Therapy for Trauma
If you have experienced difficult experiences which you might consider traumatic, we recommend connecting with an experienced practitioner for guidance prior to reading this page of content. This page includes brief clinical descriptions of trauma which may be triggering. Click here to make contact with our team, to be connected with a trauma-informed psychotherapist.
What is Trauma?
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Trauma can be understood as experiences which lead to a feeling of helplessness and severe emotional distress. These experiences overwhelm the normal systems of information processing, leading to post-traumatic symptoms instead of coherent memories.
A traumatic experience may fit into the following clinical categories -
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Acute - A single incident of trauma, often leading to Post-traumatic Stress Disorder.
Chronic - Repeated experiences which are in themselves traumatic or cumulatively traumatising. A necessary precursor to Complex PTSD.
Trauma of Commission - When a trauma occurs through harm enacted upon the individual, including abuse, violence and physical harm.
Trauma of Omission - When a traumatic experience occurs through the lack of an essential care. I.e. Experiences of neglect.
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Principles of Trauma-Informed Therapy
People who have experienced trauma often feel a pervasive sense of threat, danger or uncertainty. Trauma-informed care operates on a number of important principles to help trauma survivors feel comfortable and supported when engaging with psychotherapy.
Safety
The physical space should be clean, comfortable, private and with visible exits. Emotional safety is prioritised in therapeutic practice, through regularly "checking-in" about the client's felt sense of safety.
Empowerment
Each individual has hidden strengths which has supported them in surviving and coping with their traumatic experiences. The therapist brings these strengths to light and celebrates the client's hidden resources.
Choice
As trauma often encompasses a loss of choice through circumstance or violation, the therapist always provides multiple options within the therapeutic process, never enforcing ideas or methods upon the clients and always attaining informed consent.
Collaboration
The therapist acknowledges that they are not the authority or expert in the client's life, so they work collaboratively to find the tools and methods which work best for the client.
Trust
Trust is slowly developed in therapy, through a kind, respectful and collaborative therapeutic approach. Transparency on the part of the therapist is key in helping clients gain and maintain trust.
Intersectionality
Trauma often occurs within other experiences of oppression, including racial, socioeconomic, sexuality and gender oppression. Therapy recognises these forms of injustice and is respectful of racial, economic, sexual and gender diversity.
The theory behind trauma-informed practice
Human Development is Interpersonal
Human psychological development is a complex process which occurs in relation to our environment over the course of a life time ‘from cradle to grave’ as the pioneer of attachment theory, John Bowlby, says. We are emotional and relational animals and we learn how to love, play, care and fight through exploring and adapting to our environment. The social environment interacts with the brain, the body and the internal world in complicated ways, especially in the early years of life and sets the stage for how we grow and adapt to change throughout the course of our lifetime.
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Trauma impacts our innate ways of coping with stress.
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What trauma and attachment theory have taught us is that there are certain environmental conditions that promote safety, connection, intimacy and flourishing and other circumstances that pose significant challenges to our emotional development and our ways of coping. Throughout our lives we do our best to find creative ways of dealing with stressfull times. In times of trauma we see that usual ways of coping with stress are overwhelmed and we become rendered helpless. It is for this reason that we might think of Trauma as ‘experiences that are too painful to be experienced’.
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As a result, trauma can lead to a range of somatic, emotional and interpersonal symptoms, often the result of the disorganisation and disintegration of our usual ways of coping. In the words of Janina Fisher “trauma returns as symptoms rather than memories”. Once more the trauma survivor often feels helpless, isolated, alienated and overwhelmed as they are unable to understand and give meaning to their experience.
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How Psychotherapy Supports the Healing of Trauma
It is often at these times of breakdown that we reach out for support or seek assistance to give some sense of meaning to the experiences in our lives that we are grappling to make sense of. Therapy provides a space where we can begin to connect with the experiences that have been foreclosed or shut out from our memory, consciousness and sense of self.
Trauma informed practice recognises the complexity of interaction between environment, the brain and our inner world and promotes the conditions of safety, care and understanding that we know are crucial for human flourishing. A sense of personal safety, a ‘secure base’ is the starting point of any Trauma therapy. It is only from this place that we can begin to integrate traumatic experiences into the story of our lives and from here find the way back from the overwhelming effects of trauma, finding again a sense of hope, meaning and connectedness to our world.
The Process of Therapy for Trauma
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Safety and Stabilisation
This process occurs from the beginning of therapy and is continuous. In this phase, we develop trust within the therapeutic relationship, the capacity to stay within the window of tolerance within and outside of therapy, connect with our emotional experience and to relate collaboratively.
In this phase, we actively notice your embodied experience within sessions. This includes emotions you are feeling as we speak, signs of dysregulation and your embodied experience within the therapeutic relationship. Importantly, we are looking to gain a felt sense of safety within the therapeutic relationship and beyond.
When this phase is complete, you should feel relatively steady outside of session, able to identify and utilise tools for moments of triggers and feel trust within the therapeutic relationship.​
​2. Processing of traumatic memories
In trauma processing, we revisit the difficult memories of the past, so as to heal and integrate these experiences. This is important because the shock of trauma disturbs our normal processing of experiences into memory and they then re-enter the present in fragmented and dysregulating ways.
The work we have done in developing the tools to notice your emotional experience and to regulate distress become essential. For the integration of these memories, we need to be in contact with your emotional experience as we discuss them but not entering a state of dysregulation, which would essentially be re-traumatising.
This is a challenging part of the work, though an important part of the healing. We move towards this phase only when you are ready and we agree that enough safety has been established for this to occur.
We actively notice your embodied experience within sessions. This includes emotions you are feeling as we speak, signs of dysregulation and your embodied experience within the therapeutic relationship. Importantly, we are looking to gain a felt sense of safety within the therapeutic relationship and beyond.
When this phase is complete, you should feel relatively steady outside of session, able to identify and utilise tools for moments of triggers and feel trust within the therapeutic relationship.​
3. Integration
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This is the time we consolidate and celebrate therapeutic changes. Ending therapy might take 3-6 sessions (or more) within which we understand what has come to pass and narrativize the experience. Through make conscious what has helped in therapy, you can then use these tools or states of mind actively outside of therapy. This prepares you for entering the new chapter of your life and gives us some time to acknowledge the bond which has been created and the journey walked together in therapy.
The content of this page was written by Todd Mills and Alexandra Scoleri.