As therapists, we’ve chosen a profession that puts us directly on the frontlines of trauma exposure ….
Day in and day out, we’re immersed in our clients’ struggles, witnessing, listening, and often participating in the child’s play as trauma unfolds before us. The old adage that the therapist stays an “objective observer” when facilitating someone else is … well, impossible. We know this because of our more recent understanding of interpersonal neurobiology and neuroscience.
We’re impacted by the trauma we encounter because of our natural empathy, the brain’s mirror neuron system, and our own histories that inevitably surface. Dr. Daniela Sieff highlights this well by asking, “When a therapist’s wounds are hit, can they regulate their own bodily emotions well enough to stay connected to their client?” The ability to do this lies in the therapist’s ability to navigate their own physiological responses while staying present for their client.
One piece that’s often overlooked is that, as therapists, we don’t just observe our clients’ stories; we imagine ourselves in them. We don’t only listen and watch; we feel, internally track, and sometimes even embody their struggles. This means we’re not just there for the experience—we’re in it with them, activated alongside them. When a client expresses fear, anger, sadness, or confusion, we feel it too, right down to the somatic level.
Mirror Neurons and Somatic Impact
Why can’t we avoid being impacted? It has a lot to do with the brain’s mirror neuron system. When we’re in the midst of listening or playing through the trauma with the child, we’re tracking our client’s non-verbal cues. And as we’re tracking our client’s non-verbal cues, their non-verbal cues are giving us insight into what is happening within them.
A child in a state of fear may become more active, quickening their pace or showing distress in their facial expressions. As they embody this fear in play, our mirror neurons activate, allowing us to “feel” their experience. This shared somatic experience, along with the mind’s natural propensity to imagine being in the story, puts us directly in the story unfolding before us.
Consequences of Shared Trauma Exposure
We are the most susceptible to compassion fatigue, vicarious trauma, or secondary traumatization when our protective patterns or own unresolved trauma history comes into the therapy session. When this happens, it can feel within us like a dorsal withdrawal, shutting down, pulling back, or revving up into a flight or fight response needing to protect ourselves in some way. The result may be inadvertently shutting down the child’s play, projecting our experience into the session, not being able to be present, or directing the client away from their own experience because the intensity is too much in our nervous system. This last part can look like asking questions, shifting the client’s play, or not naming an emotion coming into the room.
We do this because we’re trying to protect a part of ourselves that has been activated … and because we’re having a hard time staying connected to the intensity in our own system.
Caring for Ourselves and Staying Present
In moments of intensity, our clients need us to stay connected and grounded; they rely on our ability to regulate ourselves so they can feel safe. When we’re able to take a step back and regulate, we show them that we’re fully in it with them, no matter how intense the experience. The ability to do this requires self-care, in and out of the playroom.
Much of the research on managing secondary trauma emphasizes what to do outside of sessions. However, in the moment—when we’re across from a client and strong emotions surface in us—staying connected to ourselves in the midst of the intensity is key to mitigating trauma exposure’s effects. This grounded presence is exactly what our clients need to feel we’re fully “in it” with them.
Here are some things we can do in moments of activation:
- Mindfully track our experience.
- Stay with our sensations.
- Access our ventral state for a felt sense of safety. This may include taking a breath, moving our body, naming our experience out loud, getting a sip of water, placing a hand on our heart, or touching the ground to remind us we’re here.
And of course, taking care of ourselves outside of sessions is also incredibly important. This means therapy, self-care, setting boundaries, and doing what we love to stay inspired.
- Therapists need therapists. Having someone to help us process the traumas we encounter, and support us when our own “stuff” arises, is essential. Having our own therapist helps us find internal safety so we can stay connected in the therapy room.
- Have a self-care strategy. Self-care strategies are best when individualized. It could be quiet time, dancing, creating, exercising, journaling, meditation, massage, or breath work—anything that helps our body heal, process energy, and work through the natural responses that emerge for us in sessions.
- Know our limits and set boundaries. We need to understand our window of tolerance and recognize when our caseload is too much. This may mean saying “no” at times, setting boundaries, or structuring sessions in a way that provides containment and gives our nervous system a break.
- Refuel. My definition of refueling is “doing what you love.” Finding deeply meaningful and inspiring activities not only brings our autonomics into optimal functioning but we also find inspiration. In a field where we encounter trauma daily, these reminders of hope and joy are hugely restorative.
Our commitment to self-care helps us process our own activation while keeping clear that this is our client’s trauma, not ours. These practices also reduce the impact of compassion fatigue, vicarious trauma, and secondary traumatization, helping sustain our ability to stay in this field long-term.
Acknowledging the Work We Do
This work we’ve chosen is no small feat, and it’s important to take a moment to acknowledge our own sacrifices and resilience. With every act of self-care and every moment of self-connection, we expand our capacity to support our clients in moving through their trauma. We’re not just helping others heal; we’re building a lifestyle that sustains us in the career we love.
Much love on the journey 💜
Lisa
