How to tell your therapist about trauma

Deborah C. Escalante

What does it mean to experience trauma?

To experience trauma is to live through an experience that creates long-lasting pain or distress in our lives. There is no one size fits all definition of trauma. Things like witnessing violence, surviving assault, or being in an abusive relationship are common understandings of trauma, but it is actually much more expansive than that.

Many people do not even know they have experienced trauma until much, much later. In the moment, while uncomfortable, your mental defenses might put your concentration firmly onto survival that you aren’t able to recognize the trauma for what it was until you’re safe to unpack and explore what happened. Signs that you have experienced trauma can include:

  • Feelings of shock, disbelief, denial
  • Trouble concentrating
  • Mood swings (anger, irritability, etc.)
  • Impulse to withdraw from others
  • Nagging feeling of guilt or shame
  • Feeling disconnected from your life, as though you are just going through the motions
  • Trouble sleeping
  • Startling easily
  • Frequent body aches + pains
  • Fatigue
  • Increased anxiety

Read: Big T vs Little T Trauma

What happens if we don’t address or unpack our trauma?


Even if we know we need to, addressing our trauma is incredibly difficult. Even with a therapist! It makes us feel vulnerable. Add on top of that, any sort of gaslighting you may have experienced after the trauma–from others or yourself–and we can start to feel extreme shame when thinking of our trauma. Gaslighting can sound like:

  • “It wasn’t that bad.”
  • “Other people have suffered worse.”
  • “You’re being dramatic.”
  • “Can’t you just move on?”
  • “That sucks but don’t think you’re making too big of a deal out of it?”
  • “That didn’t happen.”
  • “I don’t believe it’s actually that bad.”

Gaslighting doesn’t just come from others–it often comes directly from ourselves. We don’t want to be weak or broken, so we tell ourselves that what we have experienced wasn’t that bad, that we have made it up, that if we were just stronger we’d get over it, etc. Deep down, we know it’s not true. The pain we are feeling is real and present and affecting our daily lives. But even if we know deep down that our pain needs to be dealt with and healed, part of us is likely afraid that if we bring up our trauma in therapy, our therapist will say things like this back to us–confirming our worst fears about our experience.

Read: 6 Things You Should Know Before Your First Therapy Appointment

How to bring up past trauma in your therapy session:

Tell your therapist about your fears:

You don’t have to dive into the deep end on your first try. Your trauma therapist is there to help you work through and heal your pain in whichever way is best for you. And you are the expert on yourself. If jumping right in is too much, talk to them about why that is first. You can say something like:

BACA JUGA:   The emerging evidence for long-term psychodynamic therapy

“There is something I’m struggling to move past. I know I need to face it to move forward, but I’m afraid to talk about it. I think I’m afraid I will be judged, or that you will think I’m overreacting.”

traumaYou don’t even have to say what it is you’re talking about. Let them know you have work you want to do, but that fears are blocking you from being able to actually do that work. Then, you and your trauma therapist can work together to make sure you feel comfortable and safe before you do anything else.

Write it down:

When we talk about a traumatic event, we can feel pulled back into the event itself–like we’re experiencing it all over again. That can make talking about it difficult. Instead of pressuring yourself to be composed and calm while explaining a traumatic experience, give yourself the space to feel your feelings freely without an audience. Sit down with a pen and paper, or a note app on your phone, a blank doc on your computer, etc. and make a few notes about what you want to talk about.

Then, in session, let your therapist know that speaking off the cuff in regards to your trauma is too difficult, but that you have written down a few notes. And if you move away from the notes and start to struggle, ask your therapist to remind you that you can refer back to your notes when you begin struggling to communicate.

Remember you can stop at any time:

There is no rule that says once you have started talking about something in therapy, you have to finish. If you start unpacking trauma and it becomes too much for you, remind yourself that you can stop. Tell your therapist that you appreciate the space they have provided to talk, but you’re not ready to discuss it any further.

We know that the experience of traumatic events may impact your living situation, relationships, health, and mental well-being. If you need help dealing with this, then we’re here to help. You can also get online counseling if you live in California, Colorado, and Texas.

Dear Working on Healing,

I just started therapy and I really like my therapist so far. Also, I have had trauma in my life that is pretty bad. I want to know how you can tell if it is a good idea to bring up trauma with your therapist. How long should I wait? I don’t want her to think that’s all I am. I also am worried what if I get upset if I tell her? What if I had a flashback while I was there? What if she cried or something? – Working on Healing

Thank you for these fantastic questions. I am going to answer each question individually, as you bring up quite important issues; but before I get to your questions, I’m going to ask you one. Does your therapist have specialized training in working with survivors of trauma?

