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 steps 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. ”

Top-Down (Talk) vs Bottom-Up Therapies

Traditional talk therapy, known as a “top-down” therapy, tries to solve problems with the conscious mind, which  resides in the neocortical region of the brain. Brainspotting therapy works “bottom-up” by focusing on the brain-body connection, with the goal of unburdening the physical stress in the body and releasing the emotional stress. The latest neuroscience teaches us that our body responds to the environment first, with the conscious mind or the neocortex being the last to follow, like the caboose on a long train. By processing emotions directly where they “live” – in the body and in the limbic part of the brain, we work bottom-up with Brainspotting, resulting in an efficient and effective treatment.

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