How Trauma Therapy Works

<p>Vladimir Vladimirov / Getty Images</p>

Vladimir Vladimirov / Getty Images

Medically reviewed by Kathleen Daly, MD

Trauma therapy is a branch of psychotherapy—or talk therapy—that helps you process traumatic experiences. Trauma is a natural reaction you might have after experiencing a life-threatening or fear-inducing situation, such as a natural disaster, sexual assault, or war. Trauma can be a one-time event or chronic (long-term), such as having repeated exposure to violence in your community.

Some people are able to process trauma on their own, while others may need more support as they heal and recover. As such, trauma therapy is designed to help you work through the trauma you’ve experienced, reduce the effects of trauma on your life, and improve your well-being. Trained mental health providers can assist you in your healing and teach you how to cope with your memories of a traumatic incident so the event doesn't continue to interfere with your everyday life.

Who Should Consider Trauma Therapy?

Some people who have experienced trauma may develop post-traumatic stress disorder (PTSD). People with PTSD continue to experience fear and stress as a result of a traumatic event. If you experience PTSD, you may find that your symptoms develop immediately after the event. But in some cases, it's possible for symptoms to occur much later. It's also common for symptoms to fluctuate, or come and go, over time.

Some symptoms of PTSD that may warrant therapy include:

  • Having flashbacks or frightening thoughts about the event

  • Feeling isolated or detached from other people

  • Having trouble sleeping

  • Experiencing memory problems or trying to avoid memories of the event

  • Feeling angry, worried, sad, or guilty

  • Having difficulty managing negative thoughts or feelings

  • Getting easily startled or feeling “on edge”

  • Experiencing frequent stomachaches or headaches

Types of Trauma Therapy

There are several different kinds of trauma therapy. Generally, most treatment plans for trauma include exposure (or, learning to manage your fear by being reexposed to the trauma), and cognitive restructuring (or, learning to think about the incident more productively and realistically). Your mental health provider (e.g., a therapist, psychologist, social worker, etc.) can also use a combination of therapy approaches or choose just one form of therapy for your treatment plan.

Prolonged Exposure Therapy

Prolonged exposure therapy is based on the premise that if you don't emotionally process trauma during or shortly after a traumatic incident, you can experience symptoms of fear afterward. The focus of prolonged exposure therapy is to address how fear may be affecting your daily life.

Usually, prolonged exposure therapy lasts for about eight to 15 sessions. During this time, you may learn about PTSD and trauma, practice breathing techniques, and imagine or reexpose yourself to the trauma or fear that is causing your symptoms. Research shows prolonged exposure therapy can reduce symptoms of PTSD or eliminate the need for a PTSD diagnosis altogether.

Cognitive Processing Therapy

Cognitive processing therapy helps you identify your beliefs and thoughts about a traumatic event and how these thoughts may be contributing to dysfunction in your life. This type of therapy uses a combination of cognitive therapy and exposure techniques. Research has shown that cognitive processing can reduce symptoms of PTSD, depression, and anxiety, while also lowering your risk of receiving a PTSD diagnosis.

If your mental health provider believes this therapy is right for you, your treatment plan might consist of individual sessions with a therapist or group therapy. Generally, cognitive processing therapy can last around 12 weeks.

Cognitive Behavioral Therapy (CBT)

Another common treatment for a variety of mental health conditions is cognitive behavioral therapy (CBT). There are several versions of CBT that a therapist may use, but for helping process trauma, your mental health provider will typically utilize trauma-focused CBT.

The focus of CBT is to help you identify, address, and reframe unhelpful behaviors, feelings, and thoughts related to a traumatic event. CBT also incorporates exposure and cognitive techniques and can reduce or eliminate trauma symptoms.

Eye Movement Desensitization and Reprocessing Therapy (EMDR)

EMDR is a treatment style that has historically not been as widely studied as some of the other trauma therapy approaches, but shows promising effects for people with PTSD.

EMDR focuses specifically on addressing the way the memory of the event is stored in your brain to reduce your symptoms. The treatment involves you moving your eyes in a specific way to help you reframe memories. This therapy takes about one or two sessions per week for six to 12 weeks to see an improvement in symptoms.

Narrative Exposure Therapy (NET)

NET is a type of treatment that therapists often use for people who have experienced chronic (long-term) trauma throughout their lives. With narrative exposure therapy, your provider may ask you to tell a narrative (or, story) about your life, including the trauma you’ve experienced as well as the positive and negative emotions and aspects of your journey. This therapy may consist of group or individual sessions and usually involves completing four to 10 sessions in total.

How Long Does Trauma Therapy Take?

The length of your treatment can vary depending on the type of trauma you have, the symptoms you're experiencing, and the type of treatment your mental health provider uses. Most treatment methods last between eight and 15 weeks, but each person’s experience may be different. If you’re curious about how long trauma therapy might take for you, ask your mental health provider for an estimate of how long you can expect to commit to therapy.

Benefits of Trauma Therapy

Trauma therapy can help you reprocess or relate differently to the trauma you’ve experienced. Over time, you may find that treatment helps you reduce your symptoms. It's also possible to no longer fit the diagnosis for PTSD and other mental health conditions if therapy is effective and successful for you.

The primary benefit of attending trauma therapy sessions is seeing an improvement in your symptoms and overall quality of life. Trauma therapy can help you reduce the following trauma symptoms:

  • Re-experiencing symptoms like flashbacks or nightmares from the traumatic event

  • Avoiding places, people, or situations that remind you of the traumatic event

  • Feeling on edge and jittery or the belief that you constantly have to be on the lookout for danger

  • Unhelpful cognitive and behavioral symptoms, such as blame, guilt, or negative thoughts

How to Get Started

If you’d like to find a trauma therapist, consider asking your primary care provider for a referral to a trusted mental health provider, searching online directories, checking with your insurance company or employer for therapists in your network, or requesting therapist recommendations from loved ones.

When looking for a trauma therapist, it’s important to check if the provider specializes in trauma-informed care. If you’ve found a therapist who might be a match, ask them about their experience supporting people with trauma and what strategies they use in treatment. It’s important that you feel comfortable with them and trust them as you embark on your healing journey.

What to Expect During a Therapy Session

What your trauma therapy sessions look like will often depend on the type of therapy your mental health provider is using and the symptoms of trauma that you have. In general, trauma therapy often combines activities such as gradually exposing yourself to the trauma or stressor, having your therapist guide you in restructuring harmful thoughts and behaviors, and participating in conversations about how you're feeling.

For a better understanding of what to expect during your treatment plan, ask your therapist during your first session. They can outline what the goals of your treatment are and help you understand what sessions may look like in the coming weeks and months.

Keep in mind: for therapy to work as intended, it’s important that you trust your therapist and try your best to stick to the treatment plan they recommend. However, it's just as important to be honest about your feelings and discuss what you hope to gain from therapy. It's worth noting that working through trauma can be uncomfortable or difficult, particularly at the beginning of treatment. But, staying committed to your treatment plan can help ease your trauma and aid in your wellness.

A Quick Review

Trauma therapy, which consists of a few different kinds of therapy, is a useful tool for treating PTSD and other trauma-related mental health conditions. If you’ve experienced trauma and think you may need treatment, it’s important to seek care from a therapist who is properly trained in trauma-informed therapy.

Each person's treatment plan is unique to their experience and symptoms. That said, to learn more about what your treatment plan might consist of, it's important to talk with your provider about what to expect during your sessions. Talking about a traumatic incident isn't always easy—and it's critical to remember that whatever you are feeling is valid. That's why being honest with your provider and communicating your feelings is essential as you continue therapy and heal.

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