What is Trauma?
Trauma is the response to a deeply distressing or disturbing event that overwhelms an individual's ability to cope, causes feelings of helplessness, diminishes their sense of self and their ability to feel a full range of emotions and experiences. It does not discriminate and it is pervasive throughout the world ...
Peter Levine
Symptoms of trauma and working with trauma
Understanding Trauma
Psychological trauma is a response to events or experiences that overwhelm an individual’s ability to cope. Trauma can arise from a single incident—such as an accident, medical procedure, natural disaster or an act of violence—or it may stem from chronic and repeated experiences, such as domestic abuse, emotional or physical neglect, sexual violence or growing up in a persistently unsafe environment.
We can also be impacted by vicarious trauma, which occurs when we witness distressing events happening to others, especially those close to us. Each person’s response to trauma is unique and shaped by a range of factors, including early life experiences, personal resilience, social support and the nature and duration of the traumatic exposure.
Trauma may manifest through a wide range of physical, psychological and emotional symptoms. These can include:
- Physical: chronic pain, fatigue, digestive issues, a racing heart and muscle tension
- Psychological and emotional: intrusive thoughts or images, flashbacks, anxiety, depression, sleep disturbances (including insomnia), emotional numbness, confusion, hopelessness, dissociation and symptoms associated with diagnoses such as DID, BPD and EUPD
My Approach to Working with Trauma
My work with trauma is grounded in an integrative model that combines several recognised and evidence-based approaches, including:
- Somatic Experiencing (SE)
- Sensorimotor Psychotherapy
- Internal Family Systems (IFS)
Stage 1: Stabilisation and Building Safety
We begin by establishing a sense of safety—both within the therapeutic relationship and within your nervous system. This stage focuses on understanding how trauma affects the body and mind through psychoeducation and building tools for regulation, such as grounding techniques, nervous system awareness and identifying triggers and early warning signs of overwhelm.
The aim of this stage is not to rush into trauma content, but to build the resources and capacity needed to tolerate emotional and somatic experience without becoming overwhelmed or re-traumatised.
Stage 2: Trauma Processing
Once a stable foundation has been established and you're able to remain within or gently expand your window of tolerance, we can begin to process the trauma itself. This may involve working with body memory, revisiting traumatic material, or engaging in parts work through IFS.
Processing is done at a pace that respects your system’s capacity and is always led by your readiness. The goal is to make meaning of the traumatic experiences, release stuck patterns and reintegrate fragmented parts of the self in a safe and contained way.
Stage 3: Integration and Rebuilding
In the final stage, we focus on integration—bringing together the insights, shifts and inner connections developed through the work. This stage is about reclaiming agency, exploring new possibilities, and moving from survival into intentional living.
Here, we reflect on how you relate to yourself, others and the world around you. Patterns that once defined your sense of self begin to loosen, making space for new choices, relationships and ways of being.
FAQ
What is the Polyvagal Theory in therapy?
To very briefly summarise- the Polyvagal Theory is a tool for working with trauma and social connection based on how our nervous system reacts and responds to external stimuli varying from safety to danger. More information: https://www.rhythmofregulation.com
What is the window of tolerance?
The window of tolerance is a concept originally developed by Dr. Dan Siegal to describe the optimal zone of arousal for a person to function effectively in every day life. When a person is operating within their window of tolerance they can effectively manage and cope with their emotions.
However, for clients who have experienced trauma, it is often difficult for them to regulate and manage their emotions and their window of tolerance becomes narrowed- we might experience our world as, "getting smaller". In therapy, we work on widening your window of tolerance (through resourcing and both learning and integrating ways to self and co- regulate) we work on increasing your resilience, capacity and ability to stay present.
However, for clients who have experienced trauma, it is often difficult for them to regulate and manage their emotions and their window of tolerance becomes narrowed- we might experience our world as, "getting smaller". In therapy, we work on widening your window of tolerance (through resourcing and both learning and integrating ways to self and co- regulate) we work on increasing your resilience, capacity and ability to stay present.
what is resourcing?
Resourcing in trauma therapy is the process of working to identify and implement safe ways of regulating the nervous system and both creating and restoring a sense of safety. We will each have our own unique ways of resourcing, often things we may not even think about such as burning candles or walking in nature etc- essentially the things we do (perhaps unconsciously) which help us to feel "better". Resourcing is an essential element of trauma therapy as it enables us to stabilise our nervous system and thus move towards processing our trauma in a safe way to avoid re traumatisation.
what does bottom up processing mean?
The limbic brain is where our trauma responses originate. This part of the brain is the earliest part of our brains to develop. It is the limbic part of the brain which instinctively responds to threat through the fight/ flight/freeze "playing dead" responses. These instinctive responses happen before we are cognitively aware of them. When trauma symptoms are activated we may feel overwhelmed by anxiety, anger, fear the urge to flee/ escape (flight) or fight. We may be overwhelmed by body sensations such as nausea, headaches, muscle tension, racing heartbeat, and many other physical symptoms. We are often unaware of what has triggered our past trauma, especially if we are typically disconnected from our bodies.
"Trauma survivors – they’re living so much of their life in the bottom part of their brain… with the amygdala, the smoke alarm of the brain, shooting off [signals of] ‘danger, danger, danger,’ that they can’t access that top part to be able to start there.” (Robyn Brickel, MA, LMFT)
Trauma responses are automatic and unconscious, the prefrontal cortex (thinking/rational )part our brain is not involved
A bottom-up approach to trauma therapy aims to undo trauma’s imprint on the body by directly accessing the limbic system and sensory receptors located throughout the body and in doing so regulate and adjust the visceral responses associated with complex trauma
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"Trauma survivors – they’re living so much of their life in the bottom part of their brain… with the amygdala, the smoke alarm of the brain, shooting off [signals of] ‘danger, danger, danger,’ that they can’t access that top part to be able to start there.” (Robyn Brickel, MA, LMFT)
Trauma responses are automatic and unconscious, the prefrontal cortex (thinking/rational )part our brain is not involved
A bottom-up approach to trauma therapy aims to undo trauma’s imprint on the body by directly accessing the limbic system and sensory receptors located throughout the body and in doing so regulate and adjust the visceral responses associated with complex trauma
.
Mindfulness in therapy
The use of mindfulness exercises in trauma therapy allows us to be more aware of the present moment and in doing so "orient" to safety in the here and now (i.e. the absence of threat). This strengthens our ability to self regulate by taking us out of the thinking mind and into the safety of the here and now. There are different types of mindfulness based exercises such as grounding and using the five senses to bring us into the present moment.
what is dysregulation
Dysregulation is the term used to describe the experience of being unable to regulate or tolerate overwhelming emotional and physical responses.