Trauma related disorders, complex trauma and post traumatic stress disorder

I use a cautious, deliberate, and trauma-informed approach when working with trauma and believe this is crucial to ensure ongoing safety, to ensure it leads to good outcomes, and to find a comfortable and collaborative way of working together. In my opinion, establishing emotional safety in our relationship and within the therapy room itself is if utmost importance. 

Trauma is not defined by the experience or event(s), but by the emotional reaction which may result in the aftermath of such an experience. The physical and emotional impact can occur almost immediately but equally take place many months or years after the situation(s) have ended. The onset of symptoms can be sudden, and the person may be puzzled and confused. This delayed reaction is often precipitated by a triggering event or increase in unrelated stress which may be entirely unrelated to the background trauma. The traumatic experience(s) are considered vulnerabilities for the development of mental health issues, and not just trauma-related disorders. 

Some traumas are based on a one-off event or several situations where the person may have experienced a real or perceived threat to their life, subjected to sexual assault, or been witness to a life-threatening situation. However, other traumas occur repeatedly and over a longer period. This is often referred to as ‘complex trauma’ although we should recognise that all trauma-responses are complex in nature. 

I have received extensive training on the topic of trauma and have worked with trauma throughout my career. I continue to seek out education and training as part of my annual professional development plan as a clinical psychologist. 

I consider myself and my practice to be ‘trauma-informed’. The concept of integrating trauma-informed aspects into therapeutic practice is vital for any practitioner who provide therapy to people with trauma-related conditions. For example, you may have noticed the many photos I use of my consulting room as well as posting a photo of myself on this website. This is a deliberate trauma-informed strategy. People who have experienced trauma may be emotionally overwhelmed by anxiety and fear by the thought of therapy. Seeing photos of the consulting room and the clinician can be comforting to reduce (anticipatory) anxiety. People I have worked with over time will also attest to the many ongoing small changes to the decoration in the room. Again, a deliberate strategy to avoid association-based anxiety and threatening memories that may attach themselves to items in the consulting room. 

It is important to carefully consider the timing of address past trauma. Pending this assessment, we may focus our therapy on better containing past trauma memories, to focus on achieving better emotional stability, to reduce life stress, or focus on minimising specific symptoms. This is part of a 3-staged therapeutic approach I often use in my practice.