The Trauma Lineage
The tradition that cuts across all other traditions — because trauma does too
Clinical and evidence statements in this lineage remain under review. The source checks below apply only to their stated treatment, population and outcome.
Guideline sources for approaches in this lineage
EMDR
Guidelines and official sources (7)
7 clinical guideline checks
Read the recommendation and its scope. A source may discuss an approach without recommending it.
- Clinical Practice Guideline for Management of PTSD and Acute Stress Disorder
Recommendation for the stated population
EMDR is explicitly strongly recommended.
Scope: Adults with PTSD
- Post-traumatic stress disorder (NG116)
Recommendation for the stated population
For adults, NICE considers EMDR at 1–3 months if preferred and offers it after 3 months for non-combat trauma. This scope is not a contraindication for combat trauma.
Scope: Adults after non-combat trauma; separate restricted option for ages 7–17
- Clinical Practice Guideline for the Treatment of Posttraumatic Stress Disorder in Adults
Recommendation for the stated population
APA conditionally recommends EMDR as a second-line adult PTSD treatment compared with no intervention or treatment as usual.
Scope: Adults with PTSD; comparison with no intervention or treatment as usual
- Clinical Practice Guideline for Management of PTSD and Acute Stress Disorder
Discussed in the source
VA/DoD suggests co-occurring disorders should not preclude these PTSD treatments. This addresses access to treatment, not a separate claim of treating substance use.
Scope: PTSD with co-occurring substance-use disorder or other disorders; therapies named in recommendations 8 and 9.
- Clinical Practice Guideline for the Treatment of Posttraumatic Stress Disorder in Adults
Insufficient evidence for or against
APA finds insufficient evidence to prefer EMDR over those comparators. Its recommendation versus no treatment or usual care does not establish superiority over active therapy.
Scope: Adults with PTSD; EMDR versus the other active psychological treatments listed in the table.
- Mental Health Gap Action Programme (mhGAP) guideline for mental, neurological and substance use disorders
Recommendation for the stated population
WHO includes EMDR in a conditional recommendation. The 2023 guideline book rates certainty as low, while WHO’s web summary reports moderate quality; that discrepancy remains unresolved. Delivery requires appropriate training and supervision.
Scope: Adults with PTSD, within the mhGAP non-specialist-care context.
- Mental Health Gap Action Programme (mhGAP) guideline for mental, neurological and substance use disorders
Recommendation for the stated population
WHO includes EMDR in a strong recommendation based on moderate-certainty evidence. Clinicians need relevant training and demonstrated competence; lay providers require comprehensive training and close supervision.
Scope: Children and adolescents with PTSD.
Prolonged Exposure
Guidelines and official sources (7)
6 clinical guideline checks · 1 professional reference check
Read the recommendation and its scope. A source may discuss an approach without recommending it.
- Clinical Practice Guideline for Management of PTSD and Acute Stress Disorder
Recommendation for the stated population
PE is one of three specifically named strongly recommended trauma-focused psychotherapies.
Scope: Adults with PTSD
- Post-traumatic stress disorder (NG116)
Recommendation for the stated population
NICE explicitly includes PE among trauma-focused CBT interventions.
Scope: Adults with clinically important PTSD symptoms; timing and diagnosis determine the recommendation
- Clinical Practice Guideline for the Treatment of Posttraumatic Stress Disorder in Adults
Recommendation for the stated population
APA strongly recommends PE as a first-line adult PTSD treatment compared with no intervention or treatment as usual.
Scope: Adults with PTSD; comparison with no intervention or treatment as usual
- Clinical Practice Guideline for Management of PTSD and Acute Stress Disorder
Discussed in the source
VA/DoD suggests co-occurring disorders should not preclude these PTSD treatments. This addresses access to treatment, not a separate claim of treating substance use.
Scope: PTSD with co-occurring substance-use disorder or other disorders; therapies named in recommendations 8 and 9.
- Clinical Practice Guideline for the Treatment of Posttraumatic Stress Disorder in Adults
Insufficient evidence for or against
APA finds insufficient evidence to prefer PE over those comparators. Its recommendation versus no treatment or usual care does not establish superiority over active therapy.
Scope: Adults with PTSD; PE versus the other active psychological treatments listed in the table.
- Clinical Practice Guideline for the Treatment of Posttraumatic Stress Disorder in Adults
Recommendation for the stated population
APA strongly recommends this combination; the table includes PE plus usual care and the COPE protocol.
Scope: Adults with PTSD and co-occurring SUD; PE-based treatment plus usual SUD care versus usual SUD care alone.
