So this is a video that's actually been requested and it's been on my list to do for quite a while now. Um, it's all gonna focus on tips for therapists around working with childhood trauma. I'm Patrick Tian. I'm a child of trauma specialist, licensed clinical independent social worker. I do a lot of videos on education about the abusive family system of origin.
I've worked in inpatient. Psychiatry. I've worked in community mental health, all that was before starting my own private practice like about 10 years ago. Um, and I'm primarily a childhood trauma therapist working in group work, individual and couples. But the real work really happens in group formats with me.
Most of my time now, I'm not really taking anybody on right now, but most of my time now is focused on creating content about childhood trauma recovery and training other therapists on working with individuals in childhood trauma. So that's me. So in this video, I don't wanna offend you, I don't want to offend your model, I don't want to offend your training.
There is the right kind of therapy for the right kind of with the right kind of therapist for the right kind of client at the right time. I think this isn't a do it my way kind of video. Um, although it's probably gonna. Sound like that, and it is a little warning here. It is gonna probably sound pretty preachy.
Just wanna apologize for that upfront. So I'm sharing what I know about childhood trauma and what resonates with childhood trauma survivors. As my channel is now approaching about 18 million views about therapy, about the toxic family system of origin and how to recover and all that sort of jazz, I do wanna say that I know that views don't make me right.
But they do say something about what childhood trauma survivors are seeking in the therapy office. So whether you're just starting out or you have years of practice or decades of experience, I do want to share with you what I've learned from clients who either get to my videos or they get to my practice.
So unfortunately, they report very shaming experiences in therapy, very invalidating experiences around childhood trauma with different. Therapist. There's also a parent in what I see on this is also apparent in what I see online. If you go to Reddit, if you go to the comment section of these videos, you've probably heard a lot about that as well.
And I also want to acknowledge in that, I also wanna say that clients can be difficult. While working inpatient psychiatry, I've had my life threatened. I've had tables thrown on me and in private practice I've had clients casually ghost me on huge therapy tabs that they had with me. I don't keep tabs anymore, so I'm trying to see that both parties in therapy can be problems.
And it can be really hard work for really anybody involved. So if you like this video, feel free to hit some buttons on the screen. You really can't miss with any of the buttons. Specifically the like button to subscribe. Button the share button. And if you're interested in training with me, maybe not after hearing all my preachy tips.
Um, I'm offering a training on Saturday, September 17th and a level one relationship recovery program or RRP, which is the type of therapy model that I do. That training is about getting clinicians sort of to be able to use three specific tools and starting to work with clients on their child to trauma and getting them to process and getting them to know about their family system of origin trauma.
You just click the white ball up here and then it'll get. Get you the details on how to register, and I'll also have the link in the description to this video. So here it goes. Let's dive in. I'll frame each of these tips, which at the end with some suggested like do's and don'ts at the end of each one.
So number one might be the most controversial one that we'll get into. So let's get this one out of the way. Number one is don't suggest family reconciliation with the client's family of origin upfront. Or if ever when it comes to childhood trauma, this happens when, say, as a therapist, you're either trained in getting families to work no matter what, and I get that.
Or you actually might have your own family personal experience of you having to accept. An abusive or tricky parent of your own, which I get that too. It also involves suggesting any of the following ideas or statements to a client suggesting that a, uh, that a client do family therapy upfront, like have your parents come in and we can do a session together.
Um, and you, you, you're not really hearing that the parent is highly abusive or highly dysregulated or narcissistic or both, or suggesting that to the client that their parent did the best that they could or su suggesting to the client that they need to like, move beyond what happened to them. And accept the parent who was abusive because the client should know better since the parent is less functioning.
Please be aware that the, the therapist who is making these suggestions upfront is behaving just like the client's abusive family, where they're told that you need to get over it because. They don't really have any real problems. It's the parents who have the real problems. It's very shaming experience.
So my primary, my primary message about this one is the therapist is assuming a bunch of stuff. They're assuming that the abusive parent is workable or has insight or is safe. That's usually not true for this stuff. Assuming that the client can actually heal by dismissing their own story or their trauma or their symptoms or their stuck places, and this is a big one.
I see many therapists simply assuming that is a client who is being grandiose. Or self-involved or self-consumed or resentful or paranoid or displaying symptoms of cluster B stuff, problems. Assuming that upfront. Sure that happens from time to time, but I see clinicians treating all childhood trauma survivors and this polite kind of get it over.
Get over it kind of way, and like the client is left to feel like they are crazy. Also, when the therapist suggests reconciliation with an abusive family upfront, it sends a message that the client hears that they shouldn't be believed and that they're the problem. So I know that this is unintentional, but many therapists get these situations wrong.
