When I first became a counsellor, I felt disappointed that not every counsellor is trained in treating trauma. Due to my healing journey from trauma, I had the naive perspective that every counsellor would be trained so that they could work with the complexities of trauma. Unfortunately, that’s not the case, and can be very confusing for clients. Trauma counselling requires a specialized approach that integrates modalities that are beneficial for working with trauma.
Here is an overview of what trauma counselling is and what to expect from it.
What is trauma counselling
While there are some standard rules about what trauma counselling is, please note that there are a variety of approaches out there and each trauma counsellor is likely to have a different perspective on what trauma counselling is. Here are some of the points that trauma counselling covers:
Healing process
Trauma counselling is a therapeutic process designed to facilitate healing for individuals who have experienced trauma. In a simplified way, it is about healing the effects of the trauma. This process varies for each individual and depends on what has happened to the individual and the symptoms the person is experiencing.
Many people experience symptoms of trauma but aren’t aware that they are connected with trauma. Here is an overview of common symptoms of trauma: depression, anxiety, fear, anger, irritability, guilt, mood swings, decreased interest, problems with concentration, insomnia, shame, and self-blame. Symptoms of trauma may also show up as feeling numb or hopeless, having suicidal thoughts, or experiencing nightmares and flashbacks. Other symptoms can be substance use since it can help people to regulate a dysregulated nervous system. Additionally, mental health diagnoses like borderline personality disorder, dissociative identity disorder, or eating disorders are often closely related to trauma.
Trauma counselling includes how trauma affects our body, mind, and soul. The approach is based on a holistic model that includes the physical, mental, emotional, social, and spiritual aspects of the individual. While trauma counselling includes developing practices and skills to manage emotions and navigate the symptoms of trauma, it goes beyond coping skills. Its long-term objective is to heal the effects of trauma at its core.
Since most traumatic experiences are connected with misuse of power, trauma counselling intends to return the power to the individual. A trauma counsellor should pay special attention to navigating the power differential in the therapeutic relationship.
Safer, non-judgemental, stigma-free space
The mental health field still has pathologizing views on people who have experienced trauma which aren’t helpful for the healing process. Trauma counselling intends to provide a safer, non-judgmental, and stigma-free space. Symptoms are seen in the context of what has happened to the individual. Trauma counselling explores what has happened to individuals which stands in contrast to the pathologizing views of the medical field which comes from the perspective of “what’s wrong with you?.” In general, trauma counselling requires that the counsellor does their work to overcome stigmatizing beliefs that they may have taken on from society.
Specialized approach
Trauma counsellors integrate modalities that are beneficial for working with trauma. This includes modalities that focus on the connection between the mind, emotions, and body. Trauma counselling usually follows a stage-based approach for trauma recovery that meets the client where they are at. Additionally, It uses specialized methodologies and evidence-based practices. There are different evidence-based approaches available to work with trauma. They include EMDR (Eye movement desensitization and reprocessing), parts-work-related approaches like Internal Family Systems (IFS), Prolonged Exposure therapy, and somatic approaches for trauma like somatic experiencing and sensorimotor psychotherapy.
Pacing
To heal from trauma, people need to be able to be with their inner felt sense without being overwhelmed by it. While this is easy to say, it’s a process to get to accomplish this goal. Just to give you some examples: some clients may have a narrow window of tolerance due to the trauma that happened to them. Sometimes, people have strong rational parts that want to move forward as quickly as possible, however re-connecting with the body and the emotions takes time. There can also be parts that are scared to connect with the body due to the trauma that happened to the individual. If the recovery process is too fast, there is a risk that the nervous system gets overwhelmed or parts get excluded in the recovery process. Therefore, pacing is an important element of trauma counselling - whether it is related to expanding the window of tolerance or reconnecting the client with self and their parts, or other interventions. Usually, it is better to go slower than faster although each client will have their unique speed of recovery.
Client empowerment
Trauma is often connected to a deep violation of boundaries and a sense of loss of control. Trauma counselling supports the individual in regaining a sense of control in their lives, rebuilding their sense of self, and reconnecting with their sense of self and their inner resources. Trauma counselling focuses on giving the individual their power back by giving them choices and collaborating with them. Trauma counselling may suggest practices and exploration but is mindful of the client’s boundaries.
Trauma-informed care
Trauma counselling is based on the principles of trauma-informed practices. Trauma-informed practice is a systemic approach and can be used by any counselor, coach, or organization. Trauma-informed practice moves away from the stigmatizing question of “What’s wrong with you” and explores the question “What has happened to you.” The key principles of trauma-informed practice are safety, trustworthiness and transparency, peer support, collaboration and mutuality, empowerment and choice, as well as cultural, historical, and gender issues.
