First Hand Accounts of Trauma Treatment Modalities

Part of an ongoing series about life with complex post-traumatic stress disorder

Since being diagnosed with CPTSD a few years ago, I have done a lot of work on myself and gone through therapy with some great practitioners. I have been really fortunate to have access to care that has really changed my quality of life. But I realize that these are out of reach for a lot of people, or that they might only be able to try one at a time. So I wanted to describe what each modality is like in an actual session, so that they’re a little less scary, and you can think about what sounds the best for you.

EMDR
Description: EMDR stands for Eye Movement Desensitization and Reprocessing. It is a type of therapy that helps people process traumatic memories and experiences. During EMDR therapy, the therapist guides the person through specific eye movements or other forms of rhythmic stimulation while they recall the traumatic event. The idea is that this bilateral stimulation can help the brain reprocess the traumatic memory in a more adaptive way, reducing the distress associated with it.
Session notes: EMDR often starts with “resourcing” — building a safe memory space to come back to if you get triggered. Then, they use binaural beats or left/right movement in combination with memory processing. So, you might put on headphones and have music that ping pongs in your left/right ears, tap your left/right shoulders, or hold buzzers that alternate side to side. What I remember most about this, is that it extracts the poison from memories and flashbacks. Things that used to haunt me I now remember factually, without the former surges of emotion. Note: Therapists will make sure that you are stabilized and have coping skills before starting trauma processing with you. That can take a while.

Brainspotting
Description: Brainspotting is a type of therapy that focuses on identifying and processing traumatic or emotionally-charged experiences that are held in specific areas of the brain and body. The therapist uses eye positioning to locate these “brainspots,” which are believed to be related to the stored emotional or physical trauma. Once the brainspot is identified, the therapist helps the person to focus on it while using various techniques to facilitate processing and healing. The goal of brainspotting is to promote resolution of trauma and associated symptoms by accessing and processing the underlying neural networks.
Session notes: In these sessions, the therapist holds a long wand, and they position it in several different spaces around the room. They ask you to notice which you fixate on, then you hold your gaze in that spot, while discussing everything that is coming up for you memory wise, or emotionally. Brainspotting can be a lot gentler than EMDR, and seems especially good at processing phobias.

Somatic Experiencing
Description: Somatic Experiencing is a type of therapy that focuses on the physical sensations and reactions that are associated with trauma. While trauma affects the mind, it gets stored in the body. During somatic experiencing therapy, the therapist helps the person to identify and release this pent-up energy and tension through gentle physical movements and mindfulness exercises. The goal is to help the person regain a sense of safety and regulation in their body, reducing the impact of trauma symptoms on their daily life.
Session notes: In one SE session, I took a walk outside with my therapist, and we talked about how I walk and move and occupy space in relation to others. In another, we analyzed my posture and tone. Of all the therapies I tried, I miss SE the most. It felt extremely profound and also alien compared to anything else I tried. As a cerebral person, it was also really hard.

IFS
Description: Internal Family Systems (IFS) is a type of therapy that views the psyche as a complex system of sub-personalities or “parts,” each with its own thoughts, feelings, and behaviors. The goal of IFS therapy is to help the person to better understand and integrate these different parts of themselves, particularly in relation to past trauma or negative experiences. The therapist helps the person to identify and interact with different parts of themselves in a more compassionate and accepting way, promoting healing and greater self-awareness. The focus of IFS is on developing self-leadership skills, promoting integration, and achieving a more harmonious inner state.
Session notes: IFS didn’t work well with me, because it doesn’t play nice with other types of parts work (like the structural dissociation model). But for many people, it is a powerful way to manage internal conflict.

Psychodrama
Description: Psychodrama is a type of therapy that uses role-playing and group dynamics to explore and process personal issues and past trauma. During a psychodrama session, the person works with a therapist and a group of other participants to create a “drama” that reflects their personal experience. The therapist may use various techniques, such as role-reversal, to help the person gain a deeper understanding of their own thoughts, feelings, and behaviors, as well as those of others. The goal of psychodrama is to promote emotional catharsis, insight, and personal growth through the exploration of inner conflicts and relational dynamics.
Session notes: I love psychodrama, I think it is one of the coolest and most underrated modalities! In each group, you share an internal conflict you’re experiencing. Then, different group members are assigned to play the different conflicting thoughts/feelings in your mind, and externally. You sit at the center, and conduct the volume of each part that is speaking to reflect on the experience. Then, everyone discusses how that makes them feel.

