In the past 21 years since I entered the field, a lot has changed in how we identify, understand, and help people heal trauma. Thankfully, research over the past thirty plus years has helped us shift our knowledge base and thus inspired newer body-based (somatic) therapies to fully address the way that trauma shows up in the body.
Whether or not you have read more recent books on trauma such as Bessel van der Kolk’s “The Body Keeps the Score”, Judith Herman’s “Trauma and Recovery”, Peter Levine’s “Waking the Tiger”, or Pat Oden’s “Trauma and the Body”, just considering the titles gives us the idea that perhaps the body is involved in trauma and how trauma impacts us. That idea is not only correct, but also what has shifted us to understand the need for trauma therapies that involve the body. Knowing this, we have come to understand that to heal trauma, the body must be involved. What follows is a peek into some of these treatment options. It is not meant to be an exhaustive list or prescriptive in any way, but just a way to share what may be available to you. I have also shared some adjunctive treatments to trauma therapy as they can greatly assist in the healing process.
What does it mean to have “trauma”?
Before we get into some of the integrative treatment options for healing trauma, let’s clarify what we mean by trauma. In the 5th Edition of the Diagnostic and Statistical Manual (DSM5), what is used by many clinicians for diagnosis of psychological disorders, traumatic events are those we have experienced or witnessed in which we were exposed to actual or threatened death, serious injury, and/or sexual violence. Under certain circumstances, this can include learning about a traumatic event happening to a close family member or close fired or “experiencing repeated or extreme exposure to aversive details of the traumatic event(s) (e.g., can happen with therapists, first responders, police officers, and others).
The tough part is, for some who grew up in unstable family situations a disappointing look filled with shame from a parent could be experienced as trauma; a child experiencing this could fear abandonment or being harmed in some way, or something else potentially life threatening. So in some ways, trauma is in the eye of the beholder. This doesn’t mean that everything that upsets us or that we don’t like is trauma. It is just important to understand that trauma doesn’t have to be being raped, beaten, blown up or shot at, or other experiences like those. In trauma therapy, we refer to those trauma experiences as “big T” traumas - essentially traumatic events that almost everyone and anyone would see as traumatic. “Little t” traumas are still traumatic. They just tend to be more individualized based on the circumstances, as in the case with the aforementioned disappointing and shaming look.
Note that while we may have a history of trauma, we may or may not meet criteria for Post-Traumatic Stress Disorder (PTSD). That doesn’t mean your trauma doesn’t impact you and that you don’t need treatment. It just means that at the time of being assessed, your symptoms do not align with what we now consider to be PTSD.
Now that we have an idea of what trauma is, let’s take a look at some integrative therapies.
Eye Movement Desensitization and Reprocessing Therapy (EMDR Therapy)
EMDR Therapy is a well researched and effective treatment for trauma that can also be used for some other presenting issues such as anxiety, stress, anger, shame, and many others. It assists your brain's natural ability to process information and heal from trauma, particularly when your natural healing process has been interrupted or turned off. Developed in 1987 by Francine Shapiro, EMDR Therapy has been well researched since that time. It has been accepted as a treatment for PTSD by the American Psychological Association and the American Psychiatric Association as well as the Department of Defense and the Department of Veteran's Affairs. It is important to note that EMDR Therapy is a client driven therapy. That is, if we decide EMDR Therapy is appropriate for you we will work together to honor your pace and therapeutic needs.
We begin EMDR Therapy by working on stabilization skills and resourcing to prepare for the trauma reprocessing phase of treatment, a phase of treatment that can be quite intense. Once you and your EMDR therapist agree that your system has stabilized enough to tolerate the trauma reprocessing phase, you will work methodically through your trauma memories as related to your current symptom picture.
For more information about EMDR Therapy click here or go to https://www.emdria.org.
Internal Family Systems (IFS)
Internal Family Systems (IFS), sometimes referred to as "parts work", honors the fullness of who we are recognizing that at our core, our Self-energy helps us navigate the world with compassion, curiosity, clarity, confidence, courage, creativity, connection, and from a place of calm. However, sometimes extreme events such as trauma can interfere with our ability to connect with our inner wholeness. IFS helps us heal so we can reconnect with our ability to live and lead from a grounded, connected place.
For more information on IFS click here or go to https://ifs-institute.com.
Sensorimotor Psychotherapy ®
Sensorimotor Psychotherapy is a method developed by Pat Ogden for processing traumatic memory from a body-based orientation. It integrates sensorimotor processing with cognitive and emotional processing to holistically address all parts of the system impacted by trauma. It joins somatic therapy and psychotherapy into a comprehensive method for healing the disconnection between body and mind that often occurs with trauma. Ogden identifies as particularly helpful with dissociation, emotional reactivity or flat affect (i.e., numbed out), frozen states or hyperarousal and other PTSD symptoms.
For more information about Sensorimotor Processing Therapy click here or go to https://www.sensorimotorpsychotherapy.org.
Somatic Experiencing® (SE)
Somatic Experiencing (SE) is a body-oriented approach to healing trauma and other stress related disorders. SE was developed by Peter LeVine over the course of his career studying stress physiology, psychology, ethology, biology, neuroscience, indigenous healing practices, and medical biophysics. He reports 45 years of successful clinical application with this approach. SE’s approach is one of freeing the nervous system from being stuck in the fight, flight, or freeze responses through movement.
For more information about Somatic Experiencing click here or go to https://traumahealing.org/about-us/.
ADJUNCTIVE TREATMENTS TO TRAUMA THERAPY
Trauma Center Trauma Sensitive Yoga (TCTSY)
Trauma Center Trauma Sensitive Yoga (TCTSY) is a SAMHSA Approved, evidence-based protocol for treating PTSD and complex trauma developed by leading researchers in the field of trauma and psychology. TCTSY is based on clinical trials performed at the Trauma Center at JRI in Brookline, Massachusetts by psychiatrist and leading trauma researcher Dr. Bessel van der Kolk and yoga teacher David Emerson.
TCTSY is a somatic (body-based) modality that has been proven as an effective adjunctive treatment for psychological trauma. The intent of it is to engage the neural networks in the brain impacted by trauma. TCTSY is an opportunity for you to be in complete control of your body in the present moment. You are welcome to make choices and notice feelings in your body in a way that feels useful to you. Through the process of interoception, feeling and moving the body, we can reconnect the damaged neural networks. Interoception is a learn-able skill we can practice together!
Additional potential benefits include:
The Safe and Sound Protocol (SSP)
The Safe and Sound Protocol is a five-day auditory intervention that has been shown to address anxiety and trauma related stressors as well as inattention, stressors impacting social engagement, social emotional difficulties, and auditory sensitivities.
The Safe and Sound Protocol (SSP) was developed by Stephen Porges as a way to calm one's physiological and emotional states. In doing so we can reduce stress and enhance social engagement and resilience through increasing vagal tone. In turn, this can improve communication and lead to more successful therapy.
The SSP is best used as an adjunctive to psychotherapy, as it helps enhance the process of psychotherapy and related treatments. It can be useful to engage in this protocol prior to trauma work to help enhance trauma therapies.
For more information about the SSP, click here.
If you are experiencing challenges in your life from trauma, I encourage you to connect with a trauma therapist who offers one or more of the above treatments. You don't have to suffer in pain; there is help.
This blog is for information only. Reading this blog or interacting with it is not medical advice and does not constitute a therapeutic relationship. This blog is not a substitute for mental health care. Please be sure to seek out mental health care as needed.