Trauma-Therapy, a Challenge, How can people live with the imprints of their past and regain mastery of the present

Trauma by definition is unbearable and intolerable. Traumatic experiences may happen to people in a combat, accident, natural disaster, expulsion, torture or when human beings are emotionally or bodily abused in their childhood.Traumatic events leave traces in minds, emotions, and bodies of the afflicted persons. They are disturbed in their capacity to feel joy and intimacy and their bodies keep the score (Bessel van der Kolk 2016) as long as they do not get help.Trauma may lead to various psychological diseases (Depressions, Anxieties, Panic-Attacks, Dissociation, Personality –Disorders, Alcohol, and Drug- Abuse) and physiological diseases (Chronic Pain, Somatic Dissociation, and Somatization Disorders).Traumatized people lose their sense of themselves, their orientation in life. They feel helpless in managing themselves and their relationships to family members and persons of their social life are disturbed. They do not know the origin of their psychological and physical problems. Their life has got out of order and they believe, not to be worthy of belonging to the human society.Many feel themselves ashamed of their utter weakness and vulnerability and do not dare to seek for help, also because other people mightthink they are liars. Sometimes traumatized people have pushed out the terrible events out of their minds. However, long after the traumatic experience has happened fragments of the terrible event intrude insistently into the persons in form of flashbacks and nightmares. They experience sensory and bodily elements of the trauma without being able to make sense of their feeling and seeing. They start to suffer from Posttraumatic Disorder (PTSD).Neuroscience showed that trauma produces neurophysiological and neurochemical changes in the brain, including a recalibration of the brain s alarm–system, an increase in stress-hormone activity and alteration in the brain system which filters relevant information from irrelevant. The fight-, flight-, freeze- reactions of their nervous system can be reactivated by the slightest trigger from outside, and these persons need a high amount of energy to live from day to day.The increase in knowledge about the basic processes,which underlie trauma, has opened new therapeutic possibilities of treatment. There are fundamentally three avenues:1 Top-down-method by talking (re)connecting with others, allowing the traumatized person to know and understand what is going on with him, while processing the traumatic memories.2 Bottom-up-method by allowing the body to have new experiences which contradict the helplessness, rage or collapse due to the trauma.3 Taking medicine that shut down inappropriate alarm reactions or utilizing technologies, which change the brain s ways of information.Therapists should clarify the patient s most disturbing symptoms, his priorities, and treatment goals. Among the available options, intervention with the strongest supportive evidence should be given the priority. The overall therapeutic goal should be stabilizing the Patient´s life, reducing his self-destructive behavior, and addressing his pervasive loneliness and despair.