ACT
Description: Acceptance and Commitment Therapy (ACT) is a type of therapy that focuses on helping people to develop psychological flexibility and acceptance of their own thoughts and feelings, rather than trying to eliminate or control them. The goal of ACT is to help people to identify their core values and commit to taking action in line with those values, despite the challenges and discomfort that may arise. During ACT therapy, the person works with a therapist to learn mindfulness techniques, acceptance strategies, and behavior change skills. The goal is to promote greater psychological flexibility, reduce the impact of negative thoughts and emotions on daily life, and cultivate a more meaningful and fulfilling life experience.
Session notes: My favorite thing that I took from this was that “I am the sky, and my thoughts and feelings are the weather.” It feels kind of zen, and kind of stoic.

Process Groups
Description: Process groups are a type of therapy that involve a small group of people coming together regularly to explore their thoughts, feelings, and behaviors in a supportive and confidential setting. During a process group, participants have the opportunity to share their experiences, receive feedback and support from others in the group, and gain insights into their own patterns of behavior and interaction. The focus of process groups is on building connections and community among group members, as well as promoting personal growth and self-awareness. The goal is to create a safe space where people can share openly and honestly, gain support from others, and work towards personal transformation and healing.
Session notes: A lot of people with trauma struggle to relate to others safely. Process groups allow you to learn to manage your emotions and others in a safe setting. You practice holding space, relating interpersonally, and offering support to each other. It’s about learning to relate and exist in connection. I found this excruciating at first — I was taught not to share anything with anyone about how I felt growing up, because vulnerabilities were used to manipulate me — but gradually came to appreciate the safe space. Just seeing other people experience emotions, and not be judged or ridiculed is really powerful for me.

DBT
Description: DBT teaches tactical skills for emotion regulation, distress tolerance, interpersonal effectiveness, and mindfulness. The goal is to help the person develop a greater sense of control over their thoughts and emotions, improve their relationships with others, and cultivate a more meaningful and fulfilling life experience.
Session notes: My favorite parts of DBT therapy are the frameworks that you learn — for example, TIPP skills for grounding, and “DEAR MAN” for communication. You often practice these together in a group. I found the mindfulness part of DBT the hardest. If other therapies feel too fluffy for you and you want to start with something concrete and stabilization-oriented, give DBT a shot.

Sensorimotor
Description: Sensorimotor Psychotherapy is a type of therapy that focuses on the relationship between the body and the mind, particularly in relation to past trauma or negative experiences. The goal of sensorimotor therapy is to help the person to become more aware of the physical sensations and reactions associated with trauma, and to develop techniques for regulating these experiences. During sensorimotor therapy, the therapist helps the person to identify and release physical tension and sensations through gentle physical movements, mindfulness exercises, and other techniques.
Session notes: My therapist says things like, “Where do you feel that in your body? How do you know you are anxious/tired? Where is that emotion stored? Let’s work together to increase your rocking motion…what does it feel like to rock?”

Neurofeedback
Description: Neurofeedback is a type of therapy that uses real-time monitoring of brain activity to help people regulate their brainwaves and improve cognitive function. During neurofeedback therapy, the person sits with sensors attached to their scalp that detect brain activity, while a computer program provides feedback in the form of visual or auditory signals. The person then learns to modulate their brainwaves in response to this feedback, which can help them to improve attention, focus, and emotional regulation.
Session notes: There are a few different types of neurofeedback. In general, they tape electrodes to your scalp in a few places, then you complete segments of time watching shapes on a screen while listening to odd noises or music. The noises/screen get brighter/darker/quieter/louder depending on how your brain responds. It doesn’t hurt, and it’s not unpleasant, and can also help with things like ADHD or TBI recovery. It is a little strange though, and you may want to wear a hat on the way home because it gets goop in your hair (some protocols have a cap with a lot of sensors, and some have just a couple, it depends on the program you are using). It is a time commitment because you usually have to do it a couple times a week at least for a minimum of ~20 sessions.

