When an individual is suffering from the after effects of trauma, it is often suggested these days that he or she go take part in some kind of talk therapy. There is a deeply ingrained belief that talking about distressing feelings can resolve them. But is this really true? Does talk therapy really help?

Well…yes and no.

Some trauma survivors come to therapy but are simply unable to share their stories. This might be because they are so painful but more often are because they are simply unable to access the memories. The brain often provides strong protective barriers in order for the person to carry on functioning and it is important to respect the brain’s wisdom. The person is simply too vulnerable to protect themselves without these barriers. There are many therapies available today that don’t involve a person telling their story at all, or perhaps no more than a basic outline. This includes body-centred therapies, EFT, EMDR and the Rewind  visualisation technique. (This is something I use in my own counselling practice and I’ll be writing about this in a future blog).

But still, talk therapies still have an extremely important part to play – with the following provisos: “Re-living” trauma by talking about it, has the potential to lead to re-traumatisation which can be totally overwhelming. If a trauma survivor does feel ready to tell their story (and it is only for themselves that they wish to do it), it is important that they feel internally and externally extremely safe and know when to stop if necessary.  It goes without saying that they should ensure that the therapist they are working with is skilled in this type of work.

What kinds of talk therapies work best?

So having got the warnings out of the way, what kinds of talk therapies are available and what work best?

Trauma-Focussed CBT

Trauma-focussed Cognitive Behaviour Therapy (CBT) is used with both children and adults and is based on the acronym PRACTICE which stands for:  Psychoeducation and parenting skills. Relaxation techniques (such as focused breathing, progressive muscle relaxation, and visual imagery).  Affective expression and regulation (helping the client  manage their emotional reactions and  participate in self‑soothing activities). Cognitive coping and processing (helping the client understand connection between thoughts, feelings and behaviours.) Trauma narrative and processing (verbal, written, or symbolic recounting of abusive events.) In vivo exposure ( gradual exposure to trauma reminders in the clients environment.) Conjoint (work to enhance communication and connectivity.) and finally Enhancing personal safety and future growth.

Dialectical Behavioural Therapy (DBT)

Dialectical Behavioural Therapy (DBT) was developed in late 1970s by Marsha Linehan originally to treat people with borderline personality disorder and suicidal individuals. Today it is used successfully for trauma and PTSD recovery. It is designed to work towards helping people to spot the triggers that lead to emotions and behaviours. It helps them to choose alternatives to destructive patterns including distraction, self soothing, radical acceptance, a mind that is willing and open to do what is effective and mindfulness practices such as finding meaning and purpose in what you are doing, guided imagery, relaxation, taking breaks, self-encouragement.

Here is a link to some more information on DBT:

http://behavioraltech.org/resources/whatisdbt.cfm

Group Therapy

Group therapy is normally not a substitute for individual therapy but some people find it a useful addition. Obviously it very much depends on where you live but there can be a variety of different groups for trauma survivors, some led by therapists, others by peers. Some groups are set up to help family members or friends who are caring for someone with PTSD, some are educational, some focus on giving support, and other groups are therapeutic in nature.

Ideally a support group can help with learning tips on how to handle day-to-day challenges, learning how to accept support from others and connecting to others who understand you (such as fellow soldier in a military setting), learning how to talk about things that bother you or how to ask for help, learning to trust other people and hearing about new perspectives from others.

Here is a link to an excellent video about group sessions for PTSD veterans:

https://www.youtube.com/watch?v=eAMPuWg4ISA

Need some advice and support?

If you are looking for support and advice, whether you are experiencing anxiety, low mood or the after effects of trauma, and would like to talk it over in complete confidentiality, call Alison Winfield, Mindfully Well Counselling Cork on 087 9934541. I use elements from both trauma-focussed CBT and Dialectical Behaviour Therapy in my work, where appropriate.

See also:  Trauma and Resilience, Trauma and the body