Have you ever wondered what the best therapy is for trauma and C-PTSD?
Embarking on a journey of self-discovery and trauma recovery can be transformative and empowering, yet it’s important to acknowledge that this path may also be tumultuous at times. For women who may carry the weight of early childhood wounding, the notion of trauma might be familiar or entirely new. You might have arrived here because of self-destructive or self-protective patterns and behaviours (such as disordered eating or addiction), and wanting help for those, however, it’s important to understand that beneath the surface may lie attachment injuries, developmental and complex trauma.
Complex trauma involves exposure to prolonged and severe stressors, often rooted in interpersonal experiences, you can read more about it here. In this post, I share (after over 20 years of working with trauma), what I think are the best therapies for trauma & C-PTSD.
The Best Therapy for Trauma & C-PTSD
Circle of Security
The Circle of Security (COS), initially designed to enhance secure bonds between caregivers and children, has proven to be a transformative approach when applied to adults seeking healing from trauma. Founded by Kent Hoffman, Glen Cooper, and Bert Powell, COS is rooted in attachment theory principles, emphasising the crucial role of secure attachment in fostering emotional and social development. When extended to adults, particularly those dealing with trauma, COS becomes a powerful tool for creating an internal secure base and safe haven. This adaptation focuses on instilling a sense of internal security to counteract pervasive feelings of anxiety and feeling unsafe in the world.
The core concept of “being with,” a fundamental principle in Circle of Security, becomes a guiding light in the therapeutic process for adults with trauma histories. The emphasis shifts towards individuals learning to “be with” themselves, establishing an internal secure base where they can find refuge and comfort amidst the challenges of their internal landscape. By nurturing the ability to be present with one’s emotions, thoughts, and memories, the Circle of Security empowers individuals to create a self-soothing internal safe haven. This internal secure base becomes a foundation for navigating the complexities of trauma, fostering emotional regulation, and ultimately facilitating a transformative journey towards healing and wholeness.
Creative Arts Therapies
Creative arts therapies such as using art, bibliotherapy, drama, music, movement, and movie therapy provide non-verbal avenues for trauma expression and processing, allowing individuals to explore and release emotions that may be challenging to articulate verbally. Engaging with these modalities promotes self-discovery, emotional regulation, and the integration of traumatic experiences. Here are some of the techniques that Creative Arts Therapists might use but are not limited to:
- Art Therapy: Involves visual art as a therapeutic medium, offering a non-verbal way to express emotions. Sessions may include drawing, painting, or sculpting.
- Bibliotherapy: Harnesses the healing power of literature as a therapeutic tool, encouraging individuals to engage with written material that resonates with their experiences, emotions, and personal growth. Reading relevant texts can complement other creative arts therapies, fostering self-reflection and insight.
- Drama Therapy: Utilises theatrical techniques, role-playing, and improvisation for emotional exploration and expression. Participants may act out scenarios to gain insights.
- Music Therapy: Utilises the power of music for emotional expression, communication, and healing. In sessions, individuals may engage in listening, playing instruments, or songwriting.
- Movement Therapy: Incorporates body movement for emotional processing. Dance, yoga, or other movement forms can be employed.
- Movie Therapy: Utilises cinematic experiences for therapeutic reflection, tapping into the potential for catharsis through watching and discussing films. This approach allows clients to gain insights into personal narratives and emotions, fostering a unique avenue for self-discovery and reflection.
Engaging with these modalities not only facilitates self-discovery and emotional regulation but also fosters the integration of traumatic experiences. Whether through visual art, literature, theatrical techniques, music, movement, or cinematic experiences, these therapeutic approaches provide diverse avenues for individuals to navigate and heal from the complexity of their trauma.
Ecotherapy, a holistic branch of psychotherapy, invites individuals to embark on a transformative journey through nature. Rooted in the belief that the natural world holds profound healing potential, ecotherapy stands as a therapeutic approach that aligns human well-being with the interconnected vitality of the Earth. This therapeutic paradigm recognises nature as a powerful ally in the process of healing from trauma, fostering connections with self, others, and the broader environment. As we delve into the diverse realms of ecotherapy, it becomes evident that this approach offers not only a path to individual recovery but also a reaffirmation of the symbiotic relationship between human and environmental well-being. Here are some types of Ecotherapy:
- Green Exercise: Involves individuals in physical activities such as walk and talk amidst natural settings, leveraging the benefits of movement while immersed in nature.
