#30: What Trauma Therapy Is Right For You?
APRIL 10, 2025
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Discover the most effective trauma therapy approaches in this comprehensive guide to healing. In this episode, we explore trauma and the symptoms of PTSD that millions struggle with daily.
Whether you're dealing with a single traumatic event or complex trauma, we break down seven evidence-based therapy methods that can help: Internal Family Systems (IFS), EMDR, Somatic Experiencing, Cognitive Processing Therapy, Narrative Therapy, Psychodynamic Therapy, and Mindfulness-Based Approaches.
Learn how each therapy works, what makes it unique, and who might benefit most from each approach. From body-based therapies that release stored trauma to cognitive approaches that reshape harmful beliefs, this episode provides practical insights to help you or someone you love find the right path to recovery. Trauma doesn't have to define your future - discover the tools and treatments that can help you reclaim your life and well-being.
[00:34] Understanding Trauma and PTSD
[04:34] Internal Family Systems (IFS) Therapy
[07:02] Eye Movement Desensitization and Reprocessing (EMDR)
[09:35] Somatic Experiencing (SE) Therapy
[12:38] Cognitive Processing Therapy (CPT)
[15:09] Narrative Therapy
[18:16] Psychodynamic Therapy
[21:26] Mindfulness-Based Approaches
[26:11] Choosing the Right Therapy for You
Episode Links:
Transcript
Anna: Hey everyone. Welcome to another episode of Courage to Heal. I'm your host, Ana Keva, and today we're again diving into something that affects millions of people worldwide, but often goes unaddressed trauma, more specifically. We're exploring effective approaches to trauma therapy and how to find the right fit for your specific situation.
Before we jump into the different types of therapy out there, let's talk about what trauma actually is. You know, trauma isn't just about experiencing something terrible, though that's certainly a part of it. Trauma is what happens when an experience overwhelms our ability to cope. It's when something happens that's so intense, frightening, or distressing that our brain cannot process it normally.
Think about it like this. Normally when something happens to us, our brain files it away as a memory, but with trauma, it's like the filing system breaks down. Instead of being neatly tucked away, these memories stay active, raw and intrusive. They keep popping up when we least expect them. Trauma can come from a single event, like a car accident or an assault, or from prolonged exposure to distressing situations like combat abuse or neglect.
And here's the thing. What's traumatic for one person might not be for another. We all have different thresholds and coping mechanisms. When trauma isn't processed and healed, it can lead to post-Traumatic stress Disorder or PTSD. Now, not everyone who experiences trauma develops PTSD, but many do and the symptoms can be debilitating.
So what does PTSD actually look like? There are four main categories of symptoms. First, there are intrusive symptoms, like unwanted memories that force their way into your consciousness. These can be flashbacks where you feel like you're reliving the event. They could be nightmares or just distressing thoughts that you cannot seem to control.
Second, there's avoidance. People with PTSD often go to great lengths to avoid anything that reminds them of the trauma. Certain places, activities, objects, situations, even thoughts or feelings. Then there are changes in mood and thinking like persistent negative emotions, feeling detached from others and having distorted beliefs about yourself or others.
Like, I can't trust anyone, or it was all my fault. Finally, there are changes in physical and emotional reactions, being easily startled, always feeling on edge, which is referred to as hyper vigilance, maybe having angry outbursts, trouble sleeping, or concentrating and engaging in self-destructive behavior.
It's also important to mention. A person who lived through repeated or chronic trauma can develop complex PTSD, which has additional symptoms compared to just PTSD. For example. People with complex PTSD develop a negative self concept and tend to struggle in relationships. Living with these symptoms is exhausting.
It's like your nervous system is stuck in high alert. Your body and mind never get a chance to truly rest. That's why getting the right therapy is so crucial. Today we're going to walk through seven different approaches to trauma therapy that have shown real results. Each has its own philosophy and methods, and what works for one person might not work for another.
So let's break them down to help you figure out. Which might be the best fit for you or someone you care about? We're going to start with Internal Family Systems or IFS. This approach has a fascinating way of looking at our inner world. IFS suggests that our minds aren't just one unified thing, but rather made up of different parts.
Almost like different sub personalities or aspects of ourselves. According to IFS, we all have a true self with a capital S at our core. This is the calm, connected, compassionate part of us. But trauma can cause this self to become obscured by protective parts that develop to help us cope. These protective parts fall into two main categories.
