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by Alex Tripoli

Dec 2, 2023

From Pain to Power: A Success Story in LGBTQ+ Trauma Therapy and Healing

QueerPsych spoke with Alex Tripoli to discuss working with LGBTQ+ clients impacted by trauma, approaches to trauma therapy and therapeutic relationships, and more.

Can you describe your approach to working with individuals who have experienced trauma? How do you tailor your trauma therapy techniques to address the unique needs of each client?

You are the expert in your own experience. That understanding is paramount for my work with those who have experienced trauma. This approach allows my clients space to honor their past, and it helps me meet them in the present to define a path forward.

Beyond that, there are a few modalities I keep returning to that have delivered positive results with these clients: Mindfulness, Seeking Safety (for substance use and trauma), Cognitive Behavioral Therapy (CBT), and Narrative Therapy. Choosing a therapeutic modality or method isn’t a unilateral decision, though; it’s a collaborative conversation with my client that empowers them to choose how they want to proceed.

Any therapeutic relationship requires mutual communication, trust, and understanding, and these things are especially important when it comes to working with trauma.

Trauma can manifest in various ways and impact different aspects of a person’s life. How do you collaborate with clients to identify the specific effects of trauma they’re experiencing and set goals for their healing process within the trauma therapy sphere?

“What has your trauma taken away from you that you want to get back?” This is the question I ask my clients to help kickstart the collaborative process of goal setting and recovery. It’s true; trauma affects every individual differently. An event shared by two people could traumatize one person and not another.

Often, trauma can be traced to feelings of powerlessness in a given situation – something happening to you over which you have no control. I work with clients to help them gain insight into the causes and effects of their trauma, which we then use to inform goal setting. I work to empower my clients to explore the life they want to live, instead of settling for a life they inherited from their trauma.

Trust is crucial in trauma therapy. How do you establish a safe and supportive therapeutic relationship that allows clients to explore and process their traumatic experiences at their own pace?

Trauma corrodes trust in others, in society, and in ourselves. It is my job to help my clients begin to trust themselves again, which in turn empowers them to determine how they choose to trust the outside world. Trauma influences our behaviors in ways we would never anticipate. It causes us to do things we normally wouldn’t do.

It is not your fault for reacting how you did to your trauma. It is, however, your responsibility to process it, learn from your experience, and grow into the person you want to be. I provide a judgment-free space for clients to share their experiences on their own time. In this way, we build rapport and trust, which only grows as the client begins to make progress toward their goals.

Trauma can often involve revisiting painful memories and emotions. What strategies do you use to help clients manage distressing reactions and regulate their emotions during the therapeutic process?

This is the crux of trauma therapy. In order to diagnose a client with PTSD, physical and/or mental avoidance must be present. Trauma memories hurt, and they can come out of nowhere. It makes sense that we would develop a range of behaviors that help distract us from those negative feelings. Paradoxically, the repeated exposure to those memories and emotions allows us to make meaning of trauma and move past its effects.

That’s why I introduce emotional regulation tools such as grounding and breathing techniques at the very beginning of the therapeutic journey. I also ask permission and prepare clients when a session is leading toward trauma processing. This helps clients examine their trauma without being traumatized all over again. It gives them power over their reactions and emotions, and helps them choose when to access their memories, rather than letting those memories invade their lives.

Trauma therapy can sometimes uncover repressed or difficult emotions. How do you ensure that clients have the necessary coping tools and resources outside of the trauma therapy setting to continue their healing journey effectively?

Practice, practice, practice. Much of our time in trauma therapy is spent honing tools that are meant to be used outside the therapeutic space. Deescalating oneself in session is great, but applying that in the world while experiencing real-life stressors is the end goal. Unfortunately, there is no silver bullet for our mental health, no one tool that will unlock a lifetime of emotional regulation and control.

Mental wellness is instead like a constant garden. Sometimes our garden is full of weeds, and we must amass a variety of tools to help clear and till the soil. A shovel or rake alone does not ensure seeds are planted and grown. It is the experienced application of those tools (cultivated over time in therapy) that helps our mental wellness flourish.

Regarding homelessness, can you tell me about your approach to trauma therapy for LGBTQ+ individuals experiencing homelessness? How do you address the unique challenges they face within the trauma therapy setting?

While people do experience PTSD associated with a single traumatic event, real life doesn’t always fit into such a well-defined box. The LGBTQ+ community more often experiences countless traumas and microaggressions that compound over time. The same can be said of the homeless and housing insecure community. When an individual belongs to both those communities, they are likely to be experiencing constant harm, called complex trauma.

When working with such clients, safety is the number one priority. My biggest focus at this point is to do what we can to prevent future traumas from occurring. We can think of this like putting a tourniquet on a wound. One’s survival and safety must be secure in order for true healing to begin.

LGBTQ+ individuals facing homelessness might have encountered various forms of discrimination and trauma. How do you incorporate a culturally sensitive and trauma-informed approach into your trauma therapy sessions?

You are the most important person in our therapy sessions. As such, I create a safe space for clients to share their perspectives and the ways in which their identities have shaped their lives. Cultural competence and trauma-informed care go hand-in-hand, so I make sure to stay informed and educate myself when I experience a new culture. Honoring your unique identity is what drives therapeutic healing, so I do everything in my power to do just that.

Can you share a success story or a case study that highlights the positive impact of your trauma therapy and overall therapy work on an LGBTQ+ individual dealing with homelessness? What were the key factors that contributed to their progress?

One individual who comes to mind was not homeless at the time, though he was a gay man who had experienced homelessness in the past. I had been seeing him for a few months and one day he stormed into my office yelling threats that he was going to quit our program. I then saw one of our security guards bounding up the stairs after him. I de-escalated the situation and separated the two.

My client and I discussed the incident privately and it became clear that in that moment, he was reliving every authority figure and law enforcement officer who had ever traumatized him just for existing. The pain poured out of his body and voice. I simply sat and took on the role of bearing witness to his pain. All he wanted was someone to acknowledge his hurt.

We then grounded ourselves with breathing and I asked his permission to facilitate a restorative justice conversation with the security guard. My client’s back straightened and chin lifted in the security guard’s presence as he asserted his right to exist in our office. The security guard apologized for making him feel attacked and the client melted into this apology. He was heard, understood, and validated.

Our work continued after that day with a renewed sense of confidence and self-love.

Mental Health

by Alex Tripoli

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