- Horticultural Therapy: Utilises gardening and plant-related activities for therapeutic purpose and encourages individuals to connect with the rhythm of nature through nurturing plants.
- Wilderness Therapy: Involves therapeutic interventions conducted in the wilderness and harnesses both the challenges and serenity of nature to facilitate personal growth.
- Equine Therapy: Incorporates interactions with horses as a therapeutic medium and explores the unique connection between humans and these intuitive, non-judgmental animals.
- Animal-Assisted Therapy: Encompasses various therapies involving animals to support healing and recognises the therapeutic benefits of human-animal interactions.
- Indoor Nature Therapy: This approach recognises the potential benefits of nature exposure even within indoor settings and aims to create a therapeutic environment that incorporates elements of the natural world.
Scientifically, the benefits of ecotherapy are well-established. Exposure to nature has been shown to reduce stress levels, enhance mood, and regulate the nervous system. The evidence-based nature of ecotherapy positions it as a potent tool for trauma recovery, tapping into the inherent healing properties of the natural world.
Ecotherapy extends an invitation to individuals seeking healing from trauma—a journey guided by the wisdom of nature. As outdoor sessions weave together talk therapy and engaging activities such as working with natural objects, symbols and fairytales, nature emerges as a co-therapist, providing a transformative space for holistic well-being. Beyond addressing trauma, ecotherapy reinforces the interconnectedness of human and environmental health, emphasising that the path to individual recovery is intricately woven into the broader tapestry of our natural world.
Emotional Freedom Techniques (EFT), developed by Dr. Roger Callahan and later refined by Gary Craig, represents a unique approach to trauma recovery with growing evidence supporting its efficacy. Dr. Callahan’s discovery that tapping on meridian points could enhance well-being laid the foundation for EFT. This technique, often referred to as psychological acupressure, is deeply rooted in the principles of Traditional Chinese Medicine, specifically the meridian system.
Research studies on EFT have shown promising results in reducing symptoms associated with trauma, anxiety, and stress. Tapping on specific acupoints is believed to stimulate these energy meridians, facilitating the release of emotional blockages. The combination of tapping and cognitive restructuring, a key component of EFT, has been found to create positive shifts in emotional responses and thought patterns.
The versatility of EFT makes it particularly useful in-between trauma therapy sessions, providing individuals with a practical and accessible tool for managing distressing emotions in real-time. As the body of research on EFT continues to grow, its integration into trauma recovery demonstrates its potential as a valuable therapeutic modality.
Health at Every Size
Health at Every Size (HAES), deeply rooted in the principles of the Association for Size Diversity and Health (ASDAH) and further popularised by Dr. Lindo Bacon, represents a revolutionary and holistic approach to well-being by challenging weight-based judgments. The core guidelines of HAES underscore three fundamental pillars: intuitive eating, joyful movement, and an unwavering focus on health, regardless of an individual’s size.
In trauma therapy sessions under the HAES umbrella, individuals are provided with a supportive space to navigate complex issues related to their trauma and disordered eating, food, weight, and body image concerns. Therapists guide clients through exploring the profound societal impact on body image, helping them develop resilience against external judgments and promoting a positive self-image. HAES therapy stands out as an empowering and trauma-informed approach that addresses the intricate interplay between societal influences and individual well-being, offering a path towards genuine self-acceptance and holistic health.
A Health at Every Size (HAES) approach can be crucial when working with individuals with complex trauma for several reasons:
- Body Neutrality and Safety: Many individuals with complex trauma may have a history of body-based trauma or shame. A HAES approach promotes body neutrality, allowing individuals to focus on health and well-being without judgement, fostering a sense of safety.
- Avoiding Retraumatisation: Traditional approaches that focus on weight or appearance may inadvertently trigger trauma responses. HAES avoids weight-based judgments, reducing the risk of retraumatisation and creating a more supportive therapeutic environment.
- Empowerment and Autonomy: HAES emphasises intuitive eating and joyful movement, empowering individuals to reconnect with their bodies and make choices based on their own internal cues. This autonomy is crucial for those who may have experienced a loss of control in their past.
