When we think about grief and loss, we often think about the death of someone we love. While that is certainly one form of grief, it’s not the only one. Many of us experienced childhood loss that was never recognized as grief. These losses can take many forms, including:
A parent’s divorce or separation
The death of a grandparent or another important caregiver
Moving away from friends, family, or familiar surroundings
Growing up with a parent or family member struggling with addiction
Emotional neglect or inconsistent care-giving
Living with chronic illness
Bullying or peer rejection
Growing up in an unpredictable or unsafe home
The loss of safety, stability, or innocence
The childhood you needed but never had
While each of these experiences is different, they can all represent meaningful losses that deserve to be acknowledged. Many of them can involve ambiguous loss—a loss that is real and deeply impactful, but often lacks clear closure or social recognition. Because these losses aren’t always acknowledged as grief, we may carry their effects without realizing we’re grieving in the first place.
Although these losses happened in childhood, they don’t always stay in the past. They can influence how we experience relationships, respond to conflict, view ourselves, and even what feels safe or familiar. The ways we learned to seek comfort, protect ourselves, or connect with others in childhood often become the blueprint for our relationships in adulthood. Instead of asking, “What’s wrong with me?” we can begin asking, “What happened to me?”
How Children Adapt to Loss
As children, we often don’t have the language or emotional capacity to make sense of our losses. Instead of grieving them, we adapt.
Many of us learn to become independent because asking for help didn’t feel safe. We may become the “responsible one” because someone had to hold things together. Some of us will learn to people-please in an effort to avoid conflict or rejection. We stay emotionally guarded because vulnerability once led to disappointment.
These adaptations are often incredibly resourceful. They helped us survive difficult circumstances.
When Childhood Survival Strategies Follow Us Into Adulthood
The challenge is that the strategies that once protected us can begin to limit us. What helped us survive childhood may make it difficult to trust others, ask for help, or believe we’re worthy of care as adults.
These unresolved losses can show up in ways we don’t immediately recognize. For example, you might notice:
Difficulty trusting others or asking for help
Fear of abandonment or rejection
Feeling responsible for other people’s emotions
Believing you have to earn love through achievement or care taking
A persistent sense that something is missing, even when life appears to be going well
This doesn’t mean that every struggle in adulthood is rooted in childhood grief and loss. The human experience is complex, and there are many reasons people may experience anxiety, depression, relationship difficulties, or low self-worth. But for some people, early losses are an important part of the story, especially when those losses were never acknowledged or processed.
Healing Begins by Acknowledging What Was Lost
One of the most powerful aspects of therapy is having a safe space where you can finally acknowledge those losses with compassion. Grieving isn’t about staying stuck in the past. Instead, you can honor what was lost, recognize how those experiences shaped you, and allow yourself to respond with the care and understanding you may not have received at the time.
Healing doesn’t mean forgetting the past or pretending those losses didn’t happen. Rather, it means making space for those experiences to be acknowledged, understood, and integrated so they no longer have to define how we relate to ourselves and others.
Looking at Your Story with Compassion
When we begin to grieve what was missing—not only who or what we lost, but what we needed and never had—we often discover that through healing we can move forward with greater freedom, self-compassion, and deeper connection to ourselves and others.
If you’ve ever wondered why certain relationship patterns, emotional reactions, or beliefs about yourself seem so difficult to change, it may be worth considering whether there are losses in your story that never had the opportunity to be grieved. Recognizing those losses does not change the past, but it can change the way you understand yourself, and that understanding can become the foundation for meaningful healing.
What childhood loss in your own story may have never been recognized as grief?
If this resonates with you, you’re not alone. Therapy can provide a space to explore these experiences with curiosity and compassion, helping you understand how the past continues to shape the present while supporting meaningful change.
About the Author: Michael Marsteller
Mike Marsteller, MA, NCC, LAPC (he/him/his), has earned his Master’s in Clinical Mental Health Counseling from Messiah University and works with adults navigating trauma, grief, and bereavement, with a particular focus on attachment and early relational trauma.
Mike is especially passionate about helping clients process childhood trauma, navigate grief and loss, and break inter-generational patterns that continue to impact their lives and relationships. Drawing from his experience as a certified grief educator and facilitator of grief support groups for adults and children, he offers a space where grief can be witnessed, honored, and gradually made sense of without pressure to rush the process.
By: Dr. Scott Giacomucci, DSW, LCSW, BCD, CGP, FAAETS, TEP
Healthy relationships don’t happen by accident. Whether you’re navigating dating, marriage, family relationships, friendships, or professional connections, every relationship is influenced by communication, trust, emotion, and our past experiences.
Many people search for a relationship coach because they want to strengthen a relationship before problems become overwhelming. Others are looking for support after repeated conflicts, a breakup, or recognizing unhealthy relationship patterns they want to change. Not to be confused with couples therapy, relationship coaching is focused on helping an individual to be the best that they can be in their relationship.
At the Phoenix Center for Experiential Trauma Therapy, our trauma-informed relationship coaching services help individuals and couples build healthier relationships through greater self-awareness, improved communication, stronger boundaries, and practical relationship skills that create lasting change.
What Is Relationship Coaching?
Relationship coaching is a collaborative, goal-oriented process that helps individuals and couples improve how they relate to themselves and others. Rather than focusing on diagnosing or treating mental health disorders, relationship coaching emphasizes personal growth, communication, emotional intelligence, and developing healthier patterns of connection.
Relationship coaching may help you:
Improve communication and conflict resolution
Develop healthier boundaries
Strengthen trust and emotional intimacy
Navigate dating and new relationships
Prepare for marriage or long-term commitment
Recover from unhealthy relationship patterns
Increase confidence in relationships
Improve family and workplace relationships
Better understand attachment styles and relationship dynamics
Whether you’re currently in a relationship or not, relationship coaching can help you develop the skills needed for healthier and more fulfilling connections throughout your life.
Relationship Coaching vs. Therapy
People often wonder whether they need relationship coaching or therapy. Relationship coaching focuses on helping people develop healthier relationship skills, clarify goals, improve communication, and create meaningful changes moving forward. It is ideal for individuals and couples seeking growth, education, accountability, and practical strategies.
Individual therapy or couples counseling is often more appropriate when significant mental health concerns, trauma, addiction, severe relationship distress, or longstanding emotional difficulties require clinical assessment, trauma processing, and psychotherapy. While coaching is focused on the here-and-now and the future, psychotherapy includes a greater emphasis on past experiences.
Because the Phoenix Center offers both therapy and coaching services, we can help determine which approach best fits your goals through our free intake process.
Why Relationships Can Feel So Difficult
Many relationship struggles are more than simply communication problems.
The ways we trust, connect, communicate, handle conflict, or respond to intimacy are often shaped by our earliest life experiences. Childhood adversity, attachment wounds, neglect, betrayal, abuse, and other traumatic experiences can leave lasting patterns that continue long after the original experiences have ended.
These patterns may include:
Fear of abandonment
Difficulty trusting others
Emotional withdrawal
People-pleasing
Difficulty setting boundaries
Conflict avoidance
Becoming highly reactive during disagreements
Perfectionism
Difficulty expressing needs
These responses often developed to help us survive difficult situations. While they may have been adaptive at one point, they can become barriers to building the healthy relationships we want today.
A Trauma-Informed Approach to Relationship Coaching
At the Phoenix Center, our relationship coaching is grounded in trauma-informed care. We recognize that relationships can be both the source of our deepest wounds and our greatest opportunities for healing.
Rather than focusing on blame or assigning fault, we help clients understand how nervous system responses, attachment patterns, emotional regulation, family dynamics, and life experiences influence present-day relationships.
Our coaching integrates principles from:
Trauma-informed care
Attachment theory
Interpersonal neurobiology
Positive psychology
Psychodrama and experiential learning
Mindfulness
Strengths-based approaches
Somatic healing
Our goal isn’t simply to solve today’s conflict, it’s to help you develop relationship skills that continue serving you for years to come.
What Happens During Relationship Coaching?
Every coaching relationship is individualized based on your goals. Sessions may focus on developing communication or listening skills, building trust and connection, emotional awareness, conflict resolution, boundary setting, understanding patterns, and clarifying relationship goals or values.
Unlike traditional advice-giving, coaching is an active process. At the Phoenix Center, we often incorporate experiential exercises, role-playing, psychodrama, mindfulness, and
other interactive approaches that allow clients to practice new relationship skills – not just talk about them.
Who Can Benefit from Relationship Coaching?
