what to expect from trauma therapy
As a trauma survivor, the idea of trauma therapy may feel daunting. You might envision yourself laying on a couch, your therapist sitting behind you with glasses sliding down their nose saying, but how does that make you feel. For many of us, it takes a long time of enduring trauma before we actually seek therapy. If that is your vision of what it might entail, no wonder it’s taken you so long to reach out!
Being in the Room
Instead, picture a warm, inviting space. Perhaps imagining colors and materials that feel comforting to the touch. If a pink velvet couch is not your jam for sensory reasons, we’ve got bean bags to sit on. We can even sit on the floor if you prefer. When you enter the space, I’ll invite you to look around the room, noticing where the exits are in case you need to use them at any time. I’ll invite you to turn around, noticing the art on the wall and nothing dangerous behind you. You’ll notice large windows, allowing sunlight to peak through, and the green trees climbing up, with leaves rustling outside. You’ll notice shelves filled with little figures such as animals, and people, and ghosts, and tiny food, and cars, and other figures. You might think, this woman likes to play with tiny figures in between sessions? What you won’t see is the sand within my coffee table. When we remove the cover, it is filled with sand where you can use these figures to build worlds in the sand. Yes, trauma therapy doesn’t require words, sometimes we can just allow worlds to unfold. You might notice a large book case filled with titles such as “What Happened Too You,” “Being a Brainwise Therapist,” and “My Grandmother’s Hands.” You might think to yourself, wow this woman has read a lot of books, maybe she knows what she’s doing. In the spirit of honesty and building trust, I want you to know I haven’t read them all. In the spirit of orienting you to trauma therapy, I want you to know I do know what I’m doing and you know what we’re doing better than I do. Now you might be thinking, okay? This woman doesn’t know what she’s doing? As a trauma therapist, I view you as the expert. I know a lot about trauma but you have endured your trauma. You have lived your story. You have lived in your body your whole life. You are the expert on you.
Offering Safety
Many therapists will tell you their therapy room is a “safe space.” I can’t tell you that. I can tell you I will offer you safety in the room. As a trauma therapist, I know your feeling of safety is defined by your nervous system. It is not something I can define for you. As we move through the therapy process, we will slowly build safety together. If you haven’t felt safety within your body in a long time—or ever—it might actually feel very unsettling to experience safety (the paradox of trauma). According to Steven Porges, a researcher, it actually takes about 10 sessions to feel safe within the therapy room. For some this can feel discouraging. When you have suffered much of your life and are finally making the decision to seek treatment, the last thing you might want to hear is that it’s going to take time. Trauma causes our threat responses to be hyper sensitive. What we consider “symptoms” are actually the nervous system’s way of protecting us. While there is so much beauty in trauma therapy and many people have reported feeling “better” throughout the process, we move slowly in this work to prevent retraumatization.
Resourcing
This brings me to the next part of trauma therapy—resourcing. You may have tools that help you cope with the pain you’ve endured. Some of these tools may feel soothing, like being with friends, creating art, reading, or watching TV. Other tools you may feel shame around like self harm, substance use, shopping, or other behaviors some therapists might describe as “maladaptive.” Here’s the thing (which you’ll learn in our work together), all behaviors are actually adaptive. When we experience situations where real or perceived threat to survival occurs, we develop adaptations to help us cope, and ultimately, to help us survive (more on that soon). While some forms of therapy might ask you to drop your “maladaptive coping tools,” trauma therapy aids us in understanding them, and even offering ourselves compassion for them. We help you integrate tools called resources to aid your system in learning new ways to cope. These tools use imagery to help you orient to security and comfort. What works for resourcing will be different for each person. For some, meditative exercises are helpful, for others art or sandtray might feel helpful. You have space to try new things and see what works best for you. As we try new resources within sessions, you can begin to use them in your life outside the therapy room.
Parts
I spoke earlier about our coping tools being adaptations we’ve developed to aid in our survival. I consider these adaptations to be parts of us. Many of us tend to turn away from these parts or look toward them with shame. We often think looking away from these parts allows them to shrink. In reality, this causes our parts to yearn to be heard, making them come on stronger. When instead, we get to know these parts of ourselves and understand their jobs, they feel heard in return. You might have heard the term “self compassion.” For trauma survivors who have often gotten the message that we are bad or wrong, who have lived with pain for so very long, it can be hard to build compassion for the whole self—especially when we feel these fragmented parts. Getting to know each part of ourselves and offering compassion to each part can help us slowly build compassion for the whole self. Notice if that feels less daunting for you than offering compassion to yourself as a whole.
Trauma and the Body
You might have heard the term and book title “The Body Keeps the Score.” When you first imagined what therapy might be like, perhaps you imagined “talking about your problems” (which is what some people think we do all day as therapists—listen to people’s problems, that is). Some therapies do entail a lot of talking. Some sessions, we may do a lot of talking. The language of trauma, however, lives not in words but within the body. While we will hear and use words to understand your narrative, we will also listen to the language of your body. This language comes through in sensation, in movement, in cues. Most of us have not learned the language of our bodies. We slowly introduce this way of working to help understand how trauma lives within you. When we listen to the language of the body, we can understand how trauma is stuck within the body causing “symptoms.” We can then help to move through the trauma by following sensation and learning what movements the body needs to process the trauma. If this paragraph felt confusing, fear not! This is a new concept for many.
Memory Reconsolidation
Many who experience PTSD or cPTSD experience flashbacks, nightmares, or emotional flashbacks to their trauma. This can show up as visuals, sensory cues, or even strong emotions. Part of trauma therapy (if appropriate and you feel ready) may include memory reconsolidation. This is when we bring up images of the trauma while noticing the emotions and body sensation that arise. We use a process called EMDR, or Eye Movement Desensitization Reprocessing, to help get the traumatic memory be processed. When the initial trauma occurred, due to a flooding of hormones and survival responses, the traumatic memory isn’t stored explicitly. Instead, it’s stored in fragments and our bodies become stuck sensing the trauma is still happening when triggered or awakened. EMDR helps to process traumatic material so it can live in the past rather than the present.
Unfolding
Rather than prescriptive, trauma therapy should be an unfolding. We experience trauma in isolation. We heal in relationship. By learning to experience connection together as therapist and healing human, I hope to help you embody that you are not alone in the world. I hope to offer you a new and different experience—one where you can learn to trace your way back to safety. To learn what it feels like to feel “okay,” perhaps even “not bad,” perhaps even “good.” I hope to help you follow your inner wisdom. To know your capacity for healing is within you already. To know it is not change we are seeking for you, but coming more in to yourself. I want you to know I am in this with you—your anchor with one foot on the shore—as you enter the waters.