Thursday, September 10, 2020

What to Expect From Good Trauma Therapy

 I am about to begin my second year of training as a counselor and psychotherapist.  I am kicking off my internship with a client who was sexually abused by a family member.  It's interesting and humbling to be on the other side of the office,...the side of the therapist.  I was a therapy client for 25 years and although technically I am just beginning my work as a therapist, I feel like I have over two decades of experience in healing trauma.  My first client tried therapy once many years ago with someone who was "supposed to be excellent" and unfortunately minimized her experience and sent her running, and rightfully so, far away from therapy.  Until now she hasn't tried again. 

 It gets me thinking about my own damaging experiences with therapists who had not done their own inner work, were not adequately trained, nor even aware enough to get themselves the training needed to help me.  These therapists, I believe meant well but added additional layers to my trauma and inability to trust.  As the saying goes, "The road to hell is paved with good intentions."  Whoever said that is so right.

What I needed and what people who have experienced complex trauma need, and what they should be able to expect from me as a therapist and from themselves in therapy seems obvious to me, but may not be to others.

For starters and enders (okay, I know that's not a real word but it sounds right here) they have a right and need to a safe space physically, emotionally,  psychologically and spiritually.  

They have a right to be treated with kindness and respect at all times.  

They are the experts on themselves, not me, the therapist.  I provide a space for them to be seen and heard, and to see and hear themselves.  I am a witness to their pain and their inner world and a facilitator of their own inner ability to heal.

I, the therapist, am human and I am bound to make mistakes.  My clients have a right and responsibility to let me know if something I do or say doesn't feel right for them.  If something feels hurtful or unhelpful I want and need to know.  

The client is not, in any way, or at any time, responsible for the therapists feelings, reactions, or behaviors.  Perhaps that sentence should be in bold.  I'll write it again: The client is not in any way, or at any time, responsible for the therapists feelings, reactions, or behaviors.

Boundaries create safety.  Sessions will begin and end on time. Technical details like payment and times of session will be made clear and be agreed upon from the outset.

Contact between sessions (phone, email, WhatsApp) will be allowed with clear boundaries that will be agreed upon from the outset. We will both let each other know as soon as possible if we can't make a session.  

The sessions will be focused squarely on my client and their needs and their healing process.  Not on my own needs or process.  I know this sounds obvious, but I have experienced otherwise so many times.  

Therapy may not always help right away, but it definitely shouldn't hurt and be traumatic!  

Ongoing abuse is a trauma, which is an injury as real as a physical brain injury or broken bones.  It affects every part of our lives.  It lives in each cell of our bodies.  Healing takes time and effort.  You have to want it, and understand that it is a process.  It is not something that gets fixed overnight.  

At times healing from trauma can take over everyday functioning.  Anyone who tells you they experienced trauma and it's not a big deal for them (implying perhaps that nor should it be a big deal for you) is, in my experience, not ready to do the real work of healing.  They are living their lives with limitations that they are perhaps tolerating and accepting, but that definitely effect them and their loved ones.

Each person is different and each healing process will look different.  Trauma therapy happens in stages.  Establishing safety is the first stage and must be revisited at every turn.  Acquiring tools to ground and contain is the second stage.  Trauma work can get very overwhelming and grounding and containment are vital.  So is setting up a support system.  One therapist, once a week, is often not enough for complex trauma work.  Post traumatic stress symptoms can be debilitating.  Family and friends who can be called in a crisis, and a support group, are all part of a good support system.

When the above is in place, the trauma can be taken out and looked at one little piece at a time.  Slowly, gently, carefully and respectfully.  Slower is faster when it comes to trauma work.  The damage can be witnessed, and the feelings felt safely. The memories processed. 

 The mind and the heart can begin to heal.