Relationship coaching may be right for you if you are:
Looking for a relationship coach near you
Dating and wanting healthier relationship patterns
Preparing for marriage or commitment
Recovering after a breakup or divorce
Working through family conflict
Navigating blended family relationships
Building healthier workplace relationships
Learning to communicate more effectively
Healing from unhealthy relationship dynamics
Wanting stronger emotional connections
Relationship coaching is not only for couples. Individual coaching can dramatically improve how you relate to romantic partners, family members, friends, coworkers, and even yourself.
Why Choose the Phoenix Center for Relationship Coaching?
At the Phoenix Center for Experiential Trauma Therapy, we believe that lasting relationship change occurs through more than simply learning communication techniques. Healthy relationships develop through greater self-awareness, emotional regulation, experiential learning, and authentic human connection.
Our team combines clinical expertise with trauma-informed, experiential approaches to help clients better understand themselves, strengthen their relationships, and create meaningful, lasting change. Whether you’re seeking individual relationship coaching, couples therapy, or guidance in navigating life’s most important relationships, we’re here to help.
Ready to Strengthen Your Relationships?
If you’re looking for a compassionate, trauma-informed relationship coach or wondering whether relationship coaching or couples therapy is the right fit, we’d love to help.
Contact the Phoenix Center for Experiential Trauma Therapy to learn more about our relationship coaching services, schedule a consultation, or explore how our team can support you in building healthier, more connected relationships.
About the Author
Blog Written by: Dr. Scott Giacomucci, DSW, LCSW, BCD, CGP, FAAETS, TEP
Dr. Scott Giacomucci, DSW, LCSW, BCD, CGP, FAAETS, TEP (he, him, his) is the Director, Founder, & Owner of the Phoenix Center for Experiential Trauma Therapy. He provides clinical services at the center as well as supervision, consultation, training, and organizational leadership. Scott’s work has been internationally recognized and he is the recipient of various awards. He frequently presents training workshops at local, national, and international events and has published various articles on using experiential methods (especially sociometry, psychodrama, and group work) in clinical, educational, community, and organizational settings. Most recently, the CEO of NASW commented in a press release that “With social work leaders such as Dr. Giacomucci on the rise I’m assured the social work profession will have an especially bright future.”
Written by: Dr. Scott Giacomucci, DSW, LCSW, BCD, CGP, FAAETS, TEP
Many adults find themselves struggling with anxiety, low self-esteem, relationship difficulties, perfectionism, people-pleasing, or intense emotional reactions that seem difficult to explain. They may wonder, “Why do I keep reacting this way?” or “Why do I feel like a scared child in certain situations?”
For many people, the answer lies in experiences from childhood.
Inner child work is an approach that helps people reconnect with, understand, and heal the younger parts of themselves that were impacted by painful or unmet childhood experiences. Rather than “living in the past,” inner child work helps us understand how the past continues to influence the present – and how we can begin creating a healthier future.
At the Phoenix Center for Experiential Trauma Therapy, we frequently incorporate inner child work into trauma therapy because lasting healing often requires more than understanding what happened. It involves developing a new relationship with the parts of ourselves that continue to carry emotional pain or have been split off from our adult selves.
What Is Inner Child Work?
Inner child work is the process of exploring, understanding, and healing the emotional experiences, beliefs, needs, and protective strategies that developed during childhood.
The term “inner child” is a way of humanizing the parts of ourselves that continue to carry the wounds, defenses, emotions, and reactivity from the past. It is a way of describing the younger emotional experiences that continue to influence how we think, feel, behave, and relate to others throughout adulthood. Our inner child (or inner children) may carry fear, shame, loneliness, anger, grief, or feelings of pain. At the same time, our inner child may also carry the joy, curiosity, wonder, creativity, and playfulness that we feel like we’ve been disconnected from since the trauma.
When childhood needs for safety, love, acceptance, or emotional support were not consistently met, these experiences often continue to affect adult life in ways we may not fully recognize.
Signs That Childhood Experiences May Still Be Affecting You
Many people seeking trauma therapy don’t initially realize that their current struggles are connected to childhood experiences.
Some common signs include:
Feeling easily rejected or abandoned
Difficulty trusting others
Perfectionism or fear of making mistakes
Chronic people-pleasing
Harsh self-criticism
Difficulty setting healthy boundaries
Feeling emotionally “stuck”
Strong emotional reactions that seem larger than the situation
Fear of conflict
Difficulty accepting love or support
Persistent feelings of shame or not being “good enough”
These patterns often developed for understandable reasons. They were attempts to adapt to difficult environments, relationships, or experiences.
Why Childhood Experiences Continue to Affect Adults
Children naturally make sense of the world by making sense of themselves. When children experience neglect, criticism, abuse, bullying, loss, or unpredictable caregiving, they often develop beliefs such as “I’m not good enough,” “I have to take care of everyone else,” “It was all my fault,” “My needs don’t matter,” and “If I make a mistake, I’ll be rejected.”
These beliefs may have helped children understand confusing experiences, but they often continue operating long after the original circumstances have changed. When a child can’t fully process or make sense of a complex traumatic experience, they are likely to blame themselves or internalize negative beliefs about themselves from the event.
Inner child work helps identify these beliefs, understand where they came from, and develop healthier ways of relating to ourselves.
What Does Inner Child Healing Look Like?
Many people imagine inner child work as simply visualizing themselves as a child. While imagery can certainly be one part of the process, meaningful inner child healing can go much deeper.
Healing often involves:
Understanding childhood experiences with greater compassion
Recognizing emotional triggers in the present
Learning healthier ways to respond to emotional pain
Challenging long-held beliefs about yourself
Developing self-compassion
Grieving unmet childhood needs
Building emotional regulation skills
Creating healthier relationships
Meeting present-day needs in healthier ways
Inner Child Work and Trauma Therapy
Inner child work begins by acknowledging and befriending your inner child. This requires a newfound awareness and understanding of the past wounded parts of self. One of the most important aspects of inner child work is that we interact with our inner child from the perspective of our adult selves. This allows us to integrate the new perspective, information, and compassion between our past and current selves. While inner child work does often involve expressing emotions that were unexpressed from childhood, it does not mean that we encourage uncontained regressing into childlike states.
Interacting with your inner child may involve changing your internal self-talk, guided visualizations, letter writing and journaling techniques, parts work, somatic techniques, EMDR sessions on past trauma, psychodrama, and empty chair work. Rather than focusing exclusively on symptoms, these approaches help individuals develop a healthier relationship with themselves and the younger parts that continue to carry emotional pain.
For individuals who experienced childhood trauma, neglect, abuse, or attachment wounds, inner child work is often one component of a comprehensive trauma treatment plan. Healing childhood trauma requires more than talking about difficult memories. It often involves helping individuals experience safety, emotional regulation, connection, and self-compassion in ways they may not have experienced growing up. Rather than trying to erase painful experiences, inner child work helps reduce their influence on your current life.
Common Misconceptions About Inner Child Work
“Inner child work means blaming my parents.”
Inner child work is not about assigning blame. Many caregivers did the best they could with the resources they had. At the same time, acknowledging how childhood experiences shaped us is an important part of understanding ourselves. Healing involves developing awareness, not simply finding someone to blame. Though there is sometimes blame to assign to others for past trauma, the responsibility for healing rests within ourselves.
“I had a good childhood, so I don’t need inner child work.”
Many people experienced loving families while also encountering painful experiences such as bullying, death, grief, medical trauma, emotional neglect, divorce, discrimination, or other significant stressors. Inner child work is about understanding your unique experiences – not comparing your childhood to someone else’s. Avoidance and minimization is actually one of the four symptom clusters of posttraumatic stress disorder.
“Talking about childhood means living in the past.”
The goal of inner child work is not to stay in the past. The goal is to understand how the past continues to influence the present so that you can respond differently moving forward. Inner child work actually helps us recognize the ways that we are already living in the past so that we can heal and integrate those experiences into a healthier adult self. At its core, inner child work helps us stop living in the past.
How the Phoenix Center Can Help
At the Phoenix Center for Experiential Trauma Therapy, we believe healing occurs through compassionate relationships, meaningful experiences, and developing new ways of relating to yourself and others. Our therapists integrate trauma-informed care with experiential approaches that help clients move beyond simply understanding childhood experiences intellectually. Through therapies such as EMDR, psychodrama, somatic therapy, parts work, and other evidence-based approaches, we help clients process painful memories, strengthen emotional regulation, build self-compassion, and reconnect with the resilient parts of themselves.
