The Quiet Anxiety Therapists Can Have About Trauma Work and What Rewind Trauma Therapy Changes
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- 7 min read
There is something a lot of therapists never say out loud but after a few cups of tea at a CPD day, or in supervision, it sounds something like this:
I think I'm okay with most things, but I get a bit nervous when someone walks into my therapy room with trauma though.
If that connects with you in any way, you are in very good company. In over a decade of counselling, training and supervising, I have lost count of the number of experienced, competent, kind counsellors and psychotherapists who have told me some version of the same thing. They are not new to the work and they are not careless. They are people who care very deeply about doing right by their clients, and that care is exactly what can make trauma work feel a bit overwhelming at times.
This is for you if you have ever felt out of your depth with a PTSD client, quietly avoided trauma referrals, or wondered whether your training really equipped you for what you are now hearing in the room.
Trauma Is Already In Your Caseload
One of the things I notice when I run training is how often therapists describe trauma symptoms in their clients without using the word trauma. They talk about the client who cannot sleep, the one who is hypervigilant at work, the new mother who keeps replaying the birth, the man who has never quite been the same since the accident, the child struggling with emotional regulation after difficult early experiences, or the woman who freezes when her partner raises his voice and cannot explain why.
These are not unusual presentations, they are some of the most common things we see. The intrusive recall, the avoidance, the numbing, the irritability that nobody can quite account for. Trauma is rarely the reason someone books their first session, but it is very often what we end up sitting with by session four or five.
So the question is not really whether we work with trauma. The question is whether we feel equipped when we realise that is what is in front of us.
Why Many Therapists Feel Anxious About Trauma Work
When I ask therapists honestly what holds them back, the answers tend to cluster in a few places.
Fear of making things worse. This is the big one. The worry that asking the wrong question, going too deep too fast, or pressing on a detail will tip a client into something they cannot manage. Re-traumatisation is a real clinical concern, and it is right that we take it seriously. It is also, sometimes, a fear that grows in proportion to how little practical training we have actually had.
Imposter syndrome. Many therapists feel that trauma is a specialism, something other people do, people with extra letters after their name and more years on the clock. I think that core counselling training across the UK gives most of us a thoughtful, ethical grounding and very little hands-on trauma practice. That needs to change and improve.
Fear of being overwhelmed yourself. Sitting with another person's worst moments is not a small thing. Vicarious trauma and compassion fatigue are well documented, and most of us have at some point ended a working week feeling hollowed out by what we have heard. The fear of taking that home, of carrying it into the next client, of finding ourselves changed by it, is legitimate.
Not knowing what to do with what comes up. Several therapists have said to me, I can listen to the story, but then I don't feel like I know what to do. They tell me what happened but I don't know how to actually help them move through it. That is not a confidence problem, that is a tools problem.
When you put those things together, it is not surprising that some therapists quietly steer clients toward other practitioners, stay with stabilisation work indefinitely, or feel a flicker of dread when the words flashback, panic attack or nightmare come up.
What UK Therapists Offer
The therapies most commonly recommended for PTSD in the UK include trauma-focused CBT and EMDR. Both are evidence-based, both are valuable, and both ask quite a lot of the client and the therapist. They tend to involve repeated, detailed engagement with the traumatic material. For some clients, that is exactly right but for others, it is the very reason they do not begin treatment, or drop out part way through.
Research has been very honest about this. A 2018 meta-analysis in JAMA found that reductions in PTSD symptoms across the main evidence-based therapies were, in the authors' own words, relatively modest. Other reviews have flagged the same pattern, alongside the high dropout rates in trauma-focused work.
Olff and colleagues, writing in the European Journal of Psychotraumatology, said there is an urgent need for more effective treatments. I share that not to criticise CBT or EMDR. They have helped many people, including clients of mine, but the research matters. We do not yet have a treatment that works for everyone, and that means it is reasonable, even necessary, to know more than one way of working.
What Rewind Trauma Therapy Is
Rewind Trauma Therapy was developed by Dr David Muss, who first published the technique in the British Journal of Clinical Psychology in 1991. It is a structured, brief intervention that works through what researchers describe as memory reconsolidation. In plain English, it helps the brain reprocess a traumatic memory so that it no longer triggers the same fear response through a visualisation technique.
