Trauma, Its Biological Effects And The Importance Of ‘Bottom Up’ Therapy

  • Trauma can be defined as a stressful experience that is so overwhelming that a person can’t cope with it and is not able to integrate their response to it. 
  • This leads to dysregulation of the autonomic nervous system and overactivation of the sympathetic part of the system (the fight or flight response) and underactivation of the parasympathetic part of the system (the ‘rest and digest’ response). It is this dysregulation that leads to many of the symptoms of PTSD/complex PTSD such as hypervigilance and an inability to feel comfortably relaxed. 
  • But what counts as a traumatic experience? The answer to this is that the experience of something being traumatic is subjective. So, what one person finds traumatic another person may not find traumatic which explains why two people may have similar experiences but only one develops a trauma-related pathological condition.
  • Being traumatized or having PTSD/Complex PTSD is not a sign of weakness and is a normal response to overwhelming stress. It is a neurological condition and can not only affect the brain’s functionality but its very architecture. It is not ‘just’ psychological and is not something a person can ‘just get over’ without the help of trauma-focused therapy. 

BECAUSE OF THE BIOLOGICAL EFFECT OF TRAUMA, IT IS VERY IMPORTANT TO KNOW THE DIFFERENCE BETWEEN ‘TOP DOWN’ AND ‘BOTTOM UP’ THERAPIES. I EXPLAIN THIS DIFFERENCE BELOW:

WHAT ARE ‘TOP-DOWN’ THERAPIES?

A ‘top-down’ therapy is one that aims to create a positive change in the individual’s behavioral, emotional, and somatic symptoms in a ‘top-down’ direction (i.e. by beneficially ALTERING THE INDIVIDUAL’S THOUGHT PROCESSES). Techniques for doing this include cognitive restructuring and increasing the traumatized individual’s insight into his or her condition, amongst many others.

Whilst ‘top-down’ therapies are necessary and can be very effective, there is now a growing realization when treating the traumatized individual, the addition of ‘bottom-up’ therapeutic techniques may be of paramount importance in relation to treating the bodily adverse effects of trauma such as sensorimotor symptoms and autonomic dysregulation.

WHAT ARE ‘BOTTOM-UP’ THERAPEUTIC TECHNIQUES FOR THE TREATMENT OF TRAUMA? Unlike ‘top-down’ therapies, which concentrate on an individual’s thinking processes to treat the effects of trauma, ‘bottom-up’ therapies concentrate upon BODILY EXPERIENCES as an initial route through which to treat the effects of trauma by ameliorating dysfunctional trauma-related, chronic and automatic bodily responses.

This approach is taken because it is theorized that our nervous systems and muscles store distressing images and memories on an unconscious, nonverbal level and that this is manifested in various physical and bodily ways, such as :

  • body posture

  • how the person moves 

  • pain and bodily sensations

Bodily reactions to emotions, events, and situations In essence, then, ‘bottom-up’ approaches to the treatment of the adverse effects of trauma aim is to correct the sensorimotor dysregulation that has occurred as a result of childhood trauma. Examples of ‘bottom-up’ therapies for treating the bodily effects of trauma include :

  • sensorimotor psychotherapy

  • yoga

  • somatic experiencing

  • breathing exercises

  • EMDR

  • drama

  • singing

  • drumming

  • tapping / Emotional Freedom Technique
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