Mark Lewis

Relational Trauma Therapy

Therapeutic approaches with a relational focus

I use the term Relational Trauma Therapy for the longer term often multi-layered and complex trauma work that requires a blend of therapeutic approaches with a relational focus.

Of course, all effective trauma therapy should be relational to some degree. However I use this term for these specific reasons:

  1. Most complex trauma has occurred within the context of relationships, often through the developmental stages of childhood in relation to parents or other attachment figures.
  2. Trauma that has happened in the context of relationships inevitably affects how we function in relationships, our levels of connection, trust and emotional reactions.
  3. Trauma that has been caused in the context of relationships needs to be treated in a relationship context.
  4. Longer term trauma work provides a therapeutic relationship within which the effects of relational trauma can be identified, understood and gradually worked through.

The wide ranging effects of relational trauma can include:

Somatic issues including unresolved states of nervous system arousal, shutdown and freeze. There may be identifiable PTSD symptoms as well as a low tolerance for stress.

Emotional issues including emotional hyper-sensitivity and reactivity (triggering). There may be a lack of, or a disconnection from, aspects of emotional experience.

Cognitive issues including disabling thoughts, appraisals and beliefs about oneself, one’s history, others or the world in general.

Relating issues including difficulties with connection, merging, boundaries. In particular there may be difficulties with managing to be in touch with one’s own feelings and needs when in relationship and managing intimacy.

Dissociative issues including links to all of the above areas, manifesting as particular problems with feeling real and present as well as ‘joined up’ in how one experiences things.

Relational trauma can be understood and gradually worked through

By using Somatic Experiencing and adding aspects of psychodynamic and cognitive behavioural approaches, I aim to address these complex issues. The Somatic Experiencing supports releasing of traumatic stress and grounding in present reality.

The psychodynamic perspective allows for careful attention to relationship dynamics particularly as they manifest in sessions. This perspective also has a very good appreciation of developmental stages and attachment issues.

The cognitive behavioural elements brings ways of improving coping, working with avoidance and increasing emotional regulation.

See also my article ‘What is trauma?’ and the ‘Client self assessment form’ in Resources.