What does a trauma counselor do
Each trauma counsellor has different training, professional expertise, and approaches to treatment, therefore it is likely that you’ll have a different experience dependent on who you work with. Here is a summary of what trauma counsellors do:
Non-judgemental, non-pathologizing approach
Many people who have experienced trauma have some socially stigmatized symptoms. Some people may have parts who are suicidal or parts that use self-injury or they may experience overwhelming anger. Many of these symptoms are adaptive coping skills to navigate trauma that helped the individual survive extreme situations. Trauma counsellors explore these symptoms in a non-judgemental way and frame them from a trauma-informed lens. Curiosity to understand the client’s experience is essential for trauma counselling. Furthermore, trauma counsellors also come from a strength-based approach, which means they also acknowledge the strengths they see in a client. Since everyone is shaped by social conditioning, trauma counsellors need to do their growth to release stigmatizing beliefs and stereotypes they have taken on from society.
Establishing safety and trust
Many people who have experienced trauma don’t feel safe or never experienced a trustworthy environment. The therapeutic relationship between the trauma counsellor and the client plays an important role in the healing process. A trauma counsellor is attentive to establishing safety and trust. Trauma counsellor can navigate the power differential between the counsellor and the client healthily. This includes that they can handle their privilege(s) healthily if they work with clients from intentionally marginalized communities. They also have awareness and knowledge of how social dynamics can play out in the client’s life. Establishing safety and trust doesn’t mean blind trust or unrealistic expectations about safety. Learning to have healthy boundaries, trusting one’s feelings, and learning to discern is a vital part of establishing safety and trust.
Assessment of symptoms
Trauma counsellors collaborate with the client to assess the impact of the traumatic experience on the individual’s mental, emotional, spiritual, and physical well-being and explore the symptoms of trauma together with their clients. As an example, this may include an assessment for dissociations or exploring the individual’s capacity to be in their window of tolerance. Assessment and diagnosis are two different things. In general, counsellors don’t diagnose people. If you want to receive a diagnosis, a psychiatrist or psychologist is more likely to support you.
Nurturing healthy coping practices to increase well-being
Trauma counsellors work together with their clients to find practices and coping skills that increase the individual’s well-being. This includes but is not limited to skills to manage emotions, hypo- and/or hyperarousal, breathing techniques, coping skills to contain painful memories or emotions, as well as skills to navigate rumination or worries. Since most people also have parts that struggle with using these practices, the counsellor will also support the client to explore their inner world more deeply to navigate inner conflict healthily.
Collaboration with the client
A trauma counsellor collaborates with the client, i.e. they use power with instead of power over. While a trauma counsellor will make suggestions and invitations, they also invite the client to respect their boundaries. A trauma counsellor pays attention to giving clients choices and gives them back their control. The decision-making is done collaboratively with the client. A trauma counsellor pays attention to interpersonal boundaries and focuses on empowering the client instead of using power over dynamics like telling the client what to do. They are transparent in their interaction with their clients and admit if they made a mistake.
Promoting self—exploration and expression
Encouraging clients to explore and express their thoughts and emotions related to the trauma is a significant aspect of trauma counselling. This may involve talking, journaling, or engaging in creative activities as a means of processing and making sense of the experience.
Providing psycho-education
Trauma counsellors educate their clients about the physiological and psychological symptoms of trauma and explore what resonates with the client. This helps the client understand their reactions and symptoms and can reduce the effects of stigma. A trauma counsellor views symptoms as protective coping skills and is curious how these responses helped their clients survive extreme situations. They also provide psycho-education around important concepts, like the window of tolerance or structural dissociations to help their clients understand how trauma can impact their thoughts, feelings, behaviors, and relationships. The psycho-education intends to enhance the individual’s self-awareness, decrease the impact of stigma, and normalize the symptoms and behaviours of the clients.
Trauma recovery
Trauma recovery is an inner change process that improves the individual’s health and wellness and supports them in living a self-directed life and achieving their full potential. The process needs to respect what has happened to the individual and consider the mental, emotional, physical, social, and spiritual aspects of the individual. While the process is individually different, here are the main ideas when it comes to trauma recovery from a counselling perspective:
Empowerment and regaining control
Trauma recovery involves empowering individuals to regain a sense of control over their lives. This includes fostering autonomy in decision-making, setting personal boundaries, and reclaiming a positive sense of self.
Parts work
Everybody has multiple parts that form part of their personality. Parts work supports us to embrace and express the diversity in ourselves. Parts can be related to feelings, roles or certain ages, gender, or any other descriptions like colours, animals, or objects. Examples of parts are shy parts, angry parts, sad parts, a three-year-old part, a 12-year-old part, a worried part, a caregiving part, or a peacemaking part. Since we are all unique, we also experience parts differently. Parts work is an important part of trauma recovery, especially if people have experienced relational or developmental trauma since it allows us to re-connect with our inner world and express the complexity of it.
