Traumatic events can deeply impact a person’s ability to feel safe and secure in the world. Mental health professionals, especially those who are trauma-informed, understand the significance and prevalence of trauma, and they aim to respond to the unique client needs for physical, psychological, and emotional safety. It is estimated that 50-90% of people seeking mental health care have experienced one or more forms of trauma in their lifetime (CDC & Kaiser Permanente, 1995-2011); this is important for mental health professionals to consider, especially when there is a significant client history of interpersonal conflict.
The effects of trauma are frequently felt in relationships with friends, family, and coworkers, and this is often displayed in the form of fear or “expectations of danger, betrayal, or potential harm within new or old relationships” (ISTSS.org). A person with a trauma history may struggle to connect with themselves and others, carry shame or guilt, withdraw or isolate from others, and dissociate or feel numb in relationships. The effects of trauma vary considerably for each individual, and in relationships there is potential for a collision of trauma histories. In intimate relationships where trauma has not been therapeutically addressed, partners may experience disturbances in intimacy, sexuality, and physical closeness.
With a focus on relationships, it is appropriate for counselors to examine the nature of trauma in relationships and consider the presence of complex trauma (CT). CT is often linked to forms of childhood abuse and can manifest into “negative intrapersonal and interpersonal relationships, survival-based coping skills, and a general view of the world and others as unsafe and untrustworthy” (Lawson, 2017). CT includes the core symptoms of posttraumatic stress disorder (PTSD), but also includes problems with self-regulatory capacities such as (a) emotion regulation, (b) self/relational capacities, (c) alterations in attention and consciousness, (d) belief systems, and (e) somatic symptoms and/or medical problems (Lawson, 2017).
Counselors working with clients who have trauma histories can help guide their clients in healing by using a three-phase model; a model that is trauma focused, attachment/relationship based, and includes cognitive behavioral interventions (Courtois & Ford, 2013). Phase 1 should address safety, stabilization, and alliance formation; phase 2 involves processing of traumatic memories; and phase 3 allows the client to integrate and consolidate new learnings. With any form of counseling, the therapeutic relationship is a critical component to successful therapy outcomes. With trauma, the therapeutic relationship is “integral to the resolution of major relational traumas” (Briere & Scott, 2015, p. 109).
References
Briere, J. & Scott, C. (2015). Principles of trauma therapy: A guide to symptoms, evaluation and treatment (2nd ed). Thousand Oaks, CA: Sage Publications
Courtois, C. A., & Ford, J. D. (2013). Treating complex trauma. New York, NY: Guilford Press.
Lawson, D. M. (2017). Treating Adults With Complex Trauma: An Evidence-Based Case Study. Journal of Counseling & Development, 95(3), 288–298. https://doi.org/10.1002/jcad.12143
Trauma and Relationships - ISTSS. (n.d.). Retrieved June 16, 2020, from https://www.istss.org/ISTSS_Ma...elationships_FNL.pdf
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