According to the I to the IFS model, managers and firefighters managers try to keep us functioning in daily life. They're the parts that might make you a perfectionist or a people pleaser to avoid rejection or failure. Firefighters on the other hand, jump in when painful emotions get triggered. These are the parts that might push you towards substance use.
Binge eating or other behaviors that provide immediate relief but might be harmful long term. And then there are parts that are called exiles. These are the vulnerable wounded parts, carrying the pain and trauma. They hold the memories, the shame, the fear, and they've been pushed away or exiled be because their pain feels too overwhelming.
In if FS therapy, you work with a therapist to access yourself. And from that place of calm centeredness, you get to know these parts, understanding their roles, appreciating what they've been trying to do for you, and eventually helping the exile parts release their burdens. What's really cool about IFS is that you don't necessarily have to retell or relive your traumatic experiences in detail.
Instead, you work with the internal system that developed in response to the trauma. This makes it gentler for many people who find direct trauma processing to overwhelming. The next therapy we're going to talk about is EMDR, which stands for eye Movement Desensitization and Reprocessing. This might sound a bit technical, but the concept behind it is actually pretty straightforward.
When we experience trauma, it can get stuck in our nervous system and its original unprocessed form. That's why flashbacks can feel so real. That memory hasn't been properly filed away as passed and resolved. EMDR uses what's called bilateral stimulation, typically having you follow the therapist fingers with your eyes from side to side, though sometimes they might use tapping or sounds that alternate between your left and right ear or holding vibrating buzzers in each hand while you briefly focus on the traumatic memory.
This bilateral stimulation is thought to mimic what happens during REM sleep when our brains naturally process experiences. So what actually happens in an EMDR session? First, you'll identify a specific traumatic memory to work on along with the negative belief you have about yourself because of it like, I'm not safe, or I'm powerless.
You'll also identify physical sensations that come up when you think about the trauma. As you hold these aspects in mind, the therapist guides you through sets of bilateral stimulation between sets. You report whatever comes up, new thoughts, memories, sensations, without any judgment. This process continues until the distress level drops significantly.
Then comes what's called the installation phase, where you strengthen a positive belief to replace the negative one. Like shifting from I'm powerless to I can handle difficult situations. What's remarkable about EMDR is how quickly it can work, especially for single incident traumas. Some people find significant relief in just a few sessions.
And unlike some other approaches, you don't have to discuss all the details of what happened. You just need to briefly access the memory while focusing more on your current experience of it. Now let's talk about another approach called somatic experiencing or se. This approach is all about the body.
Because trauma isn't just stored in our memories, it's stored in our physical beam. Have you ever watched NA Nature documentaries where animals face life-threatening danger? They go into fight or flight mode, and after the threat passes, they literally shake it off, trembling. Breathing heavily, discharging all that survival energy before going back to grazing peacefully.
Well, it turns out that humans have the same natural mechanism, but we often suppress it when faced with overwhelming threat. Our body prepares for fight or flight, flooding our system with energy, but if we can't complete that survival response. If we're trapped, overwhelmed, or socially constrained, that energy gets stuck in our nervous system.
That's trauma according to somatic experiencing. In a somatic experiencing session. The therapist creates a safe environment where you can gradually access these incomplete responses and allow them to complete. The therapist closely tracks subtle changes in your body, shifts in breathing, muscle tension posture, and helps you become aware of these sensations.
You might work with just small edges of the traumatic material at first pendulating between the trauma, activation and resources that help you feel safe and grounded. The therapist might guide you to notice sensations of constriction in your body and then help you find sensations of expansion or release.
The magic of Somatic experiencing is that it works directly with your nervous system, helping it discover its own natural capacity to regulate and heal. Because it focuses primarily on bodily sensations rather than the trauma narrative. It can be less overwhelming than approaches that require detailed recounting of traumatic events.
I've heard clients describe profound shifts from somatic experiencing, like feeling chronically tight, shoulders, finally relaxed after years of tension. Or noticing. They no longer startle at loud noises. These changes happen not because they figured out the trauma intellectually, but because their body has finally completed the responses that were interrupted during the traumatic experience.
Alright, shifting gears a bit, let's explore cognitive prop processing therapy or CPT. This approach focuses on how trauma changes the way we think about ourselves, others, and the world. After experiencing trauma, it's coming to develop what therapists call stuck points, unhelpful beliefs that keep you trapped in suffering. These might be things like, I should have done something different. No one can be trusted, or the world is completely dangerous. Cognitive processing therapy helps you identify these stuck points and examine whether they're accurate or helpful, and you'll learn to distinguish between facts and interpretations and to consider evidence for and against these beliefs.
