Why is Trauma Therapy a type of Relationship Counselling?

In my work as a Counselling Psychologist, I pay close attention to the relationship between client and therapist. This article explores why that relationship can matter when working with trauma, emotional neglect and difficulty trusting others.

People who have experienced trauma, complex trauma, or emotional neglect will likely immediately see what I mean. Relationships feel fundamentally unsafe. Your therapist providing a relationship you can begin to feel safe is at the heart of trauma work.

This is not about being nice, warm, or non-judgmental as even many therapists think. It is about understanding how the relationship between client and therapist is a window into the client’s internal world and the effects of the trauma they experienced. 

Different approaches to trauma therapy offer different ways of working. My practice is informed by ISTDP, with careful attention to the therapeutic relationship, anxiety and pace. A trusting relationship supports the work; it does not replace assessment or consideration of appropriate treatment options.

Let me give you an example about what I mean that trauma work is a form of relationship counselling. Nikos invites Yvonne to tell him what is the issue she needs help with. As she begins to give him insight Nikos stops her in her tracks. Something terrible is unfolding and he intends to make a point that this is is not a place where she is going to be ignored and neglected.

Nikos points out to her that she is very anxious. Has she observed this? She seems to have noticed, yes.

Nikos then makes a simple observation.

 “Yvonne, when I invited you to pay attention to yourself by letting me know what you need help with, your anxiety shot up. You then ignored this and gave me and my question priority. You made me the important one here. Do you agree with me when I say this?

It is highly likely that Yvonne will reveal a history of emotional neglect. She will likely show you how she has become used to being focused on others and ignoring and neglecting herself. Yvonne may become deeply sad when she hears this.

By noticing this moment, the therapist gives Yvonne an opportunity to explore what it is like to receive attention. This is a possibility to consider together, rather than proof of a particular childhood history.

I feel very passionate about this work. About the fact that whatever kind of trauma work you do, the relationship between therapist and client is at the heart of it. 

If you are looking for trauma therapy, ask your therapist:

“Whatever else we do, will you be able to hold in mind that your careful and caring attention to me may be the biggest challenge I have faced so far? Because it is also my biggest longing”. 

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I offer individual therapy for adults in Kensington and online. You can book a free 15-minute introductory call to discuss whether working together might be helpful.

*These are not real people, but composites of clients I have met over the course of my clinical career.

Photo by https://www.instagram.com/anniespratt