How Trauma Therapy Works, According to Therapists (2023)

SHOCK, FLASHBACKS, AND DENIAL are just some of the emotions that can accompany a traumatic event. Sometimes, you need trauma therapy to work through this emotional distress, especially if it’s affecting your relationships or ability to carry out your day.

“Trauma therapy can greatly improve a person’s ability to heal from past trauma and regain emotional security,” says Angeleena Francis, L.M.H.C., executive director at AMFM Healthcare. “Seeking professional support to identify the most effective modality to address trauma is the first step.”

About 70 percent of adults have experienced a traumatic event at least once in their lives, according to the National Council for Behavioral Health. It could stem from abuse, an accident, natural disaster, grief, war or conflict, or witnessing a violent act.

“The events can be profoundly altering,” says Avi Klein, L.C.S.W., clinical director and owner of Downtown Somatic Therapy in New York City and a Men’s Health advisor. “People develop coping strategies or long-term changes in their behavior and ways of relating as a result of those experiences.”

Trauma therapy, or trauma-focused therapy, can help you heal and learn to cope with the emotions that come from the traumatic event. It can encompass several different types of therapy, including cognitive behavioral therapy, eye movement desensitization and reprocessing therapy (EMDR), exposure therapy, and others.

“Trauma therapy has been really impactful,” Klein says. “For people who feel hopeless, there’s a lot of hope and possibility out there for them.”

Here, therapists explain what trauma therapy is, how it can help, and what you should know about seeking out the treatment.

What Is Trauma?

Trauma is an emotional response to a horrific event, according to the American Psychological Association. It can cause fear, helplessness, dissociation, confusion, or other disruptive feelings that have a long-term negative impact on your life, including how you think, view the world, and function daily.

It can result from abuse, military combat, being the victim of a crime, being in an accident or natural disaster, or anything other impactful experience.

Trauma can range in severity and isn’t a diagnosable condition, Klein says. Post-traumatic stress disorder (PTSD) is a diagnosable psychological disorder, but not everyone who’s experienced trauma meets the criteria for PTSD.

“Sometimes therapists might say there's a capital T trauma and then lower-case T trauma,” he explains. “There are experiences and events that might be the classic symptoms of PTSD, like flashbacks, nightmares, and dissociation. And, then there are other events that can be traumatic, which are overwhelming and frightening.”

A hallmark of trauma is unprocessed experiences, and that’s why flashbacks are common, Klein says. “It seems as if something that happened in the past is happening in the present, and you have cortisol spikes at moments when you wouldn’t expect to.”

Other symptoms of trauma can include:

  • Headaches
  • Pain
  • Fear
  • Depression and anxiety
  • Stomach problems
  • Nightmares
  • Mood swings
  • Sleep problems
  • Isolation

What Is Trauma Therapy?

Trauma-focused therapy basically focuses on a specific trauma from your life, explores how the trauma affects you, and helps you heal from it, explains Alfred Tabaks, L.P.C., a licensed professional counselor with Thriveworks in Arlington, Texas, who specializes in trauma.

“Healing looks different from person to person, but the way I usually describe it is: trauma is a wound that will eventually scar over,” he says. “It doesn't necessarily go away, but its impact lessens, and we learn how to handle it as it comes.”

How Trauma Therapy Works, According to Therapists (2)

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For instance, if the trauma stems from abuse or another event caused by another person, you might focus on forgiveness—for you, not the other person, Tabaks says. Forgiveness doesn’t necessarily mean reconciliation but helps you release yourself from the hurt.

Therapy for event-related trauma might focus on acceptance, he adds. “It’s important to realize that trauma can rewire the brain.”

What Are the Types of Trauma Therapy?

Trauma therapy creates a safe space for you to process the emotional consequences of the trauma, Francis says. It can include several different types of therapy.

Trauma-Focused Cognitive Behavioral Therapy

Cognitive behavioral therapy (CBT) focuses on how your thoughts, feelings, and behaviors are linked, and how changing one area can improve another, according to the APA. It helps you learn to change behaviors, thoughts, and feelings that interfere with your functioning. CBT targets the symptoms related to trauma and helps you learn coping skills.

