How To Talk About Trauma in Therapy

Learn how to talk about trauma in therapy with FOLX Health.

February 13, 2023
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This piece was written by guest contributor Emily and clinically reviewed by FOLX clinician Kaity, MSN, CNM, PMHNP-BC. The updated version of this piece was edited by Katie. Illustrations were drawn by Ocean.

When it comes to managing mental health, we often hear about trauma therapy or trauma-informed therapy. COVID-19, in particular, has pushed the topic of collective trauma into the mainstream.

Trauma therapy is an umbrella term for different kinds of therapies. While some therapists specialize in certain types of psychotherapy, others use a combination of techniques specific to the client's healing. Additionally, it’s important to distinguish trauma from PTSD (Post Traumatic Stress Disorder). Some people seek therapy to process traumatic events but don't necessarily have PTSD, so the treatment and approach can look different.

What makes a therapist trauma-informed? A trauma-informed therapist creates a safe environment for a person to feel empowered to share their story, process trauma, and work towards healing. The aim of the therapist is to acknowledge that every person has their own unique traumatic experiences and to approach them accordingly with this understanding.

Many therapists can use a trauma-informed approach with certain therapeutic approaches, but some modalities lend themselves more to the sensitivity of trauma survivors than others. There isn’t a specific modality for trauma therapy that works for everyone, so it often depends on what someone's goals are. For instance, if your therapeutic goal involves changing your thought and behavior patterns, you might consider trying out cognitive behavioral therapy (CBT).

However, talk therapy generally can be an excellent place to process traumatic experiences. This provides you with a safe environment to work through any emotions that may arise, whether they are directly or indirectly linked to specific types of trauma, by giving you the necessary time and space to do so.

While someone doesn't necessarily need a trauma-focused therapist to talk about traumatic memories in therapy, it’s often a great keyword to use when looking for a therapist. Seeking out a trauma-informed therapist may be a good starting place to ensure you find someone competent and safe to work with.

One of the most important things psychological trauma survivors can do before disclosing their stories in a therapy session is to pay attention to what their body is telling them. If a certain sound or thought makes your heart beat faster and your vision blurry, for instance, you might want to pay attention to how your nervous system is reacting to that trigger. Common symptoms of trauma include: intrusive memories, avoidance, negative changes in thinking and mood, and changes in physical and emotional reactions. Physical and emotional reactions can manifest as trouble sleeping, trouble concentrating, and irritability.

Many therapists will suggest coping skills and coping strategies in a therapy session through psychoeducation, such as self-care strategies. This is often as simple as understanding how your brain reacts to certain stimuli or learning breathing techniques when you start to notice symptoms of an anxiety attack. Simply understanding the connection between your mind and body can be a great starting point for understanding your own coping mechanisms. Developing a resilient skillset can help reduce emotional distress related to trauma.

Know that your traumatic event or experience isn’t your fault. Even childhood trauma can affect adults through experiences, such as panic attacks, flashbacks, or dissociation. These experiences can impact your attachment styles and emotional regulation. Working through, or even naming past traumas, can bring about new memories, symptoms, or associations. As you begin the work, it's important to remember that your experiences and posttraumatic symptoms are not reflections of you or any decision you made.

Trauma can exist on an individual or global scale. We must be cognizant of the many layers that could be affecting our behaviors. For example, many people around us likely carry trauma from the COVID-19 pandemic. Many of us carry traumas in our everyday lives that often impact our minds and bodies more than we realize. 

When looking for a trauma-trained therapist, you might come across treatment approaches such as eye movement desensitization and reprocessing (EMDR) and prolonged exposure (PE) therapy. EMDR is described as "a structured therapy that encourages the patient to briefly focus on the trauma memory while simultaneously experiencing bilateral stimulation (typically eye movements),” according to the American Psychological Association. The goal through this process is to reduce "vividness and emotion associated with the trauma memories." Prolonged Exposure (PE), otherwise known as exposure therapy, involves being gradually exposed to trauma-related memories, feelings and situations by facing a fear we’ve been avoiding. A person learns that trauma-related memories and cues do not need to be avoided because they are no longer dangerous. Both of these evidence-based treatments have helped many people work with their Post-Traumatic Stress Disorder (PTSD) and generalized trauma.

Another avenue to consider is somatic experiencing (SE). SE utilizes your nervous system's natural reactions such as dizziness, hot/cold sensation, or numbness to track how your body is responding to the memories of the trauma. A therapist will then guide you through different release techniques called pendulation. It's important to note that SE doesn't have as much research and evidence behind it as other trauma-related treatments. 

While many therapists claim that they work with trauma survivors, you may want to seek out a therapist who has specific trauma-therapy training. Things to look out for include a clinical focus on trauma and specializations in evidence-based treatment practices. Recognizing your own traumas and finding help can be a scary journey, but know that there are many resources available to you. All of this brings you closer towards improved mental well-being.

FOLX Health is now offering mental health care in select states, with more to come.


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