A friend recently shared her experience of having her physician recommend she change counselors to one who did Cognitive Behavioral Therapy (CBT) to better address her trauma-related symptoms of anxiety and depression.
Her current therapist was using principles of Peter Levine’s Somatic Experiencing. This therapy was the choice because we know that traumatic memories are stored in the autonomic nervous system and also based on the work of Seigel who stresses the importance of creating coherent narratives since at the heart of trauma are shattered, unintegrated memories.
The latter two approaches are much more time consuming and less prescriptive in their approaches. They assume recovery and healing will take a fairly long time because significant trauma histories leave major emotional and sensory wounds. Unfortunately, we live in a world that values and often imposes quick-fix approaches to address trauma wounds. CBT is based on using a person’s abilities to be cognitive, which does not acknowledge the fact that trauma wounds reside in the lower parts of the brain where one is not cognitive.
Fortunately, my friend knew enough about trauma to know that CBT would not be effective for her, at least not yet while her trauma-symptoms were so sensory in nature. When trauma is significant, it is important for the person and anyone who supports him or her knows that not all therapies are alike and some actually do harm.
Neuroscientists, psychiatrists, therapists and others who develop approaches for helping their patients or clients with mental health issues have worked for years to discover the kinds of therapies that might have genuine impact on those with unresolved trauma. Much has been learned over the years about how trauma impacts the brain and what is needed to help the brain eventually recover and heal based on this brain science.
For example, in Peter Levin’s Trauma and Memory: Brain and Body in a Search for the Living Past, he describes a therapy that originally seemed to hold a lot of promise but actually did harm. “Some therapies, such as critical incident debriefing (CID) or prolonged exposure therapy, encourage the reliving of a traumatic event, presuming it will ‘desensitize’ the patient to the emotions associated with that event. However, considerable research about CID shows that implementing this approach directly after a traumatizing event, when people are emotionally stirred up, actually reinforces it and may lead to extended distress and re-traumatization. This type of repetitive exposure can lead to a compulsion to relive and repeat, i.e., creating a habitual cycle which may be built on addictive re-stimulating of the neurochemicals of hyperarousal (adrenaline) and/or dissociation (opioids).” (pp. 146, 147)
A good rule of thumb in assessing the efficacy of any kind of trauma therapy is to do research around the principles of the approach, looking for approaches that are somatosensory in nature, meaning they deal with body memories and associated sensations rather than approaches that are primarily talk-therapy focusing on changing cognitive beliefs and behaviors.
Good trauma therapy needs to be based on principles that incorporate an understanding of the nature of trauma, how traumatic experiences are stored in the brain and what helps release traumatic energy so healing can occur. Readers are encouraged to do research using websites like David Baldwin’s Trauma Pages in order to search some of the resources that are available for both clinicians and laypeople to enhance their knowledge about effective forms of trauma therapy.
Determining what kind of trauma therapy someone might need can be a daunting task but one that is extremely important in order to ensure that no harm is done as a result of therapies that are not based on the latest neuroscience. Significant trauma can do such damage to a person’s brain and mind, especially in children. It is important that therapeutic efforts do not exacerbate that damage.
Invitation to Reflect
- Think about what you know about therapy in general. To what extent have your experiences with therapy been positive and helpful? Have you had experiences in which therapy has been ineffective or even harmful?
- How does this information help you be a better consumer of therapeutic approaches? Are you clearer about what you or anyone seeking therapy for trauma-related issues needs to understand?
Diane Wagenhals, Lakeside Globabl Institute