic phase of life. It is difficult for them and for their daughters to see a light through the tunnel.

What is most beautiful about my work as a wilderness therapist though, is that I get to see this light at the end of the tunnel, and parents and their daughters have this opportunity, too. I see girls come in, dejected, afraid, and lacking a sense of themselves, often simply overwhelmed and shut down from the pain of the world and the confusion inside of them. Many of them don’t know they were in a ‘tunnel’ to begin with- they just know they felt sad or lonely. This is always the first step of our work in the wilderness: insight and understanding… understanding how and why life had become so stressed and dark. Often the girls know how to label it, “I have depression, I have PTSD, I have anxiety, I have trauma”. But they lack a deeper understanding of the pains that source these symptoms and issues, they lack the skill to cope, and they lack an environment that can slow down the buzz and distraction around them to help them tune into themselves and find their own capacity. Their parents need that break and that insight too, to reduce their own anxiety, which had often resulted in frustration and over-control. While there is never a perfect cure all to these struggles, to the society that forges them, or to the complex and long standing work it takes to heal, I am grateful to work in a setting gives these girls and parents a chance to break the regular paradigm to find a new strength inside. Today I will share and discuss some of my own insights, learnings and methods for treating the trauma and anxiety of teenage girls and young adult women through a wilderness therapy outlet.

Wilderness therapy seems nothing short of ‘bizarre’ for many of the teenagers and parents that we work with. It involves 8-12 weeks living completely in the outdoors, living out of a backpack of outdoor gear, surrounded by a group of other struggling teens and caring guides, mentors, and therapists. Each day, these girls are responsible for cooking their own meals, setting up and breaking down their camp, hiking, climbing or biking in a new area, and most importantly: to look deeply and introspect into some of the deepest and most meaningful areas of life. Most our students are scared out of their mind when they get here; their parents, too. But incredibly, in all this foreign and barebones outdoor living, comes a peace, and a space for true perspective and insight that is hard to match elsewhere.

Treating trauma in the wilderness, whether it is a discreet trauma such as abuse, rape, or the more daily accumulated trauma of failure and rejection, is a complex process. The goals of a short-term intensive intervention therapy such as wilderness therapy tend to center around behavioral/emotional stabilization, psychological assessment, and building insight and motivation toward change (intervention work). The treatment of trauma, on the other hand, is often looked at in the therapy world through a longer-term lens of processing and attachment- more than the typical 8-12 weeks a girl may stay in a wilderness therapy program. That said, after seeing many girls come and go through their stay in the woods, I know that the processing of their trauma is inevitable, as their healing in such a supportive and empowering environment comes so naturally. A trauma therapist for child protective services before coming to Aspiro Adventure Wilderness Therapy, I have worked intensely with trauma-focused evidenced based treatment modalities such as Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) and Eye Movement Desensitization and Reprocessing Therapy for the treatment of post-traumatic stress, identity disorders, and anxiety issues. In wilderness therapy, the therapeutic work happens through a combination of intensive individual and group clinical therapy sessions (where I use TF-CBT and EMDR) plus what I like to call the ‘built in benefits’ of the wilderness and group living situation.

While living outdoors can be challenging and harsh at times, the tribal living and natural escape from daily pressures creates a perfect environment for these girls to develop a sense of safety, and a cleanse from the people, behaviors and expectations that may have bound them to a certain way of thinking beforehand. The moment they get a complete change of pace and a release from regular pressure and expectations; the floodgates of emotion open. The brain wants to heal itself when it has the opportunity to, and these girls find this out here in their wilderness ‘tribes’. The complete change of environment and perspective gives these girls (and their families) a chance to step outside the ‘tunnel’ and understand what was happening in their lives: to me, this is the first natural step of the trauma and anxiety work done in the wilderness (and I would argue it is often the necessary component missing from many regular outpatient modalities of trauma care). Imagine the force of an entire group (what we call the ‘tribe’) of young women working together on their person issues. A backbone of the great work these girls can do is the connection and strength they have together. This sense of ‘togetherness’ and ‘acceptance’ is key to making any of the other pieces of trauma work possible. We call it ‘emotional saftey’, something the everyday world seems to put little effort in. The camaraderie these girls develop through such a challenging, empowering and vulnerable experience is healing in and of itself. On top of that, healthy regularity of their daily schedule: eating good food three times a day, regular exercise, and a bunch of sunshine only further lends to creating an environment of growth and balance, and a space for these girls to do their hard emotional work.

One of the first teaching steps of all evidence based trauma therapies involves ‘affect regulation’- which means helping a person to express and understand their emotions and have skills to cope with their emotions so it does not overwhelm or hi-jack their lives. Before delving into in-depth trauma work, a person needs to be able to keep their ‘life together’, and deal with the difficult emotions that come up in trauma work. Coping-skill development and emotional communication is one of the 24/7 components of wilderness therapy- as ubiquitous as these kids learning to cook their beans and rice or layer their clothing properly. As you can imagine, the regular difficulties and discomforts of living outside with a group of angsty teens creates quite the outlet for expressing emotion and practicing skills. The Aspiro girls group practices daily Dialectical Behavioral Therapy Skills (an emotional regulation evidence based treatment) to learn how to tolerate their distress, modulate emotion, relate to others effectively, and practice mindfulness. Many students come to wilderness with some background in skills training (having been to previous outpatient and IOP programs). However, wilderness therapy gives them the space to practice these skills out loud and intentionally with one another, as well as in the moment feedback on how the girls are doing with their skills. Seeing the difference in the way a girl expresses her frustration or pain her first week (throwing down her pack, crying, shutting down) in wilderness as it compares to her last week (sharing a vulnerable “I feel” statement and creating solutions to her problem) is pretty incredible. These are skills they bring home, and skills we capitalize on in the therapy world to then access some of the deeper roots/cores of the issues; now that the girls can handle their big emotions more effectively.

