CBT for Trauma

Cognitive Behavioural Therapy (CBT) is the most highly recommended psychotherapeutic intervention for people with PTSD (American Psychiatric Association).

CBT works in a top-down way in the brain, meaning it activates the logical part of the mind (the neocortex), in the hope that our automatic responses (in the base of the brain) will be calmed by our rational thinking.

Although CBT has its limitations, it can be a fantastic tool to use when we are within the window of tolerance and our brain is still capable of thinking rationally.

I find naming my emotion when I feel overwhelmed can be a great starting point as it turns on a different part of my brain, a part that needs to identify and label, rather than run for my life.

For example:

I have been in a car accident and every time I approach an intersection my heart rate increases and my body tenses expecting to be hit by another car.

I bring the loving parent online…

  1. Right now, I feel – Scared I am going to be hit
  2. I understand this because – last month I WAS hit by a car in an intersection
  3. However – the chances of this happening again are really slim, I am a great driver
  4. I will – slow my breathing, be aware of my body in the car, be aware of what I can see and hear, and if I need to, I will pull over and take a break.

CBT is intended to help the person reconceptualize their understanding of the trauma, and their coping abilities. If used too early, it can be re-traumatising and worse, it can be de-humanising, especially if it is implied their ‘thinking about the trauma is ‘unhelpful’.

I personally align with the bottom up approach (see my previous post called “the bottom-approach to trauma”), which starts working with the brain stem, which governs automatic functions such as breathing and sleeping. This approach starts with the BODY. It recognises that trauma is stored in the body and the body needs to be engaged in the healing process, along with the mind.⁣⁠
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I use Gendlin’s ‘Focusing’ as the primary method to work bottom-up with trauma. It allows the body to speak to us in a very safe way. We are with the feeling AND also safely in the present. There is a dual awareness of current safety and past lack of safety without feeling unsafe now.⁣⁠
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As we connect with the body, the body becomes a safe place again. We start to inhabit our body in a new way and there is 𝐦𝐨𝐫𝐞 𝐞𝐧𝐞𝐫𝐠𝐲 𝐟𝐨𝐫 𝐥𝐢𝐟𝐞 𝐚𝐠𝐚𝐢𝐧.⁣⁠


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