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Trauma Therapy in St. Louis

We can help you find safety in your body, your relationships, and your life.
image of a person with braids who is crying and looking off to the side

What is trauma?


The word trauma literally means “wound.” Psychological trauma refers to events or experiences that cause lasting harm to our mental health. When we hear the word “trauma” many of us think about very intense events, like near-death experiences, sexual assault, or violence experienced in combat. While these kinds of experiences are traumatic, it’s important to remember that they aren’t the only types of events that can cause trauma. 


While there are many different ways to define trauma, one definition is that trauma happens when a person experiences something that is “too much, too fast, or too soon” for them to be able to process. Often these experiences overwhelm our capacity to cope. However, trauma can also involve experiencing “too little, too late”, such as trauma from experiences of neglect. For example, when our physical or emotional needs are unmet, particularly when we are children. 

The “too much, too fast, too soon / too little, too late” definition is helpful because it leaves space for the fact that each person is unique, and what “too much” or “too little” looks like, is going to vary from person to person. For example, two siblings may experience the same traumatic event, such as the loss of a parent, but they may respond in different ways based on differences in age, personality traits, or the types of support they receive after the loss. 


When we step away from trying to define “how intense” or “how bad” an event needs to be in order to label it as traumatic, we can more accurately identify and address the ways that we have been hurt during our lives, and we can begin to move towards healing.

Painful life experiences can leave us feeling isolated and afraid.


  • Exhausted from being constantly anxious or on edge.

  • Disconnected from people you love, or the world around you.

  • Numb, or like you can’t connect to your emotions.

  • Ashamed about painful life experiences from your past.

  • Guilty about using risky coping mechanisms, such as self-harm or substance use.

  • Overwhelmed by nightmares, flashbacks, or disturbing memories.

  • Confused, or struggling to concentrate or make decisions.

  • Afraid to trust yourself, or the people closest to you.

  • Stuck, like life is going on around you, but you aren’t moving forward.

  • Hopeless that you will ever feel happy and safe again.


two people cuddlig on the couch

At its core, trauma impacts our ability to feel safe in our bodies, our relationships, and the world around us. While the symptoms of trauma are quite diverse, they are all tied to the concept of safety. 


When we experience trauma, our minds and bodies adapt to cope with the painful experiences. Sometimes this can look like our bodies freezing in a moment of crisis–like an animal threatened by a predator, our bodies are trying to “play dead” to help prevent us from being attacked. Other times, we may feel our heart race during a crisis, as our body prepares to flee from an incoming threat, or fight to defend ourselves. 


These kinds of body responses can be very helpful when we are in the midst of a crisis. They may be the very thing that allows us to survive the danger. But sometimes we can get stuck in these states. For example, we may notice our heart racing, or our body or mind freezing, when something reminds us of the traumatic event, even if we are not actually in danger. This can cause us to struggle with symptoms like anxiety, panic attacks, dissociation, and depression.

Trauma can also have a big impact on our relationships. When we feel unsafe, it is normal for humans to reach out to others for support and connection. Our relationships with others help us feel calm and regulated. But if we have experienced trauma–especially when we have been abused by others–our ability to feel safe in relationships is interrupted. We may have learned as children that trusting others will lead to them taking advantage of us, so we pull away from the ones we love. Or we may have learned that we can’t trust ourselves and over-rely on our loved ones to help us regulate. Both of these situations can make it harder for us to maintain healthy relationships with the people we love.


At Healing Exchange, we believe that healing happens in relationships. Because so many folks experience trauma in relationships, a key part of the healing process is experiencing what it is like to relate to another human in a safe and supportive way. 


Therapeutic relationships can be a wonderful opportunity to experience safety in connection with others. For example, when we open up to a therapist about experiences that we feel shame about, and the therapist responds with compassion and validation, we can take a step towards trusting others in our lives. We can also practice setting boundaries or addressing conflict with our therapist, to help gather evidence that we can advocate for ourselves without being harmed in response.

two people embracing. black shirt reads "no homophobia, no violence, no racism, no sexism, yes kindness, yes peace, yes equality, yes love


At Healing Exchange, we recognize the critical role that systemic oppression plays in the lives of our clients. Experiencing discrimination and oppression–whether it is in the form of being abused or attacked because of our identities, or daily exposure to microaggressions and implicit bias–is a form of trauma. The racism, ableism, heterosexism, fatphobia, and other forms of oppression that we face everyday can interrupt our ability to feel safe in our bodies, relationships, and the world at large. 


We approach trauma treatment from an anti-oppressive framework. We can support clients in exploring how systems of oppression have contributed to their experiences of trauma, and unlearning the ways that they have internalized the beliefs of these oppressive systems.

Did you know… 

  • LGBTQ+ people are nearly 4 times as likely to experience a violent assault during their lifetime, compared to cisgender and heterosexual people.

