A Trauma Therapist's Guide to PTSD Treatment
Are you looking for the best trauma therapy but have no idea where to begin? All you want to do is feel better and you get the run around on all these different types of treatment with fancy acronyms such as EMDR, TF-CBT, DBT, IFS, SE, SP. It’s hard not to respond with, “WTF?”
When you're having flashbacks, nightmares, and the world feels unreliable, the last thing you want is to be unsure about where to seek help. Some people say that EMDR saved their lives while other people say that it did nothing. Who do you believe? Should you take the risk to see yet another therapist if it might not work? You don’t know what to do or where to turn for accurate information about trauma treatment and you feel stuck.
With over a decade of experience as a trauma therapist, my goal is to provide you with the latest information on effective treatments for trauma and PTSD.
Finding effective trauma treatment is not only about the intervention(s) used. It is also about the therapist. Unfortunately, I cannot reduce barriers to accessing treatments (such as time, money, location). and I can't guarantee just because a therapist has adequate trauma training, they will be a good fit for you. Research shows that the relationship with your therapist is either equally important or even more important than any specific therapeutic intervention. I can provide tips to help you understand how to “interview” a trauma therapist to determine who might be the right fit for you and your needs.
How Do You Find a Trauma Therapist?
Finding any medical professional is hard, especially a trauma therapist. Here at Embodied Wellness, PLLC, we always tell people during my free 15-minute phone consultations that finding a therapist is very different from a dentist. We love our dentists, but we hopefully only see them twice a year and most of that time, their hands are in our mouths. Therapy is different. Therapy involves connecting on a weekly or biweekly basis and exploring some of the deepest parts of our souls. You cannot and should not do this with just anyone. It's important to interview and assess whether the therapist you're talking to is reliable, well-trained, and empathetic.
Questions to ask a therapist during a free consultation:
How many years of experience do you have treating (my condition)?
What specific trauma training do you have?
Can you explain your (specific) trauma training to me?
What is your approach to therapy?
Do you take insurance?
Would you recommend the therapy you specialize in for someone with my symptoms (explain your symptoms)?
Below are some green flags a therapist may not be a good fit:
You feel a relative sense of safety with them.
You believe your therapist will not share any of the information you tell them.
You feel they are trustworthy, respectful, empathetic, and compassionate.
You gain new insights and awareness about yourself in therapy.
You feel an increased sense of hope after therapy.
Your therapist is reliable, accountable, and consistent.
Your therapist helps you come to your own conclusions rather than making decisions for you or telling you what to do.
They have experience with trauma and any other symptoms that you experience.
Below are some red flags a therapist may not be a good fit:
They talk about themselves a lot in session.
They do not accept you for who you are (in regards to your race, ethnicity, sexual identity, religion, etc.)
They give advice.
You feel judged, criticized, or belittled.
They cancel your sessions a lot or no-show your appointments.
They do not have any specific training in trauma.
After working together for a while, you do not feel like you are feeling any better.
You don’t feel like you can trust them.
Although finding the right therapist might take some time and can feel like an uphill battle, it is a journey that is worth the effort and time. If you could heal from reading self-help books or meditating, you would have already done that! It is okay to take breaks from your search if you are feeling discouraged and get back out there when you feel more up to it.
Signs and Symptoms of Trauma
Have you ever wondered if you would benefit from trauma therapy? How do you know if you need trauma treatment? Do you wonder if you have PTSD? There are no right or wrong reasons to seek out therapy. If you have experienced a traumatic or stressful event, either recently or in your past, trauma therapy can be beneficial. Even though you have been through an overwhelming event does not mean you have trauma or post-traumatic stress disorder (PTSD). Here are common signs and symptoms of PTSD:
Difficulty with sleep (trouble falling asleep, staying asleep)
Avoiding feelings, memories, or situations related to the traumatic event
Reliving certain aspects of the traumatic event (flashbacks, nightmares, intrusive thoughts or images)
Alertness or feeling on edge (hypervigilance, easily startled)
Negative beliefs or feelings (intense blame, overwhelming feelings of anger, guilt, shame, or worthlessness)
Feeling detached from yourself, others, or the world.
Difficulty experiencing pleasure and joy in activities you used to.
Problems in relationships including relating to and trusting others
Self-destructive behavior such as substance use, promiscuity, self-harm, and recklessness.
Types of Trauma Treatments:
Below is a non-comprehensive list of trauma therapies and PTSD treatments.
Cognitive Therapy
What is cognitive therapy?
Cognitive therapy, or what’s more often known as “talk therapy” is a type of therapy that focuses on how your thoughts impact your mood and actions. One of the main goals of cognitive therapy is to identify irrational thinking and then change those thinking patterns. If you can change your thoughts, you can change how you feel and respond to different situations, particularly those related to trauma.