- mhGAP evidence profile STR1/STR2: PTSD psychological interventions
Discussed in the source
The WHO evidence review includes PE within individual trauma-focused CBT. The clinical recommendation is for that class, not a separately graded PE recommendation.
Scope: Adults with PTSD
CPT
Guidelines and official sources (5)
4 clinical guideline checks · 1 professional reference check
Read the recommendation and its scope. A source may discuss an approach without recommending it.
- Clinical Practice Guideline for Management of PTSD and Acute Stress Disorder
Recommendation for the stated population
CPT is explicitly strongly recommended.
Scope: Adults with PTSD
- Clinical Practice Guideline for the Treatment of Posttraumatic Stress Disorder in Adults
Recommendation for the stated population
APA strongly recommends CPT as a first-line adult PTSD treatment compared with no intervention or treatment as usual.
Scope: Adults with PTSD; comparison with no intervention or treatment as usual
- Clinical Practice Guideline for Management of PTSD and Acute Stress Disorder
Discussed in the source
VA/DoD suggests co-occurring disorders should not preclude these PTSD treatments. This addresses access to treatment, not a separate claim of treating substance use.
Scope: PTSD with co-occurring substance-use disorder or other disorders; therapies named in recommendations 8 and 9.
- Clinical Practice Guideline for the Management and Rehabilitation of Post-Acute Mild Traumatic Brain Injury
Discussed in the source
The guideline discusses CPT versus SMART-CPT while directing treatment of co-occurring behavioral disorders to their relevant guidelines. It does not make a new CPT recommendation for mTBI itself.
Scope: Co-occurring PTSD in people with a history of mild-to-moderate traumatic brain injury.
- mhGAP evidence profile STR1/STR2: PTSD psychological interventions
Discussed in the source
The evidence profile includes CPT within individual trauma-focused CBT. STR1 recommends that category conditionally; this is not a separately graded recommendation for CPT.
Scope: Adults with PTSD.
Somatic Experiencing
Guidelines and official sources (2)
2 clinical guideline checks
Read the recommendation and its scope. A source may discuss an approach without recommending it.
- Clinical Practice Guideline for Management of PTSD and Acute Stress Disorder
Insufficient evidence for or against
VA/DoD finds insufficient evidence for or against somatic experiencing for PTSD.
Scope: Adults with PTSD
- Clinical Practice Guideline for the Treatment of Posttraumatic Stress Disorder in Adults
Insufficient evidence for or against
APA finds insufficient evidence to recommend for or against somatic experiencing for adult PTSD.
Scope: Somatic experiencing for adults with PTSD
Sensorimotor Psychotherapy
Guidelines and official sources (1)
1 clinical guideline check
Read the recommendation and its scope. A source may discuss an approach without recommending it.
- Guidelines for Treating Dissociative Identity Disorder in Adults, Third Revision
Discussed in the source
The guideline includes a named discussion of sensorimotor psychotherapy. It offers expert practice guidance without a separate evidence grade or a general recommendation for PTSD.
Scope: Sensorimotor work within phase-oriented treatment for adults with dissociative identity disorder.
Narrative Exposure Therapy
Guidelines and official sources (5)
3 clinical guideline checks · 2 professional reference checks
Read the recommendation and its scope. A source may discuss an approach without recommending it.
- Evidence summary: psychological treatments for PTSD in adults
Recommendation for the stated population
ISTSS gives NET a Standard recommendation, distinct from its Strong category.
Scope: Adults with PTSD
- Clinical Practice Guideline for the Treatment of Posttraumatic Stress Disorder in Adults
Recommendation for the stated population
APA conditionally recommends NET as a second-line adult PTSD treatment.
Scope: NET for adults with PTSD compared with no intervention or treatment as usual
- Clinical Practice Guideline for Management of PTSD and Acute Stress Disorder
Insufficient evidence for or against
VA/DoD finds insufficient evidence for or against NET for PTSD. This assessment does not determine its status for other conditions.
Scope: Individual psychotherapy for adults with PTSD.
- mhGAP evidence profile STR1/STR2: PTSD psychological interventions
Discussed in the source
NET is included in the trauma-focused CBT evidence grouping. This does not establish a separate WHO conflict-settings recommendation.
Scope: Adults with PTSD
- mhGAP evidence profile STR1/STR2: PTSD psychological interventions
Discussed in the source
The evidence profile includes kidNET in individual trauma-focused CBT. The strong STR2 recommendation concerns the treatment category, rather than a separate rating for kidNET or adult NET.
Scope: Children and adolescents with PTSD; the review includes kidNET.
Attachment-Focused EMDR
Guidelines and official sources (1)
1 clinical guideline check
Read the recommendation and its scope. A source may discuss an approach without recommending it.