  • People with disabilities are four times as likely to be victims of crimes compared to people without disabilities.

  • Black and Hispanic folks in the United States are more likely to experience maltreatment during childhood, including witnessing domestic violence. Among those who are exposed to trauma, Black folks are more likely to go on to develop PTSD than folks belonging to other racial or ethnic groups.

  • Children with Autism Spectrum Disorder (ASD) are more than twice as likely as the general population to have experienced sexual abuse.

  • More than 27% of homeless people in the US have PTSD. In contrast, the prevalence of PTSD for the general population in the US is less than 4% (American Psychiatric Association). 

  • Women are about twice as likely to develop PTSD as men.

Experiencing trauma and developing PTSD is generally more common for folks belonging to marginalized groups. This is likely due to the fact that folks belonging to these groups are more likely to have experienced discrimination, which is a form of trauma. However, in addition to directly experiencing discrimination as a form of trauma, folks belonging to marginalized groups are also more likely to experience interpersonal violence, and less likely to have access to the resources they need to survive, such as food, housing, and medical care. 


therapist looks onto trauma client with care and compassion

Internal Family Systems Therapy (IFS)​

Trauma-Informed Expressive Arts Therapy​

​Somatic Experiencing (SE)

​Cognitive Based Therapy​

Eye Movement Desensitization and Reprocessing (EMDR)

Clinicians Specializing in Trauma and PTSD

Rafaella Smith-Fiallo, relationship, sex, and trauma therapist in St Louis

Rafaella Smith-Fiallo (she/ella)

LCSW, Certified Clinical Trauma Professional (CCTP-II)

Rafaella specializes in treating trauma through centering autonomy and pleasure. She is trained in processing and treating trauma using EMDR, IFS, and CPT while creating space for clients to envision what their most pleasurable and harmonious lives could look like and reclaiming it for themselves. Learn more about Rafaella.

Rafaella’s specific areas of focus within the trauma field include:

  • Supporting adult survivors of sexual abuse and violence that occurred across the lifespan. Being connected to your body, present during sex, and able to experience pleasure may feel impossible at times, but sexual agency and satisfaction awaits you.

  • Supporting adults who have experienced various or ongoing unsafe, unstable, and traumatic experiences throughout their lives. This is often referred to as complex trauma; together we’ll unpack the pieces and create a unique mosaic of understanding.

  • Demystifying unhealthy behavior patterns that cause confusion, create distance, and don’t align with your deepest desires for healthy connection and community. Now it’s time to create healthier ways of living.

  • Re-connecting to the body and parts of the self that have been avoided or cut off in order to remain unnoticeable and stay safe. We’ll build a relationship with yourself that is rooted in consent, trust, and boundaries that will transfer into relationships with others.

Melony Crayton, relationship and trauma therapist in St. Louis

Melony Crayton (she/her)


Melony specializes in treating complex and relational trauma. She takes a holistic, attachment-oriented, and trauma-informed approach in supporting clients to transform their relationship with their emotions and build a healthier relationship with themselves and others. Learn more about Melony.

Melony's specific areas of focus within the trauma field include:

  • Supporting adults who feel ongoing fear, powerlessness, and worthlessness due to repeated, interrelated, and long-term exposure to traumatic experiences. This is often referred to as complex trauma; together we’ll access the version of you who doesn't have to carry pain and reclaim a sense of wholeness.

  • Supporting adults who experienced relationship trauma cycles that disrupt intimacy, cause self-abandonment, and relational imbalances. You can choose to build healthy and loving connections that don’t require you to abandon yourself.

  • Supporting adults who lacked a consistent and safe emotional connection with a primary caregiver in childhood and have difficulty building secure relationships in adulthood. This is often referred to as attachment trauma; together we’ll nurture the parts of you that needed to feel loved and supported.

River Chew, trauma and eating disorder therapist in St. Louis

River Chew (they/them)


River specializes in treating trauma and eating disorders. River has experience in the field of trauma treatment both as a client and a therapist, and they enjoy bringing their own experience in recovery into their work with clients. Learn more about River.

River’s specific areas of focus within the trauma field include:

  • Working with adult survivors of child sexual abuse, including those who were abused by other children. This is often referred to as child-on-child sexual abuse (COCSA), or sibling sexual abuse (SSA). 

  • Working with clients who struggle with using risky coping or safety-seeking behaviors, such as self-harm, substance use, risky sexual behaviors, or disordered eating. This includes folks who have been diagnosed with borderline personality disorder. 

  • Working with clients who struggle with their relationship to their body as a result of trauma. This includes folks who have experienced body-focused discrimination, chronic illness, chronic pain, or body dysmorphia. 

  • Working with folks impacted by vicarious trauma, who have witnessed or been exposed to traumas experienced by others. This includes mental health professionals, first responders, or loved ones of trauma survivors.

