A therapist who lacks the capacity for self-awareness and attunement may, at best, provide surface-level support, but they’re also likely to cause harm, especially to trauma survivors. Without the ability to co-regulate and deeply connect with their clients’ internal states, such therapists might reinforce feelings of mistrust, disconnection, or even trauma, despite their best intentions.
Their inability to hold a safe space can do the opposite of healing by:
Reinforcing Trauma Patterns:
When a therapist is not attuned, it can feel to the client like they are re-experiencing the emotional neglect or misattunement they may have encountered in the past. This only deepens trauma patterns, leaving the client feeling more isolated, invalidated, or misunderstood.
Causing Dysregulation:
A therapist who is dysregulated or unskilled in co-regulation can inadvertently dysregulate the client. Without the safety of a regulated nervous system in the room, the client may leave sessions more anxious or overwhelmed, amplifying their distress.
Breaching Trust:
The therapeutic relationship relies on trust and safety. When a therapist can’t connect with the client on a nervous system level, this breaks the trust. For trauma survivors, this can feel like another relational betrayal, reinforcing the belief that no one can truly understand or help.
Blocking Healing:
True therapeutic work involves accessing vulnerable emotions and deep body-based experiences. Without the right support, clients might find themselves stuck, unable to move through trauma because the therapist lacks the necessary skills to guide them safely.
Therapists who aren’t aware of the felt sense or their own nervous system dynamics may unintentionally cause harm by repeating patterns of invalidation or disconnection. While they may help in limited ways (e.g., offering practical coping strategies), they cannot offer the kind of deep, reparative healing needed for complex trauma. For people with severe developmental trauma, this misattunement can be particularly damaging, as it further disrupts their capacity to trust others or their own internal experience.
In such cases, clients must seek out a therapist who understands and embodies principles of Interpersonal Neurobiology (IPNB) and somatic work, someone who is both emotionally and physiologically attuned and capable of creating a truly healing space. I recommend those trained in the NeuroAffective Relational Model (NARM), which is non-pathologizing, shame-busting, neuroscience-based, attachment-focused, and somatically oriented.