- Self-Compassion: HAES encourages a non-diet approach, fostering self-compassion and body acceptance. This is particularly important for individuals with complex trauma who may struggle with self-esteem and negative body image.
- Holistic Well-Being: HAES focuses on overall health rather than a specific weight goal. This aligns with a holistic approach to well-being, addressing physical, emotional, and mental health, which is essential in complex trauma recovery.
- Trauma-Informed Care: HAES principles align with trauma-informed care by recognising the impact of trauma on an individual’s relationship with their body. It provides a framework that considers the potential sensitivity around body-related issues in trauma survivors.
In summary, a Health at Every Size approach is important in trauma therapy as it promotes safety, empowerment, and holistic well-being, while minimising the risk of retraumatisation associated with weight-based judgments.
Inner Child Therapy
Healing the inner child is a transformative approach rooted in the psychodynamic and psychoanalytic traditions. It explores the impact of adverse childhood experiences (ACEs) on adult emotions, thoughts and behaviours. Developed within the broader framework of depth psychology, this modality delves into the concept that the child within us holds memories, emotions, and unresolved experiences from our formative years. The therapist works collaboratively with clients to identify and nurture the inner child, creating a safe space for exploration and healing.
In Inner Child Therapy, individuals engage in a process of revisiting and reimagining pivotal moments from their past, allowing the therapist to guide them toward understanding and reparenting their inner child. This therapeutic journey aims to address unresolved issues, promote self-compassion, and foster emotional integration. By establishing a connection with the inner child, individuals can develop a more authentic relationship with themselves, leading to increased self-awareness, emotional resilience, and a sense of inner harmony. This approach proves particularly beneficial for those seeking to break free from patterns of self-sabotage, build healthier relationships, and cultivate a more compassionate self-view.
Roberto Assagioli, a pioneer in transpersonal and psycho-spiritual psychotherapy, integrated mindfulness into his work as early as 1908, blending Western psychology with Eastern spirituality, drawing inspiration from both his Jewish background and Buddhist influences. In the subsequent wave of therapists, Dr. Jon Kabat-Zinn developed Mindfulness-Based Stress Reduction (MBSR) in the late 1970s, combining mindfulness meditation and yoga to manage stress and improve overall well-being. Stephen Hayes continued this integration with the development of Acceptance and Commitment Therapy (ACT).
Promoting present-moment awareness and non-judgmental observation of thoughts and feelings, mindfulness enhances emotional regulation and stress reduction. Practices include meditation, mindful breathing, and awareness exercises, adaptable for individual or group settings, indoors or outdoors, such as mindful walking of a labyrinth.
Narrative therapy, co-founded by Michael White and David Epston in the 1980s, offers a transformative approach that places individuals as active authors of their own stories. This model recognises the power of storytelling in shaping narrative identities, fostering personal agency and cultural sensitivity. White and Epston’s collaborative efforts laid the foundation for this influential psychotherapeutic approach.
In narrative therapy, clients engage in collaborative conversations where they actively construct and reconstruct their life stories. This process explores alternative narratives, emphasising personal agency, cultural relevance, and resilience in the face of challenges. The approach extends beyond individual struggles to acknowledge the impact of collective trauma and cultural influences on personal narratives.
This model is particularly relevant for First Nation Peoples due to its cultural sensitivity. Narrative therapy provides a space for expressing unique experiences within a collective context, recognising the influence of cultural identity, land, ancestry, and community in the healing process. By empowering individuals to reshape their narratives, emphasising strengths, and acknowledging resilience, narrative therapy stands as a dynamic and transformative approach to healing and post-traumatic growth.
Safe & Sound Protocol
The Safe and Sound Protocol (SSP) stands as a pioneering therapeutic intervention designed to address trauma and support overall emotional well-being. Developed by Dr. Stephen Porges, a renowned neuroscientist and creator of the Polyvagal Theory, the SSP is rooted in understanding the intricacies of the autonomic nervous system and its role in regulating physiological responses to stress and trauma. Dr. Porges’ groundbreaking research emphasises the importance of the vagus nerve in mediating social engagement and emotional regulation.
