THERAPY TOPICS • April 13, 2026

LAST UPDATED: APRIL 2026

Last reviewed: June 2026 by Annie Wright, LMFT

Lucia sits alone in her car, the engine humming quietly beneath the heavy weight of silence. The Seattle rain taps rhythmically against the windshield, a soft percussion that contrasts sharply with the storm inside her chest. Her hands grip the steering wheel tightly, knuckles blanching, as tears spill over and streak down her cheeks, blurring the city lights beyond the glass. The ache in her throat tightens into a knot, making each breath shallow and uneven. Just eight weeks ago, she described herself as “pretty functional”. Someone who could carry the weight of sadness and anxiety without breaking, who managed her days with a semblance of calm control. Now, after each therapy session, the fragile façade fractures. The rawness of memories she thought buried surfaces unpredictably, leaving her vulnerable and disoriented.

This morning, she snapped at two colleagues during a meeting. Sharp words she immediately regretted but couldn’t retract. The shame coils deep inside her, mingling with an anxious buzzing that refuses to still. Last night’s dream claws at her mind: her father’s face, twisted in a way she doesn’t want to remember, replaying in vivid detail. She pulls out her phone and types a message to her therapist, fingers trembling: “I think this is making me worse.” The question lingers, heavy and unresolved. Should she stop, or is this part of a deeper journey she must endure?

In short: Feeling worse when trauma therapy begins is clinically normal because accessing suppressed material temporarily intensifies distress before the nervous system can integrate and release it.

What Is the Window of Tolerance?

In my work with clients who’ve experienced trauma, the Window of Tolerance serves as a foundational framework for understanding emotional and physiological regulation. This window isn’t a fixed entity; it’s a dynamic range that fluctuates depending on context, internal states, and therapeutic progress. When you’re operating within your Window of Tolerance, you can process difficult memories, emotions, and sensations without becoming overwhelmed to the point of panic or dissociation.

Clinically, the Window of Tolerance helps us understand why trauma survivors often experience such extreme fluctuations in their emotional states. When trauma is active or memories are triggered, you may find yourself outside your window. Either hyperaroused or hypoaroused. Hyperarousal (the “fight or flight” response) shows up as heightened anxiety, agitation, irritability, or panic. Hypoarousal manifests as emotional numbness, dissociation, or shutdown. The “freeze” response. Within the window, these responses are modulated, letting you stay present and engaged.

Understanding this concept is crucial because it informs the pace of trauma therapy. Contrary to what you might expect, the early phases of trauma work often appear to narrow the Window of Tolerance before it ultimately widens. This paradoxical narrowing can feel alarming. Yet it’s a normal and necessary part of healing. When therapy begins, you’re invited to approach memories and sensations that have been avoided or suppressed for years. This engagement can initially destabilize your regulatory capacity, temporarily shrinking the window. Your nervous system, which has adapted to protect you by limiting access to traumatic material, reacts to this renewed exposure with increased arousal or shutdown.

From a neurobiological perspective, the brain’s threat detection systems become activated when traumatic memories are accessed. This triggers a cascade of physiological responses designed to protect you. But which can overwhelm your current capacity for regulation. You may experience heightened anxiety, intrusive memories, or dissociative episodes. At this stage, the therapist’s role is to provide containment, grounding techniques, and safety, helping you tolerate these intense states without retreating into avoidance.

Therapeutically, this process is like stretching a muscle held in a contracted position for years. Initially, the stretching causes discomfort and resistance. Similarly, your nervous system must gradually habituate to trauma-related stimuli. This habituation is not instantaneous but unfolds over time as you learn new ways to regulate and process distress. The therapist assists by titrating the intensity of exposure. Introducing trauma material in manageable doses that challenge but don’t overwhelm your regulatory capacity. This titration is essential to prevent retraumatization and support the gradual widening of your window.

In my clinical experience, clients often report that the initial phases of trauma therapy feel more destabilizing than stabilizing. They describe increased emotional volatility, sleep disturbances, or flashbacks. While understandably discouraging, these symptoms aren’t signs of treatment failure. They’re indicators that your nervous system is beginning to engage with previously inaccessible material. Over time, with consistent support, you develop greater resilience and flexibility. The window expands, allowing you to tolerate higher levels of distress without becoming dysregulated. If you’re curious about what somatic tools can help this process along, this overview of body-based tools from trauma research is a useful starting point.

