Finding Your Way Through Trauma: A Guide to Different Therapeutic Approaches

Why Different Approaches Exist

Trauma affects people in many ways. For some, it shows up in the body, as tension, exhaustion, or feeling “on edge.” For others, it shows up in thoughts, emotions, or relationships. Because trauma touches both body and mind, different therapies have developed to meet people where they are.

Some therapies work mainly “from the body up” (known as bottom up), helping the nervous
system calm, regulate, and find safety again. Others work “from the mind down” (known as
top down), helping us put words to what happened, make sense of it, and re-shape our beliefs.
Many approaches, including psychodynamic psychotherapy, do both.

There isn’t one “right” therapy for trauma. Sometimes one approach is what’s needed, and at other times a combination is most helpful. Healing can be a journey of trying different ways of working until something feels like a good fit.

Psychodynamic Psychotherapy: Making Sense of Trauma in
Depth

Psychodynamic psychotherapy is the approach I offer. It has been at the heart of talking therapy since the beginning and was one of the first to notice that trauma often lives on in the body and unconscious as much as in memory.

In this therapy, the whole of you is welcome, even the parts that feel hidden, confusing, or unacceptable. Here are some ways it helps:

Welcoming all parts of the self
Trauma often causes aspects of the self to split off. These parts might show up as strong feelings, as numbness, as bodily reactions, or even as distinct “voices” inside. In psychodynamic therapy, these parts are not pushed away. They are recognised, respected, and slowly brought into dialogue, so that you can feel more whole.
Thinking together about what feels unthinkable
Trauma can leave experiences that feel impossible to put into words. In therapy, we create a safe space to think about what has been overwhelming — not to force a story, but to make it bearable and meaningful.
Working with feelings as they appear in the room
The patterns and feelings from past trauma often show up in the therapy relationship. Rather than seeing this as a problem, we use it as an opportunity: together we notice what’s happening and open up new ways of responding.
Listening to the body and the unconscious
Dreams, slips of the tongue, sudden reactions, or unexplained body states often carry traces of trauma. In psychodynamic work, we pay attention to these signals — they are ways the mind and body communicate what has been hard to face directly.
Supporting lasting change
By working through these hidden, fragmented layers of experience, people often notice that change goes beyond symptom relief: relationships become safer, feelings more manageable, and life more connected.

This approach is especially valuable when trauma has been repeated, relational, or longstanding.

Other Ways of Working With Trauma

While psychodynamic therapy offers depth and integration, it is not the only path. Other therapies include:

Trauma-focused CBT and EMDR – structured methods for processing traumatic memories.
IFS (Internal Family Systems) – a structured “parts” model that also focuses on self-leadership.
Creative therapies – art, drama, and writing to express what can’t be voiced. I integrate therapeutic writing into trauma work when requested and appropriate.
Body-based approaches – yoga, tai chi, pilates, or somatic therapies to calm the nervous system.
Group therapy – connecting and healing in community.
Nature-based therapies – gardening and ecotherapy to find grounding and rhythm.

Many people find it helpful to combine approaches, for example, body practices alongside
psychodynamic talking therapy.

Choosing What’s Right for You

There is no single therapy that works for everyone. Trauma affects people in very different ways, and what feels helpful for one person may not be right for another. The way I work, psychodynamic psychotherapy, can be very powerful, but it isn’t the only approach, and it may not always be the best fit for what you need right now.

That’s OK. Choosing therapy is about finding the approach, and the therapist, that feels safe and useful for you. Sometimes that means trying different ways of working or combining therapies. Sometimes it means realising that one approach isn’t right for you at this stage, and that’s part of the process too.

If you find that my way of working doesn’t match what you are looking for, that doesn’t mean therapy isn’t for you, only that another form of help may suit you better. My hope is that this guide gives you a sense of what I offer and also introduces you to other approaches you might want to explore and try.

Footnote: Historical and Contemporary Context

Psychodynamic psychotherapy is not a fixed tradition but an evolving set of ideas and practices. While its roots lie in early psychoanalysis, the field has moved far beyond Freud’s time.

Much of this development has been led by women clinicians and researchers, who have emphasised the relational, embodied, and social dimensions of trauma. Judith Herman’s influential model of recovery, and the Tavistock approach shaped by Jo Stubley and colleagues, highlight the importance of safety, relationship, and the capacity to think about overwhelming experiences. Valerie Sinason draws attention to dissociation and the presence of split-off parts of the self, an area where psychodynamic therapy has long worked, welcoming all aspects of the self whether they appear as distinct “parts,” bodily states, or unconscious processes.

These perspectives align with newer insights from body-oriented approaches such as sensorimotor psychotherapy, which recognise how trauma is held in somatic states as well as in mind. Contemporary research supports the ongoing value of psychodynamic psychotherapy in working with complex trauma, and services such as the specialist Trauma Service at the Tavistock and Portman NHS Foundation Trust continue to draw on
psychoanalytic and psychodynamic practice as part of evidence-based care.

How I can help : Trauma Psychotherapy in Bromley

About me : Professional Background and Qualifications.

Contact me : Ask a question or Book an initial call.

References

Herman, J. L. (1992/2015). Trauma and Recovery: The Aftermath of Violence – From Domestic Abuse to Political Terror. Basic Books.

Ogden, P., Minton, K., & Pain, C. (2006). Trauma and the Body: A Sensorimotor Approach to Psychotherapy. W. W. Norton.

Paintain, E., & Cassidy, S. (2018). “First‐line therapy for post‐traumatic stress disorder: A systematic review of cognitive behavioural therapy and psychodynamic approaches.” Counselling and Psychotherapy Research, 18(3), 237–250.

Sinason, V. (1994). Mental Handicap and the Human Condition: New Approaches from the Tavistock. Free Association Books.

Smith, J., 2025. Psychotherapy integration from the bottom up: A unifying, science-based view of psychotherapy’s infrastructure. Journal of Psychotherapy Integration.

Spermon, D., Darlington, Y., & Gibney, P. (2010). “Psychodynamic psychotherapy for complex trauma: Targets, focus, applications, and outcomes.” Psychology Research and Behavior Management, 3, 119–127.

Stubley, J. (2010). “Attachment and trauma: Working relationally with survivors of extreme experiences.” In Relational Trauma: A Contemporary Introduction (Eds. P. Hughes & J. Baylin). Routledge.

Tavistock and Portman NHS Foundation Trust. (2021). Trauma Service. Retrieved from https://tavistockandportman.nhs.uk

Van Nieuwenhove, K., & Meganck, R. (2020). “Core interpersonal patterns in complex trauma and the process of change in psychodynamic therapy: A case comparison study.” Frontiers in Psychology, 11, 122.