Why you would benefit from seeing a trauma-informed therapist, even if you don’t have PTSD

Trauma-informed therapy may help you see a clearer and fuller picture of what you are dealing with.

Not everyone knows about or seeks trauma-informed therapy. Often times, when we meet with new clients for the first time, they will not identify themselves as trauma survivors. They may not mention any significant traumatic event in their lives, such as a natural disaster, school shooting, physical or sexual assault, major medical trauma, car accident, or participating in combat. They may not meet all the criteria for what the DSM-5 identifies as Posttraumatic Stress Disorder (PTSD).

And yet, they have had chronic depression or anxiety, their minds are restless, their relationships are wrought with difficulties, they have found ways of avoiding people, places, activities that make them feel ill-at-ease. They may have seen a therapist for depression, panic attacks, feeling stuck at a job, relationship problems or anger. And yet, they do not feel well and the problems are not going away by themselves, or even with the help of a therapist generalist. Sounds familiar?

Here is why a trauma-informed therapist may be better equipped to help.

On the one hand, there are those of us who, for a number of reasons including shame, self-blame, or cultural stigma, may not be identifying certain life events as traumatic. For example, childhood adversity, such as witnessing a domestic discord or aggression between your parents, having a parent who is an alcoholic or a drug user, living in poverty or in an unsafe neighborhood, being exposed to bullying (even as a witness), having early losses of loved ones, or even having a parent with PTSD or another mental illness, adjusting to the challenges of immigration, multiple moves or separations from loved ones, can contribute to what we call developmental trauma.

Developmental trauma is not the same as the DSM-5 diagnosis of PTSD, but it does lead to problems like:

  • frequently feeling like our emotions are out of control,
  • feeling stuck in our jobs, relationships, life in general, but not having the motivation or self-confidence to change them
  • having difficulty creating or maintaining meaningful intimate relationships,
  • viewing others or the world as dangerous, scary, and untrustworthy,
  • experiencing chronic depression, loneliness, or helplessness,
  • and coping with these through the use of food, substances, self-harm, overworking, isolation, reckless or risky behaviors, and other ways of numbing out the pain

There are many reasons why we do not acknowledge these events and characteristics of life as traumas. We live in a kind of “suck it up and pull yourself by the bootstraps” society which is quick to blame our mental health problems on us. If we are depressed or anxious, then we are just not trying hard enough.

There is also a kind of a reluctance to use the word trauma or seeing ourselves as traumatized by something that happened in our lives. We like to believe that we are resilient, and often fail to see that having survived adversity AND being impacted by it do not negate our resilience. It is not uncommon in our profession to hear people talk about all kinds of childhood adversity and in the same sentence say that it did not affect them. They have often experienced the rejection or abandonment of others, who minimized or downplayed the impact of such events. It is difficult in such an environment to recognize that, say, chronic bullying or your parents’ dealing with alcoholism/addiction can be traumatizing to a child. Importantly, the problems you are likely to have as an adult, resulting from such early adversity, may not and, in fact, often do not manifest themselves as clinical PTSD. 

On the other hand, this is not to say that trauma is at the root of every mental health problem.

There are truthfully many of us who do struggle with depression or anxiety, are chronically stressed or overwhelmed, or are experiencing difficulties in our relationships or jobs, and do not have significant trauma histories. We then become very good at beating ourselves up for having these symptoms—a harsh inner critic constantly chanting “Nothing that bad has ever happened to you, so then why do you still feel this way?! You must be broken, your brain is broken!”

Or maybe you are going through a particularly stressful time in your life, such as a transition, unemployment, medical problems, divorce, or grief. Your mind feels overwhelmed and trapped in the circumstances, and you are aware that you will eventually come out of it, but right now, your head is in a fog and you cannot see the way out. In all of these situations, a trauma-informed therapist will be best equipped to connect the dots of your past and present. He or she will pay attention to the threads and themes running through your life. In trauma-informed therapy, you will not only gain insight into how difficult experiences and stressors are connected to your current difficulties, but also learn how to manage them.

Trauma-informed therapists learn early on to look at all behaviors as adaptations.

Even ones that may be preventing you from living the life you envisioned, such as substance use, emotional shutting down, anger and aggression, chaotic relationships. Such behaviors-adaptations should not immediately be condemned, but understood. They may not be adaptive anymore, but they once were, whether ensuring your physical or emotional survival. A trauma-informed therapist will look at the function that these behaviors and emotional reactions serve and help you learn and practice new, healthier ones that would lead to achieving this function, whether it be safety, becoming more assertive, feeling more competent, reducing feelings of sadness, emptiness, or depression, or achieving healthier intimacy.

And then there is the mind-body connection.

A growing area of interest for psychologists today is what we call “embodied cognition.” It is the idea that our mind is inextricably connected to our bodily and physiological experiences, our thoughts, feelings, and the images which we use to process them cannot exist irrespective of our physiological states. Trauma-informed therapists are on the front lines of driving this knowledge and research, because we know that trauma is first and foremost in the body. It is a massive shock to our system and everything else following it, all the symptoms of PTSD or other traumatic responses are a way of coping with that has happened. In that sense, even if you do not suffer from PTSD or have significant trauma in your past, a trauma-informed therapist will help you get better connected to your body, to more effectively identify patterns of physiological activation or deactivation, and how they are connected to your thoughts, feelings, interactions, and ultimately mental health.

Behavioral and cognitive therapies tend to give significant importance to your thoughts and trying to challenge and modify the ones that are considered negative and therefore related to depression or anxiety (e.g. “I am unworthy of love, nobody will want to be with me” or “I cannot drive over a bridge without having a panic attack”). However, they miss a very critical component of how these thoughts are represented in our bodies, through physiological activation that can initially be so subtle that we do not even notice an emotional reaction start to unfold until it is too late and we are now deep into a panic attack, screaming match with a loved one, or a cycle of depression and self-criticism that we cannot pull ourselves out of.

Education and experience.

And last but not least, education and experience. A trauma-informed therapist will not only have obtained training in all of the traditional therapeutic modalities throughout their graduate school years. They will also have received additional training and post-graduate education in a field that is relatively new. Understanding the impact of trauma and toxic stress on the body are a fairly new branch of psychology and clinical practice. This means that your trauma-informed therapist is also someone who has invested time and resources to learn about cutting-edge techniques and most up-to-date understanding of how human beings work.

If you are interested in learning more, you can request a free phone consult with one of our trauma-informed therapists HERE or simply call us at 631-683-8499. All of our counselors at STEPS have made it our mission to expand our knowledge in trauma-informed care and provide the most expert, competent, and compassionate care to you and your family.

Author: Dr. Valentina Stoycheva

Dr. Stoycheva is the Co-Founder and Director of STEPS: Stress & Trauma Evaluation and Psychological Services, Long Island, NY (www.traumaprofessionals.com). STEPS is a group practice staffed with expert and dedicated clinicians, who strive to provide the highest quality trauma-informed and evidence-based treatment for all affected by stressful events and traumatic experiences. STEPS offers individual, as well as group and family therapy for adults and children of all ages who have been exposed to traumatic events, or love someone who is struggling to recover from a traumatic event.

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