This expansion is facilitated by the development of internal resources: mindfulness, self-compassion, and somatic awareness. You learn to identify early signs of dysregulation and implement coping strategies that anchor you within your window. The therapeutic relationship itself is also critical. The presence of a safe, attuned therapist provides a corrective relational experience that fosters trust and safety. As these supports strengthen, your nervous system recalibrates, and you experience a more stable and expansive Window of Tolerance.

The Neuroscience of Destabilization

At the core of these destabilizing emotional experiences lies the intricate interplay between brain structures involved in memory, emotion regulation, and threat detection. The amygdala. Often described as the brain’s alarm system. Plays a pivotal role. In individuals who’ve endured early trauma, especially chronic interpersonal trauma like childhood abuse or neglect, the amygdala becomes hyper-responsive, sensitized to detect even subtle cues reminiscent of past danger. This heightened vigilance is, in essence, a survival mechanism that was adaptive in unsafe environments but becomes maladaptive in safer adult contexts.

Simultaneously, the hippocampus, responsible for contextualizing memories and distinguishing between past and present, often shows altered functioning in trauma survivors. Research has demonstrated that chronic trauma can impair hippocampal volume and activity, weakening its capacity to anchor emotional responses within a coherent narrative timeline. This neurological disruption explains why emotional flashbacks may occur without accompanying visual or narrative recall. The emotional brain reacts as though the traumatic event is happening now, while cortical regions responsible for explicit memory and context remain disengaged.

Judith Herman, MD, in her seminal work on trauma and recovery, delineates the healing process as unfolding in stages that directly correspond to these neurobiological realities. In Stage 1, Safety, the paramount task is to restore a sense of physical and emotional security. Without safety, the brain remains locked in hyperarousal or freeze, unable to access the therapeutic window necessary for processing traumatic memories. Herman’s emphasis on safety is consistent with contemporary neuroscience: only when the threat detection system is regulated can higher cortical functions engage, allowing for the integration of traumatic experiences.

Once safety is established, Stage 2. Remembrance and Mourning. Can begin. This stage involves the deliberate processing of traumatic memories, often requiring you to revisit and reframe painful experiences. From a neuroscientific perspective, this phase leverages the plasticity of the brain to rewire neural circuits through new, corrective emotional experiences and narrative integration. The hippocampus and prefrontal cortex become more active, enabling you to situate memories in their proper temporal and contextual framework, thereby reducing amygdala hyperactivity.

Bessel van der Kolk, MD, expands on this through his articulation of the “therapeutic window”. A neurobiological state of optimal arousal in which you’re neither overwhelmed by your emotions nor emotionally numb. Within this window, the brain is primed for learning, memory reconsolidation, and emotional regulation. If you’re pushed beyond it. Into hyperarousal or dissociation. Destabilization occurs and therapeutic progress can stall. Navigating this delicate balance is central to effective trauma therapy. Many clients find it helpful to understand their freeze response as part of this same neurobiological picture.

In practical terms, destabilization reflects moments when your neurobiological systems become dysregulated, often triggered by internal or external stimuli reminiscent of trauma. These triggers activate the amygdala’s threat response while the prefrontal cortex’s regulatory capacity diminishes. The resulting flood of intense emotion. Shame, terror, helplessness. Can feel incomprehensible and uncontrollable. Understanding this neuroscience of destabilization reveals trauma as a profoundly embodied experience rooted in the brain’s alarm and memory systems. Through the work of Herman and van der Kolk, we know that healing requires carefully staged interventions that first cultivate safety, then gently invite remembrance within the therapeutic window.

How This Shows Up in Driven Women

In my clinical work with driven women, the process of early trauma recovery often reveals itself through a constellation of deeply interwoven experiences that can feel both bewildering and profoundly unsettling. These women. Who’ve cultivated a strong exterior of competence and control. Find themselves confronting internal shifts that challenge long-held patterns of coping and relating. To illustrate these themes, I often reflect on the experience of Lucia, a professional I first met in the early stages of her trauma recovery.

