What Does Trauma-Informed Care Look Like In Therapy?
We see the word “Trauma” thrown around a lot in culture today. It shows up in your social media feed, favorite books, and on the websites of most therapists you have perused so far when looking for “trauma-informed care near me.” While the use of the word ‘trauma” in our everyday vernacular is great for destigmatizing aspects of mental health, over use of the term also means that many of us don’t actually know what it means or how it applies to us and therapy treatment.
What Does "Trauma" Actually Mean Beyond the Buzzword?
Trauma, as defined by the American Psychological Association, is “Any disturbing experience that results in significant fear, helplessness, dissociation, confusion, or other disruptive feelings intense enough to have a long-lasting negative effect on a person’s attitudes, behavior, and other aspects of functioning.” What that means in simpler terms is that trauma is something that has happened to you or around you that has caused you significant distress. When you think about whether or not you fit the label of “trauma” I would encourage you to think less about whether or not your check off the diagnostic boxes and more about whether you feel like you are carrying the effects of something that has happened to you or around you in a way that is destabilizing to your day to day.
If you feel like you identify as having experienced some form of trauma, then seeing a therapist who can work with you from a trauma informed lens is critical to successful therapy work. Trauma rewires our nervous system and so it means that in therapy we not only need to take into account our brain and context but also our somatic systems.
What Does Trauma-Informed Therapy Look Like in Practice?
What this looks like in therapy first is an approach that is slow. Everyone comes to therapy in a different place with trauma. Your trauma may be fresh or it may be something you have processed in therapy before. Together we will work to evaluate a safe pace to our sessions that accounts for the emotional dysregulation and processing you feel you can withstand. We want to keep you safe in our work first and foremost and so we will work together remembering that the fastest solutions and insights are not always the safest.
Next, trauma-informed care is contextual. Trauma-informed approaches to care also take into account how trauma can trickle down and have impacts on aspects of the self and environment more broadly. It is importantly that while not letting a traumatic experience define you, a therapist can understand how it informs your behaviors, symptoms and perspectives holistically. This means looking at how the environments you are in have shaped your experiences of trauma, exposure to ongoing triggers, and even understanding of what happened to you. It is critical to look at not just the traumatic even but the context of the past and present to understand the wider impact of trauma in your life.
Trauma informed care also looks at the relationship the client has with their body. Experiences of trauma sit in our somatic systems in ways that require us to look in therapy at how our emotions and experience are showing up in our bodies. In practice, this looks like noticing and spending time with where you may notice tension, heat, openness, fidgeting, and other physical markers of trauma in your body. This noticing may look like a tight jaw, tension in your chest, heat in your hands, or jittery legs. We will often pause and evaluate together in session what your physical response is to what we are talking about, making room for the experience of your somatic system in our work together.
Rebuilding Safety and Trust in Therapy
Some clients come to me after having experiences in the mental health care system where their trauma was not dealt with in a way that rushed and not safe. These individuals often have hesitations about returning to therapy or opening up about their history. This hesitancy is completely expected and valid after previous harmful care experiences. You and I will work to build trust with one another, starting not with trauma, but first with building a relationship that feels safe so that it can later hold the hard work of trauma processing.
This is what Trauma-informed care looks like. It looks like collaboration in our path in sessions week to week. It looks like transparency between the therapist and the client about what we are experiencing in the therapy room together and what our needs are. Trauma-informed care looks like safety in the slowness and intentionality in the therapeutic relationship and rapport building phases of therapy. It looks like choice in what we talk about, when we talk about it, and how we approach it together. The goal of all of these lenses of trauma-informed care is ultimately empowerment. Making you feel like you are the owner of your experience, empowered in your emotions and confident in weathering their triggers in your everyday life.
Wherever you are in your journey with trauma, I promise to hold you gently and with curiosity. I promise to go slowly, intentionally, and safely into our work together. And I promise to meet you where you are in your story. If you are curious how trauma informed work can feel, I invite you to reach out on my website for more information.