Many of us are impacted by adverse events and experiences that occurred to us in childhood, adolescence or during other times in our life. These might include interpersonal emotional and psychological abuse, neglect from our caregivers or other people in our families and communities, sexual and physical abuse as well as exposure to family violence and the impacts of unsafe and inconsistent living environments. Sometimes, our caregivers and parents have their own trauma histories and they are still impacting them when they have children.
The effects of trauma often mean that these events and experiences impact us in the way we relate to others, see ourselves or feel safe in the world. They can have an ongoing impact on our health, well-being, relationships and connections with our communities.
There are many ways for people to heal and recover from these experiences. Many survivors turn to health professionals for trauma-informed counselling. Others find other pathways which can include a range of different approaches including cultural practices, creative pursuits, yoga, mindfulness etc. Trauma-informed care has become somewhat of a buzzword with health professionals and service providers, but what does it mean?
UNDERSTANDING TRAUMA
At its essence trauma-informed interventions and approaches entail always considering the possibility that anyone with whom you are interacting may have experienced or be experiencing trauma/s. As we go through life, we experience many ups and downs which impact us along the way. Normal ups and downs of life create challenges for us all but are not the kinds of traumas that we are talking about. Sometimes people experience a single incident of trauma or a series of single incidents that are traumatic or challenging. We call these single incident traumas. We all have our own experiences and most of us have experienced some kind of trauma, over time. This can include bushfires, floods, accidents or single episodes of assault as an adult.
COMPLEX TRAUMA
Complex trauma is different from this. This kind of trauma occurs with people in our lives over time and repeatedly. Many trauma survivors have not identified that what happened to them was abusive or indeed traumatic. Some will have ‘forgotten’ about their experiences or not made the connections between what happened to them and their current challenges. Many times, community views about trauma are that the events need to be significant and physical in nature. Many survivors of trauma may have experienced these kinds of traumas but others will have experienced psychological and emotional traumas as well as neglect, bullying and unsafe living environments. Emotional /psychological and environmental traumas also have significant impacts.
Complex trauma often leads to a sense of self blame and shame for the survivor, and a belief that there is something wrong with them rather than an understanding that something unbearable happened to them. Many survivors have not realised how these relationships and situations impacted them as they were growing up.
While people survive these adverse experiences as best they can, experiences of trauma threaten a person’s basic sense of safety and are often a fundamental abuse of power and betrayal of trust. The sheer power of surviving needs to be acknowledged and honoured.
While many survivors display remarkable resilience and their strengths, and coping strategies need to be celebrated, trauma, especially when repeated, and experienced in childhood can leave the person struggling with significant impacts. Much of what has traditionally been called symptoms are coping strategies and impacts. A trauma-informed perspective understands people’s struggles with shame, self-blame, low self-esteem, difficult relationships, every day activities, health and well-being in the context of what happened to the person. And looks past the difficult and challenging behaviours to their meaning for that person.
BEING TRAUMA-INFORMED
Trauma-informed services, and those who work in them, are aware of how common trauma is, of the ways the body, mind and emotions respond to trauma, especially when it is repeated and the ways survivors cope. This includes an understanding of the body’s physiological fight, flight, appease and freeze responses, triggers, and the challenges many survivors have with regulating strong emotions and managing their different in levels of arousal i.e. from being hyper-aroused (hyper-vigilant and easily started) to shut down and hypo-aroused. These services understand trauma, its dynamics and its effects and how best to work with people to help them feel safe, build trust and understand their own reactions.
Practitioners who are trauma-informed understand the importance of working with the whole person – with their body, mind and emotions supporting each person to identify and build on their internal resources (this means supporting them to build their own capacity to understand what is happening to them and increase their capacity to manage triggers and challenging situations as they occur), and to start to identify and access external supports, as much as possible. In so doing workers and practitioners can support survivors to better manage their emotions, identify and their manage triggers, and calm their nervous system to allow them to think, process and respond rather than react.
