Environment can have an impact. I don't feel comfortable in overly sterile office-y or clinical settings. They just feel too formal and also I've had a few medical traumas. I am not comfortable sitting in chairs. My therapist and I sit on the floor (she just sits on more pillows than I do). Or hold a stuffed animal. I do a body-somatic sort of therapy and it helped early on to do some mirroring things, where it was just sort of playful but helped me feel connected to my therapist without pressure of words, and without me half detaching from the situation (so like she did some movement with her arms and I copied, then for a while I led, etc.). I was brave enough to ask for that one day when I felt disconnected and not willing to trust much. Low lights helps too (and ideally not flourescents). I also have to face the door and not have anyone sitting in my way.
I also need to be able to move and express what I'm feeling with my body or my posture since I don't have words for much. In regular cbt talk therapy I made a couple different therapists uncomfortable by my squirminess and I spent so much time focusing on containing my own tension. If I can have something to squeeze, or be allowed to lay down or curl into a ball, or kick against the couch a little, I feel safer and trust is a lot better for me. With my complicated stuff it's just too hard to sit in a chair and have a conversation like we're out for coffee. So much about it has to do with allowing my body to feel comfortable and safe, and then sometimes go into trauma stuff.
