Many of my clients share similar fears when I ask what they expect trauma therapy to be like.

I often wonder if this misconception is one of the reasons people hesitate to start trauma therapy. While I can’t speak for all trauma therapists, I hope that explaining what I typically do in the first few sessions can be helpful if you or someone you love is on the fence about starting.

General Therapy vs. Trauma Therapy

General therapists treat a wide range of mental health concerns and may not always have advanced, specialized training in trauma treatment. Trauma therapists, on the other hand, seek out specific training in trauma-focused modalities such as EMDR, parts work, somatic experiencing, sensorimotor psychotherapy, and others.

These are big words, but they all point to one important thing: we include the body in treatment.

Decades of research show that trauma is stored not just in the brain, but also in the body. When therapy is purely cognitive or talk-based, the body can be left out—often leading people to continue struggling with trauma symptoms despite years of therapy.

I frequently work with clients who have done talk therapy for years and still feel stuck. When we begin trauma therapy, many start to experience relief.

Takeaway: Trauma therapy works best when the body is included.

What the First Sessions Look Like

Every trauma therapist is different. In my practice, the first few sessions are focused on gathering information similar to a standard therapy intake, family of origin, social support, relationship with food (as I’m also an eating disorder therapist), current symptoms, goals for therapy, and safety concerns.

From the very beginning, I tell clients that answering questions is always optional. It is more than okay to not share something if it feels too dysregulating. It takes me time to assess a client’s window of tolerance, dissociation, and triggers.

When discussing trauma history, I ask for only a few words, like a blog post title. This isn’t because I don’t want to hear your story. It’s because we don’t want to open something we don’t yet know how to regulate or safely close.

Following Sessions

Trauma therapy moves at the client’s pace. Sometimes that means spending weeks or months building rapport and safety. This is not a delay; it’s essential. Trauma therapy is relational, and lasting progress depends on a foundation of trust and stability.

When starting trauma treatments like EMDR therapy, I spend time explaining the phases and what to expect. Clients are encouraged to ask questions and share any concerns.

Trauma therapy is also not linear. We may move into reprocessing, then pause to return to resourcing if life stressors come up. This might include nervous system regulation, parts work, skills building, or talk therapy.

Key Takeaways

If you take anything away from this blog post, I hope it’s that trauma therapy is not about forcing you to relive painful experiences. Trauma therapy is intentional, collaborative, and paced with your nervous system in mind.

You are never expected to share more than what feels safe. A trauma therapist pays close attention to signs of dysregulation and will prioritize stabilization and resourcing before doing any trauma processing. This means learning skills to help your body feel grounded, present, and regulated before touching traumatic material.

Trauma therapy is also not a one-size-fits-all approach. What works for one person may not be right for another, and that’s okay. Part of the work is figuring out what feels supportive for you, whether that includes EMDR, parts work, somatic techniques, talk therapy, or a combination of approaches.

It’s also important to know that progress in trauma therapy doesn’t always look like constant forward movement. There may be times when we slow down, pause, or return to resourcing because life happens. This is not a setback; it’s part of doing trauma work in a way that is sustainable and respectful of your nervous system.

Finally, trauma therapy is not about “fixing” you. Trauma responses are adaptive and often developed to help you survive difficult or overwhelming experiences. The goal of trauma therapy is to help your system feel safer in the present so that those survival responses no longer have to work so hard.

If you’ve been hesitant to start trauma therapy because you’re afraid of being overwhelmed, retraumatized, or pushed too quickly, I hope this offers some reassurance. Trauma therapy should feel supportive, empowering, and grounded in safety. Healing happens at your pace, and you don’t have to do it alone.

By: Megan Samuels, MSW, LCSW-C, Trauma and Eating Disorder Therapist at The Eating Disorder Center

Photo Credit: Unsplash

Guest Post Disclaimer: This guest post is for educational and informational purposes only. Nothing shared here, across CPTSDfoundation.org, any CPTSD Foundation website, our associated communities, or our Social Media accounts, is intended to substitute for or supersede the professional advice and direction of your medical or mental health providers. The thoughts and opinions expressed are those of the guest author and do not necessarily reflect the views of the CPTSD Foundation. For further details, please review the following: Terms of Service, Privacy Policy and Full Disclaimer

Megan Samuels

Megan Samuels, MSW, LCSW-C, is an eating disorder and trauma therapist at The Eating Disorder Center, practicing in Maryland and Virginia.  She offers therapy for teens and adults, focusing on the intersection of trauma (including complex trauma and dissociative disorders) and eating disorders.  She is passionate about providing compassionate and supportive care for folks struggling with an eating disorder and/or trauma.

