There are many types and styles of therapy out there. Many of us have heard of "DBT" and "CBT," but these are only two of a multitude of options. While it is important to consider the skills and experience that a therapist has, it is also necessary to balance this with what our individual needs and goals are. This is especially true if we have experienced any kind of trauma throughout our lives.
Enter: trauma informed therapy.
So, what exactly is trauma informed therapy? This is an approach to therapy that highlights the awareness that trauma impacts a person's life in complex ways. We are all unique individuals with differing life experiences and unique ways of being in the world. While we might be inclined to think of trauma as this "big thing" that happens to "other people," the truth is that the majority of people have experienced at least one stressful event in their life that has impacted them in one or more of the following areas: trust, power and control, safety, intimacy, and self esteem. Trauma informed therapy puts YOUR experiences in the forefront of the relationship in a compassionate and thoughtful manner so that you have the opportunity to build more space between the trigger (or automatic response you feel when something happens), the emotion experienced, and what you do next.
I want to emphasize that how we cope with stress and/or trauma is not "bad" or "wrong." We or society may shame us for how we respond to stress, but this does not make our actions--or us, for that matter--inherently bad. Sure, downing our favorite carton of ice cream on the daily or chain smoking may not be the healthiest coping skill. But if helped you to regulate and get to the next day, there is no shame in that. And, if you are here looking for healthier ways to regulate, that is awesome! This is not to downplay any feelings of shame we might experience when we engage in an activity that we don't want to be engaging in. Rather, it is to highlight that regulating is a very complex matter that many of us were not overtly taught how to do. Trauma informed therapy allows for an additional layer of understanding of how adversity can impact a person, and that coping can be complicated.
What if I don't know if my experience counts as trauma?
Great question! We have all experienced suffering at some point. And, this suffering has led us to cope in the best way that we can. At the end of the day, we are all doing the best that we can with what we have and what we know. While we may "think" we know the best thing to do, it isn't always possible with the resources we have. Again, we don't learn how to cope with stress or trauma in school. If we are lucky, we have at least one parent to model this for us, but this isn't always the case.
We don't have to define our experiences as "traumatic" to benefit from trauma informed therapy. What matters is YOUR experience of the world. Trauma informed care centers your experiences with compassion and curiosity.
How do I know if my therapist is trauma informed?
This question is tough because there are many therapists out there who have not had a formal training in trauma informed practices, and yet they are able to provide this care to their clients. There are also therapists who have had trainings, but may struggle with this. The best way you can find out is to ask. My favorite questions include: "how do you approach working with trauma?" "Do you have experience in working with people with similar trauma to me?" "What is your approach/experience in working with racialized or gendered trauma?" "If I get flooded or triggered in a session, how would we work through this together?"
There are many other questions you can ask. These are just a starting point to learn more about if the approach feels right to you. Not all approaches are going to make sense for everyone, and this is ok. What is important is that you feel seen and heard.
You mentioned styles of therapy earlier. What styles can help me narrow my search down?
There are many trauma informed therapies out there. I will do my best to describe a few kinds, but keep in mind that this list is not exhaustive. Look for blog posts on some of these topics in the near future!
Cognitive Processing Therapy (CPT)
Cognitive Processing Therapy is a style of therapy that works specifically on how thoughts impact trauma responses. It is a manualized treatment -- meaning, each week is pre-planned -- that is designed to help individuals with PTSD to recover from their symptoms. CPT utilizes an exposure based lens, so you can expect to talk about the trauma directly. The idea here, is that with repeated exposure, the memories or experiences will become less intense over time. CPT focuses on getting to the root belief systems that were caused or reinforced by the trauma (i.e. "I am bad" or "I am unloveable") and working with the thoughts that hold these systems in place. The first few weeks are spent learning about PTSD and processing the trauma while the remaining weeks focus on learning how the trauma has impacted your life in specific areas. A round of CPT is 12 weeks, though I have seen clients finish in as early as 8 weeks or as many as 20 weeks. CPT is a great option for those who only have a short period of time in therapy and are looking for relief as soon as possible. CPT works best for single event traumas, though it is possible to process multiple events by extending the length.
Somatic Experience Therapy (SE):
Somatic Experience Therapy is a lesser known therapy that focuses on nervous system regulation. This is just a fancy way of describing a therapy that is "body based." Most SE practitioners that are licensed as therapists, use traditional talk therapy in combination with body based skills that will help a client to regulate more efficiently. An example of this is is breathwork to slow the heart rate. One of the main goals is to build more resiliency within the nervous system by increasing one's capacity to cope with a wider range of experiences. What this means is that if you are struggling with a variety of physiological stress (panic attacks, anxiety attacks, becoming flooded with memories, restlessness, dissociating, energy that doesn't seem to leave your body, tension, insomnia, etc.), this may be a great option for you. SE doesn't require you to talk directly about the trauma if you do not want to. A skilled SE therapist will work with you in fine tuning self monitoring and regulating skills prior to stepping into trauma work. This therapy model is flexible and can easily be used for a variety of non-trauma related issues--i.e. procrastination, avoidance, or even things like increasing joyfulness. This is a fantastic model that allows the therapist to pull from other theories and tailor the care specifically to the client. Somatic Experience also lends well to single event trauma, complex trauma, or trauma that was ongoing/continuous.
Dialectical Behavioral Therapy (DBT):
DBT is a form of therapy that has been researched and vetted since the 1970s. It has been validated for treating a variety of issues, like substance use, suicide ideation, PTSD, eating disorders, complex trauma, depression, anxiety, etc. DBT is a manualized treatment that focuses on four core areas: distress tolerance, mindfulness, emotion regulation, and interpersonal effectiveness. This type of therapy helps clients to learn skills, practice them between (and during) session, and integrate them into their life. DBT clinics and therapists often have a coaching service available after hours to help problem solve issues that arise between sessions. This can be really helpful for when you are experiencing a big emotion and cannot figure out how to work through it. Research shows that DBT is effective in both the individual and group setting. DBT also lends well to complex trauma or trauma that was ongoing.
Eye Movement Desensitization and Reprocessing (EMDR):
EMDR is one of the more common trauma treatment modalities. It is a type of therapy that works with clients in reprocessing traumatic memories in order to find relief from symptoms created by these memories. EMDR is a phased and focused approach that helps clients to integrate traumatic memories in a more adaptive way. During an EMDR session, clients are encouraged to briefly focus on a specific part of the adverse event while simultaneously experiencing bilateral stimulation (usually left to right eye movements--though tapping, sound, or vibrating pads are also techniques used to stimulate this). The therapists works with the client to process the memories, emotions, or sensations by encouraging the client's own natural healing capacity to take the lead.
A few Other Shoutouts:
Internal Family Systems (IFS)
Brainspotting
Mindfulness Based Stress Reduction
Trauma Focused CBT
Other Somatic Therapies
Other Exposure Therapies
Hypnotherapy
Narrative Based Therapy
A few final thoughts...
There are many other forms of therapy that are specifically designed to treat trauma and trauma related symptoms. However, you do not have to have experienced trauma to benefit from these models. Trauma informed therapy, ultimately, just means that the therapist has taken extra time and effort to understand the complexity of what it means to work with clients who have experienced trauma or adverse events. Even if this doesn't apply to you, working with someone who has this additional level of care will undoubtedly still be felt.
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