The next major step of trauma work, as we employ it in the wilderness is ‘exposure’ component. ‘Exposure’ means finding calculated and specific ways to have a student explore a past painful experience through writing, speaking about it, or facing it head on. Most people with trauma or difficult experiences avoid triggers to their pain, whether that means they do not want to talk about the rape, the bullying, or whatever other invalidating and painful experience they may have had. As a therapist in the wilderness setting, I tailor the way I have each girl look at their pain based on what is likely to be the most effective way for them to express themselves. For some, it is a trauma narrative, where they write down the specific account of the trauma or they describe the pains they have experienced. I have had students do letter writing ceremonies with their group, where they write letters of their trauma, and then may ‘release’ their pain into a campfire, or they may ‘put it to rest’ symbolically in the ground. For some students, we may explore and process trauma through EMDR therapy, a memory based therapy where a person talks about their painful memories and is guided towards seeing the times they were more safe and more strong, to come to resolution. These girls learn to see that their narratives (as painful as they can be) have meaning, but do not need to define them, own then, or limit them. And their outlet to share these narratives in the group provides a space for mutual understanding and support that seems to only further the girls’ willingness to explore their painful issues. Once a student has explored and shared their trauma it becomes less scary and more accessible for others to support them. The next major step is ‘cognitive reprocessing’, where the therapists and guides help challenge a student on some of the ‘distorted, irrational or unhelpful’ ways she may have begun to see herself through the lens of trauma. For instance; a girl who has been raped may believe she ‘deserved it’ that she is ‘unworthy’ or ‘damaged goods’. A student who has been bullied may believe he/she is ‘incapable’, or ‘unacceptable’. We teach our students to ‘rethink’ the ways they began to see themselves using techniques in cognitive behavioral therapy and cognitive reprocessing.

Perhaps the most unique part of wilderness therapy, and particularly adventure wilderness therapy (where a student experiences a different adventure skill such as rock climbing, skiing or backpacking each week) is that a student gets to ‘challenge their negative ways of thinking about themselves’ and build self-efficacy and positive self-regard through having successes with totally novel experiences. Whether it be learning to ride a bike, reaching to top of a climbing wall, starting their first fire with a bow drill, or being vulnerable and shedding tears in front of their group; these students take on challenges day in and day out that build their sense of self and identity. With novel physical and emotional activities, students cannot as easily pull out their ‘measuring stick of comparison’. Some of the negative core beliefs they may harbor from failure or trauma; “I am not good enough, I am not capable, I am not worthy” are not challenged through talking (or through hearing it from Mom and Dad), but rather through doing. Seeing that little girl who came in broken and pained from the world, 3 weeks later proudly put on her harness and climb to the top of a wall with confident skills and bravery is something that keeps me coming back to my job every day. Student’s need to find their own sense of mastery to then really fill themselves with the belief that they can overcome and they can succeed. When they see themselves as capable and empowered, it gives them every bit more strength to face and overcome the struggles from the past.

Parents have an integral role in the processing of trauma as well, and while their feet may not be in the dirt each day, they take on leg-work every week to better understand and respond to their child’s needs. The space they from parenting and managing problems while their child is safe and in treatment, give parents the space to see their children in a different light. Parents get to practice seeing their child’s behaviors as a form of communication, and not a representation of their child’s self or character. As a therapist, I teach about trauma (whether it be major trauma or the small painful invalidations of life) as they accumulate to form the symptoms we see (the depression, anxiety, avoidance, identity confusion, etc). Week by week, parents learn empathic and effective ways to communicate with their kids and how to balance loving emotionality with boundaries. Often parents need to learn how to actually take a step back from over-involvement and over-control of their daughter’s emotions and pain, because for so long they were responsible for protecting and consoling their daughter’s emotions. But through the wilderness therapy process, with some space from the daily work of parenting and with specific training and skills work; parents learn to respond effectively to their daughter and to her pain. They learn to support her empowerment and processing so her good work can continue past her time in the wilderness.

Nature has a beautiful ability to heal, as does the human mind. We all have innate strength, love and resilience deep inside; but at times we need to dig deep and use some ‘heavy duty excavation tools’ to source that strength. I am grateful to work in an environment that so naturally lends to parents and children having the time, space and support to find peace and hope. Is wilderness therapy the end all be all of trauma therapies?; of course not. It is time limited, it is a highly novel environment that can make generalization to the ‘real world’ difficult at times, and unfortunately, it can be financially costly and difficult for many families to access. Most girls who do have the privilege to come and do this empowering and uplifting work, still need a great deal of support following their time in wilderness in a structured and therapeutic environment. That said, there is no denying that there is a very special healing space created out here through natural immersion, a supportive tribe, specific trauma-based therapeutic intervention and skill building, and an opportunity for self-confidence and mastery. It is an experience that truly generates hope, and helps a girl define herself apart from her difficult experiences and struggles . This ‘force of nature’ in wilderness therapy sets a stage for continued growth, healing and true connection with self and others…arguably the most beautiful gift a person can have. Personally, I look forward to many more years of serving young women and their families in this mission towards empowerment and am ever-grateful for having the best allies possible; mother nature and the resilience of the human spirit. Whichever therapeutic setting you work in or seek out; seeking challenging and novel experiences, being vulnerable and connected with others, immersing ourselves in the natural world (as opposed to the competitive and technological one) and honing in on our unbridled capacity are the keys to true healing and growth.

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