What Is Trauma Therapy And How Does It Work?
By Sarah Fader
Updated November 07, 2019
Reviewer Melinda Santa
My Trauma Hurts
When you've experienced trauma, it can be excruciating. You may feel at a loss as to how to process what you've been through or start to heal. Even if you feel lost, there's hope and treatment that can help you.
How Trauma Affects The Brain
There are many reasons that trauma hurts us. One thing you may not know is that trauma physically changes our brains. When you experience a traumatic event, your mind changes. Areas of your brain that once worked in a particular way change based on hyperarousal due to trauma. For example, the amygdala gets over-activated after a traumatic experience. When you hear the phrase "fight, flight or freeze" that's when you have a physical and emotional response to a trigger. You remember your trauma, and your amygdala becomes overactive. You're hypervigilant, and you're on alert, making sure that you're safe from danger. Your trauma is real, and your brain is telling you that you're hurting and need help.
Getting Help For Trauma
It's essential to get help after you've experienced trauma. You need to talk about your pain and start to process what happened to you. This may sound scary, but think of it as an empowering statement. You truly have the ability to process past events and live an empowering, fulfilled life. One of the best places to do this processing is with a mental health professional who is skilled at helping people who have been through trauma. There are many kinds of therapy, but trauma therapy is explicitly focused on helping people who have had unfortunate things happen to them. Remember you didn't bring your trauma upon yourself, but you can take steps to heal from it with the support of a mental health professional. You can work with a therapist in your local area or seek the help of an online therapist.
Psychological trauma can affect your life for many years after the event or situation that caused it. It isn't a problem that's easily resolved, especially if you try to do it on your own. However, talk therapy has proven valuable in helping people overcome the distress, pain, and dysfunction that come from having lived through the most overwhelmingly threatening experiences. In fact, there is evidence that CBT and other forms of therapy can actually change the way your brain works after trauma, through something called Neuroplasticity. How does this work?
Neuroplasticity means that our brains are malleable. The pathways in our minds can mold and change over time. This concept is especially crucial for people who have experienced severe trauma, because it means that with the right tools, we can re-alter our brains in positive ways following trauma. According to scientific researchers Su, Veeravagu, and Grant (2016), three distinct phases of neuroplasticity occur after a person experiences trauma:
1. Directly after the trauma, neurons within the brain begin to die. Cortical inhibitory pathways decrease, which severely changes the mind. During this phase, which lasts one to two days, secondary neural networks are uncovered. These pathways may never have been used.
2. After a few days, new synapses form and neurons, as well as other cells, replace dead cells. Healing starts within the brain.
3. Within a couple of weeks, new synapses keep appearing. The brain starts changing, and new pathways are opening up. It is a critical time for healing from trauma. You can begin to rehabilitate your mind and body with therapy and medication.
You can be among those who work on their traumatic pasts and start to heal over time. If you're considering seeking help to get past trauma and reclaim your life, understanding trauma therapy can help you feel more comfortable starting the process.
What Is Trauma Therapy?
Trauma therapy is a type of mental health treatment that counselors use to help people overcome psychological trauma. A traumatic event is defined as one in which you perceive a threat to your life, bodily integrity, or sanity. The other component of the definition is your reaction to the event or situation. If you can cope with the event, even if it is a serious threat, it isn't trauma. Trauma occurs when your ability to handle the event is comprised.
Trauma therapy is not one specific type of treatment. A variety of therapies can be used alone or in conjunction with one another to help you deal with the trauma and move on with your life. If you seek trauma therapy, the best way to begin is to find out what type of therapy the counselor uses to treat trauma patients.
Goals of Trauma Therapy
Before you undertake any type of counseling or any endeavor at all for that matter, it's important to know what you want to get from it, what you want to accomplish, and how you want your life to look when it's over. It is important to be aware of your trauma, what your triggers are, and in what way do your react. It is also important to know what your goal in therapy will be? Is it to tell your story? To create awareness? To be at peace? To confront your abuser, or some other reason not listed?
The most crucial goals of trauma therapy are typically:
- To face the reality of the past event without getting stuck in it
- To reduce or eliminate trauma symptoms
- To work towards shifting focus from the past to the present
- To improve daily functioning
- Raise awareness of hereditary trauma
- To reclaim your personal power
- To overcome addictions associated with traumatic stress
- To gain skills that prevent relapse
You may have unique goals of your own based on the kinds of problems you've encountered since the trauma and the kind of life you want to move towards. Talk to your counselor early on to decide what you hope to gain from your time in trauma therapy.
Types of Therapy Most Often Used for Trauma
Three types of therapy have been shown to help with trauma: Trauma-Focused Cognitive Behavioral Therapy (TFCBT), psychodynamic psychotherapy, and Eye Movement Desensitization and Reprocessing (EMDR). Following is a discussion of each, including what each is and how it works.
Trauma-Focused Cognitive Behavioral Therapy (TFCBT)
What It Is: Trauma-Focused Cognitive Behavioral Therapy is a special type of CBT used for people who have experienced trauma. It's especially-formulated to address the thoughts associated with the traumatic experience. Typically used for children and adolescents, along with their parents, as well as adult survivors of trauma, TFCBT has been consistently proven effective at meeting the needs of people who have faced trauma. It is a short-term type of therapy that typically lasts between 8 and 25 sessions, although further therapy may be needed afterward to address secondary problems resulting from the trauma symptoms.
