3 Reasons Why Traditional Psychotherapy Is Less Effective For Trauma

There are alternatives to traditional psychotherapy that are more effective when it comes to trauma. We'll tell you what they are.

Written and verified by the psychologist Elena Sanz.

Last update: 29 August, 2023

Trauma is the body’s reaction to an adverse, shocking, and unpredictable event that exceeds a person’s ability to manage it. Faced with an experience of this nature, we feel terror, defenselessness, and a series of side effects appear. Professional support is essential, but not all alternatives are equally effective. For example, traditional psychotherapy seems to be less effective in these moments.

It’s worth mentioning that all internal work that’s carried out to overcome trauma in this regard will bring benefits, and that each person is different. The preferences and traits of each person influence whether they feel more attuned to one psychotherapeutic approach and another.

However, the characteristics of the adverse experience in question mean that certain interventions focused more on speaking aren’t the best alternative. Let’s find out more.

What is traditional psychotherapy?

Psychology isn’t a homogeneous science. Since its inception, progress and transformations have been made based on new findings. In addition, there are different schools and currents that have their own ways of intervening in thought, emotions, and behaviors.

Although these approaches can be categorized in many ways, most take a variety of paths to address the problem. The most traditional currents are based on conversations between patient and therapist and are directed “from top to bottom”; that’s to say, that thought, language, and reflection are at the center of the process.

Within these traditional approaches, we find currents such as psychoanalysis, narrative therapy, dynamic therapy, or dialectical behavior therapy (DBT). It’s even possible to place cognitive-behavioral psychotherapy within this category.

The truth is that these approaches have shown to be effective in the treatment and resolution of disorders and diseases. For example, DBT is useful in intervening in borderline personality disorder. On the other hand, dynamic therapy helps in emotional management and anxious-depressive symptoms, as stated by a publication in the Journal of the Spanish Association of Neuropsychiatry.

In addition, cognitive-behavioral therapy has been shown to be effective in a multitude of psychological problems, as mentioned by Naturopathic Medicine. However, these techniques may not be as beneficial in terms of trauma.

Why is traditional psychotherapy less effective for trauma?

According to an interesting article published in the Journal of Transactional Analysis and Humanistic Psychology, there are various reasons that explain why traditional psychotherapy is less effective for trauma. Among the main reasons are those that we’ll explain below.

1. Access to trauma

Traditional psychotherapy works with the rational part of the brain (neocortex), but trauma isn’t stored there, but rather in the emotional brain (the limbic system) and in the body.

In fact, when we go through an experience with a great negative emotional impact, the rational area disconnects. This is why dissociative experiences occur and, sometimes, the trauma isn’t recorded in conscious memory.

Therefore, trying to access the event through reflection, in most cases, isn’t productive. The person may not know why they act the way they do and yet be unable to avoid it. What’s more, they may spend hours talking about what happened without it changing their symptoms at all.

2. Ability to verbalize

Sometimes the trauma can’t be put into words. And this is because it’s not stored correctly and remains stored in the body through bodily sensations, smells, images, or sounds.

Traumatic memories are easier to cram into implicit memory, which operates automatically and unconsciously and remains active during times of stress.

To verbalize or narrate an event, it would have to be based on explicit memory (which includes concepts, facts, or ideas and allows the event to be narrated with cohesion). But this is inhibited due to the action of stress hormones that suppress the activity of the hippocampus.

3. Activation of the nervous system

For people with post-traumatic stress, the symptoms of anxiety, panic, sleep disturbances, and concentration difficulties are based on an overactivation of the autonomic nervous system. These symptoms, at the time of the event, help to safeguard the physical or psychological integrity of the person.

However, once the event has passed, this activation becomes chronic, generating the disabling sensation of alertness.

Therefore, the primary work has to deal with bodily sensations, being able to identify, feel, and release them, in order to later describe them and give them meaning through language.

What alternatives exist to treat trauma?

All of the above makes traditional psychotherapy less effective in addressing trauma and recovery. However, there are useful alternatives available to patients.

These consist of ‘bottom-up’ approaches; that is, they start from emotions and sensations, from that which is automatic and emotional, to later move on to rationality and verbal expression.

In short, the main objective of recovery is to integrate all those unconnected elements that were stored and give them meaning as a complete experience that has a beginning and an end. To do this, you have options such as the following:

• Neurofeedback: Helps the patient to self-regulate their brain activity, thus changing the patterns that cause post-traumatic stress and also the associated behaviors.
• Sensorimotor therapy: Facilitates somatic processing caused by trauma, incorporating body-oriented interventions. It combines the theory and techniques of cognitive therapy, as mentioned in an article from the Open University of Catalonia.
• Mindfulness-Based Approaches: Mindfulness-based exercises and techniques are a great complement to the usual approach to trauma and help reduce symptoms. This is stated in a meta-analysis published in the Journal of Trauma & Dissociation.
• EMDR: The objective here is to achieve the processing of traumatic memories by applying bilateral stimulation. This technique is called eye movement desensitization and reprocessing and helps to reduce and improve post-traumatic symptoms.

Final recommendations

In short, there are different psychological currents that are capable of addressing trauma and its effects. As we’ve seen, some are better adapted than others to the specific characteristics of post-traumatic disorders.

Traditional psychotherapy is less effective for trauma, but this doesn’t mean that it doesn’t work. In this case, however, the treatment may be longer and less productive.

Despite this, it’s crucial to place yourself in the hands of a professional who’s specialized in trauma, knows and manages the most effective and up-to-date interventions, and is capable of recommending the best therapeutic alternative in each specific case.