Seeking Therapy After Trauma
By Dr. Emily Muszynski
Life is unpredictable. At some point we all go through experiences that are frightening, life-threatening, or overwhelming. This, very generally, is what we call trauma. When the impact of trauma leaves you feeling lost and overwhelmed, counseling can provide an opportunity for healing. Yet, accessing effective counseling can feel difficult. What should you look for in a therapist? What does trauma therapy involve? The purpose of this blog is to help you navigate these questions on the road toward trauma recovery.
As you search for a therapist in the aftermath of trauma, it is important to seek trauma-informed care (TIC). Trauma-informed care is a broad term that reaches across settings and disciplines – from schools to hospitals to therapy rooms. The Substance Abuse and Mental Health Services Administration (SAMHSA) describes the “Four R’s” of TIC. According to SAMHSA, a trauma-informed therapist will:
1. Realize the pervasiveness of trauma and its effects on people and groups - Did you know that 70% of adults experience at least one traumatic event in their lifetime? Trauma is widespread, and it impacts individuals and groups in varying ways. Trauma-informed care is sensitive to the impact of trauma on mental health. Additionally, a TIC provider knows that trauma may present differently or hold different meanings across cultures and sub-groups.
2. Recognize the wide array of trauma signs and symptoms - Trauma can have a profound impact on a person. Not only does trauma impact our feelings and behaviors, but it effects our body, relationships, and identity as well. A trauma-informed professional is attuned to the various presentations of trauma symptoms.
3. Respond by applying a trauma-informed approach - This means that the professional adapts their language, interventions, policies, and approach to address the impact of trauma.
4. Resist re-traumatization - It is common that trauma impacted people “re-live” their trauma through flashbacks, nightmares, or more subtle experiences, such as a hyper- or hypo-active nervous system. It is imperative that TIC makes active attempts to avoid re-traumatization so as not to further harm a trauma survivor.
As it applies to psychotherapy, TIC is not about any one counseling approach or intervention. There are many evidence-based and empirically-supported treatments that are trauma-informed. However, there are some key signifiers of trauma-informed psychotherapy. A trauma-informed therapist will work to establish a collaborative relationship with you – one that is based on mutuality, transparency, choice, and empowerment. Additionally, TIC pays special attention to cultural, historical, and gender dynamics that may impact an individual’s trauma response. Overall, a trauma-informed clinician will understand your symptoms and your struggles within the context of trauma.
Also, because TIC makes attempts to avoid re-traumatization, your therapist may or may not ask you about the details of your traumatic experience. Often, therapists will work with you to establish feelings of safety and the ability to manage distressing feelings before venturing into trauma details. Other approaches solely focus on the impacts of the trauma, without going into depth about the entire event(s). If you are anxious about having to recount your trauma, please know that a trauma-informed therapist will make active attempts to help you feel safe and avoid trauma triggers. Because TIC emphasizes choice and empowerment, your therapist should take your lead in preparing to detail your trauma history.
Here are some questions you might ask potential therapists to better understand their approach to trauma work:
· What is your experience working with trauma?
· What types of trauma do you have experience treating?
· Do you consider yourself trauma-informed? If so, what does trauma-informed mean to you?
· Will I be required to detail my traumatic experiences during the first session?
· What is your approach to trauma work? What will sessions look like?
· What do you believe trauma healing means?
One last note: Trauma research shows that counseling is one important piece of the healing puzzle. However, healing from traumatic experiences can come in many forms. Research on trauma resiliency shows that the following factors can protect individuals from the devastating impacts of trauma:
· Community support
· Connecting to a sense of purpose or meaning (e.g., through religious practices, cultural traditions, connecting to your values, etc.)
· Gentle physical activities, such as yoga (there are even trauma-informed yoga practices specifically for this purpose!)
If you or a loved one are reeling from the aftermath of trauma, please know that healing is possible. Trauma-informed practitioners are here to walk with you towards recovery, and you do not have to make the journey alone.
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Substance Abuse and Mental Health Services Administration. (2014). SAMHSA’s concept of trauma and guidance for a trauma-informed approach (p. 9). HHS Publication No. (SMA) 14-4884. Rockville, MD: Substance Abuse and Mental Health Services Administration.
The National Council for Mental Wellbeing. (n.d.).How to manage trauma. The National Council for Mental Wellbeing. Retrieved December 1, 2022, from https://www.thenationalcouncil.org/wp-content/uploads/2022/08/Trauma-infographic.pdf
