Psychoeducation For Trauma

Psychological trauma is a response involving complex debilitation of adaptive
abilities—emotional, cognitive, physical, spiritual and social—following an

event that was perceived by our nervous system as life-threatening to oneself or
others (especially loves ones).
Trauma can be a one-time event, a prolonged event or a series of events.

Trauma that affects a community or a country is called collective trauma.
Traumatic injury shocks and changes all systems. These include:
 Cognitive:The trauma affects the ability to process thoughts and make

good judgments
 Emotional: Looping with emotions of shame, guilt, fear, anger, and pain
 Physical:It affects muscles, joints, digestion and metabolism,
temperature, sleep, immune system, etc.
 Spiritual:The trauma affects our worldview, the lenses with which we
see reality (typically so we see it as unsafe), our understanding and
meaning of life, society, and the world
 Social: The trauma affects relationships with spouses, family, friends,
colleagues, and strangers (because it affects so many so deeply, it
affects structures of societies)
Post-Traumatic Stress Disorder (PTSD) is a set of alarm responses that occur

when a survivor’s nervous system remains on high alert after trauma in order
to protect against further harm. The survivor’s alert systems respond to
reminders of the traumatic memories as a threat. Often, additional triggers are
added to a growing list of stressors.
Developmental trauma occurs early in life and disrupts normal sequences of

brain development. As a result, other aspects of development such as
emotional, physical, cognitive, and social are also impacted.
Bottom-up modalities are experiential ways of engaging survivors with a
focus on enhancing self-regulation through body awareness, and expanding a
survivor’s sense of control and ability to tolerate inner and outer triggers.
Examples of bottom-up modalities are: expressive therapies (arts, drama,

movement, dance, music), body-oriented therapies, certain mindful modalities,
and certain neurofeedback protocols. These modalities include use of talk to
process the dynamics of therapy but they do not rely on cognitive processing.
 Body awareness means learning to detect and trace what is happening

in the body. It’s particularly important to understand what sensations are
associated with various triggers, emotions, movements, associations,
images, etc.
 Self-regulation is the ability to control one’s emotional responses. Self-
regulation in the context of trauma therapy focuses on three
dimensions:
 Sensory regulation (integration): Expanding control in response to

sensorial triggers and alerts.
 Emotional regulation: Expanding control over one’s emotions.
 Cognitive regulation: Expanding control over thoughts, and increasing
capacity to respond rather than to react.
Top-down modalities usually refers to talk-based therapies, such as
cognitive and behavioral therapy (CBT) modalities. Top-down modalities focus
on thought processing and reframing, behavioral modifications, emotional
processing, and some forms of narrative processing. Some top-down
approaches combine modalities, for example, mindfulness-based cognitive
therapy.
 Mindlessness vs. mindfulness. Both are practices that can increase

the ability to quiet an alerted nervous system. However, mindfulness is
a mental state that focuses on awareness of what is here and now
(present moment sensations, feelings, thoughts), whereas
mindlessness brings attention to focus on a task or activity and seeks to
be fully absorbed by it.
o Mindfulness can be very challenging for trauma survivors since,
along with awareness of the present can come expanded
awareness of sensitivity to certain sounds, smells, or textures.
These sensitivities, known as triggers and alerts, torment many
survivors by bringing to the surface unwanted memories and a
flood of emotions. If not developed slowly and gradually,
mindfulness can cause more harm than good.
o Intentional mindlessness that incorporates creative activity can
be just as calming to the nervous system as mindfulness, and
engaging in it enhances the ability to be spontaneous. When
practicing intentional mindlessness, we want to engage in activity
that fully absorbs us (and during which the mind doesn't flit to
other thoughts or to what we are thinking and feeling), and that
increases our sense of joy. Typically activities: playing games,
scribbling and doodling, exercise, and so forth (see this post).
o
 “Imaginal Space” is an abstract, creative space of play, fantasy, and
spontaneity in which a trauma survivor is able to explore and engage
with different aspects of her experiences (including traumatic ones)
through art, play, movement, dance, drama, music, and so forth.
 Trauma processing. Many trauma survivors seem to expect that, if

only they will be able to tell their story, they will be “healed.” A heavy
focus on telling the traumatic story reflects outdated notions of what
trauma does to people and how to respond to it. Since traumatic
memories are implicit and somatic, face-to-face, talk-based processing
of trauma is not the best way to go about therapy.

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Psychological trauma is a response involving complex debilitation of adaptive

abilities—emotional, cognitive, physical, spiritual and social—following an

Trauma can be a one-time event, a prolonged event or a series of events.

Traumatic injury shocks and changes all systems. These include:

 Cognitive:The trauma affects the ability to process thoughts and make

Post-Traumatic Stress Disorder (PTSD) is a set of alarm responses that occur

Developmental trauma occurs early in life and disrupts normal sequences of

Examples of bottom-up modalities are: expressive therapies (arts, drama,

 Body awareness means learning to detect and trace what is happening

 Sensory regulation (integration): Expanding control in response to

 Mindlessness vs. mindfulness. Both are practices that can increase

 Trauma processing. Many trauma survivors seem to expect that, if

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