- Post-traumatic stress disorder (NG116)
Discussed in the source
The recommendation specifies EMDR delivered using a validated manual. It does not name attachment-focused EMDR or validate automatic transfer to this adaptation.
Scope: EMDR for adult PTSD after non-combat trauma; validated manual required
Trauma-Sensitive Yoga
Guidelines and official sources (5)
5 clinical guideline checks
Read the recommendation and its scope. A source may discuss an approach without recommending it.
- Clinical Practice Guideline for Management of PTSD and Acute Stress Disorder
Discussed in the source
VA/DoD finds insufficient evidence for or against yoga. This broad category does not separately grade a specific trauma-sensitive-yoga protocol.
Scope: Yoga as an intervention for adult PTSD
- Clinical Practice Guideline for the Treatment of Posttraumatic Stress Disorder in Adults
Insufficient evidence for or against
APA explicitly lists group trauma-sensitive yoga and finds insufficient evidence to recommend for or against it.
Scope: Group trauma-sensitive yoga for adults with PTSD
- Management of Major Depressive Disorder
Discussed in the source
VA/DoD suggests adjunctive exercise, including yoga as an example (weak for). It does not name or separately recommend trauma-sensitive yoga.
Scope: Adults with MDD; exercise as adjunctive care.
- Management of First-Episode Psychosis and Schizophrenia
Discussed in the source
VA/DoD suggests yoga alongside other evidence-based treatments (weak for). It does not name or separately endorse trauma-sensitive yoga.
Scope: Adults with schizophrenia; positive and negative symptoms.
- Management of Type 2 Diabetes Mellitus
Discussed in the source
VA/DoD finds insufficient evidence for or against yoga for this population and outcome. It does not separately assess the trauma-sensitive yoga protocol.
Scope: Adults with type 2 diabetes and diabetes distress.
Written Exposure Therapy
Guidelines and official sources (5)
4 clinical guideline checks · 1 professional reference check
Read the recommendation and its scope. A source may discuss an approach without recommending it.
- Clinical Practice Guideline for Management of PTSD and Acute Stress Disorder
Recommendation for the stated population
VA/DoD suggests WET with a weak recommendation. The recommendation does not independently validate numerical outcome claims.
Scope: Adults with PTSD; individual, manualized Written Exposure Therapy.
- Clinical Practice Guideline for Management of PTSD and Acute Stress Disorder
Discussed in the source
VA/DoD suggests co-occurring disorders should not preclude these PTSD treatments. This addresses access to treatment, not a separate claim of treating substance use.
Scope: PTSD with co-occurring substance-use disorder or other disorders; therapies named in recommendations 8 and 9.
- Clinical Practice Guideline for the Treatment of Posttraumatic Stress Disorder in Adults
Insufficient evidence for or against
APA finds insufficient evidence for this efficacy comparison. Its separate comparisons with active treatments reach a different evidentiary finding.
Scope: Adults with PTSD; WET versus waitlist or usual care.
- Clinical Practice Guideline for the Treatment of Posttraumatic Stress Disorder in Adults
Discussed in the source
APA reports no difference in effect and makes no recommendation between these treatments. This is distinct from the insufficient-evidence finding versus waitlist or usual care.
Scope: Adults with PTSD; WET versus CPT, CPT with account, or PE.
- mhGAP evidence profile STR1/STR2: PTSD psychological interventions
Discussed in the source
The evidence profile includes written exposure therapy within individual trauma-focused CBT. STR1 recommends that category conditionally; this is not a separately graded recommendation for written exposure therapy.
Scope: Adults with PTSD.
Seeking Safety
Guidelines and official sources (3)
3 clinical guideline checks
Read the recommendation and its scope. A source may discuss an approach without recommending it.
- Clinical Practice Guideline for Management of PTSD and Acute Stress Disorder
Insufficient evidence for or against
VA/DoD finds the evidence insufficient for a recommendation for or against this treatment.
Scope: Seeking Safety for adult PTSD treatment.
- Clinical Practice Guideline for the Treatment of Posttraumatic Stress Disorder in Adults
Discussed in the source
APA reports no difference in effect on PTSD symptoms or substance use and makes no recommendation for or against these comparisons.
Scope: Adults with PTSD and co-occurring SUD; Seeking Safety, with or without usual care, compared with usual SUD care.
- Clinical Practice Guideline for the Treatment of Posttraumatic Stress Disorder in Adults
Insufficient evidence for or against
APA finds insufficient evidence to prefer either side of these active-treatment comparisons.
Scope: Adults with PTSD and co-occurring SUD; Seeking Safety compared with COPE or Creating Change in the reviewed care arrangements.