For lack of understanding which side to choose. You can actually take a side when it comes to childhood trauma survivors, despite your training. Um, but going with the things like your parents probably had childhood trauma too. So what are you gonna do? I call that it's like a, it's like a, it's like a.
Everybody wins kind of idea, which really means be careful with this. That really means suggesting to the client to do all the bridging work with the families that are usually unworkable. So also, while totally skipping what happened to the client as a child. And going on into their adulthood, would I suggest reconciliation?
So after the client has gone through a long process of processing what happened to them, and they have reclaimed their ability to embrace healthy intimacy and heal to the point that the abusive family no longer has power over them, that last part is super important. I, I also only suggest reconciliation if the parent has some significant insight.
Can handle some boundaries and wants to actually own something about how they raise their child. I know that that's a tall order, but that's the only times that I would suggest doing it. In short, I believe, and again, this is me, this is my opinion, that reconciliation with abuse of family members is just as damaging as something like conversion therapy because it tells a client that they're wrong.
Their feelings are flawed and they are broken and they need to change and be able to adapt to their family or society just because, so my last thought on this is I, I think in the psych and recovery world is there are all these like platitudes, like that are thrown around and they often get repeated, like a new grad might hear from a professor or a supervisor say, well, I think all parents do the best do that they can and they do their best without really thinking that through.
And it just gets repeated and not explored or challenged. Is that really true? Did they do the best that they could? Well, what was their worst? So we really have to look at that, and I wonder if that some therapists say these things because they don't actually know how to talk to a client about the abusive family system of origin, like feeling that the client is making it a moral issue.
As opposed to a factual issue. Some do's and don'ts on this one. Do familiarize yourself with the abusive family system of origin and take in what all that means for healthy development for a child, and that would hopefully lead into a successful emotional adulthood. Do challenge yourself about your own codependency and trying to make everything work in a client's family, like any countertransference there for you that makes you wanna suggest reconciliation upfront.
I. Don't suggest reconciliation until post healing. Um, or if you can engage that the abusive parent has truly changed and is in recovery themselves. Number two is what I'm calling trauma informed isn't the same as trauma trained. Be as specific as you can about what you do and what you don't do. And I know you know this, but the point of this one is that clients don't know this.
You'll see what I mean. When we list our services online, it's helpful to be thorough about what we do, what insurance we take or not and about. And being trauma informed at this point is crucial about knowing how to talk about symptoms and situations and guide the conversation and to specific places of things that might be helpful to the clients, like another type of therapy or whatever.
Um, or when and when not to talk about it, but I'm suggesting that the client who is usually overwhelmed trying to. Find you and is probably already shooting in the dark about finding a trauma Therapist just sees the word trauma and they think they're good to go with getting a really solid trauma treatment because you've listed trauma informed on your thing.
So my suggestion with this one is when you do a phone call or a consult or communicate with potential clients, be really specific about what you do and what you don't do. Like you are a trauma. Formed, but you don't necessarily do necessarily do trauma specific work like using EMDR to process family, AB origin and stuff or whatever.
If you are a general talk therapist and help clients navigate tricky situations in their present life and that's it, they probably don't know that and they assume you can do trauma because, because of whatever. Here's why is, I'm not saying you're being dishonest or misleading. I'm suggesting we need to be explicit.
In what we put out there, because as consumers, and this is a funny thing, clients assume that any therapist can handle a problem and they're, they're not wrong. Sort of in that assumption. Like, if I go to my primary care physician, I can rightly assume that they know how to treat me for things like diabetes.
Clients assume the same with us. But it's mental health conditions. That's not always true. And because of that assumption, they might get to you and the expectations don't line up. They want to get help around their narcissistic mother, and you do manualized treatments such as DBT or CBT. That doesn't get into all that.
So, and unless you have successfully taken clients from being emotionally raw, from childhood trauma symptoms to being healed in a good enough way, in a, in a much more happier place, in a much more functioning state through the specific type of trauma symptom, uh, system that you do, don't describe yourself as a trauma therapist.
Talking about it isn't sufficient as awareness doesn't change clients. Healing work does. And I, I want to be explicit about that. So when clients do a consultation with me, I tell 'em that I only work on the childhood trauma piece. Um, that is really rooted in the past and we relate that to some problems in the present, you know, and I let them know that after a few sessions of kind of getting sort of the intake stuff, we'll be working on specific tools on their family system.
Them and begin working with their inner child to start a re-parenting process. I also let them know that it's not just gonna be open-ended sessions all the time about just problems that like come up in the week. And lastly, I tell them that the majority of the work that I do is usually done in one of my groups.
