Using only a top down approach in psychotherapy sessions isn’t enough for trauma because:
- When a person is experiencing flashbacks or even recalling a traumatic event their body can literally feel like it’s in the past. All the stored survival stress is back in the form of body sensations. These body sensations can get unbearable. And just talking about all of this won’t help because it doesn’t relieve the body sensations. Without a somatic approach to help handle the body sensations, the client can feel like they’re drowning in the gut wrenching sensations.
- The body sensations can feel very triggering because the client feels as if they’re reliving the entire traumatic event rather than just talking about it. A cognitive approach to make sense of this doesn’t help until the body feels safer to inhabit, until the client can get a grip on the body sensations. No amount of cognitive processing can make the person understand that it’s in the past. While a cognitive approach can help in observing the body’s sensations, the bottom up approach can help in “recalibrating the nervous system” ( Kolk, 2004, p. 63-64) which is vital to begin with.
- During a traumatic event, the body goes into survival mode and the amygdala, the smoke detector of the brain ( Kolk, 2004), only sees the danger and directs the body to escape the danger via FFF. The frontal cortex, especially the medial Prefrontal Cortex goes offline during trauma. Bessel Van Der Kolk calls it the ‘watchtower’ which helps in making important decisions. The trauma is stored in a non linear, fragmented manner and doesn’t have a coherent narrative. So explaining what happened when it’s mostly the fragmented sights, sounds, smell etc of the traumatic event, is very difficult in a talk therapy session.
Sensorimotor Psychotherapy by Pat Ogden, Tapping acupressure points (EFT), Alpha/Theta training, Somatic Experiencing by Peter Levine, Neurofeedback, EMDR, are some of the techniques mentioned in the book, The Body keeps the Score, that are effective in resol
Reference: van der Kolk, B. A. (2014). The body keeps the score: Brain, mind, and body in the healing of trauma. Viking.