STAIR
Guidelines and official sources (1)
1 clinical guideline check
Read the recommendation and its scope. A source may discuss an approach without recommending it.
- Clinical Practice Guideline for Management of PTSD and Acute Stress Disorder
Insufficient evidence for or against
VA/DoD finds the evidence insufficient for a recommendation for or against STAIR. This is not a positive recommendation for complex PTSD.
Scope: STAIR for adult PTSD treatment.
Safety Planning
Guidelines and official sources (4)
3 clinical guideline checks · 1 professional reference check
Read the recommendation and its scope. A source may discuss an approach without recommending it.
- Assessment and Management of Patients at Risk for Suicide
Insufficient evidence for or against
Recommendation 7 is neutral because evidence is insufficient for this outcome. The guideline also incorporates safety planning in routine care; these statements need to be read together. No Safety Planning Intervention studies and one crisis-response-planning trial met this review’s inclusion criteria; this is not a statement that no SPI research exists.
Scope: Reducing attempts in adults aged 18 and over with recent suicidal ideation and/or a lifetime attempt history.
- Study Evaluates Prevalence of Four Recommended Practices for Suicide Prevention
Discussed in the source
The Joint Commission article describes formal safety planning as expert-recommended practice and distinguishes it from explicit National Patient Safety Goal requirements.
Scope: Hospital suicide-prevention and discharge practices.
- Mental Health Gap Action Programme (mhGAP) guideline for mental, neurological and substance use disorders
Recommendation for the stated population
WHO conditionally supports considering safety-planning-type interventions that include several components or follow-up/support, with very low-certainty evidence. It found insufficient evidence to recommend safety planning as a stand-alone intervention.
Scope: People with thoughts or plans of self-harm in the past month, or acts of self-harm in the past year.
- Self-harm: assessment, management and preventing recurrence (NG225)
Recommendation for the stated population
NICE says to consider a plan with the person. This practice recommendation draws on committee experience and supporting qualitative/component evidence; it does not independently prove that a standalone plan prevents attempts.
Scope: Collaborative safety planning as part of care for people who have self-harmed.
CAMS
Guidelines and official sources (2)
1 clinical guideline check · 1 professional reference check
Read the recommendation and its scope. A source may discuss an approach without recommending it.
- Assessment and Management of Patients at Risk for Suicide
Insufficient evidence for or against
The 2024 guideline finds insufficient evidence for or against CAMS for reducing suicidal ideation. Inclusion in the guideline is not a positive recommendation. The guideline describes a small pooled ideation benefit versus alternative interventions but no statistically clear benefit in military/Veteran samples, with limitations in study quality and delivery.
Scope: Adults aged 18 and over at risk of suicide; CAMS for reducing suicidal ideation.
- Treatment for Suicidal Ideation, Self-Harm, and Suicide Attempts Among Youth
Discussed in the source
SAMHSA describes CAMS but distinguishes assessment-tool validation from youth treatment efficacy. Its dated evidence statement should not be read as a current review of all youth trials.
Scope: Youth assessment and suicide-focused care; source published in 2020.
Accelerated Resolution Therapy
Guidelines and official sources (1)
1 clinical guideline check
Read the recommendation and its scope. A source may discuss an approach without recommending it.
- Clinical Practice Guideline for Management of PTSD and Acute Stress Disorder
Insufficient evidence for or against
VA/DoD finds insufficient evidence for a recommendation for or against ART. Emerging is not the recommendation’s strength label.
Scope: Accelerated Resolution Therapy for adult PTSD treatment.
Adaptive Disclosure
Guidelines and official sources (1)
1 clinical guideline check
Read the recommendation and its scope. A source may discuss an approach without recommending it.
- Clinical Practice Guideline for Management of PTSD and Acute Stress Disorder
Insufficient evidence for or against
Adaptive Disclosure is explicitly listed among therapies with insufficient evidence for or against their use for PTSD. It is not absent from the guideline.
Scope: Adaptive Disclosure for adults with PTSD.
Structural Dissociation
Guidelines and official sources (1)
1 clinical guideline check
Read the recommendation and its scope. A source may discuss an approach without recommending it.
- Guidelines for Treating Dissociative Identity Disorder in Adults, Third Revision
Discussed in the source
Structural dissociation is discussed as one etiological model. This does not make it a separately recommended treatment or the sole basis of the guideline.
Scope: Conceptual models of adult dissociative identity disorder.
TF-CBT
Guidelines and official sources (4)
2 clinical guideline checks · 2 professional reference checks
Read the recommendation and its scope. A source may discuss an approach without recommending it.