Eye Movement Desensitization and Reprocessing

EMDR was developed in the late 1980s to treat PTSD, according to the APA. It relies on Adaptive Information Processing, which is a theory suggesting that your brain stores normal and traumatic memories differently. EMDR is a multi-step therapy that encourages patients to focus on the traumatic memory while experiencing bilateral stimulation, usually eye movements. The goal is to make the memory feel less vivid and reduce the emotions associated with it.

Cognitive Reprocessing Therapy

This is a type of cognitive behavioral therapy that helps you learn to challenge trauma-related thoughts and beliefs and change how you react to them, according to the APA. It can help you feel unstuck with your thoughts and behaviors, and it’s a common treatment for PTSD.

Exposure Therapy

Exposure therapy helps you confront your fears, which can help you break your trauma-related thoughts and behavior patterns, APA says. Your therapist will create a safe space to expose you to what you fear and avoid, which will, over time, help you feel less fearful and stoping avoiding it.

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The Benefits of Trauma Therapy

Different people respond to different types of trauma therapy. Klein says the goal is to access feelings of safety—“so helping them ground, focus on their breath, orient themselves to the present, and retrain their body to relax.”

How Trauma Therapy Works, According to Therapists (3)

Trauma therapy helps you process the traumatic event and deal with it without the emotional response, Francis adds. You learn to feel safe in having the memory.

“At the core of trauma therapy is the assistance in that scarring over of the wound,” Tabaks says.

Trauma therapy can ultimately reduce stress levels and the intensity and severity of triggers, he adds. You’ll also learn coping skills for dealing with the emotions related to the trauma.

Are There Any Downsides to Trauma Therapy?

Trauma therapy can be intense, Tabaks says. You should prepare yourself for possibly mentally reliving the trauma and for the feelings from the trauma to resurface.

A good therapist will ensure that you’re prepared for this experience, he adds.

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Trauma therapy works best when you also use other tactics to help you deal with stress and anxiety, like meditation, exercising, journaling, or other kinds of self-care, Klein says.

Should You Seek Trauma Therapy?

Trauma, especially unresolved trauma, can affect every aspect of your life: relationships, work, and anxiety levels, Francis says. When it’s interfering with your ability to be self-sufficient or function normally, you should seek help.

Trauma-focused therapy takes work, though, Tabaks says. “It's difficult and can even be scary at times, but it's worth it,” he adds. “You don't need to feel alone, and you don't need to do this on your own. There are plenty of therapists who are experienced in trauma therapy that are ready to work with you. Sometimes, the most difficult step is starting.”

How Trauma Therapy Works, According to Therapists (4)

Erica Sweeney

Erica Sweeney is a writer who mostly covers health, wellness and careers. She has written for The New York Times, HuffPost, Teen Vogue, Parade, Money, Business Insider and many more.

(Video) What is TRAUMA THERAPY?


What is trauma therapy and how does it work? ›

Trauma therapy, or trauma-focused therapy, is a specific approach to therapy that is built on the understanding of how traumatic experiences affect an individual's mental, emotional and physical well-being. This type of therapy aims to help children, adolescents and adult survivors heal from the effects of trauma.

How does a therapist help process trauma? ›

The role of the therapist is to help the person understand his/her situation, teach strategies to express him/herself, and cope with potentially stressful situations. The therapist can also offer the individual or family tools to help them manage difficult feelings, and/or negative thoughts and behaviors.

What is the success rate of trauma therapy? ›

Some studies showed 84-90% of single event trauma victims no longer had PTSD symptoms after three ninety minute EMDR sessions. Another study showed 100% success rate for single event trauma victims.

What are the 3 concepts of trauma informed practice? ›

There are many definitions of TIC and various models for incorporating it across organizations, but a “trauma-informed approach incorporates three key elements: (1) realizing the prevalence of trauma; (2) recognizing how trauma affects all individuals involved with the program, organization, or system, including its ...

