Umberto Crisanti CBT, Counselling and Psychotherapy in Canterbury

How can I help with trauma?

To help with processing trauma, we need to create a context of emotional and physical safety during therapy sessions. In this journey together, we can explore sensing, naming, and identifying what is going on inside - these are the first steps towards recovery. You can see from the image below (taken from the book 'The Body Keeps The Score') how much more activity appears on the right side of the brain than on the left. What is the role of the right hemisphere of the brain? Well, this is where we process emotions and the perception of safety or risk. We can therefore distinguish two types of trauma processing:

The first is experiential and sensorial (also called Bottom Up approach):
Compassion Focused Therapy and Mindfulness are very helpful here because we learn to enhance the sense of internal and external safety.
The second is narrative processing (Top-Down):
The Top-Down process involves flashbacks and contains more motion words, suggesting that flashbacks are a form of memory that elicits a response such as fight or flight.

In therapy, we will work on updating the memory from "I am stuck and in danger" to "I can take action and I am safe now". We need to a) draw out blocked sensory information b) help clients befriend, not suppress, body energies needing to be released and c) complete the self preserving physical actions that were thwarted when the survivor was restrained or immobilized by terror. (p. 96).

From the book the 'Body Keeps the Score' we know that effective trauma therapy involves the following steps for clients to achieve (p. 203-204):

1) finding a way to become calm

2) learning to maintain that calm and focus when triggered with past thoughts, emotions, reminders, etc.

3) finding a way to be fully alive, in the present, and engaged with others

4) not having to keep secrets from self including the ways the person has managed to survive.

And that the trauma has to be revisited in more than the logical brain:

"The fundamental issue in resolving traumatic stress is to restore the proper balance between the rational and emotional part of the brain." (p. 205), this aspect is similar to a paper I published in 2019 (Crisanti, 2019):

"The therapeutic implication is that therapists need to be able to understand and attune to their clients both emotionally - by considering a fundamental problem in an implicit emotional system (Gilbert, 2010) - and cognitively."

Resources. Imaging a flashback with fMRI

The abc of CBT , Discover Your Emotional Triggers:

This worksheet may help to build awareness of how you think and to see patterns of your feelings and behaviours over time. It can also help to track down irrational, illogical and unhelpful thoughts so that we gradually learn to dispute them. This tool is also helpful to detect emotional triggers, for example the need to be in control, to be treated fairly, to be understood, valued, loved or perhaps simply reacting to uncertainty or change, etc.

Awareness is the way out: if we are unable to acknowledge the need that triggers the emotional reaction, we then can become a slave to that need and we tend to react in auto pilot. So, with greater awareness, we are freer to choose our reactions.

The Trauma Egg

The Trauma Egg is an intervention tool that I use with some clients in therapy for treating emotional trauma

In a mindfulness group we asked what music lifts you up when you're feeling down?

This is their playlist:

Resources. What music lifts you up and makes you feel better?

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