Learn more at https://www.theeatingdisordercenter.com/

As I listen to Elton John’s “Don’t Let the Sun Go Down on Me” on a loop, I mentally counter the lyrics with the fantasy that the sun will just fall from the sky. Can’t it do me the courtesy of burning out and shrouding me in complete darkness at long last? All it does is illuminate the scorch of my pain. The cruelly ironic side effect of CPTSD is that it often leaves us longing for invisibility even as we are desperate to be seen. It seems to “force” us into actions that are counterproductive to our well-being. Take, for example, my self-imposed exile to a darkened room, where I  repeatedly listen to a song that only makes me sadder. I’m not doing myself any favors, but here I sit.

In a deep depression, compounded by the uncomfortable weight of a generalized sense of claustrophobia, I want to hide from the light. As an added bonus, my seasonal depression, which swings in the opposite direction of what many people experience, buries me deeper in despair. Most people afflicted with Seasonal Depression Disorder experience it at a time of year when the world is overcast, gray, and cold. Meanwhile, in the middle of the hottest and brightest month of the year, I find myself barricaded in a completely darkened room, longing for the forlorn and lazy days of winter to wrap me in a blanket of security. I lay shrouded in the comfortable embrace of darkness and the familiar numbness of profound loneliness. I don’t see any reason to get out of bed or find the light in anything. Right now, I only have room in my heart for darkness.

Part II:

Fortunately, before I sank too deeply into the cave of my pain, my therapist coaxed me from my hole. In the previous day’s therapy session, I voiced profound despair; today, I reached out to her via the patient portal to let her know that the spiral continued downward. She asked if a quick call would be beneficial; that’s usually the part where I say “I’m okay” before covering my head with my pillow. Fortunately, a part of me knows that I don’t want to live that way anymore. I’m tired of burying myself in my head and hiding in the darkness. On the opposite end of the spectrum, my other go-to “coping strategy” of working myself so hard I don’t have time for contemplation also holds no allure. I’m exhausted with being a prisoner of the extreme coping mechanisms that long “saved” me while also suffocating me. Things have needed to shift for a long time, and I’ve allowed myself to shift in increments; I thus accepted my therapist’s offer for a call. Accepting help is a sharp deviation from my usual script. I grabbed hold of the metaphorical hand she offered, partially out of curiosity. What would happen if I didn’t fall into my usual patterns?

Our conversation, short but impactful, represents a slight but mighty shift from my “norm.” The fact that I allowed myself to even participate in an introspective discussion while locked deep in the jowls of depression constitutes a bit of a “miracle.” I am not someone who reaches outward when in despair; instead, I deflate, falling inward. So why wouldn’t I use my coveted vacation time to hide in my room and drown myself in a self-defeating soundtrack of sadness? Knowing my appreciation for Bob Dylan, my therapist encouraged me to change the tune to “Forever Young” and venture out into the sunshine. I said I would try, thinking I would do no such thing. After some contemplation, I admitted to myself that she’s usually right about these things. I begrudgingly dragged my emotionally exhausted carcass outside. 

Part III:

Although I have not teleported into the land of rainbows and lollipops, I am surprised to discover beauty in the day. When I close my eyes, the sun glimmers across my eyelids like glitter. Even as the darkness beckons me inward, I feel the current of hope tugging patiently at my heart. I am gently reminded by the breeze that lands upon my cheek that I will be okay. I’ve changed the soundtrack, and tears of gratitude trickle down my face. I reflect on the irony that the words and sentiment of this song, “Forever Young,” make me think of my Grandma (whose upcoming death anniversary has contributed to my spiral). I reflect on how her “youth” rubbed off on my old soul in many of our moments together. I smile in silent remembrance. I am grateful for the love she planted deep in my heart, even as others stripped me bare. It’s a reminder that things don’t have to be “all or nothing.” It doesn’t have to be pitch dark or glowingly bright. I can sit in the sunlight while feeling the darkness within. I’m in pain, and I’m healing; one does not negate the other. 