- Post-traumatic stress disorder (NG116)
Discussed in the source
NICE offers individual trauma-focused CBT to ages 7–17 after 3 months and considers it for other specified child groups. The umbrella wording does not independently name every branded protocol.
Scope: Ages 5–17 with PTSD or clinically important symptoms; age and time since trauma matter
- Clinical Practice Guideline for the Treatment of Posttraumatic Stress Disorder in Adults
Discussed in the source
APA recommends the trauma-focused CBT family for adults. Footnote 4 explicitly defines a broad grouping, not a specific therapy; this does not establish a child Cohen TF-CBT recommendation.
Scope: Adults with PTSD; comparison with no intervention or treatment as usual
- Trauma-focused cognitive behavioral therapy: NCTSN resource listing
Discussed in the source
SAMHSA lists the NCTSN TF-CBT resource. A resource listing is not a graded CPG recommendation.
Scope: TF-CBT information for children/adolescents and caregivers
- mhGAP evidence profile STR1/STR2: PTSD psychological interventions
Discussed in the source
The review includes trauma-focused CBT for children and caregivers in a broader trauma-focused CBT category. WHO explicitly distinguishes that broad label from the specific Cohen protocol; STR2 does not separately grade the named protocol.
Scope: Children and adolescents with PTSD.
Imagery Rehearsal Therapy
Guidelines and official sources (3)
2 clinical guideline checks · 1 professional reference check
Read the recommendation and its scope. A source may discuss an approach without recommending it.
- Clinical Practice Guideline for Management of PTSD and Acute Stress Disorder
Insufficient evidence for or against
VA/DoD finds insufficient evidence for or against IRT for nightmares associated with PTSD.
Scope: Nightmares associated with PTSD
- Position paper for the treatment of nightmare disorder in adults
Recommendation for the stated population
AASM recommends IRT for these nightmare presentations. It calls this a position paper, not a graded CPG.
Scope: Adults with nightmare disorder or PTSD-associated nightmares
- Clinical Practice Guideline for the Treatment of Posttraumatic Stress Disorder in Adults
Insufficient evidence for or against
APA finds insufficient evidence for or against IRT for adult PTSD relative to no intervention or treatment as usual. This is a different scope from AASM’s nightmare-specific position.
Scope: IRT for adults with PTSD compared with no intervention or treatment as usual
Neurofeedback
Guidelines and official sources (3)
3 clinical guideline checks
Read the recommendation and its scope. A source may discuss an approach without recommending it.
- Clinical Practice Guideline for Management of PTSD and Acute Stress Disorder
Insufficient evidence for or against
VA/DoD finds insufficient evidence for or against neurofeedback for PTSD.
Scope: Adults with PTSD
- Clinical Practice Guideline for the Treatment of Posttraumatic Stress Disorder in Adults
Insufficient evidence for or against
APA finds insufficient evidence for or against neurofeedback for adult PTSD relative to no intervention or treatment as usual.
Scope: Neurofeedback for adults with PTSD compared with no intervention or treatment as usual
- Clinical Practice Guideline for the Non-Surgical Management of Hip and Knee Osteoarthritis
Insufficient evidence for or against
VA/DoD finds insufficient evidence for or against neurofeedback in this population. This does not establish its status for other conditions.
Scope: Treatment of hip or knee osteoarthritis.
Child-Parent Psychotherapy
Guidelines and official sources (2)
1 clinical guideline check · 1 evidence registry check
Read the recommendation and its scope. A source may discuss an approach without recommending it.
- Child-Parent Psychotherapy: program ratings
Not a treatment recommendation
CEBC rates CPP 1 for infant and early-childhood mental health, and 2 for child/adolescent trauma and domestic-violence services. These are topic-specific registry ratings, not clinical guideline recommendations.
Scope: Children aged 0–5 who have experienced trauma and their caregivers.
- Children’s attachment (NG26)
Discussed in the source
NICE says to consider parent–child psychotherapy based on the Cicchetti and Toth model. This specified model should not be assumed equivalent to every intervention called CPP.
Scope: Preschool attachment difficulties where parents have maltreated or are at risk of maltreating their child; safeguarding concerns must be addressed.
DBT
Guidelines and official sources (9)
8 clinical guideline checks · 1 evidence registry check
Read the recommendation and its scope. A source may discuss an approach without recommending it.
- Borderline personality disorder: recognition and management (CG78)
Recommendation for the stated population
NICE says to consider a comprehensive DBT programme for this specified population. This does not establish a recommendation for every personality disorder or every presentation.
Scope: Women with BPD for whom reducing recurrent self-harm is a priority.
