Understanding trauma in therapy: In conversation with Dr. Priya Puri

20 September 2023
Pallavi Suri Written by Pallavi Suri
Pallavi Suri

Pallavi Suri

Pallavi has over 5 years of experience in writing. Mental health and social issues are topics...

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“Doing trauma work is a very delicate task. Let’s say you have a very thin and delicate chiffon dupatta stuck in a bed of thorns. If you try to pull it out forcefully, your entire dupatta will get torn. So you have to be very patient and pull it out thorn by thorn. “ – Dr Priya Puri

Trauma can change how we perceive things around us and look at life. While there is growing conversation around mental health in India, the concept of trauma and how deeply it can impact our lives remains misconstrued and unknown. 

With 10 years of dedicated experience in Clinical Psychology and trauma, Dr. Priya Puri unravels the nitty-gritty of trauma and the way toward holistic healing. She is also an expert in Trauma-informed Care and Schema Therapy. With an MPhil from the Institute of Psychiatry and a PhD from NIMHANS, Dr. Priya is an active advocate for mental wellness across social media.  

In this wide-ranging conversation with Dr. Priya, we explore what trauma means, her venture, The Healing Space, and how we can construct our own healing journeys. 

Dr. Priya, you chose clinical psychology as your career at a time when people were hesitant about choosing psychology as their career. How did you decide to become a clinical psychologist?

It was a very conscious choice. 

In 2003, psychology wasn’t a popular career choice. I was extremely shy and introspective in my teenage years. At that time, a counselor came to our school and spoke about mental health and psychology. That was the first time I realized I wanted to become a psychologist. 

During the 11th grade, I dropped math to take up psychology, even though psychology wasn’t a mainstream subject. 

I took this leap of faith. It wasn’t an easy path. In 2006, when I finished my 12th board, only 5 colleges in my city of Calcutta offered psychology. Out of the 5, only two colleges were good.

At that time, I didn’t know exactly the path I had to follow and where it would lead me. 

After my MPhil, I decided to do a PhD. All I knew at the beginning was that I had to do psychology. The rest happened one after the other. 

A PhD must have been challenging too? 

Yes. There was no internet, nor were there people to answer my questions. My parents were concerned if I was 100% sure about my choice. 

I also began doubting my career choices. Psychology is a slow and long career path. Cousins younger than me had already begun working. All  this filled me with doubts. 

In the first year of my post-graduation, I lost my dad – my anchor. It just wasn’t about the process anymore; it became about the outcome. I had no choice but to make something viable from my career. 

You work as a clinical psychologist and certified trauma specialist. Why did you choose trauma specifically? 

While pursuing my PhD, I realized that trauma wasn’t popular, and most psychologists weren’t even aware of it. I came across many resources and realized we only look at surface-level things. 

I started reading about how healing can happen through trauma-informed therapies. I have been able to use this knowledge for myself and with many of my clients. 

Tell us about your entrepreneurial journey with ‘The Healing Space’?

Becoming an entrepreneur was never on my list. I was always fond of teaching and going into academia. But it didn’t happen.

By the end of 2019, I had submitted my thesis; by the beginning of 2020, I was pregnant. So I thought of taking a break, but then Covid happened.   

I realized I needed some flexibility in my work schedule. After taking a few online classes, in March 2022, I came up with ‘The Healing Space.’ It’s been good so far. Again, it was quite unplanned. 

How do you see trauma? 

Understanding trauma in therapy: In conversation with Dr. Priya Puri

Trauma really changes the way in which we look at people around us. It impacts how our nervous system behaves and affects how we see ourselves and others. 

Trauma is invisible, deep, psychological, and so subtle that many don’t even know they have it. 

For example, if someone has had a childhood trauma where they have been badly abused. Such an adult is always going to be hypervigilant and stressed under pressure. They will have considerable mistrust toward others. Some people have difficulty regulating their emotions, and may have anger issues. The impact of trauma is such a trajectory that the impact can go as far as you can think. 

Some people who had suffered some trauma in their childhood suffer from the impact even in their 50s and 60s. That’s because the trauma happened during the formative years of our life. 

Right. And what about trauma therapy?

The regular forms of psychotherapy, such as cognitive behavior therapy (CBT) is more about counseling the client to help them look at things differently. It is a top-down approach – from cognition to emotion.

