How Relational Trauma May Show Up in Therapy—and What to Do About It
Relational trauma refers to the wounds we carry from relationships that were meant to nurture us but instead left us feeling unsafe, unseen, or unsupported. Often stemming from childhood experiences, relational trauma can shape how we engage with others throughout our lives. These patterns don’t simply disappear when we enter therapy; in fact, they often surface in therapeutic relationships, sometimes in ways that can get in the way of healing.
Let’s explore how relational trauma might show up in therapy, how to recognize it, and how the right therapist can help you turn these moments into opportunities for deeper understanding and growth.
What Is Relational Trauma?
Relational trauma happens when a person’s early relationships—typically with caregivers—are marked by neglect, abuse, or emotional inconsistency. Instead of learning that relationships are safe and trustworthy, individuals with relational trauma may internalize beliefs like:
“I have to take care of others to be accepted.”
“If I express my needs, I’ll be rejected.”
“I’m too much for people to handle.”
These beliefs often lead to survival patterns like people-pleasing, self-sacrifice, or emotional suppression, which may have helped you navigate difficult relationships in the past but can create barriers to connection in the present.
For instance:
Maybe your mom didn’t protect you from your narcissistic dad and chose to stay silent instead of prioritizing you, leaving you feeling like you didn’t matter.
Or perhaps your mom could never take accountability and often manipulated or gaslit you, making it hard for you to trust your gut and leaving you feeling insecure.
Maybe you had a scary parent who made you feel unsafe, so you learned to please and appease to protect yourself, a pattern that now manifests as chronic people-pleasing.
These early dynamics can profoundly shape how we relate to others and ourselves, often persisting into adulthood in subtle and not-so-subtle ways. You can read more about relational trauma, attachment trauma, and complex PTSD on my website linked below.
Relational Trauma in Therapy
It’s no surprise that the patterns formed through relational trauma show up in all aspects of life, including therapy. While therapy is meant to be a space for safety and healing, it’s also a relationship—and as with any relationship, old wounds and survival strategies can emerge.
Here are some examples of how relational trauma may show up with your therapist:
Caretaking Your Therapist: Constantly worrying about whether your therapist is okay with what you’re sharing or feeling responsible for their emotional state.
Avoiding Your Needs: Not asking to switch topics when something feels more pressing, saying you understand something when you don’t, or leaving out honest details that you think might make you look “bad.”
People-Pleasing Behaviors: Always agreeing with your therapist, even when their perspective doesn’t resonate with you, or going along with their suggestions because you’re afraid to speak up.
Fear of Conflict: Avoiding bringing up concerns about something your therapist said or did that bothered you.
Self-Sacrificing: Pretending the scheduled time is fine, even when it’s inconvenient or stressful.
Difficulty Asking for Support: Struggling to request more time, clarity, or specific guidance.
Compulsive Gratitude or Humor: Over-thanking your therapist or cracking jokes to lighten the mood and avoid emotional intensity.
Assuming Rejection: Believing your therapist is annoyed with you or secretly judging you, despite a lack of evidence.
These behaviors are protective—they’re attempts to avoid discomfort, rejection, or perceived conflict. However, they can also prevent you from getting the full benefit of therapy.
Finding the Right Therapist
The right therapist will understand that these patterns are normal responses to relational trauma and will actively work to create a space where they can be explored. Here are a few qualities to look for in a trauma-informed therapist:
Awareness of Relational Dynamics: A good therapist will recognize when relational trauma is showing up in the room and gently call attention to it. They won’t shame you for these behaviors but will instead invite curiosity and compassion.
A Safe, Nonjudgmental Presence: They will create an environment where you feel safe enough to be honest about your thoughts, feelings, and needs without fear of rejection or judgment.
Willingness to Address Difficult Topics: A trauma-informed therapist won’t shy away from exploring how your patterns—including those that emerge in therapy—are impacting your life. They’ll see these moments as opportunities for growth.
If you’re in Colorado and resonate with these struggles, I am a trauma therapist in Denver and offer virtual therapy sessions to people throughout Colorado to help you work through relational trauma with a somatic and relational approach. Somatic therapy focuses on the connection between your mind and body, helping you process trauma through awareness of physical sensations and emotions. A relational approach emphasizes the therapeutic relationship as a space to explore and heal patterns rooted in past relationships. Together, we can create a space where these patterns can be explored and transformed, allowing you to move toward more authentic and fulfilling connections.
Turning Patterns Into Opportunities for Growth
When these relational trauma patterns show up in therapy, they’re not obstacles—they’re opportunities. Bringing these behaviors into the open allows you to explore them in real time, deepen your understanding of yourself, and have a healing, reparative experience with your therapist.
For example:
If you notice you’re avoiding a topic because you fear making your therapist uncomfortable, you might practice naming that fear and observing how your therapist responds. This can challenge old beliefs that expressing your needs leads to rejection.
If you compulsively thank your therapist or crack jokes to diffuse tension, you might reflect on where those habits originated and what it would feel like to sit with vulnerability instead.
Over time, these small moments of honesty and risk-taking can help rewire your nervous system’s response to connection. You can begin to trust that relationships can be safe, supportive, and reciprocal. And THAT'S the power of the therapeutic relationship.
Final Thoughts
Relational trauma may shape how you show up in therapy, but it doesn’t have to define your healing process. By working with a trauma-informed therapist who understands these dynamics, you can transform old patterns into opportunities for growth, self-compassion, and connection. Therapy becomes not just a place to talk about your past but a space to actively rewrite it, one safe and supportive interaction at a time.
About the Author
Martha Carter is a licensed therapist providing virtual services in Colorado. She is trauma-informed and trained in somatic, neurobiology-based modalities to help people with all types of trauma, chronic pain, and eating disorders heal from the inside out.
(Colorado residents only)
