Hey everyone, so today's audio is the penultimate audio in the trauma series and it's going to be focused on treatment options for trauma and PTSD. We've spoken already at length about how trauma and PTSD can manifest, how it might affect one's life and ways in which to notice that and also to try to regulate the sort of more negative symptoms associated with it.

I want to start by saying, really, that trauma is absolutely treatable and I think one has to be understandably wary and cautious, but with an experienced therapist who's well versed in their treatment modalities, then there's no reason why you shouldn't be able to… in fact, I'm of the view that almost everyone can process.

And the only reason that they might struggle to within therapy is because they have numerous protective parts which are seeking to stand in the way of that. And it's really a case of whether the client and the therapist can navigate their way through that. Typically though, certainly here in the UK, I need to bear in mind, obviously, that our audience is wider than that, but here in the UK the NICE guideline recommended approaches for treating trauma are generally cognitive behavioural therapy - trauma focused, and EMDR therapy: eye movement desensitization, reprocessing therapy.

There are other modalities, certainly I like to use internal family systems therapy as well in conjunction with those two models and there are various other things that other practitioners use but those are not current UK NICE guideline recommended approaches. So trauma focused therapy, trauma focused CBT therapy, should I say, is more of a narrative based approach where the client and the therapist would work together perhaps to develop a script of the event and the therapist would look to work with what we call hotspots in the traumatic event.

These are the parts that are generally where that person experiences got more extreme fluctuations of emotions. Maybe there's some sketchy, memory related to that part of the memory. And what the therapist would be looking to do with the client is to update those hotspots over time, getting the client to listen to a recording of them talking about the event, or just the client reading a script of that event.

There are different and incantations and ways of doing that. Personally I found it to be very effective, its particularly good for single index trauma or where a client often dissociates in the room, doing this kind of approach can be really helpful.

The figures actually for treating single index trauma are very positive. I think the CBT and EMDR figures are, for a single incident trauma, is an 80 to 85 percent likelihood of successful treatment, which is higher than any other anxiety disorder. So I'll often say that, yeah, give me a PTSD case any day of the week over other anxiety disorders, because not only is the change more extreme so it's more positive outcomes, but yeah, there's, there's a higher efficacy rate as well.

And this is a personal preference and I know other clinicians might take trauma focused CBT as their primary focus. I like to use EMDR therapy, where the therapist seeks to stimulate what we call bilateral stimulation. That's a dialogue between the left and right brain, and we might do that through eye movements, or tapping, or use of buzzers, sending a vibration up to the brain.

It's not as dramatic as it sounds, by the way. And that is very effective in treating trauma it taps into the memory and the client literally process the, hopefully anyway, processes the event right there in the room. Both of those approaches do require some degree of reliving the event.

Obviously that can sound really scary to somebody. But hopefully the therapist will do a really good job of reassuring you that it's really a case of just creating a safe space. Creating a feeling of it being safe enough to remember, is the term I generally tend to use. Now, again, I can only speak for the UK, but there are various ways of accessing this type of treatment.

And much really depends on the volume of trauma. Are we talking a single incident, are we talking a cluster of incidents, or are we talking a lifetime of trauma? If it's the latter, then sometimes that can create problems for the client, not only in terms of how symptoms manifest so we're talking more of the complex end of CPTSD here.

And that might mean that they could potentially fall between the gaps of secondary and primary care mental health services, which is very difficult for that person involved. And there's, that's a real grey area in the UK, really. And I'd really love to see... more specific specialized trauma centers being funded by the NHS in order to pick up this and help this client group. It's very important in my mind and it's a lot of the work I do privately here in my practice.

But if it's in the other two clusters, say maybe a handful of traumas or a single incident trauma, absolutely do try to get treatment via your GP who can make a referral to primary care mental health services locally or you can self refer as well. And yeah there.

I just want to just reiterate really that there is absolutely something you can do about this and it's, I guess like anything, you've got to want to do it, even if it seems scary. Nobody really tends to do that well in therapy if they're just told to go to therapy. It has to be a decision you come to yourself.