Widening the window of tolerance
The window of tolerance is an important concept for trauma recovery. The window of tolerance is the space where we can experience intense emotions while still being in control. Many people who have experienced trauma have a narrow window of tolerance. Trauma recovery often means that we learn to identify the states we are in, learn practices to get back into our window of tolerance and widen it throughout recovery.
Establishing safety and stabilization
This aspect of trauma recovery includes different elements dependent on what happened to the individual. Safety can be related to creating inner and outer safety. It also includes reducing further relational harm if the individual is in an abusive or toxic relationship. It also means to stabilize the life of the client, whether it is internally or externally.
Reprocessing of traumatic experiences
Reprocessing traumatic experiences is a pivotal aspect of trauma recovery, representing the transformative journey toward healing. This step usually requires that the client has the skill to be in their window of tolerance when feeling intense emotions. This therapeutic process involves revisiting and reframing the traumatic memories in a safe and controlled environment, often guided by a trauma counsellor.
When EMDR is used for reprocessing, the client does not need to talk about the traumatic memories. Processing means that the experiences that cause problems can be appropriately digested, mentally, emotionally, and in the body. On the one hand, it allows people to learn what was beneficial from the experience and that can be used as a resource in the future. On the other hand, it allows people to release painful emotions, body sensations, and beliefs. EMDR aims to leave people with the emotions, understanding, and perspectives that will lead to healthy and life-affirming behaviours and interactions.
Grieving the losses
Trauma is associated with losses. As part of trauma recovery, we need to grieve these losses. The grieving process can be different for individuals depending on what happened to them. For example, people who have experienced childhood abuse, need to grieve the losses they had due to the abuse that happened. This can be a loss of trust or betrayal. They also need to grieve the childhood they never had, I.e. the happy childhood they would have deserved to experience. People who belong to intentionally marginalized communities need to grieve the losses they experience due to systemic oppression or systemic racism as well as the society they deserve to experience, i.e. a society that is free from systemic oppression and where they are treated as equal. While systemic oppression is normalized in our society, these dynamics are not ok.
Integration and meaning-making
Trauma often affects our perspective on life and our values. People often want to fix traumatic experiences, however, we usually cannot go back to being the same person we were before the trauma happened. If we integrate trauma, we can generate a deeper understanding of ourselves, our relationship with ourselves, other people, and the world. While we cannot change what has happened to us, we can grow from it and gain a deeper understanding of life. In many cases, trauma changes our values and core beliefs.
Trauma recovery stages
Trauma counselling usually follows the stages (or phases) of trauma recovery. While it is important to understand the stages of recovery, the healing journey is usually not as linear as the stages imply. The goals for recovery in the different stages depend on what happened to the individual and what their symptoms are. The stages were defined by Judith Herman in the book “Trauma and Recovery.”
The first stage of trauma recovery is about safety, stabilization, skill-building, and strength-building. This stage includes stabilizing the individual’s life, reducing harm as much as possible, and increasing their inner and outer safety as much as possible. It also includes to widen the window of tolerance. Boundary work is often an essential part of this stage. It also includes building the skills to be able to discern between healthy and unhealthy behaviours in relationships. The second stage of trauma recovery is about trauma resolution and mourning. This phase is about reprocessing the traumatic experiences and mourning the losses. The third phase of trauma recovery is about reconnection and meaning-making. This includes but is not limited to reconnecting with people, finding meaningful activities but also re-evaluating one’s values and beliefs after the traumatic experiences. For people who belong to intentionally marginalized groups, it is also about finding empowering ways to navigate systemic oppression even if these dynamics aren’t ok.
How long does trauma recovery take?
The duration of trauma recovery is highly individualized and can vary significantly from person to person based on various factors. Here are four ideas to consider regarding the timeframe for trauma recovery:
Varied timelines, individual journey
Recovery from trauma is a complex process, similar to the hero's journey, it starts with the jump into the unknown. Various factors, such as the complexity of the traumatic experiences, the nature of the trauma, individual symptoms, personality, and genetic factors, contribute to the duration of the recovery.
Due to the uniqueness of each individual's story, providing a precise prediction for the duration of recovery is challenging. Despite the vagueness, it can be useful to break down the trauma recovery journey into specific goals for each phase, such as expanding the window of tolerance and improving boundaries to provide a more tangible and measurable approach. This also allows individuals to evaluate their progress more effectively.
