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Writer's pictureEmily Smith

The Depths of Severe Trauma Treatment: Trauma Therapists Have to Dive Deep

In the world of mental health and therapy, perhaps no calling is as nuanced and delicate as working with clients who have endured severe trauma. Whether it stems from childhood abuse, combat experiences, emotional neglect, natural disaster or the vast array of other traumatic events and prolonged experiences, the effects can ripple through every aspect of a person's life, leaving deep scars that may seem impossible to heal.


As a therapist specializing in trauma, I've witnessed firsthand the transformative power of providing a safe and supportive environment for clients to explore and process their experiences - this is sort of "trauma therapy 101." Time and again however, I've been witness to and heard stories from clients who truly wanted to experience the intensity of deep resolution, though they felt like they "couldn't quite get there." Not all therapists are one-size-fits-all. There are mental health professionals with specialized approaches who are trained to handle and hold space for the most intense trauma responses, contrasting this approach with methods that may inadvertently retraumatize or overlook the depth of a client's suffering. We understand that the conscious memory of our experience and the unconscious impact on the mind, body, and spirit often take root in different places. Therefore, more "traditional" forms of therapeutic work don't touch the trauma.


One crucial aspect of trauma therapy is understanding and addressing dissociation, a common response to overwhelming stress or trauma. Dissociation involves a disconnection between thoughts, identity, consciousness, and memory, and it can manifest in various ways, from feeling numb or detached from reality to experiencing a lack of memory surrounding the traumatic events. For many therapists, encountering dissociation in a client can be daunting, leading them to either avoid addressing it altogether or attempting to "fix" it quickly. In my work as a trauma therapist, I've more often seen intense responses to severe trauma be treated as the wound itself that needs healed, versus the window to the pain that holds the key for long-lasting healing.


Therapists that work with severe forms of trauma recognize dissociation as a natural survival mechanism—a way for the mind to protect itself from experiencing overwhelming emotions or sensations. Rather than seeing dissociation as a problem to be solved, they view it as a valuable tool for coping with trauma. By gently guiding clients to explore their dissociative experiences without judgment or pressure, therapists can help them reclaim agency over their minds and bodies, gradually reintegrating fragmented aspects of their selves.


Central to this approach is the concept of holding space—a term often used in therapeutic circles to describe the act of being fully present and attentive to a client's emotional experience without trying to steer or control it. Holding space means creating a container of safety and trust where clients feel empowered to explore the depths of their trauma at their own pace. It's a term that is so widely used, yet rarely do we take the time to break down what it actually means - especially in the context of trauma work. "Holding Space" most often involves validating a client's emotion, normalizing their experiences, and providing gentle guidance when needed. In the trauma-treatment world, it also requires the trauma therapist to communicate verbally and nonverbally the message that they are able to "handle" the raw elements of a client's pain. Those of us that do this work know that our clients can feel within themselves - either consciously or unconsciously or both - whether or not their therapist will be able to go to to the depths that they need to go to. In my work with client's is a perpetual goal of mine to communicative in every way that I can - "I've got you. I'm with you. Whatever you have to bring here, I have room for it. There is not a level of pain that you can share with me that I will not hold space for."


Contrarily, methods that treat trauma responses in a more timid or cautious manner risk perpetuating feelings of shame, guilt, or inadequacy in clients. When therapists shy away from addressing dissociation or other intense trauma symptoms, clients may feel misunderstood or invalidated, hindering the therapeutic process and potentially exacerbating their symptoms.


Even further, by avoiding the discomfort of confronting trauma head-on, therapists may inadvertently reinforce avoidance behaviors in clients, preventing them from fully processing and integrating their experiences. Trained trauma therapists understand that healing from trauma requires courage and resilience—the willingness to confront pain and discomfort in order to emerge stronger and more whole on the other side. We also know that because they're sitting across from us, they already have that courage and resilience. Perhaps, the ingredient that's really missing, is a professional with the tools to dive deep.




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