What to Expect in Trauma Therapy: A Step-by-Step Guide to Healing
Starting therapy for trauma can feel intimidating. You might be wondering what it will be like, how it will work, or whether engaging with your past experiences will be overwhelming. Understanding what to expect can help reduce some of that uncertainty and make the process feel more manageable. One helpful framework many trauma therapists follow today is Judith Herman’s triphasic model of trauma therapy. While therapists may be trained in different types of therapy, there is wide agreement that trauma work generally follows Herman’s three stages, each focusing on a different part of the recovery process.
Stage 1 Trauma Therapy – Building Safety and Stabilization
In this stage of trauma therapy, the focus is on creating a sense of safety by gently increasing your capacity to tolerate emotions and bodily sensations. Learning skills to manage and contain these feelings doesn’t erase them, but it helps you feel more confident that they won’t take over or overwhelm you.
Trauma can leave us feeling flooded or overwhelmed by our internal experience, and there is some evidence that telling your story in a way that feels like you’re reliving the experience can actually be harmful. Babette Rothschild, author of The Body Remembers and other books on trauma, describes emotional overwhelm in trauma as similar to shaking a bottle of pop. If you open it quickly, everything explodes out and makes a mess. But if you slowly crack the lid to release a little pressure at a time, tightening it back up in between, the pop gradually settles. Over time, you gain confidence that if the cap does get opened—if you are triggered into intense emotions—you can also tighten it back up. Trauma therapy works similarly: we release emotional intensity gradually, while learning skills to contain emotions, so when strong feelings inevitably show up, you feel more confident handling them.
Make the implicit explicit
Sometimes the first step in healing is bringing what’s beneath the surface into focus—making the hidden patterns of the body visible so you can choose new ways of responding.
Particularly with somatic-based therapies, a lot of the focus in Stage 1 is trying to make the implicit explicit. Trauma memories often exist on multiple levels:
Explicit memory: The narrative of the experience we can describe.
Implicit memory: Somatic, sensory, and emotional memories, sometimes called “body memories,” because we primarily experience them in our bodies, below conscious awareness.
With trauma, we may or may not have an explicit memory of what happened—that is, a narrative of the experience we can describe—but we will always have an implicit memory. Implicit memories are the somatic, sensory, and emotional parts of a memory. They are sometimes called “body memories” because we primarily experience them in our bodies, below the level of awareness.
Over time, implicit memories can become procedural—automatic sequences of behavior, like riding a bike. Trauma responses can similarly become automatic over the years. In Stage 1 trauma therapy, especially sensorimotor therapy, the goal is to interrupt these automatic responses, giving you more choice in the moment. The first step is cultivating mindful awareness of these trauma-related procedures as they show up in your body, mind, and behavior.
Recognizing Trauma Responses
A key part of Stage 1 is understanding what is normal. Trauma can leave us with intense emotions like panic, rage, despair, or numbness that take over at unexpected times. These are survival responses, the ways your body adapted to protect you at the time of the trauma.
Trauma survivors often feel immense responsibility and shame for what happened to them and for their reactions. It’s helpful to understand that intense emotions and the survival instincts paired with them are normal. Your counsellor will provide education to help you get to know and understand your reactions. We need this awareness to catch what’s happening in the moment and be able to respond differently when those reactions show up.
Your therapist may also help you identify triggers. Being sensitive to triggers is a survival mechanism—your body remains on alert for what felt dangerous during a traumatic event. Often, we try to avoid triggers, but many will inevitably arise. Being able to anticipate them and have a plan for responding helps you feel more prepared and empowered, rather than caught off guard.
Building skills to regulate emotions
An important part of Stage 1 is learning how to regulate emotions and calm your nervous system. This involves both identifying the ways you already (perhaps unconsciously) try to calm your body, and also developing new ones to support your nervous system. These skills need to be specific to you. In therapy, your counsellor will help you refine and adjust different strategies so you can feel calmer when distress rises and gradually build confidence in managing emotions that may currently feel overwhelming. Practicing this over and over again is like building a muscle in your brain. Each time you practice, you strengthen your ability to respond differently.
