Psychological trauma therapy: what it is and how it works

Trauma is a very shocking and difficult experience that we go through that ends up leaving a big mark on our psyche.

In addition, they also encompass the consequences of this experience. Psychological trauma therapy relies on two techniques: exposure and cognitive restructuring.

In this article, we will learn about the typical symptoms after experiencing a traumatic event, as well as how psychological therapy focused on treating these traumas works. We will analyze the two techniques that compose it, their variants and how they can be applied in therapy to help the patient.

    Trauma-related disorders

    Before we get into psychological trauma therapy, we need to understand what trauma is and what its implications are.. Trauma is the result of a very shocking event that we are going through, and which causes us such stress that it ends up affecting our psychological functioning, interfering with our daily life and decreasing our psychological well-being. The term “trauma”, however, is also used to refer to the traumatic event in question.

    The consequences of trauma can vary greatly from person to person; however, when we use this term we are generally referring to the onset of PTSD (post-traumatic stress disorder) or ASD (acute stress disorder). While PTSD lasts at least 1 month, ASD lasts at most 1 month; that is, TSA becomes PTSD when this period of time elapses.


    Symptoms of a traumatic disorder typically include physical, psychological, and behavioral manifestations.. On the physical level, the person can manifest remarkable psychophysiological symptoms and more often relive the traumatic experience, causing him the same physical symptoms that he was experiencing at the time of the event.

    Psychologically, you may feel anxious, worried, nervous, irritable, or fearful. Finally, on the behavioral level, he can have behaviors to avoid any detail related to the traumatic event; this translates into avoiding talking about it, avoiding going through places close to the event, etc.

    Psychological trauma therapy

    As we have seen, undergoing trauma involves considerable suffering for the person as it stagnates them in many aspects of their life, preventing them from progressing and developing a normal life. While it is true that there are different degrees of involvement depending on the event and the person, as well as different types of trauma, PTSD can be referred to as the main (and most common) disorder caused by trauma, such as We have seen it.

    Due to the different symptoms caused by PTSD, psychological trauma therapy will focus on the patient’s ability to cope, process and integrate what he has been through, Without repressing anything and working on the aspects that impacted or upset him the most.

    It is important for the patient to feel comfortable, free and calm so that they can fearlessly express their feelings and to what extent this event interferes with their normal functioning.

    Psychological trauma therapy relies on two main techniques: exposure and cognitive restructuring.

    1. Exhibition

    Exposure to trauma is a key component of psychological trauma therapy; it can be behavioral or narrative. A more modern type of exposure therapy has also been used, with promising results: EMDR (Eye Movement Desensitization and Reprocessing). Let’s see what these three types of exposure consist of.

    1.1. behavioral exposure

    Behavioral exposure involves the person being directly exposed to stimuli, events or thoughts related to the trauma.

    1.2. Narrative exhibition

    The narrative exhibition, on the other hand, focuses on the patient recounting and describing (or writing) in as much detail as possible the traumatic experience; that is, to explain in their own words what they experienced on the day (or days) of the event, how they felt, what objects or people were there, etc.

    1.3. EMDR (desensitization and reprocessing of eye movements)

    EMDR, in Spanish “Desensitization and Reprocessing by Eye Movements”, is a type of therapy created by Jewish psychologist Francine Shapiro. This therapy, like the previous exposure variants, is used as psychological therapy for trauma. It is used to decrease the negative symptoms associated with trauma.

    It consists of stimulating the patient bilaterally, by different methods, which can be: eye movements (mainly), sounds or tapping. According to Shapiro and supporters of the technique, this stimulation stimulates a cerebral hemisphere.

    If we analyze EMDR step by step, and in a very concise way (without going into details), the first thing the therapist will do is ask the patient to remember the traumatic event, with all the details. possible (sensations, images, thoughts …). The treatment phase will then begin, where the therapist will ask you to re-evoke the event while stimulating it.

    This will be done using sequences containing guidelines in between. The therapist will then ask the patient for his thoughts. In addition, positive images will be included for the patient to imagine and which will be associated with the traumatic memories. In reality, EMDR is made up of several phases (eight in particular) that the therapist must know in depth to correctly apply this type of technique.

    Exhibition characteristics

    On the other hand, it is important to note that the exposure should be prolonged and applied gradually. This exposure will be to the traumatic memories of the patient, in relation to the trauma he has experienced.

    But what is the exhibition for? It is a fundamental element for the patient to gradually process what he has experienced. It is important that the repressed aspects of the unconscious are brought to light, so that they can be addressed; the goal is for the traumatic experience to be integrated into the patient’s life experience, as part of it.

    We have to know that exposure is a very painful process for the patient because it somehow relives very hard and painful sensations and experiences; moreover, it is frequent that resistances appear in the history of the same. This is why the therapist must work with empathy and understanding, validate the patient’s emotions at all times and offer him support.

    It will also be important for the therapist to give the patient tools so that they can deal with the negative thoughts they have, as well as nightmares, intrusive memories, etc.

    2. Cognitive restructuring

    Cognitive restructuring as part of psychological trauma therapy aims to modify dysfunctional thought patterns. which manifests the patient, to later provide tools that allow him to develop alternative and adaptive thoughts.

    This component of therapy is essential because PTSD is often associated with negative alterations in the patient’s cognition and mood.

    In order for the trauma patient to assimilate this experience, it is important that they have space to express themselves without pressure or conditioning; cognitive restructuring is an essential tool for working on the negative thoughts and guilt that patients who have had a particularly painful and shocking experience often have.

    This way, it is important for the patient to be able to change the way they perceive and remember what they have been through, in case this is in an inappropriate way. On the other hand, behavior changes, resulting from cognitive-behavioral psychotherapy, are obtained by changing one’s own thoughts (and vice versa).

    This is why for the patient to cope with the experience, it will be necessary to work on his avoidance behaviors already mentioned, because the fact of avoiding and repressing, can end up generating important psychological problems in the future, which end up exploding to form anytime or in the face of a trauma-related trigger.

    Bibliographical references:

    • American Psychiatric Association -APA- (2014). DSM-5. Diagnostic and Statistical Manual of Mental Disorders. Madrid: Panamericana.

    • Horse (2002). Manual for the cognitive-behavioral treatment of psychological disorders. Flight. 1 and 2. Madrid. 21st century.

    • Laco, I. and Larraz, G. (2012). EMDR: Review of the technique and application to a clinical case. Notebooks of Psychosomatic Medicine, 104: 45-56.

    • Pérez, M., Fernández, JR, Fernández, C. and Amic, I. (2010). Guide to effective psychological treatments I and II :. Madrid: Pyramid.

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