Three Questions

In my years of working as a therapist, especially with people recovering from trauma, I’ve noticed there are three questions underlying all therapy. Of course, people aren’t directly asking these questions. Yet, therapy seems to follow the themes within these questions.

Am I safe?
To begin any healing journey, this question has to be answered first. It is similar to Maslow’s hierarchy of needs. We have to have our basic needs like food, shelter, water, clothing, and air available to live and work our way up to “self actualization”. In the context of therapy, safety means feeling physically and emotionally safe with others, in your environment, and internally with your thoughts, feelings, and body sensations. Safety in the context of trauma work means being empowered, having choices, your voice is heard, things are predictable, and things you say and feel are met with compassion.

From an evolutionary and survival perspective, if you are running from a tiger in the savannah, this is not the time to worry about if the tribe accepts you or what your purpose in life is. This is the time when your brain and body is solely focused on survival and safety. In the modern day, you’re hopefully not running from a tiger. Your brain and body, however, might still be registering danger and make you feel stuck in survival mode. My job as a therapist is to help you learn skills to accurately register danger and safety and move from surviving to thriving.

If you’ve had traumatic experiences, there is a possibility that you might not feel safe when you first come to therapy. This is why the first part of therapy is about establishing rapport, trust, and building skills to feel safe. People often think of EMDR or any trauma treatment as having to relive the painful memories, thoughts, feelings, and sensations associated with the trauma. Yet, a big part of trauma therapy is learning how to regulate your nervous system so that you are not stuck in fight, flight, freeze, or other defenses. There are a number of ways that people try to manage feeling unsafe including through perfectionism, people pleasing, getting angry easily, shutting down into depression, and avoidance.


Am I Enough? Am I okay?
Once safety is established, the next question is often some variation of “Am I good enough?” It can take the form of I feel worthless, I’m not good enough, I’m too much, I have to be perfect, No one likes me, and other self critical beliefs. In one way, it is another way to establish safety through acceptance from others. Humans are wired for connection. Despite the American myths of individuality, we do better together. Using the evolutionary example with the tiger, we were much safer in a tribe coming up with ways to defeat the tiger than out on the savannah on our own. On a side note, this is why loneliness and rejection feels a lot like physical pain.

Sometimes the stuckness with this question looks like codependency, relationship problems, trouble with boundaries, isolation and loneliness, lack of trust in others, and social anxiety. Building on the foundation of safety, therapy addresses this basic question of connection. Your brain will always offer self critical thoughts and stories, but you can learn how to have self compassion, you can better understand those protective parts, and to love yourself. When we establish that yes, we are good enough, okay the way we are, and loveable, we can move out of survival and into healthy connection.

What do I desire? What is my purpose and meaning?

Following right along Maslow’s hierarchy, this question often comes after we feel safe and connected to others. This question comes when we are connecting with our highest, wisest, inner self and there is an awareness of something bigger than ourselves. It isn’t impossible, but quite difficult to think about the meaning of life or what you actually want if your brain is stuck on survival and acceptance.

I think this question gets overlooked when we think about therapy. It is a question often left to spiritual communities and pursuits. Yet, once you’ve resolved trauma, integrated it, and have learned how to regulate our nervous system, it is natural to start asking the bigger picture questions. Part of posttraumatic growth is having more empathy and having more clarity about what your values are.