I made a presentation to a mental health service to consolidate my experience in the past 18 months of offering virtual therapeutic service for clients who have experienced complex #trauma.
In the past few months, I have learnt that unless the home (in which the client is currently residing) is a source of trauma, unsafe or isolating, it can play a significant progressive role in therapy. Trauma-informed therapists like myself follow a phased approach to therapy in which the first two stages we exclusively focus on safety, stabilization and resourcing. In this context, the home can become the secure base from where nervous system capacity can be built back.
I share a few of my insights due to which I am growing stronger in my belief that virtual therapy is a gift for clients with a #trauma history.
- The sessions are set up on an equal footing where the client, actively choose their spatial orientation, personal comfort, and objects of belonging. Some examples include determining if they would sit indoor or outdoor, on the floor or table or have their animals nearby or away.
- When we have an unsettled, #nervous system, the last impulse is change, shift and transition like going to a new environment and sitting on the edge, vigilant at the slightest cue of danger. At home, the nervous system feels at ease with known scents, sights, and sounds. When we feel relaxed, we can connect to our internal and external world. Infact when we face moments of distress (during a session); association of nourishment is at arm’s reach—for example, a favourite cushion, blanket, plant or a cuddly toy. The process of pausing to attend during sessions, teaches us to do the same in-between sessions thus improving the capacity of nervous system to face dysregulation.
- The conditions in which we can experience #safety, trust, and resourced in a therapeutic relationship are optimal when the client, not the therapist, is in charge. I know for myself that as a therapist working with client’s remotely, I feel at the edge (of discomfort). To focus on the relational space, I have to acknowledge (in me) the unknowns that I cannot control which brings attention to how the client may be feeling in daily living. Infact, I find that opportunities to work together to problem solve can aid collaboration and connection.
Of course, this approach may not work for clients in the following scenarios
- When they live in a shared house without any privacy.
- If they are socially isolated, and meeting your therapist is an essential to aid contact.
- Lack of optimal internet infrastructure.
- When the client is in unstable mental health and at risk of self-harm.
Choosing is a significant protective factor to the therapeutic process, and virtual sessions offer them like never before.
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