The SSP operates by delivering specifically filtered auditory stimuli to the nervous system, promoting a sense of safety and engagement. This intervention aims to recalibrate the autonomic nervous system, shifting individuals from a state of heightened arousal or shut-down associated with trauma to a more regulated and resilient state. By leveraging the principles of neuroplasticity, the SSP seeks to rewire the brain’s response to stress, ultimately fostering emotional and physiological resilience.
The protocol has demonstrated efficacy in alleviating symptoms associated with trauma, anxiety, and sensory processing challenges. It has been particularly impactful for individuals who may have experienced complex or developmental trauma, offering a unique and innovative approach to trauma recovery. The Safe and Sound Protocol stands at the forefront of trauma therapies, showcasing the potential of cutting-edge interventions in facilitating healing at the somatic and neurological level.
Psychoanalysis & Psychodynamic Psychotherapy
Psychoanalysis and psychodynamic psychotherapy, pioneered by Sigmund Freud and further developed by influential figures such as Carl Jung, Donald Winnicott, Melanie Klein, John Bowlby, and Heinz Kohut, delve into the exploration of unconscious processes and early life experiences that profoundly shape present behaviour and one’s sense of self. This therapeutic approach is experiencing a significant resurgence in recent years due to medical model research for biological causes hitting dead ends and the abundance of research, as highlighted by Jonathan Shedler, showcasing the enduring positive outcomes of depth psychotherapy.
Within this framework, therapists create what Winnicott coined a ‘holding environment.’ Drawing from Melanie Klein’s object relations and Bowlby’s attachment theory, this integrated approach establishes a secure base for clients, fostering an environment where they can navigate emotions and relationships while building an internal sense of trust and safety. The therapy ensures that clients feel secure enough to openly express their thoughts, emotions, and memories. Contrary to common misconceptions of this modality being solely talk or insight-oriented, it extends beyond verbal dialogue, incorporating a relational focus on somatic cues, body language, symbolic and experiential exploration.
While historically sessions were conducted on the couch, contemporary psychoanalytic trauma therapists often offer clients the choice between a couch or a chair. Sessions are at least weekly, and psychoanalysis and the broad range of psychodynamic therapies employ techniques such as free association, dream analysis, and interpersonal exploration, fostering a gradual and transformative process within the context of a long-term therapeutic relationship.
Psycho-Spiritual Transpersonal Psychotherapy
Psychosynthesis, a transpersonal psychotherapy known globally as a psychology with a soul, uniquely integrates the best of Western psychology and Western and Eastern spirituality. It is a truly holistic, depth trauma psychotherapy. This distinctive approach, blending principles such as presence, mindfulness, meditation, and visualisation, offers a holistic exploration of diverse dimensions influencing health and well-being.
Founded by Roberto Assagioli, a psychoanalyst and neurologist, Psychosynthesis aligns with empirical research linking spirituality to improved health outcomes. This model, which addresses both crises and awakening, not only fosters empowerment and resilience but facilitates post-traumatic growth, helping clients find value, meaning, and purpose out of their suffering. Rooted in relational dynamics, Psychosynthesis emphasises the therapeutic alliance’s impact on emotional, mental and physical and spiritual well-being.
Utilising a multifaceted approach, including subpersonalities, inner child, dream work, art therapy, mindfulness, and self-awareness, psychosynthesis guides individuals on a transformative journey toward personal growth and healing from their attachment, complex and developmental trauma.
Somatic psychotherapy, a dynamic field influenced by pioneers such as Wilhelm Reich, Alexander Lowen, Moshe Feldenkrais, Ron Kurtz, Peter Levine, Babette Rothschild, Pat Ogden, Kathy Kain and more, explores the intricate interplay between body and mind for trauma healing. These pioneers have contributed unique insights and methodologies to integrate somatic approaches into trauma recovery and overall well-being.
This therapeutic approach focuses on the profound connection between the mind and body, aiming to release physical tension and stored trauma while utilising body awareness to promote regulation and healing. Sessions often incorporate gentle body movements, breathwork, and mindful attention to bodily sensations, offering a holistic approach to trauma recovery, mental health and well-being.
