1. Lesson 30 Working with Trauma
NCFE Level 3 Diploma in Counselling Skills

2. Learning Objectives What is trauma? Post-trauma symptoms
Differences between counselling trauma and ‘regular’ counselling
How to counsel trauma
Note: Be aware of your own emotional well-being, especially if you feel you have gone through a traumatic experience yourself.

3. What is trauma?

4. What is trauma? Trauma can generally be defined as an exposure to a
situation in which a person is confronted with an event that involves actual or threatened death or serious injury, or a threat to self or others’ physical well-being (American Psychiatric Association, 2000)
Some examples:
Severe car accident
Physical, emotional or sexual abuse
Threat of life, such as a robbery
Severe neglect (for instance as a child)
Separation from family members (as a child)
War experiences
Nature disasters (tsunami’s etc)
Being a witness to something that shocks you deeply

5. Rothschild, B (2000) The Body remembers, First Edition, W. W
Rothschild, B (2000) The Body remembers, First Edition, W.W. Norton & Company

6. Different types of trauma
Singular trauma:
Singular event without prior trauma
Complex trauma:
Repetitive, cumulative, or prolonged exposure
Most often interpersonal, involving direct harm, exploitation, and maltreatment including neglect/abandonment/antipathy by primary caregivers or other ostensibly responsible adults. Intentional form of harm.
Often occurs at developmentally vulnerable times in the victim's life, especially in early childhood or adolescence, but can also occur later in life and in conditions of vulnerability associated with disability/ disempowerment/dependency/age /infirmity, etc
Dr. Courtois article, “Understanding Complex Trauma, Complex Reactions, and Treatment Approaches” 

7. Objective and subjective:
Jon Allen reminds us that there are two components to a traumatic experience: the objective and the subjective:
“It is the subjective experience of the objective events that constitutes the trauma…The more you believe you are endangered, the more traumatized you will be…Psychologically, the bottom line of trauma is overwhelming emotion and a feeling of utter helplessness. There may or may not be bodily injury, but psychological trauma is coupled with physiological upheaval that plays a leading role in the long- range effects.”
Allen, J (1995), Coping with Trauma: A Guide to Self-Understanding, Second Edition, American Psychiatric Press Inc

8. PTSD
Posttraumatic Stress Disorder, is a psychiatric disorder that can occur following the experience or witnessing of a life-threatening events such as military combat, natural disasters, terrorist incidents, serious accidents, or physical or sexual assault in adult or childhood.
Source: [accessed 16th May 2017]
Diagnosing PTSD:
The problems you experience after this exposure continue for more than a month
The symptoms cause significant problems in your ability to function in social and work settings
The symptoms negatively impact relationships.
treatment/diagnosis/dxc [accessed 16th May 2017]

9. What are post-trauma symptoms?

10. What are post-trauma symptoms?

11. Why is counselling trauma different?

12. 5-phase model Building and maintaining a supportive relationship
Symptom reduction, stabilization and developing self-care strategies
Processing memories and emotions
Sense-making and meaning-making
Integration and rehabilitation.
These phases are cyclical and relational due to the very nature of trauma.

13. Managing post-trauma symptoms
Re-living
Avoidance behaviour
Hyper arousal

14. Dual awareness

15. Fight/ Flight/ Freeze/ Friend/ Flop

16. Guilt
2 forms of guilt:
“I should have/ should not have done something during the trauma.
Survivors’ Guilt: The client survived, others may not have.
What would be the function of guilt?

18. Yourself as an instrument vs trauma
Awareness of your strengths and limitations
Fears and hopes

19. Counsellors vs Vicarious Trauma
Be aware that there is a healthy reaction to the kind of work you’re doing.
Strive for a healthy balance between work and personal life. Ensure that you have enough relaxation in your life.
Actively participate in supervision to monitor your own well-being.
Discuss any issues with a colleague or manager.
Ground yourself during sessions.

20. Additional information
Have a look into EMDR, as a treatment to PTSD.

21. Did we cover this? What is trauma? Post-trauma symptoms
Differences between counselling trauma and ‘regular’ counselling
Counselling trauma

22. Closing