Every person’s story is different. Rather than following a one-size-fits-all approach, we tailor treatment to your unique history, strengths, and goals. This often includes integrating multiple modalities into your treatment experience.
Ready to Begin Healing Your Inner Child?
Healing your inner child isn’t about becoming someone different. It’s about reconnecting with the parts of yourself that have always deserved safety, compassion, acceptance, and care. If childhood experiences continue to affect your relationships, emotions, self-esteem, or daily life, you don’t have to navigate that journey alone.
The trauma therapists at the Phoenix Center for Experiential Trauma Therapy provide compassionate, evidence-based treatment to help individuals heal from childhood trauma, strengthen resilience, and create healthier, more fulfilling lives.
Contact us today to learn more about our trauma therapy services or schedule an appointment with one of our experienced clinicians.
About the Author
Blog Written by: Dr. Scott Giacomucci, DSW, LCSW, BCD, CGP, FAAETS, TEP
Dr. Scott Giacomucci, DSW, LCSW, BCD, CGP, FAAETS, TEP (he, him, his) is the Director, Founder, & Owner of the Phoenix Center for Experiential Trauma Therapy. He provides clinical services at the center as well as supervision, consultation, training, and organizational leadership. Scott’s work has been internationally recognized and he is the recipient of various awards. He frequently presents training workshops at local, national, and international events and has published various articles on using experiential methods (especially sociometry, psychodrama, and group work) in clinical, educational, community, and organizational settings. Most recently, the CEO of NASW commented in a press release that “With social work leaders such as Dr. Giacomucci on the rise I’m assured the social work profession will have an especially bright future.”
Written by: Dr. Scott Giacomucci, DSW, LCSW, BCD, CGP, FAAETS, TEP
Many people think of therapy as simply talking about problems. While talking can be an important part of healing, trauma is not stored only in our mind, it also affects our nervous system, body, and physiological responses.
If you’ve ever felt your heart race during a difficult conversation, experienced muscle tension when thinking about the past, or found yourself frozen during conflict despite knowing you were safe, you’ve experienced how emotional experiences live in the body.
Somatic therapy recognizes that healing from trauma often requires more than changing our thoughts. It also involves helping the body and our nervous system learn that the danger has passed.
At the Phoenix Center for Experiential Trauma Therapy, we integrate somatic therapy with other evidence-based trauma treatments to help individuals regulate their nervous systems, process traumatic experiences, and reconnect with a greater sense of safety, resilience, and well-being.
What Is Somatic Therapy?
Somatic therapy is a body-centered approach to psychotherapy that recognizes the close connection between the mind, brain, body, emotions, and nervous system. Rather than focusing only on thoughts or behaviors, somatic therapy helps people become more aware of their physical sensations, emotional experiences, and physiological responses while learning new ways to regulate stress and trauma.
The word somatic comes from the Greek word soma, meaning “the living body.” Somatic therapy is not massage therapy or physical therapy. It is psychotherapy that intentionally incorporates awareness of the body’s responses into the healing process. Though they are different from therapy, healing often does involve other holistic somatic approaches such as massage, reiki, reflexology, acupressure, mindfulness, and yoga.
Why Trauma Affects the Body
Trauma is not defined simply by what happened to us, it is also shaped by how our nervous system responds to overwhelming experiences. When we encounter danger, our bodies automatically prepare to survive through protective responses such as fight, flight, and freeze. These responses occur automatically and often outside of conscious awareness. Even after the danger has passed, the nervous system may continue responding as though the threat is still present. This can contribute to symptoms such as:
Chronic anxiety or depression
Hypervigilance and hyperarousal
Emotional numbness
Panic attacks
Difficulty relaxing
Muscle tension
Concentration struggles
Sleep disturbances and nightmares
Somatic flashbacks of past trauma
Digestive problems
Feeling disconnected from your body
Difficulty feeling safe in relationships
Inability to tolerate physical touch
Understanding these responses often helps people realize that their symptoms are not signs of weakness, they are adaptive survival responses that have become stuck.
What Happens During Somatic Therapy?
Somatic therapy is not about forcing people to relive traumatic experiences. Instead, somatic therapy often involves helping clients gently notice what is happening in their bodies while remaining emotionally regulated and connected to the present moment.
Depending on your needs, sessions may include:
Increasing awareness of body sensations
Identifying physical signs of stress or activation
Developing awareness of emotional states
Building tolerance for difficult emotions
Learning nervous system regulation skills
Mindfulness and grounding exercises
Breathing techniques
Cultivating safety and strength in the body
Exploring the connection between thoughts, emotions, and bodily experiences
Releasing stuck somatic energy
Integrating traumatic memories while maintaining emotional stability
Many people are surprised to discover how much information their bodies provide about stress, safety, and emotional needs.
Somatic Therapy for Trauma
Trauma often disrupts a person’s sense of safety – not only psychologically, but physically. Even when someone logically knows they are safe, their body may continue reacting as if danger is still present. Somatic therapy helps bridge the gap between intellectual understanding and physiological experience.
Rather than trying to convince yourself that you’re safe, somatic therapy helps your nervous system gradually experience safety through new emotional, relational, and bodily experiences.
Is Somatic Therapy Evidence-Based?
Research continues to demonstrate that trauma affects both the brain and the body. Many evidence-based trauma treatments already include important somatic components. For example:
EMDR helps people process traumatic memories while attending to present-moment somatic experiences and bilateral stimulation.
Psychodrama and parts work integrate movement, posture, and action into treatment.
Mindfulness-based therapies increase awareness of bodily sensations and emotional experiences.
Somatic Experiencing and Sensorimotor Psychotherapy emphasize the role of movement and body awareness in trauma recovery.
Many expressive arts therapies intentionally incorporate movement and body-based approaches.
While different somatic therapies vary in their research support, growing evidence suggests that integrating body awareness with psychotherapy can enhance trauma treatment for many individuals.
Somatic Therapy at the Phoenix Center
At the Phoenix Center, we don’t only view somatic therapy as a standalone technique. Instead, we integrate body-centered interventions into comprehensive, trauma-informed treatment based on each client’s unique needs. Depending on your goals, somatic interventions may be incorporated into:
Our therapists help clients understand the connection between their nervous system, emotions, thoughts, behaviors, and relationships while developing practical tools for emotional regulation and healing.
Who Can Benefit from Somatic Therapy?
Somatic therapy may be helpful for individuals experiencing:
PTSD or Complex PTSD
Anxiety disorders
Panic attacks
Childhood trauma
Chronic stress
Grief and loss
Emotional dysregulation
Dissociation
Burnout
Relationship difficulties
Medical trauma
High levels of nervous system activation
Because every person is different, our therapists carefully tailor treatment to your symptoms, history, preferences, and goals.
Common Misconceptions About Somatic Therapy
“Somatic therapy means I won’t talk.”
Talking remains an important part of therapy. Somatic therapy simply expands the conversation by paying attention to what is happening in your body alongside your thoughts and emotions. Somatic therapy doesn’t only focus on somatics, it also integrates other aspects of experience.
“It’s just breathing exercises.”
Breathing is helpful (and required on some level!), but somatic therapy involves much more than relaxation techniques. The goal is to help individuals better understand and regulate their nervous system while integrating difficult experiences in ways that promote lasting change. Somatic therapy involves exploring various bodily sensations related to past trauma and present day experiences while also engaging in body-based interventions to change the somatic imprints of trauma.
“The body stores trauma.”
You may hear people say that “the body keeps the score” or that trauma is “stored in the body.” While these phrases are useful metaphors and have some truth, they can oversimplify a complex process. Trauma affects the entire person – including the brain, mind, nervous system, body, emotions, beliefs, behaviors, relationships, and spirit. Somatic therapy emphasizes that healing is most effective when we address all of these interconnected systems rather than focusing on thoughts alone.
Begin Healing Through Mind and Body
Healing from trauma is not simply about understanding what happened in the past. It is about helping your entire system (mind, body, and spirit) experience greater safety, flexibility, and resilience in the present.
At the Phoenix Center for Experiential Trauma Therapy, our clinicians integrate somatic therapy with evidence-based approaches such as EMDR, psychodrama, experiential therapy, and attachment-informed treatment to provide individualized care for every client.
If you’re interested in learning whether somatic therapy or other holistic somatic healing approaches may be right for you, we’d be honored to help. Contact the Phoenix Center today to schedule a consultation and begin your journey toward healing.
