You know that feeling when you step out of a movie theater in the middle of the day?  Like something is off… like you’re a little disoriented?  That’s the best way I could describe to others how I felt walking out of talk psychotherapy sessions when past trauma came up.

Therapy is supposed to help, right?  I’m supposed to feel better, right?  So why did I feel completely dysregulated, surreal, and sometimes even suicidal after a therapy session? I want to be clear that support is essential if this is happening to you. You deserve care that helps you feel safer, not more destabilized.

Here are some important things I learned that will hopefully help spare you from the retraumatization that can happen in therapy.

Not All Therapists Are Trained in Trauma

Not all therapists are trained in trauma.  I know…right?!  More often than not, I’m shocked to hear the phrase, “I’m not a trauma therapist” from licensed therapists.  Now, I understand that there are some therapists who focus their work around trauma and treating it. But I truly thought that every therapist would be trauma-informed. I believed every therapist knew how to hold a container for clients when serious trauma came to the surface in session.

Unfortunately, this is not the case.  If you are going to work with a therapist on trauma, make sure you ask them their background and ability to support you. Not only that, you must equip yourself as well, which brings us to the next important piece.

Why Coping Skills Matter Before Trauma Work

It can be counterproductive, and even potentially retraumatizing and dangerous, to enter into psychotherapy for trauma if you don’t have adequate emotional coping skills. Even if you have the most qualified therapist and you feel safe and supported in session, if you feel completely dissociated and unable to function after you leave the office…if you don’t know how to self-soothe, regulate your emotions, distract from the distress, and cope effectively until your next session, that’s an issue.

I found all of this out the hard way on my journey.  In fact, I tried to participate in a “trauma recovery” group years ago, in which we were encouraged to participate in exposure therapy by repeatedly writing, reading, and speaking aloud the details of a trauma incident.  I bet this could work wonders for some people, but for me, it made me feel sick.  I was reliving and retelling graphic details and then going home and checking out emotionally, having appetite and sleep issues, and being expected to function like a typical person, working, being in relationships, etc. All while feeling nothing less than retraumatized. It was too much.

What I learned is that I needed what I eventually found in dialectical behavior therapy (DBT) skills. DBT is a structured set of emotional coping skills broken down into four categories: Mindfulness, Distress Tolerance, Emotion Regulation, and Interpersonal Effectiveness.

What DBT Gave Me That Therapy Alone Didn’t

DBT Skills helped me to finally regulate my emotions (no more crying at work or quitting because I had a hard day and didn’t think I could cope or face people and go back), embrace my emotional sensitivity (it’s okay to feel deeply, we just don’t want our feelings to be at the wheel, dictating our choices when it leads to impulsivity and regret), be more effective in relationships (bye bye fear of abandonment and rejection fear that used to destroy my relationships and have me terrified to be alone), and not be thrown into a dissociative spiral before, during, and after therapy.

As I practiced, I built confidence in my ability to use the skills and in their ability to help me through.  This gave me an anchor to feel safe and self-sufficient between therapy sessions. It also helped me day-to-day with the symptoms of borderline personality disorder (BPD), which many believe is caused by childhood trauma (though of course not in every case), anxiety, and cPTSD.

An Invitation to Learn DBT Skills Together

For the past 12+ years, I’ve made it my mission to teach others not only DBT skills but the the nuances of implementing them in real life and seeing results.  I do this through DBT Path at EmotionallySensitive.com, where I’m able, with other team members, to provide supportive, non-judgmental feedback to homework submissions, questions, and shares about DBT in real life.

If you’ve resonated with any of this and would like to learn more, I warmly invite you to consider my online dbt class. It’s a supportive, structured program designed to help you build emotional stability before and alongside deeper healing work.

You don’t have to keep suffering or blaming yourself for being “unable” to cope with the past or to do your emotional healing work. Some of us need a little something more, just like I did, in the form of these evidence-based, gentle, effective DBT Skills. I’d love to teach you all I know about them and how they helped me to no longer meet the diagnostic criterion for a BPD diagnosis. (And yes, that is possible!)

Again, I’ve done this for 12+ years now and have seen it heard it all. You’re not broken. It’s not too late for you (no matter your age), and yes, you do have the power to change the trajectory of your life.  I hope I get the honor to work with you and be part of that journey!

In kindness,

Debbie
Founder of DBT Path at EmotionallySensitive.com and
HealingFromBPD.com