And I'll gradually be sort of suggesting that or steering them towards that. Once they feel comfortable and they know all of that upfront, given all that info, the client to decide that they want to work with me or not, they might be freaked out by all that. Cool beans. Well, not cool beans, but you know what I mean.
Here are some do's and don'ts in consultation or general communication with clients. Do be explicit on if you are trauma trained or not. Trauma informed is not the same thing. Clients don't know this. I know that you know this, but they don't. So do refer out as best as you can when a client is seeking trauma work and you haven't walked a client through a specific process or that change.
Um, or it's simply if it's not your cup of tea, um, I know that this sounds super pedantic, but you would be surprised. Don't assume that a talking cure is going to make significant changes in someone's childhood trauma symptoms or their history. So there's that. Moving on to number three, this one's a little bit weird, but don't do trauma work.
Casually, um, childhood trauma survivors are primarily wounded around, I think two things, perception and connection due to their family system of origin. And due to that, I think a good childhood trauma therapist really has a depth of skills at connecting with a client. Irvin Yellen once said that the treatment modality doesn't matter as much as the relationship, which I think is really true.
But a solid relationship in a skilled trauma activity or a. Tool-based model is a powerful combination. What I mean by this one is that clients have reported that in some, that they feel like some of the therapy just felt too short, too pragmatic, not very close with the therapist, not seen. I don't recommend doing short and personal runs of some kind of trauma work where the therapist.
Can often just feel like they're just a paid professional or an instructor and not connecting with the client. I think clients, not all clients, but the majority of them do better in therapy When the therapist really gets them, creates a safe place for them and there's gonna be like a realness going on on both sides and that the therapist can put themselves.
Within the client's shoes, they can sort of imagine what it would've been like, um, growing up and all that. This is an ongoing process as a lot of clients are guarded or they're weirded out by all that. But again, the trauma is around disconnection. So clients also report that they feel safe when the therapist really gets what they're experiences are like with say, the narcissistic parent or growing up in chaos or growing up in domestic violence, they just don't hear from the therapist like, hmm.
Sounds hard, which I've literally seen therapists do to, to, to clients at times, like right in front of me. So in short, we can't treat doing childhood trauma, work with clients the same way we would treat doing same manualized therapies such as DBT or something like CBT. Yes, connection can definitely exist in those treatments.
But this is different. It's, it's intimate work because the trauma was personal. And also intimate trauma. You know, here are some do's and don'ts about doing trauma work casually do take extra time and really build a relationship with a client to be safe, to be a safe space for them. This might be a moot point for you if you already do this, I'm sure you already do.
But for new therapists, it can be a skill that needs to kind of be built over time. Hard to not feel confident in your ability to really connect with somebody. And as a side note, I, I believe this to be true too, is like it's therapy is a lot weirdly like dating in a way that. Um, we're not gonna have the same chemistry Clients aren't gonna have the same chemistry with you all the time.
You're not gonna, you know, it's not a one size fits all kind of a thing. There's just some clients that I've had that I've never really been able to make a connection with. I think it's just part of what. This what this world of therapy is like. Um, it takes me a year to really get to know somebody, to really get to know their story, what their triggers are, what makes them tick, and it takes a deep connection for a deep problem, such as childhood trauma.
And to be fair, there are clients who. Might want a super fast and not very deep experience doing childhood trauma work, but that doesn't really take in the, the problem of childhood trauma or the severity of it. So I don't think that that really works, you know, to be honest. Do expand, say your clinical eye and try to imagine what it was like.
For, to be the client and walk in their shoes and be thinking what it was like to be that kid from that kind of family before you think of anything like a round diagnosis or that kind of a thing. Um, sometimes our training wants us to skip right to the solution to a problem as opposed to really taking.
The person's experience in, which is something I try to do in the first couple sessions. A solid don't here is don't treat childhood trauma in short term or in casual ways. Meaning like the therapeutic relationship. I've seen advertisements for holistic practices where it's just like, do a weekend retreat on your childhood trauma, and I cringe at that stuff because I, it feels like the person's gonna open up to their childhood trauma and talk about it.
It's gonna be over before they know it. Now they leave it, it's still open, still on their mind, or there's no. Really safe home base to come back to. I think it takes a long time for the person to become traumatized in their 20 years of development. A weekend isn't gonna cut it. Moving on to the last one, which is number four, is don't wait for the client to bring it up or to figure it out.
So related to the second tip about being really clear about what you do, I'm really specific about my role. Which is that I help clients figure out their family systems and I'm going to be doing a lot of the talking, some exploring, some suggesting some reflecting back on what I think offering tools and talking about what the healing process is gonna look like.
