They’ve moved from “contemplation” to

“precontemplation”

Their insurance benefits now pay for therapy

They have experienced a sudden shift in

attachment style due to environmental change

Their coping resources have become overextended,

making even ordinary stressors feel overwhelming

A neurobiological tendency toward emotional

detachment in high-stress environments

Over-identification with the trauma narrative,

leading to resistance to change

The roles of protection, secret-keeping,

cultural and historical suppression, and pressure to engage in “positive

thinking”

Cognitive rigidity and difficulty adapting to

new therapeutic frameworks

Loss of language development, executive

functioning, and attention

Loss of memory, loss of future orientation, loss

of emotional control

Loss of identity, childhood, and innocence

Loss of family support, educational opportunity,

and physical health

The experience of trauma should be

compartmentalized to preserve a coherent sense of self

Identity formation depends primarily on

pre-trauma personality traits rather than post-trauma reflection

Trauma becomes a fixed part of identity that

cannot be altered through therapy

How individuals relate to their trauma and sense

of self shifts over time and with treatment

Psychodynamic Therapy

Interpersonal Therapy (IPT)

Emotion-Focused Therapy (EFT)

Cognitive Behavioural Therapy (CBT)

A parent who models appropriate grieving and

encourages Sally to talk

A parent who is emotionally unresponsive,

invalidating Sally’s feelings by telling her to stop and watch TV

A parent who is overwhelmed but attempts to

validate Sally’s emotions

A parent who expresses their own grief openly to

connect with Sally’s experience

The therapist becoming a secure base, fostering

safety, empathy, and emotional presence

The client maintaining emotional neutrality to

avoid countertransference

The client's willingness to share details of

their trauma early in treatment

The therapist's ability to provide

psychoeducation and structure sessions around measurable goals

As a decision that must be made early in the

healing process

As a psychological process with ups and downs,

better understood as dynamic rather than static

As a technique to quickly reduce symptoms of

anger and anxiety

As a moral obligation that leads directly to

emotional resolution

It is a common coping strategy, but it

ultimately prevents full trauma processing—healing requires facing the trauma

It is

effective when paired with cognitive restructuring and distraction techniques

It is a short-term strategy that reliably

reduces long-term PTSD symptoms

It allows individuals to focus on rebuilding

their identity before addressing trauma

It helps build a sense of safety and

containment, which is essential before addressing overwhelming experiences

It allows time for the therapist to gather

background information and assign a diagnosis

It encourages clients to focus on future goals

rather than revisiting painful past events

It ensures that the client does not become

overly dependent on the therapeutic relationship too soon