You Don’t Have to White Knuckle It Through Every Session

Wait, what?!

What was your reaction to this blog title? 

Did it piss you off? Leave you in disbelief?

My intention was not to give you any false promises or leave you feeling invalidated, but it’s true - you really don’t have to white knuckle it through every client.

You know what this is like - bracing yourself for sessions, starting a minute (or few) late, knowing there are sessions you dread or finding yourself dreading all of them.

Then, once session starts, feeling like you’re holding a shield in front of you to protect yourself because it’s all become too much.

Guess what is happening in your brain during these moments - the fight, flight, or freeze response.

Trauma Therapists Have a Survival Response Too

Yep, that’s the essence of Vicarious Trauma, call it a parallel process of sorts, where our brain will use the same survival strategies our clients use to deal with their trauma history.

This is a natural reaction to the work we do, not a deficit in our wiring, ok?

That doesn’t mean it always feels great when it’s happening (duh), which is why today’s blog topic is so friggin’ important.

So, if you’re ready to honor your brain and body’s natural responses AND want to stop white knuckling it through your caseload, then keep reading!

The Window of Tolerance

You’re likely familiar with the Window of Tolerance - we have a sweet spot where our brain and body are functioning pretty well and we’re not over or under stimulated.

BTW, we can be inside of our window of tolerance even when we are dealing with stress, e.g. a tough day of doing trauma work.

But...when we go ABOVE our window, we go into a state of hyperarousal where we feel constantly on guard and overwhelmed.

Going below our window of tolerance, or hypoarousal, is when we numb and check out.

Both of these are coping responses to going into fight, flight, or freeze, and, while totally normal, neither is really helpful when it happens to us in session nor over the long term.

So what do we do about this?

When this happens in session, we gotta get our prefrontal cortex back online, getting out of the limbic system and brainstem.

First things first, you have to know when it’s happening so before you go any further, jot down some notes of what hyper- and hypoarousal are like for you when you’re in session.

Next, brainstorm strategies that you already know work to get you back into your body, in the present moment. Grounding and breathing are always go tos for me.

Lastly, start to practice a new skill called Somatic Stops. This is a really helpful modification of the EMDR container exercise that you can use as the therapist with any sort of client:

1. When you first start to notice the warning signs for hyper- or hypoarousal, briefly label them with a word that describes the sensation, thought, or image you’re noticing.

2. The next step requires a bit of prep work - you want to have a small box or physical container on your desk or somewhere discrete ready for the final part of this exercise.

3. Right after you label the thing that tells you you’re about to leave your window of tolerance, reach for the physical container, open it, quickly visualize the thing going into it, and close the container.

4. As you place the container down, take a deep breath and return to the present moment with your client, inside your window of tolerance.

Ideally this will all take only a few seconds. Admittedly, this strategy will be easier to employ when you’re doing a virtual session, but there are creative ways you can incorporate this into in-person work as well.

For example, maybe your “container” is a jar of lotion that you open and apply to your hands as you send the survival response into the jar and set it down. Or, if you take handwritten notes during session, you can draw a box in the margin and send it there.

In any case, the goal here is to acknowledge and validate the survival signals your brain and body are sending while giving them a place to go, knowing they’re not very useful in session.

It’s important to check in with yourself after the appointment so you can engage in the introspective work you deserve, which will help you better understand what kinds of things trigger your own survival response.

What Next?

• Check in with yourself after sessions, especially ones when you used the Somatic Stop.

  • This will help you better understand what kinds of things trigger your own survival response

• Respond to yourself with compassion

  • There is nothing wrong with you for being human and having feelings about this work

• Make sure you know who is on your support team - both professional and personal supports

  • Isolation is one of the greatest risk factors that can turn the normal reaction of vicarious trauma into a direct flight to burnout

• As always, reach out with questions or to share your own stories of using Somatic Stops!