A few lesser-known goals of trauma therapy (with no therapy speak)
It’s common (and understandable) to feel uncertain about what you’re hoping to get out of therapy. When I first entered therapy as a client, all I knew was that I felt really bad and I needed help. Therapy should be a safe place not to know, and it’s OK if you don’t have the words to express what you want. The words will come.
During discussions about hopes for therapy, it’s common for me to hear clients say that they want to feel more at ease, better understand their own needs and wants, or address a pattern that is concerning them. Curious minds might read these ideas and wonder, but how? It’s a valid question, and one that has kept me engaged for years and years—how does all of this work? What helps us to recover from trauma and feel better?
I can only speak from my experience and my own professional approach, but I thought it might be fun to share my thoughts about some of the underlying and perhaps lesser-known processes of good trauma therapy.
Building capacity
OK, to be fair, this topic does sound like therapy-speak, but I really can’t think of another way to say it! Let me break it down a little.
Most of us have felt things that we wish we did not have to feel. Powerful, emotionally-driven experiences such as grief, self-hatred, or dread are extremely uncomfortable, and sometimes even unbearable. We can all recognize the urge to get rid of these feelings, and how life has a way of teaching us that our best option is to numb or disconnect (essentially, to not feel at all).
Another way to look at this is that he problem is not the feelings, or the fact that we are feeling them, but that we do not yet have the internal capacity to safely experience and process them. When we haven’t built capacity, our emotional experiences are going to overwhelm us easily, causing us to feel too much or too little. Our brain is saying: it doesn’t feel safe to stay present with this. By experiencing emotions in a safe environment, and in manageable amounts, we can “teach” our brain that emotions can be safe (even if they are uncomfortable), which leads to less overwhelm. Like building strength or flexibility in the gym, repeated practice helps us build the capacity for feeling uncomfortable emotions.
Experiencing a safe relationship
Therapists are trained to provide a safe space for their clients. This can mean many things, but things like non-judgement, positive regard, and empathy are often cited as elements of the therapeutic relationship. While this is evident in all good therapy, some therapists, like myself, emphasize relational safety more than others. To me, establishing a professional, safe relationship with my clients is not just a bonus—it is a foundational aspect of the therapy we’re doing.
In my practice, people usually come to therapy because they have had repeated, negative experiences in relationships. Often, these happen in relationships with people who are meant to have our best interests at heart. Our brains learn from experience and unconsciously inform us about what is safe and what is dangerous. Even though we know on a logical level that relationships can be safe, it is difficult to feel that way (and really believe it) when your experiences have repeatedly shown you otherwise. People sometimes say tell me that they want to heal from these negative experiences so they can feel safe enough to establish healthy relationships again.
When you have a therapist who you feel safe with and who has your best interests at heart, your brain gets to have repeated new experiences in the context of a relationship. Because our brains “understand” the experiential language of relationships so well, these positive experiences can help us start to feel more safe with the idea of relationships in general. This is why the therapeutic relationship itself is a foundational part of the healing process.
As this process continues, we might become more clear about what kinds of things make a relationship feel safe (in a believable, tangible way that the nervous system can experience). For example, we might learn through experience with a therapist that it can be safe to have needs, to say no, to be more expressive, to say what we really think, or to disagree. We might even begin to feel that we matter, that our needs are not shameful, that we deserve support and protection, or that we are a person of worth.
Regaining a sense of agency
When we repeatedly go through difficult or overwhelming experiences, one of the first things we can lose touch with is the feeling that we are the author of our own lives. We might feel like we’re just reacting to what’s happening to us, or like we’re stuck within a negative pattern that we didn’t choose. This can leave us feeling small, believing that we are powerless, or even like we’re watching our lives happen without any ability to change things in a meaningful way. To me, it’s one of the tragic things about trauma, because it disconnects us from one of the things we need most: our agency. Agency is our sense of control, choice, and power over our own bodies, thoughts, and actions.
There are many reasons that our agency might fade into the background (mostly to do with survival and self-protection), but it is never fully gone. Therapy can be a place to rediscover agency and begin to feel a greater sense of empowerment. This has a way of helping us feel more “adult” in a sense—knowing (and really believing) that we have a voice, we have power, we have choice—these can help us face conflicts, fears, or potentially disempowering experiences with a greater sense of what we need.
One of the ways that this happens is (to reference the previous section) through the relationship with the therapist. In my view, a good therapist has the client’s best interests at heart, and this includes wanting clients to experience greater agency in their lives and in the therapy room itself. A safe therapeutic relationship will deeply respect a client’s autonomy and gradually support the client in rediscovering their own autonomy, strength, and power. An attuned therapist can help their clients notice and identify areas where they are feeling diminished agency, explore what is going on internally and externally that makes it feel that way, and help the client find their way back to what is reasonably within their control and/or what things they can pay attention to that may help them express and utilize their agency more freely and easily.
It is sometimes surprising to clients how many of the challenges they are currently facing stem from a temporarily diminished sense of agency. It is a joy for me to witness people rediscover agency not just as an idea, but as something that they can tap into as a tool for recovery.
