Trauma Counseling: What Feeling Safe in Therapy Really Means

Trauma-informed therapy has gotten a lot of attention over the past 20 years. Research shows that 10-70% of adults in America (depending on population) have experienced at least one traumatic event in their lives. Studies also indicate that “depression, functional impairment, and PTSD improve significantly” with trauma-focused psychotherapy (Melegkovits et al., 2022).  Which is good news, until the obvious question arises:

How can I feel safe in therapy, if a lack of safety is what leads me to therapy in the first place?

The most common definition of trauma in the mental health field is the result “from an event, series of events, or set of circumstances experienced by an individual as physically or emotionally harmful or life threatening and that has lasting adverse effects on the individual’s functioning and mental, physical, social, emotional, or spiritual well-being”(SAMHSA, 2014). Essentially, a real or perceived threatening event that has a long-lasting negative impact on a person’s sense of safety. 

Traumatic events can include one-time experiences like a car accident or natural disaster, or on-going events like military combat or assault. In every instance, the impact is felt on multiple levels like physically, mentally, emotionally, and socially. For this reason, trauma-informed therapy addresses a client’s nervous system, thoughts, feelings, and relationships. It requires a degree of strength and vulnerability which brings us back to safety.

Physical Safety

We’re all familiar with physical responses to danger: fight, flight, freeze. The processes involved in keeping us alive alter our sympathetic and parasympathetic nervous systems. Everything from brain function to the pores of our skin react to threat. Which is why physical symptoms of trauma often include body pain, heart problems, and digestive issues, among many others.

Physical safety in therapy looks like helping your muscles relax, your breath deepen, and your body functions regulate. Techniques that help the body “rest and digest” are often the first ones a therapist will use in trauma counseling.

Emotional Safety

A critical part of healing from trauma is processing what happened by talking about your experience with others. But too often friends and family aren’t able to provide the support you need. This is why trained trauma counselors are so essential.

Emotional safety means knowing you can share your past without fear of being judged, dismissed, or shamed. Trauma-informed therapists listen with curiosity and compassion. Usually not forcing you to remember, process, forgive, heal, or move on unless it’s what you want to do.

Relational Safety

Counseling is rooted in the promise that therapists are reliable and respectful. This is important in trauma counseling because it is understood that someone struggling with trauma may need a calm, consistent, and patient person to walk alongside them. Relational safety means having a therapist with clear and predictable boundaries. Who lets you determine the direction or pace of treatment and lets you say “no” when you need to.

Safety and Comfort Are Not the Same in Trauma Therapy

In trauma counseling, it’s important not to confuse safety (something without danger) with comfort (something that feels good or familiar). Thinking, feeling, and talking about horrible experiences won’t feel comfortable and that’s ok. The long road of repair and resilience happens gradually. Building trust with your therapist is the first step to building trust in a future where your voice is heard and your choices are respected. Working with a trauma-informed therapist is an ideal place to start.

How We Can Help

If you’re wondering how to begin healing when your safety has been disrupted, working with a trauma-informed therapist can offer a place to start at your own pace. Our therapists are trained in a variety of trauma-focused approaches and prioritize creating physical, emotional, and relational safety. We also offer options through our Affordable Counseling Program to make support more accessible so schedule a free 20-minute consultation to explore what feeling safe in therapy could look like for you.

Sources:

Melegkovits, E., Blumberg, J., Dixon, E., Ehntholt, K., Gillard, J., Kayal, H., … Bloomfield, M. (2023). The effectiveness of trauma-focused psychotherapy for complex post-traumatic stress disorder: A retrospective study. European Psychiatry, 66(1), e4. doi:10.1192/j.eurpsy.2022.2346 

Substance Abuse and Mental Health Services Administration. SAMHSA’s Concept of Trauma and Guidance for a Trauma-Informed Approach. HHS Publication No. (SMA) 14-4884. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2014.

Author Biography

Cierra McNamara is an intern therapist and a provider for the Affordable Counseling Program at Catalyss Counseling. She works with ill or aging adults and overwhelmed caregivers to manage grief, anxiety, depression, exhaustion, and compassion fatigue. Her goal is to help you uncover the courage, patience, and wisdom you need to feel whole when life is falling apart. Cierra has two decades of experience working with individuals and families who are navigating critical illness and end of-life. Follow Catalyss Counseling on LinkedIn, Facebook, and Instagram.

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Other Therapy Services Available at Catalyss Counseling:

Here at Catalyss Counseling, we want to meet all of your counseling needs in the Denver area. Our supportive therapists provide depression counseling, therapy for caregiver stress, grief and loss therapy, stress management counseling and more. We also have specialists in trauma and PTSD, women's issues, pregnancy and postpartum depression or anxiety, pregnancy loss and miscarriage, and birth trauma. For therapists, we can also provide clinical supervision! We look forward to connecting with you to help support your journey today.