Healing from Trauma: Options Supported by Research
*Disclaimer: Please note that I am a counsellor, not a healthcare professional. I am not able to provide advice or recommendations for any medications or drugs. This post is to present options that are evidence based or emerging options through research. Please speak with your doctor or another healthcare practitioner if you are wanting to explore pharmacological treatment options.
Everyone’s journey with trauma, and we cope or heal with its impacts, is going to look different. Something I remind my clients of over and over again is that our response to trauma is extremely protective. Our minds and our bodies are doing everything they know to keep us safe. Sometimes that shows up as hypervigilience, panic attacks, dissociation, or numbing out with drugs or alcohol (to name a few of many potential responses). You are reacting in a normal way to abnormal events. While however traumas impacts are showing up for us is understandable and protective, it might have also become maladaptive and may no longer be serving us.
While around 70% of the population has experienced least one type of a traumatic event [1] research tells us that for every three people who experience a traumatic event, one will go on to develop Post-Traumatic Stress Disorder (PTSD) [2]. Typically symptoms show up within a few days after the event, but sometimes the onset of PTSD can be months or even years after the event (known as delayed expression, when the onset of PTSD is at least 6 months after the event) [3]. While many cases of PTSD resolve within several weeks and 50% resolve within a year (some even without treatment), for 10-20% of people, symptoms continue to persists and cause distress long-term [4].
Options for Healing
It’s important to note that this is a non-exhaustive list of options for healing from trauma. You may find other options that are supportive in your journey that aren’t listed here. Many therapists like myself incorporate several treatments as we support clients through their healing journey. When I work with clients who have experienced trauma, I prefer to use a combination of Internal Family Systems (IFS), Trauma Informed Stabilization Treatment (TIST) which focuses on incorporating stabilization, grounding, and mindfulness, and eventually moving to process and integrate the trauma in order for clients to move forward.
My intention is to simply list treatments that have been shown through research to reduce symptoms of trauma, so that clients might know what to expect and might be able to find a practitioner who operates within the modality that they feel best suits their needs.
Talk Therapy
Internal Family Systems (IFS)
IFS is a talk therapy modalities that views us all as having many different “parts” [5]. An easy way to think about this is to consider a time that you’ve felt conflicted about something - maybe part of you wanted to do one thing, and a part of you wanted to do another. It’s natural and normal to have these different parts, and these parts have good intentions to guide us down the right path or to protect us. When we encounter trauma or experience attachment injuries, these parts can be pushed from their naturally valuable states into roles that might keep us in negative cycles or that are destructive. For change to occur, our parts need to be heard, understood, accepted, and integrated so that they might be removed from their extreme roles and unburdened.
In recent years, IFS has gained popularity and more researchers have studied it as a treatment for trauma and PTSD. IFS is experiential, individualized, and less standardized, making it harder to test in randomized centralized trials. While more and larger studies are needed in the area, thus far IFS has been shown to be effective in reducing trauma symptoms [6, 7, 8].
Cognitive Behavioural Therapy (CBT)
CBT focuses on the interactions between one’s thoughts, feelings, and behaviours, and is based on the assumption that challenging or changing in one area can lead to changes in others [9]. In session a therapist might help clients identify blocks and re-evaluate distorted beliefs about safety, control, or guilt.
Because of how structured and manualized CBT is, it is much easier to research in randomized controlled trial formats, and thus a large base of research exists. CBT has been shown to be an effective treatment for PTSD [10, 11, 12]
Eye Movement Desensitization Reprocessing (EMDR)
In EDMR, the therapist guides their client through questions and thoughts about the traumatic event while simultaneously having the client follow a movement with their eyes back and forth, typically using a light bar [9]. These eye movements similar to those in the REM sleep cycle.
EMDR has been found to be an effective treatment for trauma and PTSD [13 , 14]. Some studies have found EDMR to be slightly more effective than CBT in decreasing overall PTSD scores, and decrying intrusion and arousal symptoms, but more research is needed based on the limited number and quality of these initial studies [15].