Blog Written by: Dr. Scott Giacomucci, DSW, LCSW, BCD, CGP, FAAETS, TEP
Dr. Scott Giacomucci, DSW, LCSW, BCD, CGP, FAAETS, TEP (he, him, his) is the Director, Founder, & Owner of the Phoenix Center for Experiential Trauma Therapy. He provides clinical services at the center as well as supervision, consultation, training, and organizational leadership. Scott’s work has been internationally recognized and he is the recipient of various awards. He frequently presents training workshops at local, national, and international events and has published various articles on using experiential methods (especially sociometry, psychodrama, and group work) in clinical, educational, community, and organizational settings. Most recently, the CEO of NASW commented in a press release that “With social work leaders such as Dr. Giacomucci on the rise I’m assured the social work profession will have an especially bright future.”
Written by Dr. Scott Giacomucci, DSW, LCSW, BCD, CGP, FAAETS, TEP
The Connection Between Trauma and Shame: How to Break Free from Trauma-Related Shame
Trauma and shame often go hand in hand. While trauma is something that happens to us, shame has a way of convincing us that we are the problem. For many trauma survivors, the emotional wounds don’t end when the traumatic event is over. Long after the experience has passed, shame can continue shaping how we see ourselves, our relationships, and our future.
The good news is that shame is not a permanent part of who you are. It can be understood, challenged, and healed.
Why Trauma Often Leads to Shame
Trauma is, by definition, an experience that overwhelms our ability to cope. When something terrifying, abusive, or deeply painful happens, especially during childhood, our brains naturally try to make sense of it.
Children, in particular, often lack the developmental ability to understand the complex circumstances surrounding trauma. Instead, they may arrive at painful conclusions like:
“It must have been my fault.”
“I deserved this.”
“There’s something wrong with me.”
“I’m broken.”
“I’m unlovable.”
These beliefs are not facts. They are survival adaptations created by a mind trying to explain the unexplainable. Unfortunately, abusive individuals and dysfunctional family systems often reinforce these distorted beliefs, leaving survivors carrying emotional burdens that never belonged to them.
When the Shame of the Perpetrator Becomes Your Own
One of the most painful aspects of trauma is that survivors often absorb the shame of the person who caused the harm.
Psychologists sometimes describe this process as identification with the aggressor, a phenomenon in which the victim unconsciously internalizes the emotions, beliefs, and shame of the perpetrator. Instead of recognizing that the abuse reflected the actions of another person, survivors begin believing the abuse says something about who they are. This is one reason trauma-related shame can feel so deeply rooted.
Common Signs of Trauma-Related Shame
Trauma-related shame doesn’t always announce itself directly. Instead, it often shows up through patterns of thinking, feeling, and behaving.
Some common signs include:
A Harsh Inner Critic
Many trauma survivors speak to themselves in ways they would never speak to another person. Their internal dialogue becomes filled with criticism, perfectionistic demands, and relentless self-judgment.
Feeling Unworthy
Shame often creates a persistent belief that you’re undeserving of:
Love
Success
Happiness
Financial security
Healthy relationships
Freedom
Even when opportunities arise, shame may convince you that you don’t deserve them.
Avoiding Relationships or Opportunities
Shame often fuels fears like:
“If people really knew me, they’d reject me.”
“I’m too damaged.”
“I’ll just fail anyway.”
These beliefs can lead people to avoid dating, friendships, promotions, new careers, or meaningful life experiences, not because they lack ability, but because they fear exposure or rejection.
People-Pleasing and Perfectionism
Sometimes shame doesn’t lead us to withdraw, it pushes us to overcompensate. People-pleasing, perfectionism, and codependent patterns are often attempts to earn worthiness by constantly meeting other people’s expectations. When we believe we’re fundamentally flawed, perfection can become an impossible strategy for trying to feel enough.
Losing Your Sense of Self
Trauma can disconnect us from who we truly are.
Instead of living from our authentic identity, we begin defining ourselves by the messages we received during the trauma. Psychology refers to these internalized messages as introjects, beliefs that originate outside of us but become accepted as if they are our own. Healing requires recognizing these messages and asking an important question:
“Whose voice is this?”
Healing Means Changing the Narrative
Recovery isn’t about pretending trauma never happened.
It’s about recognizing that trauma is something you experienced, not the definition of who you are. When shame becomes the center of our identity, every decision gets filtered through the belief that we’re defective.
Healing involves developing a new story:
A story of resilience.
A story of recovery.
A story of growth.
The trauma remains part of that story, but it no longer defines the entire narrative.
Self-Compassion Is Essential
One of the most important skills in healing shame is learning self-compassion. Many survivors have spent years speaking to themselves with criticism, contempt, or unrealistic expectations.
Instead, try asking yourself:
How would I speak to someone I deeply love who had gone through what I’ve experienced?
You might even imagine how gently you’d care for a beloved pet. That same kindness is something you deserve as well. Self-compassion isn’t making excuses. It’s creating the emotional safety necessary for healing.
Shame Cannot Heal in Isolation
Shame thrives in silence. It grows stronger when we hide our experiences and believe we’re alone. Healing happens in safe relationships where we can be seen without judgment. Supportive therapy, trusted friendships, recovery groups, and compassionate communities provide experiences that directly challenge shame’s core message:
“If people knew the real me, they would reject me.”
When acceptance replaces secrecy, shame begins to lose its power.
Trauma Lives in the Body
Trauma isn’t stored only in our thoughts, it affects our nervous system and our bodies. Because of this, body-based approaches can be incredibly valuable in trauma recovery. Helpful interventions may include:
EMDR
Somatic therapies
Somatic Experiencing
Psychodrama
Inner child work
Breathwork
Grounding practices
Mindfulness
Yoga
Therapeutic movement and exercise
These approaches help people reconnect with their bodies, regulate their nervous systems, and process experiences that words alone often cannot reach.
Understanding the Difference Between Shame and Guilt
One of the most important shifts in recovery is learning the difference between shame and guilt.
Shame says:
“Something is wrong with me.”
Guilt says:
“I did something wrong,” or “Something wrong happened to me.”
That difference may seem subtle, but psychologically it is enormous. When we believe we are the problem, change feels impossible. When we recognize that behaviors can change, or that harmful experiences happened to us rather than defining us, hope becomes possible.
Research consistently shows that chronic shame is associated with increased risk for anxiety, depression, PTSD, substance use disorders, relationship difficulties, and many other mental health concerns. Healthy guilt, however, often supports accountability, growth, repair, and resilience.
The Shame Was Never Yours to Carry
Perhaps the most important truth to remember is this:
Healing from trauma often means letting go of shame that never belonged to you in the first place. The beliefs you formed during trauma may have helped you survive.
But they don’t have to determine the rest of your life. With support, self-compassion, and trauma-informed treatment, it is possible to release shame, reconnect with your authentic self, and move toward a life defined by healing rather than by what happened to you.
At the Phoenix Center for Experiential Trauma Therapy, we witness this transformation every day. Recovery is possible, and no one has to walk that path alone.
Dr. Scott Giacomucci, DSW, LCSW, BCD, CGP, FAAETS, TEP (he, him, his) is the Director, Founder, & Owner of the Phoenix Center for Experiential Trauma Therapy. He provides clinical services at the center as well as supervision, consultation, training, and organizational leadership.
After completing hundreds of intake calls with new clients, I can count on one hand how many times a potential client has asked this question. Many clients assume that once licensed, all therapists have the same level and type of training. This often leads to disappointment in the therapeutic process. Others believe they need a therapist with advanced training and decades of experience to heal from complex trauma or complex PTSD, which is often not true.
So, how much experience does a therapist need to be considered a “good therapist”? To answer this question, we first need to explore therapists’ formal education.
Education and Experience
In Pennsylvania, professional counselors, marriage and family therapists, and clinical social workers typically receive similar education in their post-graduate programs. They also all require internship experience before graduating with their master’s (MS, MA, MSW, or MFT). After graduation, these therapists generally receive a provisional license and must practice under the supervision of a fully licensed professional.
All therapists must acquire a certain number of direct client hours to be eligible for full licensure. For social workers, counselors, and marriage and family therapists, this often amounts to 3,000 client hours after graduation. Many times this amounts to 2-3 years of experience, working full time as a therapist, plus a year or more during internship while in school.
By the time a therapist is fully licensed, they will have three or more years of experience doing direct, face-to-face clinical work with clients.