Healing is a nonlinear process filled with fluctuating moments of despair and hope, sometimes existing simultaneously. Some days I move forward, and others I fall backward. I often stand motionless. Every once in a while, I take a gigantic leap forward. I am taking it all in stride and am confident that I will eventually arrive at a place where I feel at home in my body and mind. For now, I’ll just sit here, patiently waiting for what comes next.

Lesson Learned:

Sometimes, small shifts can flip the script, which matters because we are the story we tell ourselves.

Sometimes, small shifts can flip the script, which matters because we are the story we tell ourselves. Although power may have been out of reach in the small and big moments that eroded our confidence in the world, in other people, and ourselves, we do have the power of choice in the small things as we move forward. Shifting just a little bit can be enough movement to redirect our trajectory in a healthier direction, ground ourselves in the place we are meant to be, and/or return us to our path of healing after we have temporarily lost our footing. Although we can’t change what happened to us, we can adjust trauma’s impact within us. We can learn to dance with, rather than battle with, the ghosts of the past. As a child, I could not liberate myself from the isolation created by the secrets that I carried around like an invisible suitcase. Decades later, I finally have the power to unpack the pain. I can’t change where I was then, but I can change where I am now. I can’t change who I was (or was not allowed to be) then, but I can be who I want to be now. 

Much of the pain I feel today lies rooted in the turbulent landscape of the past; it feels simultaneously ancient and new. The truth is that sometimes I need to wallow in it because when I lived it the first time in real time, I did so in survival mode. I couldn’t sit in anything too long. So, now, as an adult sometimes I do surrender to the pain. I’ve earned that right. And…I don’t want to stay in a place of deep pain. I don’t want the there and then of my life to dominate now. I can still honor what I survived, but I now hold the power to remove myself from the darkness. I can change the song and shift the scenery. Doing this enough times allows me to rewrite my script. 

I think that most of us who live with CPTSD have developed coping mechanisms that, over time, have crystallized into patterns. Although these coping strategies are born in efforts motivated by self-protection, they can hurt us and keep us stuck in places we don’t want to be anymore. None of us is ever going to wake up miraculously healed. Some days, it truly is a matter of just getting through the day. That piece by piece, day by day reality of healing can be excruciating and…it can be empowering. Each day is an opportunity to make small shifts that allow us to change the song and scenery. We can rewrite our script one action and one day at a time. We are the writers and directors of our lives now. 

Photo by Hannah Olinger on Unsplash

Guest Post Disclaimer: Any and all information shared in this guest blog post is intended for educational and informational purposes only. Nothing in this blog post, nor any content on CPTSDfoundation.org, is a supplement for or supersedes the relationship and direction of your medical or mental health providers. Thoughts, ideas, or opinions expressed by the writer of this guest blog post do not necessarily reflect those of CPTSD Foundation. For more information, see our Privacy Policy and Full Disclaimer.

Heather Jurvelin

Finally feeling truly alive for the first time in my life, I am writing from a place of gradual healing with an eye to the future and a hope of connecting with others on similar paths. Forced to withhold a tsunami of emotions deemed irrelevant under the roof of my childhood “home,” the blank white pages of my notebooks invited my raw reflections without judgment. Writing allowed me to free the burdens of my soul, but at some point, I muzzled myself. My pen lay dormant for years until, at 41 years old, I experienced a traumatic flashback during an everyday activity that shook me to the core. Five days later, I started writing about the things I had long withheld. I couldn’t stop. Written words have once again become my refuge. I now recognize that these words, resurrected from the ashes of my pain, may have the power to help others. Above all, I want to magnify and share the messages that I have most treasured on my journey: we are not alone and we don’t ever have to go back. This is where we live now and the future is ours.

The scaffolding that supports both therapists and their clients must extend throughout a career

Providing trauma-informed and trauma-focused care is not a static skillset. It requires ongoing learning, humility, and reflective practice. While clinical supervision is a mandated component for licensure, the professional and ethical responsibility to seek guidance does not end once a therapist becomes licensed. The scaffolding that supports both therapists and their clients must extend throughout a career.

