What is trauma-sensitive counselling?
If you have been wounded relationally, you may be wary with good reason about choosing a therapist or going to therapy at all. Some people who come to therapy may also be living with symptoms associated with trauma, including complex trauma presentations and what is sometimes described as complex PTSD (CPTSD), particularly where experiences have been ongoing and relational in nature.
Your gender, culture, and experiences with violent trauma, emotional blackmail, family violence, hate and discrimination might also make it difficult to reach out. I understand that pacing and not being forced but invited to talk when you feel you are ready is important.
Pacing, a safe relationship and consistency are important in trauma-sensitive therapy
If you come to see me for trauma-counselling, 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. If starting our conversation talking about what feels most painful is right for you I will help you hold it, but we can also begin elsewhere.
I may use gentle invitations to help you put words to thoughts, feelings and bodily sensations. I know shame is a frequent companion alongside trauma, and it thrives in being un-storied.
Being Trauma-sensitive is a balance between approaching, but not in a bluster, so your agency is lost. Lost agency and subsequent lack of help from others is what might have enabled trauma to stay in your life as a long-term impact on your joy, and ability to love and work.
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 consistency of a regular appointment time on the same day at the same time, week after week.
Feeling understood is also important and acknowledging that understanding goes beyond liking your therapist and that you and your therapist can weather a few storms together.
If you lose your words and find it hard to speak, and words come out jumbled, that is okay, we have enough time to do the work as my frame for therapy is seeing people weekly.
Weekly therapy is in itself trauma-sensitive and protective as we can tend to any overwhelm faster—therapy every fortnight, every third week or monthly does not cut it in my opinion if we work with trauma.
A person is more than their trauma
What can happen if we focus narrowly on trauma instead of being sensitive to trauma in relation to all the different aspects of you?
We may overlook the whole you. I come from the position that if we focus only on the trauma, on technique and quick fixes, we may overlook the impact of early and long-term relational traumatic experiences. Additionally, we may overlook the relationship with other things that matter, such as culture, gender, personality styles (styles, not to be confused with disorders) and sense of self.
Why does the therapeutic relationship matter even more in trauma-therapy?
One of the best predictors we have for good outcomes in therapy (Bargmann and Chow, 2014) is the common factors. One of these is the therapeutic relationship and, in particular, the therapist’s ability to adapt to your needs. For example, I use the relational aspect in sessions. I use attunement to underlying feelings kept in check by anxiety and fear, mental and bodily sensations. But I will always have to adapt to how you might be feeling on the day or where you are at in your journey.
An example of me adapting to your needs might be that I do not ask you how you feel in your body if that becomes unbearable. Somatic therapies have become increasingly popular, but for people with severe abuse and neglect or an eating disorder, this may be too much.
People often think trauma therapy is primarily about techniques. While techniques can be useful, many people who have experienced trauma have also experienced relationships where they were ignored, controlled, shamed, dismissed, or left alone with overwhelming feelings.
For this reason, the relationship with the therapist matters. A trauma-sensitive therapist pays attention to whether you feel heard, whether the pace feels manageable, and whether you have a sense of choice in the process.
Trust usually develops gradually. Rather than expecting immediate disclosure, a trauma-sensitive therapist makes room for the relationship to develop over time.
A trauma-sensitive therapist pays attention not only to what happened to you, but also to what is happening between the two of you in the room. Do you feel rushed? Do you feel heard? Are you able to disagree? Do you feel you have choices about the pace of therapy?
The best trauma therapist is not necessarily the therapist with the most impressive list of techniques, but someone with whom you can gradually develop trust and feel sufficiently understood.
If this understanding of trauma-sensitive therapy resonates with you, you can read more about my dedicated trauma counselling in Bendigo and how I work, or reach out to discuss next steps.
References
Bargmann, S., & Chow, D. (2014). Feedback Informed Treatment (FIT): Achieving Clinical Excellence One Person at a Time. Independent Practitioner (APA).
