3 Counselling Strategies for Trauma Healing

One of the primary goals of trauma counselling is to slow down and notice the difference between emotions, bodily sensations, and thoughts. When heart rate increases (physique) out of fear (emotion), then the thought “I am not safe” (cognition) emerges. This leads to a brain-body-mind connection that is overwhelming and that can push a person outside of their window of tolerance.

In the trauma healing process, we must help our clients to slow down and notice these distinctions. This has the dual purpose of normalizing the experience of responding to trauma and of teaching our clients how to calm themselves down and to settle their bodies and minds.

The brain-body-mind connection is presented here as a framework from which to root the rest of your practice. Trauma presents as an overwhelmingly complex set of symptoms and responses and can be experienced this way by both the client and the counsellor. Separating the experience of trauma into the brain-body-mind connection can help to simplify and normalize the trauma response and also provides a framework for effective practice.

One of the primary goals of trauma counselling is to slow down and notice the difference between emotions, bodily sensations, and thoughts.

Strategies for Trauma Healing

1) Strategies focused on the brain are grounding techniques that facilitate a sense of safety.

When the brain’s alarm system is triggered and the client feels unsafe in the present moment, you can apply the following strategies:

• Use grounding techniques, which help clients centre themselves in the present moment. For example, ask the client to feel their feet on the ground, to use their senses to notice their surroundings, and to generally pay attention to what is actually happening in the present moment.
• Observe with your client the act and effect of these activities while you do them. By clearly and transparently inviting your client to do a grounding activity while noticing the sensation of their feet on the ground, for example, you can help build a calming connection in their brain between the prefrontal cortex and the autonomic nervous system. This helps the brain to notice fully that it is safe in this moment and that the trauma is in the past.

2) Strategies focused on the body bring the mind’s awareness to the body.

These approaches teach the client how to move back into a sense of safety and calm, even when the client is experiencing physical discomfort. A slight increase in tension, change in rate of breathing, or butterflies in the stomach are signs of something coming up in the body. Invite your client to notice these shifts so they can expand their ability to discern where the trauma is being held with these techniques:

• Use more active exploration through movement exercises. Ask clients to stand and root themselves into the ground by feeling their feet connecting with the floor. If you practice yoga or other body-based approaches, such as reiki, this is an excellent point in which to introduce techniques to your clients.
• Teach progressive muscle relaxation. In this approach, you can direct the client to work from the top down or from the bottom up by moving from head to toes, holding the muscles in a tensed position and then releasing the muscles to a relaxed position, and working along the whole body. I use this approach with clients who have difficulty connecting to their bodies. The practice of tensing then releasing the muscles reconnects the person with their body from head to toe (or toe to head), in a way that is controlled.
• Facilitate a body scan. The process involves inviting a client to scan from the top of their head to their toes and to notice any tenseness, tightness, or pain, and to just notice the sensation without changing anything. I encourage clients to breathe through the body scan and imagine they are shining a light of awareness along their body as they do the scan. This practice helps to re-establish a brain-body-mind connection and to find comfort and calm amid the discomfort and stress of the body.
• Teach the client to approach discomfort with techniques like pendulation. Pendulation activities ask the client to move their attention from the area of discomfort to any area of the body that feels calm or relaxed, and then back and forth repeatedly. This is paired with deep and regulated breathing, as well as encouraging the client to just notice the sensations in their body. If your client reports that the discomfort is still present, continue with the pendulation (moving back and forth repeatedly). If your client reports the discomfort has lessened or disappeared, invite your client to lead themselves through practicing the pendulation to enjoy the calming feeling of their body.

3) Strategies focused on the mind engage both feelings and thoughts.

By using the client’s name, making eye contact, and modelling calmness, you embody safety. Additionally, offering psycho-education about feelings and thoughts while engaging clients in conversations about how they feel and what they think when they experience symptoms builds collaborative safety. Often symptoms of trauma feel so overwhelming that thoughts and emotions cannot be separated.

• Using an emotion wheel or list (a diagram with the primary emotions labelled along with related feeling words), ask your client to identify the presenting emotion. It’s not uncommon for clients who have experienced trauma to lose track of their emotional experiences. This can present as a loss of emotional vocabulary. If you work with an individual who has suppressed their experience of trauma for a prolonged period of time, they have likely distanced themselves from emotions that feel unsafe.
• Help your client recognize and identify negative thoughts such as “I am not safe,” “I am worthless,” “I should have done something,” and “It is not safe to feel my emotions as they are shared in session.” Negative thoughts can become so ingrained for clients that they perceive them as normal. These negative thoughts become the baseline for viewing the self and the world. Use a ready-made negative and positive thoughts list to help your client identify their thoughts, or make a list with your client of their negative and positive thoughts. With this awareness, the client can begin to identify these thoughts as a result of trauma, rather than as the truth.

In a trauma state, emotions can no longer be trusted as guides for thoughts because emotions are felt as both intense and urgent.

In counselling, the mind is the focus of most interventions. The mind is where we organize information, make to-do lists, and decide how we are going to execute tasks. It is also where feelings are put into words. With trauma, the emotional and cognitive processes do not always match or work well together. In a trauma state, emotions can no longer be trusted as guides for thoughts because emotions are felt as both intense and urgent, which can lead to cognitive processes that are impulsive and irrational. Using the three strategies above will help you empower clients to respond to trauma in a way that’s healthy and rational.

This blog is based on an excerpt from our book, Counselling Insights.

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Download our free printable handout, Principles for Being Trauma-Informed from our website. For more FREE RESOURCES on this topic and others, visit our free resources page.

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