Updated: Jun 26, 2022
In nursing school, after a grueling eight-hour day of lectures, one of my classmates piped up during a particularly boring lecture on psychiatric medications and said, “Why do we have to know this? I’m not going to be a psych nurse,” to which my professor responded, “If you work with people, you work with trauma.”
As my career progresses, this phrase gains more meaning to me by the year. Trauma-informed care is a relatively new concept in medicine, and a relatively unknown one in personal training. Four years into my personal training career, I had never heard the phrase. One nursing degree, a pandemic, and a lot of life experience later—I finally realize the importance of understanding and incorporating trauma-informed care into the fitness industry.
So what is trauma-informed care, and what’s its current role in healthcare? And why do I believe it’s essential that we as personal trainers and coaches incorporate trauma-informed care into our work?
What is trauma-informed care?
First, let’s establish some key language. Trauma-informed care is a framework that guides medical clinicians that simply posits that most of our patients have likely experienced some kind of serious trauma in their life. The purpose of utilizing a trauma-informed framework in all of our patient interactions is the reduction of harm to that patient.
Put plainly, trauma is extremely common, and it has far-reaching, serious effects on the patient’s mental, physical, and emotional health.
Also, seeking medical care ITSELF can be traumatic, and it is our job to assure we do as little harm as possible in those interactions.
What does this look like in practice as a nurse?
In any patient interaction, I make a concerted effort to do two simple things:
Explain everything before I do it, leave space for questions, and respect their need for breaks.
When needed, ask permission to touch them, and let them know exactly where on their body I will be touching, and why.
Victims of abuse—which is exceedingly common, remember—have often had their bodily autonomy violated, and so it is essential that I create an environment that makes them feel safe. By simply emphasizing their autonomy, and acting with empathy, this encounter will likely be much easier for me as the clinician, and much less traumatizing for the patient.
You may be thinking, ok Meg, I’m a personal trainer. What do my clients’ past experiences have to do with my job now? I just need to get them shredded / stronger / bigger / faster, etc.
Well, according to these three research studies, utilizing coaching modalities that emphasize curiosity, self-compassion, focused on the science of behavior change, has EVERYTHING to do with their current fitness goals, and whether they will reach them or not.
Moving away from harmful personal training trends
As fitness has evolved, we have finally begun to move away from the ‘No pain no gain’, “Pain is weakness leaving the body’ 1990s nonsense to understanding that long-term health goals are met by conducting a deep dive, and understanding that person’s motivations, patterns, and yes—traumas.
As coaches, we are not therapists, but being able to prod gently to understand your client in a way that is not harmful to them, but leads to greater understanding for you both, is essential.
We must go beyond the generic PAR-Q and lifestyle questionnaires to truly connect with our clients to better serve them.
The reality is, many of the clients I have coached over the years—a startling amount really—check many of the boxes for conditions that can be harmful to their health, such as body dysmorphia, disordered eating, orthorexia, exercise addiction, and even full blown eating disorders.
In fact, even some of my colleagues and fellow athletes have as well. How many trainers, competitive lifters, and hardcore clients have you met that qualify for one of the above disorders?
How many have you had a conversation with? Addressed in a meaningful way?
My point here is not that coaches should play armchair psychologists, but rather, as personal trainers we are in a unique position to help clients create meaningful change in the way they interact with exercise, food, and their bodies. We should offer support, guidance, and resources in a way that sparks curiosity within our clients, and when necessary, have difficult conversations if they choose to share something with us that prompts a discussion.
Our clients look up to us, they trust us (enough to pay our high hourly rates). They follow us on social media, they pick our brains about the latest fad diets, cleanses, and more.
I believe then, that we should all have the tools to take into those interactions, that allow us to communicate evidence-based information, in an empathetic, non-damaging way.
What does trauma-informed care look like in personal training?
Always get consent before touching your client. ALWAYS. Like, every time.
Be mindful of the way you talk about their body, and your own. Language matters. Even off the cuff critical remarks can send someone with an eating disorder into a tailspin.
In fact, in general, focus on process-based compliments over physical ones. “Love the consistency, keep prioritizing movement!” vs “Looking tiny/skinny/toned!” etc.
Don’t assume your client’s goals. Not everyone is interested in fat loss, weight loss, or body composition change. Take the time to conduct thorough intakes and set goals together.
Many disabilities are invisible. Respect their stated limitations, injuries, and concerns. Your client is the expert regarding their own body.
Have a referral network. It is essential as a coach to know your scope of practice, and refer out as necessary. Remember, your client trusts you - make the most of that connection and refer them to services that they need. Some other professionals you may want to have contact information on hand for example: physical therapist, registered dietician, massage therapist, etc.
If this list seems obvious to you—great job! You’re already coaching with a trauma-informed framework. If not, now you know better, so you can do better. It takes courage to try new things and change our ways of thinking, and I applaud you for that.
Being a coach is a privilege. Whether you are a personal trainer, athletic coach, or nutrition specialist, coaching through a trauma-informed lens can make all the difference in building genuine relationships with your clients, and helping them reach their health and fitness goals.