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Behavior:
Client expressed a desire to work on trauma but shared fear about discussing it in detail, stating, "I don't think I can handle going through it all again." Client reported experiencing symptoms including nightmares, flashbacks, and hypervigilance. Client identified crowded places and sudden loud noises as present-day triggers. Client appeared relieved when reassured that trauma healing does not require reliving the pain.
Intervention:
50-minute session held in the office. Therapist explained a stabilization-first approach, focusing on current symptoms and resource-building before addressing trauma narratives. Therapist guided client in identifying present-day triggers and facilitated a safe place visualization exercise, with client describing her grandmother's garden. Nervous system regulation techniques, including slow breathing and body awareness, were practiced.
Response:
Client appeared relieved by the stabilization-first approach and stated she feels like she can "actually do this now." Client engaged in the exercises and demonstrated the ability to describe her safe place in detail. Client showed understanding of the techniques and appeared motivated to continue building resources.
Plan:
Client assigned homework to practice safe place visualization daily and track triggers without judgment. Therapist and client will continue focusing on stabilization and regulation in future sessions. Next session scheduled for next week.
We had a 50-minute office session today. Nina came in and said she's been wanting to work on her trauma, but she's really scared of having to talk about it in detail. She said quote 'I don't think I can handle going through it all again' unquote. She's been having symptoms, nightmares, flashbacks, hypervigilance, but the idea of retelling the story feels overwhelming, and she's worried it'll make things worse.
I reassured her that trauma healing doesn't have to mean reliving the pain. We can work on the symptoms and help her feel safer in her body without doing intensive trauma narrative work. I explained that we'd use a stabilization-first approach, focusing on what's happening for her now and building up her resources before we ever go near the details. She seemed really relieved to hear that.
We started by identifying her present-day triggers, situations, sounds, smells, or feelings that set off the trauma response. She said crowded places and sudden loud noises are big ones. Then we worked on resourcing, I asked her to think of a place, real or imagined, where she feels completely safe. She described her grandmother's garden, and we spent some time building that image in detail so she could use it as an anchor when she feels triggered. We also did some nervous system regulation work, practicing slow breathing and noticing where she feels calm or neutral in her body, so she can start to build a sense of safety from the inside out.
Her homework is to practice going to her safe place visualization once a day, and to notice her triggers this week without judgment, just tracking them. We'll keep working on stabilization and regulation, and we won't move into trauma processing until she feels ready and resourced enough. She said she feels like she can actually do this now. We'll meet again next week.
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