TMS
Description: TMS stands for Transcranial Magnetic Stimulation. It is a non-invasive type of brain stimulation therapy that uses magnetic fields to stimulate nerve cells in the brain. During TMS therapy, a small coil is placed on the scalp and an electromagnetic current is delivered to targeted areas of the brain. This can help to regulate and improve brain function, particularly in relation to conditions such as depression, anxiety, and chronic pain. TMS therapy is typically administered over multiple sessions, and the number and frequency of sessions may vary depending on the individual’s needs and response to treatment. The goal of TMS therapy is to improve symptoms and promote overall well-being by targeting the neural circuits that are involved in mood regulation and pain perception.
Session notes: There are two types of TMS, accelerated, which is made of ten treatments a day for five days, and traditional TMS, which is one session a day for six weeks (80% and 50% depression remission rates, respectively). The doctor targets a certain part of your brain with the magnet depending on what you want to treat. In the version I did, you have to wear a funny tripod on your head to position the magnet, and it feels like having a big rubber band snapped against your scalp for ten minutes, while it makes a cracking sound. But, you get to watch TV while they do it. Note that you have to get a 3D MRI before you can do TMS.

Acupuncture
Description: Acupuncture is a type of traditional Chinese medicine that involves the insertion of thin needles into specific points on the body to promote healing and balance. During an acupuncture session, the practitioner will place needles into various points on the body, depending on the person’s individual needs and health concerns. The needles may be left in place for several minutes or longer, and the person may experience a mild tingling or sensation of warmth in the affected area.
Session notes: Acupuncture rarely hurts, and can really help with sleep/GI issues/body tension/stressors that accompany PTSD. It’s usually a very calming experience with gentle music, a heat lamp, and a quiet dark room. A lot of acupuncturists also do cupping (where they put little round glasses on your back, and suck out the air to stretch the muscles) or gua sha (kind of like massage).

Craniosacral
Description: Craniosacral therapy is a type of gentle bodywork that involves the manipulation of the bones and tissues in the head, neck, and spine to promote relaxation and balance in the body. During a craniosacral therapy session, the person lies down fully clothed while the practitioner uses gentle touch to feel for areas of tension or restriction in the body. The practitioner then uses gentle techniques to release these areas of tension, which can help to improve the flow of cerebrospinal fluid and promote overall relaxation and well-being. Craniosacral therapy is believed to work by restoring balance to the body’s natural rhythms and promoting the body’s innate healing processes. It can be used to treat a variety of physical and emotional health issues, such as chronic pain, headaches, and stress. The goal of craniosacral therapy is to promote relaxation, reduce pain, and improve overall health and well-being.
Session notes: This was a very strange experience at first — being gently held, until your body responds to the touch, and releases tension. It is very quiet, calming, and slow. The therapist asks questions about what you notice in terms of body sensation, and is just still/with you. It’s very consent-based and nurturing.

NeuroAffective Touch
Description: NeuroAffective touch is a type of touch therapy that is focused on promoting nervous system regulation and emotional healing. During a neuroaffective touch session, the practitioner uses a combination of touch, movement, and breathwork to help the person regulate their nervous system and access deeper emotional states. The touch is gentle, nurturing, and focused on creating a safe and supportive space for the person to explore their emotions and sensations. Neuroaffective touch is believed to work by activating the body’s natural healing mechanisms, including the release of oxytocin and other feel-good hormones. The goal of neuroaffective touch is to promote nervous system regulation and emotional healing by fostering a deeper connection between the mind and body.
Session Notes: This somatic modality is very gentle but also very hard if you struggle with bodily autonomy, being “in your body”, or being touched. The therapist might use warm weighted pillows and ask, “Which would you like to hold? How do you feel? What do different parts of you think? What do you notice?” and so on.

Structural Dissociation Therapy
Description: Structural dissociation therapy is a type of psychotherapy that is focused on working with complex trauma and dissociation. The therapy is based on the idea that people who have experienced severe and ongoing trauma may develop a divided sense of self, with different parts of their personality functioning in separate and sometimes conflicting ways. The therapy works to help the person identify and work with these different parts of themselves, to help them become more cohesive, functional, and resilient .
Session notes: This type of work is super powerful and can help people learn so much about themselves. It can be very hard at first, but is very worth it and truly important for those who need it.

Apollo Neuro
Description: Apollo Neuro is a wearable device that uses low-frequency vibration therapy to promote nervous system regulation and reduce stress. By stimulating the body’s natural relaxation response, the device can help to regulate the nervous system, reducing the activation of the sympathetic “fight or flight” response and increasing activation of the parasympathetic “rest and digest” response. This can lead to reduced stress levels, improved sleep, and enhanced cognitive performance. The device can be used in a variety of settings to promote nervous system regulation and improve overall health and well-being.
Session notes: This looks a bit like a pager, and feels kind of like a cat purring. It has several modes — e.g. Sleep, Focus, Relax, Social — that help you get in the right nervous system state. I honestly have no clue if it works, because I started using it while also pursuing a bunch of other treatment, but it is kind of fun and comforting. The only annoying part is that you have to charge it every other day, and that the watch strap doesn’t have good velcro, so I use the clip instead.

