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How to Open Up to a Therapist About Trauma

Addressing trauma can be difficult, even when you are finally ready to deal with it and move on with your life. It can be hard to know how to open up to a therapist about trauma. Opening up can feel vulnerable. That is particularly true if you’ve ever experienced gaslighting from others (or even from yourself). Examples of gaslighting include:
“It wasn’t that bad.”
“Other people have suffered worse.”
“You’re being dramatic.”
“Can’t you just move on?”

Gaslighting yourself

Rather than feel weak or broken, you tell yourself that what you experienced wasn’t that bad, that you made it up, that if you were just stronger you’d get over it, etc. Yet deep down, you know it’s not true. The pain is real and present and affecting your daily life.

However, even if you know deep down that your pain needs to be dealt with and healed, part of you may be afraid. You feel that if you bring up your trauma in therapy, the therapist will say gaslighting things like this back to you. This will then confirm your worst fears about your experience. This makes it hard for you to open up to your therapist about the trauma.

So even though you may be able to tell yourself logically that this is a safe space, it’s easy for you to stop yourself from opening up and discussing difficult things about the trauma. Unfortunately, that’s when missed opportunities can occur. When you omit certain facts or distort the truth, a therapist may believe that an issue is less important than it actually is, which can impact the kind of support you receive. The bottom line: the more your therapist knows, the better they can understand you and help you reach your goals.

Trauma therapy

Trauma therapy is simply a form of therapy aimed at treating the mental, emotional, and/or nervous system consequences of trauma. It is also known as trauma-focused therapy. In trauma therapy, your mental health professional will help you process psychological trauma, heal nervous system dysregulation, and teach coping skills to help you manage your trauma symptoms and achieve your goals.

There are different forms of trauma-focused therapy which can be tailored to your situation. Here are some common trauma therapies:

EMDR (Eye Movement Desensitization and Reprocessing)

This is a body-oriented, research-backed therapy. It involves recalling the trauma and paying attention to subtle shifts in your recollection as you also notice a back-and-forth movement, sound, or sensation. Examples of this are your eyes tracking the movement of light on a horizontal bar or the therapist’s finger waving from side to side, the side-to-side alternating tones in a headset, or the sensation of gentle pulses alternating from tappers held in the hands. The recollection of the trauma and its associated negative beliefs can quickly become less distressing with EMDR. Also, new, life-giving beliefs can be installed.

Related Reading: What You Need to Know Before Pursuing PTSD Treatment with EMDR

Somatic Experiencing

This body-based, naturalistic therapy is focused on returning the body’s Autonomic Nervous System from dysregulation to self-regulation through completion of self-protective responses that may have been thwarted during the trauma. It also gently guides you in developing increased tolerance for difficult bodily sensations and suppressed emotions. With this increased tolerance, you can learn tools to manage your own system. SE therapy does not require the person to re-tell or re-live the traumatic event. It specifically seeks to be non-retraumatizing. It is an ideal therapy if you’ve experienced a lot of emotional or physical dysregulation because of the trauma.

Internal Family Systems

While not strictly a trauma therapy, IFS is often used very effectively as a therapy for trauma. It is especially helpful with developmental trauma (that is, early childhood, attachment-based trauma). The idea of IFS is that each of us have sub-personalities of parts of self that operate a bit like a family. Trauma often serves as a catalyst for poor functioning in this “family.”  ISF helps these parts work more effectively together in supporting the leadership of your core Self.

Trauma-Focused CBT

Just like the name suggests, this is a research-backed approach to trauma therapy that is built on the components of Cognitive Behavioral Therapy. Rather than digging into the past, this therapy focuses more on resolving the current symptoms and effects of the trauma.  It does this by working through the relationship of your thoughts, feelings, and behavior. The idea is that as you shift one area of this relationship, the other two areas are also affected.

Prolonged Exposure (PE)

This trauma therapy is similar to Exposure and Response Prevention (ERP) which is used to treat Obsessive-Compulsive Disorder. Prolonged Exposure is a type of cognitive-behavioral therapy that gradually exposes you to the trauma-related memories, feelings, beliefs, etc. that you have been avoiding. This exposure reduces the fear and desensitizes your reaction to these feared things. While the therapy is backed by research and considered a “gold-standard” for trauma treatment, many people find it retraumatizing.

Suggestions for Opening up in Therapy

Regardless of the trauma therapy you choose, using one or more of the following suggestions can help ease the way in opening up to your trauma therapist.

• Take some pressure off by jotting down a few talking points before going to your first session. Just sit down with a pen and paper, or a note app on your phone, a blank doc on your computer, etc. Make a few notes about what you want to talk about. Then let your therapist know that speaking off the cuff about your trauma is too difficult, so you have written down a few notes. If you move away from the notes and start to struggle, ask your therapist to remind you to refer back to your notes.
• Similarly, between sessions write down significant events, experiences, or feelings you want to bring up in therapy.
• Remember, it takes time to build trust and rapport. Until you feel more at ease, you can talk about topics that have a less emotional charge. For example, you may talk about an argument with your partner rather than your childhood trauma.
• If jumping right in is too much, first talk to your therapist about why that is. You don’t even have to say what the trauma is. Let them know you have trauma work you want to do, but that fears are blocking you from being able to actually do that work. You and your trauma therapist can then work together to make sure you feel comfortable and safe before you do anything else.
• Talking about a traumatic event can sometimes make you feel pulled back into the event itself, like you’re experiencing it all over again. That can make talking about it difficult. Instead of pressuring yourself to be composed and calm while explaining a traumatic experience, give yourself the space to feel your feelings freely. It’s OK to slow down.
• If you are hesitant because you are unsure how to talk to a therapist, you do not need to feel pressure to disclose everything all at once. A therapist can work with a variety of Trauma Therapy techniques that best fit your situation and comfort level.

Related Reading: Why Understanding What Trauma Does to the Brain Helps You Heal

Know that your trauma therapist is there to help you work through and heal your pain in whichever way is best for you. They have the same goal you do – to see you back in the swing of life again, unencumbered by the effects of trauma.

If you live in northern Illinois and are ready to open up to a therapist about your trauma, know that the trained trauma therapists at Life Care Wellness are ready to help you in our Glen Ellyn, Sycamore, and Chicago (Jefferson Park) offices or by telehealth. Contact us today to start your healing!

Rhonda Kelloway, LCSW, SEP
Rhonda Kelloway is a co-owner and principal therapist at Life Care Wellness, a group psychotherapy practice in Glen Ellyn, Chicago (Jefferson Park neighborhood), and Sycamore Illinois. She is a trauma specialist utilizing a Somatic Experiencing framework to utilize the body’s wisdom in healing. She also uses EMDR and a variety of traditional psychotherapy approaches in her work. In addition to being a psychotherapist, she is a trained divorce and family mediator.