Effective ways of working with trauma

Trauma isn't a mental illness: it is an injury. Therefore, we need different ways of working with trauma than we would if we were trying to work with a mental health condition. In this article, we will explore what works.

This article is not designed to provide a complete list of every possible option. But it will provide you with an overview of some of the most effective ways of working.

Body-based therapies

Individuals struggling with trauma often know they are safe on a cognitive level but still struggle with symptoms on a bodily level. As such, we need a psychotherapy that can work at this body level rather than with our thoughts.

Right from the start with Freud, the body was viewed as important and this continued through Gestalt Therapy. Today, there are several that focus on the body such as Sensorimotor and Somatic Experiencing.

Yoga

Individuals with trauma often feel disconnected from their bodies. Using body-based psychotherapies can help, but it is not the only route into helping people re-engage with their bodies.

Yoga can be another avenue. It is important that this is done in a trauma-informed way. This might involve working much slower, being selective about poses, always keeping eyes open and using contract-free adjustments.

Eye Movement Desensitisation and Reprocessing (EMDR)

One of the limitations of talking therapy is that it requires a client to put words to their experiences. But often what has happened to them affects them on a lower non-verbal level.

EMDR avoids this problem: a client can do EMDR without having to narrate what happened to them. It uses what is known as bilateral stimulation to help clients to reprocess painful memories.

Trauma-Focused Cognitive Behavioural Therapy (TF-CBT)

While I have repeatedly quoted the phrase "you cannot think your way out of trauma", CBT can be helpful for some clients. Specifically, TF-CBT is a form of CBT adapted to help people with trauma.

What CBT often brings is structure: it helps an individual understand what is going on, gives them practical coping strategies for managing their feelings and, if a client can to verbalise their experience, reduces the emotional charge through exposure.

Neurofeedback

Neurofeedback is a relatively new approach to trauma that is exciting for several reasons. It helps the brain rewire itself and again, does not require the client to talk about their traumatic experiences.

Neurofeedback uses biofeedback and electroencephalography (EEG). The client wears non-invasive electrodes (it looks like a balaclava) that monitor brain activity. They then play a computer game controlled by their brain waves. Scoring points rewards the brain for generating certain brain waves creating a positive feedback loop.

Early research suggests it produces meaningful and long-lasting results. But it is early days, the equipment is still expensive and fiddly, and the client goes home with a head covered in gel.

Conclusion

Trauma is not a "thinking problem" and therefore requires a different approach to therapy. In this article, we explored multiple ways of working with trauma that work with the somatic experience of trauma and avoid the client having to talk about their traumatic experiences.