What is the difference..

What is the difference between “regular” therapy and trauma therapy?

I have complex developmental trauma. For those who’ve experienced healing for these sorts of wounds through trauma therapy, or other therapy, what sort of therapy has helped or is helping?

What I consider most helpful is the relationship. I knew what I should do even before the therapy, but I didn't have the strength to do it "just for myself". I had to share my story with someone, get feedback. I could never get that from thinking on my own or writing a journal. I need a human person to be my companion. In my case I need a very patient T who doesn't push me too much, who respects that my progress is slow.

I don’t know of many who don’t need a patient therapist. I certainly do

If the FOO (family of origin) are withholding, disrespectful, abusive, a patient and caring therapist is especially needed.

If they start pushing us without support ... without respecting us as the unique human being we are,..it’s time to leave

Thanks for your reply

IDK. In many ways I think "trauma therapy" is nothing more than a marketing label. It isn't a modality; it's a multi-faceted response to a pattern of events (for complex trauma). Single incident trauma is a different situation and amenable to a particular protocol.


Trauma as a label seems to reflect a level of intensity, maybe long-term. But the underlying injuries caused by trauma seem to me to not be so different psychologically from other difficulties. I do think the identification of trauma necessitates a long-term approach, and I think the rise in usage of the term came about to distinguish from specifically short-term approaches, esp CBT varieties.

This isn't to take anything away from people like Judith Hermann, but that paradigm is more applicable to single incident response.

My former T was a Counseling Psychologist, rather than a Clinical Psychologist: the former emphasizes seeing difficulties as developmental injuries (rather than as a pathological process), reflecting the different life stages, while the latter views difficulties as symptoms of illness. I think the Counseling perspective, grounded in a solid knowledge of a variety of psychological theories, was most helpful.

Thanks for your reply

What's important is a T who knows if they are cut out to take on trauma victims....many aren't....So many.

I think this is a lot of it. Some therapists just don't know how to work over a long arc of time, and navigate a lot of chaos without blaming the client and making a mess of things.

I was in therapy for many years without it ever touching on trauma. It was just not discussed or acknowledged. I was in therapy for depression and it was a lot less intense, there was none of the tedious work of identifying and mitigating triggers. So yeah, someone without trauma could have a similar therapy experience, but it probably won't take as long and be so fraught with landmines.


I think mine is often ready to off herself to get out, but then she will say something like, well, this is how it goes...(meaning, a lot of half step forward, ten back).

It could also be that they have more training in ways to help someone dislodge from stuck places, and be more comfortable with dissociation.

For as hard as it is to find a good therapist for any kind of need, I would not see one who does not have experience in going through childhood trauma resolution over a long period of time.

I don't know what 'trauma therapy' is exactly, I don't hear or use labels a whole lot. I know I have a lot of trauma, and that it's part of therapy.

I'd say about 95% of the sessions we talk about what happened last week, how I had an issue with a friend, what I was struggling with the most during the week. Then once in a while there's a session where overall I'm feeling good, but I really want to talk about some things from my past. Then we try to talk about that and get however far we get. I can say I'd not want to talk more and we could stop. I can answer the questions I want and not talk about things I don't want. And my T makes sure I don't get too agitated, and if I dissociate he will guide me through what I can do to get me back.

To me, regular therapy isn't "trauma informed"...at least in my country...and not being trauma informed can cause harm.

https://www.psychologytoday.com/us/b...why-it-matters

For example, there's important differences between regular CBT and trauma focused CBT (TF-CBT).

Both ex T and current T are trauma therapists and therapy with them is very different to therapy I had 10 years ago when I was dangerously anorexic. The thing that stands out most for me is that the trauma informed Ts are hyper aware of trauma reactions in therapy. Thy are really tuned in to physiological reactions that get triggered in the therapy room and use appropriate interventions to help ground.
I experience trauma therapy as much safer than therapy that isn't informed by the neurophysiological understanding of trauma. In normal t I was often very severely triggered in therapy and the therapist was either clueless or didn't know what to do about it. I would leave in a highly triggered state (dangerous at times) and truly suffer in between sessions. In trauma therapy when I am triggered the therapists are acutely aware of it had help me to get grounded. I rarely leave in a triggered state. I am emotionally safe.

when i started therapy, trauma Ts were few and far between where i live...especially those who could work with CPTSD, let alone dissociation. so i settled for a psychodymanic T who i felt i clicked well with...after all, everyone kept saying that 'it's the relationship that heals'. when asked, my T said he had worked with CSA, but later it was discovered that i was his first client with DID. kudos to him, even though he did not have any experince with DID, he was willing to continue to work with me.

