What to Look for in a Trauma Therapist, Brain Processes, and the Window of Tolerance Explained
Research shows that one of the largest factors for positive outcomes in therapy is the relationship between the therapist and client. Still, when looking for a trauma therapist, there are a few aspects to consider. Based on my education and experience working with clients, I recommend seeking a therapist who has specific training in trauma therapy (e.g., Eye Movement Desensitization and Reprocessing (EMDR), Brainspotting, etc.). Evidence-based modalities like Cognitive Behavioral Therapy (CBT) can also be effective for trauma, but they may fall short if they focus solely on cognitive processing. Cognitive processing can have value, but it can be insufficient if the body is dysregulated—a hallmark of trauma. When the body is dysregulated, brain function is impaired. Because of this, a trauma therapist will likely educate you about brain functioning, introduce concepts like the “window of tolerance,” and help you understand and practice strategies to regulate your body.
In short, our brains are highly adaptive—they are constantly working to keep us safe! Part of the brain, the amygdala, acts like a fire alarm or bodyguard, scanning for real or perceived threats. The amygdala works with the hippocampus (which is responsible for memory storage) to assess what might be a threat. This threat could come from something strongly reminiscent of a past experience that felt dangerous or was dangerous, or it could stem from a subtle aspect of that experience, such as a thought or feeling that triggers memories of it.
When our brain doesn’t sense any threat, we are within our “window of tolerance,” an optimal zone of arousal. While in this state, we can experience a range of emotions, feel more able to regulate ourselves, and communicate better because our brain isn’t focused on sending signals of danger to the body.
When a threat is perceived, our system adapts by activating us and causing us to “exit our window” (triggering fight, flight, or freeze responses). This happens because, when there’s a threat, we need to act quickly. The part of the brain that is active while inour window of tolerance is not as accessible once we exit the window, as it’s too slow for urgent action. Our system quickly decides whether to enter fight, flight, or freeze mode—we don’t consciously choose this.
Essentially, if your brain has determined that something, like public speaking, is dangerous, it will react the same way it would if you encountered a bear while hiking. When we go into fight/flight mode (hyper-arousal), our body prepares physiologically to run or fight. In freeze mode, our body also undergoes physiological changes, preparing us to shut down and immobilize.
I’ve worked with many clients who feel shame about what causes them to exit their window of tolerance. It’s important to recognize that we do not consciously choose what we find threatening. Threats can stem from unconscious fears or beliefs. Many clients I work with have childhood experiences that, if encountered as adults, they likely wouldn’t find threatening. However, as children, these experiences felt terrifying. The brain learns over time, and one of the goals of trauma therapies like EMDR is to help the brain unlearn these associations, recognizing that something is no longer a threat.
The concept of the window of tolerance also highlights the importance of taking care of ourselves physically when working through trauma. Our window can “widen” when we meet our basic needs, such as sleep, food, and physical activity. A wider window makes it less likely that we will slip into hyperarousal or hypoarousal. On the other hand, it can “shorten” (making us more easily triggered to exit the window) when our basic needs are not met, especially when past trauma is involved. A trauma therapist can support you in strategies that help you better stay within your window of tolerance and understand how to get back in our window of tolerance once activated, ideally through body-based (“bottom-up”) methods.
These concepts can be hard to wrap our heads around if they are unfamiliar, or, if we have a lot of shame around our responses. Give yourself time to think about it if you’re unsure if it resonates or not. Dan Seigel has a great simple way of explaining the window of tolerance and brain function – if you’re needing more clarity I would recommend googling his “hand model of the brain” video. Stay tuned for more on the nervous system and polyvagal theory explained simply.