One of the most effective ways to strengthen that scaffolding is through clinical consultation. Far more than an optional professional activity, consultation is an essential element of sustained growth, ethical decision-making, and high-quality client care. It offers therapists a reliable place for connection, safety, and reflection—while also modeling the very principles we aim to provide in therapy.

Supervision vs. Consultation: Distinct and Complementary

Many clients (and even some therapists) wonder: if supervision is required during training, why does consultation matter afterward?

Clinical Supervision – Required
In Virginia, as in most states, residents in counseling, marriage and family therapy, or other therapeutic degrees must complete a structured supervisory process before they may practice independently. During clinical supervision, a Virginia Board–Approved Supervisor (a licensed therapist with at least two years of post-licensure clinical experience and specialized training in supervision) helps residents integrate theory into practice, document hours, and develop the competencies that safeguard clients and set the foundation for a long career.

Clinical Supervision has a formal written contract with defined goals, required documentation, regular evaluation, and Board reporting. It supports the resident’s skill development, ethical practice, and confidence as a therapist-in-training, to safeguard the public, cultivate professional competence, and prepare them for independent practice. Clinical Supervisors take on this role to support newer therapists in building their experience in providing trauma therapy, guided by ethical judgment, clinical skills, and a strong professional identity.

Clinical Consultation – Optional and Vital 

Clinical consultation is for already-licensed therapists who want to deepen their skills, process complex cases, or learn new modalities. Not mandated by licensing boards, it is a voluntary, collegial process for licensed clinicians seeking advanced growth.

Clinical consultation is a growth-focused approach. It’s a collaborative space. Therapists bring questions, ethical dilemmas, and clinical puzzles to a supportive, nonjudgmental setting. Consultation ensures therapists are not practicing in isolation but instead have a community for connection.

Whether you’re pursuing advanced training (such as EMDR certification, which requires consultation hours for certification) or simply seeking peer feedback on complex cases, consultation is a space for learning and curiosity without the evaluative component of supervision.

A Trauma-Informed Approach

Consultation, like therapy itself, is most effective when grounded in trauma-informed principles. These principles ensure that the space for clinicians mirrors the environment we strive to create for our clients:

• Safety – Creating a welcoming, respectful space where sensitive clinical material can be shared.
• Trustworthiness & Transparency – Maintaining clear communication and a consistent structure to foster professional trust.
• Choice – Honoring the autonomy of each therapist in identifying consultation needs and applying feedback.
• Collaboration – Engaging in mutual problem-solving and shared decision-making.
• Empowerment – Highlighting strengths and validating the clinician’s expertise to build confidence.

When consultation is trauma-informed, therapists are reminded that they, too, deserve care, reflection, and support. This recognition sustains resilience and models the very principles that help clients heal.

Why Ongoing Consultation Matters for All Clinicians

Research shows therapists who engage in consultation report higher professional satisfaction and more effective client outcomes. Beyond data, consultation provides a lived experience of connection and growth that directly benefits both therapists and their clients.

Clinical consultation offers benefits that ripple out to every client:

• Professional Growth – Therapists refine existing skills, integrate new research, and their practice into specialized areas such as EMDR, parts work, or Trauma Informed Stabilization Treatment (TIST).
• Ethical Clarity – A structured space for navigating boundaries, confidentiality concerns, and complex clinical decisions.
• Relational Support – A safeguard against professional isolation and burnout through connection and shared wisdom.
• Bias Awareness – Opportunities to identify and address blind spots, cultural assumptions, and systemic factors that can impact equitable care.
• Creative and Collaborative Problem-Solving – Brainstorm treatment approaches in a judgment-free environment.

For therapists working with trauma, ongoing consultation is especially critical, and the work is never finished. Each client brings new challenges and unique histories that require us to think flexibly and compassionately. Even the most skilled practitioners benefit from consultation—deliberate, reflective professional support—to sustain ethical, effective, and compassionate care. As clinicians engage with clients’ deepest wounds, consultation becomes not a luxury but a foundational safeguard for both therapist and client.