Closure Without Disclosure, And Why It Matters
In Rewind, we talk about the option of closure without disclosure. This means that the client does not have to share the event with us in detail in order to be helped. They can hold their memories privately and still have successful treatment. Many clients do want to talk about what happened, but for others, words feel impossible or simply too overwhelming at that point.
The woman who has never spoken about what happened in her marriage. The veteran who cannot find words for what they saw. The survivor of childhood abuse whose memories are fragmented and somatic rather than narrative. The court witness who has been told not to discuss the case while proceedings are ongoing. The man whose shame about what happened has kept him out of every therapy room he ever considered.
For these clients, doing Rewind as a closure without disclosure treatment can be an incredibly helpful option.
Why I Trained In It Myself
I share with trainees that I had Rewind as a client before I started practising it professionally. A combination of life events left me with complex PTSD. I was functioning, but I was not living. I was getting triggered by conversations, films and news headlines. I was having nightmares, panic attacks and flashbacks. I was isolating, dissociating, and quietly believing this was simply how life was going to feel from now on.
I had four years of therapy before I had the treatment. The counselling and therapy I had before Rewind was good, with experienced and compassionate therapists, although like many people I also had one or two difficult experiences along the way. I learned a great deal, but underneath it all I was still living in fight, flight or freeze.
I went along to a training event with Dr Muss and volunteered to have Rewind, and it honestly gave me my life back. I do not share that to tell anyone Rewind will do for them what it did for me, every client is different. I share it because it changed how I viewed trauma and how I work with trauma clients now.
I know, what it feels like to be the person who has tried everything and is resigned to thinking this is simply how life is now. Wondering whether anything will ever help. And I also know what it feels like when the worst experiences of your life no longer affect you in the same way. That you can stop feeling resigned and hopeless. That is the experience I bring to training and part of why I feel so passionately about this work.
Rewind gives you a clear, replicable and structured method that you can use when a client says, I had this experience and it's affecting my life. What I commonly see change for the therapists I train, is the relationship with the work itself. When you know you have something concrete to offer, you stop quietly hoping trauma will not turn up on your books. You stop steering away from PTSD intake calls and you begin to feel more confident in your toolkit.
Why Trauma CPD Matters Even If You Do Not Want To Specialise
You do not have to call yourself a trauma therapist to need good trauma training. Trauma symptoms walk into general practice rooms every day, with both adults and children. Anxiety that does not respond to the usual interventions. Relationship patterns that look like attachment but are actually fear. Inexplicable rage. Inability to sleep. Bodies that flinch.
Therapists who understand what is happening neurologically, who recognise the symptoms early, and who have at least one reliable tool to offer, do better work across the board. Good trauma CPD is not just for people who want a niche, it is for any therapist whose caseload includes human beings.
What To Expect, Realistically
If you train in Rewind, I will not promise you that every client will be “fixed” in one session. Many no longer meet the criteria for PTSD after one session, but some still do. Some clients need two or three sessions, some need to do other work first, and most need additional therapeutic work afterwards. What I will say is that for a great many clients, the relief is real, observable, and faster than they have come to expect from therapy. Clients often tell me, sometimes with disbelief, that the memory is still there but the emotional charge around it has gone. And honestly, I still remember and I understand why that can feel hard to believe when something has affected your life so deeply for such a long time.
A Grounded Note To End On
Trauma work does not have to feel daunting. The anxiety that many therapists carry about it is not a sign that you are not cut out for the work. It is a sign that you have been asked, for years, to sit with very difficult material without perhaps being given enough practical tools.
Adding a good, structured, evidence-supported method to your practice gives you another practical option when a client tells you their world has not felt the same since a traumatic experience.
If you are curious about Rewind Trauma Therapy training, you are welcome to read more on my training page, or get in touch with any questions.
Julia
Julia Summers is a counsellor, clinical supervisor and author of Game Over: Uncovering the Secrets of Unhealthy Relationship Behaviours and Manipulation.
She is an IARTT Accredited Rewind Trauma Therapy Trainer based in Cheshire and delivers Rewind Trauma Therapy training to qualified therapists across the UK, both live online and in person.
Details and upcoming dates are available at www.haventherapy.co.uk
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