- Assessment and Management of Patients at Risk for Suicide
Insufficient evidence for or against
The 2024 guideline finds insufficient evidence for or against DBT for these outcomes. This recommendation is separate from NICE’s BPD recommendation.
Scope: Adults aged 18 and over at risk of suicide; DBT for reducing suicidal ideation, suicide attempts or suicide.
- Psychotherapie bij persoonlijkheidsstoornissen
Recommendation for the stated population
DBT is named among recommended specialist BPD treatments.
Scope: BPD; treatment delivered as described and studied
- Dialectical behavior therapy for BPD
Discussed in the source
The archive lists Strong under 1998 criteria, with 2015 re-evaluation pending; this is an evidence listing.
Scope: DBT for BPD
- Self-harm: assessment, management and preventing recurrence (NG225)
Discussed in the source
NICE says to consider the adolescent adaptation, DBT-A, for this specified self-harm population. This does not grade every DBT programme or suicide-related outcome.
Scope: Children and young people with significant emotional dysregulation and frequent self-harm
- Clinical Practice Guideline for Management of PTSD and Acute Stress Disorder
Insufficient evidence for or against
VA/DoD finds insufficient evidence for or against DBT for PTSD. This assessment does not determine its status for other conditions.
Scope: Individual psychotherapy for adults with PTSD.
- Clinical Practice Guideline for the Treatment of Posttraumatic Stress Disorder in Adults
Insufficient evidence for or against
APA finds insufficient evidence to recommend one of these treatment arrangements over the other. This does not assess DBT for BPD.
Scope: Adults with PTSD; DBT plus PE versus DBT alone.
- Mental Health Gap Action Programme (mhGAP) guideline for mental, neurological and substance use disorders
Discussed in the source
DBT is named in the reviewed third-wave therapy category. WHO recommends that category alongside other structured therapies; it does not give DBT a separate recommendation or separate certainty rating here.
Scope: Adults with moderate-to-severe depression, within the mhGAP non-specialist-care context.
- Mental Health Gap Action Programme (mhGAP) guideline for mental, neurological and substance use disorders
Discussed in the source
WHO conditionally supports digital interventions based on approaches including DBT, with low-certainty evidence. This is not a recommendation for every full DBT program, and the reviewed trials did not establish benefit for attempts or deaths and were underpowered for those outcomes.
Scope: Digital support for people with suicidal thoughts.
Trauma is not a single therapeutic tradition — it is a phenomenon that forced every tradition to adapt. What makes this lineage unique is that it draws from psychoanalysis, behaviorism, neuroscience, somatic therapy, and dissociation research simultaneously. Pierre Janet described dissociation and traumatic memory in the 1880s. Freud initially agreed, then retreated to fantasy. The field forgot trauma for decades. Vietnam veterans, the feminist movement, and disaster research brought it back. The diagnosis of PTSD in 1980 created a clinical category; the treatments that followed — Prolonged Exposure, CPT, EMDR, Somatic Experiencing, Sensorimotor Psychotherapy — draw from different parent traditions but converge on the same clinical reality: what happens when experience overwhelms the capacity to integrate it.
Full Contents
Read all 17 entries as a single page
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Pierre Janet
The true founder of traumatology — before Freud, and more accurate than Freud. Janet described dissociation, traumatic memory, and the phase-oriented treatment of trauma (stabilization → trauma processing → integration) in the 1880s-90s. His work was forgotten for nearly a century.
Concepts: Dissociation · Traumatic memory vs. narrative memory · Fixed ideas (idées fixes) · Mental energy / mental efficiency · Phase-oriented treatment · Subconscious acts
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Freud's Retreat
Freud initially agreed with Janet: hysteria results from real traumatic experience (the "seduction theory"). He then retreated — reinterpreting patients' reports as fantasies driven by infantile sexuality. This single move set back trauma research by decades.
Concepts: Seduction theory → its abandonment · Fantasy vs. reality · Repression vs. dissociation · Abreaction / catharsis
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War & Combat Trauma
Each major war produced a wave of trauma research: shell shock (WWI), combat neurosis (WWII), and the Vietnam veterans' movement that led directly to the PTSD diagnosis in 1980. Kardiner's "traumatic neuroses of war" (1941) described what we now call PTSD with remarkable accuracy.
Concepts: Shell shock · Combat neurosis · Traumatic neurosis · Physioneurosis · Rap groups (Vietnam)
Relation: War trauma forced psychiatry to acknowledge external causation — these were healthy men broken by experience, not people with pre-existing pathology. The Vietnam veterans' advocacy movement, combined with the feminist anti-rape movement, created the political conditions for the PTSD diagnosis.
