Psychological therapy for trauma and post-traumatic stress disorder (PTSD): What are they key ingredients for therapy?
Working with trauma and PTSD (or complex PTSD) is one of the areas where clinical psychologists and trauma therapists can have a significant impact. There are a range of different approaches in treating trauma and PTSD from a psychological perspective including trauma focused Cognitive Behavioural Therapy (CBT), Narrative Exposure Therapy (NET) and Eye Movement Desensitisation Reprocessing (EMDR).
Regardless of approach there are key ingredients which are universally important in working with trauma.
Overcoming avoidance and processing the trauma. Most trauma focused therapy involves “processing” the trauma in an active way. The therapist will re-visit key memories with you in a safe space within your control. This is likely to be the opposite of your current coping mechanisms. Avoidance (of reminders, memories, emotions) is a key and understandable component of PTSD. As therapists we are asking you to overcome avoidance through processing trauma memories (and associated emotions) because we know this is what works. However, there are other important factors to consider.
The therapeutic relationship. Research shows the therapeutic relationship is an important predictor of effective therapy. To process trauma memories, you must put your trust in the therapist. You may also be overcoming feelings of fear and shame through putting what you have been through into words, perhaps for the first time. A safe and supportive therapeutic relationship is key.
Readiness and safety. Not everyone wants or is ready to do trauma therapy. You need to be at a time in your life where you feel ready to tolerate this work. It can be challenging, particularly in the early stages. However, for many as the therapy progresses there is a sense of hope and relief. How do you know you are ready? You may already have some helpful ways of coping with difficult emotions and distress without resorting to more harmful ways of coping (e.g. substance use, alcohol, self-harm). If not, a clinical psychologist could support you with this initial work (sometimes called stabilisation work). The ultimate goal in treating trauma and PTSD, is ensuring your safety whilst doing this work.
Rebuilding life and social support. Ideally before starting trauma therapy, you will have some support outside of the therapy. Often people who have been though trauma or may be experiencing PTSD symptoms have become very isolated in their daily lives. This could be a friend or family member, or a group where you feel supported. Throughout therapy the theme of “reclaiming life” is important. This includes taking actions towards goals in rebuilding life (including things you used to enjoy or social connections). As with any therapy what you do in the therapy room is just a part of your recovery journey and changes you make in your life alongside this are key.
Thinking of taking the first steps in your journey? Contact Dr Emma for an initial consultation today…