When workers, practitioners and services are trauma-informed they support survivors in a way which seeks to not retraumatise them and which promotes healing, through a variety of strategies and approaches. Being trauma informed means adhering to 5 basic principles as well as attuning to the person being supported – this means attuning to all sorts of diversity and culture. The five core principles are safety, trustworthiness, choice, collaboration and empowerment.
HOW DO YOU CHOOSE THE COUNSELLOR FOR YOU?
We are all different and what helps one survivor might not suit another person. Many people do not wish to go to counselling or therapy and cannot either because they can’t access it; it is not affordable; no one offers trauma-informed counselling in their area or the idea of counselling is not part of their culture. Many survivors have other needs – from housing support, assistance navigating Centrelink or finding a group, help with shopping or care in the home or finding culturally appropriate ways to heal and recover. Regardless of what support you need, it can make a big difference if the service, support worker or counsellor is trauma-informed. This is not always easy and often depends on where you live as to what is available.
Here are a few things to consider / ask for which might help you in your search:
If I come to your service, what is it like? Is it in a place in which I will feel safe and comfortable?
If access is challenging, does the service provide other ways of delivering their service, eg video conferencing, telephone, home visits?
Do all the staff understand about trauma, including the people at the front desk?
Is there a waiting list?
What can and can’t your service do?
What are the spaces like? Can I have a choice as to where and when we meet?
Who will see me? Will it be the same person as much as possible?
Think about what you need to help you to feel safe, have choices and feel empowered and ask questions which help you see if those needs will be met? This can relate to different qualities in the practitioner and the way they work together with you.
CULTURAL CONSIDERATIONS
If you have needs that relate to your culture, here are a few things to consider / ask for which might help you in your search:
Does the service have workers from your culture or who understand these cultural needs and are culturally sensitive?
Does it try to find out about your cultural needs?
Does the service have a gender diverse approach?
Does it welcome and attune to diversity?
THE SESSIONS
If you are looking for a trauma-informed counsellor It can be very hard for anyone to choose a counsellor, therapist or service. It can be especially challenging if you were abused or traumatised as a child. It can feel confusing and time-consuming. It is a good idea to ‘shop around’ before you choose. If you are in touch with other survivors in your area, ask them for their suggestions. It is also helpful to prepare a list of questions eg What is his/her experience in working with survivors? Be clear about what you need and want from a therapist.The following advice might help you:
What approach(es) does he/she use?
How much will it cost? Is there a concessional rate? What are payment options?
How available is he/she?
What happens in a session? How long are they?
What happens if I need to cancel a session?
Can I make contact between sessions? What happens when you take holidays?
What happens when we finish therapy? Could I come back again? Will I be part of the decision-making process?
THINGS TO BEWARE OF:
Beware of therapists who stress a particular approach or technique, or who are dogmatic about issues such as forgiveness, confrontation, etc.
Beware of therapists who give hugs, shake hands too readily, or sit too close without invitation, who seem like they will be your friends or who suggest informal meetings.
If you do feel uncomfortable when interviewing a therapist, trust your instincts.
Beware if your therapist seems overly interested in your sexual history and questions you in detail, especially when the questioning appears irrelevant.
Be aware of therapists who talk about their own abuse history - the sessions should be about you not about the therapist.
Beware if your therapist avoids sensitive issues and talks in generalities. Is your therapist able to handle the feelings and content that you bring to therapy?
YOUR EXPERIENCE:
The therapist you choose should be a good listener. They should be empathetic and non-judgmental. Your therapist needs to be a trusted partner in your process. Ask yourself the following:
Do I feel intimidated by this therapist?
Does he/she listen to me?
Do I believe that I can disagree with him/her?
It is also important for your therapist or counsellor to seek your feedback in a genuine way. All relationships can experience have ruptures from time to time It is important for you to be able to share with the therapist situations that haven’t gone well for you or that you are anxious or concerned about. This is part of relationship building and important in the work. A good therapist will welcome your feedback without being defensive.
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