Trauma
Trauma work, paced by you.
For the single event you cannot put down, and for the long early kind that taught you to read a room before you entered it. I am a trauma care specialist and this is a large part of my practice.
Brandy Roggentien, LCSW, Licensed Clinical Social Worker (LCSW) #22723. Telehealth across California.
What trauma actually does
Trauma is less about the event than about what the event did to your alarm system. Something taught your body that the world required constant readiness, and the body, being loyal, kept it up long after the danger ended.
That is why the symptoms look so unrelated to the cause. You are exhausted but cannot sleep. You are safe but scanning. You go blank in conversations that matter. Small things produce a reaction out of all proportion and you are left embarrassed about it afterwards, which adds a second layer of trouble on top of the first.
The kinds I see most
- Single-incident trauma. A crash, an assault, a medical emergency, a sudden death, a disaster. One identifiable before and after.
- Developmental and complex trauma. Years of it, usually in childhood, usually from people who were supposed to be safe. No single event to point at, which is exactly why people discount it.
- Secondary and occupational trauma. Nurses, first responders, teachers, social workers, carers. Accumulated exposure to other people's worst days.
- Traumatic loss. Grief complicated by shock, by how it happened, or by everything left unsaid.
The approach
Steady first, then the hard part, then put it down.
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Stabilize before anything else
Before we touch the difficult material we make sure you have something that works when the alarm goes off: breathing, grounding, the daily routine I teach, and a plan for the evening after a heavy session. People get hurt in trauma therapy when this step gets skipped.
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Work at the edge, not past it
We approach the material at a pace you set, close enough to do something with it and not so close that you are flooded. You can stop any subject at any time. I watch for the signs that we are going too fast, because in the moment you often will not.
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Change what it means now
Most of the lasting damage is in the conclusions drawn at the time: that it was your fault, that you should have stopped it, that you are fundamentally unsafe. Those conclusions were reasonable then and are usually wrong now, and that is workable.
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Give it a smaller place
The aim is not deleting the memory. It is that the event becomes something that happened to you rather than the organizing fact of your life, and that your body stops treating today as a repeat of it.
Questions about trauma therapy
Will I have to describe what happened?
Not before you are ready, and not in more detail than the work requires. I do not believe in making someone relive an event to prove it mattered. A great deal of useful trauma work happens without a full narrative ever being told out loud.
It happened a long time ago. Is it too late?
No, and old is not the same as resolved. Some of the most useful work I do is with people in their forties, fifties and sixties who assumed the window had closed. The nervous system does not keep a calendar.
Nothing dramatic happened to me. Does it still count?
Usually yes. People discount what they went through because it was not a single catastrophic event. Sustained fear, unpredictability, humiliation or neglect over years does more lasting damage than many single incidents, precisely because it never announced itself.
What if I start and it becomes too much?
Then we stop and steady it, in that session. Pacing is my responsibility, not yours. You are allowed to say "not today" about any subject, and that is treated as information rather than avoidance.
Do you do EMDR?
My work is cognitive behavioral and trauma-informed rather than EMDR certification. I do use bilateral stimulation in the daily anxiety routine I teach clients. If formal EMDR is clearly what you want, say so on the first call and I will tell you honestly whether to look elsewhere.
You can start by saying very little
A first call does not require you to explain anything you are not ready to explain. "Something happened and it is still affecting me" is a complete sentence and an entirely sufficient place to begin.