Lucia came to therapy after years of pushing herself to excel in her demanding career, all while managing a persistent undercurrent of anxiety and a vague sense of emotional disconnection. She described herself as “always on,” driven by a relentless internal voice that demanded perfection and achievement. Yet beneath this drive lay a fragile core, shaped by early relational wounds. Experiences of neglect and subtle emotional invalidation that she had long minimized or forgotten. As Lucia began the stabilization phase of trauma therapy, drawing on Janina Fisher’s framework, she encountered what Fisher describes as the dynamic interplay between the ANP and EP. The initial recovery phase brought these parts into greater awareness and dialogue. But this awakening was often accompanied by intense and confusing phenomena. This is often connected to what I call the double life driven trauma survivors lead, managing a capable exterior while quietly crumbling inside.

One of the most pronounced experiences Lucia faced was an increase in emotional reactivity. Where she had once prided herself on remaining composed under pressure, she now found herself overwhelmed by feelings that seemed disproportionate to the immediate situation. A minor disagreement with a colleague could trigger tears or irritability, leaving her feeling vulnerable and confused. This heightened emotional sensitivity is common in early trauma recovery, as the EP begins to surface and the protective barriers maintained by the ANP weaken. For driven women like Lucia, who have relied on their capacity to control and compartmentalize emotions, this sudden vulnerability can feel destabilizing. Yet it’s an essential step toward healing. It signals the gradual reintegration of emotional experiences that were previously inaccessible.

Alongside this emotional reactivity, Lucia also developed a hyperawareness of relational dynamics. In her work and personal relationships, she noticed herself becoming acutely attuned to subtle shifts in tone, body language, and underlying intentions. This reflects the trauma survivor’s heightened vigilance. A survival mechanism that evolved to detect threat and maintain safety in early adverse environments. Fisher elaborates on this as part of the stabilization phase, where you learn to differentiate between the ANP’s usual functioning and the EP’s heightened sensitivity to relational threats. For Lucia, this meant an ongoing internal negotiation: how to stay grounded in present reality without being swept away by alarms rooted in the past.

Sleep disruption and vivid, often distressing dreams were another hallmark of Lucia’s early recovery. Sleep disturbances are common in trauma recovery, reflecting the brain’s ongoing attempt to process and integrate traumatic memories during REM sleep. For driven women whose days are structured and goal-oriented, the intrusion of such nocturnal unrest can feel deeply disorienting. It challenges their sense of control and predictability, further emphasizing the need for self-compassion and patience during this vulnerable time.

Grief, too, emerges prominently in this phase. Lucia began to recognize a profound sadness beneath her drive. A mourning not only for specific losses but also for the parts of herself that had been sacrificed in the name of survival and achievement. This grief is often multilayered; it encompasses the loss of childhood innocence, the absence of nurturing relationships, and the forfeiture of emotional authenticity. For driven women, grief can feel unfamiliar or even shameful, as their identity has often been constructed around resilience and success rather than vulnerability. Yet engaging with grief opens the door to reclaiming a fuller sense of self. Many clients find it useful to read about post-traumatic growth during this stage, not to rush past the grief, but to understand that the grief itself is part of what makes growth possible.

Finally, relational disruption frequently accompanies these internal shifts. Lucia noticed changes in her interpersonal connections. Some relationships became strained, while others deepened unexpectedly. This disruption is a natural consequence of the internal realignments occurring during trauma recovery. As the ANP and EP begin to communicate more openly, your relational needs and boundaries may shift, sometimes challenging established patterns and expectations. Therapeutic work often focuses on helping you navigate these relational transitions with clarity and compassion, fostering relationships that support rather than undermine ongoing healing. This kind of disruption frequently connects to people-pleasing patterns that begin to crack open in therapy. And that cracking is, counterintuitively, healthy.

Both/And: Feeling Worse Can Be Evidence You’re Getting Better

One of the most challenging and yet profoundly important paradoxes in therapy is the experience that feeling worse can actually be a signal that you’re getting better. This is a dynamic that often surprises and unsettles people, especially when they come to therapy with the expectation that by now, they should simply feel lighter, calmer, more at peace. Instead, what they find is a deepening awareness of pain, complexity, and contradiction within themselves and their relationships. This paradox. The both/and of feeling worse and better simultaneously. Isn’t a sign of failure or regression; it’s a critical phase of healing.