Benefits of Working with Pre-licensed Therapists
There are many benefits to working with a pre-licensed therapist. The most noticeable difference is cost. Pre-licensed therapists tend to offer lower rates as they are working towards full licensure. During this time, they must be supervised by at least one licensed therapist. This oversight can be extremely beneficial to a client. Supervision provides another set of eyes, or ears, along with different ideas and perspectives. If a client feels stuck in the process, you have two or three therapists brainstorming and bouncing ideas off each other. Once a therapist becomes fully licensed, that therapist is often flying solo and the client loses that oversight.
If you have been in and out of therapy for most of your life, you likely understand that formal education and experience do not always guarantee positive outcomes. For instance, you might see a therapist who is fully licensed, has multiple advanced certifications, but is currently experiencing burnout or personal turmoil. This could affect their presence and empathy during sessions. Alternatively, a pre-licensed therapist who gained substantial experience during their internship, arrives ready to engage in each session, and provides you with the best therapy experience you’ve ever had.
The Benefits of a Phoenix Center Intern
At the Phoenix Center, we believe that valuable experience begins during an internship. Many of our interns have received more trauma training in their first year than the majority of licensed therapists in the field. Most licensed therapists have been trained to avoid discussing past trauma due to inexperience, it falling outside their scope of practice, or fear that it may cause further harm to a client. Many therapists completed their school/training years ago, before trauma was more fully recognized as an underlying fueling factor of many mental health disorders.
If an intern or pre-licensed therapist has received extensive training in a trauma-focused environment, they can provide quality care that meets or exceeds that of a fully licensed professional. Many of our interns pursue advanced training while on-site and are skilled in offering EMDR, psychodramatic interventions, somatic techniques, and internal family systems.
Scope of Practice & Specialties
Between a therapist’s internship and full licensure, they can begin forming their scope of practice and pursuing advanced trainings and certifications. This often delineates therapists trained in trauma therapy, DBT, or EMDR, which is typically what clients seek.
It’s important to recognize that these advanced trainings and certifications are often funded by the therapists themselves, contributing to higher hourly rates. These certified trainings can be time-consuming and costly; for example, becoming a certified psychodramatist requires 780 hours of hands-on training, potentially costing upwards of $30,000. Adding certifications in EMDR, IFS, or somatic therapy increases that expense further.
Think of these therapeutic modalities similarly to specialists in the medical field. As their specialties increase, their rates typically rise, and their availability decreases due to high demand. Unfortunately, insurance companies do not reimburse therapists at a rate that makes acquiring these advanced trainings financially feasible, leading many therapists who offer these modalities to practice out of network.
Choosing to work with a pre-licensed therapist who is actively engaged in training that aligns with your therapeutic goals can be a way to access quality care at a more affordable cost.
Which type of therapist is right for me?
The type and level of experience you prefer in a therapist is unique to your needs and expectations. Financial considerations are also essential since clients may not be able to afford out-of-network therapists. This is one reason we maintain a large intern team, allowing us to offer trauma-focused therapy at a significantly lower rate than a pre-licensed or licensed therapist.
Our interns are fully committed to their internships, often attending advanced trainings on weekends and receiving 3-4 hours of supervision per week from trained trauma professionals. All our pre-licensed therapists started as interns at our center, ensuring that even a new pre-licensed therapist has at least a year of specialty training with us.
It Starts at Intake
As the intake specialist, my goal is to ask questions that will help us determine what level of experience you might need and which member of our team aligns best with your goals and expectations. It’s essential to remember that much of the work done in therapy is based on the formation and continuation of a healthy relationship between you and your therapist. This connection should model a healthy relationship characterized by trust, respect, reliability, and accountability.
It’s within this relationship that we can begin to accept and foster healthy interactions in our lives. While training and experience are important, the relationship you develop is even more significant.
About the Author
Chris Klem is the Manager of Community Relationships at The Phoenix Center and connects with every new client to complete intake, assessment, and referrals. Chris’ main goal is to ensure every client feels seen, heard, and paired with a therapist that will help them meet their goals. Having worked in the mental health field for twenty years, Chris brings experience and compassion to every intake call. He also provides continuing education and training for organizations.
Artificial intelligence (AI) has become quite popular in recent years as it is remarkably good at answering questions, summarizing information, and even carrying on conversations that feel surprisingly human. It is now common for people to talk to AI about anxiety, trauma, relationships, grief, or depression before ever reaching out to a therapist.
While AI can be a useful educational tool or source of gathering general information (we use it as a tool too!), it is a poor substitute for psychotherapy. In some cases, relying on AI as a therapist may actually reinforce the very mental health symptoms you are trying to overcome. If you’re struggling with emotional distress, trauma, or relationship difficulties, it’s important to understand the difference between talking to AI and engaging with a trained mental health professional.
Why AI Can Feel Like a Good (Free) Therapist
There are understandable reasons why people turn to AI for emotional support. AI is available 24 hours a day. It doesn’t judge. It responds immediately. It can be accessed for free. It can validate emotions, summarize psychological concepts, and offer coping suggestions within seconds. For someone who feels isolated or overwhelmed, this can provide temporary comfort.
For many people, accessing therapy can be complicated – especially in trying to navigate complex health care systems, insurance benefits, unaffordable self-pay rates, and limited local options for therapy. Many people have had bad experiences, or even hurtful experiences, with therapists in the past which can also contribute to someone turning to AI as a therapist instead of a human therapist. For many, AI isn’t replacing therapy, it is filling a gap created by systemic failures and those realities deserve serious attention. The concern isn’t that people are using AI; my concern is when AI becomes the primary place where someone is seeking psychological healing and guidance on human relationships.
AI has access to enormous amounts of information on the internet which is pretty impressive. This can leave us with an assumption that AI is more knowledgeable than any human and thus better equipped to help us. However, AI’s responses are generated from general information on the internet and the limited text-based information that you provide it – whereas a human therapist is interacting with you based on more individualized and context-specific information while also considering the rich non-verbal communication in the session. The problem is that therapy is much more than receiving information, identifying patterns, or receiving reassurance.
Therapy Is More Than Advice
Many people assume therapy is simply receiving good advice. In reality, effective psychotherapy is built on much deeper processes than advice giving. Many of us avoid giving advice in most cases and instead focus therapy on helping clients discover their own answers to questions.
Healing often occurs through:
A genuine therapeutic relationship
Emotional attunement
Embodied somatic experiences
Corrective interpersonal experiences
Exploration of unconscious patterns
Experiential learning
Working through difficult emotions
Repairing ruptures in relationships
Building tolerance for uncertainty
Developing new ways of relating to oneself and others
These are fundamentally human processes.
An AI can simulate empathy through its responses, but it cannot genuinely experience empathy, emotional resonance, or a mutual human relationship. It cannot notice subtle shifts in body language, changes in affect, or patterns emerging across interactions in the same way an experienced therapist can.
Many therapy modalities involve complex experiential interventions, such as EMDR, psychodrama and empty chair work, and expressive arts therapies. These interventions are action-based and three-dimensional. They can’t be effectively and safely be implemented by a two-dimensional AI program through a computer screen.
AI Can Accidentally Reinforce Mental Health Symptoms
One of the biggest concerns is that AI often responds in ways that reduce immediate distress rather than promote long-term wellness or recovery. Many psychological disorders are maintained by patterns of avoidance, reassurance-seeking, compulsive checking, or distorted thinking. Unfortunately, AI conversations often unintentionally strengthen these patterns. One of the most common ways that this happens is when someone avoids asking for help or going to therapy and instead only talks to AI about their struggles.
Anxiety
People with anxiety often seek certainty. They repeatedly ask questions like:
“Do you think something is wrong with me?”
“What if this symptom means I have cancer?”
“What if I lose my job?”
Each reassuring response may temporarily reduce anxiety.
Instead of searching websites, someone experiencing health anxiety may repeatedly question AI about symptoms, diagnoses, medications, or rare illnesses. Although each conversation may temporarily reduce fear, it often increases vigilance toward bodily sensations and reinforces the belief that constant checking is necessary to stay safe. This can create an endless feedback loop of symptom monitoring and reassurance that maintains health anxiety.
Unfortunately, this teaches the brain that reassurance, not tolerance of uncertainty, is the solution. Over time, reassurance-seeking often strengthens anxiety rather than reducing it. Instead of helping someone build tolerance for uncertainty, repeated AI interactions may strengthen dependence on external validation.
Someone may begin asking AI dozens or even hundreds of questions every day, creating a digital version of an anxiety compulsion.
Obsessive-Compulsive Disorder (OCD)
For individuals with OCD, AI can become another source of compulsive reassurance. Someone may repeatedly ask:
“Are you sure I didn’t do something wrong?”
“Does this sound like OCD or psychosis?”
