A Neurobiologically-Informed Approach for Fast Trauma Treatment
Trauma isn鈥檛 just remembered. It鈥檚 relived. Our clients don鈥檛 walk into our offices struggling to recall what happened. They walk in struggling to not feel it happening all over again. That鈥檚 because trauma lives in the body. And neuroscience shows us why.
When we experience threat, our instinctive brain takes over. The amygdala activates the fight-flight-freeze response and shuts down the prefrontal cortex. Thinking goes offline. Survival kicks in. And when the traumatic experience is over? The nervous system doesn鈥檛 just forget. It gets sensitized. It learns to expect danger, even when it鈥檚 no longer there.
That鈥檚 why trauma treatment must start with the body.
It鈥檚 Not Just About Remembering鈥擨t鈥檚 About Regulation
For years, we thought healing required talking about the trauma. Putting the story into words. But as trauma-expert Bessel van der Kolk and others discovered, trauma isn鈥檛 primarily stored in the verbal memory. It鈥檚 stored implicitly in the body, in sensations, and in impulses. Our clients may say 鈥渘othing happened,鈥 yet their nervous system tells another story. Their posture, reactivity, and emotional volatility say: 鈥淚鈥檝e been hurt.鈥
So we don鈥檛 begin by asking what happened. Especially not in the first session. Especially not when the prefrontal cortex is offline.
Instead, we begin by helping clients understand what鈥檚 happening in their nervous system. We teach them that their reactions (rage, collapse, panic, dissociation) are not flaws. They鈥檙e adaptations. Their nervous system has been trying to protect them.
Our first task isn鈥檛 to excavate the trauma. It鈥檚 to build a foundation. That means:
- Psychoeducation: Give clients a map of their nervous system.
- Mindfulness: Teach them to notice their sensations, not analyze them.
- Window of Tolerance: Help them expand their capacity to feel safely.
Every Symptom Has a Story鈥攁nd a Purpose
Whether a client cuts, binges, dissociates, or freezes, it鈥檚 not pathology. It鈥檚 protection. When we reframe symptoms as the nervous system鈥檚 way of finding relief or control, we shift the conversation from shame to compassion.
A client doesn鈥檛 self-harm because they want to suffer. They do it because, in that moment, it鈥檚 the only tool they have to regulate unbearable overwhelm. The goal isn鈥檛 to shame the behavior. It鈥檚 to expand their toolkit.
We ask: What was happening right before? What were you feeling in your body? What did your nervous system need in that moment? That鈥檚 where healing begins.
The Body Remembers鈥擲o We Work with the Body
Sensorimotor Psychotherapy and other body-centered approaches teach us that we can help clients regulate by working through the body. A sigh. A hand on the heart. Lengthening the spine. These small interventions can re-engage the prefrontal cortex and restore access to choice.
Trauma survivors often lose their sense of agency. We help them reclaim it鈥攏ot by forcing them to 鈥済o there,鈥 but by giving them permission not to. We say: You didn鈥檛 have a choice then. You do now.
Healing Doesn鈥檛 Require a Complete History
One of the most powerful realizations I鈥檝e had is this: our clients don鈥檛 need to remember everything to recover. They need to change their relationship to the past. They need to become less afraid of the feelings and sensations that arise. Resolution lives in how the body holds it today.
That鈥檚 why I often work with implicit memories through the lens of parts, especially child parts. We help clients identify: Who in me feels this fear? Who in me still believes they鈥檙e unsafe? And we bring those parts into relationship with curiosity, compassion, and co-regulation.
The Nervous System Is Not Broken鈥擨t鈥檚 Brilliant
What I tell clients again and again is this: There鈥檚 nothing wrong with you. You have a nervous system that adapted to survive. That鈥檚 not a disorder. That鈥檚 brilliance.
Our job isn鈥檛 to fix our clients. It鈥檚 to help them reclaim their power. To recognize their symptoms as survival strategies. And to offer new ways of regulating that are grounded in present-day safety.
When we do this, we don鈥檛 just reduce symptoms. We help people feel whole.
Learn foundational body-based techniques, including somatic experiencing skills, breathwork, movement, polyvagal, Hakomi, neurobiological & more techniques.
Janina Fisher, PhD, is a licensed clinical psychologist and former instructor at The Trauma Center, a research and treatment center founded by Bessel van der Kolk. Known as an expert on the treatment of trauma, Dr. Fisher has also been treating individuals, couples, and families since 1980.
She is past president of the New England Society for the Treatment of Trauma and Dissociation, an EMDR International Association Credit Provider, Assistant Educational Director of the Sensorimotor Psychotherapy Institute, and a former Instructor, at Harvard Medical School. Dr. Fisher lectures and teaches nationally and internationally on topics related to the integration of the neurobiological research and newer trauma treatment paradigms into traditional therapeutic modalities.
She is co-author with Pat Ogden of Sensorimotor Psychotherapy: Interventions for Attachment and Trauma (2015) and author of Healing the Fragmented Selves of Trauma Survivors: Overcoming Internal Self-Alienation (2017) and the forthcoming book, Working with the Neurobiological Legacy of Trauma (in press).
Speaker Disclosures:
Financial: Dr. Janina Fisher is an international expert and consultant on Trauma and Dissociation. She is a consultant for Khiron House Clinics and the Massachusetts Department of MH Restraint and Seclusion Initiative. Dr. Fisher receives royalties as a published author. She receives a speaking honorarium, recording royalties and book royalties from Psychotherapy Networker and 小蝌蚪视频. Dr. Fisher has no relevant financial relationships with ineligible organizations.
Non-financial: Dr. Janina Fisher is on the advisory board for the Trauma Research Foundation. She is a patron of the Bowlby Center.
