Is Your Trauma Therapy Trauma-Safe?

I wasn’t planning to write this blog post today. I had other things to do, but after reading something I feel both angered and concerned, and I want to explain why…

I have a message here for those seeking help with trauma
…and I’m also hoping this will catch the eye of some of the people practising trauma intervention therapy out there and even those who are about to pay money to train to offer one or more of these therapies. And there is SO much out there! So many therapies that claim to heal trauma, PTSD or even CPTSD.

There are things that I would like you to be aware of before you take up coaching or therapy from someone who claims they can completely heal or cure your trauma or past abuse. Even from those who claim their therapy is science-based or evidence-based.

I want you to be aware of some important matters before your choose your therapy, because I have personally experienced some of the negative consequences of bad therapy first hand. Experiences I had in therapy before I knew better. Sadly, not just one experience – multiple experiences with multiple therapists that left me in a worse place than before I started, so you could say I learned the hard way. It was these experiences that pushed me to learn, and question my learning, and reflect and learn some more, sometimes from unexpected sources, and from that learning, and eventually I developed Gentle Trauma Therapy.

It might be considered impolite, or even unprofessional for me to criticise the work that others are doing. After all, aren’t we told that a big component in the success of any therapy is the quality of the therapeutic relationship between client and therapist? And surely we must agree that not one approach works for all people? And that different people can need different forms of help at different times?

I agree with all of the above. But that does not mean that anything goes in therapy, and today I saw something that was both potentially exploitative of a particular group of traumatised people and also it could be harmful to at least some of them, and I felt so angry I had to write about it.

Firstly, there was a dubious proposition: the service claimed to enable the abused person to avoid being abused again.

Now, education about warning signs of abuse has a place. And with foreknowledge, it may be that victims can make an exit at earlier stage, maybe before the abuser is able to cause any lasting harm. This ‘service’ wasn’t aimed at children, but let us be clear: it is NEVER OK to place the responsibility on children for avoiding being abused. But just because this particular service was aimed at adults, it doesn’t make it entirely unproblematic.

You may have heard of the Freedom Programme, which in it’s original form is aimed at supporting victims of abuse by intimate partners to recognise and recover from abuse. It’s a good programme.

If you have experienced domestic abuse, whether physical or psychological, if you can access the Freedom Programme, I recommend it. I have some of the material available in my consultation room and it is sometimes helpful in shedding light on patterns of abusive behaviour. And in my experience of the Freedom Programme, whilst it aims to help women identify patterns of abuse, and hopefully get away earlier if they encounter an abuser again…

IT DOES NOT CLAIM TO GIVE WOMEN SUPER POWERS TO AVOID BEING ABUSED EVER AGAIN.

There is a recognition within the Freedom Programme that domestic abuse is a societal problem and while there are still abusers at large, they will find someone to abuse. It is never within the victim’s power to completely avoid being abused. Ask someone who has lived through workplace bullying!

AND what is more, the Freedom Programme is offered FREE OF CHARGE!

So, you can see that if someone offers a programme that sounds at least in part, very similar to the Freedom Programme, but paid for, I’m already rather concerned. Both on the grounds of charging for a watered-down version of the tried and tested original, and by implying that this will somehow make you abuse-proof. No one can guarantee this for certain.
But that is not the thing that I felt really angry about. It was the claim that by offering in a single session… and not even a one to one session… a GROUP session… that you could completely heal from abuse.

Now, I NEVER string out therapy. And I never push the idea that therapy has to take a long time. Sometimes it does, and for very good reason, and that topic deserves it’s own blog post. After being involved in hypnotherapy, NLP and various other approaches for a long time, I’ve heard the claims made by therapists and trainers, I’ve seen the results, the good, the bad and the ugly, and I have seen traumas healed in one session on so many occasions.

The positive transformations I have witnessed have been inspiring and affirmed why I want to keep doing this work.

But completely heal from abuse? Who can claim that?

Do we EVER heal completely from anything that was genuinely traumatic?

If someone steps on a young plant and bends and breaks its stems, as long as the plant has the right resources, good soil, water, light and warmth, it may regrow, but it will be shaped differently. It will never regain what was broken and lost, but it might regrow in a new direction, one which it might never have taken. And so it can be with people who have been abused. It doesn’t ever make the abuse ok or justifiable, but there is the chance of growth in a new direction….given the right conditions, which regrettably, are not always within the power or control of the traumatised person.

So here’s the thing… far too many people do not have the right conditions… the social support…. the financial resources to support their healing and regrowth. Maybe therapy wouldn’t even be necessary if we all had the right kind of emotional support in times of need. And time to process, heal and grieve without financial and societal pressures that force us to internalise trauma and stress and push through, fuelled by adrenaline and cortisol, using our bodies’ costly survival resources in a way that they were never meant to be used, and ultimately impacting upon our health. The trauma load we carry reduces our ability to deal with day to day stressors. And then there are what has been called UnRecovery factors, which affect some people more than others that have nothing to do with whether a person is ‘resilient’ or not.

