5 Common Myths About Trauma Therapy

One of the things I’ve learnt during my time as a Clinical Supervisor for therapists is that myths and misconceptions are rife in the trauma field. Although some of these myths are well-meaning and aimed at protecting clients, they can also get in the way of good quality clinical practice.

In supervision, I hear the same things over and over again. Today, I want to walk you through some common myths and explain why I think they’re misleading.

5 Common Myths About Trauma Therapy

1. Clients Must Tell the Whole Story for Therapy to Work

One of the biggest misconceptions I hear is that clients need to go into graphic detail about what’s happened to them in order to heal from the trauma these events have caused. In reality, forcing or encouraging full disclosure without an appropriate evidence-based intervention can be distressing and potentially traumatising.

Some approaches like Trauma Focussed CBT may include an element of reliving the event, but this is done in a very structured, specific way. Other modalities like EMDR don’t actually require people to describe the trauma in much detail at all. Clients do need to think about what’s happened and connect with the material, but the level of detail required is much lower than you would think.

2. You Can’t Do Trauma Work if the Client’s Trauma is Still Ongoing

Obviously, safety is important, and somebody’s ongoing circumstances can impact their ability to engage with therapy. It’s vital that clients have enough space to focus on and prioritise the work you’re doing. However, we don’t have to wait until someone is out of a difficult situation to process some of what they’ve been through.

For many, the fallout of trauma (such as seeing themselves in a negative light) can keep them in an ongoing, difficult situation. By processing this trauma, we can sometimes help people extricate themselves from difficult or dangerous situations. So, if trauma is ongoing, there is still huge value in some of the work that can be undertaken in trauma focussed therapy.

3. Clients Must be Fully Stable Before Engaging in Trauma Processing

Okay, so this one is my absolute pet hate! While client safety is paramount, and achieving some form of stability is important, there is a very mixed evidence base for a prolonged period of stabilisation before beginning trauma therapy.

On the whole, I feel there is too much focus on this idea. For some clients, stability will never come while their trauma remains unprocessed. By focusing on achieving this before treatment, we are essentially keeping them from the therapy they need.

I’ve found the push for complete stability is often related to therapist anxiety because trauma therapy is tricky work. I see stabilisation (or preparation for trauma processing) and the processing itself as overlapping phases. They’re not distinct from one another and sometimes we might move between the two to achieve a good balance for the client.

4. Clients Can’t Participate in Trauma Therapy if they’re Using Substances

Substance use, whether alcohol or drugs, is common in trauma survivors. It often becomes one of their main ways of coping with difficult feelings. There’s a common belief that therapy can’t take place until someone is completely sober. But again, for some people, being forced to wait until this point means they’ll never get there.

People often use substances to deal with the pain of trauma. When we take that substance away and the trauma isn’t processed, they’re still left with that pain. Instead, I would encourage people to get both kinds of help at the same time. This will allow them to slowly and safely reduce any dependence on drugs and/or alcohol while also building a new repertoire of coping skills and beginning to process some of the trauma that led to their substance use in the first place.

5. Clients Must Remember Everything in Detail to Process the Trauma

People often ask whether a trauma memory can be processed if somebody can’t recall every detail. I think people worry the work won’t be effective if this is the case. But, by their very nature, trauma memories are often fragmented. They can be stored as body sensations, images and thoughts. It doesn’t always look like a neat chronological narrative. This isn’t an indicator that a memory can’t be processed. It’s a representation of how the brain handles memories from overwhelming events.

In this sense, fragmented memories are a good indicator that these are things we can address in therapy. We can work with whatever fragments are available, whether this is a feeling in the body, a single snapshot, or even just a sense that something happened. It’s not about digging around for memories to uncover. It’s about working on the thing that’s causing distress in the here and now.

Why It’s Important to Dispel These Myths

Trauma therapy isn’t black and white. We can’t organise people into neat little boxes that tell us exactly what we can and can’t do to help them. Instead, we have to look at the individual, recognise the complexity of the situation, and balance things like safety with the need to act.

If we lack flexibility and are always waiting for the perfect circumstances to begin trauma therapy, there are thousands of people who will miss out on the opportunity to heal from their past. For me and my clients, I prioritise being safe and stable enough to start. If necessary, I would rather hit pause and revisit things like stabilisation than prevent someone getting off the starting blocks at all.

About Shelley

I am a qualified, trauma informed Clinical Supervisor with experience supporting individuals, groups and trainees. I’m also an EMDR Consultant and Training Facilitator, a BABCP accredited CBT therapist and lecturer and a RN(MH). My supervision style is relaxed, supportive and focussed on providing a safe space to learn and share knowledge. Learn more about my services here and please get in touch to discuss working with me.