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The term ‘Trauma therapy’ is the collective name for treatment of persons who have suffered a psychological traumatization. Definition of a psychological traumatization A so-called psychological trauma develops as a result of extraordinarily stressful events, whereby feelings of powerlessness and complete helplessness shake the sense of security to the core. The decisive factor in whether someone is traumatized or not is the subjective feeling of being overwhelmed, not the type of trauma. This feeling of overwhelm reflects the overwhelm of the autonomous nervous system resulting in an ongoing protective state that inhibits connection and integration. In the following, I would like to briefly describe the most important types of trauma, although it should be noted that the transitions in reality are not always so clear-cut. (Classic) post-traumatic stress disorder (PTSD) The term PTSD is the big container for all trauma diagnoses, so to speak, before further specializations (such as complex PTSD) were introduced. Also known as shock trauma, this type of traumatization from a single, isolated incident is much less common than complex PTSD. Characteristic symptoms include (1) flashbacks (uncontrollable, trigger-induced emotional memories), nightmares, anxiety, (2) avoidance of anything reminiscent of the trauma, and (3) hyperarousal (overexcitability, constant “alertness”), and hypoarousal (e.g. feeling emotionally numb, to the point of dissociation) and more. Complex post-traumatic stress disorder (cPTBS) In contrast to classic PTSD, where someone has experienced a single event (monotrauma) (e.g. a car accident in adulthood), people with PTSD have experienced repeated traumatic events in early childhood. This can include physical and sexual violence, but also emotional abuse (shaming, punishment, neglect, etc.). This kind of traumatization can severly hinder healthy emotional and mental development. As a consequence of their (healthy) adaptation, the children may develop survival strategies that they continue to use as adults. Symptoms of complex PTSD include (in addition to the three areas of classic PTSD) (1) difficulties regulating one's own emotions and impulses, self-harming behaviour (including self-harm), sexuality disorders, disturbances of perception or consciousness (dissociation, depersonalization, etc.), distorted self-perceptions (body image, feeling of being defective, relationship disorders: fear and longing for contact, too little or too much trust, revictimization tendencies, etc.), somatization (unexplained physical symptoms or pain), loss of future perspective, meaning of life, etc. The terms 'complex PTSD' and 'developmental trauma' are not clearly differentiated. Although the latter is limited to early traumas, it is also often used for healthy imprints.   Dissociative identity disorder (DID) The diagnosis of DID is at the extreme end of the traumatic spectrum. It is characterized by a persistent splitting off of some parts of the personality. These have separate memories, abilities, personality traits, age, language skills, etc. People with this degree of structural dissociation have often experienced the worst kinds of traumatic experiences as very young children, such as years of sexual and/or physical exploitation, the repeated absence of any kind of support. Surprisingly, people with a DID have a “seemingly normal functioning personality part”, and some can work and interact in the primary labor market. This points to the person's enormous adaptability. The symptoms of a DID include amnesia, uncontrollable changes in personality traits with partially dissociated actions, perceptual disorders of the environment and of oneself, plus all the symptoms of classic and complex PTSD. Developmental trauma A developmental trauma is the result of an early trauma, generlly before the age of three.  That includes prenatal, perinatal (i.e. birth complications, etc.) and postnatal incidents such as medical interventions, being left alone (e.g. unaccompanied hospital stays), and emotional, physical or sexual abuse. Such incidents become traumatic when a young child is left defenceless against a perceived threat and is not rescued from this state. The term developmental trauma is still not an official diagnosis, but usually falls under “complex post-traumatic stress disorder”. As very few people have explicit memories of the first years of life, developmental trauma often remains invisible. However, existential or other “irrational” fears, difficulties relaxing or an urge to be constantly on the move can be indications of developmental trauma. Peter Levine also calls these conditions GHIA (global high intensity activation). More about developmental trauma on the NARM page. Elements of trauma therapy Today, there is a wide variety of methods for treating trauma. Despite the great differences between the methods, there are some common elements. The following general effective factors can be summarized: • Psychoeducation: education about the definition and symptoms of trauma, introduction of helpful models, information about treatment and expectations. • Stabilization: The main aim is to learn how to regulate emotions, which means restoring the ability to resonate: How can I feel my emotions without having to resort to defensive strategies? This step means, among other things, establishing a connection to the body and the emotions. • Ability of mindful self-observation: This is the central instrument of top-down regulation, which must be learned: Observing *thoughts, emotions, body sensations, sensory perceptions and behavioral impulses. • Connection to the body: The trauma is located in the right hemisphere of the brain, in the implicit body memory, the senses, the emotions and movements. It is therefore necessary to involve the body. Complete integration means embodied learning.  • Trauma exposure: dealing with the traumatic memories, connecting thoughts, emotions, body sensations, sensory perceptions, images,  irrational beliefs, identifications and behavioral impulses. • Reorganization of memory functions: Developing a coherent, explicit narrative about yourself. Used methods I work using the following methods: SE (Somatic Experiencing): SE is a body-based trauma-oriented treatment method that can be seen as a practical application of the Polyvagal Theory. The goal is to restore the connection to one-self and with that, the resilience which serves as the basis for processing trauma and difficult experiences. SE can - but does not need to - include touch. More Info EMDR (Eye Movement Desensitization and Reprocessing) Traumatic memories and irrational cognitions are processed through rapid eye movements. Very effective and scientifically proven method. So-called 'gentle method'. More info NARM (Neuroaffective Relational Model): The founder Laurence Heller was a long-time trainer of Somatic Experiencing (SE). NARM expands the body-oriented approach of SE to include a psychodynamic, development-oriented perspective. The goal in this very gentle, nonregressive and integration-oriented approach is to move towards your life energy. More Info Ego-state therapy: Working with inner personality parts can help to classify and understand split-off, possibly erratic behavior and experiences. The method of choice for complex PTSD and patients with dissociative symptoms, but also very effective for healthy people! Treatment of trauma-associated dissociation:  In his many years of work with people with dissociative identity disorder (DID), psychotherapist and researcher Ellert Nijenhuis has developed a systematic approach based on the “democratic” integration of the different parts of the personality. NET (Narrative Exposure Therapy): NET is a lean, language-based method with a focus on exposure, creating a coherent narrative and embedding it in one's own life story. Literature about Trauma therapy • What is EMDR? • NET - Narrative Exposure therapy • Ego-state-therapy • NARM (Neuroaffective Relational Model) • Treatment of the trauma-associated dissociation of the personality