Trauma Therapy London Guide
What is trauma?
A trauma is a psychological wound caused suddenly by a shock, or gradually over months or years by psychological abuse. When we encounter something which is too overwhelming to process, it can bypass the conscious mind and become stored in the body.
It takes the form of tension, a holding of the shock or pain, and can be kept in the body for many years. Left untreated, trauma can cause psychosomatic symptoms and long term physical and problems.
I’m a qualified and licensed psychotherapist, with a practice in Central London. In this guide I’ll explain how I approach the treatment of trauma. I’ve also included an A to Z of trauma therapies available in London.
The two types of trauma
Trauma can be caused by a sudden one-off event, a series of sustained events over time or both.
This is a trauma caused by a single incident, such as an accident or assault, an illnesses, or a life threatening event. It can leave you feeling distressed and shocked. You might feel disorientated, and unable to relate to the world and other people who seem to be carrying on as normal. There can also be unexpected unfamiliar feelings as well as physical symptoms.
Acute traumas often work themselves out over the first few weeks of an event. But sometimes other symptoms begin to appear, such as flashbacks, nightmares or unexplained physical sensations.
Chronic trauma is caused by recurring or long term traumatic events which you were unable to escape from. This could be being around war, bullying, childhood abuse, domestic abuse or sexual abuse. Often called complex trauma, it can interfere with your ability to trust people and form relationships. Your emotions might feel out of control, or there may be an underlying sense of worthlessness, shame and hopelessness.
Post traumatic stress disorder (PTSD)
Most people recover from a traumatic incident in a few weeks. But if you still have symptoms after a month, you might be suffering from PTSD.
Or maybe you seemed to recover from the trauma, but really developed a coping mechanism, which is only effective for the short term. The symptoms of Post Traumatic Stress Disorder can manifest differently for everyone, depend on your personality type, and your style of expressing emotion.
The effects of PTSD include:
- Hyper-vigilance – always on the lookout for danger
- Hyper-sensitivity – to loud noises and unexpected movements
- Anxiety or panic attacks
- Shame or guilt – feeling you were responsible for the traumatic event
- Depression, anger, or emotional numbness – not able to feel anything
- Social anxiety or withdrawal from company of others
- Avoiding places, situations or people that remind you of the traumatic event
- Lack of confidence and low self esteem
- Relying on drink or drugs as a coping mechanism
Complex post traumatic stress disorder (C-PTSD)
You may have heard of Complex PTSD, with symptoms similar to PTSD, but with the more difficulty managing emotions and forming satisfying close relationships.
You’re more likely to be suffering from Complex PTSD if you have a background of prolonged trauma, such as childhood abuse, bullying, domestic abuse or being around war. These are all situations where it was difficult to escape the trauma, and some form of trauma counselling would probably be helpful.
The effects of CPTSD include:
- All of the PTSD symptoms above
- Feeling worthlessness shameful and guilty
- Not being able to manage your emotions
- Difficulty making connections with other people
- Difficulty keeping friends
- Difficulty forming a relationship with a partner
The benefits of trauma therapy
The aim of trauma therapy is to start making the connection between the symptoms you’re experiencing, and their relation to past traumas. You’ll gently face the trauma, or the bodily sensations associated with the trauma, in order to process the emotions and fears in a safe environment.
If you’re having flashbacks or dissociative episodes, you can learn tools to bring you back into your body and feel grounded.
A reduction in symptoms can have a huge positive effect for anyone living with PTSD or C-PTSD. You’ll be able to reduce the need for avoiding people and places, or situations which remind you of the trauma.
Building safety and trust
If you’ve had complex trauma, you might have been abused by someone close to you who should’ve been taking care of you. Part of the trauma therapy, is learning how to build trust in a safe supportive environment. As you build a good relationship within therapy, it becomes a blueprint for relationships in your life.
Gaining confidence and creativity
Undergoing trauma counselling or therapy can bring you into your own sense of personal power and confidence. You might discover for the first time, what it’s like to have a sense of playfulness, spontaneity and creativity. The short term coping mechanisms you may have developed, such as drug or alcohol dependence, or avoidance, can finally be dropped.
Fight or flight and the brain
When you’re exposed to a type of threat, a signal is immediately sent to the amygdala, where it triggers an automatic fight or flight response. It’s a useful response for extreme danger, such as jumping out of the way of a bus on a busy London street. The signal will be sent before you’re even consciously aware of the bus, so your body will automatically flee.
