What is trauma-sensitive counselling?
If you have reason to be extra careful in relationships and perhaps have been diagnosed with complex PTSD due to relational trauma, you may be wary with good reason about choosing a therapist.
Pending your gender and culture, experiences with violent trauma such as sexual assault, emotional blackmail, family violence, hate and discrimination, you may be looking for a female therapist or someone who understands neurodiversity or another specific context. If you are male and have experienced trauma that left you ashamed and confused, chances are it might also be difficult to ask for help.
Why I prefer to use the word trauma-sensitive instead of trauma-focused
What do we do if we do trauma-focused counselling instead of trauma-sensitive counselling?
We may overlook the whole you, and may even lose sight of your agency in the work as afterall early relational trauma often silences people and rob you the ability to speak up.
I come from the position based on research and experience, that if we focus only on the trauma and a technique and quick fixes, we overlook the impact of early and long-term relational traumatic experiences and other things that matter, such as culture, gender and personality styles (styles, not to be confused with disorders).
The best predictor we have for good outcomes in therapy (Bargmann and Chow, 2014) is still the common factors, and one is the therapeutic relationship and in particular, the therapist’s ability to adapt what they are doing to your needs.
I use the relational aspect in our sessions. I use attunement to underlying feelings kept in check by anxiety and fear, mental and bodily sensations present.
Pacing and a safe relationship is important in trauma-sensitive counselling
When you come to see me, I don’t expect details of traumatic events, although I will ask for what has brought you into therapy at this point as an open-ended question. I may use gentle invitations to help you put words to thoughts, feelings and bodily sensations, as shame is a frequent companion with trauma, and it thrives in being unnamed.
Not everyone who comes to therapy is aware of the impact of trauma, but may have struggled for a while with anxiety, depression or numbness (dissociation).
Safety comes in the form of the container of a regular appointment time on the same day at the same time week after week.
If you lose your words and find it hard to speak, and narratives come out jumbled, that is okay, we have enough time to do the work.
Who’s the best trauma-therapist?
I don't engage in profession-bashing. I studied my master's degree in Narrative Therapy within a cohort of people from clinical psychology, social work, Occupational Therapists and general counsellors. Training and length of training matters, but also the depth of therapists doing their own work.
Research tells us, that some of the therapists who get good outcomes are the therapists who also understand that relationships matter (Shedler, 2010) over techniques such as CBT and EMDR.
References
Bargmann, S., & Chow, D. (2014). Feedback Informed Treatment (FIT): Achieving Clinical Excellence One Person at a Time. Independent Practitioner (APA).
Shedler, J. (2010). The Efficacy of Psychodynamic Psychotherapy. American Psychologist, 65(2), 98-109. https://doi.org/0.1037/a0018378