None of these factors are in a person’s control, so how can any therapy promise the same results, namely to “heal from abuse” for all clients?

So that is part of why I felt so angry, but not all of it. Here’s the last part:

For some people, intervention therapies, even those which are explicitly framed as being trauma therapies are NOT TRAUMA SAFE.

Let’s let that sink in. 

I’ll say it again:

Some trauma therapies are not trauma safe.

I learned this after training in one particular trauma therapy. I had some misgivings on the training, which to a degree I ignored because I had been convinced of the expertise of my trainers, but I learned afterwards I was not the only one concerned about this therapy. The training included some very good insights and effective ways of working, but it lacked specific knowledge about WHO could be helped with this approach, WHY, HOW to identify who NOT to use this therapy with and what what missing from the approach that would have made it far safer. In the support that was provided to trainees afterwards I saw that by doing what they had been trained to do, some trainees were getting into problems and potentially harming clients. The people behind the therapy and those responsible for training were not identifying the problems in these case studies and as a result, trainees were given no better understanding of what to do to help these clients.

In order to explain this I need to use some clinical terms, and I will keep it as straightforward as possible, because it’s not actually that complicated!

First of all, let us think of our plant again:

If this plant germinated from a seed that had been stored in favourable conditions and germinated in soil that gave it what it needed and it had pretty much the right levels of heat and light and moisture, that young plant was already getting off to a good start and as long as the conditions remained good, after that terrible incident of being stamped on, it could be expected to make a good recovery, albeit in that adapted and changed direction.

If we translate this to human experience, a one-off trauma experienced by a person who had sufficient early care-giving and sufficient current resources can be referred to as a ‘simple trauma’ presentation. A well-targeted, trauma intervention led by a competent therapist MIGHT help the person feel that the traumatic event is truly in the past and be freed from the lingering, embodied stress of it. PTSD symptoms might improve, even after that one session, and the client MIGHT once, again feel connected with life and themselves, albeit an emergent, new, adapted sense of self as one who survived the trauma. But we’ve already acknowledged that therapy is a very personal thing and there has to be a sense of connection with the therapist and different interventions suit different people.

But how many people who seek therapy have experienced ideal early childhood conditions?

How many trauma presentations are really this ‘simple’? When is simple not all that simple and what is needed in therapy in those cases?

But let’s return to our plant… Let’s imagine that the conditions were never ideal; it grew in very poor soil, it was planted in deep shade, it survived a drought and then endured a massive rainfall that flooded the ground and left its roots exposed to the air, as well as the specifically traumatising event of being stepped on and broken.

It might be easy to look at the event of the plant being stepped on in isolation and think, that was unfortunate, but no one is stepping on you now, you can regrow, so why don’t you recover?

But the plant hasn’t got a strong foundation of well-established roots to support its regrowth, nor the current resources to do so. We can liken this to developmental trauma. And that narrow focus on the past event, and NOT THE CONTEXT, is what happens when developmentally traumatised clients seek therapy with a therapist who only uses trauma intervention therapy. You can target the specific memories of trauma, but it will take time and more resources than just trauma intervention therapy for the person to start to adapt, to stabilise, to heal and to ultimately, grow.

Let’s consider another scenario:

Imagine our plant got off to a good early start, having pretty much the resources it needed, but then someone stamped on it. And when they moved their foot off most of the plant, they stayed standing on a single small stem. Enough to stop that part growing. And then the whole plant was stamped on again. And again. And a careless gardener splashed a bit of weed killer on a couple of leaves. The plant survived, but it caused even more damage. And then it was pruned at the wrong time of year, and there was a drought and a hosepipe ban. You get the idea…

So if we liken this to a person, this time we might refer to this client as having a complex trauma presentation. A therapist could try to target the bad events with trauma-intervention therapy, but there’s just so much, so many superficially minor, but extremely hurtful things, as well as the very obvious traumatising events, and it all merges into one, and it feels never ending, and there IS a strong foundation, but it’s so hard to connect with that feeling of being strong and capable and of just being happy and free. AND there is so much grief and loss AND conflicting feelings and so many layers…

… and ALL of this deserves space and time in therapy.

To process. To examine. To make sense of. To grieve. To be witnessed. To be accepted. To be psychologically ‘held’ and supported. And to risk generalising, but I believe in this case I am justified in saying:

Trauma resulting from domestic abuse is ALWAYS complex trauma.

Think about it… the psychological control, coercion, mind games, low-level constant threats, manipulations of reality, the unpredictability, isolating from friends and family, aside from any physical and sexual abuse. It’s about more than individually traumatising experiences. It’s about the systematic dismantling of a person – their identity, their autonomy, their fundamental worth as a person, their needs, wants and wishes.

Let us consider the trauma intervention itself. In the case that sparked me to write this post, I know what the therapy is and who teaches it. But it doesn’t necessarily matter. There ARE some good trauma interventions out there. And, as I have already stated what works for one, won’t work for all with any therapy.But there are particular problems with inflexible, protocol-based and scripted interventions.