But trauma therapy goes way deeper.  For example, a patient may tell me they are feeling sad. I would say it’s very natural to feel that way. So here I am, not trying to talk them out of it, I am trying to acknowledge that emotion. 

I would ask them where they feel any pain or heaviness in their body. I would then ask them to observe these sensations and allow their body to process the feelings. I will ask them to breathe in and out or tell them to do some kind of calming activity or exercise. 

We help the mind connect with their body, in a bottom-up approach. Acknowledge the emotion and process it. 

So, how can trauma therapy help patients to heal?

Trauma therapy believes that trauma is actually stored inside our bodies. The present is just cross-sectional information. 

This holistic therapy goes into the deep levels of the mind, memories, childhood experiences, and bodily sensations. We try to embed the present emotions into the context by going deep into memories, childhood experiences, and bodily sensations. 

Trauma therapy is not all or none. Those experiences will be there, but you will be more at peace, and the impact of those traumas on your present will also reduce. 

How do you make sure your patients are comfortable enough to share their deepest fears? 

The slower we go, the deeper we can get. The more patient you are with your clients, the better the therapy can be. 

You give them validation and unconditional acceptance, and you give them that space that there is no hurry. That is what makes them comfortable to share their deepest experiences. If the client is given the impression that they have to tell everything for healing to begin, they will get very anxious. Secondly, they will get ‘retraumatized.’ 

Understanding trauma in therapy: In conversation with Dr. Priya Puri

As a therapist, I take quite a slow approach. First, I will have to build their emotional regulation. When they are feeling a little stable emotionally, that is the juncture where I can go deep into the childhood memories.  

While there is more awareness around trauma, are we in some way minimizing the significance by talking so much about it?

When we loosely use terms like trauma, we increase the stigma around it, not reduce it. 

Some of the terms we use today- narcissism, depression- have to be used cautiously. 

The larger community can help in this regard. People relate better to a layman who is a mental health advocate. People who have benefitted from therapy should help bust myths around trauma. 

Could you explain a bit about the different types of traumas from a layman’s perspective? 

There are two types of trauma, according to recent research. PTSD and CPTSD (Complex Post Traumatic Stress Disorder). 

Regular stress in day-to-day life is not trauma. Single-event trauma is known as PTSD. Under PTSD, one extremely major life-changing event happens, after which there are flashbacks and anxiety around it.  

Now, there is something known as complex trauma or CPTSD. Sometimes, a series of negative events where one becomes extremely helpless may cause trauma to build up slowly inside you. 

Abuse of any kind- emotional, domestic, sexual, for instance- at any stage of life can lead to complex trauma. 

Was there an early clinical error you made in your career? What were your learnings?

I did make some mistakes. Today, when I think about those clients, I feel that I tried to help them in the best possible way with what knowledge I had then. 

But I could have done much more with what I know now and have expertise in. So, it’s a constant learning curve. Sometimes, a session doesn’t go as planned, or sometimes, there isn’t a not-so-very-pleasant interaction between me and the client. 

In such times, it is best to take accountability and apologize. We are all human; we make mistakes, but realizing and learning from them is important. 

When does the warning bell strike for a person to become aware that they must approach a professional?

Understanding trauma in therapy: In conversation with Dr. Priya Puri

When we start observing the shifts in our feelings, that should be the warning bell. Let’s say you have been calm and composed or cheerful and bubbly. Suddenly, you or the people around you start observing that you have become a little more irritable, snappy, or more sensitive these days.

 We don’t have to reach that breaking point to consult a counselor. Nor does a one-off change in behavior when you aren’t feeling okay mean you need therapy. If you consistently feel things are not okay, you are reacting more, or emotions are getting out of hand, that is a point where one should approach a therapist. Whether trauma is involved or not, let the therapist figure it out. 

How do you manage stress for yourself or deal with conflict? 

I try to prioritize some form of self-care. I try to have some hours only for myself as I have an energetic three-year-old!

I go to the movies, catch up with a friend, and go for therapy sessions. I also enjoy listening to music, and meditation. I take care of my diet because that helps me be fit.  

What would be the one book you would recommend to the readers?

There are many books that one can read, such as Body Keeps a Score, Waking Up the Tiger, and Surviving to Thriving. But not everyone will be able to relate to these books.

More than reading, have an open mind, an empathetic approach, and educate yourself about mental health and well-being. 

Whatever you do, just be compassionate to the people around you. And treat them the way you want others to treat you. 

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