What Does a Trauma-Informed Approach to Therapy Mean?

Starting therapy after trauma can feel daunting. You may wonder whether you will be expected to talk about things you are not ready to revisit, or worry that exploring the past will leave you feeling overwhelmed.

For some people, simply making the decision to seek therapy can bring up difficult questions. How much will I have to talk about? Will I be believed? What happens if I become upset? Will I lose control of my emotions?

A trauma-informed approach begins with an awareness of these concerns. It recognises that experiences of trauma can affect how a person feels, thinks, relates to others, and experiences their own sense of safety.

What Trauma-Informed Therapy

Means

Trauma-informed therapy is not a particular therapeutic method. The term is used to describe an approach that takes seriously the ways in which trauma can affect a person’s experience of themselves and the world around them.

For someone who has experienced trauma, things that might seem straightforward to another person can sometimes feel much less simple. Trust may be difficult. Closeness may feel unsettling. A situation that appears safe may still create a strong emotional or physical response.

These reactions can make more sense when they are understood in the context of what a person has lived through. Rather than seeing them as weaknesses or problems that need to be overcome, therapy can explore how they developed and what they may have been protecting you from.

Safety, choice and pace

One of the most important parts of working with trauma is that you do not have to tell your story before you are ready.

Therapy can begin with what is happening in your life now. We might think about anxiety, relationships, emotional reactions, difficulties with trust, or a sense of always needing to stay alert. As we begin to understand these experiences, connections with the past may gradually become clearer.

There is no need to force those connections. Some people have clear memories of what happened. Others have a less definite sense that something from their past continues to affect them. Both experiences can be meaningful.

Working at a manageable pace can be particularly important when experiences have left you feeling that you have little control. Having a say in what you talk about, what you do not talk about, and when you want to explore something further can itself become an important part of the therapeutic process.

Understanding what happens in the present

Trauma is not only about what happened in the past. Its effects can continue to be experienced in the present.

You may find yourself becoming anxious in situations that remind you of earlier experiences, even when you know intellectually that you are safe. You might become very alert to changes in other people’s moods, find it difficult to relax, or feel disconnected from your emotions when things become too much.

Relationships can be affected too. You may find it difficult to trust, fear rejection, feel responsible for other people’s feelings, or struggle with closeness even when you want connection.

Understanding these responses can help make them feel less mysterious. Rather than asking why you cannot simply stop reacting in a particular way, therapy can explore what the reaction means and how it has developed.

How this informs my work

In my own work with people who have experienced trauma, I try to keep this understanding in mind throughout therapy. This means paying attention to safety, choice and pace, and being careful not to assume that talking in detail about traumatic experiences is always the right place to begin.

Sometimes the most useful work is about understanding what is happening now and finding a greater sense of stability in everyday life. At other times, it may feel helpful to make sense of experiences from the past and the ways they continue to shape the present.

The work is different for each person. There is no single way that trauma needs to be approached, and therapy should respond to the person rather than asking the person to fit a particular model.

What can change

Trauma does not have to remain the organising force in your life.

As experiences become more understandable, it can become easier to recognise what you are feeling, distinguish past from present, and have more choice in how you respond. You may begin to feel less governed by fear or vigilance, more able to trust yourself, and more able to experience relationships without the same sense of threat or uncertainty.

Change is usually gradual. It is not about erasing what happened or pretending that it no longer matters. It is about finding a different relationship with what you have experienced, so that the past has less power to determine how you live in the present.

If you are considering therapy following difficult or traumatic experiences, you may also wish to read my page on Therapy for Trauma in London, where I describe more about how I approach this work.