Which therapies are most effective?
According to Bessel Van der Kolk, Professor of Psychiatry, Boston University School of Medicine, and Medical Director, the Trauma Center, Boston, MA, the most effective therapies in working with trauma are:
- Eye Movement Desensitization and Reprocessing (EMDR)
- Somatic (body oriented) therapies
- Sensori Motor Psychotherapy
- Somatic Experiencing
- Body Work
- Moving Mindfulness experiences: Yoga, Tai Chi, Chi Gong
- Emotional Freedom Technique (EFT): focus on the body’s energy field by tapping on acupuncture points while focusing on a traumatic memory
- Cognitive Behavioral Therapy and Dialectical Behavioral Therapy
How does Phyllis Lorenz begin working with a client?
Good trauma treatment is about re-wiring the brain’ i.e. disrupting old trauma responses and rewriting the script/narrative from “I’m going to die” to “I survived” or “I’m OK”, or “I deserve to be loved.” Good trauma therapy works on the Right Brain, which is where trauma is stored.
The first phase of therapy is stabilization, in which the client develops resources for staying within the window of tolerance. The techniques used are: mindfulness, breathing, grounding, or anything that gets the client back into the body. The client is encouraged to notice his or her habitual responses, to develop curiosity, to separate facts from feelings, to separate the past from the present, and to have new experiences, all of which help to begin “re-wiring” the brain.
What is the Leading edge in Therapy and Research?
- Trauma therapy needs to consist of helping people to be in their bodies and to understand their bodily sensations. (Bessel van der Kolk, 1998)
- Neuro-plasticity: the changing of neurons, the organization of their networks, and their function via new experiences.
- “Re-wiring” the brain via Mindfulness techniques. If people can be mindful of their bodies going into hyper arousal, then they can learn to regulate their responses. Body awareness precedes cognitive awareness. Sensori motor psychotherapy begins with the body but seeks to integrate all avenues of awareness: thoughts, feelings and sensations.
- Understanding that talk therapy can be harmful in being fixated on the trauma. It keeps people from being able to take in new information and construct new realities.
What is the role of Medicine in treating Trauma?
Medicine is often useful in helping to regulate clients enough so that they can “do” the work of therapy. But medication alone is not the answer.
How long does Therapy Take?
The duration of therapy varies depending upon type, extent, severity of trauma and the age and support available at the time of trauma If a person can develop resources to help them to function in the here and now, in contrast to living with the reminders which trap them in the “there and then”, they are more likely to recover their previous level of functioning.
How can you tell if a person is getting well?
It depends on where they are in the “trauma spectrum.” If they can be in their body, which precedes being in their frontal lobes, the more new neural networks can develop. It also depends on the extent of trauma, quality of attachment and amount of external support available.
The client is getting well when they are able to have flexibility to move between different states of arousal, and not get stuck, i.e. they are mindful about when and how they get triggered. They are able to function in day to day living, able to stay present, have their emotions without resorting to either hyper-arousal reactions or numbing reactions. If they can stay in the window of tolerance and have their emotions without BEING their emotions