Pouring Your Heart Out Too Quickly: The Necessity of Building Safety and Stability When Healing Trauma

By: Kendall Raymond AMFT 127810

A client sharing disturbing material from a traumatic event prior to the therapist helping them establish safety and emotion management skills to calm down is like taking a hot apple pie out of the oven without using oven mitts and immediately dropping it onto the floor: dangerous, ineffective, and irresponsible.  The way in which we digest a traumatic event in our lives is an essential treatment consideration throughout the trauma recovery process.  Pushing clients to go into explicit detail about a traumatic memory before they have mastered any calming strategies is a mistake because it can re-traumatize the client, according to the trauma experts, Biere and Scott (2015), who authored Principles of Trauma Therapy: A Guide to Symptoms, Evaluation, and Treatment.    In order to help traumatized clients regulate their mood, it is best to build safety and stabilization within the therapeutic window by utilizing the client-therapist relationship.  This safety-building period involves providing clients with psychoeducation to integrate a general understanding of how trauma impacts people, as well as grounding techniques, trigger awareness/prevention, meditation, breathing, etc. to stabilize and rehabilitate the client from immediate dysregulation. 

Certain therapeutic techniques bring a great sense of a comfort to trauma survivors during the safety and stabilization phase of treatment.  Learning meditation and mindfulness techniques would call upon clients using settling skills and exposure in their trauma treatment to strengthen relaxation and metacognitive awareness to let go of any intrusive/distressing thoughts when sharing disturbing memories and feelings that would otherwise dominate therapy sessions (Briere & Scott, 2015, Ch. 10, p. 223).  Mindful exposure would also help clients desensitize and countercondition emotionally heavy material in a way that teaches them to consciously feel their fear, while reducing its power to cause significant distress (Briere & Scott, 2015, Ch. 10, p. 223).  Body movements through yoga and breathing could also loosen up any physically traumatic ailment that a person potentially harbors, leading to a greater sense of control, tolerance, and resolution over emerged negative emotional states (e.g. panic) that may arise.  Additional empathic attunement on the end of the therapist, by remaining compassionate and focused during sessions, would activate the client’s attachment by encouraging safety, connection, and openness that counter any relational distress and promote the client’s own self-attunement (Briere & Scott, 2015, Ch. 10, p. 228). 

These early mindfulness interventions are integral to the trauma recovery process, teaching survivors how to enter deep places safely and consciously within themselves prior to going into a heavy story.   As we aim to help clients heal from their residual pain brought on by a trauma, clinicians must carefully tailor interventions to the client’s idiosyncratic experience and diagnostic profile in order to reduce hyperarousal/distress and increase self-regulation capacity so that they don’t become too overwhelmed by revealing painful information too quickly, thus causing all of their emotional labor to go out the door.  As clinicians, we must be sensitive and informed when probing clients to relive some of their most heart wrenching experiences in the therapy room, thus equipping them with strategies to relax and reach an inner security to prevent any emotional fallouts.  Similar to taking the pie out of the oven with bare hands at a rapid pace, a lack of handled care in a person’s trauma processing could incur an overwhelmed survivor to plummet back into the depths of what haunts them, leaving them to feel just as bruised and irreparable as a splattered pie on the ground.