A typical CPT treatment follows a structured protocol over about 12 sessions. Early on, you'll likely write an impact statement about what the trauma means to you and how it's affected your beliefs. Then you'll write a detailed account of the traumatic event itself, reading it aloud in session and at home to process the emotions that come up.
The therapist will help you identify stuck points from these writings. And then teach you structured ways to challenge them using worksheets called challenging question sheets and patterns of problematic thinking worksheets. You'll examine how your beliefs affect your feelings and behaviors and practice develop in more balanced perspectives.
CCP T specifically addresses how trauma affects five key areas, safety, trust. Power and control esteem and intimacy. By working through beliefs in each of these areas, you can develop a more balanced healing perspective. What's powerful about CPT is that it gives you concrete tools to take home and practice.
You're not just processing trauma in the therapy hour. Your learning skills that can continue to help you challenge unhelpful thinking patterns throughout your life.
And now let's shift to narrative therapy, which focuses on the stories we tell about ourselves and our experiences. This approach recognizes that we make meaning of our lives through the narratives we construct. Trauma can often lead to stories that keep us stuck in pain or shame In narrative therapy, there is a fundamental principle.
The person is not the problem. The problem is the problem. This creates separation between you and the trauma, allowing you to externalize it rather than seeing it as part of your identity. A narrative therapist might ask questions like, how has trauma influenced your life? Rather than, how are you traumatized?
This subtle shift helps you gain perspective and agency.
And there are several specialized forms of narrative therapy for trauma. Narrative exposure therapy helps you create a chronological autobiography, placing traumatic events in the context of your entire life story. This helps integrate fragmented traumatic memories. Into a coherent narrative where they become just one part of your story, not the defining feature.
And then skills training in effective and interpersonal regulation. Narrative therapy combines narrative work with skills, training for emotional regulation and interpersonal effectiveness. It recognizes that trauma, especially childhood trauma. Can disrupt our ability to manage emotions and relationships.
Then there is written exposure therapy, which involves writing about traumatic experiences for a set time under specific guidelines. This structured writing process help organize and process traumatic memories. What's powerful about narrative approaches? It's how they help reclaim your voice and ship over your own life.
Trauma often leaves people feeling like passive victims in their own story. Narrative therapy helps you become the active author again, rewriting your relationship to the trauma and its meaning in your life. I especially love how narrative therapy looks for unique outcomes. Or exceptions to the problem saturated story.
Maybe there was a moment when you stood up for yourself despite feeling powerless, or a time when you trusted someone despite the trauma teaching you not to. These exceptions become the foundation for building new, more empowering narratives.
Now let's talk about psychodynamic therapy, which is the oldest of these approaches tracing its roots back to Freud, but evolving significantly since then. Psychodynamic therapy is based on the idea that much of our mental life operates outside our awareness, that unconscious conflicts often stemming from childhood experiences.
Influence our current functioning with trauma. This approach looks at how the traumatic experience interacts with your existing psychological makeup and history. Unlike some of the more structured approaches we've discussed, traditional psychodynamic therapy tends to be more open-ended. The therapist creates a safe relationship.
Where unconscious patterns can emerge naturally through your interactions. You might notice that you relate to your therapist in ways that mirror patterns from other relationships in your life, providing valuable insights into underlying dynamics. There are several specialized psychodynamic approaches for trauma.
Brief eclectic psychotherapy, combine psychodynamic elements. Cognitive behavioral techniques focusing particularly on processing emotions like shame and guilt that often accompany trauma. It also incorporates symbolic gestures and rituals that can be healing, like writing letters you never send or performing ceremonies to mark.
Transition points in your recovery. And it's worth mentioning an offshoot of the classic psychodynamic approach called Accelerated Experiential Dynamic Psychotherapy, or A EDP. A EDP is particularly well suited for attachment or developmental trauma, the kind that happens in close relationships, especially early in life.
A EDP therapists focus on creating a deeply secure therapeutic relationship where you can experience corrective emotional experiences. The therapist actively works to undo aloneness and help you process emotions that might have been unsafe to feel in the past. A psychodynamic approach might be particularly helpful if your trauma is complex or rooted in childhood.
