Trauma occurs after overwhelming experiences that could not be processed. A distinction is made between…
1. post-traumatic stress disorder (PTSD)
2. complex post-traumatic stress disorders (k-PTBS)
3 According to Scaer (2014), “minor trauma” occurs after less serious life events. These “sub-clinical” traumas produce distressing symptoms, but do not allow a PTSD diagnosis. Scaer describes a trauma spectrum that ranges from minor to severe traumatization. Repeated life events can also add up in their effects.
Frequent triggers are accidents, violence or abuse. Typical symptoms are flashbacks, avoidance, sleep problems and constant inner tension. The nervous system remains on alert even though the danger has passed.
Complex PTSD is usually caused by prolonged or early traumatization, e.g. in childhood. In addition to the typical PTSD symptoms, there are emotional outbursts (such as anger, fear, etc.), chronic shame, inner emptiness and relationship problems. Those affected often suffer from a negative self-image. This can be worked on in therapy. People with less pronounced but stressful symptoms also benefit from therapeutic support.
Flashbacks, nightmares, insomnia, anxiety, irritability and emotional numbness. Many avoid anything that reminds them of the trauma. Without treatment, PTSD can become chronic. Early help significantly improves the prognosis. Subclinical symptoms such as tension, chronic fatigue or excessive demands can also be caused by trauma.
1. stabilization: The affected person learns to regulate themselves better and literally feel the ground under their feet again. This is achieved through breathing techniques, mindfulness, visualization or mindful bodywork, among other things. Only then can the actual trauma be carefully dealt with. Depending on the degree of traumatization, this phase can take longer or shorter.
2. trauma processing: Many traumatized clients have no access to stressful feelings and memories. In the integration phase, these are carefully processed – similar to a digestive process. In addition to memories, physical and emotional reactions are particularly important. The therapy helps to gradually integrate the fragmented experience. The aim is to relieve the nervous system, release frozen reactions and create new connections in the brain.
Resources help: positive inner images, supportive relationships and a new sense of identity. Healing does not mean undoing what has happened – but reconnecting with yourself, your body and other people.
This gradually creates a new inner balance. The trauma loses its power and new life energy is released. Those affected experience more vitality, sociability and trust again – in themselves and in life.
3. re-integration: In the final phase of trauma therapy, the aim is to make the work done applicable to everyday life. New inner attitudes, body perceptions and self-regulation skills are consciously anchored in life – at work, with friends and in the family. The transfer supports sustainable change and makes it possible to remain connected and capable of acting even in situations that are initially still challenging.
An empathic therapist, a safe therapy room, mindful working and an experience-oriented approach are very helpful. The methods used in practice, such as the Neuro Affective Relational Model (NARM), Somatic Experiencing (SE) and EMDR, help to regulate the nervous system, recognize old patterns and release traumatic imprints. An individual, step-by-step process is important. There are also other approaches, such as cognitive behavioral therapy (CBT).
Body-oriented approaches directly involve the nervous system. Trauma reactions are often stored in the body (e.g. overexcitation, numbness). Through sensing, movement impulses and mindfulness, the body can gain new experiences of safety. This addresses deep levels of self-regulation. This work is also suitable for people who feel “somehow cut off”, empty or chronically stressed.
NARM (according to Laurence Heller) addresses attachment trauma that occurred in childhood. It helps to recognize old protective strategies and to develop a new relationship and self-perception. Instead of analyzing one’s own history, the focus is on the here and now. The goal is healthy self-regulation. NARM also offers new ways of connecting with people who feel “functional but empty inside”.
SE according to Peter Levine releases frozen reactions such as numbness or flight impulses. Mindful awareness and slow oscillation between stress and resources strengthens the nervous system. It is particularly gentle and does not overstrain. SE can also support self-regulation in the case of subtle stress reactions or diffuse complaints.
EMDR works with bilateral stimulation (e.g. eye movements) to process stressful memories (shock and developmental trauma). The trauma is emotionally decoupled and better integrated. EMDR can also have a supportive effect in the case of less clearly remembered stresses in childhood.
Trauma is not only in the head, but also in the memory and in the nervous system. A dialogue between therapist and client can stabilize, but does not resolve the deeper reaction patterns. Experiencing sensations in the body is central to healing. Even those who suffer from “normal” stress reactions usually benefit from body-oriented work.
Flashbacks are intense and very vivid memories in which the trauma feels “real”. Those affected suddenly experience images, sounds or feelings as they did in the stressful situation at the time. Grounding techniques and mindfulness help to bring you back to the here and now.
Dissociation is a protective reaction: you “leave” the moment to avoid feeling pain. Many experience emptiness, fog or the feeling of being “not quite there”. In therapy, people learn to take countermeasures at an early stage and stay in their body. Dissociation can also play a role in mild forms such as frequent daydreaming or inner absence.
The nervous system remains on alert. Nightmares, waking phases or problems falling asleep are common. Stabilization, evening rituals and trauma-oriented methods help to improve sleep. Persistent difficulty falling asleep without clinical trauma may also be due to unconscious stress.
Emptiness is often the result of emotional shutdown. This is how the psyche protects itself from being overwhelmed. Therapy is about reconnecting with feelings – slowly, safely, at your own pace. Even those who feel “not quite alive” can benefit from body-centered work.
Many of those affected find it difficult to trust, overreact or withdraw. Old protective patterns often interfere with bonding and closeness. Therapy helps to gain new relationship experiences and develop healthier patterns of behavior and communication. Relationship difficulties can always be caused by the trauma spectrum.
There is no “best method”. Studies have repeatedly shown that the therapist’s presence, empathy and attitude are more important than tools and instruments. Approaches that are individually adapted are effective. In my practice, NARM, SE and EMDR complement each other very well: they combine bodywork, relationship work and memory processing. It is crucial that therapy offers safety and is experience-oriented.
Many excellent books have been written on the subject in recent decades. I often recommend
1 to clients. “Post Traumatic Stress Disorder – From Survival to New Life: A Practical Guide to Overcoming Childhood Trauma” by Pete Walker (6th edition 2023)
2. “The Trauma Inside You: How the Body Holds the Horror and How We Can Heal” by Bessel van der Kolk (2023 paperback; previously in 9th edition hardcover)
3. “Language Without Words: How Our Bodies Process Trauma and Return Us to Inner Balance” by Peter Levine
4. “The Trauma Spectrum – Hidden Wounds and the Power of Resilience” (2014) by Robert Scaer
5. “Post-traumatic stress disorder” S3 guideline of the German-speaking Society for Psychotraumatology (DeGPT). This scientific guideline was developed by leading experts and reflects the state of scientific knowledge in Germany in 2019.