One of the biggest barriers to starting trauma therapy is not knowing what will happen. Many people picture themselves sitting across from a therapist, being asked to recount the worst moments of their life in vivid detail, becoming overwhelmed, and leaving feeling worse than when they arrived. This fear keeps people stuck for months, sometimes years, putting off the very thing that could help.
The reality of modern trauma therapy is quite different. You will not be asked to dive into the trauma in your first session. You will not be forced to describe things you are not ready to talk about. And the process is designed to help you feel more in control, not less.
Therapy Happens in Phases
Most evidence-based trauma therapies follow a phased approach. This structure exists precisely because processing trauma requires preparation. Asking someone to revisit painful memories without first building the right foundations would be neither safe nor effective. The three phases are: stabilisation, processing, and integration.
Phase One: Safety and Stabilisation
Your first few sessions are about building a foundation. Your therapist will want to understand what you are experiencing now, how the trauma is affecting your daily life, and what your goals are. There is no pressure to go into the details of what happened.
During this phase, you will also develop practical strategies for managing distress. These might include grounding techniques that bring you back to the present when you feel pulled into a memory, breathing exercises for moments of high anxiety, and ways to create a sense of safety between sessions. These are not just warm-up exercises. They are genuine clinical tools that you will use throughout therapy and beyond.
This phase also establishes something that matters deeply in trauma work: pace. You and your therapist agree on how to move forward together. Nothing happens without your input and consent. If something feels too much, you say so, and the approach is adjusted.
Phase Two: Processing the Trauma
Once you feel stable and equipped, the active trauma work begins. This is where the specific therapy approach makes a difference.
EMDR (Eye Movement Desensitisation and Reprocessing) uses bilateral stimulation, typically guided eye movements or tapping, to help your brain reprocess traumatic memories. During an EMDR session, you bring a distressing memory to mind while following the bilateral stimulation. Over the course of several sets, the memory gradually loses its emotional intensity. Many people describe the memory as becoming more distant, like watching something on a screen rather than reliving it.
One thing that surprises people about EMDR is that you do not need to describe the trauma in detail. Your therapist guides the process, but the reprocessing happens internally. This makes EMDR particularly well suited for people who find talking about their experiences extremely difficult.
Trauma-focused CBT works differently but is equally effective. It helps you make sense of what happened, identify the beliefs that formed around the trauma (such as “it was my fault” or “I am not safe anywhere”), and gradually test and update those beliefs. CBT also addresses avoidance, helping you re-engage with situations, places, or activities you have been steering clear of because they trigger distressing memories.
Both approaches are recommended by NICE as first-line treatments for PTSD.
Phase Three: Integration and Moving Forward
The final phase of therapy focuses on consolidating what you have gained. By this point, the traumatic memories typically carry far less emotional charge. You may still remember what happened, but it no longer hijacks your body or your day.
Integration is about rebuilding. It might involve reconnecting with parts of your life that the trauma pushed you away from, developing confidence in your ability to cope, and recognising how far you have come. For some people, this phase also involves making sense of how the experience has shaped them, not in a way that minimises the pain, but in a way that allows them to move forward.
Common Fears, Honest Answers
“Will I have to tell you everything that happened?” No. Particularly with EMDR, you can process traumatic memories without narrating them. With CBT, your therapist will work with you to decide what to focus on and how much detail is helpful. You are always in control of what you share.
“Will it make things worse before it gets better?” Some people notice that their awareness of trauma-related feelings increases in the early stages of processing. This is a normal part of the work, not a sign that something is going wrong. Your therapist will help you manage this, and the stabilisation skills from phase one are there for exactly this reason.
“How long does it take?” Many people notice meaningful improvement within 8 to 12 sessions. The exact timeline depends on the nature of the trauma, how long ago it occurred, and whether there are multiple traumatic experiences to address. Your therapist will give you an honest estimate early on.
Starting Does Not Mean Rushing
The phased approach exists because your safety and sense of control matter at every stage. A good trauma therapist will never push you faster than you are ready to go. The goal is not to “get through it” as quickly as possible. It is to help you process what happened in a way that reduces its hold on your present life.
If you have been putting off trauma therapy because you are not sure what it involves, get in touch to book a free 15-minute consultation. We can talk through your concerns and help you decide if it is the right time.
