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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 ,   even   though   developed   indepdendently. 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