Trauma Focussed Cognitive Behavioural Therapy (CBT)
This is a summary of some of the core elements of Trauma Focussed CBT. Please don't hesitate to contact me for an informal chat and/or signposting to other resources if you would like further information about Trauma Focussed CBT
Trauma Focussed CBT is also an evidence based treatment for PTSD and equally recommended as Eye Movement Desensitization Reprocessing (ENDR) by the NHS as an effective treatment for PTSD. This is also a therapy I offer. As in EMDR treatment trauma focussed CBT also involves a very specific set of procedures, and involves talking about the details of the trauma but in a very specific way. As with EMDR treatment support will be very present and coping strategies and resources are built up beforehand. The treatment rationale is the same as for EMDR and I have outlined this below.
When a traumatic event is experienced, the brain does not process it in the way that a non traumatic event would be processed. Imagine that each of us has a filing cabinet of memories in our brain. If we want to remember a certain event in the past, or someone asks us about an event in the past, or something reminds us of an event in the past, for example; your last holiday; providing this didn't involve serious trauma we can 'retrieve' the file marked 'my last holiday' and bring it into our present consciousness, talk about it, and then file it away again, and get on with the rest of our day without any problems or intrusions from our holiday memory.
With a traumatic experience the part of the brain that processes information becomes overwhelmed and the processing procedure becomes interrupted. The trauma memory often becomes fragmented, it might be difficult to remember the events in order, there may be blanks in the memory. The memory also stays very 'alive' and 'present' and it won't seem to go into the past no matter how hard the person tries. This is because the traumatic event remains un processed. The brain attempts to wall the information off, but it is a bit like an overfull cupboard, every time the door is open, something falls out. Reminders in the present can cause parts of the memory to fall out of the 'cupboard door' and intrude into the present so that the person can feel as if the trauma is happening all over again. The person can have intrusive images, and/or feelings, and/or nightmares.
Trauma Focussed CBT treatment through a very specific set of procedures allows the brains processing system to 'fire up' again and to process the traumatic information. It involves taking the memory out from behind the 'wall' or the 'cupboard' and with the help of the trauma focussed CBT treatment and support from the therapist, the person can be helped and supported to make a narrative of events, and to process the events of, and thoughts and feelings about the traumatic event which then enables full processing to occur so that this event/memory can be filed in the same way as other memories are filed in the filing cabinet. To continue with the use of the analogy of the overfull cupboard, the only way to solve the problem of an overfull and untidy cupboard is to take everything out; sort through it piece by piece, and put things back in order. It may seem unthinkable for a traumatic event or even feel disrespectful to the event to think about making order, or meaning from it, but the therapy supports the person to make their own individual sense and order of the trauma, so that the person is able to live their lives free of being controlled by the extremely debilitative effects of PTSD.