There are two categories that most approaches to trauma therapy fall into: top-down and bottom-up. The top-down approach is traditional talk-based therapy with a focus on the cognitive parts of the brain. The goal with this top-down approach to processing trauma is to improve your emotional well-being and behavior. A bottom-up approach tends to go deeper into the areas of the brain that store trauma, emotions, and memories with a goal to address the root of the symptoms. Treatment methods with the bottom-up approach may include eye movement desensitization and reprocessing (EMDR), somatic experiencing, internal family systems, and expressive arts therapy.
Top-down therapy works to heal using the parts of the brain associated with thinking, speaking, and current emotions. These utilize the areas of the brain that include the neocortex, frontal lobes, and prefrontal lobes. A bottom-up approach involves areas of the brain responsible for reflexes, memories, and survival responses. These are located at the base of the brain.
The Biggest Differences in Top-Down and Bottom-Up Therapy
The top-down approach to trauma processing involves cognitive behavioral therapy through traditional talking sessions with a trained therapist. The goal is to change your way of thinking, making you aware of inaccurate or negative thoughts that are occurring. Through this shift in thinking you can make better decisions in challenging situations. This approach focuses on talking, with you and your therapist working to retrain your way of processing situations and thoughts. Over time this can reshape your emotional and psychological response to certain settings.
A bottom-up approach to trauma therapy focuses on the body’s sensations, noticing what triggers these negative feelings. Through therapy, you can learn how to manage these feelings when they do occur, changing your response and behavior without having to block out the feelings. Over time with this approach, the brain can learn that it is safe and that the feelings are often just memories. The bottom-up technique for processing trauma operates under the belief that the trauma is not only stored in the mind, but also the body. By releasing the trauma energy from your body, you can reconnect with your body’s sensations and regulate your nervous system.
Deciding Which Approach to Trauma Therapy is Right for You
Every person working to process trauma is different, and there is no one therapy option for everyone. A trained trauma therapist can help you to find the right approach to help begin healing from these past experiences. Some trauma victims will find that one approach is better for them, while others may even find that taking a two-pronged approach to their trauma processing is most effective. The advantages of taking a dual approach to trauma processing is that you are addressing all areas of the brain that may be storing this trauma, while also addressing its effect on the body.
Whether you choose the top-down or bottom-up approach, it is important to find a trained professional that can help you begin the process of healing from your trauma.