For example, let's say you experienced a traumatic experience such as a car accident and think it is “all your fault.” This negative thought can make you feel guilty, depressed, and angry, which may lead to you isolate from others. You also might be scared of driving so you only walk or ride your bike. In cognitive therapy, you would learn to recognize negative thoughts. Then you would learn how to replace them with more helpful thoughts. For example, instead of thinking "It's all my fault" you might think, "There are many factors that caused the car accident including the weather conditions, the other drivers, and the faulty traffic signal.”
Types of cognitive therapy
CBT: Cognitive behavioral therapy
TF-CBT: Trauma-Focused Cognitive Behavioral Therapy
CPT: Cognitive Processing Therapy
Who can benefit from cognitive therapy?
Children, adolescents, and adults can all benefit from cognitive therapy! People of all races, ethnicities, religions, and backgrounds can be good candidates. Cognitive therapy offers benefits to people with trauma in addition to those dealing with depression, anxiety, substance use, eating disorders, and relationship issues.
Things to consider about cognitive therapy
There are a few factors to consider when seeking out cognitive therapy for trauma. Since cognitive therapy mostly centers on identifying and fixing unhelpful thoughts, if you have cognitive or intellectual disabilities, you might not get the complete advantages from this kind of therapy. Additionally, since children under the age of 3 mostly communicate via play rather than through talking, cognitive therapy has not been found effective with this population.
Cognitive Therapy Resources:
Somatic Therapy
What is somatic therapy?
Somatic therapy, also known as body-centered therapy, is a way of helping with trauma that looks at how the mind and body are connected. In somatic therapy, we pay attention to things like how your body feels, moves, and images. The central idea of somatic therapy is that our bodies, not just our minds, remember traumatic experiences. By noticing and getting curious about how your body feels, you can deactivate stuck survival responses such as fight, flight, and freeze
During a somatic therapy session, instead of only focusing on the external story, such as “a scary event happened,” your therapist will encourage you to tune into your body sensations. As you talk to your therapist, you will be asked questions such as “What do you notice inside?” and encouraged to slow down and get curious about how your body feels. You will be guided to notice sensations, track your body’s experience, and gradually release any held tension or unresolved emotions.
Types of somatic therapy:
SE: Somatic Experiencing
SP: Sensorimotor Psychotherapy
Who can benefit from somatic therapy?
Somatic therapy can be beneficial for children, teens, and adults who experience trauma, anxiety, depression, pain, stress, or grief.
Things to consider about somatic therapy
Although somatic therapy is a treatment designed to treat trauma, it can be triggering because it invites you to check into your body and its sensations. As trauma survivors, our bodies might feel scary, uncomfortable, or unsafe. Being asked to go into our bodies may feel like being asked to spend time with a tiger. Hating or being at war with your body is not a reason to avoid somatic therapy, but it is helpful to know that the process will be slower and can bring up stress and be triggering at times. A trained somatic therapist will have the skills to guide you through this process.
Somatic Therapy Resources:
Internal Family Systems:
What is Internal Family Systems?
Internal Family Systems, or IFS, is a therapy developed by Richard Shwartz, that focuses on understanding and working with the different “parts” or aspects within yourself. According to IFS, everyone has “parts” that have thoughts, feelings, beliefs, and behaviors. There are no bad parts. The goal of IFS is to help you develop a relationship with your parts, understand why they are there and help them get along. You will learn how to access your ”Self, “ core essence of yourself that has qualities such as curiosity, compassion, calmness, and clarity.
In an IFS session, your therapist will help you to get to know your parts, identify their different roles, characteristics, and the needs of each part. For example, when talking about an "anger" part related to a trauma, your therapist may ask questions. These include: “Where do you notice this part in or around your body?” “How close do you feel to this part?” “How are you feeling towards this part?”
Who can benefit from this IFS?
IFS is helpful for adolescents and adults who have depression, anxiety, panic, phobias, trauma, substance use, eating disorders, and pain.
Things to consider about IFS
Some people believe if you have active delusions, paranoia, or schizophrenia, IFS can be detrimental because there can be a misunderstanding of the idea of “parts." Other people do not see any contraindications of IFS.
IFS Resources:
Exposure Therapy
What is exposure therapy?
Exposure therapy aims to make you less scared and anxious by slowly and safely helping you face the things that make you afraid or anxious. The idea is that when you meet your fears over and over again, in a safe and helpful place, you can learn that they're not as terrifying as you believed.
During exposure therapy, your therapist will help you develop an exposure hierarchy, which is a list of feared situations. This list starts from least anxiety-provoking to most anxiety-provoking. Then you are gradually exposed to the feared situation in a controlled and planned way. Eventually, the exposure is sustained for an extended period of time to allow you to experience a decrease in anxiety.
Examples of exposure therapy
PET: Prolonged Exposure Therapy
NET: Narrative Exposure Therapy
ERP: Exposure and Response Prevention
Who can benefit from exposure therapy?