What techniques are used in trauma therapy? ›

5 Trauma Therapy Techniques for Busy People
  • Try the 5-4-3-2-1 method. Working backward from 5, use your senses to notice what's happening around you. ...
  • Practice deep breathing. Slowly inhale and then exhale. ...
  • Notice how your body feels. ...
  • Start journaling.
Feb 15, 2022

What is the most effective therapy for trauma? ›

The gold standard for treating PTSD symptoms is psychotherapy, particularly cognitive behavioral therapy, cognitive processing therapy, and prolonged exposure therapy. EMDR and EFT have also shown promise in helping people recover from PTSD.

What is the structure of trauma therapy? ›

In general, there are three phases of trauma treatment: Safety & Stabilization, Processing Trauma and Integration & Connecting with others (this concept was originally described by Pierre Janet, one of the first psychologists to really explore the impact of trauma and dissociation in therapy).

What is an important component of trauma therapy? ›

Empathic Listening/Reflection- The therapist listens intently to what the client is saying and will reflect back (or summarize) what they have heard from the client to ensure they accurately have understood what was said.

How long does therapy take to work for trauma? ›

Conditions such as post-traumatic stress disorder typically take around 15-20 sessions for 50% of patients to feel improvement. It's been found that those treated with Cognitive Behavioral Therapy report feeling better after around 10-20 sessions.

Is counselling enough to treat trauma? ›

Talk therapy and counselling are both options that provide a strong foundation that will enable you to process and express thoughts and feelings. Despite the huge benefits of both talk therapy and counselling, these alone are not enough to effectively treat PTSD.

How many therapy sessions do you need for trauma? ›

You'll usually have 8 to 12 weekly sessions of trauma-focused CBT, although fewer may be needed. Sessions usually last for around 60 to 90 minutes.

Does trauma therapy change the brain? ›

Exposure to trauma can be life-changing—and researchers are learning more about how traumatic events may physically change our brains. But these changes are not happening because of physical injury; rather, the brain appears to rewire itself after these experiences.

What are the 4 R's of trauma care? ›

The trauma-informed approach is guided four assumptions, known as the “Four R's”: Realization about trauma and how it can affect people and groups, recognizing the signs of trauma, having a system which can respond to trauma, and resisting re-traumatization.

What are the 3 R's of trauma? ›

The three R's – Reaching the traumatised brain. Dr Bruce Perry a pioneering neuroscientist in the field of trauma has shown us to help a vulnerable child to learn, think and reflect, we need to intervene in a simple sequence.

What are the 5 pillars of trauma? ›

The Guiding Values/Principles of Trauma-Informed Care

The Five Guiding Principles are; safety, choice, collaboration, trustworthiness and empowerment. Ensuring that the physical and emotional safety of an individual is addressed is the first important step to providing Trauma-Informed Care.

How is trauma therapy different from regular therapy? ›

Unlike other therapeutic modalities, trauma therapy delves deeper into a client's memory of a painful experience in order to “release” it. Common examples used in practice include cognitive behavioral therapy, eye movement desensitization and reprocessing, and prolonged exposure therapies.

What is the first line treatment for trauma? ›

Trauma-focused psychotherapy as preferred treatment — For most adults diagnosed with PTSD, we suggest first-line treatment with a trauma-focused psychotherapy that includes exposure rather than other types of therapy, or medication (eg, selective serotonin reuptake inhibitor [SSRI] or serotonin-norepinephrine reuptake ...

Why do clients smile when talking about trauma? ›

Smiling when discussing trauma is a way to minimize the traumatic experience. It communicates the notion that what happened “wasn't so bad.” This is a common strategy that trauma survivors use in an attempt to maintain a connection to caretakers who were their perpetrators.

Which therapy is used immediately after trauma? ›

Exposure therapy can be particularly helpful for flashbacks and nightmares. One approach uses virtual reality programs that allow you to re-enter the setting in which you experienced trauma. Eye movement desensitization and reprocessing (EMDR).

How do therapists treat complex trauma? ›

Complex trauma is treated through a combination of psychotherapy (talk therapy), eye movement desensitization and reprocessing (EMDR), medications, and the development of strong coping mechanisms.

