A basic tenet of trauma informed therapy practice is, when a patient tells you something about their experience, you err on the side of assuming their reaction makes sense, is connected to reality somehow, & isn't necessarily evidence of "dysfunction."

I know. RADICAL. Not only does trauma informed practice NOT assume a survivor's emotional or behavioral response is "evidence" of dysfunction-- it assumes that, possibly, their response was the MOST functional thing about a f*cked up situation.

Many trauma survivors who have had the courage to seek mental health treatment have learned the hard way that if we express suicidal thoughts, many elements of mental health delivery systems will view us as a walking risk management problem. Some people do get into therapy for support managing their suicide risk. But if therapy becomes only or mostly about managing suicide risk, the stuff that REALLY needs to be talked about, tends NOT to get talked about.

Cognitive therapy did a great thing in demonstrating how distorted thoughts can lead to unnecessarily painful feelings.

Then the field of clinical psychology lost is goddamn mind & spent decades spouting bullsh*t about how distorted thinking was the CAUSE of painful feelings. There are LOTS of things that contribute to painful feelings & behaviors (including, but not limited to, trauma & subsequent triggers). "Your emotional pain & counterproductive behaviors are the result of your thoughts" is victim blaming--&, btw, not what Aaron Beck taught.

Sayings like "your results are a reflection of you" & "what's in the well comes up in the bucket" encourage people to judge their fundamental essence by external results. Which is the kind of simplistic toxicity I expect from self-help charlatans-- but not experienced therapists. There are times when kind people aren't their best selves. There are times when hard workers don't produce results. There are moments when amazingly smart or competent people are hamstrung by triggers.

Trauma therapists & programs have zero interest in convincing anyone whose difficulties aren't rooted in trauma, that they are.

I love this fantasy that the trauma treatment field is pushing an "everyone has trauma" narrative for the sake of profitability. The trauma treatment specialty EXISTS because NOT everyone has trauma-- therefore clinicians need to know what trauma DOES look like so they know it when they see it.

I think what we say on social media about trauma & recovery matters, because the internet is very often the first place survivors look when they're ready to change how they've been living & coping. I've been the unit psychologist on a trauma & dissociation specialty unit. I've trained & worked in trauma outpatient programs. I wrote my dissertation (& my master's thesis) on trauma. I've known & worked with hundreds of complex trauma survivors.

There's a LOT we don't know about how memory works, & suggestibility in therapy relationships is definitely a thing-- but dissociative amnesia ("repressed"/recovered traumatic memory) ABSOLUTELY happens. There's no doubt the way some therapists, especially in past decades, tried to work w/ incomplete & confusing memories created big problems for how recovered memories are perceived & understood by the world.

I talk in terms of "recovery," rather than "healing," because to me "healing" feels passive & uncertain, while "recovery" speaks to me of choices, experimentation, habits, rituals-- active choices that may not be perfect, but which WE choose to be safe, stable, & functional. It drives me up a f*cking WALL when some therapists speak of "healing" as something that happens as the eventual result of a magic "relationship," therapeutic or otherwise.

I didn't have time for that, especially early in my recovery. My LIFE was on the line.

"It's not always a trauma response, sometimes you're overreacting."

Tell me you don't know what "trauma response" means without telling me. "Feelings are often irrational, sometimes we misunderstand things and have big emotional reactions."

So, we, uh, don't have the right to feel things that are triggered by misunderstandings? Huh. Someone tell our amygdala & adrenals that.

Validating your right to feel things is an important step toward realistically managing them.

There is NO conflict between validating feelings & emotional regulation.

You can't "manage" an experience you're actively denying & disowning is even happening. One of the biggest OBSTACLES to realistic emotional regulation is our compulsion to police our emotions to make sure we're not feeling the "wrong" thing at the "wrong" intensity.

Hey. Don't get freaked out by all those posts declaring how much work recovery is, how there are no shortcuts, how it takes long term commitment, blah blah blah.

You just worry about today. This hour. This minute.

Breathe; blink; focus.

And let's get through this together. Yeah, recovery's a big project, & it's easy to get freaked out. But check it out: all we can handle this minute, is this minute.

So let's handle that.

You're gonna be okay. Be here with me.

Let them stress about the next 20 years. You be right here, right now.