over the years, as my therapy seemed to stall in progress (along with worsening truama symptoms) i started to look for alternatives to help me address the truama. i finally read Bessel van der Kolk's book, 'The Body Keeps the Score' and it definilty opened my eyes. i finally felt like someone understood what my truama was like and i felt a new sense of hope again. Bessel writes about Nuerofeedback (NFB) for addressing truama in one the chapters in his book, and he also writes about a T, Sebern Fisher, who uses NFB to help clients overcome developmental trauma/CPTSD. she has written a book too, and i quickly got my hands on it, 'NFB for the Treatment of Developmental Trauma, Calming the Fear Driven Brain'. for the first time in all of my years of therapy and reading many therapy books, i was reading something written from a Ts perspective that absolutely understood and explained exactly what i was experiencing...especially the dynamics of the transference and counter transference that was playing out in my therapy and why i was experiencing therapy the way i was, including the things my T was missing in the dynamics. Soon after reading her book, i found a clinical T who offered NFB. as luck would turn out, he was actually trained in NFB by Sebern Fisher.

so, long story short and to answer your question, for me, the therapy that helped to process my truama (including my DID), was doing NFB therapy. i did the NFB at the same time i was doing talk therapy with my T. the NFB helped so much with calming my emotional dysregulation, anxieties, and fears, that after a year of doing the NFB i felt i was able to finally leave therapy all together. to this day, i continue to feel pretty content in my life and rarely experince any truama symptoms.

I think a huge difference in whether trauma therapy specifically helps or is unnecessary is whether the client has PTSD or serious dissociative disorders. Although I experienced dissociation, it did not rise to the level of a disorder, and I never had PTSD. A lot of the options available are based on single incident trauma, and those methods aren't necessarily applicable to complex trauma where dynamics can play a more central role. I appreciated the developmental approach because it was non-pathologizing, and although it was acknowledged that I was victimized, there was no emphasis on identifying me as a victim. I think it's a fine line between recognizing victimization and the assignment of a victim identity. Some of what I read--like the Psych Today article--makes me uncomfortable because I feel like the line is crossed, and it becomes a "once a victim, always a victim" perspective and I never wanted that identity for myself.

I don't have ptsd either nor a dissociative disorder ("just" anxiety) yet definitely experience dynamics like traumatic transference with my therapist which trauma informed therapy helps with...

I'm glad not everyone needs trauma informed stuff though. It sometimes seems like everyone carries some form of trauma.

I don't believe in the victim vs survivor dichotomy. Not fond of the pervasive view in my country that victim is seen as weak, wallowing, disempowered, stuck etc. Got really mad with my therapist when I thought she implied such a dichotomy, which I had experienced with my first therapist (not trauma informed) who pathologised me a lot.

I don't believe someone is forever broken by complex trauma, but I believe that trauma can shape a person in positive and negative ways.

For some of us, there might have never been a "before trauma" time of our life. And some folks talk about post traumatic growth, which gives me hope.

I think maybe my link to the Psych Today article wasn't the best. My intention was to try to explain some of the differences between trauma informed therapy is regular therapy.

In my experience trauma therapy is more specialized than regular therapy. Art therapy has also helped me with trauma and is good if you have trouble talking about the trauma.

Thank you for this. My therapist has encouraged me to do NFB, but there is a paucity of therapists who do that in my area.

I don't like the "victim" vs "survivor" dichotomy either, and we don't generally take the extreme negative view of victims that is common in some areas of the world. But since the first wave of abuse scandals and heightened awareness that came in the 80's, there has been increased blurring of the distinction between being someone who experienced trauma to identification as a trauma victim to "survivor." And what I've seen also is a proliferation of "survivor groups" which encompass both victims who choose "survivor" as a label (rejecting any pejorative connotations of the word "victim") , as well as those who consider themselves "survivors." But I question how healed someone is if they choose to continue to label themselves "survivor." If healing has truly been achieved, why would anyone feel the need to self-identify as a "survivor"? To me, that reflects a shift in identity that ultimately, I don't think is healthy--but I think our culture has encouraged this since the 80's.

I think much of this attitude has been borrowed from the addictions model, and peer counseling as a life-long protocol. The idea of recovery being dependent upon self-identification as having an addiction for life. (And this may be necessary for addiction because of the physical/possibly genetic basis for addiction.)



I think what bothers me about the PT article is that it reflects very much how the issue is often written about here recently: that victims are identified in an ultimately isolating way; the focus seems to be on identification and devising a special protocol, but in a weird way, individual identity is largely ignored--as though people are just walking constellations of symptomatic dysfunctional responses and fictitious illnesses.

The fact that this alarm has needed to be sounded I think speaks to a shift in T training from everyone having a solid grounding in psychodynamic principles, to highly specialized--and largely behavioral--modality training. Probably some of the shift is the influence of insurance provider pressures here and which modalities are reimbursed-- favoring short-term behavioral models. One of the reasons I like older Ts is because they were trained before this shift took hold. My former T exhibited an understanding of the principles underlying trauma, but would not have specifically referred to himself as a "trauma T." He didn't employ the more specific behavioral techniques which address PTSD and dissociative disorders because it wasn't applicable to me.

nicely said

pretty rare where i live too! the clinician i worked with was a 90 min drive away (at that time, he was one of the few clinicians doing NFB and actually provided training to others Ts in my country). because of the distance, he helped to get me set up with the equipment so i could do the NFB at home with the help of my husband.