Rupture and repair

The difficulty of trust for the traumatized

Trust. It’s probably the number one criterion when we’re talking about what we need from a therapist. After all, how are you supposed to get someone to help you change or move anything about yourself or your life, if you can’t trust that someone? But what do we actually mean by trust? What is it that we hope for when we start talking to a professional about our most intimate problems, emotions, desires and fears?

It may seem like a simple question at first, and sometimes it is. We want to know that the information we share is truly confidential. I’ve heard many folks say (usually in the course of talking about why they never will go to therapy) that they fear a therapist will find them crazy, and try to have them committed or exercise some other form of coercion over them. Some folks, especially folks who talk to me, just want to know that they can say things about sexuality or gender or kink, and that the therapist won’t tell them that there’s something wrong with them, or that their sexualities or desires are the root of all their issues. Mostly, trust in a therapist means something fairly simple: people want someone they can talk to who won’t judge or condemn them, who will listen with an open mind and heart, who will validate their feelings and experiences, and who won’t tell anyone.

But something I’ve learned over the course of growing my practice in the past year and change is that therapeutic trust is a moving target when you’re talking to traumatized people. Given that I myself am a traumatized people, I feel like I can speak to this issue from both sides of the therapeutic relationship.

All of the above trust needs are still true, of course, when you’re talking to people with complex trauma. But there are greater challenges, too. Trust—a feeling that can be in short supply for folks from rough childhoods, abusive relationship histories, or other traumatizing situations—often has to be earned, and re-earned, and re-earned again, and seemingly little things can easily undermine it. Sometimes, therapeutic relationships can end over such ruptures, and often, therapists might not even know what happened.

Pete Walker, author of the marvelous Complex PTSD: From Surviving to Thriving, has much to say about this. He notes how many clients with C-PTSD may never have had a trusting relationship, and some have had repeated relationships in adulthood with people who replicated the dynamics of their abusive childhoods. (Walker calls this “repetition compulsion;” I also love the phrase “the allure of the familiar” for this phenomenon, in which trauma survivors are unconsciously attracted to people who remind them of what intimacy looked like in their earliest experiences.)

When people who struggle with relationships seek out a therapist, the therapy itself is bound to create lots of opportunities for trust to be broken, or at least, for the client to feel as though it has been. After all, the client is sharing their most intimate details with someone who, due to their position, is in an unequal power dynamic with them. The same might be said of a teacher and student, a doctor and patient, or of course, a parent or caregiver and a child. Walker warns us,

For many such clients, we [therapists] are their first legitimate shot at a safe and nurturing relationship. If we are not skilled enough to create the degree of safety they need to begin the long journey towards developing good enough trust, we may be their last.

The thing to remember about trauma is that it tends to magnify every small situation. Things that would go right by someone who is securely attached might feel like a massive betrayal of trust to a survivor—because a small misattunement was often a presaging of something horrible happening in the survivor’s past.

I’m fond of telling my clients that the source of a wound and its healing are frequently found very close together. That is to say: when a survivor gets close to feeling trust, or love, or contentment, or safety with someone, they’re usually very close to their own trauma, and even more susceptible to triggers. It’s why we seek out people who treat us similarly to those who traumatized us, and it’s also why, when we make a healthy connection, we can be so desperately afraid that that connection is going to harm us. Stress, abuse, abandonment, maltreatment—all of that is very familiar to a survivor. But compassion, empathy, listening, helping without an ulterior motive? That looks like a trap.

It makes perfect sense, then, that clients can shut down and return to a position of distrust after small moments of misattunement. Something like changing a detail of how you meet with a client, timed alongside their revealing something very intimate, can cause a survivor to link the two events and wonder if the therapist is judging them for what they so vulnerably revealed.

Sometimes, a therapeutic intervention can make a traumatized person feel profoundly unsafe, even if a bond of trust has already been established. Trying to help someone get grounded, or even pointing out that they seem to be in distress, can make someone feel called out and like they need to bolt.

For any therapist, this situation of “trying to help” backfiring can be demoralizing. Sometimes, a therapist can get caught up in overidentifying with their view of themselves as a “good therapist,” or worry too much about whether they “can help” any given person. The trap here is that the fear of not helping someone enough, or not being good enough, can be counterproductive to the client’s healing. Sometimes all a client needs is someone who is listening well, who notices subtle changes in a client’s tone, and who doesn’t push too hard at the wrong time. If a traumatized client feels too seen, too quickly, it can spook them. If a therapist does something that seems small to them but that reminds a client of their own abandonment—being late, or having trouble scheduling them, or looking at their watch or their phone while talking to them—it can unravel the fragile trust that may have been earned over the course of several sessions.

Pete Walker talks about several skills a therapist can develop to help cultivate this sense of trust in clients who don’t have much experience with trusting relationships, but perhaps the most powerful one is the skill of repair after such a rupture. Noticing these misattunements as they come up, and owning my part in them, often results in a kind of healing that allows the relationship to continue, and even, at times, deepens the healing potential.

The key thing is to remember, whether you are a therapist, a client seeking therapy, or a person who loves someone with a trauma history, is that it’s really hard for trauma survivors to trust. It may sound basic, but it is critical that you not ask them to trust too quickly, nor ask questions like “why can’t you just trust me?” Trust above all that there are plenty of reasons they can’t. And know that if you do finally earn that trust, it can be one of the most rewarding experiences you’ll ever have.