People often arrive at therapy braced for the worst. They have decided that this is the year they finally deal with it, they have steeled themselves, and they turn up to the first session ready to tell me everything. Sometimes they do tell me everything, in one go, quite fast.

And then they feel terrible for three days afterwards.

I want to say something about why that happens, and why, if you come to see me, I might not take you straight into the difficult material even if that is what you have come for.

Telling the story is not the same as processing it

There is a common assumption that trauma therapy means describing what happened in as much detail as you can bear, and that the describing is what heals you. It is a reasonable assumption. It is roughly what most of us have absorbed from films, and it is what a lot of people mean when they say they want to talk to someone.

But trauma is not really stored as a story. It is stored in the nervous system, as reactions that fire faster than thought. That is why you can understand perfectly well that you are safe now and still find your heart racing when someone raises their voice in the next room. The knowing and the reacting are running on different tracks, and information does not travel easily from one to the other.

So going over the story, on its own, does not necessarily change anything. What it reliably does is activate the reaction. If you leave a session flooded and go back to work, or to your children, or to an empty flat, with no way of settling yourself down, you have not processed anything. You have relived it. Do that enough times and your system learns that therapy is another place where you get overwhelmed, which is precisely the opposite of what we are trying to build.

What we do instead, at least at first

There is a model I work with, sometimes called the tri-phasic model, which sequences trauma work into three phases: stabilisation, processing, and integration. Most of the work I do sits in the first phase, and I want to be honest that it often stays there for quite a while.

Stabilisation sounds like a holding pattern. It is not. It is the actual work of making your system able to tolerate what comes next.

In practice it might mean learning what is happening in your body when you are triggered, and why. It might mean noticing the early signs of a flashback before it takes you over, because most people can name the crash but not the ten minutes before it. It might mean building a set of things that genuinely bring you down again, which is a highly individual list and rarely the one from the internet. It might mean working out what to do at three in the morning.

None of that is preparation for the real therapy. It is the real therapy. A great deal changes in this phase, and for some people it is enough.

Why the shame lifts first

The thing that often shifts earliest, and that people are most surprised by, is the shame.

Most people who have lived through something come to believe that their reactions are proof of some fundamental defect in them. They are too much. They overreact. Other people managed worse and are fine. There is something wrong with them at the level of their character.

Almost always, what looks like a defect is an adaptation. Hypervigilance made sense in a house where you needed to know what mood someone was in before they came through the door. Going numb made sense when there was nothing you could do. Anticipating what everyone else needed made sense if being useful was the safest way to be. These were intelligent responses to the situation you were in. The difficulty is that they carried on running after the situation ended.

When that lands, and I mean actually lands rather than being understood as a nice idea, something shifts. You are no longer a broken person managing your symptoms. You are a person whose system learned something and can learn something else.

Going at your own pace, genuinely

I am aware that this can be frustrating. If you have waited years to talk about something, being told we are going to spend time on grounding first can feel like being fobbed off, or like being told you are too fragile.

So I want to be clear about two things.

The first is that you set the pace, not me. I will say if I think we are moving faster than is safe, because that is my job and you are paying me for that judgement. But I am not going to keep you away from something you want to talk about. I have never met a client who benefited from being managed.

The second is that pacing is not the same as avoiding. Slowing down is a clinical decision with a purpose, which is that the work holds afterwards. Anyone can open something up in a fifty minute session. The question is what happens to you at half past eight that evening.

If you are thinking about starting

You do not need to arrive with your history organised, and you do not need to be ready to tell me the worst of it. You are allowed to come and say that you do not know where to begin, or that you are not sure any of it counts.

It counts. And we can go slowly.

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I am a BACP registered integrative psychotherapist working with adults, children and young people, online and face to face. If you would like to talk about whether we might work together, you are welcome to get in touch: shabnum@shabnumhasancounselling.com