If you have trauma then looking for the right trauma-informed therapist matters. Therapists have access to a wide range of training opportunities for trauma treatment but just saying they’re “certified” as “trauma-informed” might not be enough.
Here is a a short list of questions to ask your therapist at your first session to find out if your therapist is ready to do the work with you or just giving trauma lip-service.
What are the most important things you think about when starting up with someone who has a history of trauma?
The most important thing to establish before doing any kind of trauma work is a relationship. That means that it might be several sessions before you even begin talking about the trauma that might have brought you into therapy, and that’s okay, it’s even expected!
The relationship between both the therapist and the client needs to feel relaxed and safe—if you are starting to ease into things but you are still sensing your therapist is anxious, unsettled, or unsure about how to move forward, that’s a good sign that it isn’t the right fit.
Also, after a connection has been made it has to be maintained. One of the hallmarks of trauma is the impact that it has on our ability to securely navigate the rupture and repair cycle of a relationship (meaning when something goes off track it feels like you can repair it and talk about it with the other person safely).
Misunderstandings are going to happen in the therapeutic relationship, especially as you get to know someone, and a trauma-informed therapist needs to be able to hear when they’ve got something wrong or made a mistake and offer support and understanding, whether they felt like they were in the wrong or not. (Please don’t outright lash out at your therapist though, or you might be met with boundaries before the dialogue begins.)
A quality relationship is the cornerstone of good trauma work—without it you are not going to be able to settle into the work in a meaningful way and reap the full reward. A trauma-informed therapist will lead you back to relational safety with confidence and compassion.
Have you been impacted by trauma?
This is a sneaky but important question and here’s why: not every therapist will (or should) disclose their own personal trauma (especially in any detail!) but a trauma-informed therapist will recognize immediately that we have all experienced trauma in one way or another, and will be able to talk about how trauma impacts different spheres of life.
Also, it’s not enough as a trauma-informed therapist to simply say you are trauma-informed, you need to have experience integrating trauma in a meaningful way. That doesn’t necessarily mean that your therapist needs to have dealt with difficult or life changing trauma, but simply working in a therapy setting exposes therapists to trauma and they need to have some personal understanding of the way it feels to integrate it.
This is the difference between hiring a professional baker to make you a birthday cake versus someone who’s taken a class on cake decorating. The concepts are the same but the experience is remarkably different. A lot of therapists can get “certified” as “trauma-informed” and still have no “boots on the ground” experience of actually integrating trauma. If you’ve got trauma, you deserve to have a therapist who fundamentally understands what that means and what to do about it.
So…
How do you integrate trauma?
When someone says “I want to heal my trauma”, my reframe tends to be, “Let’s integrate it”.
Integrating trauma means that you collect all of the pieces of the experience of trauma (thoughts, feelings, core beliefs, and your felt, “somatic” or “body-centered” experience—think about your five senses) and bring them together into one cohesive narrative. Different trauma-informed modalities do this differently, but once a relationship is established, they all seek to have the same impact: integration that includes a meaningful dialogue about your somatic (body-centered) experience of the trauma.
When you ask a trauma-informed therapist how to integrate trauma they should be able to tell you (without hesitation) how they plan on doing that for you. Talking is not enough. In fact, a lot of my clients often tell me that they have spent months, sometimes even years, in traditional talk therapy talking through their trauma and it either felt like it had a very small impact or at times even made things feel worse.
There are many ways of integrating trauma…
Trauma-Focused Cognitive Behavioral Therapy (TF-CBT), Eye Movement Desensitization Reprocessing (EMDR), Somatic Experiencing (SE), the Hakomi Method, and a looser but quickly growing collection of newer treatment modalities that ask you to focus on your underlying energetic experience of the trauma from a body-centered perspective while using tried and true interventions that the Western Scientific World has borrowed from Eastern Religion and philosophy (think trauma-informed yoga, trauma-informed breath work, trauma-informed Reiki, and trauma-informed meditation just to name a few) all designed to get you into your body, allow the experience of trauma to move through, and help you focus on the conditioning beliefs that are associated with the experience of trauma itself. Some somatically focused trauma interventions just work with your body, like Tension and Trauma Releasing Exercises (TRE).
Red flags that your therapist might be giving lip-service to trauma informed treatment without any real experience to back that up:
Your therapist doesn’t prioritize building safety, security and relationship (or you feel this is lacking).
Your therapist is pushing you to do trauma work faster than you are ready to do it.
You’ve met for 3 sessions but your therapist hasn’t outlined a plan on how to move forward.
There’s no structure to your sessions, especially over time.
Your therapist is letting you lead the sessions and isn’t talking directly about addressing your underlying trauma.
Your therapist seems anxious, worried, overwhelmed, or distracted.
Your therapist had an emotional reaction to your experience that got in the way of their work with you.
Your therapist isn’t asking you about what you are feeling or sensing in your body.
Your therapist isn’t providing you with any education or tools to explain what’s happening to you or how to cope with it.
Something just doesn’t feel right. (This might be the most important--Always trust your gut!)
If you have concerns, what should you do?
Talk to your therapist and explain what you think might be happening. Therapists are humans too and sometimes we get things wrong.
Again, what makes the experience of therapy good is the relationship between a client and a therapist—if you don’t like something that’s happening, or you feel uncomfortable about something, make a plan to give your therapist direct feedback (even if it’s over email or secure texting) and give them a chance to repair the relationship. Your therapist wants to get it right and wants to give you a good experience. Some of the best relationships have a lot of ups and downs—trust is built when things go wrong and we are able to repair them.
If you give your therapist direct (non-aggressive) feedback and there is no attempt to fix things (or they fail to take responsibility or put the responsibility solely on your shoulders) then stop making appointments. There are a lot of great therapists out there and you do not need to be a learning experience for them.
Here are some examples of things that you could say to your therapist in this situation:
“Something feels off to me and I’m not completely sure what it is, but I feel uncomfortable when we meet. What are you noticing about our sessions?”
“These sessions feel like they’re moving too slow/fast for me. What can we do?”
“We’ve met for three sessions and I’m not sure this is the best fit. What do you think?”
“I’m a little confused about what should be happening in sessions, can you give me some clear guidance about what the plan is/what my treatment plan is?”
“I like coming to talk to you, but it feels like we’re not getting anywhere. What happens next in this process?”
All of these questions should be a cue to your therapist that they need to stop and evaluate what is happening in the sessions. The answers to these questions should provide you with reassurance, validation, and a structured plan for moving forward (or a combination of these things).
Again, therapists who are truly trauma-informed are going to value the relationship above and beyond whatever treatment interventions they are using because they will know that no successful trauma work is ever going to occur if the relationship does not feel safe and relaxed.
The next time you are on the hunt for a therapist, be trauma-informed yourself and find right fit!