How is trauma stored in the body? ›

Trauma is not physically held in the muscles or bones — instead, the need to protect oneself from perceived threats is stored in the memory and emotional centers of the brain, such as the hippocampus and amygdala. This activates the body whenever a situation reminds the person of the traumatic event(s).

What is one of the most important goals of trauma-informed therapy? ›

Trauma-informed care seeks to: Realize the widespread impact of trauma and understand paths for recovery; Recognize the signs and symptoms of trauma in patients, families, and staff; Integrate knowledge about trauma into policies, procedures, and practices; and.

How do I know if trauma therapy is working? ›

6 Signs You May Notice As You're Healing From Trauma
  1. You Begin Feeling Your Emotions (Rather Than Minimizing Them) ...
  2. Practicing Living Mindfully (Rather Than Mindlessly) ...
  3. Your Body Releases Tension & Trauma. ...
  4. You Reach Out More For Support & Ask For Help (Rather Than Isolating)
May 29, 2023

Is therapy every 2 weeks enough? ›

Biweekly Sessions

Often you're only able to discuss one area or thing that happened to you. Therapy twice a week on the other hand allows you to go much deeper. We recommend this option for people who want to take the skills they've learned in therapy and apply them to their life in a more practical way.

What not to do in trauma therapy? ›

Top 5 mistakes therapists make when treating clients with trauma
  • Trying to convince the client that it wasn't their fault. ...
  • Being too human/not human enough. ...
  • Treating clients fragily/equating feeling badly as bad, and feeling good as good. ...
  • Confusing ruminating with intrusive thoughts.
Feb 15, 2016

What to do when therapy is not enough? ›

What to Do if Therapy Isn't Working
  1. Reassess Your Therapy Goals. ...
  2. Increase the Frequency of Therapy Sessions. ...
  3. Try a Different Type of Therapy. ...
  4. Explore Medication Options if Therapy Isn't Working. ...
  5. Consider Inpatient Mental Health Treatment.

Why is trauma therapy so hard? ›

Ways trauma therapy is difficult:

It makes you feel like you can't trust anyone or anything. These feelings make establishing safety between yourself and a mental health professional challenging. But safety is necessary for you to share openly and understand how what happened to you affects you.

What is the success rate of EMDR? ›

EMDR Therapy for PTSD

Several studies have shown that Eye Movement Desensitization and Reprocessing (EMDR) is incredibly effective for those suffering from PTSD, with some showing as much as a 77% success rate.

Is 10 therapy sessions enough? ›

Therapy has been found to be most productive when incorporated into a client's lifestyle for approximately 12-16 sessions, most typically delivered in once weekly sessions for 45 minutes each. For most folks that turns out to be about 3-4 months of once weekly sessions.

How long does the average person stay in therapy? ›

Therapy can last anywhere from one session to several months or even years. It all depends on what you want and need. Some people come to therapy with a very specific problem they need to solve and might find that one or two sessions is sufficient.

What therapy rewires brain from trauma? ›

EMDR therapy changes the way a traumatic memory is stored in your brain using eye movements or rhythmic tapping. This allows you to process the trauma so that you can remember the event without reliving it. EMDR is considered a medical procedure because of the way it changes the structure of the brain.

How does the brain rewire itself after trauma? ›

Repetition – Neuroplasticity allows your brain to rewire itself in a way that will dedicate more brain cells to a specific task. The best (and perhaps the only sure) way to promote this is through repetition. Your brain is best at the things it does most often, so if you want to be good at something: repeat it.

Where is trauma stored in the brain? ›

When a person experiences a traumatic event, adrenaline rushes through the body and the memory is imprinted into the amygdala, which is part of the limbic system. The amygdala holds the emotional significance of the event, including the intensity and impulse of emotion.

What are the ABCs of trauma management? ›

The ABCs of trauma assessment-airway, breathing/oxygenation and circulation-represent the first steps in determining the extent of injury and patient care priorities; however, other factors must also be considered to provide effective and timely care.

