This is a copy of an article I posted on Counselling Directory. Click here for original article.
A search of the internet on the effectiveness of talk therapy for trauma recovery reveals various high-ranking sites claiming that talk therapy doesn’t resolve trauma and can even force you to reiterate the events which can be retraumatising. Many of these sites state that somatic (body-centred) therapy is the path to healing trauma. This tension between talk and somatic therapy approaches can leave potential clients wondering whether talk therapy is effective and suitable for trauma recovery.
The answer lies in understanding how trauma impacts the mind and body, and the ways therapists can help clients to integrate traumatic experiences to achieve a sense of safety, empowerment and healing.
The impact of trauma on mind and body
Trauma is not only related to the traumatic events that were experienced but also how those experiences were internalised and the longer-lasting imprint on the mind and body.
Neuroscience research shows that trauma-related emotion and body memories are stored in the subconscious brain system and that the verbal memory areas of the conscious brain shut down when these emotional and body memories are triggered.
In this respect, trauma survivors may struggle to remember (and talking about) the full story of what happened, but might unexpectedly be triggered by sensory memories such as images or sounds associated to the trauma, emotions memories of how it felt, or body memories such as trembling, increased heart rate, and a sinking feeling in the stomach. The cognitive memory may be limited to deeply held core beliefs of shame and worthlessness tied to the traumatic emotional and body memories.
Any of the five senses (sight, hearing, touch, smell, taste) may trigger emotion or body memories of the trauma outside of conscious awareness. As the subconscious brain has no concept of time, the body reacts as if the danger is here in the present. Therefore, the legacy effect of trauma is the past repeatedly showing up in the present, triggering flight, flight or freeze response, reacting to a threat that the subconscious brain believes is real and present. Cognitively the body and emotion response make no sense as the person may be aware they are not in any imminent danger which can lead them to question whether they are losing their mind.
When trauma memories are triggered, the body is anticipating threat, and adrenaline (and subsequently cortisol) is pumped into the bloodstream, heart rate and blood pressure go up, and glucose and fats are released into the bloodstream supplying energy to all parts of the body. When the threat passes, cortisol levels fall dampening the stress response. However, in trauma survivors persistent stress may prevent cortisol levels from falling sufficiently to enable to body to relax and can contribute to various physical health problems.
Trauma survivors may turn to addictive behaviour or self-harm as a survival strategy. These behaviours produce a neurochemical reaction in the body which can help regulate trauma responses. For example, self-harm stimulates the production of adrenaline and endorphins - adrenaline produces a surge of energy while endorphins are associated with pleasure and pain relief – combined they provide physical and emotional relief. However, repeated use leads to the body developing tolerance and requiring continual increases in dosage to maintain the same degree of relief which can become increasingly dangerous.
Trauma survivors also develop unconscious protections against feeling emotional pain associated with the trauma wounds. Fragmentation of the personality into different sub-parts and dissociation are ways the mind copes with too much stress caused by traumatic experiences. This may involve feeling disconnected from yourself and the world around you, detached from your body or feeling as though the world around you is unreal.
The path to recovery: Integration of traumatic memory
For trauma treatment to be effective survivors do not need to remember, retell or re-experience the traumatic events, but they do need to develop a physical, emotional and cognitive awareness that it is over and in the past.
As discussed above, when a trauma survivor is triggered the emotion and body memories take over, the thinking brain shuts down, and the body goes into survival mode reacting to past threats. Therefore, keeping the thinking brain online so there is awareness of being in the present, and not in the past, is an important part of trauma recovery. Healing is then possible by helping the protective parts of the personality to relax to let the trauma wounds be reintegrated into the personality.
All trauma therapy should emphasise the importance of finding approaches that help integrate traumatic memories, restore balance of the nervous system, and reestablish a sense of safety and empowerment.
"Successful treatment of traumatic memory consists of helping patients to overcome the traumatic imprints that dominate their lives: the sensations, emotions, and actions that are not relevant to the demands of the present but are triggered by current events that keep reactivating old, trauma-based states of mind.” - Bessel van der Kolk
In this respect, trauma therapy benefits from both a top-down ‘talking therapy’ and a bottom-up ‘somatic therapy’ approach. This helps the thinking brain to stay online and able to have an internal dialogue with parts of the personality, while also addressing dysregulation of the nervous system to stay present and connected. All trauma-informed therapists should have knowledge of the need to work with both the mind and body. Holistic approaches that include somatic, emotional, and cognitive processing and integration may be best for trauma therapy.
However, it's important to remember that regardless of the type of therapy offered, the therapeutic relationship is the key factor in achieving good outcomes.
“The core experiences of psychological trauma are disempowerment and disconnection from others... Recovery can take place only within the context of relationships; it cannot occur in isolation” - Judith Herman.
Finding a therapist that you feel safe with, and able to be vulnerable without fear of judgement, is the most important factor when seeking therapy.
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