Preparing for Trauma Work in Therapy

Therapy session-preparing for trauma work

Preparing For Trauma Work in Therapy
Preparing for therapy requires more than having motivation.  To get the best out of your sessions, one of the most helpful things you can do prior to starting treatment is some background reading on trauma.  Also, explore your treatment options beyond talk therapy.  For instance, is EMDR a good treatment option for you?  Would you do better with a cognitive vs. a sensory approach?  This will help you and your therapist decide upon the best overall treatment approach for you.  Below are some practical suggestions and reflections on aspects of therapy that many clients overlook in their decision-making process regarding therapy. Included are some tips on how to best prepare for your first session. 

At Urim Recovery, we want you to value your sessions as “prime real estate” in which you learn about and practice new strategies that you take home and implement into your everyday life.  Do much of your background reading, information gathering and preparation in between your sessions!

Mind and Body May Have Different Levels of Readiness
While many treatment approaches are helpful and evidence-based (i.e. supported by clinical research), clients show up with many defense mechanisms that protect them from exploring and addressing painful experiences like trauma.  If you have never had treatment or have had much therapy to no avail, part of your preparation is to invite a mindset of acceptance regarding your body’s limitations.  Hopefully, this will flow to your consideration of overblown expectations.

Many of the defense mechanisms that come into play to distract you from what you need to do in treatment happen subconsciously .  So while a client might be very motivated, their minds say one thing, “help me, I’m ready,” while their bodies recoil at any intervention.

 

Growth Chart Making Progress in Mental Health Treatment

Making Progress in Therapy
This can result in a feeling of “push/pull” on the part of the therapist or a client who is attuned to their internal ambivalence.  Either way,  clients can find themselves frustrated by the pace of progress and not realize that they are ambivalent (e.g. of two minds) about getting better. 

It is normal to want to get better, but fear change also. This is a reflection of ambivalence.

Of course, not everyone is ambivalent and oftentimes defense mechanisms don’t come into play. Many clients are open or undecided about the course of treatment and things run smoothly from the first session onwards. 

Sometimes preparing for treatment just means showing up and that’s ok.

Expectations and Readiness for Counseling
Many clients show up to therapy with expectations that don’t quite jive with their body’s state of readiness.  One common occurrence is when some clients feel that they must “get their story out” no matter how triggering, before they can explore and address root causes. This can become problematic if clients take on more than they can handle as they can easily plummet into overwhelm and grow disenchanted with therapy. 

It’s simply not true that you need to divulge every detail of your trauma to heal from that trauma. Sometimes repeating trauma details without therapeutic guidance on how to do so is merely retraumatizing.

Losing hope so early in the process can be devastating. Many clients come to realize that the ways of healing can sometimes be counterintuitive. Allow yourself to be curious about how therapy might work in ways that are beyond what might seem to make sense.  Consider whether you might want to include supports in your sessions. Certainly, ask questions about why certain things work and others don’t. Sometimes it’s the case that individuals respond differently to certain treatments and sometimes it’s the case that certain individuals have been misdiagnosed. Common symptoms can mask very different underlying causes. Diagnosing by inexperienced therapists, self diagnosing and diagnoses by multiple providers are common reasons why some clients enter treatment with diagnoses that are incorrect and unhelpful in treatment.

EMDR – Accelerated Healing?
To be fair, sometimes these expectations arise out of the implicit promises of therapeutic interventions such as EMDR.  Many therapist techniques sometimes unwittingly convey the impression that healing will occur following application of the strategy.  This is unrealistic if for no other reason that clients present with all manner of capabilities and tolerance for discomfort in addition to capacity for insight.  It’s not uncommon for trauma to sap one’s strength over time and also diminish memory. 

 

How Best To Prepare For Your Session
Doing a little background reading ahead of time can save you time, money and energy prior to starting your first session and provide an opportunity for acceptance of your current capacity to heal.

Preparation for Telehealth Therapy Session

Here are some other practical suggestions to hit the ground running in your first and subsequent sessions:

  • Journal a typical day and bring it to your first session
    • Identify your daily routine.
    • Note any symptoms that occur indicating times, frequency, intensity and duration
    • Provide examples of triggers
  • Check your connection and technology before your first session if you are using telehealth. Arrive ten minutes early to your first session and check again.
    • Have a back-up device on hand.
    • Set your phone or computer at the right angle for face-to-face communication that frees your hands.
    • Make sure your microphone and speaker work if you are using a headset. It’s not uncommon that a headset reconfigures your microphone/speaker settings. If this happens during the session, simply log in and log out.
    • Charge your devices.
    • iPads don’t tend to work as well as a computer or your phone. If you would like to engage in EMDR, please use a computer.
  • Bring a daily planner with a weekly view, post-its and composition book to your sessions.
    • In your first session, all will be explained as to how you will use these!
  • Bring a Driver’s License or some other government issued identity card to your first session if you are using telehealth.
    • You don’t need to upload an ID to your client portal if doing so is complicated or tricky.
    • Remember, you must be in Arizona to receive mental health services in Arizona. If you go out of state, you must let your therapist know.

 

  • If you are using telehealth, set aside a therapeutic space for your session that is decluttered and minimizes  distraction.
    • As a general rule, don’t engage in therapy from your work desk especially if work stress is an element you would like to address in treatment. If you have no option, try moving your seat or clearing your desk. 
    • Remove triggering elements from your therapeutic space. This might include selecting a time and space where you can maintain privacy.

 

Below are some links to information to help you understand trauma on a deeper level:

You can find other soundbites related to well-being, self-compassion and healing here .  Stay in tune with issues related to your well-being and mental health right here in the Urim Recovery Journal updated 2x a week.

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