Consider Morgan, a 42-year-old surgeon two months into the course I facilitate. When she enrolled, she brought with her the quiet hope that relief would arrive swiftly. But at this midpoint, Morgan is navigating a different terrain. In a session last week, she shared, her voice steady but edged with a new kind of intensity: “I thought I’d feel better by now. Instead, I’m noticing things about my marriage I never saw before. I’ve been the emotional manager for both of us for fifteen years. I’m not angry at my husband. I’m angry at myself for not seeing it sooner.”

This present-tense scene encapsulates the essence of the both/and experience. Morgan’s increased emotional awareness has peeled back layers of unconscious coping and denial that had long buffered her from deeper truths. In becoming more attuned to the emotional dynamics in her marriage, she’s simultaneously confronting feelings of frustration, disappointment, and self-reproach. These feelings are raw and uncomfortable. They can feel like a step backward. Yet they’re also the very evidence that healing is underway.

Early in therapy or personal growth work, there’s a phase where the mind and heart begin to loosen their habitual defenses. This loosening allows for the emergence of feelings and insights that were previously suppressed or unnoticed. It’s as if the emotional landscape suddenly becomes more vivid and detailed, revealing shadows and textures that had been invisible. This isn’t a sign of worsening. It’s a sign of greater clarity and depth. The emotional “worse” is the necessary terrain before arriving at a new equilibrium. This dynamic intersects with what I write about in my piece on the dark night of the soul in trauma recovery. That profound undoing that precedes genuine transformation.

Morgan’s experience is emblematic of this. For years, she functioned as the emotional manager in her marriage. Not in a clinical sense, but in the day-to-day, unspoken labor of holding space for both her own and her husband’s emotional needs. This role required immense strength and resilience, but it also demanded a kind of invisibility, a silencing of her own deeper feelings in order to maintain relational harmony. Now, as she becomes more conscious of this dynamic, the protective scaffold is dismantling. The anger she feels isn’t directed outward in blame, but inward. A reflection of the pain of realizing how much she sacrificed her own emotional truth.

This inward anger is a crucial and often misunderstood part of the healing process. It’s a form of grief, a mourning for the years spent in emotional invisibility and self-neglect. It signals that old patterns are breaking down, making space for new ways of relating to self and others. The paradox of feeling worse as a marker of getting better also intersects with how clients often view progress. There’s a cultural narrative that healing is linear and that improvement means a steady reduction in distress. Yet the clinical reality is far more complex. The journey toward emotional well-being often resembles a spiral more than a straight line. One revisits old wounds, uncovers hidden truths, and experiences waves of discomfort that paradoxically signal new life stirring beneath the surface. Working with reclaiming anger in recovery is often part of this arc.

Ultimately, the both/and of feeling worse and better is a call to embrace complexity and uncertainty. It invites you to hold seemingly contradictory experiences simultaneously: the discomfort of newfound pain alongside the hope of emerging freedom; the anger at past blindness alongside the gratitude for present insight. As Morgan continues her journey, she embodies this truth. By allowing herself to feel the anger, the sadness, and the disappointment. And by reframing these feelings as evidence of growth. She’s laying the groundwork for a more authentic and fulfilling life.

The Systemic Lens: Why We Pathologize the Mourning That Healing Requires

In my work with clients, I’ve come to recognize that the challenges faced in early trauma recovery aren’t merely individual struggles. They’re profoundly shaped by the cultural context in which healing unfolds. When we zoom out to consider the broader societal fabric, it becomes clear that our culture’s deep-rooted emphasis on productivity, performance, and unceasing forward momentum leaves little room for the profound disorganization that trauma recovery demands. This cultural framework, which prizes efficiency and visible progress, often misconstrues the natural, necessary phases of mourning and emotional unraveling as pathological regressions or failures.

The modern cultural narrative is one of relentless drive and achievement. From early childhood, individuals. Particularly women. Are socialized to equate worth with output, to measure success by the ability to maintain composure, meet deadlines, and manage competing roles with seeming ease. In this context, vulnerability, emotional upheaval, and the disintegration of a previously functional façade are often perceived as signs of weakness or breakdown rather than integral components of growth. The driven woman who “falls apart” in therapy. Who experiences emotional flooding, confusion, or a temporary loss of her usual coping mechanisms. Frequently encounters a double bind: she may internalize shame for her perceived failure to maintain control, and simultaneously face external judgments that her distress signals regression rather than progress.