Some examples of skills that might work for you to help calm or energize your nervous system are:
Grounding
Using movements
Boundaries
Centreing
Posture and alignment
You don’t need a long list of skills, usually 2–4 reliable techniques are enough. Your therapist will help you build these skills, and make adjustments with you so that they work for you. There is no one-size fits all strategy that will be the best fit for everyone. For instance, deep breathing may calm some people, but exacerbate panic in others. For someone who tends to feel more numb and shutdown rather than panicked, certain movements may be more helpful to energize and sharpen focus whereas a passive grounding exercise might not feel helpful.
Strengthening New Pathways
Just as rivers carve new paths and grow deeper over time, each time we practice calming our nervous system we strengthen those new pathways, making it easier to respond in different, healthier ways.
I often think about automatic reactions, whether related to trauma or not, as being similar to how rivers and streams grow over time. There may have been an initial event, like a flood or storm, that set the water flowing in a certain direction. Over time, that stream deepens and widens. After many years, it can form a canyon, making it seem impossible for the water to flow any other way.
When we try to respond to overwhelming emotions in new ways, it’s like asking the water to flow in a completely new direction. At first, the path isn’t carved out, so it’s harder for the water to move that way. But with repeated practice, the new pathway deepens, and it becomes easier for the water to flow in that direction. While the original canyon will always remain, using it less allows it to fill with weeds and dust, making it less dominant.
We can’t erase our default patterns, but we can create new ones and strengthen them with practice. In Stage 1 trauma therapy, when we work on skills to regulate emotions, calm our bodies, and respond differently, we’re essentially carving out and reinforcing these new pathways, giving ourselves more choice in how we react.
How Long Does Stage 1 Trauma Therapy Take?
The length of Stage 1 trauma therapy can vary widely depending on a person’s past experiences and the sense of safety they’ve had in life.
For someone who grew up in a reasonably supportive environment, with safe adults who responded to their needs, childhood often leaves them with a foundation of trust in themselves and others. If this person then experiences a single-event trauma, like a car accident or an assault, their ability to regulate emotions may be temporarily disrupted—but it’s often easier for them to re-establish skills they already had. For someone like this, Stage 1 trauma therapy may only take a few sessions. It’s less about learning new skills and more about refreshing ones that were already present.
For someone who grew up without a reliable sense of safety, who lacked supportive adults, or who internalized messages that emotions are dangerous or burdensome, Stage 1 looks very different. These individuals may need to build skills not only to regulate themselves but also to identify what and who feels safe. When safety was absent in childhood, the world can feel consistently unsafe. For them, Stage 1 trauma therapy can take much longer, sometimes months or even years.
Some people find that what they gain from Stage 1—feeling more grounded, more in control of their knee-jerk reactions when triggered, and less overwhelmed by emotions—is enough. They may choose not to move on to later stages of trauma therapy, and that’s completely ok.
Stage 2 Trauma Therapy – Processing Memory
Processing looks different depending on the therapy, but the common thread is that trauma disrupts and distorts memory, and those traumatic memories need help to integrate. Processing is like “re-filing” those memories—helping the brain consolidate them in a way that makes sense, so the door can finally be closed.
The second phase of trauma therapy focuses on processing memories of the past, not just recalling events or putting them into words, but also noticing how they live in the body. The goal is to integrate the effects of those memories so they no longer hold as much power in your present life.
This work often involves recognizing implicit, nonverbal memories from childhood or moments of trauma that still shape how you feel and react today. Rather than reliving or avoiding them, you learn to work with these memories in ways that bring healing and integration.
As you process, you may rediscover forgotten resources and strengths that helped you survive. You might also explore physical impulses, like the urge to run away, that weren’t possible at the time but now offer a sense of empowerment. Sometimes this phase includes revisiting painful experiences from early life and working through the emotions connected to them, with support to regulate your nervous system along the way.
Telling the full story, or not
Healing doesn’t always require telling every detail of your story—sometimes growth comes from finding other safe, supportive ways to process your experiences.
There are many different types of therapy and these modalities approach stage 2 trauma therapy in different ways. Some focus on exposure and a re-telling of the trauma narrative, while other therapies like sensorimotor psychotherapy and EMDR focus on processing the responses the client has when they call a traumatic incident to mind. There is some disagreement in the field about the risks of retraumatizing a client during trauma processing, and also disagreement about what constitutes retraumatization, but we do know that some people will notice an increase in distress and trauma symptoms from retelling their story.