“Can you guarantee this won’t happen?”
Each response briefly lowers anxiety. However, evidence-based treatments for OCD, such as Exposure and Response Prevention (ERP), intentionally reduce reassurance because learning to tolerate uncertainty is what weakens obsessive-compulsive cycles.
Frequent AI reassurance may unintentionally reinforce OCD symptoms or become part of a new compulsive-driven ritual that maintains the OCD symptoms.
Depression
Many people with depression become trapped in cycles of rumination – repetitively analyzing past events, perceived failures, or negative beliefs about themselves.
AI may respond thoughtfully and compassionately, but lengthy conversations about depressive thoughts can sometimes encourage additional rumination instead of behavioral change. Depression often tricks people into believing that if they just think about the problem a little longer, they’ll finally figure it out. Unfortunately, rumination rarely produces clarity, it usually produces more rumination. Spending another hour discussing the same hopeless thoughts with AI may feel productive, but it can unintentionally deepen the habit of living in the problem rather than moving toward life outside of it.
Depression often narrows perspective and reinforces negative beliefs.
If someone consistently frames experiences through hopelessness or self-criticism, AI may respond with validation that unintentionally strengthens those beliefs without adequately challenging cognitive distortions or helping create meaningful behavioral change.
Similarly, depression often involves withdrawal from meaningful activities, relationships, work, and hobbies. Talking with AI can sometimes become another sedentary activity that replaces rather than supports real-world engagement.
While reflective conversations have value, recovery from depression often requires doing something different and taking new action, not simply thinking differently. In many recovery communities, we say that “you can’t think your way into new behaviors, you must act your way into new thinking”.
Effective therapy balances empathy with gentle challenges, accountability, and action.
Trauma, PTSD, and CPTSD
Many individuals with PTSD or CPTS have experienced ongoing interpersonal trauma, neglect, betrayal, or attachment wounds. Because relationships have been sources of pain in the past, trusting another person often feels difficult or impossible.
AI can feel safer as it is consistently available, doesn’t disappoint, and won’t reject you. While these qualities provide temporary comfort, they can also make it easier to avoid the vulnerability required for healing relationships.
Much of the healing in complex trauma occurs through experiencing a consistent, trustworthy therapeutic relationship where safety, boundaries, repair, emotional attunement, and authenticity are experienced over time. These relational experiences cannot be fully simulated through conversation with software.
For some individuals, relying primarily on AI for emotional support may unintentionally reinforce interpersonal avoidance and delay opportunities for corrective relational experiences and a more fulfilling trauma recovery journey.
Trauma recovery involves much more than talking about traumatic experiences.
It requires careful pacing, emotional regulation, nervous system stabilization, and gradually integrating traumatic memories without overwhelming the individual. Trauma therapy is a process of changing our relationships to the trauma within us.
AI cannot monitor physiological arousal, recognize dissociation, assess safety in real time, or modify interventions based on subtle changes in emotional regulation.
As a result, individuals may repeatedly revisit traumatic memories without adequate preparation, containment, or integration. In some cases, repeatedly recounting trauma without processing it may strengthen traumatic memory networks rather than transforming them.
Trauma work requires a therapist who can recognize when someone is becoming overwhelmed, emotionally shut down, or disconnected from the present moment. Trauma recovery involves developing new emotional, relational, and physiological experiences – not simply generating more words about painful events and receiving validation.
AI Will Tell You What You Want to Hear
Another concern is that AI is generally designed to be helpful, agreeable, and cooperative. While this usually improves user experience, it can reinforce existing beliefs rather than gently challenging them. Even when you ask AI not to only tell you what it thinks you want to hear, it will eventually revert back to doing so.
Therapists routinely ask difficult questions, notice inconsistencies, help clients recognize blind spots and carefully confront avoidance. Sometimes growth comes from hearing something that is uncomfortable, but necessary.
If every interaction with AI (or a therapist) simply confirms your current perspective, emotional growth will be limited.
Where AI Can Be Helpful
None of this means AI has no role in mental health or should be avoided completely. AI can be useful for many things including:
Learning about mental health conditions
Understanding therapy concepts
Practicing mindfulness exercises
Organizing thoughts before therapy
Journaling prompts
Psychoeducation
Identifying questions to ask a therapist
Reviewing coping skills between sessions
Summarizing notes after therapy (while protecting privacy)
Used this way, AI functions best as an educational assistant, not as a therapist. Though be sure to instruct AI to only get info from reputable sources, otherwise it will take any information from the internet (including teenagers’ reddit conversations) and present it to you as factual information.
AI is a Bad Therapist, but a Good Therapy Tool
While AI may provide comfort, information, or temporary reassurance, it cannot replace the depth of human connection, clinical judgment, emotional attunement, ethical responsibility, or relational healing that psychotherapy offers. In some situations, frequent reliance on AI for reassurance or emotional support may actually strengthen anxiety, OCD, PTSD, avoidance, or other mental health symptoms by reinforcing the patterns that keep those conditions alive.
It’s worth noting that these concerns aren’t even unique to AI. The same processes can occur with Google searches, Reddit forums, online mental health communities, well-meaning family members, or poorly trained therapists who provide endless reassurance while avoiding uncomfortable conversations or providing new corrective experiences. AI simply reinforces these patterns faster and in a way that is accessible at all times.
If you’re struggling with trauma, anxiety, depression, or relationship difficulties, AI may be a helpful supplement for learning and personal growth, but it should not replace working with a qualified mental health professional.
About the Author:
Dr. Scott Giacomucci, DSW, LCSW, BCD, CGP, FAAETS, TEP (he, him, his) is the Director, Founder, & Owner of the Phoenix Center for Experiential Trauma Therapy. He provides clinical services at the center as well as supervision, consultation, training, and organizational leadership.
Many people are familiar with Post-Traumatic Stress Disorder (PTSD), but fewer have heard of Complex PTSD (CPTSD). While PTSD often develops following a single traumatic event, Complex PTSD typically results from repeated, prolonged, or interpersonal trauma. Experiences such as childhood abuse or neglect, domestic violence, chronic bullying, emotional abuse, identity-based trauma, community violence, or other long-term adverse experiences can contribute to the development of CPTSD.
If you struggle with persistent anxiety, depression, shame, emotional overwhelm or numbness, relationship difficulties, low self-worth, or feeling disconnected from yourself and others, you might be experiencing Complex PTSD. Fortunately, effective treatment is available.
What Is Complex PTSD?
Complex PTSD includes the same symptoms associated with PTSD, such as intrusive memories, nightmares, hypervigilance, avoidance, dissociation, and emotional distress related to past experiences. However, CPTSD also affects how people view themselves, manage emotions, and relate to others.
Common symptoms of Complex PTSD include:
Difficulty regulating emotions
Emotional numbness or disconnection
Negative beliefs about self
Persistent feelings of shame, guilt, or worthlessness
Difficulties trusting others
Relationship struggles
Feeling stuck in survival mode
Chronic anxiety or depression
Many individuals with CPTSD have spent years adapting to difficult environments. The coping strategies that once helped them survive may now interfere with their ability to fully engage in life, relationships, work, and personal growth.
Why Complex PTSD Requires Specialized Treatment
Complex PTSD is not simply a collection of symptoms. It reflects the impact that repeated trauma can have on a person’s nervous system, identity, relationships, and worldview. Healing requires more than simply reducing the negative effects of the trauma – it must also include a focus on building a life in trauma recovery and cultivating growth after trauma. Effective treatment addresses both the traumatic experiences themselves and the ways those experiences continue to shape present-day thoughts, emotions, behaviors, and relationships.
Treatment needs to be tailored to each person’s unique experiences, strengths, goals, and identity. There is no one-size-fits-all approach.
Effective Experiential Treatments for Complex PTSD
EMDR Therapy
Eye Movement Desensitization and Reprocessing (EMDR) is one of the most researched trauma therapies available. EMDR helps individuals process traumatic memories that may continue to contribute to emotional distress, negative beliefs, and survival-based reactions. Rather than repeatedly talking about traumatic experiences, EMDR helps the brain reprocess and integrate difficult memories so they become less emotionally overwhelming and disruptive.
The EMDR process includes developing internal resources to cope with difficult emotions, processing past traumatic memories, desensitizing present-day triggers, and creating a vision for the future about how to respond differently in previously triggering situations.
When engaging in EMDR therapy, it is important to work with a professional who truly understands complex trauma and CPTSD. The EMDR process will need to be modified slightly to reduce risks of overwhelm and harm while increasing effectiveness in addressing CPTSD.
