Rethinking Trauma Therapy: The Key Role of the Immune System

My journey in trauma therapy has taken unexpected turns, leading to profound insights that have revolutionized my approach to trauma integration.

In 2012, after our move to Africa, my children experienced a sudden developmental regression, which thrust me into the world of biomedical health research. This initial foray into understanding the body's complex systems would later prove invaluable, allowing me to enhance the expressive trauma integration framework with sensory and bilateral integration elements before these approaches gained widespread recognition.

Life had more lessons in store. In 2021, I needed to step back from my work with expressive trauma integration when my children developed an autoimmune condition in 2018. This challenging period, though painful and traumatizing for our family, opened new doors of understanding in trauma therapy. My intensive study of the immune system revealed crucial connections I hadn't previously recognized.

Again, the insights gained from this personal journey transformed my clinical practice. I began incorporating psychoneuroimmunology principles when working with clients who had developmental and complex trauma. The results were remarkable. While we didn't witness instant miracles, we observed steady improvements in overall well-being among clients who, under traditional treatment approaches, might have been hospitalized in psychiatric facilities.

My work has led me to a specific focus on the interactions between emotional states, nervous system function, and the immune system. This interdisciplinary field, psychoneuroimmunology, is the missing link for a complex set of neurological and neuropsychiatric symptoms that often do not respond to standard therapies.

This experience has led me to a profound conclusion: psychoneuroimmunology must be central to the future of mental health treatment. As trauma therapists, particularly those working with complex and developmental trauma, we need to develop a deep understanding of the bidirectional relationship between the immune system and the nervous system.

Our traditional approach of focusing primarily on symptom mitigation and regulation must evolve. I propose a three-stage treatment framework.

First Stage: Addressing the Immune System

As trauma therapists, we tend to immediately dive into self-regulation techniques. However, I have learned that this is impossible when the immune system is overactive. At this stage, we must investigate what triggered the immune system response and find how to treat it. This step is done in collaboration with a medical doctor who is a neuroimmune specialist (there are not many).

This is not a short process. Sometimes, we are lucky to figure out quickly what is going on, and treatment becomes effective fast. Mostly, it is more complex due to the many years that have passed since the immune system became dysregulated. Only then can we effectively address nervous system regulation.

Second Stage: Secure Attunement and Biohacking Dysregulation

This stage involves implementing a secure attunement framework while biohacking dysregulation, building on the foundation of a calmer immune system.

Biohacking involves using knowledge and practices from biology, genetics, neuroscience, and nutrition, translating to "do-it-yourself practices." Biohacking dysregulation (PTSD) involves controlling one's sensory reactions and increasing the ability to respond appropriately to situations emotionally and cognitively. Research indicates that traumatic memories are stored in areas of the brain that cognitive methods cannot reach. Addressing embodied memories (the body's dysregulation response to traumatic memories and triggers) requires targeting the lower parts of the brain.

Attunement is a nonverbal process of being with another person in a way that attends fully and responsively to that person. A key aspect of attunement is that it is a joint activity, experienced in interaction with a caregiver. In therapy, the therapist attunes to the client with a goal to become a "co-regulator" with the client's responses. Over time, the client is able to transfer the sense of being co-regulated to self-regulation outside of the therapy room, in everyday life. Through attuned relationship, clients learn to expand their capacity to endure the pain and loss of trauma and its aftermath.

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This stage requires meeting clients more intensively to develop the therapeutic relationship necessary to address the impact of developmental and complex trauma.

Third Stage: Long-Term Sustainability

The final stage focuses on ensuring that progress can be sustained over time. Several practices have been demonstrated to be effective in mitigating nervous system dysregulation and enhancing the capacity to experience joy:

• Mindfulness and simplified self-compassion.
• Mindlessness (spontaneity and play).
• Sensory and bilateral integration.
• Sport and movement.
• Fascia-based occupational therapy and physical therapy.
• Cognitive reframing and behavioral modifications (top-down).
• Expressive arts.
• Brain-training neurofeedback.
• Stellate ganglion block (SGB).
• Individualized nutrition.

It's important to note that this process is not linear. However, it is impossible to move ahead before getting the immune system calm enough to address neuroinflammation, without which the nervous system remains overactive.

This integrated approach represents a paradigm shift in trauma therapy. It acknowledges that true healing requires us to address the complex interplay between our body's various systems. By understanding and treating the immune system's role in trauma, we open new possibilities for healing that weren't previously available through traditional therapeutic approaches.

As we move forward in the field of mental health, it's crucial that we continue to expand our understanding of these interconnections. The future of trauma therapy lies not just in psychological interventions, but in a holistic approach that honors the intricate relationship between mind, body, and the immune system.

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