Complexity of trauma and presenting symptoms
Trauma recovery also depends on the complexity of trauma that happens to an individual and the symptoms they experience. While there are exceptions, recovery is likely to be faster if an individual has experienced one or a few traumatic events and has already the capacity to be in their window of tolerance when they have intense emotions. Recovery is likely to be longer when an individual has experienced relational trauma or developmental trauma.
Therapeutic relationship and therapeutic interventions
The type and intensity of therapeutic interventions can impact the speed of recovery. Regular therapy sessions and the use of evidence-based therapeutic approaches may expedite the healing process. However, it's essential to recognize that progress may still occur at an individualized pace. Additionally, the quality of the therapeutic relationship between the client and the counsellor may also influence the recovery time.
Commitment and motivation
The commitment to recovery and the motivation for change influence the outcomes of the therapeutic process. Many of us have parts that are afraid of recovery or find reasons to avoid recovery due to the trauma that happened to them. It is often helpful to stick to the process, explore these patterns, and find a way to collaborate with these parts instead of giving up.
Additionally, it is helpful if the client applies the coping skills and tools outside of the session. To change our nervous system or embody a change, we need to practice just like we do with physical exercise. Just to give you an example: In a workshop with Staci Haines about embodied transformation that I attended, she stated that we need to repeat the embodied practices about 300 times to apply them in a situation with a normal stress level and up to 3000 times in high-stress situations. While the counseling session matters, the effort of the individual outside of the session also matters.
Individuals must acknowledge that healing is a nonlinear process. Patience, understanding, and ongoing support are vital components of assisting someone through their trauma recovery journey. It's also advisable for individuals to communicate openly with their trauma counsellor to set realistic expectations and goals for their recovery. Recovery requires bravery and persistence.
Why choosing trauma counseling matters for long-term well-being
Trauma can impact our lives negatively and reduce our sense of well-being. Trauma counselling supports people to improve their long-term well-being. Here are some of the benefits of choosing trauma counselling:
Preventing or reducing negative long-term effects
Traumatic experiences can have enduring effects on mental, emotional, and physical well-being if left unaddressed. Trauma counselling provides an opportunity to process and cope with the impact, preventing the potential development of chronic mental health issues, such as post-traumatic stress disorder (PTSD) or depression. Additionally, it can help individuals recover from PTSD or other mental health issues. Furthermore, it can support people to reduce or prevent chronic health conditions related to adverse childhood experiences.
Improving emotional regulation and wellbeing
Trauma often disrupts emotional regulation and leaves the nervous system dysregulated. This can lead to heightened stress, anxiety, feeling numb or dissociated. Trauma counselling supports individuals in understanding their nervous system and equips individuals with the tools and strategies needed to regulate emotions effectively. Learning healthy coping mechanisms is essential for long-term emotional well-being and resilience.
Breaking the cycle of maladaptive coping
Some individuals may develop unhealthy coping skills to navigate the impact of trauma that can be damaging to their well-being or the well-being of others. For example, some people may have parts that are suicidal or use self-injury, and some people may have parts that show their anger in a toxic way. Trauma counselling can help an individual to understand these symptoms based on what happened to them and find healthier strategies to navigate these situations.
Re-establishing/ building a sense of trust and safety
Many people who have experienced trauma experience a loss of their sense of safety and trust. People who have experienced relational trauma in their childhood may never have learned to trust people because it wasn’t safe to do so. Trauma counselling supports people to rebuild their sense of safety and trust that is realistic and healthy.
Enhancing resilience
Trauma counselling contributes to the development of resilience by helping individuals navigate adversity and bounce back from challenging experiences. It equips them with adaptive coping skills, enhancing their ability to face future stressors and challenges with greater resilience and strength.
Restoring a sense of wholeness
People who have experienced trauma often feel a disconnect from their sense of self. This is often connected to protective coping mechanisms. Healing from trauma includes reconnecting with the sense of self and our parts which is essential for our wellbeing. The more we are in a good relationship with our self and our parts, the more we can be in a good relationship with the outside world. This also includes that the individual can make choices that are for their best. Often, healing trauma allows us to have a greater appreciation of life, feel more connected to others, and have a renewed sense of meaning.
Post-traumatic growth
Post-traumatic growth refers to positive psychological changes and personal development that individuals may experience as a result of coping with and overcoming trauma or adversity. It happens to many people who have experienced trauma. Post-traumatic growth may show up as a deepened appreciation for life, improved relationships with others, seeing new possibilities in life, a renewed sense of personal strength, or a spiritual change. Improved relationships include an increased level of connection with others and more emotional sharing.
Take your next step for trauma recovery
I invite you to schedule a free 20-minute discovery session with me.
In this session, you will receive a needs assessment, gain clarity on the process of trauma counselling, and understand how I would work with you.
Book a free discovery session today.
