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Trauma therapy should be phased

It is not unusual for people to walk into a therapy session for their first or second session expecting to share the details of their story. They want, or feel like they should, describe and relive their traumatic experiences with the expectation that telling will bring healing. While there certainly can be healing in sharing our stories, in being seen, in having someone else hold our worst moments for us … this retelling of our worst moments can, instead, destabilize and retraumatize us, leading to an increase in the very symptoms we are seeking relief from.

To guard against destabilization and retraumatization, research shows that trauma therapy needs to occur in a phased approach. While different theories recommend different phases, three common phases include:

1. Stabilization

2. Trauma Processing

3. Integration

Stabilization usually includes psychoeducation and helping people develop skills and resources needed to regulate painful emotions. Phase one includes making sure individuals are no longer in danger, especially inside of their own homes, as well as the reduction of harmful and impulsive behaviors including substance abuse, self-harm, and other process addictions. This creates the foundation that people with trauma need in order to process their trauma safely, without significantly decreasing daily functioning.

Once people are stabilized, trauma processing can safely begin. Return to phase one stabilization is normal throughout treatment as present day life stressors or trauma processing increases stress levels and a refocus on safety, resources, and skills becomes beneficial.

You should not be asked to relive/retell the details of your trauma when starting out in therapy. Doing so ignores the golden standard of phased trauma treatment and may cause significant increase in symptoms and decrease in daily function.

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