I don’t treat trauma. I treat people.

Your recovery program needs to be tailed to you. There is no “one size fits all approach.” 

I used to be the unit psychologist and primary therapist for an inpatient psychiatric unit that specialized in the treatment of complex trauma and dissociative disorders. Most of our patients were adults who had been abused or otherwise traumatized as children, and who were now having difficulty functioning in their everyday lives. 

In that job, I learned— often the hard way— that if recovery is to succeed, it needs to start with each patient’s strengths, values, and goals. 

And no two patients are going to be exactly the same when it comes to strengths, values, and goals. 

Unfortunately, I see many, many programs— and individual therapists— who want to start out from the exact opposite approach. 

They label themselves “trauma therapists,” and they tend to start out— with the best of intentions— from models of trauma treatment, instead of with individual patients. 

It’s one of my central disagreements with the trauma treatment field in general that we need to start out from the phenomenology of trauma (i.e., what “trauma” in broad, general strokes looks like and does to the brain). 

I disagree with this premise because its’ my observation and experience that “trauma” rarely affects any two people the same. 

We can understand “trauma” all day long, in the abstract…but none of it does us much good if we don’t understand the person who has been traumatized. 

Recovery is not about treating trauma. 

Recovery is about treating, healing, rediscovering, and rebuilding people. 

Real life people. People who are mothers, fathers, sons, siblings. 

People who own cats and dogs, who like rock concerts and classical sonatas. 

I would once have said I am a trauma therapist. I don’t say that anymore— but not because I don’t work with patients who have been traumatized. 

I now say I am a therapist who treats people who have been traumatized. 

I don’t treat trauma. I treat people. 

And I am so, so over programs and therapists that seem to think their specialty is “trauma.” 

Why does any of this matter to you? 

Because the way many clinical systems are structured right now tends to overemphasize diagnosis and pathology. 

By their very nature they want to categorize people by what’s “wrong” with them. 

Don’t get me wrong, on a practical level, I understand why this is. If you’re an insurance company or a hospital, you have to have some way of organizing and prioritizing the way you deliver services. 

But on the level of therapists and patients, this emphasis on diagnosis and prognosis can be crippling. 

People are not their pathology. 

You are not your diagnosis. 

You are a human with experiences, goals, values, needs— and strengths. 

Not to mention the toughness and resilience that got you this far. 

When you are creating your individual recovery plan, whether you are doing it on your own or with the collaboration of a mental health care professional, don’t start with the phenomenology of trauma. 

Start with you. 

Start with who you are and what kind of life you want to create. 

Start with what you are good at, what you’ve succeeded at in the past. 

Don’t start by asking what’s gone wrong— start by asking how you’ve survived so far. Ask yourself HOW you’ve gotten this far. 

Start from a position of individuality and strengths. 

Then head in the direction of solutions.