The “Oxygen Mask” Idea

We often remind clients about self-care. The same is true for therapists. The emotional demands of the profession are real, and without adequate support, even the most skilled clinicians risk exhaustion or compassion fatigue.

Clinical consultation serves as the “oxygen mask” for the clinician—critical scaffolding that supports those entrusted with the healing of others. Just as passengers must put on their own mask before helping others, therapists must prioritize their own grounding and support in order to provide safe and effective care. Consultation offers that lifeline: a chance to breathe, reflect, and return to the therapy room with renewed clarity and compassion.

What This Means for Clients

For clients, the idea that your therapist participates in ongoing consultation may be reassuring. It means your therapist is not working in isolation but is actively engaging in continued education, reflective practice, and ethical dialogue with peers. It also means your therapist values humility—the recognition that no single practitioner has all the answers, and that collaboration leads to better care.

When your therapist seeks consultation, they are investing in you. They are ensuring that your care is grounded in the most thoughtful, current, and responsive practices available.

How Can I Help?

At Brickel and Associates, we are deeply committed to this standard of care. I offer:

• Virginia Board–Approved Supervision for residents in counseling and marriage & family therapy seeking Virginia licensure.
• EMDRIA-Approved Consultation for clinicians seeking EMDR certification or simply wanting to strengthen trauma-informed practice.
• Trauma-Informed Stabilization Treatment (TIST) Consultation provided by a Certified TIST Therapist and Senior Facilitator, for clinicians seeking expansion of their skills to work with complex trauma survivors
• Individual and Group Clinical Consultation is designed to foster collaboration, curiosity, and professional renewal for clinicians at all stages of their careers.

Therapists cannot pour from an empty cup. Consultation is the scaffolding that supports the clinicians who, in turn, hold their clients. Whether you’re on the road to licensure or decades into your career, you deserve a safe, skilled, and trauma-informed place to connect and grow.

Clinical consultation is more than professional enrichment—it is a cornerstone of ethical, effective therapy. For therapists, it offers community, reflection, and growth. For clients, it translates into safer, more attuned, and more effective care.

Just as therapy itself is a relationship built on trust, consultation is the behind-the-scenes scaffolding that sustains therapists so they can, in turn, hold their clients with presence and compassion.

Therapists cannot—and should not—do this work alone. Consultation is not just about professional development; it is about protecting the sacred space of therapy itself.

Photo by Christina @ wocintechchat.com on Unsplash

Guest Post Disclaimer: Any and all information shared in this guest blog post is intended for educational and informational purposes only. Nothing in this blog post, nor any content on CPTSDfoundation.org, is a supplement for or supersedes the relationship and direction of your medical or mental health providers. Thoughts, ideas, or opinions expressed by the writer of this guest blog post do not necessarily reflect those of CPTSD Foundation. For more information, see our Privacy Policy and Full Disclaimer.

Robyn Brickel

Robyn is a Licensed Marriage and Family Therapist with 20+ years of experience providing psychotherapy, as well as the founder and clinical director of a private practice, Brickel and Associates, LLC in Old Town, Alexandria, Virginia. She and her team bring a strengths-based, trauma-informed, systems approach to the treatment of individuals (adolescents and adults), couples and families. She specializes in trauma (including attachment trauma) and the use of dissociative mechanisms; such as: self-harm, eating disorders and addictions. She also approaches treatment of perinatal mental health from a trauma-informed lens.

Robyn also guides clients and clinicians who wish to better understand the impact of trauma on mental health and relationships. She has a wide range of post graduate trauma and addictions education and is trained in numerous relational models of practice, including Emotionally Focused Couple Therapy (EFT), the Psychobiological Approach to Couple Therapy (PACT), and Imago therapy. She is a trained Sensorimotor Psychotherapist and is a Certified EMDRIA therapist and Approved Consultant. Utilizing all of these tools, along with mindfulness and ego state work to provide the best care to her clients. She prides herself in always learning and expanding her knowledge on a daily basis about the intricacies of treating complex trauma and trauma’s impact on perinatal distress.

She frequently shares insights, resources and links to mental health news on Facebook and Twitter as well as in her blog at BrickelandAssociates.com

To contact Robyn directly:

Robyn@RobynBrickel.com

www.BrickelandAssociates.com

brickelandassociates.com/