As clinicians, we come across clients who have faced uncountable traumas.
While the concept of trauma has numerous definitions, one element that is consistent across any definition around trauma’s impact is the feeling of a lack of safety and trust in relationships. Most importantly, clients with a trauma history may not trust or feel safe with you as a clinician when beginning the work. The therapist needs to earn this trust.
Laying the groundwork for healing trauma
As therapists, we are wired to feel compassion and have a deep desire to help our clients. This sometimes leads us to jump directly into the client’s trauma narrative. After all, we have been trained to think that once the client is able to tell us their story and make connections between past and present, through that insight they will begin to recover and their suffering will be alleviated.
Clinicians should be careful not to overlook crucial factors before delving into this trauma narrative. Two such important details are as follows:
STABILITY
Since reliving memories of the traumatic past can bring increased distress, unsettling emotions, disorientation, and sometimes dissociation, the therapist should ascertain the client’s current level of stability and safety. If there is instability in biological functioning (e.g. sleep, nutrition), or in the client’s relationships or work life, trauma work can lead to further destabilization.
SUPPORT SYSTEM
The clinician should also gauge whether the client has sufficient internal resources (temperament, coping skills) and external resources (family, friends, significant others) that will serve as protective factors as they delve into their trauma story. When the therapist feels that the client is stable and has a good support system, trauma work can bring much-needed relief and restoration from the clutches of their traumatic past.
Looking beyond words for a narrative
In seeking therapy for trauma, our clients present with a wide range of effects. Some have difficulty in talking about it and change the topic, while others readily share gory and horrific details. This can sometimes put the therapist in a bind about how to help the client work through their trauma. To be able to help, the therapist must look beyond the verbal account.
Recent studies have shown how trauma impacts neurophysiology, including the memory of the trauma, how they verbalize their trauma, and how it impacts their nervous system. Because we now know that our body can store trauma, we can use this knowledge to our advantage. This means that therapists should look beyond the verbal narrative and focus on the presentation of the client’s nonverbal behavior – the somatic and sensory experiences that arise when talking or thinking about their trauma.
So many of our clients feel disconnected or dissociated from their bodies, so this leap into accessing trauma through their sensory and somatic experience is vitally important. In addition, the therapist’s own awareness of their sensory and somatic experiences in response to the client’s narrative can be equally helpful in integrating the client’s trauma.
As therapists, we need to be holistic in our approach to being present to the client’s experience of trauma. In order to be fully present with the client’s experience of trauma and to create a complete narrative, the therapist would be well-served by a holistic approach that goes beyond words and accesses primal responses.
In summary, in order to work with trauma, therapists should consider all aspects of the client’s experience. By carefully considering when to delve into the trauma narrative, and by adopting a holistic approach, the therapist can facilitate a feeling of safety and trust in the client’s world, enabling them to heal from the deep wounds of their traumatic past.
ABOUT THE AUTHOR
Kratika Choudhary is a Professional Clinical Counselor Intern (PCCi) at Well Clinic, specializing in child therapy, couples counseling, mood disorders, trauma and helping people with life transitions.
