When Phase 1 Is Not a Phase: Rethinking Stabilization in Trauma Treatment

Phase 1 trauma treatment is often taught as stabilization: a time focused on symptom management, affect regulation, and skill or capacity development. This framing is clinically useful. Structure matters. Orientation matters. Clear phases help therapists avoid premature depth work and ethical missteps.

And yet, in practice, Phase 1 rarely unfolds as cleanly or uniformly as it is taught.

For many clients—particularly those with histories of early, chronic, and relational trauma—Phase 1 work emerges in complex, recursive, and deeply relational ways. When this complexity is not named, both therapists and clients can be left feeling confused, ineffective, or discouraged.

This post offers a broader way of thinking about Phase 1: one that supports clinical discernment, calms the therapist’s nervous system, and creates space for difference rather than deficit.

Phase 1 Depends on What Is Already There

Phase 1...

There is a quiet cost many of us carry as clinicians—the cost of not knowing. There is no way to know everything or have an answer for everything in our work.  However for those of us working with complex trauma, attachment injury, and dissociation the cost can be heavy. It’s the cost of not always knowing what to do next, how to respond, or how to stay grounded and attuned when the work feels heavy, slow, or unclear.

This cost doesn’t show up on a balance sheet, but we feel it:
in the sessions we replay on the drive home,
in the moments of self-doubt,
in the way we carry work home with us from time to time.

For many of us, investing in clinical consultation has been one of the most meaningful ways we’ve learned to pay that cost down—not by finding perfect answers, but by widening the field of support, perspective, and relational safety around our work.

Keeping Stamina for the Journey

Research tells us that treatment for clients with complex trauma is lengthy and can span years. Th...