When talking isn’t enough


A bottom up approach in healing from trauma

In most approaches to psychotherapy, the working premise is using a “top-down” approach.  In other words, a change in the client’s thinking, either through insight, exposure or cognitive restructuring, in conjunction with remembering or re-experiencing the traumatic event, will help to bring about healing of emotions, behaviour and physical symptoms. This approach is necessary and effective in helping many clients with therapeutic tasks, but is it enough for dealing with trauma?

MacLean (1985) has proposed that the brain is a brain with a brain.  To explain, the first brain to develop in a human infant is the reptilian brain (brain stem and cerebellum). This brain governs arousal, homeostasis, reproductive drives, sensation and instinctual movement impulses, the very heart of all sensorimotor experiences.  The second brain to develop is the limbic brain which serves to regulate somatosensory experience, emotion, memory, some social behaviour, and learning.  The last brain to develop is the neocortex, which enables cognitive information processing, self-awareness, executive functioning, and conceptual thinking (MacLean, 1985)

Traumatised people suffer from dysregulated autonomic arousal, which generates strong waves of body sensations and affects, which are interpreted by the cognitive brain as threat, exposure, or helplessness.  Traumatic memories largely consist of this reactivated nonverbal and habitual procedural responses with limited explitic memory components

In our culture and society we are told to talk about and retell the story for healing to occur.

When unresolved trauma is concerned, when we re-tell the story, often again and again, our nervous system is overwhelmed and our brain and physiology respond to these past events as if they were still current, because they ARE still present and held in our body.  So if there is an increase in heart rate, the message received by the neocortex may be that “I am not safe,” making physical sensation and emotion to intensify, creating further arousal to overwhelm the person’s integrative capacity. Top down regulation is temporarily lost, leaving the person at the mercy of “bottom-up hijacking” as it were.


Neurogenic tremors occurring during TRE, are automatic and are regulated by the reptilian brain.  During TRE, the client attends exclusively to physical sensations without attributing meaning or connecting emotion to it.  With the support of a facilitator who creates a safe place to discharge the arousal, physiological responses diminish and settle.  As the emotions become calm, the self-awareness and cognitive information is processed in the neocortex, enabling meaning transfer to occur from the body to the brain. 

Our TRE programme are not specifically for traumatised people, instead we focus more on stress and stress-related symptoms. This is because many people do not believe or have forgotten that they have suffered trauma. However, they frequently present with stress-related physical symptoms, as well as anxiety, fear, and sleep difficulties to name the most common ones. 

During TRE, trauma is often resolved without a conscious memory of the incident

During a TRE session with a client, she felt a wave of tremors moving up her body, followed by an intense emotion of sadness, where she wanted to cry.  The tremor was experienced again, with a less intense emotion, and then a third time, with just a slight feeling of sadness.  No explicit memory came up.  The client reported a week later that her anxiety had reduced completely, and that she felt more calm and grounded within herself.  

When a memory surfaces during tremoring

During a TRE programme with refugees, a man reported that while he was tremoring, a memory came up which he had long suppressed and forgotten. (He indicated that he suffers from sleep problems, anxiety, worry and irritable bowel syndrome).   He saw himself loading partially decomposed and dead bodies onto a truck while serving as a soldier during the war in Zimbabwe .  He spoke about this incident afterwards without any adverse bodily or emotional reactions.  As the hyperarousal of the limbic brain was reduced, his neocortex could process the memory, allowing integration and healing to occur.

If you are interested in doing TRE, we will do an assessment to find out if you are a good candidate for online TRE. It is recommended that those suffering with severe PTSD symptoms would be better with in person treatment.

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