What is the best approach for trauma treatment?

The simple answer is there is no particular approach that works best for trauma. This is because we are all unique and some ways of working resonate more than others.  We all have our opinions of what might work best.  Your doctor, friends, family and what you read on the internet. Including on this website.  It is important to take in that information in terms of what makes sense to you, what interests you in trying. All approaches have something to offer.

The most important criteria to start with is who you like and feel drawn to as a therapist.  Regardless of approach your relationship and connection with a therapist is the most important indicator of a successful outcome.

Having said this there are some things about the effects of trauma that are important when considering approaches.

Working with the Body.

The counselling field has become much clearer about the effect of trauma on the body and in particular the nervous system.  We have learnt that traumatic energy is held in the nervous system and when it is unreleased traumatic responses of fear, helplessness, tension, shame and anger will become prominent. The mind develops beliefs and thoughts associated with the emotional and physical responses to the trauma.

So a therapist who incorporates a focus on the body into their approach has an understanding of how the nervous system is affected by trauma and will have ways of bringing your attention to your sensations (mindfulness and somatic inquiry) and regulating the nervous system (calming down the crisis states to a tolerable level), building tolerance of emotional material related to the trauma and ways of releasing emotions and tension in the body.

This can be scary for many people because when we experience trauma we will cut off from our bodily experiences to cope with the trauma. Therapists need to take this at your pace and having other approaches/interventions that focus on the cognitive aspects of your experience (meaning, analyzing, making sense of things) can be helpful to build tolerance particularly at first to create more safety. At some point though without becoming more connected to your physical self your trauma can not be resolved.

Attachment/relational issues.

Most of our trauma occurs at the hands of others and often as we are growing up in our families with people we trust.  This makes relationships difficult and our ability to trust and form connections.  There are many approaches that understand early attachment disruptions and work within the therapeutic relationship to build a secure attachment. 

Some final thoughts.

As hard as it is try not to be overwhelmed by the many different approaches as many overlap with each other and are often doing very similar things in the therapy process.  By keeping these few criteria in mind and again, most importantly, finding someone you can connect with and feel that you can open up to will serve you. Don't be afraid to try out a few therapists to compare and find the right one for you.