Talk vs Trauma-Focused Therapy

MSMW Editor

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You are looking for a therapist. You can see that they each offer different modalities. Some you may have heard about. Others you may not have heard of at all. With so many different modalities available, where do you even start?

If this sounds like you, you’re not alone. Many people struggle when choosing a therapist for exactly these reasons. To try and demystify the process, this article will discuss some different modalities and how they work.

Talk Therapy
Talk therapy is what most people imagine when they think of a therapy session. Clients sit on a couch and talk about their issues. The clinician listens and provides some insight into their issues.

The most popular and heavily researched form of talk therapy is Cognitive Behavioral Therapy (CBT). This evidence-based modality is used to treat addiction, anxiety, depression, and other severe mental health disorders. The goal is to help clients examine how their thoughts influence their feelings and behaviors and to work on reframing these thought patterns.

Other treatment methods that are based on CBT include dialectical behavioral therapy, a modality used primarily for clients struggling with borderline personality disorder; mindfulness-based cognitive therapy, a modality that helps clients sit with uncomfortable thoughts and feelings without judgment; acceptance and commitment therapy, which challenges clients to change how they respond to their inner thoughts and feelings; and rational emotive behavior therapy, which teaches clients to replace negative thoughts with healthier, more productive ones.

Of course, CBT is not the only evidence-based form of therapy as Internal Family Systems (IFS) and Eye Movement Desensitization and Reprocessing (EMDR) are research-based trauma focused approaches. Other helpful modalities include psychodynamic therapy, which helps clients examine how their early childhood experiences influence their thoughts and behaviors; humanistic therapy, which avoids pathologizing clients, focusing on them as individuals; and solution-focused therapy, which helps clients develop problem-solving strategies.

Trauma-Focused Therapy
Trauma-focused therapy is an emerging modality that helps clients recognize how traumatic experiences from early childhood impact their thoughts, feelings, and behaviors. A ‘trauma’ may be something very small, like the perception that your sibling received favorable treatment, or something quite serious, such as injury or sexual abuse. When clients encounter a situation that is similar to these traumatic incidents, the emotional memories resurface and impact how they respond.

There are many modalities that support in different ways as individuals are complex and can benefit from a variety of different approaches hence a well-known approach targeting the trauma is EMDR. Developed by Francine Shapiro in 1987 to treat clients struggling with post-traumatic stress disorder, clients are encouraged to follow an object with their eyes for several seconds, such as the clinician’s finger, a moving light, or an image of a bouncing ball on a screen or tapping which activates bilateral stimulates in the brain. Clients then convey whatever thoughts came to mind and report their distress level. When clients reduce their distress levels sufficiently, clinicians ask them to identify a new, positive belief about the trauma.

EMDR has spawned a host of similar treatment methods, including brainspotting, where clients focus on a spot where their eyes ‘stick’ when processing trauma; accelerated resolution therapy, where clients replace images of traumatic memories with positive ones; and the comprehensive resource model, where clients use breathing and visual meditations to reduce distress in order to access a new truth.

Another approach is Internal Family Systems (IFS), but very helpful especially when working with clients that have experienced complex trauma throughout their life. IFS targets acute or single incident trauma, PTSD or chronic trauma, complex or relational trauma, extreme or dissociative identity disorder (DID), anxiety, depression, substance abuse, and eating disorder. In your experience with your treatment in IFS the client will go internally in the emotional self and work through the different emotional parts. The goal of IFS is to reach permanent healing of emotional wounds (developed by psychologist Richard Schwartz). As you can see IFS can be helpful with working on emotional wounds that may be stemming from attachment trauma.

What to Look For in a Therapist?
According to research, EMDR is shown to be marginally effective in treating anxiety and trauma, however Cognitive Behavioral Therapy also supports with symptoms such as anxiety and depression from trauma as IFS, Mindfulness and a few others. There are different modalities that target working through trauma besides CBT and EMDR and contain distinct differences. Understanding their core differences and how they can be of benefit to you can lead you to seek the approach that may best suit your needs.

There are many intensive, cutting edge and evidence-based practices that support different aspects of trauma and other mental health disorders. Some focus on the brain, others focus on specific traumas and challenging thoughts, and other approaches on the energy of a person and their wholesome such as IFS.

If you’re uncertain which you would find most helpful, a good idea is to find a therapist who is familiar with both talk and trauma-focused treatment modalities. That way, you can experience each of them for yourself.

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