A signal is sent to release a cocktail of hormones, including adrenaline and cortisol to enable quick action and disable anything non-essential, such as digestion. The brain’s prefrontal cortex then assesses whether it’s appropriate to stay on high alert, or whether to calm down. If the threat has passed, adrenaline and cortisol levels should drop, returning your heart rate and blood pressure to normal levels.
But if there’s a constant stress, or threat, the amygdala becomes hyperactive while the prefrontal cortex becomes hypoactive (underactive). The fight or flight reaction stays activated, as cortisol and other stress hormones continue to release. This causes many of the long term chronic problems associated with PTSD.
Trauma can be passed down for generations through a family, with the same trauma and abuse happening again and again. It continues until a member of the family steps up, and takes on the work of processing it.
Historical trauma, from war situations, displacement and slavery can also be passed down through generations.
Trauma Stored in the body
Therapies with an element of body work, also known as somatic therapies, are effective in treating trauma, as the body is where much deep-seated trauma is stored. They normally involve bringing awareness to the body, and repairing the split between body and mind.
My work as a body therapist
I first encountered the power of the mind body connection when I worked as an Alexander Technique teacher in the 2000s. Most of my clients were referred to me by their GP or chiropractor because they were in some sort of physical pain which wasn’t subsiding through conventional treatment. My job was to help them move with more awareness, freedom and efficiency by showing them were they were holding onto tension.
Often, my clients would sometimes get more than they were expecting. As well as alleviating the physical pain, there was a sense of psychological lightness and ease.
Sometimes in a session, the release of a physical tension would also release an emotional charge from the past. It would be accompanied by tears and painful feelings which had been unknowingly repressed.
I had one client who was chronically depressed, and reported that the Alexander Technique sessions completely cured her. While I wasn’t qualified at the time to make that assessment, I could see how she was holding tension in the chest area, which she gradually learned to release. Her posture become far more open and fluid, as her personality flowered.
The mind body connection continues to play a strong role in my current work as an integrative psychotherapist. While I don’t do any ‘hand’s on’ work, I always encourage clients to connect to their bodies in a way that works for them them.
Integrative Psychotherapy for trauma
Psychotherapy is an effective evidence based therapy for chronic trauma, and the symptoms of PTSD and C-PTSD.
Complex trauma can also tie into other areas of your life, such as your upbringing, and the belief system you’ve inherited from your parents or caregivers. Working with an integrative psychotherapist gives you option to explore any related areas as they come up in as much depth as you need to.
An integrative approach allows the therapist to tailor the sessions to your particular needs, working at your pace. There’s also the flexibility to change or modify approaches when necessary.
My work as a psychotherapist
Central to my work as an integrative psychotherapist is gently bringing you back into the present moment. This includes developing a heightened awareness of the body, so you can recognise where the trauma resides.
This can start with a simple awareness of the movement of the breath. I won’t be showing you any special breathing techniques. Just learning how to observe without changing is one of the most powerful things you can do.
Through focusing on the body, places that were frozen and numb begin thawing out. Sensations start coming back, often with emotions that have been frozen with time. You’ll be in a quiet place, away from the noise and bustle of London, where its safe to express any emotions that come up.
I’ll provide a safe confidential space where you can talk freely about what’s troubling you without the fear of judgement or blame.
Because of the work I’ve done on myself, I have a calming presence, which will help you to develop a calm and regulated nervous system too. I’ll be meeting you on many levels, and will be open to using other psychotherapeutic modalities wherever needed.
If you feel you could benefit from trauma therapy, don’t hesitate to book an initial consultation. You don’t have to prepare for this, just come as you are and we can look into how I might be able to help.
“When someone really hears you without passing judgment on you, without trying to take responsibility for you, without trying to mould you, it feels damn good…”Carl Rogers
A toZ of trauma therapy in London
I’ve made a guide of some of the therapies that can be effective for healing trauma. While I use some of these approaches as part of my work, many are untested by me. I invite you to do your own research if a particular trauma therapy resonates with you.
- Accelerated resolution therapy
- Art therapy
- Body therapy
- Complex PTSD therapy
- Cognitive analytic therapy (CAT)
- Trauma Focused Cognitive Behavioural Therapy (TF-CBT)
- Cognitive Processing Therapy (CPT)
- Creative therapy
- Exposure therapy
- Eye Movement Desensitisation and Reprocessing (EMDR)
- Imagery Rescripting
- Inner child work
- Internal Family Systems Therapy
- Narrative therapy
- PTSD therapy
- Schema Therapy
- Sensorimotor Psychotherapy
- Somatic Experiencing
- Trauma Focused Cognitive Behavioural Therapy
- Trauma focused therapy
Accelerated resolution therapy for trauma
Accelerated resolution therapy, or ART, is a short term technique for the treatment of acute trauma.