I'm not doing all the talking, I'm just doing like half of it. They know that. Like in the first phone call with me, they know that I'm gonna be asking them to be doing some, talking about their family of origin and getting some help, making more sense about that system if they want that. Like it's, it's, you know, uh, but I don't take on clients who just want general talk therapy.
That's not really for me. Um, I don't wait for the client to come in with epiphanies because I've been a very blank slate the whole time in session. This is perhaps the number one complaint of childhood trauma survivors is just. Feeling like the therapy had no direction and the therapist wasn't guiding, educating, reflecting, and it's for them, for the client.
It's like a slow, quiet, uncomfortable experience. If that's what your model of therapy about, let the client know that upfront that that's what you do. You're more of a creating a space and allowing for the quiet discomfort for things to come out that's, that's effective. But it's just, it's, you know, it's not effective for everything.
And also related to the second tip, I think the client is expecting the therapist to provide guiding. Tools, um, a model of some sort, some kind of framework. Not just that the client hit bottom with their, their dating life one day and came into the therapy session and told you that they figured it all out and they're gonna try different behaviors because you've just been sitting there and sort of silence.
That's like a Hollywood version of what therapy is. I don't believe in that stuff. I don't, you know, it's just. Really odd to me. Clients often feel. Another important piece to this is clients often feel the power difference in therapy. And as therapists, we forget how much power we actually have when we are really low key.
We don't say much, we're silent. Childhood trauma survivors who struggle with a lot of shame are probably just gonna interpret your silence as quiet criticism. Or they really might not feel good about the therapy sessions, but it takes them an an incredible amount of energy to leave any relationship because they don't want to disappoint you.
So that's what I mean about the power that we might have because they might be freaked out that they're gonna let you down by stop coming to see you because of their own codependency. Um, clients already feel. Terrible about their problems or their inner experiences. So they're most likely to not bring them up with you without really feeling good about you to take that kind of risk.
And it's not gonna happen if the relationship really isn't there because they assume, again, your quietness is, is feels. Disapproval of them. So also as a side note, some clients might say they wanna do trauma work, but when they, when the time comes, they actually don't wanna do that, and the therapist doesn't want to open them up and dysregulate the client.
So I get that. Sometimes we do sit back. But that's not what I'm kind of suggesting here. It can't be all like pressing into the client all the time, but it also can't be hanging back and letting them tell us all the time either. So some do's and don'ts. Do think about how the work in session or talking in session can be 50 50.
Um, you do guide and explore and provide tools or some kind of roadmap. Don't use a blank slate approach for everything. There's a time and a place for it, like such as allowing space for grief. Don't assume. That the client will figure it out on their own. You can suggest that you actually think that the abusive partner or the toxic boss or the emotionally immature mother is not good for the client and you can suggest what you think that they should do.
So I think that's what would be a solid therapist. Not in a controlling way, but you just sort of say what you think. Like, would you wanna spend five days with your partner's Ragy alcoholic father in a cabin in the woods over Christmas? No. Like you can help them, a client in that situation come up with a boundary game plan or tell them simply not to go and you're not a bad therapist for doing so.
I think. So some final thoughts. This video came from what hundreds of my own clients have reported to me in their prior experiences with therapy. I'm not saying I'm the grand poopa of childhood trauma, I'm just sharing what I know and what I hear. This video also comes with me reading thousands of comments on my videos.
Just check out a, a therapist role play video that I did, and you'll see what I mean. There's a link in the description. I also don't mean to say that childhood trauma clients are super different than say any other client. I'm suggesting that no client is one size fits all, like suggesting, suggesting reconciliation might work for a family that just like went through a bad.
Couple of years, like a bad patch, not decades of narcissistic abuse or substance abuse or chaos or poverty or violence or sexual abuse. We need to, you know, really be able to tell the difference between those two types of families. Don't assume it's the first all the time. Um, and a last tip for new clinicians, it's, it's a hard job, and you'll find that being more clear creates less problems.
Doing the work that you enjoy is really a good thing. Being boundaried about your time and your money keeps you less drained, and it keeps you less resentful. Getting trained reduces your anxiety about being affected. Or helpful in getting our sea legs as therapist in the same, the first couple years is really rewarding.
It's really cool work. I love my job. Um, but it can really drain you in holding what others kind of go through in their childhood and being available for them, and you're gonna have to find some way to really rejuvenate yourself and take care of yourself, because I think that's something that. Like we all kind of go through, so, okay, enough preaching.
I hope that this was helpful. Check out the upcoming training, follow the link up here. And as always, may you be filled with loving kindness. May you be well, may you be peaceful and at ease. May you be joyous.
