8.1 Establishing a Therapeutic Relationship of Mutual Trust Between Client and Clinician Mutual trust is fundamental to positive human relationships and many people are able to take it for granted. For victims of trafficking however, mutual trust has been violated. Some people who have been raised from birth into slavery or severe deprivation, may have never experienced a trusting relationship. To work effectively with victims of trafficking in therapy, mutual trust has to be established. This is a challenging process which takes time. However, once established, the client can trust the clinician to hear them, and assist them to make independent choices which improve their current lives. In turn, the clinician can trust the client to accept this assistance and to make these choices, including the decision to continue their therapy and to take care of themselves. Survivors of interpersonal violence often suffer the loss of a coherent sense of self in relation to other people and, crucially, the loss of trust in themselves and in all others. The nature of their trauma is a result of being violated by other people. People who have been trafficked become habituated to perverse human relationships and therefore to bullying, deception, exploitation and cruelty, so it is common for them to have internalized negative self-perceptions from their traumatic experiences and come to feel that other people despise or mock them, find them repulsive or irreparably damaged. Prospects for recovery progress rely upon victims’ ability to engage in enduring and healing relationships with others. Therapy therefore aims to redress the trauma suffered with a positive experience of relational support and trust. If left without this therapeutic support, victims may suffer further isolation, feelings of alienation and the consequent aggravation of trauma symptoms. HBF clinicians have to take time to observe, to listen patiently and learn about the client’s intricate and complex feelings. Clinicians need to understand the circumstances and responses of a person whose personal safety, autonomy over mind and body, and sense of their own self as a significant entity, has been violated by others. The mutuality of the therapeutic relationship helps the client to know that they are able to manage their own autonomy, to complete basic tasks, to look after themselves and to continue with their daily lives. They may also be given coping techniques for use outside of the therapy room that are specifically tailored to their psychological needs and which they have helped to create themselves. 100 As therapy sessions progress, an understanding gradually becomes established that the client-clinician relationship is one that can be relied upon as needed. The long-term nature of the therapeutic relationship enables the client to realize that the interest taken in their welfare and recovery is genuine and strong. Unlike previous relationships they have experienced, it is not going to prove deceptive or false, or to dwindle as time goes on. Gaining an intricate understanding of a victim’s history and experience from their own point of view is the only way that individual responses to trauma can be fully explored. Clinicians can then address issues of re-traumatization and self-harm, assisting the client to build agency and control over their lives. Gradually this shifts their perspective from damaging and isolating internal emotional experience, towards external, healthy, interpersonal relationships. 8.2 A Safe, Calm and Consistent Therapeutic Environment The rooms in which therapy takes place should not remind clients of any previous traumatic experiences. For example working in confined spaces is avoided as these may trigger memories of trafficking captivity, prison or detention. Clinicians ensure that they are not facing the client directly across a desk, or in any way which might suggest to them that the clinician is an authority figure. Sitting as equals in the room creates a feeling of safety and openness which assists communication. This is especially important as clients, particularly those who are also involved in legal procedures can easily be confused about the clinician’s role. It ensures that the client feels as comfortable as possible and has confidence in a process which begins with sensitivity and respect. The key is simplicity: an interaction between two people in basic and comfortable surroundings. “This space is ours; it belongs to us.” It is often the case that clients have not told anyone else about specific aspects of their traumatic experiences. Factors such as feeling guilt, shame, humiliation or the fear of being judged can mean that expressing difficult thoughts and emotions can be overwhelmingly difficult. Over time the therapy room becomes a safe place where they can express whatever they are feeling from their own viewpoint. The fear of becoming emotionally overwhelmed lessens as therapy sessions progress and trust is developed over time. This experience of “a safe place” can then be replicated using techniques that are accessed through the client’s imagination and memory.