It has many similarities to Eye Movement Desensitization and Reprocessing (EMDR), but has stricter guidelines, and there’s no in depth discussion of the traumatic event before the treatment.
Accelerated resolution therapy also draws on Exposure Therapy, Gestalt Therapy and Cognitive Behavioural Therapy, and aims to treat the trauma in around 5 sessions.
Art therapy for trauma
Art therapy uses all of the creative mediums – drawing and painting, colouring in, collaging and sculpture. There’s also scope to use digital media – photos you’ve taken or videos you’ve made or found.
This is a great way to access the energy of a trauma without directly talking about it. Talking about a trauma can sometimes make it worse, or it might not go into enough depth to make a change. An art therapist can help you access emotions and feelings through creative exploration and play.
You don’t have to be an artist or have any artistic skill to do art therapy. Often whatever you create will have a subconscious element to it which your therapist can help to point out. Effortlessly created art can reveal suppressed emotions and fears, as well as a map of possible solutions.
My approach to Art Therapy
In the trauma therapy I provide, I’ll use art therapy sometimes when needed. I might encourage you to draw something you dreamt about, or to make a mask of the face you present to the world. We’d then look at what you made together, and see how it opens up new depths and avenues in the therapy.
In one session a client told me he was always protecting himself, so I asked him where he felt that protection in the body. He managed to locate the feeling – it was like a cold metal shell. I asked him to draw it and he drew a suit of armour, but there was a crucial section missing. It opened up a whole new direction in the therapeutic process, revealing an underlying issue that we could explore.
Further reading: The Art Therapy Sourcebook, by Cathy Malchiodi
Body therapy for trauma
Sometimes, talking on its own doesn’t go deep enough to access traumas held within the body. This is especially so with what we call pre-verbal trauma, which happened before you had the ability to think in words. If you’re suffering from the effects of trauma or PTSD you may find yourself disconnected or dissociated from your body.
There’s a deep connection between your body and your mind. You can see this when your body responds to emotions – you produce tears when sad, your heart beat increases when you’re excited, and your breathing becomes shallow when you’re anxious.
Body psychotherapy is a very broad term which covers therapists who involve the body in their therapeutic work. It could range from deep massage or dance and movement, with a talking element, to talking therapists who bring an awareness of the body to the therapy.
My approach to Body Therapy
I worked as a body therapist for many years before I trained as a psychotherapist, so I have an understanding of how both worlds interconnect. I’ll show you how to become more aware of you body without using any touch. I’ll encourage you to pay attention to what happens on your body as you experience an emotion while we’re talking. And I’ll show you how to stay grounded and open when you’re not in session.
The Body Keeps the Score, Bessel Van Der Kolk
Waking the Tiger: Healing the Trauma, Peter Levine
Cognitive Analytic Therapy (CAT) for trauma
Cognitive Analytic Therapy was developed at St Thomas’ Hospital in London in the 1980s, to meet the demands of busy inner and central London areas. It brings together ideas from several therapies, into a short term therapy suitable for use in the NHS.
Cognitive Analytical Therapy is more relational than CBT, with an emphasis on the collaboration between therapist and client. In the sessions, you’ll look at how past experiences can shape the way you think and feel, and influence your behaviour.
Cognitive Analytic Therapy is sometimes offered through the NHS, with a typical duration of around 16 weeks.
Cognitive Processing Therapy (CPT) for trauma
Cognitive Processing Therapy is a type of CBT developed by Patricia Resick, for the treatment of acute PTSD.
You’ll be educated on how your thoughts can run on auto pilot, and contribute to your PTSD symptoms. Through writing about your trauma, your therapist will be able to help you recognise any unhelpful thoughts or beliefs.
Run as group sessions or individually, CPT helps you to question your thoughts and feelings around the trauma, and form a new understanding which causes less PTSD symptoms.
Complex Post Traumatic Stress Disorder Therapy
Complex Post Traumatic Stress Disorder, or CPTSD is a psychological condition, commonly resulting from childhood trauma and abuse. Trauma can be inflicted on a child in many ways – physically, emotionally, constant criticism, childhood sexual abuse or neglect.
The trauma from childhood abuse can cause you to unexpectedly react to people or situations in ways that confound you, triggering traumatic memories -overwhelming feelings of fear, rage or shame. These ’emotional flashbacks’ can last from a few minutes to several weeks.
Creative therapy for trauma
There’s many therapies that combine the creative arts – music, dance, movement or drama, with psychotherapy. Your therapist will help you to find expression through improvisation and exploration in one or more of these mediums.