This dynamic can be particularly painful in trauma recovery, where the process inherently requires a period of destabilization. Early trauma survivors often enter therapy with constructed armor. Numbness, dissociation, hypervigilance, or rigid control. That has allowed them to function in a demanding world. The therapeutic journey necessitates dismantling these defenses to access and process painful memories, emotions, and unmet needs. This dismantling can feel like falling apart, as the protective structures that maintained order give way to emotional chaos. However, this disorganization isn’t a sign of pathology; it’s a vital phase of healing. Without this necessary mourning of what was lost. Safety, trust, innocence, or a coherent sense of self. True integration and recovery can’t occur. For a deeper exploration of this, my writing on perfectionism as a trauma response unpacks why driven women are especially vulnerable to this double bind.

Unfortunately, the cultural lens through which we view this process often lacks the vocabulary or framework to honor this crucial stage. The prevailing discourse tends to privilege linear progress: improvement is signaled by visible gains, symptom reduction, and resumption of productivity. When clients don’t fit this mold. When they experience setbacks, emotional intensification, or periods of confusion. Both they and their support systems may interpret these experiences as failure or deterioration. Such interpretations contribute to feelings of isolation, shame, and self-doubt, further complicating recovery.

Moreover, the cultural valorization of strength and control disproportionately impacts women, who are frequently expected to embody resilience without visible cracks. The archetype of the “strong woman” who manages multiple roles flawlessly is celebrated, but the inevitable vulnerabilities that emerge in healing are often minimized or pathologized. Women who allow themselves to express grief, anger, or despair may be labeled as overly emotional, unstable, or regressive, reinforcing internalized messages that discourage authentic expression. This cultural dissonance creates a profound tension within therapy: the very behaviors and experiences that signify healing are often the ones most stigmatized outside the therapeutic space.

To navigate this systemic challenge, it’s essential to cultivate a collective understanding that healing from trauma is inherently non-linear and often requires a temporary surrender to disarray. This means expanding cultural narratives to acknowledge that the process of mourning. Be it for lost safety, fractured relationships, or disrupted selves. Isn’t only natural but necessary. Just as grief after a tangible loss is recognized as a process requiring time, space, and compassion, so too must the mourning involved in trauma recovery be validated as a legitimate and vital stage.

In my work with clients, I strive to create a therapeutic environment that normalizes this disorganization, reframing it as evidence of progress rather than regression. We explore together how falling apart can be a form of falling open. A courageous opening to raw material that, when tended with care, lays the foundation for renewed coherence and resilience. Ultimately, addressing the cultural underpinnings of how we pathologize mourning requires a systemic shift. It calls for a collective reimagining of what it means to be productive and successful. Not as constant outward doing, but as a dynamic process that includes periods of introspection, emotional upheaval, and reconfiguration.

How to Navigate the Discomfort

In my work with clients grappling with relational trauma, one of the most common experiences shared is a profound sense of discomfort. Both emotional and physical. That arises when confronting painful memories, feelings of vulnerability, or deeply ingrained patterns of mistrust. Navigating this discomfort isn’t about avoiding it or pushing through it recklessly; rather, it requires a nuanced, compassionate approach that honors the complexity of the healing process. When you understand discomfort as a signal rather than an obstacle, you can begin to engage with it in ways that promote growth and resilience.

The first step in navigating this discomfort is to cultivate a mindful awareness of what you’re experiencing in the present moment. This means learning to observe your thoughts, emotions, and bodily sensations without judgment or the urge to immediately change them. When feelings of anxiety or sadness arise, try pausing and naming these feelings internally. “I am feeling anxious,” or “I notice a tightness in my chest.” This practice of labeling can create a slight distance between you and the discomfort, allowing you to witness it as a passing state rather than an overwhelming identity. Mindful awareness builds the foundation for emotional regulation. Critical when working through relational trauma that often triggers dysregulated nervous system responses. Many clients find that structured somatic exercises can accelerate this process significantly.