Therapies like EMDR and sensorimotor psychotherapy focus on processing without requiring the client to share every detail of the trauma narrative. I often ask my clients if telling their story feels important, because sometimes telling our stories and having them witnessed can be an important part of healing. If so, we find a way for it to be safe and helpful. If not, we can use approaches where they don’t need to recount details, and we can still process the experience.
Stage 3 Trauma Therapy – Reconnecting to Everyday Life
Stage 3 trauma therapy is often called integration. It’s about taking everything you’ve learned so far and bringing it into your everyday life. Here, the focus shifts toward building more joy and satisfaction in everyday life. This is the point where therapy moves beyond just managing symptoms and begins opening space for fuller participation in the world—especially in relationships.
By this phase, you’ve often already developed tools to regulate your nervous system and worked through many of the memories that once felt overwhelming. Here, the goals often look a little different: taking on tasks of growth and development, challenging old limiting beliefs, learning to move through painful emotions without getting stuck, and showing up more fully in work and in relationships. It’s less about the past, and more about setting new goals for the life you want to create - one with more joy, fulfillment, and connection.
Common Concerns About Starting Trauma Therapy
It’s completely normal to feel some hesitation about starting trauma therapy. That worried look? Many people bring it to their first session, and often leave feeling a little lighter and more hopeful.
Do I have to tell the therapist everything that happened to me?
No, you don’t have to. For some people, sharing their story can feel important and even healing, especially when it’s witnessed by a supportive therapist. At the same time, revisiting trauma in detail can sometimes feel overwhelming or dysregulating, and in those cases, it might not actually be helpful. Whether or not you tell your full story is something you can explore with your therapist, weighing both the potential benefits and the risks.
If you’d prefer not to go into all the details, there are therapies designed to work with trauma without requiring a full narrative. For example, in EMDR therapy, your therapist may ask you to focus broadly on a memory you want to work with. You’ll spend time noticing how that memory affects you in the moment, but you won’t need to recount every detail for the processing to be effective.
Sensorimotor psychotherapy is another approach where the focus is less on retelling the story and more on your present experience—how the trauma shows up in your body, emotions, and mind in the therapy room. The work centers on shifting those responses rather than narrating every detail of the event.
Other therapies may involve working through the narrative of your story, if that feels important to you. It’s always a good idea to talk openly with your therapist about your comfort level. You can set boundaries around what you want to share and discuss ways to process trauma safely, whether that means telling your story, limiting the details, or focusing on your body and emotions instead.
Am I going to be in therapy forever?
While trauma does take time to heal and recover from, it doesn't mean you’ll be in therapy for the rest of your life. Because we know that trauma often leaves us overwhelmed and aversive to our own internal experience, it is often slower work then other issues that someone might come into counselling with. The three stages of trauma therapy are designed to support a full process of healing, but that doesn’t mean you need to go through all of them.
Many clients find that doing a substantial amount of Stage 1 work—learning to regulate emotions, noticing what’s happening in the body without fear, and reconnecting with positive experiences—is enough for them at that point in their life. Feeling more confident in managing emotions and triggers, and being able to experience more joy, can be a natural stopping point.
Will talking about things make me feel worse?
It’s normal to sometimes leave therapy feeling more unsettled than when you arrived. Facing difficult emotions, especially ones you haven’t turned toward before, can feel intense or overwhelming. A skilled therapist will check in with you throughout the session to make sure the work stays manageable.
Some stirring of emotions is part of the healing process: thoughts, memories, or sensations may come up, but that doesn’t mean you need to “white-knuckle” your way through it. If you find a session feels like too much or you leave feeling raw and struggling to calm down, it’s important to share that with your therapist. They can adjust the pace, focus, and depth of the work to manage overwhelm while still still being productive. While part of their job is to nudge you a little outside of your comfort zone to encourage growth and build more resilience, they can do that without pushing you beyond what feels manageable.
Finding your way through Trauma
Trauma therapy moves from building safety, to processing memories, to reconnecting with life—and while it can be challenging, the results are deeply rewarding. It asks you to face what has felt overwhelming, learn new ways of being with yourself, and practice those skills again and again. It can take time, patience, and courage. But the effort is worth it.
Through the process, many people find they feel more grounded in their bodies, more in charge of their emotions, and more open to connection with others. We can’t erase the past, but it can file it away so it’s not reignited in our everyday lives.
If some of this resonates with you and you feel ready to begin working through your trauma, I’d be honoured to support you.
