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Your Trauma Therapist · Jul 6, 2026

Exposure Therapy Has a Blind Spot for Trauma Survivors

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Your Trauma Therapist · Your Trauma Therapist

Your Trauma Therapist by Lauren Auer, LCPC is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber. For more content follow me on Instagram.

I scrolled past one of those slideshow graphics on Instagram last week that I see often and accept as truth and move on, but for some reason I hovered a little longer this time and started to really get curious about the message. Every time you avoid discomfort, you’re teaching your brain it can’t handle things. Growth and comfort don’t coexist. Push through, a little at a time, and your capacity expands.

And the more I sat with it through a trauma lens, the more it felt incomplete in a way that actually matters.

Avoidance does reinforce itself. Skip the thing that scares you and your nervous system never gets the chance to learn it was survivable, so the fear stays put or grows. That’s real, and it’s part of why exposure-based approaches help with phobias and everyday anxiety. But underneath that model is a quiet assumption, that the discomfort you’re avoiding is safe to move toward in the first place. For a lot of trauma survivors, that assumption doesn’t hold. And nobody tells you that part.

Your body is answering a different question than you think

Emotional discomfort doesn’t arrive as one flat feeling. Underneath it, your nervous system is running a much older calculation, constantly asking whether what’s happening right now is safe or dangerous. Research on interoception (your body’s internal sense of its own state) has found that trauma changes how accurately people read those signals. Some people become hyper-attuned to every flicker of sensation and label all of it danger. Others stop registering the signal much at all. Either way, the read gets unreliable, and “just push through the discomfort” becomes a riskier instruction when you can’t always trust what your body is actually reporting back to you.

I think of a client I’ll call Maya (name and details changed). She’d come across similar advice online and decided the way to get over her fear of confrontation was to force herself into every uncomfortable conversation she’d been avoiding, all in the same week. By the third one, she wasn’t at a growth edge anymore. She was flooded, shaking, unable to finish a sentence. Somewhere in the middle of it she realized she wasn’t even reacting to the conversation in front of her. She was back in an argument from a marriage she’d left five years earlier. Her body wasn’t telling her she couldn’t handle discomfort. It was telling her, accurately, that this particular door had opened onto something much bigger than the conversation she thought she was walking into.

Sometimes discomfort is a stretch. Sometimes it’s a flare. And what helps with a stretch can make a flare significantly worse.

Why safety has to come first

Judith Herman laid out a sequence in her 1992 book Trauma and Recovery that has held up well across decades of clinical work. Safety comes first, then processing, then reconnection. Not because processing isn’t valuable, but because a nervous system without some baseline of safety will treat almost everything as a threat. Living in constant threat mode is exhausting in the short term and, over time, can deepen the very patterns you’re trying to heal.

Trying to expand your tolerance for discomfort before that foundation exists is a little like trying to add a second story to a house while the foundation is still being poured. The building might go up. It’s not going to hold.

This is where a lot of well-meaning advice, including the kind on that graphic, quietly assumes everyone is starting from the same place. Most people giving it aren’t wrong that discomfort tolerance can grow. They’re just speaking to a general audience as if trauma survivors and non-survivors are working with the same nervous system. We’re not. A nervous system that spent years learning to treat discomfort as danger doesn’t unlearn that by being told to push through it.

So how do you tell the difference

In the moment, it can be genuinely hard to know whether you’re at a growth edge or somewhere past it. A few things I ask clients to notice:

Signs you’re likely at a growth edge:

  • The discomfort has an edge to it, but you can still think. You’re uneasy, not gone.

  • You can name what you’re avoiding and roughly why.

  • The intensity settles within a few minutes of moving toward it, or staying with it.

Signs you’re likely in a threat response:

  • Time, your surroundings, or your own body start to feel far away or unreal.

  • You lose access to words, or your mind goes blank.

  • The reaction is bigger than the situation calls for, and it doesn’t settle once the situation ends.

Neither list is a diagnosis, and neither is a perfect read every time. They’re a way to check in before you decide whether to lean in or step back, which is a very different question than whether you’re strong enough to handle something.

What this actually means for you

None of this means you’re stuck avoiding everything that scares you indefinitely. It means the goal was never willpower. It’s learning to tell which kind of discomfort you’re actually looking at before you decide what to do about it. A growth edge, you can lean into. A threat response needs something different first, usually more safety, sometimes more support, and almost always more time than a nine-slide graphic is going to give you credit for.

Next week I’m getting into the actual mechanics of what expanding your discomfort tolerance looks like once some safety is in place, what your nervous system needs from you in that process, and why “bit by bit” means something a lot more specific than it usually sounds. If you’ve been trying to force your way through this and it hasn’t been working, that one’s for you.

(read it here)

Your Trauma Therapist by Lauren Auer, LCPC is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber. For more content follow me on Instagram.

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