This is a critical question for you to find the answer to and here’s why. The vast majority of therapists are competent, capable and genuinely caring individuals but not every therapist knows how to work with trauma. Unfortunately, it is possible to have a wonderful and generally effective therapist make unintentional and damaging mistakes with regards to a survivor of trauma.

BACA JUGA:   How to talk to your therapist about childhood trauma

Therefore, my recommendation would be to ask your therapist if she/he has training in working with trauma, is knowledgeable about this type of healing, etc…. When asking this it is appropriate to share that you are a survivor of trauma and would like to work on this aspect of yourself. If your therapist does not have a high level of specialized knowledge regarding trauma, then feel free to talk with your therapist about your desire to find someone who does have this expertise. Keep in mind that your therapist wants what is best for you and will not be upset, angered or disappointed if you need to connect with an alternate therapist for awhile or for good. Therapists recognize that we are only one piece of someone’s healing journey. We tend to be grateful for the segment of the journey that we share with our clients and trust that our clients will find other healers and avenues for healing as they journey through life.

So, assuming that you are working with a therapist who has specialized knowledge in trauma, here are some of my thoughts.

“How can you tell if it is a good idea to bring up trauma with your therapist?”
You own your life story and this includes the trauma(s). You and you alone have the right to set the agenda of your healing. If you feel safe with your therapist, trust him/her and desire to share about your life having trauma, then by all means feel free to do so. If on the other hand you would prefer not to share this, then know you also have the right keep this information private. You also have the right to bring up the fact of trauma and express your desire to not delve into the healing. A trauma therapist will understand that you are not being resistant, evasive or avoidant and will honor the courage it took to share as well as the trust you are showing by sharing.

“How long should I wait?”
This is 100% up to you. I have had clients who have told me about trauma in the first session. I have had clients who waited months and I have had everything in between. Once again, you have the right to claim your history – your therapist understands that the choice to disclose is your choice and a part of your healing. Your therapist will not be offended if you wait a long time to share and your therapist will not be overwhelmed if you share early on.

“I don’t want her to think that’s all I am.”
A key principle in psychology is that people are complex, more than meets the eye, and not equal to one life event or type of experience. Your therapist understands that you are a multifaceted individual and will try and define you based on your experience of trauma(s).

BACA JUGA:   Role of therapist in psychodynamic psychotherapy

“I also am worried what if I get upset if I tell her.”
It is understandable to be worried about becoming upset, but rest assured that being upset in therapy is totally normal and to be expected. Your therapist will know how to help you soothe and calm your upset. If your therapist does not help you soothe and calm, then talk about this with your therapist. You have every right to require that the therapist you work with knows how to effectively handle emotions and knows how to teach you to navigate your emotions.

“What if I had a flashback while I was there?”
Pacing and timing are two important issues when healing from traumatic life events. Here’s an analogy, if you were to run a marathon, your pace would be how quickly you run each section of the race while your timing would be when within your training regime you actually run the race. In terms of healing (healing being the marathon), pacing has to do with how quickly and deeply you share about the trauma(s) while timing has to do with when you share. If you were preparing for a marathon, you and your coaches(s) would jointly make decisions about pacing and timing so that you push your body to achieve its potential while maintaining safe and achievable expectations. Once again, the analogy is apt – with regards to healing, you and your therapist jointly make decisions about pacing and timing. It is your therapist’s job to help you pace your disclosure so to minimize the chances of a flashback and if one does occur it is your therapist’s job to help you get out of the flashback as quickly as possible. The ability to recognize and manage a flashback are part of a trauma specialists skill set and makes this one of the prime reasons why working with a trauma specialist is vital.

What if she cried or something?
For many survivors of trauma, there is a deep fear that they are toxic, damaging and will inflict intolerable pain on those they share their histories with. Generally, the fear of one’s therapist crying is rooted in this fear. Due to your therapist’s training in trauma, she/he will know how to express compassion, nurture and healing in a way that teaches you that you are not damaging, toxic or the inflictor of intolerable pain. If your therapist does cry and this does overwhelm you, know that you can talk about this with your therapist.

Finally, feel free to bring up each and every one of these questions with your therapist. I know I speak on behalf of countless therapists when I say that we welcome your concerns, thoughts and worries – we believe that you are important and therefore believe that your questions are important too.

Kind regards,

Susanne Dillmann

Susanne M. Dillmann, PsyD, is a licensed psychologist based in Enscondido, California, where she specializes in posttraumatic stress/trauma. She has worked both abroad and within the United States, where she has applied a collaborative approach in helping trauma survivors grow and heal.

Susanne M. Dillmann, PsyD, is a licensed psychologist based in Enscondido, California, where she specializes in posttraumatic stress/trauma. She has worked both abroad and within the United States, where she has applied a collaborative approach in helping trauma survivors grow and heal.

Also Read