What is Trauma-Informed Therapy?
A therapeutic style that aims to avoid re-traumatization over the course of treatment by emphasizing a person-specific approach.
2 min read
Trauma is defined in the Diagnostic Statistical Manual (DSM)-5 as “exposure to actual or threatened events involving death, serious injury or sexual violation in one (or more) of the following ways:
Directly experiencing events
Witnessing events as they occur to others
Learning that events occurred to family member/friend
Repeated exposure to adverse details of the events.”
This definition of trauma focuses on external events - situations where something happened to you or someone close to you.
However, as Gabor Mate, renowned physician and author, asserts “trauma is not what happens to you. Trauma is what happens inside you, as a result of what happens to you”.
“Trauma is not what happens to you. Trauma is what happens inside you, as a result of what happens to you.”
This view expands the scope of trauma, as referenced in the DSM-5, to incorporate perhaps less dramatic seeming occurrences (parental misattunement or small scale neglect, for example) that can still have a profound impact on the psyche of a developing mind. A trauma-informed therapeutic approach would place more emphasis on what happened inside of you than what happened to you during and after a significant life event or traumatic experience.
The way a trauma-informed perspective might approach what happened inside you during an upsetting event is to examine the important role that the body plays in registering and holding negative experiences. One effect trauma has on our bodies is to trick them into believing the danger is still occurring, that the scary or difficult thing is still happening now even though in actuality it occurred in the past. This phenomenon is one reason why somatic, or body-focused, therapies (such as Hakomi, AEDP or Sensorimotor Psychotherapy) are effective in their treatment of trauma. These modalities allow people to experience what they are feeling in the present moment, releasing fears and anxieties that are rooted in the past or in the future.
Given the individual subjectivity of traumatic experience, a cornerstone of any trauma-informed approach is asking, instead of “what’s wrong?” rather “what happened to you?” This approach centers the focus on the patient as an expert of their own lived experience rather than on the idea (often shame-inducing) that they are defective and are in need of changing.
“It is important to explore with curiosity various aspects of someone’s life to understand their difficulties.”
There is not one specific method of practicing trauma-informed care, but a trauma-informed therapist will likely utilize the following interventions:
*Creating a sense of physical and emotional safety to facilitate people feeling fully present and engaged in the therapeutic process.
*A strong emphasis on collaborative care, with the goal being to instill a sense of agency to allow people to feel in control of having a role in their care.
As Stefan Allen-Hickey, a therapist at Downtown Somatic Therapy in lower Manhattan, notes: “in a trauma-informed approach it is important to explore with curiosity various aspects of someone’s life to understand their difficulties - this includes cultural, social, spiritual/religious and/or intergenerational factors that might be impacting how someone shows up in the world.”
Stefan goes on to add that a trauma-informed therapist would be sensitive to ways in which these and other facts might be “contributing to the patient’s presenting problem”.
If you think you might benefit from a trauma-informed therapeutic approach, please reach out to contact one of our talented trauma-informed therapists for in-person or remote sessions at Downtown Somatic Therapy in Lower Manhattan.