Sexual trauma work is different.

For most talk therapy, you come in, talk about what’s come up that week, and this informs the rest of the session. There may be some homework to do during the week. You may explore themes and connections that help you make positive changes in your life. For the most part, you, as the client, are dictating what you work on in each session.

This process does not work with PTSD treatment.

Let’s face it. No one wants to revisit their worst memories. No one wants to re-experience their scariest, most awful experiences ever. And yet, all trauma work incorporates this in one fashion or another.

So, most of us naturally avoid it. Worse, untrained, or unsupported therapists find themselves avoiding or changing the subject. They do not want to “re-traumatize” their clients.

Good sexual abuse counseling definitely does not re-traumatize. But, a good sexual abuse counselor is skilled in making it safe to address the issue rather than avoid it. A good sexual trauma therapist helps you build the skills needed to handle the emotions and body sensations that arise from the memory. Then, they actively guide (but do not push) you towards the bad memories as you become ready to face them. Once you can face a memory without being overwhelmed, you start thinking and feeling about it in a different way. This is the body’s healing process.  

The hard work of sexual assault counseling needs a definite beginning AND end.

Because trauma work is hard, no one wants it to last forever. Traditional psychotherapy (where you dig into new insights and work for years to uncover the unconscious reasons that cause you to do certain things) is great. But, not for a traumatized brain. Trauma work should be short-term and have a definite beginning and end. This way, you can always see the light at the end of the tunnel. Otherwise, most get lost in the tunnel and are likely to give up.

Your sexual trauma therapist’s experience is that light at the end of the tunnel. A good sexual trauma therapist always knows exactly where you are in the process. They can offer reassurance that you are on the right path. Once trauma work is complete, you can opt to work more loosely with any remaining issues you may want to address.

If you don’t use it, you lose it.

Trauma work is challenging on an emotional and intellectual level for clinicians. It takes special attention to detail. If a counselor does not do trauma work on a regular basis—even with adequate training and experience—those skills get rusty.

This can be pretty dangerous. People dealing with PTSD symptoms often also suffer from depression and other sometimes severe anxiety symptoms. Your sexual abuse therapist needs to be very in tune with how connected you feel within the session. And, how high your emotions are at any moment.

Many people freeze as part of the PTSD reaction. This can cause them to “numb out” or dissociate. This causes people to be completely out of touch with their experiences. Often, they are unaware this is happening. Dissociation can also cause a person to struggle with verbalizing how they feel. Afterward, when they “come to”, they are often flooded with emotions, flashbacks, and/or body sensations. Of course, we want to avoid this.  

So, having a trained therapist to watch for the signs of dissociation and knows how to bring you back into the present with safety is paramount. Once you can do it with your therapist, you will learn to do it on your own. This is the beginning of regaining control in your life and is a big part of the healing process.