These therapies can be really helpful where words don’t go deep enough, or where talking about a trauma feels like it might be too much. Anything involving movement and expression of the body can be good for trauma, as the body is the place where trauma is stored.
My approach to Creative Therapy
I take a creative approach to therapy, staying flexible to follow and support you in the moment. Although I offer talking therapy, we can still explore what it’s like for you to move, dance, or listen to music.
In my work as a creativity coach, I encourage clients to really get to know their bodies, as it can reveal blockages that are causing creative block.
Exposure therapy for trauma
If you’re living with trauma, you might be avoiding any situations which could trigger feelings you’re not comfortable with. This works as a short term solution, but over the long term, it can lead to an increasing spiral of fear and avoidance.
Exposure therapy gradually exposes you to the situation you’re trying to avoid. It can be done in your imagination, and combined with relaxation techniques to lessen the impact of the trauma. Or it can take place in real situations, beginning with something mildly challenging.
Exposure therapy can be effective for facing the symptoms of trauma and PTSD in a safe and controlled environment. You can work with triggers, such as smells, sounds, and physical sensations.
Eye movement desensitisation and reprocessing (EMDR) for trauma
EMDR is a short term therapy, often combined with CBT, counselling or psychotherapy. It seems like an odd technique at first, but is shown to be effective in the treatment of trauma.
In the first session you’ll talk about your history, your life and relationships. And the subsequent treatment involves focusing on a traumatic memory while identifying an associated negative belief about yourself.
The therapist moves a finger in front of your face, which you follow to create a sideways eye movement. This is called bilateral stimulation. With every movement, the memory becomes less disturbing.
Hypnotherapy for trauma
Hypnotherapy or hypnosis is a tool which can be effective for trauma as part of another therapy or on its own.
Your hypnotherapist or hypnotist will induce a trance-like state, in order for you to relax into a deep state of mind. You’ll be fully awake, but inwardly focused, and susceptible to the hypnotherapist’s suggestions.
Hypnotherapy can be helpful for trauma and PTSD in several ways. You can learn some deep relaxation techniques, identify subconscious triggers to your trauma, and reframe memories so that you see them from a different perspective.
Imagery Rescripting for trauma
Imagery rescripting is a technique for working with traumatic memories, intrusive images and nightmares.
Because the memories of trauma can be so disturbing, its normal to try and push them away in an attempt to avoid them. This can make things worse, is a fear develops from having the memory or image, as much as the trauma itself.
Imagery rescripting involves facing the memory of the traumatic event with a therapist. You’ll play it in your mind, and then rewind, and play it again with changes of your choice. You’ll be encouraged to be creative here – the replay doesn’t have to be ‘realistic’, it can be anything you want it to be.
Imagery rescripting reminds you that you have more control over your memories than you might have realised. It can be an empowering process, as you learn that memories and images aren’t necessarily fixed and automatic.
Inner Child Work for trauma
The Inner child is a concept from popular psychology and the self help movement, with roots from Jung’s ‘divine child archetype’, transactional analysis and other therapies.
The inner child can be part of many therapies, and normally involves getting in touch with childhood qualities that were repressed when young through trauma, or an unsafe environment. As you work through childhood wounds in a safe environment, these lost or repressed aspects of your personalty can be allowed back and reintegrated into your personality.
Internal Family Systems Therapy for trauma
According to the theory of Internal Family Systems, your personality contains many different characters. They each have their own nature and temperament, just like members of a family.
Internal Family Systems was developed by a family therapist and academic, Richard Schwartz in the early 1980s. He began applying family therapy theory and systems thinking to the ‘parts’ he observed within individuals.
Internal Family Systems can be effective in treating trauma, PTSD and C-PTSD, as some of the parts are considered to be in ‘exile’, often due to early childhood experiences. These parts remain repressed from consciousness, and need to be integrated to form a harmonious personality.
Behind all of the parts is the invisible witness called the ‘Self’, with the qualities of acceptance, wisdom and compassion.
Further reading: Transforming The Living Legacy of Trauma, Janina Fisher
Narrative therapy for trauma
Narrative therapy looks at the stories you’ve made about yourself, and how these stories create your identity. Your stories can have a hidden effect on your self confidence, decision making and quality of relationships.
Narrative therapy aims to empower you by giving you the role of narrator of your own life. The therapist is there to facilitate your journey in a non judgemental way, and help you to pick out any dominant themes.
You’ll be able to see the story of your life as an observer, gaining valuable perspective on any problematic issues you might be facing. You’ll be able to look at your story in detail, focusing on specific parts, and questioning whether they might need changing.