What three approaches assist in trauma recovery? ›

Some strategies to reestablish safety and stability after trauma include:
  • Meditation.
  • Light or sound therapy.
  • Mindfulness.
  • Self-care.
  • Self-soothing.
  • Grounding techniques.
Oct 31, 2022

What are the 6 key principles of a trauma-informed approach? ›

Healthcare organizations, nurses and other medical staff need to know the six principles of trauma-informed care: safety; trustworthiness and transparency; peer support; collaboration and mutuality; empowerment, voice and choice; and cultural issues.

What are the 7 domains of trauma? ›

The FDA considers the following 7 Developmental Domains:
  • N. eurological and Biological Maturity.
  • O. ver-reactive Stress Response.
  • E. motional Regulation.
  • A. ttachment Style and Relationships.

What are the three E's of trauma 1? ›

The Three E's of Trauma

They are the event, the experience, and the effects. The event is the traumatic situation, the experience is the way that someone emotionally responds to the event, and the effects are the long-term and short-term outcomes associated with experiencing a traumatic event.

What are the 4 states of trauma? ›

The responses are usually referred to as the 4Fs – Fight, Flight, Freeze, and Fawn and have evolved as a survival mechanism to help us react quickly to life-threatening situations.

What is a trauma therapy session like? ›

First and foremost, your therapist will focus on creating a safe space both in the counseling session and in your everyday life. Before you leap into sharing painful details of your ordeal, you need to establish a strong sense of safety. A focus on safety helps to rebuild confidence and a sense of control.

How do I know if I need trauma therapy? ›

You may experience nightmares or flashbacks that take you back to the traumatic event. Furthermore, you may struggle with mood swings, as well as disorientation and confusion, which can make it challenging to perform daily tasks. You may also struggle with emotional difficulties, including: Overwhelming fears.

What is the difference between regular therapy and trauma therapy? ›

There are many kinds of therapy, but trauma-focused treatments focus on helping people who have experienced frightening events, psychological harm, and subsequent personality changes or physical symptoms. With the help of a therapist who specializes in trauma, you can take steps to heal and move forward with your life.

How long does trauma therapy usually last? ›

Conditions such as post-traumatic stress disorder typically take around 15-20 sessions for 50% of patients to feel improvement. It's been found that those treated with Cognitive Behavioral Therapy report feeling better after around 10-20 sessions.

What do you talk about in trauma therapy? ›

Talking openly about what caused the trauma can be very difficult for survivors in treatment. It's helpful to learn how to be okay with being uncomfortable, acknowledge your suffering from trauma has been real, and focus on choosing words that represent how you feel about past abuse, neglect, or other traumatic events.

How does unhealed trauma show up? ›

The symptoms of unresolved trauma may include, among many others, addictive behaviors, an inability to deal with conflict, anxiety, confusion, depression or an innate belief that we have no value.

Is trauma therapy the same as EMDR? ›

Processing of a specific memory is generally completed within one to three sessions. EMDR therapy differs from other trauma-focused treatments in that it does not include extended exposure to the distressing memory, detailed descriptions of the trauma, challenging of dysfunctional beliefs or homework assignments.

What is better for trauma CBT or DBT? ›

In trauma treatment, a therapist may use CBT for common psychiatric conditions, especially anxiety and depression. Other illnesses include eating disorder, post-traumatic stress disorder (PTSD), and obsessive-compulsive disorder (OCD). On the other hand, DBT is typically preferred for: Bipolar disorder.

Why is trauma therapy so exhausting? ›

There's also a biological reason why we may find therapy so intense and tiring. Difficult memories can carry emotional burdens that can cause distress, which triggers the release of stress hormones like norepinephrine and cortisol.


1. Cognitive Processing Therapy for PTSD
(Veterans Health Administration)
2. The 3 best ways to treat trauma and PTSD
(Doctor Ali Mattu)
3. Trauma Informed Principles & Practices
(Phoenix Trauma Center & Dr. Scott Giacomucci)
4. Through The Looking Glass with Heather Pierce: On Writing
(Heidi Esther :D)
5. 5 Signs Trauma Focused Therapy Can Help You
6. How Trauma-Focused Therapy Saved A Therapist | Stephanie K. Starks | TEDxKingLincolnBronzevillle
(TEDx Talks)


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