Eric Jones, MSW clinicial mental health student

Eric Jones (he/they)

Trauma Therapist Intern

Eric focuses on trauma-informed, pleasure-centered approaches to working through trauma. He works to create the necessary conditions for you to process conflicting self-narratives around your trauma and responses to it. Eric will support you in prioritizing pleasure in your life and cultivating a more integrated sense of self. Learn more about Eric.

Eric's specific areas of focus within the trauma field include:

  • Supporting clients who are struggling to make sense of their traumatic experiences and to process the complex feelings and emotions. You feel like you are stuck in a riptide, unable to catch your breath and get back to shore, but there is a buoy in sight for you to grasp and pull yourself out of your suffering.

  • Working with clients who feel disconnected from themselves and their bodies due to trauma. You feel like an alien in your own skin. The sensations and pleasure you once loved, you now dread. You are craving for a sense of what was and what could be. 

  • Working with clients to unpack the truth behind their risky coping strategies and redefine their relationships with themselves with care and compassion for just trying to make it through. You feel ready to find new ways to cope, but you don’t know how to let go of behaviors that have provided you an outlet from your pain. We can work together to build skills focused on healing and not just relief.


Kat Seal (they/she/any)


Kat specializes in treating complex, relational, and sexual trauma. Her approach to supporting folks in trauma healing is client-centered, trauma-informed, and focuses on the mind-body connection. Kat works with individuals and relationships who value authenticity and personal growth but feel held back by past or recurring wounding. Their lens is informed by attachment and systems theory, feminist theory, and somatic practices. Traumatic systems, events, and relationships can leave us feeling numb or fragmented. Deep trauma work is possible, and Kat partners with clients to grow their sense of safety, agency, and inner aliveness. Learn more about Kat.

Kat's specific areas of focus within relationship therapy include:

  • Working at your cadence to do trauma healing that is gentle, intentional, and powerful. 

  • Supporting clients who experience somatic complaints that have roots in trauma to tune in and listen to the messages their bodies are attempting to communicate

  • Supporting clients who have experienced narcissistic abuse (in childhood or adulthood) or are in recovery from cults, including religious or spiritual trauma. 

  • Working with clients to reconnect with parts of themselves that may have been fractured or silenced from interpersonal or systemic trauma. 

  • Centering bodily agency after trauma with somatic practices that encourage self-trust and self-tending.


What is the difference between trauma and PTSD?

Trauma describes either a type of experience that is overwhelming to our system, or to the harm itself that we experience from those traumatic experiences. Post-Traumatic Stress Disorder (PTSD) is a specific type of mental illness that can result when we are not able to resolve the harm caused by traumatic experiences. Not everyone who experiences a traumatic event will go on to develop PTSD, however experiencing some form of trauma is required to receive a diagnosis of PTSD.


What is complex trauma?

When many folks think of PTSD, they imagine someone experiencing a single traumatic event, and then experiencing a big shift in their mental health symptoms afterwards. While this is true for many people who develop PTSD, there are also many people who experience multiple traumatic events throughout their lives. 


Folks who have been exposed to trauma over and over, especially those exposed to repeated traumas during childhood, may experience different symptoms than folks who have experienced a single traumatic event. For example they may struggle to maintain healthy relationships with their loved ones, or be more likely to use risky coping mechanisms, like substance use or self-harm. This different “presentation” of PTSD is often called complex trauma, complex PTSD, or CPTSD. 


Do I have to tell my therapist about my traumatic experiences?

For some folks, telling the story of our trauma to another person can be an incredibly healing experience. Many approaches to trauma therapy involve “telling our story” in some way. But no one path is right for every person. And in order for telling our stories to be healing, it is incredibly important that we get to choose to share, rather than being pressured or forced. 


At Healing Exchange, we individualize treatment for each client to meet their unique needs and goals. We have the skills and experience to support you in working towards healing from trauma, whether or not you want to tell us details about your traumatic experiences. 


What if I think I am having trauma symptoms, but I don’t remember experiencing trauma?

Some people may have symptoms of PTSD, or other trauma-related symptoms, even if they do not remember experiencing a traumatic event. Trauma impacts the way that our brains store memories, and it is not uncommon for folks who experienced trauma to have incomplete or confusing memories of the trauma, or even to not remember it at all. This is especially true for folks who experienced trauma as a young child. 


Cultural norms or lessons we learned in our families of origin can also impact whether or not we label experiences as traumatic. It is possible to have been profoundly hurt by a particular experience, but still not recognize that the experience was traumatizing for us. 


If you resonate with the experiences discussed on this page, even if you do not remember experiencing a specific traumatic event, working with a trauma therapist could help you learn more about how your past experiences may be impacting your current struggles.

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