Exposure therapy treats anxiety disorders, phobias, and post-traumatic stress disorder (PTSD) in children, adolescents, and adults.
Things to consider about exposure therapy
Research shows that exposure therapy is safe and effective if you have trauma and co-occurring conditions such as dissociation and schizophrenia but clinicians may need to make adjustments to the protocol. These adjustments might include providing sessions in an intensive and brief format rather than weekly sessions or adding in vivo (imaginary) exposure.
Exposure Therapy Resources:
Eye Movement Desensitization & Reprocessing Therapy (EMDR)
What is EMDR?
EMDR, developed by Dr. Francine Shapiro, was designed to help you process and heal from traumatic experiences. EMDR operates on the belief that traumatic experiences can become "stuck" in the brain and continue to cause distress. Examples of distress include such as nightmares and flashbacks. EMDR aims to facilitate the reprocessing of these memories, allowing you to integrate them into your life in a more healthy and adaptive way.
There are 8 phases to EMDR therapy. EMDR begins with history taking and treatment planning where you and your therapist develop a treatment plan and goals. Next is the preparation phase where you learn coping skills and relaxation techniques so you feel ready to process your trauma. In the assessment phase, you identify a specific distressing memory, event, or belief you want to target. During desensitization, you engage in side-to-side eye movements, sounds, or taps while focusing on the “target.” During this time, new thoughts, sensations, images, and feelings may emerge. When this is complete, the installation phase begins when you begin to associate a positive belief with the “target” event. After, you engage in a body scan to process any lingering disturbance. Every session of reprocessing ends with the closure phase where your therapist helps you to return to a state of calm. The last phase, reevaluation, is how each new session begins after reprocessing. This phase involves discussing the recently processed event and next steps for treatment.
Who can benefit from EMDR?
Adolescents and adults with anxiety, depression, OCD, chronic pain, and addictions can benefit from EDMR!
Things to consider about EMDR
If you experience dissociation, EMDR is not recommended until you are stabilized. EMDR may also trigger vivid dreams that can be emotionally stressful.
EMDR Resources:
Brainspotting
What is Brainspotting?
Brainspotting was developed by Dr. David Grand in 2003 as an offshoot of EMDR. The therapist helps you identify and focus on specific eye positions, body sensations, or "brainspots" that are linked to trauma, emotional pain, or other specific issues. These “brainspots” serve as entry points for trauma healing.
During a Brainspotting session, the therapist guides your attention to a “brainspot” while you engage in self-reflection about a traumatic experience. The therapist provides support as you explore the sensations, emotions, memories, and thoughts associated with the “brainspot.” The goal is to process underlying trauma responses.
Who can benefit from Brainspotting?
In addition to trauma and PTSD, Brainspotting can help adolescents and adults recover from anxiety, attachment issues, substance use, chronic pain, and depression.
Things to consider about Brainspotting
Although Brainspotting is a newer treatment, there is research and evidence that it is an effective treatment for trauma and mental health conditions.
Brainspotting Resources:
5 Reasons Trauma Treatment May Not Work
Although there are many differences amongst trauma treatments, there are a few similarities. No matter what trauma treatment you are participating in, there are a few reasons that treatment may not work.
If you are engaging in excessive substance use, it is unlikely for any treatment to be effective.
Thinking about different cultures and languages is crucial. They affect how each person reacts to therapy in their own special way.
If you are experiencing acute psychosis or severe dissociative disorders, you may need stabilization and other therapeutic interventions such as medication before engaging in trauma therapy.
There can also be a normal amount of ambivalence or hesitancy to process trauma. If this hesitancy turns into resistance to therapy or a complete lack of motivation, trauma treatment will not be as effective.
Lastly, if you are experiencing safety concerns including suicidal or homicidal thoughts, crisis intervention and a higher level of care including hospitalization is required because it is not safe to start trauma therapy. Contact 911 or your local emergency hotline if you have any thoughts of killing yourself or someone else.
Are you ready to start Trauma Therapy and PTSD Treatment in Detroit, Ann Arbor, and throughout Michigan?
If you are interested in learning more about trauma or PTSD treatment, you have come to the right place. We provide a free 15-minute phone consultation to answer all questions you may have about how these treatment options can work for you! We take Blue Cross Blue Shield PPO plans and have a limited number of sliding scale options. In order to begin trauma therapy at Embodied Wellness, PLLC follow these steps:
Be matched with one of our telehealth therapists.
Heal from trauma and PTSD today.
Other Online Counseling Services We Provide in Michigan
At Embodied Wellness, PLLC we offer a variety of holistic treatment services for adults and teens with anxiety, depression, and OCD. We also specialize in many forms of trauma therapy including Somatic therapy such as Somatic Experiencing, DBT, CBT, ERP, Internal Family Systems, and EMDR therapy. We offer online therapy in Michigan También ofrecemos terapia en español en Michigan. Start getting past your trauma today by visiting our Detroit-based practice.