“The more unconditional support the patient gets from the therapist, while being challenged to grow as and when needed, the more they feel safe to be vulnerable and get empowered towards betterment. Safety, choice, collaboration, trustworthiness and empowerment are considered to be five key pillars of trauma informed care.”

Trauma is a complex and often misunderstood concept in the 21st century. It is a devastating emotional response to a distressing event that overwhelms an individual’s ability to cope. It can leave them feeling helpless, diminished, and unable to fully experience their emotions. 

Trauma-informed therapy acknowledges the impact of trauma and works towards recovery by understanding its effects on the physical, psychological, and emotional well-being of individuals. This approach creates safe and collaborative spaces to promote healing and resilience while avoiding re-traumatization.

In our conversation with Anamika, a trained Trauma Informed Therapist, she sheds light on trauma-informed therapy, how it works, and the demands it makes on a therapist. 

What led you to specialize in trauma-informed therapy?

We were supposed to pick a dissertation topic for our Masters, and that’s when it first struck me, how much I’m interested in studying trauma, especially childhood trauma. There’s almost nothing which doesn’t get affected by trauma in a person’s life. 

Helping people heal from that seemed like my deeper calling. As a professional, that motivation only got stronger as I kept encountering more and more cases where people suffered from the consequences of trauma. So, I kept on honing my skills further and learning from appropriate courses and resources. 

Can you explain what “trauma-informed care” means to our readers?

Trauma Informed Care in therapy provides a safe space for clients to open up about their emotional wounds (due to an exposure to some traumatic event/s) to a stranger who is supposed to help them heal. Hence, the therapeutic bond between the therapist and the patient is of central importance.

The more unconditional support the patient gets from the therapist, while being challenged to grow as and when needed, the more they feel safe to be vulnerable and get empowered towards betterment.

A thorough knowledge, understanding and expertise on the technical aspects of trauma and how it can affect the mind and body is also a must for a trauma informed therapist to have.

Safety, choice, collaboration, trustworthiness and empowerment are considered to be five key pillars of trauma informed care.

What types of therapy models or techniques do you use in treating patients with trauma?

I use a variety of treatment modalities and have a holistic approach in treating my patients. While counseling plays a key role in almost all of the sessions, active listening, empathy, meaning making, qualitative analysis, confrontation and feedback are just as important.

Therapeutic tools and techniques like CBT, REBT, DBT, NLP, mindfulness, visualization exercises, existential therapy, art therapy, humanistic therapy, relaxation exercises, worksheets etc. constitute the other half. 

Can you provide an example of a challenging case you’ve worked on and the strategies you used?

It is difficult to pick one, since I’ve had quite a few complex cases in my humble years of practice so far. I can however offer some insight on some of these cases. A young adult who had been sexually abused by her brother as a child, while being bullied by her friends and family for the way she looked (she gained weight due to stress eating and genuinely overlooked her physical appearnce to unconsciously repel potential abusers).

A guy in his mid-thirties who was so badly abused and violated by his parents all his life, that he eventually had to sever his ties from them to protect himself and his wife.

A young woman who had to deal with her father’s alcoholism and daily episodes of fights at home, while trying to manage higher level education, her own mental and physical health and her and her mother’s safety, all while pretending everything is fine.

An elderly woman who tried to end her life after years of being abused by her husband and in-laws only for her adult son to also slap her in a fit of rage.

A teenage boy struggling with his sexuality while being gaslighted and mentally tortured by his parents (who were well educated) to a point of feeling suicidal and making videos to leave behind, so he could somehow explain to them what he was going through, are some of the examples that come to mind right now.

All of these cases (and many more) have been challenging and time consuming but have also been success stories. 

All of these people had one thing in common. They all were struggling with Complex Trauma i.e. a chronic, prolonged exposure to multiple traumatic events. These patients most likely had C-PTSD (Complex- Post Traumatic Stress Disorder) or at the very least, symptoms of complex trauma.

Trauma Informed Therapy worked wonders for them, to a point where they started having post traumatic growth (PTG). The strategies I used would be difficult to describe in brief. But I can say that the most important part of their healing journey in therapy was to have a safe space in therapy and form a good therapeutic bond with me, their therapist.

It was also the psychoeduaction that I provided them about their trauma and its ill effects that helped them feel validated. My approach was still solution focused and would lead to empowerment and growth. Qualitative analysis, confrontation, feedback (from both ends) along with tools like CBT, DBT and mindfulness helped further.

Their active participation in their own journey of healing however, made all the difference. It has to be a collaborative venture, for it to work.

What do you find most rewarding about trauma-informed therapy?

Post Traumatic Growth (PTG) i.e. Resilience 2.0. This is when I see patients coming into their own, finally becoming the individuals they were always meant to be, the individuals they always were before trauma got in the way. It’s rewarding and fulfilling to see patients come out of the clutches of the ill effects of trauma and heal.

When I read or hear client testimonies where they tell me how much they’ve grown not only into who they were (before the trauma) but to a better version of that, it makes my heart full. Some of them never had a pre-trauma self though and they really get to know themselves for who they really are at their core, minus the trauma as they start to heal.

Of course, the residue still remains. There is nothing like perfect healing or being 100% trauma free but one can still heal enough to lead a good, full life. And they do. That’s what healing is majorly about – growth. 

How do you maintain a work-life balance, especially considering the demands of this field?

I unplug and take time outs. I watch stand up comedy, documentaries, films and TV shows, listen to music, cook, shop, go for walks, exercise and read.

Sometimes, I just rest. These are the basics but they make all the difference. 

Have you ever had to unlearn or adapt your therapeutic approach? What was that process like?

My therapeutic approach has always come to me almost naturally, maybe by the virtue of who I am. People are usually comfortable around me and feel safe in pouring their heart out. The same happened in my professional life as a therapist.

What I did unlearn (even before I started practicing), however, is to act as the supreme authority figure just because I’m the therapist and I know better. While I may have more technical knowledge, my patients aren’t clueless about themselves either. These are functioning human beings going through a tough time in life for which they need help. I also always strive to balance between being technical and being organic. 

How do you approach treatment planning and goal-setting with patients?

It depends on and differs from case to case. While the clinical protocols remain the same, just like the technical aspects such as certain exercises and worksheets, when to do them and how, can change from patient to patient.

I also make it a point to include the patient in that process of deciding what works better for them and not and we are always open to changing something if it doesn’t work. As long as there is consistency and flow, progress is inevitable. 

What self-care practices do you practice to cope?

I make time to do the things I enjoy, want or need. Be it going out and having a good time or be it staying in and just relaxing. I listen to what my mind and body need in the moment, especially if it’s been building up for a while and act accordingly.

I also do art and craft activities as I find them extremely therapeutic and relaxing. Lately, I’ve been going back to my theatre roots, to have artistic expression and catharsis back in my life. Art helps, art heals.