If you notice patterns repeating across different areas of your life, or if previous, more symptom focused treatments haven't provided lasting relief. What's unique about this approach is its depth and breadth. It's not just about reducing symptoms. About transforming your relationship with yourself and your past on a fundamental level.
And finally, let's talk about one more approach that's increasingly being incorporated into trauma treatment, and that's mindfulness-based approaches. Mindfulness practices have roots in ancient meditation traditions, but have been adapted for clinical settings. At its core, mindfulness is about paying attention to the present moment with curiosity and without judgment.
This might sound simple, but for trauma survivors whose attention is often hijacked by past memories or future worries, it's revolutionary
trauma tends to disconnect us from our bodies. We dissociate, numb out, or get lost in racing thoughts as protective mechanisms. Mindfulness gently rebuilds that connection to the here and now creating a sense of safety in the present moment. There are several formal mindfulness based interventions for trauma.
First, there is mindfulness based stress reduction or MBSR, which is an eight week program that combines meditation, body awareness, and yoga. Then there is mindfulness based cognitive therapy, or MBCT, which integrates mindfulness practices with cognitive techniques to prevent relapse of depression and anxiety, which often co-occur with trauma.
But mindfulness isn't just a standalone treatment. It's increasingly being woven into other trauma therapies we've discussed. For example, dialectical behavioral therapy or DBT incorporates mindfulness as one of its core skills, and even therapies like somatic experiencing and IFS include mindfulness, like awareness of body sensations and internal experiences.
What makes mindfulness particularly powerful for trauma is that it helps build a different relationship with triggering thoughts and sensations. Instead of being overwhelmed by them or trying to push them away, you'll learn to observe them with some distance. I notice I'm having a memory rather than being consumed by the memory.
Research shows that regular mindfulness practice can actually change the brain in helpful ways, like strengthening the areas involved in attention and emotional regulation while calming overactivity in the amygdala, the brain's alarm system. That's often an overdrive with PTSD, and I want to emphasize that mindfulness for trauma needs to be trauma informed.
Traditional instructions to close your eyes and focus on the breath can actually be triggering for some trauma survivors. A good mindfulness teacher working with trauma will offer options like keeping eyes open, focusing on external sensations first, or using brief micro practices that don't overwhelm the nervous system.
Many of my clients incorporate simple mindfulness practices into their daily lives, like taking moments to feel their feet on the ground, noticing five things they can see, or doing a brief body scan to check in with themselves. These small practices create little anchors to the present throughout the day, gradually building a sense of safety and presence.
So there you have it. Seven different paths to healing from trauma. Each has its own strengths and focus. Internal family system creates harmony between different parts of yourself. EMDR helps your brain reprocess traumatic memories using bilateral stimulation, somatic experiencing releases, trauma stored in the body, cognitive processing therapy challenges, unhelpful beliefs that developed after trauma.
Narrative therapy reshapes the stories you tell about your experiences. Psychodynamic therapy explores unconscious patterns and childhood influences and mindfulness-based approaches build present moment awareness and a new relationship with difficult thoughts and sensations. So which one is right for you?
That really depends on your preferences, your specific trauma history, and what resonates with you personally. If you prefer a more body-based approach and don't want to talk extensively about the details of your trauma, then EMDR or somatic experiencing might be good fits. If you are drawn to mindfulness and inner exploration, IFS or mindfulness could be your path.
And if you'll like structure and concrete tools, then CPT might appeal to you. It's also worth noting that many skilled trauma therapists integrate elements from multiple approaches, tailoring treatment to your specific needs. The most important factor might not be the specific modality, but rather finding a therapist you feel safe with.
Who respects your pace and boundaries? After all, research tells us that the quality of your relationship with your therapist is seven times more important to your outcomes than the type of therapy they use. Before committing to a particular therapy or therapist, consider scheduling a consultation with a few different providers.
Ask about their approach, their experience with your specific type of trauma, and what a typical session looks like. Trust your gut feeling about whether this person and method feel right for you. Remember that healing isn't linear and different approaches might be helpful at different points in your journey.
Be patient with yourself. Celebrate small victories. Know that recovery is possible. Trauma may be part of your story, but with the right support, it doesn't have to define your future. I hope you leave feeling a little lighter and more empowered today. Remember, healing takes time and you're exactly where you need to be. Take care of yourselves and until we meet again. Be kind to your heart.
