There are two major kinds of trauma, and within them a series of sub types. Here I am going to lay out a simple, but I hope useful overview of the two main kinds, and why they need to be handled in different ways.

Single event trauma is often associated with classic PTSD (Post traumatic stress disorder), and has often historically been referred to in terms relating to grief or shock. A common version of this is battle stress, referring to a specific event where a service personnel member has been injured or witnessed an injury. These events are single events with a beginning, middle and end and are therefore often processed with any one of (or combination of) exposure therapy methods. These include, but are not limited to, EMDR, hypnosis based "visualisation processing", NLP trauma reframing, or simply talking through the event with a form of talking therapy. The emotion held in the event is the key element, and processing this, and coming to terms with the event is the main goal, either through grieving, or perhaps some form of reframing (changing the meaning).

Complex trauma is a different problem. Because it either occurs over a series of events, or a prolonged period of time, there is no distinct beginning, middle and end. Instead the various incidents and events combine to form interactions, themes, patterns and beliefs. Simple exposure therapy can actually make things worse, because sufferers of complex trauma have revisited the events over and over already, and subsequently suffered new repetitions. Exposure therapy can add to, and not diminish the effect. Complex trauma is usually best treated in three phases, and although there are a few different ways in which these phases are labelled, they are essentially 1 - Stabilise, 2 - deal with history using somatic and emotional processing, and 3 - moving on and rebuilding. Many different advanced schools come up with their own labels, meaning pretty much the same and reflecting this three stage model. The classic source is the work by Herman et al, also the NARM model.

Leading experts including Bessel Van De Kolk, Stephen Porges, Pat Ogden, Rothschild, Arizona Trauma Institute all agree that rushing into processing traumatic memory using hypnosis, EMDR or other methods UNTIL stage 1 stable self regulation has been achieved is dangerous, unethical and harms the client.

In the UK clinical guidance is produced by NICE: National Institute for Clinical Excellence. NICE make several important recommendations in relation to trauma, most importantly:

1. The practitioner should have specialist training
2. The practitioner should follow manualised treatment protocols (in other words evidence based methods like the three stage approach mentioned above)
3. Trauma debriefing is prohibited as contra indicated

Recommended evidence based methods within the three stages vary but can include Narrative Based therapy, Cognitive reframing / restructuring, Psychoeducation, in vivo or prolonged exposure, but most importantly therapy should be carried out in a holistic way structured to the individual needs of the client, and as the NICE guidelines reflect, there can be a lot of co-morbid additional issues to tackle, making a customised approach around the stages important.

Complex PTSD or trauma has a long term effect, changing behaviours, eating habits, physical health, social behaviour, perceptions and pretty much influencing every area of your life. Thus these changes have to be addressed as part of the overall package of therapy. Therefore I have trained and been certified in a range of therapy models and methods so that I can address the bi directional effect of trauma on nutritional need, the effects on the need for movement and exercise, social interaction, psycho education, somatic processing, mindfulness and of course talking therapy itself.

People come to me for help a wide range of issues. Here are a few of the more common difficulties that can be supported through counselling: