What is Trauma Therapy?

Written by Danielle “Elle” Jones, LPCC

You’ve googled “trauma therapy” to better understand what that even means. Maybe you experienced something that has caused you confusion, feeling grief, anxiety, rage. You’ve had nightmares, physical responses like easy-to-startle, trembling, increased heart rate, and sweating when thinking about it. Maybe you think about what happened a lot, maybe you try to avoid anything that reminds you of it. 

Or, maybe you notice changes in your friend, family member, coworker. Something has changed and you are concerned about them. They confide in you that they experienced an incident that has shaken them to their bones. What do you do? What can help them with the impact? 

Experiencing life after a trauma can feel like you are experiencing life from a completely different lens. If you’ve ever seen the television show Stranger Things, imagine living in the upside down after experiencing trauma. The world looks the same, but now there is a heaviness, a darkness encompassing what you see, hear, feel. Traumatic experiences can impact everything, changing the way we move, experience, and interact with our world and the people in it. The good news is that suffering from the trauma does not have to be forever. There are techniques, therapies, and people who can support you to shift from being in the upside down to flipping it. To redesign and redecorate, to heal and resolve. At Bell Jar Therapy, our goal is to be there with you as you mend, resolve, and expand. 

What is trauma therapy? This will not be a simple answer, because trauma is not simple. To best explore what trauma therapy is, having some clarifying terminology may be useful. 

Defining Trauma

Traumatic incidents can come in many shapes and forms.  Trauma is generally defined as an emotional response to an event that is distressing to the person, which impacts the ability to cope, has an element of overwhelm, and has adverse reactions ranging from physical to psychological (American Psychological Association (APA), 2024). Traumatic events can be acute, chronic, or complex, which will be explored below. There are a plethora of consequences, including social, emotional, and physical. As a result, this can impact families and direct communities, too. 

When describing trauma, identifying the type, duration, and impact, as well as when the traumatic incident happened can provide context for a mental health professional to help you, which you might be asked about during an intake or throughout therapy. When someone experiences an acute trauma, this means there was an isolated experience that caused distress. For example, someone who experienced a car accident may have negative impacts after the accident. They may experience a physical and/or emotional reaction after experiencing the incident to certain smells, sounds, and visual cues. Chronic trauma is an ongoing and prolonged exposure to trauma, such as intimate partner violence or childhood neglect/abuse. Complex trauma is exposure to a variety of incidents which leads to long-term impacts on someone’s well-being, such as how they relate to others, the automatic thoughts they experience, avoiding conflicts, etc. 

Historical trauma has been described by researchers (Brave Heart & DeBruyn, 1998, pg. 60) as “a legacy of chronic trauma and unresolved grief across generations.” Some specific examples of historical trauma include the Jewish Holocaust and atrocities suffered by Indigenous People in the Americas. Historical trauma is passed down from the generation who experienced the trauma to subsequent generations by means of social, psychological, environmental, and biological, creating a cycle of trauma (Sotero, 2006). Historical trauma increases the physical and mental health risks cross-generationally (Brown-Rice, 2014).

Intergenerational trauma, similarly to historical trauma, is trauma passed down from the survivor to their descendants. While individuals who experience intergenerational trauma do not directly experience the trauma, the symptoms and responses are inherited genetically. Because individuals do not experience the trauma directly, some symptoms are not present, like intrusive memories or flashbacks. Intergenerational trauma may show up in physical ways, such as stroke, heart disease, and other medical issues (Marschall, 2024).

All types of trauma can change brain functioning and the structures - and yes, our brains can change in the other direction through a process called neuroplasticity! Perhaps another blogpost? Time will tell. 

PTSD

While someone may experience a traumatic incident, that does not mean they will develop Post Traumatic Stress Disorder, or PTSD. By engaging in ways to process the incident, engaging in support and community, and accessing services that may help with initial impact, this can decrease the risk of developing PTSD. According to the DSM-5-TR ,(American Psychiatric Association, 2022), PTSD has specific criteria that individuals must meet in order to be diagnosed, including symptoms lasting more than 1 month, directly experiencing, witnessing, or hearing about traumatic incidents (i.e. first responders), intrusive symptoms, avoidance, persistent negative thought and mood changes after the incident, physical arousal or reactivity, and significant distress and/or impairment in well-being (social, occupational, etc.). 

Trauma Therapy

So, what happens when someone seeks out therapy due to trauma? Well, it depends! After sitting across from clients who have experienced intimate partner violence, sexual assault, losses, huge life transitions, and attachment wounds from the people my client’s cared about, there is no “one way” to heal, just as there is no “one way” someone might experience symptoms after. Trauma-informed care gives flexibility to allow for clients to gain agency and autonomy back. Trauma-informed care is typically guided by the client through goal setting and identifying their needs. This can then help the clinician or therapist create a framework to work alongside the client. Some common goals that clients come into therapy with include seeking out coping skills to deal with triggers, explore relationship patterns and the impact, learn how to set healthy boundaries at work, with friends, or in romantic relationships, and build confidence to date, engage in community, move through life transitions, etc.  Goals are specific, time-sensitive, and unique to the client and their experience. 

Some common therapies and modalities you might encounter when engaging in trauma work include acceptance and commitment therapy, dialectical behavior therapy, trauma-focused cognitive behavior therapy, internal family systems, attachment theory, somatic processing, eye movement desensitization and reprocessing therapy, art therapy, mindfulness practices, narrative therapy, and psychodynamic therapy. This is not an exhaustive list, surprisingly. Some therapists are more eclectic, meaning they blend several modalities and therapies to provide a more tailored approach. Some therapists choose one or two, with specific guidelines to support clients. 

The process of trauma therapy, just like the types, depends. Based on your therapist and your particular set of needs, you may experience a season of learning skills, such as coping tools, engaging in soothing practices, and finding ways to regulate your nervous system before addressing the trauma. Therapists may address the trauma by engaging in talk therapy and/or “bottom-up” approaches*, like eye movement desensitization and reprocessing or somatic (body-based) therapy.  The common theme here is going at a pace and identifying the client’s needs as the priority through the healing process. 

What you might expect going through therapy varies, however, it is not uncommon to notice increased mindfulness, new insights about yourself, increased confidence, changes in how you relate to others, and discomfort due to addressing the trauma directly. Post traumatic growth is a term coined by Professor Richard Tedeschi and researcher Lawrence Calhoun in the 1990s (Chapin, 2017). They identified a number of  themes in people who have survived trauma(s). Some of these themes include greater compassion for others and for themselves, increased personal strength, shifts in worldview and philosophies on life, and more resilience in relationships. The pain of the trauma cannot be erased; we can find ways to ease the pain and compassionately care for those parts of you that were hurt. By building new practices and connecting through therapy, you too might see shifts. We would be honored to join you in affirmation, liberation, and connection.

With gratitude,

Elle

Some Questions to Ask When Looking for a Therapist:

What therapies and/or modalities do you approach therapy with?

What does trauma-informed care look like in your practice?

How might you start trauma therapy with me (or a client)?

*”Bottom Up” approaches can be described as: you can’t outthink the trauma. Imagine trauma living dormant in your body and every once in a while, it pops up without warning. You react rather than respond. Your body knows before your brain can connect. It is interwoven into the body, until we turn toward it and process it, usually by focusing on how the body is reacting and then shifting to responding. 

References:

American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th-TR). American Psychiatric Association.

American Psychological Association (APA). (2024). Trauma. American Psychological Association. https://www.apa.org/topics/trauma 

Brave Heart, M. Y. H., & DeBruyn, L. M. (1998). The American Indian holocaust: Healing historical unresolved grief. American Indian and Alaska Native Mental Health Research, 8(2), 60–82.

Brown-Rice, K. (2014, October 15). Examining the Theory of Historical Trauma Among Native Americans. The Professional Counselor. https://tpcjournal.nbcc.org/examining-the-theory-of-historical-trauma-among-native-americans/

Chapin, A. (2017, August 29). Research Illuminates How Trauma Can Lead to Growth - College of Humanities & Earth and Social Sciences. College of Humanities & Earth and Social Sciences. https://chess.charlotte.edu/2017/08/29/research-illuminates-how-trauma-can-lead-to-growth/ 

Marschall, A. (2024, May 14). Intergenerational Trauma: What You Need To Know. Verywell Mind. https://www.verywellmind.com/what-is-integenerational-trauma-5211898