Another essential aspect is developing what I call a “compassionate inner voice.” Many survivors of relational trauma carry internalized messages of shame, blame, or unworthiness. When discomfort surfaces, these negative self-narratives can exacerbate distress and lead to avoidance or self-criticism. Instead, try speaking to yourself with kindness and understanding, as you would to a close friend who is struggling. A compassionate inner voice might sound like, “It’s okay to feel this way. You’re doing your best,” or “These feelings are part of your healing journey, and they don’t define you.” This is closely related to the work of reparenting yourself. Learning to offer yourself the safety and warmth that perhaps wasn’t consistently available in childhood.

Setting gentle boundaries with yourself and others is another practical strategy. Discomfort often arises when we overextend ourselves emotionally or physically, or when we engage with people or environments that feel unsafe. Learning to say no, to take breaks, or to remove yourself from triggering situations isn’t a sign of weakness. It’s an act of self-care and empowerment. In therapy, I work with clients to identify their limits and practice assertive communication, so they can protect their well-being while still fostering connection and trust in relationships.

Grounding techniques are also invaluable tools in moments of heightened distress. These techniques help anchor you in the present and reduce the intensity of uncomfortable sensations or thoughts. Common grounding methods include focusing on the breath, using the five senses to notice what is around you, or engaging in a simple physical activity like feeling your feet on the ground or holding a comforting object. Over time, you learn to use these practices independently, which cultivates a sense of safety and stability amidst emotional turbulence. If you want to understand the relationship between meditation and trauma more carefully. Including when mindfulness helps and when it can backfire. this article on meditation and trauma offers important nuance.

It’s equally important to remember that discomfort in relational trauma recovery isn’t linear. There will be times when you feel progress and hope, and other times when old wounds seem to reopen or new challenges emerge. This ebb and flow is part of the natural healing rhythm. Embracing this nonlinear process with patience and persistence. Rather than judgment or despair. Ultimately strengthens your capacity to heal. And above all, I encourage you to embrace curiosity toward your discomfort. Rather than viewing it as something to escape, invite yourself to explore what it might be trying to communicate. What unmet needs or unresolved fears lie beneath the surface? What parts of yourself are seeking recognition or healing? This inquisitive stance transforms discomfort into a teacher and guide on your path.

I warmly invite you to join me in the Relational Trauma Recovery Course, where we delve deeply into these strategies and more, providing a supportive community and structured guidance as you fix the foundations of your relational health. Together, we can cultivate healing, resilience, and connection on your journey.

Related Reading

Herman, Judith Lewis. Trauma and Recovery: The Aftermath of Violence. From Domestic Abuse to Political Terror. Basic Books, 1997.

Levine, Peter A. Waking the Tiger: Healing Trauma. North Atlantic Books, 1997.

van der Kolk, Bessel A. The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma. Viking, 2014.

Siegel, Daniel J. The Developing Mind: How Relationships and the Brain Interact to Shape Who We Are. Guilford Press, 2012.

How to Heal: Navigating the Discomfort of Getting Better

The instinct when therapy gets harder is to conclude that something is wrong. With the process, with the therapist, or with you. In my work with clients, I’ve seen this moment derail healing more consistently than almost anything else: the point where the work starts working, where the previously frozen material begins to thaw, and the discomfort of that thaw gets misread as evidence of failure. Morgan, who you met earlier in this post, came close to quitting therapy at exactly the moment her system was beginning to reorganize. Lucia told me, halfway through our second year together, that she was starting to wonder if she’d just invented all of this. A thought that, I’ve learned to recognize, tends to arrive right before a significant breakthrough. Feeling worse before you feel better isn’t a detour; it’s often the main road. Here’s how to stay on it.

Here’s the path I walk with clients, in roughly this order:

1. Start with your body, not your willpower. When the destabilization of trauma therapy sets in. The emotional flooding, the intrusive memories, the fatigue that makes it hard to hold your previous routines. The temptation is to push harder. Drive more, achieve more, compensate with output. What your nervous system actually needs in those windows is the opposite: deliberate, consistent input that signals safety. This means prioritizing sleep with genuine discipline, eating regularly even when your appetite is gone, and introducing at least one daily practice that down-regulates your system. Whether that’s somatic tools, a walk taken without your phone, or five minutes of slow breathing before your feet hit the floor. You can’t think your way through this phase; you have to resource your body first.

