If you’re wondering whether therapy works for childhood trauma or you tried therapy and it didn’t help you, this post is for you.
These are slightly different questions so I’ll answer them separately.
Does talk therapy work for childhood trauma?
Yes, given the right circumstances and combination of therapist and client, therapy can work for childhood trauma. Which is what you want to know. But I want to back up and give you some context to help you understand why I am saying this.
If you ever studied history at school, your history teacher probably said ‘look at the source’. What they mean by this, is consider who was the person who said the thing, painted the thing or created the thing and what the reason for them doing it was.
Many people who create content are trying to sell something and are invested in convincing you that their way of doing things is the best way.
As a Psychotherapist, I am also interested in selling people therapy so I am not immune from self promotion. I am not, however, interested in pretending to be the only person with an answer, the only person who can help anyone or the best person for everyone. That simply isn’t true. I am not the only effective therapist in the world and therapy can be part of healing childhood trauma alongside other things. I do believe that I am very effective with the right people, and that’s an important detail.
Why didn’t therapy help my childhood trauma?
Therapists account for a lot in therapy. Here are some common problems I see in people who have had therapy that didn’t help before.
The therapist is defensive in some way; this shows up as the therapist not being able to take feedback, blaming the client or reacting in a way that the client finds confusing without being able to explain to the client what’s happening or why. The therapist’s job is in many ways to translate things for the client. If a client pisses me off, my job is to understand what’s happening, see the underlying patterns that the client repeats in their life and translate to the client in a way that they understand what is happening and why.
As a therapist I also need to be able to do this in a non threatening and non shaming way so that the client might be able to hear what I’m saying. I need to consider my own history and triggers and whether this is even about the client (or only a tiny bit about the client). Some therapists end up feeling bad about themselves when a client gives them feedback and attack the client as a defence mechanism. Since this isn’t fun for the client, often the client leaves and nothing is understood or repaired. Therapy is supposed to help you repair the unhealthy patterns we learned growing up. If the therapist joins in with your unhealthy patterns, you don’t learn or practice how to do things differently.
What I have seen with clients who haven’t got what they needed from their therapist is this: the client often triggers the therapist (this is called Countertransference) and the therapist doesn’t seem to have seen (or been able to manage) how they feel about this and translate this into something that helps the client understand themselves better. It is also the therapist’s job here to help provide a different experience to the client and to help initiate a repair that means therapist and client understand each other better.
Some of this comes from advanced understanding of processes (such as Projective Identification), some of this comes from experience, some of this comes from the therapist understanding their own triggers and some of this comes from therapist-client fit. This is partly why I try to assess for this upfront: it’s important for me to consider whether I’m likely to be able to help someone or whether what they need, might be difficult for me to provide or hit something I don’t know how to handle well.
The therapeutic relationship is the cure-but what does this mean?
This gets bandied around a lot and I don’t think it’s well understood by prospective clients.
The therapist needs to be able to make clear for the client what confuses them. Some therapists are able to explain the problem; ‘your parents didn’t know how to be kind to you’ without being able to explain to the client the pattern: ‘you show up in rooms and you give very little away because you’re worried people won’t like you’ or ‘you make a lot of jokes but then people don’t know who you are and you are hiding what you really feel’. Some therapists can explain the pattern but aren’t sure what should be done about it.
In therapy we are trying to create a map, which shows the client where the pitfalls and problems are. These will be different for each person. The client needs to have a map so that they can recognise when they are approaching a similar problem and find a way to do something differently. This takes repetition and practice and it’s important that the client understands that this ‘failing’ is normal and has the support to keep trying until they can successfully navigate difficult situations without falling down an abandoned mineshaft and spending a week feeling stuck and hopeless.
My ultimate aim is to help people access their feelings. They may also need help tolerating them, that is I am there to reassure and explain to them what their feelings are about or to intervene and get them back if they are overwhelmed when they are trying to find them. What I help people do in therapy is to connect to their old feelings in a safe way so they can express them. If you can express the old feelings of not being good enough or being sad you don’t need to keep up the patterns or ‘coping behaviour’ so much in the present i.e. avoiding them, entertaining people or putting yourself last.