Even with ‘simple’ trauma presentations (if there is such a thing!) but lets say there is no history of early abuse, neglect, significant disruption or loss… if a therapist relies on a script… with no understanding of HOW TO ADAPT THERAPY to MEET THE CLIENT’S NEEDS WHEN THE THERAPY IS NOT WORKING, it risks alienating the client. 

And if the client has already suffered abuse, they have suffered a significant wound to their fundamental sense of ‘OK-ness’ and their ability to trust themselves. So when the ‘transformational’ therapy or whatever it is fails, it’s unlikely they will place the blame fairly and squarely on the shoulders of the therapist, to whom it belongs.

When clients experience bad therapy, they usually blame themselves.


What is more, the client is unlikely, if they can avoid it, to admit that there is a problem in the session. Social conditioning kicks in. Being nice. Being pleasant. Not wanting to disappoint the therapist. So the client might convince themselves AND the therapist that the therapy has worked. And then go home and feel bad. If not immediately, then as the gradual realisation occurs that NOTHING HAS ACTUALLY CHANGED. And our one-session transformational trauma therapist need never be troubled by the realisation that the therapy didn’t do what it was meant to! And if they ever do get an inkling that it didn’t work, I’m sorry to say, but I’ve heard this too many times, they are likely to claim that the client was ‘resistant’ or ‘unmotivated’ or didn’t really want to change. Which is NEVER true!

And then sometimes, it’s NOT just a case of the therapy not working…. 

Depending on the type of intervention, and the nature of the client’s trauma…

IF THE THERAPIST CANNOT TAKE ACCOUNT OF THE CLIENT’S SAFETY NEEDS, AND CANNOT SLOW DOWN… STOP… CHANGE APPROACH… IF THE THERAPIST CANNOT HELP THE CLIENT FIND A SAFE WAY THROUGH THE DISTRESSING MATERIAL THAT IS ENCOUNTERED AND SAFELY WORK WITH DISSOCIATED PARTS…THE THERAPIST CAN DESTABILISE THE CLIENT AND TRIGGER A SERIOUS MENTAL HEALTH BREAKDOWN.

This is the worst case scenario. But it happens. And I have worked therapeutically to help bring healing and stability back into a person’s system after this very thing happened. This person was subjected to various kinds of intervention therapy, but I worked with them some years AFTER they had been sectioned under the Mental Health Act, forcibly restrained, injected with sedating drugs, deprived of their liberty and dignity. Interestingly, most of the anecdotes I have encountered have been of people being destabilised whilst attending certain training courses. They were training as coaches and therapists in order to help others! And when the trainers of those courses refused to acknowledge that THEIR THERAPY destabilised the trainee, that the other trainees who are subsequently going to practice these methods on members of the public have no way of knowing that they were involved in causing harm and have NO WAY OF LEARNING FROM THEIR MISTAKES.

Does it make sense now, why I feel so angry at someone targeting survivors of domestic abuse, for a single group session trauma intervention?

Ah, but the therapist/coach claims they will perform their duty of care and check beforehand for ‘mental health problems’!

No, that is not good enough!

Diagnositic categories of mental disorders are not a replacement for understanding trauma.

Trauma ‘types’ or presentations (I don’t really like calling them types because humans don’t fit into neat categories) do not correspond neatly with DSM or ICD classifications of mental disorder whether trauma specific (PTSD) or not. Trauma is not always diagnosed, and the diagnosis of PTSD may be too narrow to encompass all the kinds of psychological suffering and functional impairment that stem from trauma or have trauma as a significant factor in their development. Clients do not always have the diagnoses that they might acquire if they were assessed by a mental health professional, and sometimes the diagnoses that are given may not be the most accurate fit, nor lead to the best outcomes.

I feel angry, but I also feel frustrated. It’s not always the therapist or coach’s fault. They paid for their training in good faith and trusted those who set themselves up as experts on trauma and purveyors of these various brands of fast, transformational therapy. But we need to broaden the conversation and improve general knowledge of trauma, amongst the general public AND therapists. So that clients stop handing over their money – and trust – to someone who cannot work with trauma in context, who cannot adapt their therapy to the client, and whose interventions might destabilise them and cause them to suffer more than they are already. But therapists also need to recognise that diagnoses based on DSM or ICD classifications are not a fail-safe guide of who they can and cannot work with AND that there is gentle, safe work beyond trauma treatment interventions to support those whose trauma does not fit into a textbook ‘simple’ presentation.

The message that I would like to leave you with, whether you are someone seeking therapy or coaching or practising is this:

Trauma therapy CAN often be quick and transformative, but to be truly safe, ethical and responsive to clients’ needs, it needs to be more flexible than that. You can do therapeutic work that is more than just a ‘one hit wonder’, potentially destabilising intervention… when you work gently, and responsively, at your client’s pace, and with their inner, embodied process.

Thank you for reading!