Trauma Psychotherapy: bottom-up therapy

Traditional talk therapy is considered a top-down approach because it works primarily with the neocortex (on top of our brain) where speech and language live, and encourages people to think their way through their emotional responses in their subcortical or limbic brain (mid-area of the brain) and body reactions.

The latest neuroscience has shown us that our brains and bodies actually work in the opposite, bottom-up direction, with our body, brainstem, and subcortical or limbic brain reacting to stimuli quickly first. Then some of these reactions make themselves known to the neocortex.

This article describes why talk therapy may not be helpful in processing trauma that is stored in the deeper parts of the brain. It uses the metaphor of stair to show what happens at each level.

“Bottom-up approaches seek to access and heal trauma on the lower stair steps, where it lives and thrives. Simply put, walking up the brain’s stairs instead of down allows you to address the impacts of trauma at their source. ”

https://www.psychologytoday.com/intl/blog/simplifying-complex-trauma/202112/how-bottom-treatment-can-address-trauma

Elaine Korngold, LPC in Oregon, offers Brainspotting Therapy and Internal Family Systems Therapy, both bottom-up approaches to treating trauma.