Your parents were supposed to help with this; translating what you felt into words: ‘oh you’re disappointed that Mark went out without you. You’re upset and you’re worried he doesn’t like you anymore’. They are then supposed to be able to help you manage this in some way perhaps either by saying ‘you and Mark spend a lot of time together, doing something with someone else doesn’t mean he doesn’t like you. You went out to Robert’s house yesterday but that doesn’t mean you don’t like Mark anymore’ or perhaps by helping you to see what isn’t working: ‘Hmm, Mark does a lot of things without you and that makes you sad. He says he’s your best friend but at school he completely ignores you, that’s not a very nice thing to do’. In reality many parents do not understand their own emotions or experiences well enough to provide this running commentary or are too preoccupied to see it as their job and instead you get something like ‘stop whinging about it, it’s fine’ or ‘I don’t know, I’m busy’.
Part of my job in therapy is to provide the missing structure to help you understand how people work, how you work and to put words to experiences you have had but never been able to explain.
Many people grew up with spiky, sensitive people who overreacted and didn’t give them the emotional support they needed. My job is to give you that emotional support, to be curious about what you’re saying rather than react to it, to find out why you say or do things rather than guessing or to offer alternative explanations that aren’t about blaming you. So maybe you’re not a loser, you had a bad day and got annoyed. If we can find out why you got so annoyed we can find out what triggered you and we can link that to something that happened in your past. Nobody reacts to tiny things for no reason and we need to find out why you’re so sensitive about this ‘tiny thing’.
Therapist training matters
It is a matter of some debate how qualified someone should be to provide therapy. There are currently no regulations in the UK to call yourself a therapist, counsellor, psychotherapist or psychologist (specific titles such as Counselling and Clinical Psychologists are however regulated by the HCPC). Therapists have voluntary regulation with bodies such as the UKCP, BACP, NCPS or BABCP but this does not always guarantee a good match or an effective therapist.
Some very qualified therapists are not very good. Some therapists with less training are very effective so training is not necessarily a guarantee of effectiveness.
If you have had therapy in the past and something didn’t work, I think it’s important to consider how much experience your therapist had in the issue you were seeking help for. Many therapists claim to work with everyone. If they help you then that’s great, but if you are not getting any better, you might need someone specialised in the problem you’re experiencing.
Therapy for the therapist matters
Not all courses require the therapist to have had therapy. As per qualification this does not always matter. I do think it’s worth considering that if you’re running into problems in therapy or with multiple therapists whether you could be running into the edge of your therapist’s personal experience and understanding. If they are suffering with the same issues that you are they may have taken you as far as they can go.
My course (which was a 4 year postgraduate diploma at level 7) required weekly therapy until completion of requirements. To complete the client hours and dissertation took a further 2 years and I was in weekly therapy the entire 6 years. In reality I have been in therapy for much longer than that, so I know myself pretty well. I also have regular supervision so I can explore difficulties with my client work or understand how and why things might trigger me or get help to understand what’s happening in therapy.
Therapist-client fit
It isn’t always the therapist’s fault if the therapy doesn’t work. Sometimes people aren’t ready or able to look at what is happening for them. This doesn’t always make it your fault either. It’s important to consider if you have the time, energy or money to invest in therapy and whether you’re ready to delve into your psyche and see what’s in there. Sounds serious but nobody wants to be dragged kicking and screaming into therapy and I find it works best when people are sick of their current situation and willing to try something different.
What you’re really paying me for
I’ve begun to think that perhaps people really pay me to be the adult in the room. Some people never had another real adult (because their parents acted like children, couldn’t deal with their emotions or just disengaged). You’re paying me to do some of the work that you don’t understand and explain it in a way that you get. Many people have never had this (some of them have even tried multiple therapists and still not experienced this).
Many clients tried to control, manage and take care of their parents from a young age (this is sometimes called Parentification). This means they often don’t think I will be able to handle them in therapy, worry they will need to protect my feelings, figure things out for themselves or perhaps be nice or entertain me. Part of repairing the damage that was done is to see what happens if you try something new. To see if I can tolerate how you feel if you’re not feeling ok or to risk sharing things with me that other people might not have known what to do with. If you can trust me then you might be able to find other people who are reliable and recognise them better so you can also get support outside therapy too.
You might also like: When Therapy doesn’t work
If you’d like to see if I can help you, you can book a free call to see if we’re a good fit to work together here.
Written by Sarah Lee, October 2026. UKCP Psychotherapist, about me