An Introduction to Trauma Therapy

Trauma therapy can help people recover from a wide variety of traumatic events, such as: war, natural disasters, terrorism, rape and sexual abuse, domestic violence, car accidents, being a victim of crime and witnessing distressing events. People often begin looking for trauma therapy when they are wondering if they have Post Traumatic Stress Disorder (PTSD) but you don’t need to have been diagnosed with PTSD to seek more specialized therapy.

What is PTSD?

PTSD is the name for a collection of reactions and experiences you may have in the weeks following a traumatic event. It is completely normal to feel distressed following a trauma and developing PTSD does not mean there is something wrong with you. It simply means that you may need some help with processing what happened to you so that your mind and body can fully recover. It is important to remember that PTSD responses are NORMAL RESPONSES TO ABNORMAL EVENTS.

A person with PTSD or Complex PTSD (C-PTSD) will have experienced or been exposed to actual or threatened: death, serious injury, and sexual violence. This can be in a number of ways: direct exposure, witnessing the trauma, and indirect exposure to the trauma through the course of professional duties (e.g. psychological therapists, first responders and medics.)

Responses (or symptoms) associated with PTSD:

  • Sleep problems
  • A sense of foreshortened future i.e. a pervasive and persistent belief that you will not be alive for very long. Due to this, you may struggle to think in the long term.
  • Hypervigilance (being constantly on alert) & increased startle reflex
  • Reduced tolerance to noise
  • Difficulty concentrating
  • More emotional and more intense emotions which may lead on to big emotional outbursts
  • Avoidance and numbing of anything which may remind you of the traumatic event. This is also having a profound impact on your day to day living.
  • Reliving the trauma through nightmares, flashbacks and intrusive memories.
  • Difficulty remembering all or significant portions of the trauma
  • Risk-taking or risky behaviours.

These responses need to have been present at least a month before PTSD should be diagnosed. It’s worth bearing in mind that children and young people may present differently so if you have any concerns, you can discuss those with a mental health professional or GP.

What is Complex PTSD?

C-PTSD most commonly develops after prolonged or repetitive events from which escape is very difficult or impossible. For example: Repeated childhood sexual or physical abuse, domestic violence, slavery, torture and genocide.

It has the same core features as PTSD but there are 3 additional characteristics present.

  1. “Severe and pervasive problems in affect regulation” (6B41; ICD-11): This is extensive problems in managing mood and emotions, especially to unexpected or spontaneous events.
  2. Persistent difficulties in maintaining any beliefs about oneself as having any worth. As well as deep feelings of shame, guilt, or failure that are related to the traumatic event.
  3. Persistent difficulties in sustaining relationships. Difficulties in feeling close to others. This is pervasive and cause significant impairment in the person’s function in multiple areas; personal, social, educational, occupational and any other important areas.

Both PTSD and CPTSD have dissociative aspects; most often depersonalisation and derealisation

What therapy is available?

You may have heard a few therapies mentioned when you search for trauma therapy. With a few exceptions, most therapy approaches can be trauma-informed. It has always been the case that the relationship ad how you feel about the therapy that is the most important factor in the level of success following a treatment. So often it is a bout find a good match with you and therapist, how you like to work, and what you’re capable of doing at this moment in time. For example, if you are finding it hard to concentrate and focus right now, the best approach might be one where the therapist is able to provide a framework you can work with.

  • Psychotherapy; Cognitive Analytical Therapy – helpful for deeper analysis of trauma
  • Cognitive Behavioural Therapy (useful for helping to identify destructive thought patterns developed in relation to the trauma)
  • EMDR – helps to reduce PTSD responses
  • Person-centered therapy – helpful for going at own pace
  • Mindfulness – helpful in remaining in present and reducing stress

Some exceptions:

If you experience dissociation as part of your PTSD/CPTSD, mindfulness is not advised. Mindfulness mimics many aspects of dissociation. You can, however, learn grounding techniques which are the foundation of mindfulness. Ask your therapist to teach you some or search online to get an idea of what they are.

If you have Dissociative Identity Disorder (DID) then EMDR is NOT advised by the International Society for the Study of Trauma and Dissociation unless the counsellor is knowledgeable in the treatment of dissociative disorders. When being used to treat DID a modified version of EMDR is used. This is not routinely taught. It is okay to ask a counsellor what their credentials are. Your safety is paramount and no EMDR of any kind should be happening if the person receiving treatment isn’t stable or is unable to have internal cooperation between the identities to allow for dual awareness.

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