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Judith Herman
"Trauma and Recovery" (1992) — the most influential book in modern traumatology. Connected combat trauma, sexual violence, and domestic abuse as manifestations of the same phenomenon. Proposed complex PTSD for prolonged, repeated trauma. Articulated the three-stage recovery model: safety → remembrance/mourning → reconnection.
Concepts: Complex PTSD · Three stages of recovery · Safety first · Disconnection and reconnection · Trauma as disconnection from self and others
Relation: Herman synthesized Janet's phase model, feminist analysis of power and violence, and clinical work with incest survivors. Her three-stage model became the organizing framework for virtually all subsequent complex trauma treatment.
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Bessel van der Kolk
"The Body Keeps the Score" — brought trauma into public consciousness and neuroscience into trauma treatment. Argued that trauma is stored in the body, not just the mind, and that treatment must include the body. Championed EMDR, yoga, neurofeedback, and body-based approaches.
Concepts: Trauma and the body · Developmental trauma disorder (proposed) · The body keeps the score · Trauma and the brain (amygdala, prefrontal cortex, insula)
Relation: Van der Kolk bridges neuroscience, psychoanalysis, and somatic therapy. Controversial for advocating approaches before rigorous evidence and for proposing developmental trauma disorder (rejected by DSM-5). But his core insight — that trauma lives in the body — transformed the field.
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The PTSD Diagnosis
The inclusion of Post-Traumatic Stress Disorder in DSM-III (1980) was a watershed: for the first time, an external event — not internal conflict — was recognized as the cause of a psychiatric disorder. This legitimized trauma research and created a clinical category that could be studied and treated.
Concepts: PTSD criteria (re-experiencing, avoidance, hyperarousal) · Criterion A (traumatic event) · Acute stress disorder · Complex PTSD (later)
Relation: The diagnosis was political as much as scientific — Vietnam veterans and feminist advocates fought for it. Its limitation: PTSD captures single-incident trauma but misses the effects of prolonged, repeated, relational trauma (what Herman later called complex PTSD).
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Prolonged Exposure
The most researched trauma treatment. Based on emotional processing theory: trauma creates a pathological fear structure that must be activated and then modified through new, corrective information. Imaginal exposure to the trauma memory + in vivo exposure to avoided situations.
Concepts: Emotional processing theory · Fear structure · Imaginal exposure · In vivo exposure · Habituation · Hot spots
Relation: From the behavioral tradition (Pavlov → Wolpe → Foa). The logic is pure learning theory: the fear was conditioned and can be extinguished. Controversial because it asks patients to revisit the trauma in detail — but the evidence base is the strongest in the field.
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Sensorimotor Psychotherapy
Integrates body-oriented approaches with psychodynamic and cognitive processing. Works within the "window of tolerance" — the zone between hyperarousal and hypoarousal. Tracks somatic experience, movement impulses, and body sensation alongside narrative and cognition.
Concepts: Window of tolerance · Sensorimotor processing · Core organizers · Movement impulses · Hyperarousal / hypoarousal · Top-down / bottom-up processing
Relation: Ogden bridges Hakomi (phenomenological body therapy) with trauma neuroscience and attachment theory. More integrative than SE — explicitly works with cognition and emotion alongside body sensation.
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EMDR
Eye Movement Desensitization and Reprocessing — the most controversial and most adopted innovation in trauma therapy. Bilateral stimulation (eye movements, tapping) while holding a traumatic memory facilitates reprocessing. The Adaptive Information Processing model proposes that trauma is stored in unprocessed form.
Concepts: Adaptive Information Processing · Bilateral stimulation · Eight phases · Negative/positive cognition · SUDS/VOC · Body scan · Channels of association
Relation: EMDR does not fit neatly into any parent tradition — it was developed empirically and the mechanism remains debated. Some argue it works through exposure; others through working memory taxation; others through orienting response activation. The debate continues but the outcomes are consistently strong.
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Cognitive Processing Therapy
Cognitive therapy applied to trauma. Identifies and challenges "stuck points" — the distorted beliefs about self, others, and the world that develop after trauma (e.g., "It was my fault," "No one can be trusted," "The world is completely dangerous").
Concepts: Stuck points · Assimilation (distorting the event to fit beliefs) · Over-accommodation (distorting beliefs to fit the event) · Impact statement · Challenging questions · Patterns of problematic thinking
Relation: From the cognitive tradition (Beck → Resick). The insight is that it's not the memory itself but the meaning assigned to it that maintains PTSD. CPT can be delivered with or without a written trauma account — the cognitive work alone is effective.