Somatic Therapy
Complex trauma affects the nervous system and the body. Learning to recognize physical sensations, regulate activation, and reconnect with the present moment can be an important part of recovery.
Somatic and mindfulness-based interventions help individuals develop greater awareness, emotional regulation, and a sense of safety within themselves. Somatic therapy helps one to befriend and reclaim their body while accessing the deep wisdom within it.
Psychodrama
Trauma is often stored not only in our thoughts but also in our emotions, bodies, and relationships. Psychodrama and experiential therapies provide opportunities to work with these deeper levels of experience. Approaches such as psychodrama, role-playing, guided imagery, empty-chair work, and other action methods can help individuals:
Access emotions that are difficult to express verbally
Explore unfinished experiences
Practice new roles and behaviors
Strengthen internal resources
Create corrective emotional experiences
Experience closure around past losses
For many individuals with CPTSD, experiential approaches can facilitate healing that goes beyond intellectual understanding.
Parts Work and Internal Family Systems (IFS) Therapy
Many individuals with Complex PTSD experience conflicting thoughts, feelings, and reactions within themselves. One part of self may desperately want connection, while another part fears being hurt and wants to avoid connection. One part may remind us of our worth, while another part feels overwhelmed, ashamed, or hopeless. Parts work approaches, including Internal Family Systems (IFS) therapy, help individuals understand and compassionately relate to these different aspects of self.
Rather than viewing these internal conflicts as signs of dysfunction, parts work recognizes that many parts developed to help a person survive difficult experiences. Through therapy, individuals learn to connect with wounded parts carrying pain from the past while also understanding the protective parts that have worked hard to prevent further harm. This process can foster self-compassion, emotional healing, and a greater sense of internal harmony. Parts work and IFS can help trauma survivors move beyond survival mode and toward a more integrated and authentic sense of self.
Group Therapy and Support Groups
One of the most painful consequences of complex trauma is disconnection, betrayal, and harm from others. Many trauma survivors learn that relationships are unsafe, unpredictable, or disappointing.
Trauma-informed group therapy can provide opportunities to build trust, receive support, practice vulnerability, and experience healthy connection. Through relationships with group members and therapists, individuals often discover new ways of relating to themselves and others.
Nobody heals from trauma alone. Community and relationships are essential in the trauma recovery process. Therapy groups and support groups offer trauma survivors a sense of solidarity and comradery while reducing shame and stigma.
Healing Must Go Beyond Talking about the Trauma
While addressing the trauma and traumatic stress symptoms are important, treatment for Complex PTSD is about much more than simply feeling less anxious or less depressed.
Healing often involves:
Developing a stronger sense of self
Building healthier relationships and community
Establishing boundaries
Increasing emotional flexibility
Reconnecting with personal strengths
Cultivating meaning and purpose
Moving from survival to growth
Recovery does not mean forgetting what happened. It means reducing the power that past experiences have over your present life.
There Is Hope for Recovery
Many individuals living with Complex PTSD believe they are permanently damaged or broken. In reality, many of the struggles associated with CPTSD reflect understandable adaptations to overwhelming experiences.
With appropriate support, people do heal from complex trauma, develop new ways of relating to themselves and others, and create meaningful lives beyond survival.
If you are struggling with the effects of Complex PTSD, working with a trauma-informed therapist can help you better understand your experiences and identify treatment approaches that support your goals for healing and growth.
Dr. Scott Giacomucci, DSW, LCSW, BCD, CGP, FAAETS, TEP (he, him, his) is the Director, Founder, & Owner of the Phoenix Center for Experiential Trauma Therapy. He provides clinical services at the center as well as supervision, consultation, training, and organizational leadership.
Have you ever wondered why some people become anxious, shut down emotionally, lash out in anger, or feel constantly on edge after difficult experiences? These reactions are often referred to as trauma responses – our mind and body’s natural attempts to survive overwhelming situations.
While trauma responses can be confusing or frustrating, they are not signs of weakness or personal failure. In fact, many trauma responses began as adaptive survival strategies that help us cope with experiences that felt dangerous, overwhelming, or inescapable.
Understanding our trauma responses can reduce shame or self-blame, increase self-awareness, and provide a roadmap for healing.
What Is a Trauma Response?
A trauma response is the way the brain, body, emotions, and behaviors react during or after a traumatic experience. These responses are driven by our nervous system’s primary goal: survival. Trauma responses are our innate defenses and protection against adversity. Trauma responses are activated in response to both external danger (violence, loud noises, predators, etc.) and internal threats (thoughts, feelings, sensations, flashbacks, etc.).
When the brain perceives danger, it automatically activates protective responses long before we have time to consciously think about what is happening. These reactions can be lifesaving during an actual emergency. However, after trauma, the nervous system may continue responding as though danger is still present – even when the threat has long passed. For many people, trauma responses become patterns that continue long after the traumatic experience has ended and they tend to disrupt our ability to be the best that we can be in our lives and relationships.
Why Do Trauma Responses Develop?
Our brains are designed to keep us alive, not necessarily to keep us comfortable or happy.
During overwhelming experiences, the brain and nervous system automatically responds. Sometimes fighting back is the safest option. Other times escaping, freezing, submitting, or emotionally disconnecting may increase the chances of survival. The nervous system remembers these strategies. If future situations resemble past danger, even in subtle ways, the brain may automatically activate the same survival responses.
Common Trauma Responses
Although everyone’s experience is unique, trauma responses often fall into several broad patterns. While there are various other trauma responses that we might develop, these are four of the most commonly discussed trauma responses. These responses are elicited at in the moment of real or perceived danger, but often continue to be triggered in response to the internalized trauma, long after the traumatic event has ended.
Flight
The flight response focuses on escaping danger and removing ourselves from the situation.
Signs of a flight response may include:
Restlessness and anxiety
Difficulty relaxing, concentrating, or sleeping
Increased adrenaline or energy in the legs
Intense feelings of avoidance
If we can’t diffuse a threat through social interaction, our first attempt at restoring a sense of safety for ourselves will naturally be a flight response.
Fight
The fight response prepares the body to confront incoming danger.
Someone in a fight response may:
Physically defend themselves or attack the incoming danger
Become angry or irritable
Be verbally argumentative or defensive
Attempt to control situations
Experience muscle tension or increased energy
While these behaviors may seem aggressive, they often reflect a nervous system attempting to create safety.
Freeze
The freeze response occurs when fighting or escaping does not seem possible.
People experiencing freeze may notice:
Feeling emotionally numb
Difficulty making decisions
Dissociation
Feeling “stuck” or shut down
Freeze is often misunderstood as laziness or lack of motivation when it is actually a protective nervous system response. Many trauma survivors blame themselves for not fighting back or fleeing during the moment of trauma, but what often has occurred is the nervous system has shut down to protect itself. Understanding this can help work through feelings of self-blame or shame.
Fawn
The fawn response involves increasing safety through pleasing, appeasing, or accommodating others. This was a later addition to the “flight, fight, and freeze list” and is not exactly wired into the nervous system in the same way as the others.
Examples related to a fawn response may include:
Enmeshment and codependency
Difficulty saying no
People-pleasing
Avoiding conflict
Ignoring personal needs
Feeling responsible for other people’s emotions
Befriending or idolizing someone who was hurtful
Fawning often develops in environments where maintaining relationships is essential for survival. One way to think about it is in the context of a boxing match – the safest place in a boxing ring is hugging your opponent so they can’t hit you as easily.
Trauma Responses Affect More Than Behavior
Trauma responses influence nearly every aspect of a person’s functioning including the body, emotions, the mind, and relationships.
Physical Trauma Responses
Trauma and traumatic stress may contribute to:
Increased heart rate or heart problems
Muscle tension
Fatigue
Headaches
Digestive problems
Breathing issues
Cancer
Chronic pain
Sleep difficulties
Somatic flashbacks
The body often continues carrying the effects of trauma long after the events have ended. If our nervous system is in a constant state of stress and activation due to ongoing or past trauma, the body doesn’t have the time it needs to rest and repair, which can cause negative effects on different systems in the body.
Emotional Trauma Responses
Common emotional reactions include:
Anxiety or fear
Shame or worthlessness
Guilt or self-blame
Sadness or grief
Anger or Irritability
Emotional numbness
Emotions may feel overwhelming or difficult to access altogether in the moment of trauma or in the aftermath of trauma. Traumatic stress leaves us with various complex and intense emotions resulting from the experience of harm.