Subpersonalities & Internal Family Systems (IFS)
Psychosynthesis psychotherapists have worked with subpersonalities as one of their core personality models for over 50 years. This therapeutic approach entails an exploration and integration of diverse psychological parts, with a specific focus on promoting wholeness and self-realisation. This becomes particularly crucial when addressing shamed, dissociated parts resulting from early childhood, complex, and developmental trauma. Each part is seen as pure and whole at the core, regardless of its presentation.
Beyond Assagioli’s subpersonalities, various popular parts theories and practices have emerged. In “parts” therapy, clients embark on a transformative journey involving the recognition, acceptance, integration, and synthesis of dissociative parts. The emphasis lies in disidentifying from over-identified aspects of the part and fostering a connection with the whole, the core self, a process known as self-identification in Psychosynthesis and self-leadership in IFS (Internal Family Systems).
In subpersonality or IFS therapy, clients engage in identifying and dialoguing with different subpersonalities. The therapist plays a crucial role as an external unifying centre (co-regulator) until the client is connected with their internal unifying centre, the self. The therapist and client, facilitate harmony among the internal parts through dialogue and creative interventions, such as using chairs or interacting with symbolic items in the therapy room. As an introductory resource, the movie “Inside Out” is often recommended for those new to the concept of parts work.
Here are some popular parts theories and practices other than Assagioli’s subpersonalities:
- Object Relations: Object Relations Theory, developed within the psychoanalytic tradition, delves into understanding how early relationships shape internalised mental representations that, in turn, influence emotions and behaviours. This theory explores the dynamics of the “internal objects” or mental images of significant others that individuals carry within themselves. In the context of parts therapy, Object Relations Theory provides insight into the formation of these internal objects and how they contribute to the development of various psychological parts within an individual’s psyche. This theory lies at the heart of all other parts therapies, including IFS.
- Jungian: Jungian Analysis delves into the exploration of archetypes as fundamental elements within the collective unconscious. Archetypes can be considered as distinctive psychological parts that represent universal symbols or themes shared by humanity. In Jungian Analysis, the therapist may work with clients to identify and integrate these archetypal parts, aiming to illuminate aspects of the individual psyche and promote self-awareness. This process involves recognising and understanding the influence of archetypal energies on one’s thoughts, emotions, and behaviours, ultimately fostering personal growth and a more harmonious integration of the self.
- Transactional Analysis (TA) was developed by Eric Berne, a Canadian psychiatrist, in the mid-20th century. It is still a widely used depth psychotherapy today. Berne proposed the theory of three ego states—Parent, Adult, and Child—to enhance understanding and communication in interpersonal relationships. The concept of ego states refers to the different patterns of thinking, feeling, and behaving that individuals exhibit. The Parent ego state involves learned behaviors and attitudes from authority figures, the Child ego state involves spontaneous and emotional reactions, and the Adult ego state involves rational and objective thinking. TA’s focus on ego states provides a framework for analysing and improving communication dynamics and interpersonal relationships.
- Gestalt: Founded by Fritz Perls, Gestalt therapy focuses on integrating fragmented parts in the present moment to enhance self-awareness. A popular technique used by many parts therapists, chair work, has its roots in Gestalt experimentation. This therapeutic approach aims to bring awareness to the present experience and promote a holistic understanding of the self.
- Internal Family Systems (IFS): Originating from the psychosynthesis model of Roberto Assagioli, IFS draws inspiration from the concept of subpersonalities and the spiritual Self, and the several other parts therapies mentioned above. Developed by Richard C. Schwartz, IFS conceptualises the mind as a system of subpersonalities or parts, including the Exile, Manager, and Firefighter. This approach specifically focuses on exploring the internal family system, fostering harmony among these internal parts through dialogue and creative interventions so that the individual can become more self-led (rather than part led).
The therapy for trauma & C-PTSD is rich with diverse modalities that acknowledge the unique nature of complex trauma. From psychodynamic approaches that unearth the roots of unconscious processes to somatic therapies fostering mind-body integration, and from creative arts therapies offering non-verbal expression to mindfulness practices cultivating present-moment awareness, each modality contributes distinctively to the healing process. The inclusivity and effectiveness of these therapies empower individuals to rewrite their narratives, reconnect with their core selves, and embark on a transformative journey towards healing and post-traumatic growth.