Psychiatry
Description: Psychiatry is a branch of medicine that specializes in the diagnosis, treatment, and prevention of mental health disorders. Psychiatrists are medical doctors who have completed specialized training in the assessment, diagnosis, and treatment of mental health disorders. They use a variety of approaches to treat mental health issues, including psychotherapy, medication management, and other interventions.
Session notes: Psychiatry can be so important in trauma treatment because it can help stabilize you enough through medication and prescription of other modalities in order to do trauma processing and resolution. My initial thoughts on it are here. Since writing that article, I have continued to work with a great psychiatrist and really appreciate the partnership and guidance as I work through managing challenging symptoms. Having someone onboard who understands what may work the best for me neurologically is incredibly helpful and I am very grateful for the support. It’s not a substitute for trauma therapy, more of an adjunct. Some non-obvious ways psychiatrists can help: helping with medical leave paper work, disability forms, getting accommodation letters for work, understand genetic predispositions, writing evaluations, confirming diagnoses, and helping gain access to other medical specialists.

Trauma-Sensitive Yoga
Description: This yoga practice emphasizes a non-judgmental and compassionate approach, with a focus on creating a safe and supportive environment for the person to explore their physical and emotional sensations. Trauma-sensitive yoga uses specific techniques and modifications to ensure that the practice is accessible and safe for people with trauma histories. These modifications may include the use of supportive props and adjustments to the environment. Trauma-sensitive yoga is believed to work by promoting nervous system regulation, mindfulness, and self-awareness. The goal of trauma-sensitive yoga is to promote healing and recovery by fostering a deeper connection between the mind and body, and supporting the person in their journey towards wholeness and well-being.
Session notes: It’s hard to find this, but many “yin yoga” or “restorative yoga” classes are similar. The trauma sensitive mindfulness yoga I did was all about tuning into physical sensation, doing slow stretches and holding poses, and making sure that you are conscious of and address any discomfort. It was scary at first to be so quiet and to move so slowly and to be in a room full of strangers. But I grew to appreciate it. The instructors are very careful to check in on everyone regularly, make sure people are remembering to breathe, and that everyone is ok.

Art Therapy
Description: This uses the creative process of art-making to help people express and explore their emotions, reduce stress, and promote healing and personal growth. During an art therapy session, a trained art therapist works with the person to create art using a variety of materials, such as paint, clay, or collage. The art-making process is used to facilitate self-expression and emotional processing, with the art serving as a reflection of the person’s thoughts, feelings, and experiences.
Session notes: It was really hard for me to be open minded about art therapy…it just seemed kind of silly at first. But looking back, I think it was a really good exercise in tapping into creativity, movement, and physical sensation. While I don’t do art therapy any more, I do have a hobby now where I can lose myself in the creative process, and focus in on the art I am creating rather than worrying about the world’s problems. And I think that is really healthy and world expanding for me.

Boundaries Coaching
Description: Coaching is more tactical and future oriented in most cases compared to therapy, and boundaries coaches specifically work on how to help you assert yourself — where you start/stop — to others in your life.
Session notes: This helped me develop a style and tone for setting healthier boundaries that felt comfortable to me. We ran through scenarios, and role plays to create scripts/flashcards for me to practice, to build a stronger boundaries muscle.

To find a therapist that works with these modalities, you can search for any of them on the Psychology Today site, or find the site for each modality (which usually has a directory of certified clinicians). Most can be done over telehealth, so you are not restricted to people in driving distance. Remember that many therapists use a mix of multiple modalities in their work, and that therapists usually offer 15 min intro calls so you can ask them more about their style or what might be appropriate in your case. If you’re struggling and want to try many modalities at once, you can learn about higher levels of care available here.

Note: I am not a mental health clinician, these are just my own recollections of therapies I have tried. Different things work for different people. I cannot diagnose you, recommend a therapeutic plan, or tell you what therapy might be most effective for you. Please consult a qualified mental health practitioner for support.
Some of the summary descriptions of the therapies were generated in conjunction with ChatGPT, then edited based on my knowledge and experience.