Cognitive Trauma Responses
Trauma can affect thinking by contributing to:
Difficulty concentrating
Memory problems
Racing thoughts
Intrusive memories or images
Negative self-beliefs
Distorted beliefs about others or about the world
The brain becomes increasingly focused on detecting potential threats in the environment or in relationships, which impacts our capacity for other cognitive processes. The acute stress associated with trauma can also disrupt or fragment the brain’s ability to create and store memories.
Relational Trauma Responses
Trauma frequently impacts relationships through:
Difficulty trusting others
Fear of abandonment
Avoidance of intimacy
Conflict in relationships
Social withdrawal
Challenges setting healthy boundaries
Repetition of harmful relationships
Because many traumatic experiences occur within relationships, healing often involves rebuilding a sense of relational safety.
Are Trauma Responses Always Caused by Trauma?
Not every emotional reaction or coping strategy is a trauma response. Stress, personality, temperament, mental health conditions, and life experiences all influence how people respond to challenges. However, when reactions seem disproportionate, automatic, repetitive, or difficult to control, particularly following overwhelming experiences, they may reflect adaptations that developed in response to trauma. A comprehensive assessment by a trauma-informed mental health professional can help determine what factors are contributing to someone’s symptoms.
Can Trauma Responses Change?
Yes! One of the most encouraging findings from trauma research is that the brain and nervous system remain capable of change throughout life. Healing does not mean forgetting what happened. Instead, it often involves helping the nervous system learn that the danger has passed and developing new ways of responding to stress in the present and in the future.
Treatment or support to help address trauma responses may include:
As healing occurs, many trauma responses become less intense, less frequent, and easier to recognize before they take over.
A Trauma-Informed Perspective
Trauma-informed care encourages us to view symptoms through a different lens.
Instead of asking: “What’s wrong with this person?” we begin asking: “What happened to this person?” and perhaps even more importantly, “How did these responses help them survive?”
Many behaviors that appear problematic today were once useful adaptations to overwhelming circumstances. Recognizing this can replace shame with curiosity and self-compassion.
A trauma response is the mind and body’s natural reaction to overwhelming experiences. Whether someone fights, flees, freezes, fawns, or experiences another survival strategy, these responses are rooted in the nervous system’s attempt to promote safety.
Understanding trauma responses can help people make sense of their experiences, reduce self-blame, and recognize that healing is possible. With the right support, the same nervous system that learned to survive can also learn to feel safe, connected, and resilient once again.
Dr. Scott Giacomucci, DSW, LCSW, BCD, CGP, FAAETS, TEP (he, him, his) is the Director, Founder, & Owner of the Phoenix Center for Experiential Trauma Therapy. He provides clinical services at the center as well as supervision, consultation, training, and organizational leadership.
If you’ve recently come across the term CPTSD, you may be wondering what it means and how it differs from PTSD or Post-Traumatic Stress Disorder. CPTSD stands for Complex Post-Traumatic Stress Disorder, a condition that can develop after prolonged, repeated, or multiple traumatic experiences. While PTSD and CPTSD share many symptoms, CPTSD includes additional difficulties that often emerge when trauma occurs within relationships or over extended periods of time. CPTSD is a result of complex trauma which frequently occurs in childhood, creating layers to the traumatic experience and impacting us a bit differently than when we experience adversity as adults.
Understanding what CPTSD stands for is an important first step toward recognizing the impact that complex trauma can have on your emotions, relationships, sense of self, and overall well-being.
Breaking Down the Acronym CPTSD
C = Complex
The word complex refers to the nature of the traumatic experiences that contribute to the condition. Unlike a single traumatic event, complex trauma often involves repeated exposure to overwhelming stress over months or years. It is often associated with repeated or prolonged situations where a person feels trapped, powerless, or unable to escape.
Examples of experiences associated with complex trauma may include:
The term “complex” does not mean that recovery is impossible. Rather, it acknowledges that the effects of prolonged trauma often impact multiple areas of a person’s life. Not everyone who experiences these situations develops CPTSD. Factors such as support systems, resilience, protective relationships, and access to treatment can influence outcomes.
PTSD = Post-Traumatic Stress Disorder
Post-Traumatic Stress Disorder (PTSD) is a mental health condition that can develop after experiencing or witnessing a traumatic event. Common PTSD symptoms include:
Intrusive memories or images
Nightmares and flashbacks
Hypervigilance or feeling constantly on guard
Avoidance and dissociation
Difficulty sleeping or concentrating
Increased startle response or difficulty with physical touch
Emotional distress when reminded of the trauma
Negative beliefs about self or others
Negative moods
These symptoms are often related to how the brain and body respond to perceived danger, even long after the traumatic event has ended.
How Is CPTSD Different from PTSD?
People with CPTSD experience the core symptoms of PTSD, but they also struggle with additional challenges related to emotions, relationships, and identity. These additional symptoms are referred to as disturbances in self-organization (DSO) and include:
Emotional Dysregulation
Individuals may struggle with emotional numbness or intense emotions that feel difficult to manage, including anxiety, sadness, shame, self-blame, anger, worthlessness, fear, and terror. Some people experiencing CPTSD feel overwhelmed by emotions, while others feel disconnected from them altogether.
Negative Self-View
Many individuals with CPTSD develop deeply ingrained beliefs such as:
“I’m broken.”
“I’m not good enough.”
“I can’t trust myself.”
“Everything is my fault.”
These beliefs often originate from traumatic experiences, especially when trauma occurred during childhood or within important relationships. These are often beliefs that we take on to try to make sense of the trauma as a child or beliefs that we learned from a perpetrator.
Relationship Difficulties
When trauma occurs in relationships, it can shape expectations about safety, connection, and intimacy. Complex trauma can significantly impact how people connect with others. Individuals with CPTSD may:
Struggle to trust others
Fear abandonment
Have difficulty setting boundaries
Feel isolated or disconnected
Repeatedly find themselves in unhealthy relationships
Is CPTSD an Official Diagnosis?
CPTSD is recognized as a distinct diagnosis in the International Classification of Diseases (ICD-11) published by the World Health Organization. In the United States, the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR) currently does not include CPTSD as a separate diagnosis. However, many trauma therapists, researchers, and survivors find the concept helpful because it captures experiences that are not always fully explained by PTSD alone. As research on trauma continues to evolve, awareness and understanding of CPTSD has also grown significantly.
Can CPTSD Be Treated?
YES! Recovery from CPTSD is possible, and many people experience significant improvements with effective treatment and support. Treatment may include:
Treatment often focuses not only on processing traumatic memories but also on building emotional regulation skills, strengthening relationships, increasing self-compassion, reconnecting with personal strengths, and cultivating a life in recovery.
A Trauma-Informed Perspective
One of the most important things to understand about CPTSD is that many symptoms make sense when viewed through the lens of survival. Behaviors and reactions that may seem confusing or problematic today often developed as adaptive responses to overwhelming experiences in the past. Rather than asking, “What’s wrong with me?” a trauma-informed approach encourages people to ask, “What happened to me?” and “How did I learn to survive?” Understanding the meaning behind symptoms can reduce shame and create new opportunities for healing and growth.
If you recognize these patterns in yourself or someone you care about, know that help is available. Healing from complex trauma is not about erasing the past, it’s about developing new ways of understanding yourself, building supportive connections, and creating a life that is no longer defined by trauma.
Dr. Scott Giacomucci, DSW, LCSW, BCD, CGP, FAAETS, TEP (he, him, his) is the Director, Founder, & Owner of the Phoenix Center for Experiential Trauma Therapy. He provides clinical services at the center as well as supervision, consultation, training, and organizational leadership.
“I can’t say enough positive statements about the training that Dr. Giacomucci has provided our teams- unparalleled. It elevated their skillset, quality of treatment, and confidence as clinicians in providing a modality that facilitates participation in treatment. I also believe it strengthened our cohesion as a team. We are extremely proud of the product (clinical services) we deliver.”
June 2025: Growth from Vicarious Trauma and Burnout: An Experiential Workshop
“Exceptional invitation to experience high-level training in experiential therapy.”
July 2025: Trauma-Informed Psychodrama Supervised Practice
“This was a great training and provided lots of opportunity to explore structures and interventions to use with a great amount of support. Learning the spontaneity exercises were very helpful and needed. As always, Dr. Scott was amazing and encouraged creativity.”
7/2025: Psychodramatic Explorations of Spiritual/Archetypal Roles and Intrapsychic Dimensions
“Wonderful! Flow, process, material, exercises were perfect and led to great learning.”