2. Name what’s happening without catastrophizing it. Language matters more than it seems when you’re in the middle of destabilization. I’m falling apart lands very differently in your nervous system than I’m in a hard window of the healing process, and this is known and expected. In my work with clients, I spend significant time helping them build accurate language for what’s actually occurring neurobiologically: the window of tolerance is temporarily narrowed, previously frozen material is becoming accessible, and the grief that healing requires is moving through rather than staying stuck. Understanding the neuroscience. That as Bessel van der Kolk, MD, psychiatrist and trauma researcher, author of The Body Keeps the Score, has documented, trauma reorganizes the brain in ways that predictably shift during effective treatment. Doesn’t make the discomfort disappear, but it strips away the meta-layer of panic about the discomfort.

3. Build a containment practice for the hard material. When traumatic content becomes more accessible in therapy, it doesn’t stay neatly in the therapy room. It shows up in flashbacks, in dreams, in moments mid-meeting where an old feeling arrives without warning. Having a deliberate containment practice. A specific, practiced way to acknowledge the material and set it aside until you’re in a container equipped to hold it. Is not avoidance; it’s skilled regulation. This might look like a written “parking lot” where you note the intrusion and set a specific time to return to it in therapy. It might look like a short verbal practice: I see you. I’ll be back. Not right now. The goal is to give the material a signal that it’s been received, so it doesn’t have to escalate to get your attention.

4. Let a trauma-informed therapist become your earned secure base. There’s a reason that processing traumatic memories through approaches like Somatic Experiencing and EMDR is done inside a relational container rather than alone. The research on attachment is clear: earned secure attachment. The kind that develops when a consistent, attuned other repeatedly shows up and repairs ruptures. Is one of the most powerful mechanisms for long-term change in both neural architecture and relational patterning. Individual therapy with a trauma-informed clinician provides that container. It’s also the relationship where you can be transparent about how hard the work is getting without that transparency being misread as weakness or resistance. In fact, the moment when therapy gets most difficult is often the moment when the therapeutic relationship matters most.

5. Hold the Both/And that feeling worse can be evidence you’re getting better. This is the reframe that I return to most consistently with clients during hard stretches: the emergence of grief, anger, and disorientation is not the wound getting worse. It’s the wound becoming visible enough to heal. A dark night of the soul in trauma recovery is a documented phenomenological experience that precedes significant reorganization. The driven women I work with. Who have built entire identities around having it together. Find this phase particularly destabilizing, because it looks from the outside like losing ground. It’s not. It’s the structure that was built on top of unprocessed pain beginning to release, which is exactly what has to happen before something sturdier can take its place.

6. Calibrate your expectations to the pace of actual healing. Trauma recovery is not a four-week process. It’s not a six-month process for most people. For those of us healing complex, relational, developmental trauma. The kind that formed across years of early experience. The timeline is longer, the path more iterative, and the progress less linear than we wish. Lucia’s words near the end of a particularly hard stretch have stayed with me: I keep thinking I should be done by now. What I told her then is what I tell every client in that moment: the pace of healing is the pace of your nervous system, not the pace of your ambition, and the kindest thing you can do for the process is stop competing with it. Small, consistent movement across time compounds into profound change. You just have to stay in it.

You don’t have to navigate this alone, and you don’t have to white-knuckle your way through the hard windows. If you’re looking for support while you move through this work, you’re welcome to explore individual therapy with my team, to work through Fixing the Foundations^™ at whatever pace suits this season, or to schedule a consultation to talk through what you’re experiencing and what support might fit.

References

Peer-Reviewed Research (Vancouver)

1. van der Kolk BA, Wang JB, Yehuda R, Bedrosian L, Coker AR, Harrison C, et al. Effects of MDMA-assisted therapy for PTSD on self-experience. PLoS One. 2024;19(1):e0295926. doi:10.1371/journal.pone.0295926. PMID: 38198456.
2. Cloitre M, Stolbach BC, Herman JL, van der Kolk B, Pynoos R, Wang J, et al. A developmental approach to complex PTSD: childhood and adult cumulative trauma as predictors of symptom complexity. J Trauma Stress. 2009;22(5):399-408. doi:10.1002/jts.20444. PMID: 19795402.

Books & Cultural Sources (Chicago Author-Date)

• Fisher, Janina. Healing the fragmented selves of trauma survivors. Taylor & Francis Group, 2017.
• Walker, Pete. Complex PTSD. CreateSpace Independent Publishing Platform, 2013.

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