A Thoughtful Approach to Working With Difficult Experiences
People come to trauma therapy for many different reasons.
For some, there is a particular event they continue to think about or react to—an accident, assault, loss, medical experience, frightening event, or other period in their life that felt overwhelming.
For others, there may be no single event. They simply recognize that experiences from the past continue to influence how they feel or respond in the present.
Trauma therapy provides a place to understand these experiences and determine what kind of work may be useful.
I provide in-person trauma therapy in Washington, DC, as well as secure online therapy throughout Washington, DC, Maryland, Virginia, and Florida.
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What Brings People to Trauma Therapy?
You do not need to have a diagnosis of PTSD to seek trauma therapy.
People often reach out because they notice difficulties such as:
- Anxiety or feeling persistently on guard
- Strong reactions to particular situations or reminders
- Avoiding places, conversations, or experiences
- Difficulty sleeping or relaxing
- Feeling emotionally overwhelmed
- Feeling numb or disconnected
- Difficulty during conflict
- Unwanted or distressing memories
- Changes in relationships following a difficult experience
- Understanding a problem intellectually but continuing to react to it emotionally or physically
Sometimes the connection to an earlier experience is obvious. At other times, understanding that connection becomes part of the therapy.
What Does Trauma Therapy Involve?
Trauma therapy does not mean immediately telling your entire story or describing painful experiences in detail.
We usually begin with what is happening in your life now.
That may involve understanding a particular reaction, talking about a relationship or current stressor, noticing situations that activate you, or developing ways to manage emotions that have become difficult to regulate.
For some people, this is much of the work.
For others, it eventually becomes useful to work more directly with particular memories or experiences. When we do, the approach and pace depend on what you are experiencing and your ability to remain present without becoming overwhelmed.
There is no requirement to move into trauma processing simply because you are in trauma therapy.
Choosing an Approach
Different aspects of trauma may call for different kinds of attention.
Depending on what brings you to therapy, I may incorporate EMDR, Somatic Experiencing®, Parts Work (Ego State Therapy), DBT skills, mindfulness-based approaches, or relational psychotherapy.
Rather than deciding in advance that everyone with trauma needs the same treatment, we consider what seems most relevant to the difficulties you are experiencing.
For example, someone struggling primarily with a specific traumatic memory may need something different from someone who becomes disconnected during conflict or someone whose difficulties developed through experiences repeated over many years.
The approach should fit the person rather than expecting the person to fit the approach.
Single-Event and Complex Trauma
Some difficulties follow a particular event or identifiable period of time. Others develop through experiences that were repeated, relational, or occurred over many years.
That distinction can matter for treatment.
When trauma is longstanding or connected with childhood and important relationships, therapy often involves more than processing particular memories. Patterns involving relationships, emotional regulation, self-perception, and protection may also need attention.
You can read more about this on my Complex Trauma Therapy page.
Working at a Manageable Pace
There is no advantage in moving more quickly than you can comfortably tolerate.
Sometimes slowing down, developing greater awareness of what happens when you become overwhelmed, or finding ways to remain connected to the present is itself important therapeutic work.
This is particularly relevant when dissociation or significant emotional overwhelm is present.
Decisions about when to approach difficult material are made collaboratively rather than according to a predetermined timetable.
Specialized Trauma Therapy
You may already have a sense of what you are looking for. If not, these pages provide more information about specific aspects of my work:
Complex Trauma Therapy
For difficulties associated with repeated, childhood, developmental, or relational trauma.
EMDR Therapy
A structured approach that may be used when working more directly with distressing memories and experiences.
Dissociation Therapy
For experiences involving emotional numbness, depersonalization, derealization, memory difficulties, or disconnection.
Somatic Experiencing®
A body-oriented approach that pays attention to physical sensations and nervous-system responses.
Parts Work (Ego State Therapy)
An approach for understanding different internal responses and the roles they may play.
DBT Skills
Practical skills for emotional regulation, distress tolerance, mindfulness, and interpersonal situations.
Frequently Asked Questions
Do I need to know whether I have PTSD?
No. You do not need a particular diagnosis before contacting me. We can begin with what you are experiencing and consider whether a trauma-informed approach makes sense.
Will I have to talk about what happened?
Not before you are ready. Some people want to talk directly about a traumatic experience, while others initially need to focus on what is happening in their lives now.
Do you only work with childhood trauma?
No. I work with adults affected by both recent and earlier experiences. If your difficulties are primarily related to childhood, developmental, or relational trauma, my Complex Trauma Therapy page provides more detail about that work.
How do I know which therapy approach I need?
You don’t need to decide that yourself. Part of my role is to understand what you are experiencing and consider with you which approach, or combination of approaches, may be appropriate.
Getting Started
If you are considering trauma therapy, we can begin with a conversation about what brings you in and what you would like help with.
You do not need to know exactly what kind of therapy you need or have a complete understanding of how the past may be affecting you now.
That is something we can begin to understand together.