There’s a type of Narrative Therapy developed specifically for community based trauma, called Narrative Exposure Therapy. It’s similar to Narrative Therapy, but for groups who have experienced trauma from the impact of cultural or political disruption.
Post Traumatic Stress Disorder Therapy
Post traumatic Stress Disorder, or PTSD is a term used to describe symptoms of trauma that last for more than a few weeks. The symptoms of Post Traumatic Stress Disorder can manifest differently for everyone, depend on your personality type, and your style of expressing emotion.
PTSD therapy is an umbrella term for any therapy which aims to treat the long term effects of trauma. A therapist might be trained in a single therapy listed here, or might use a combination of therapies.
Schema Therapy for trauma
Schema therapy is a cognitive therapy developed by Dr Jeffrey Young in the 1980s while working as a CBT practitioner. He recognised that some of his clients, particularly those with borderline personality disorder, needed more than CBT to make effective changes.
Schema therapy is an integrative approach, based on CBT, Gestalt therapy, and psychodynamic theories such as Object Relations and Attachment Theory.
Schemas are negative belief patterns which develop when our core needs aren’t met. These normally occur in childhood from situations such as not having a secure attachment to care givers, or not being allowed to express emotions or play spontaneously.
They can be experienced as intense emotions, such as anxiety and shame, flashbacks as well as sensations in the body.
Sensorimotor Psychotherapy for trauma
Sensorimotor Psychotherapy combines somatic therapy and neuroscience to treat the symptoms of trauma and PTSD. It’s a body focused therapy which uses the awareness of bodily sensations rather than words and talking.
Trauma can be stored deep within the body in a frozen state, often without any awareness of its existence. Where traditional talking therapies can sometimes miss these traumas, Sensorimotor Psychotherapy can bring them into consciousness, safely and gently.
Somatic Experiencing for trauma
This is a body therapy, developed by Dr. Peter Levine for treating the effects of trauma. He observed that animals in the wild are repeatedly subject to traumatic experiences, but tend to recover quickly. Humans, on the other hand, tend to get stuck in feelings of shame, fear and hypervigilance.
This is because the flight or flight response also includes a third element, freeze, which can cause disregulation in the autonomic nervous system. The traumatic event needs to be fully processed for the nervous system to fully regulate.
The Somatic Experiencing therapist introduces small amounts of the traumatic material, while the therapist and client note any physical responses and sensations. The client uses a ‘pendulating’ technique, going back and forth from the sensations associated with the trauma, to a safe internal place.
Trauma Focused Cognitive Behavioural Therapy (TF-CBT)
Cognitive Behavioural Therapy is a short term therapy, usually between 5 and 25 sessions. It works on the premise that thinking influences your behaviours and feelings. By identifying and changing thinking patterns, you can affect how you feel. CBT can be effective for processing trauma as thoughts around the trauma are identified and evaluated with your therapist.
There’s a branch of CBT called Trauma focused CBT, specifically for trauma and PTSD. As you talk about your traumatic experience, you’ll identify thoughts such as ‘Everyone’s out to get me’, or ‘I don’t trust anyone’. Once identified, these can be restructured into more positive and realistic thoughts.
Trauma focused therapy
Trauma focused therapy is an umbrella term for any therapy that is specifically designed for treating trauma, PTSD or C-PTSD. It can include short term and long term therapies, such as counselling and psychotherapy, and can involve somatic or psychological elements, or a combination of both.
How much is trauma therapy in London?
The cost of trauma therapy in London typically ranges from £65 – £250 for private therapy, counselling or CBT.
If you’re working, your employer might have a scheme, or an in-house therapist. If you’re a student, universities and colleges in London and the UK always have a counselling department you can get in touch with.
If you’re on a low wage, there’s charities and organisations, or you can contact the NHS directly. If you have insurance, or you’re looking for private trauma therapy, there are a host of therapeutic services throughout London at various price points.
NHS Trauma Therapy London
The NHS offers a range of free psychological therapies, including short term counselling and CBT for trauma. You don’t need a referral from a GP – you can access NHS Talking Therapies here.
You’ll normally be offered 6 or 8 weekly sessions, depending on which borough you live in. This can be good for short term treatment of depression or anxiety, and your counsellor might be able to suggest longer term therapies available to you through local charities.
If you have a more complex mental health condition, it’s best to speak to your GP first who can arrange specialist care and medication if needed.
Conclusion – getting help for trauma
If you feel you could benefit from trauma therapy, don’t hesitate to book an initial consultation. You don’t have to prepare for this, just come as you are and we can look into how I might be able to help.