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Somatic Experiencing
Trauma is an incomplete biological response — the fight/flight/freeze energy was mobilized but never discharged. Treatment involves carefully tracking bodily sensations and allowing the nervous system to complete its thwarted defensive responses. Titration, not flooding.
Concepts: Incomplete defensive responses · Titration · Pendulation · Discharge · Felt sense · Survival energy · Vortex (trauma/healing)
Relation: From the somatic/Reichian tradition but integrating ethology (animal models of freeze/collapse) and polyvagal theory. Levine's core insight: trauma is in the nervous system, not the event. The body must complete what it started.
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Stabilization & Safety
Janet's first phase — safety and stabilization — operationalized: Seeking Safety (Najavits) for co-occurring trauma and substance use, STAIR (Cloitre) for emotion regulation and interpersonal skills before trauma processing, Safety Planning for suicidality, CAMS for suicidal crisis management.
Concepts: Safety first · Stabilization before processing · Grounding · Emotion regulation skills · Crisis intervention
Relation: These approaches address the clinical reality that many trauma survivors cannot tolerate direct trauma processing without first building safety and skills. They embody Herman's principle: safety before remembrance.
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Child & Developmental Trauma
Trauma treatment adapted for children and developmental context: TF-CBT (Cohen, Mannarino, Deblinger) for child trauma, Child-Parent Psychotherapy (Lieberman) for relational trauma in early childhood, Attachment-Focused EMDR (Parnell) for developmental trauma, Lifespan Integration for attachment repair.
Concepts: Developmental trauma · Attachment and trauma · Caregiver involvement · Trauma narrative (child-appropriate)
Relation: These approaches address what van der Kolk proposed as "developmental trauma disorder" — the effects of early, repeated, relational trauma that don't fit neatly into PTSD criteria. They bridge the trauma and attachment literatures.
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Structural Dissociation
A comprehensive theory of trauma-related dissociation based on Janet. The personality divides into an "apparently normal part" (ANP) that manages daily life and "emotional parts" (EP) that hold traumatic experience. Treatment integrates these parts through phase-oriented work.
Concepts: Apparently Normal Part (ANP) · Emotional Part (EP) · Primary / secondary / tertiary dissociation · Action systems · Phobias of inner experience · Integration of parts
Relation: The most direct revival of Janet's work. Provides a theoretical framework that unifies PTSD, complex PTSD, BPD, and dissociative disorders under one model. Influences how IFS, ego state therapy, and phase-oriented treatment are understood.
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Brainspotting & Adjacent
Brainspotting emerged from EMDR — using fixed eye positions rather than bilateral movement to access and process traumatic material. Flash Technique allows processing without conscious engagement with the memory. Accelerated Resolution Therapy combines elements of EMDR with guided imagery.
Concepts: Brainspot · Dual attunement · Subcortical processing · Flash Technique (minimal conscious engagement) · Resource model
Relation: These approaches share EMDR's insight that eye position and bilateral processes can access traumatic material, but diverge in method. They represent the ongoing innovation at the frontier of trauma processing — empirically promising, still building evidence.
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Body-Based & Integrative
Van der Kolk's "body keeps the score" vision operationalized: Trauma-Sensitive Yoga, Neurofeedback for trauma, Imagery Rehearsal Therapy for trauma nightmares, Adaptive Disclosure for military trauma. These complement cognitive approaches by addressing the somatic and neurobiological dimensions.
Concepts: Body-based processing · Neurofeedback · Yoga and trauma · Nightmare rescripting · Bottom-up processing
Relation: These approaches reflect the convergence of trauma treatment with somatic therapy, neuroscience, and complementary medicine. They address what cognitive approaches alone may miss: the body's stored traumatic activation.
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Deep Brain Reorienting
The newest branch of the lineage, and the one that pushes furthest down the neuraxis. Corrigan proposes that trauma is registered first as an interrupted orienting sequence in the brainstem — superior colliculus, locus coeruleus, periaqueductal grey — and that therapy should re-enter that sequence before affect rather than after it.
Concepts: Pre-affective shock · Orienting tension · Attachment shock · Superior colliculus / locus coeruleus / PAG sequence · Brainstem-level processing
Relation: DBR is the logical endpoint of the lineage's long descent: Janet located trauma in dissociated memory, van der Kolk in the body, Levine in the autonomic nervous system, and Corrigan in the midbrain. Its distinguishing feature is procedural rather than theoretical — the theory was published as an explicit falsifiable hypothesis (Medical Hypotheses, 2020) before the outcome trial (Kearney et al., 2023), inverting the usual order in this lineage, where mechanism narratives have typically been retrofitted to clinical enthusiasm. The evidence remains a single waitlist-controlled RCT with the developer on the author list.