3 Keys to Avoiding Retraumatization

Retraumatization is when a client re-experiences or relives their traumatic experience. It is very possible for this to happen when treating clients with trauma. It is one of those things that cause most trauma treatment professionals a slight pause. We worry about harming clients and making things worse for them.  

I think it is good to be cautious, but we should not be immobilized by fear of retraumatizing our clients. With the right skills and the right focus, we can assist clients in successfully avoiding retraumatization for the most part. Below we will discuss the three key components to helping a client avoid retraumatization. With these three things in place, you can greatly reduce a client’s chances of experiencing retraumatization.

Now before we get into the three key components, I want to ensure that you understand this is not a guarantee, but it is something that will help clients prepare for and stay stabilized in the trauma treatment process, which will greatly reduce their chances of retraumatization.  

#1. Creating a Container in the Treatment Process

At some point in your trauma treatment journey, you might have heard the term container referring to the therapeutic environment/relationship that is created between client and trauma treatment professional. When I refer to a container, it is two-fold. The trauma treatment professional feels a sense of confidence and calmness within, and the client feels safe in the healing relationship. 

A couple of things to consider when working on your own sense of calmness and confidence is doing your own work. We recently published a podcast on the importance of this. You can check that out here.  Also it is important to track your own nervous system during the session. We also published a podcast on this topic that you can check out here. Lastly, make sure to consider getting support through consultation.  

When thinking of the client’s sense of safety in the healing relationship, pacing is everything.  Make sure to help clients understand that in trauma work, slower is faster. You can check out our podcast on pacing here

#2. Tracking Your Clients Nervous System and Maintaining Their Window of Tolerance

Noting that most clients that come in are usually consistently in a hypo- or hyper-aroused state.  It is important that we don’t just follow their lead because they are used to being outside of their window of tolerance. Our goal in treatment is to help them to re-establish a healthier pattern within their nervous system.  

One of my favorite techniques when helping clients to become more aware of their tolerance is to gently interrupt. I usually try to tell clients in my initial consultation that one of the common things in our work together is me gently interrupting: that gives me an opportunity to provide psychoeducation to them about why this is important and how it is a part of their healing journey.

#3. Establishing and Re-Establishing Stabilization

Once we have helped clients pace themselves by gently interrupting them, we will also need to help them stabilize. I believe it is important that a majority of the time in treatment is spent on helping clients establish stabilization in their nervous system; then as the work continues to re-establish stabilization. 

Another way to think about this is to help clients return to their window of tolerance repeatedly throughout the healing process. By repeatedly returning, we are helping clients repattern their nervous system in a healthier manner.  

Helping clients to avoid retraumatization is vital to good trauma treatment. We don’t have to avoid the hard topics or be riddled with fear as our clients move into deeper topics in their healing journey.  We can use the three components discussed in this blog to help clients move through the work in a safe manner.

4 Responses

  1. Thank you for these keys!

    Helping clients return to their window of tolerance can be challenging during session. I just had a client tell me “Nothing works” when in hyperarousal state. She began eating chocolate and picking her nails for comfort. I acknowledged the need for comfort and to take care of self. Then I invited her to talk about what is going well in her life. I saw a small shift.

    Any keys when client is highly dysregulated?

  2. I just started with this therapist and he asked me to close my eyes then brought up my most awful CSA memory. As I was in full-blown panic attack, he started acting like he was a father to me and asked if he could come to my couch to give me a hug. Obviously I said no but I was in shock. He had just retraumatized me on purpose in order to get a hug. Is this normal? I think he does CBT/schema

    1. It sounds like you had a really intense and overwhelming experience, and it’s completely valid to feel shocked and distressed by what happened. Your feelings are important, and it’s crucial that you have a space where you feel safe and supported. It’s okay to take the time you need to process this experience and to seek additional support if you feel it would be helpful. Remember, your well-being and comfort are paramount in any therapeutic setting.

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