How It Works: In TFCBT, the trauma sufferer learns about trauma and its effects. If the person who has had a traumatic experience is a child or adolescent, their parent is also educated on trauma and taught parenting skills that can help them understand and interact in healthy ways with their child. Sessions may be held with the child alone, the parents alone, and the child and parents together.
The counselor teaches you relaxation techniques you can use during the therapeutic process as well as later on. The counselor prompts you to talk about the experience to help you develop a trauma narrative that organizes your thoughts about the experience. You learn how to express your feelings appropriately. The cognitive component of the treatment involves examining thoughts related to the traumatic experience and learning to adopt more helpful thought patterns.
Your counselor may suggest you revisit the location or type of location where the event happened, either in real life or through virtual reality therapy. This is done gradually, with exposure beginning slowly and more elements of the scene being added a little at a time. The exposure allows you to face the situation again, this time relying on coping skills you learn earlier in the therapy.
What It Is: Psychodynamic psychotherapy, a therapy developed from earlier psychoanalysis methods, is based on uncovering the content and conflicts within a person's unconscious mind. It assumes that problems develop from childhood experiences. It also takes into account the effects of interpersonal relationships on thought, emotion, and behavior. This type of therapy relies on the relationship that develops between the trauma sufferer and the therapist. The goal of this type of therapy is primarily to gain insight.
How It Works: If you are in psychodynamic therapy, you talk about your symptoms as well as the traumatic event that caused them. You do this through the technique of free association, which means that you say whatever comes to mind, even if it seems to make no sense to you at all. Your therapist helps you identify the defense mechanisms you use to protect yourself from feelings of distress. While these mechanisms can be helpful at first, they keep you from addressing the traumatic experience directly. Once you get to the heart of the trauma, the idea is that you will have insights that will help you resolve the conflicts you have been feeling.
Eye Movement Desensitization and Reprocessing (EMDR)
What It Is: EMDR is a relatively new type of psychotherapy. It was created with the goal of helping people process traumatic experiences in healthier ways. It typically helps much quicker than psychoanalysis or even psychodynamic psychotherapy. It assumes that the mind is constantly moving toward mental health unless something blocks that flow. The goal of EMDR is to remove that blockage.
How It Works: The therapist uses some form of external stimulus to direct your attention outward. This can be eye movements, hand tapping, or audio stimulation. During this part of the session, you talk about the event, your current distress, or imagine what your future will look like while the therapist provides the external stimulus. Through this process, the therapist determines what to focus on during the second part of the session.
In the last half of the session, the therapist tells you what aspect of your story to hold in mind as you track their hand movements with your eyes or follow some other type of instruction. As you process the memories and thoughts related to the experience, you gain insights that come from within you alone. You realize that you have the strength that helped you survive. Your experience is transformed from a horrible memory to a vision of your own power.
Other Therapeutic Approaches for Emotional Trauma
Trauma therapy can include one or more of the above methods, but it can also include a variety of other therapies. Simple supportive counseling helps you feel safe while you face the trauma and change the way you think about it. Hypnotherapy is sometimes used, although there's little evidence that it's effective.
Another type of therapy that is often used soon after a traumatic event happens is a psychological debriefing. Known as Critical Incident Stress Debriefing (CISD), this type of therapy is used immediately after a traumatic event to give survivors support and the chance to talk about the experience and express their emotions. This type of therapy has been used recently for classmates of youth who have committed suicide, people who witnessed a mass shooting or a terrorist attack, and other high-profile events that might cause trauma.
While it makes sense that a debriefing would help people in such a situation, the evidence so far hasn't supported it. Single-session debriefings have shown no benefit in studies conducted after such events. If you survived a traumatic experience and received a debriefing, you likely need further therapy to prevent or overcome trauma symptoms.
BetterHelp Wants You to Process Your Trauma and Heal
The online counselors at BetterHelp care about what you've been through in your life. They want to help you process your trauma and begin to heal. There is no timeline on mental health. Your online counselor will be patient with your healing process. They want to support you as you talk through your trauma, learn about yourself, accept what happened to you, and begin to move forward with their help. Read below for some reviews of BetterHelp counselors.
"Natalie has efficiently and effectively helped me through some pretty tough times. She is very patient, sweet, understanding, and knowledgeable and I would definitely recommend her to anyone on BetterHelp. I also really liked that her appointment schedule was very flexible for those of us who work long days."
"In the past I have gone to at least five different therapy centers and therapists. I feel very grateful to have been connected to Audra by BetterHelp because she is the first therapist that has actually made me feel progress toward getting through past traumatic experiences. She is clearly very skilled and knows exactly what she is doing. Not only is she talented in her field but she also has a strong sense of empathy that makes you feel that she actually cares. I am grateful to be able to seek guidance from her and will continue to do so because it has without a doubt helped me grow and heal. Immediately you start seeing results while working with Audra on your mental health goals. Thank you Audra! I look forward to continue working with you."
Perhaps you've decided to seek therapy to deal with past trauma. Fantastic! The next step is to learn what you can do to get the most out of your treatment. Here are a few suggestions based on current research:
- Work with a therapist you can develop a trusting, comfortable relationship with
- Attend all scheduled therapy sessions
- Stick with treatment to its conclusion
How to Get Started
If you or a loved one is a survivor of psychological trauma, it's crucial to get help as soon as possible. Because the symptoms of traumatic stress can lead to secondary problems, the sooner you get help, the less challenges you'll have to overcome. Make a commitment to find a therapist you can work with and stick with therapy as long as it's needed. You can get through this, and you don't have to do it alone.