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Data:
Session duration: 50 minutes. Location: therapist's office. Client presented with concerns about working on trauma but expressed fear of discussing it in detail, stating, "I don't think I can handle going through it all again." Client reported symptoms of nightmares, flashbacks, and hypervigilance, and expressed worry that retelling the trauma story might worsen these symptoms. Therapist reassured client that trauma healing does not require reliving the pain and introduced a stabilization-first approach, which focuses on present symptoms and building resources. Client identified crowded places and sudden loud noises as present-day triggers. Client described her grandmother's garden as a safe place and worked on building this image for use as an anchor during triggering moments. Nervous system regulation work included practicing slow breathing and noticing calm or neutral sensations in the body.
Assessment:
Client appears motivated to work on trauma but is apprehensive about discussing it in detail. Client responded positively to the stabilization-first approach and seemed relieved by the plan to focus on safety and regulation before processing trauma narratives. Client engaged well in identifying triggers, creating a safe place visualization, and practicing regulation techniques, indicating progress toward building internal resources.
Plan:
Client will practice safe place visualization daily and track triggers without judgment. Therapist and client will continue working on stabilization and regulation techniques in future sessions. Trauma processing may be introduced when client feels ready and sufficiently resourced. 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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