Exposure Therapy
Exposure was designed to help people gradually reduce fear and distress connected to traumatic memories, situations, or reminders. In session, the client and therapist move through a planned progression of being exposed to triggers in a safe and controlled way, either imagination, reality, virtual reality, or in some cases a combination of the three [16]. Sessions might also include re-visiting the traumatic memories and describing them aloud in detail while the therapist monitors distress levels.
Exposure therapy has been shown to be an effective treatment for trauma and PTSD [13, 17].
Medication and Drugs
Antidepressants
Selective serotonin reuptake inhibitors (SSRIs), such as sertraline, paroxetine and fluoxetine, as well as serotonin and norepinephrine reuptake inhibitors (SNRIs), such as venlafaxine, are considered first line medical treatments for PTSD [18, 19].
Atypical Antipsychotics
Atypical antipsychotics are sometimes used in conjunction with SSRIs if the individual continues to experience symptoms of PTSD [18]. The medications with the strongest evidence for their effectiveness are olanzapine, risperidone and quetiapine.
Prazosin
Prazosin is a medication used to manage and treat hypertension (high blood pressure), however in individuals with PTSD, it can improve sleep, and reduce nightmares and overall symptoms [18]
Emerging Treatments
Ketamine-Assisted Therapy
Researchers have been looking into ketamine as a potential treatment for PTSD, however reviews have been mixed. Some researchers believe it shows promise as a safe and fast acting treatment [20] whereas others suggest that its impact is not stronger than control conditions [21]. It’s important to note that patient require close in-patient monitoring when receiving intravenous (IV) ketamine [22].
Methylenedioxymethamphetamine (MDMA)-Assisted Therapy
MDMA-assisted therapy is a promising and potentially safe and effective treatment for people with chronic and treatment resistant PTSD [23, 24, 25]. It’s important to note however that the use of unregulated MDMA, or use without a strongly controlled environment, has considerable risks [25].
Mind-Body Approaches
Yoga
Yoga is a mind-body practice that combines gentle movement, breathing, and mindfulness to help reduce stress and improve emotional and physical wellbeing. Trauma-informed yoga adapts these practices in a safe, supportive way to support healing from difficult experiences.
Some studies have found yoga to provide a meaningful reduction in PTSD [26, 27, 28] however critics state that there is low quality evidence for impacts of yoga on PTSD symptoms compared to control groups [29, 30].
Emotion Freedom Technique (EFrT)
EFrT is a mind-body approach that combines gentle tapping on specific points on the body with focused attention on emotions or memories, aiming to reduce stress, anxiety, and trauma-related symptoms.
Several studies have shown EFrT was effective in decreasing PTSD symptoms at levels similar to CBT [31, 32, 33].
Acupuncture
Acupuncture is a traditional Chinese medicine practice where the practitioner inserts very thin needles into specific points on the body to help restore balance, reduce pain, and support overall wellbeing.
Research suggests that acupuncture has little risk of adverse effects and some results are encouraging, but more research is needed to validate acupuncture as a treatment for PTSD [34, 35].
Do You Need Support?
If you live in British Columbia and are looking for a counsellor who specializes in trauma, I invite you to book in for a free 20-minute consultation by clicking here. And if I’m not the right fit? I’m always more than happy to make a referral to my trusted network of clinicians.
References
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[2] Committee on the Assessment of Ongoing Effects in the Treatment of Posttraumatic Stress Disorder & Institute of Medicine. (2012). Treatment for posttraumatic stress disorder in military and veteran populations: Initial assessment. https://www.ncbi.nlm.nih.gov/books/NBK201095/
[3] American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425787
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[5] Schwartz, R. C., & Sweezy, M. (2020). Internal family systems therapy (2nd ed.). The Guilford Press.
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[22] Canada’s Drug Agency (2014). Intravenous ketamine for the treatment of mental health disorders: A Review. https://www.cda-amc.ca/sites/default/files/pdf/htis/dec-2014/RC0572_RR_RiB_Ketamine_MentalHealth_e.pdf
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*I do my best to ensure my posts are accurate and to cite reputable sources, however if you notice something that needs a correction please reach out to me at monica@beginagaintoday.ca.
