Trauma service
Our service has special expertise to help people in the aftermath of trauma.
Trauma may come in many different forms. It may be a single episode of trauma such as an assault, a road traffic accident, a natural disaster or the loss of a loved one by murder or suicide.
People such as war veterans, asylum seekers and refugees, or victims of domestic violence may suffer multiple episodes of trauma over a period of time.
Many of the patients we treat have experienced traumatic events in childhood including sexual or physical abuse that continue to have a significant effect upon their lives.
Our specialist services
The Tavistock Trauma Service has developed a specialist arm to specifically work with Historical Child Sexual Abuse. This builds on the flexible, psychoanalytically-informed way of working that has been central to the work for over 15 years. The service uses individual, trauma-informed psychodynamic work as well as a variety of specialist groups including a trauma art therapy group, psychoeducation groups and trauma yoga groups.
The central focus of the treatment program is to offer group work which includes:
- A one year women’s group run by two senior therapists (both female).
- A one year men’s group run by two senior therapists (one male)
Consultations for this part of the service are usually for two sessions and an individualized treatment package is agreed which in most circumstances will begin with a group as described. Other options would include the treatments available in the broader trauma service.
Who we see
Some trauma services require patients to have a certain number or type of symptoms in order to be seen. We consider anyone who feels trauma is something that causes them significant distress or interferes with their relationships or daily living. Usually, the patients we see find that something has become ‘stuck’ around the trauma and they find it hard to move forward. They may experience flashbacks, nightmares, feel significantly depressed or numb, or struggle with anxiety.
Consultation and treatment
We usually offer an extended consultation over four sessions to understand the nature and impact of the trauma, using a trauma-informed psychoanalytic approach. We also explore the most suitable approach to treatment
Following the consultation we may offer:
- A trauma psychoeducation group – usually six weeks in length
- Specialist trauma groups including a women’s group, a men's group, a trauma art therapy group, a trauma- mentalisation-based therapy group, a trauma yoga group and a trauma gardening group
- Psychoanalytic psychotherapy – usually beginning at fortnightly intervals, and up to once weekly
- Treatment in our generic or Fitzjohn's unit
We usually treat individuals, but occasionally see couples and families who have suffered traumatic events.
In addition to using a psychoanalytic approach, we sometimes make use of other trauma-focused interventions. This will generally be in the context of an on-going therapy, however, these techniques (especially in complex PTSD) require a period of stabilization and secure establishing of a therapeutic relationship, and can destabilize some individuals if used alone.
We have a Service User Panel Group which meets regularly to help inform the service and to develop better service user involvement over time.
Our specialist therapies
Psychoanalytic psychotherapy is a talking therapy based on saying whatever is going through your mind.
This helps you become aware of hidden meanings or patterns in what you do or say that may contribute to your problems.
Many people come to us because they feel they are trapped by their past and want to talk it through with someone.
We provide a safe, personal space where you can talk about yourself and what troubles you, to try to understand the connections and patterns of your experiences.
Through understanding these connections and patterns therapy can:
- bring relief
- reduce confusion about what helps and what doesn’t
- identify changes that can be made in your life
- help you come to terms with what can’t be changed
Psychoanalysis is based on the modern developments of the theories of Sigmund Freud. Freud believed that bad thoughts and experiences from childhood are repressed but continue to influence your feelings as an adult.
Eye movement desensitization and reprocessing (EMDR) is a type of therapy used to treat the symptoms of trauma.
When we experience traumatic events the thoughts, feelings and memories we have about those events can get stuck. It can be hard to move on from them. The aim of EMDR is to help the brain to process distressing memories. This reduces their influence and allows patients to develop ways to more effectively get on with their lives.
Eye movement desensitization and reprocessing is suitable for children and adults. It is usually offered alongside other forms of therapy.
As well as helping us find greater flexibility and strength in our bodies, yoga can also cultivate mental clarity and ease. This course will teach some tools to help calm the mind, soothe the breath and ease the body of tensions to gently build strength in our bodies. The inter-relationship between the body and mind is being increasingly recognized, and body-based techniques such as yoga and breathing exercises alongside talking therapies can have a profound effect on psychological and physical health.
Using yoga postures and breathing helps relieve physical and mental tension and find greater focus. We will start with gentle standing poses to release and relax the body as well as energise. Over the duration of the course, we will be building on our yoga postures, going at your pace and level to increase strength and flexibility. We will introduce you to some simple breathing and mindfulness exercises to help you focus. They are also good for sleep and relieving anxiety. You will also learn some safe grounding techniques to help for when something feels overwhelming. The emphasis will be on self-care in an informal and relaxed environment. It is suitable for all levels of fitness.
What is Mentalization?
Mentalization describes the ability to think about what is going on in our minds and what might be going on in the minds of others. This helps us to understand ourselves, our emotions and relationships with other people. We learn to mentalize early on in childhood through our relationship with our main caregiver.
How does trauma affect Mentalizing?
If there is early neglect, abuse or trauma and we do not have an opportunity to talk through our experiences with a trusted other, then our ability to mentalize and to trust others may also be affected. This can mean that later on, people may find themselves struggling to understand or respond to their own feelings which may seem very intense, confusing and sudden, but also finding it hard to understand others. This may lead to finding it difficult to trust others and to build meaningful relationships. This can result in avoiding others and feeling very isolated and alone and not having the opportunity to talk through difficulties and feel supported
What is Trauma Focused Mentalization-based Treatment (MBT-TF)?
MBT-TF is an adapted MBT treatment and has been developed to support people who have experienced trauma to improve the difficulties they experience that have resulted from the trauma and to have a better understanding of themselves and others. MBT-TF is a 6 month therapy group that people will attend weekly, and will continue alongside individual therapy.
The aim of the group is to build an understanding of how traumatic experiences have affected people and their awareness of themselves as well as their relationships with others. The therapy aims to support people to build trust in relational experiences, through understanding and reflecting on themselves and what has happened to them.
Narrative Exposure Therapy (NET) is an evidence based trauma focused therapy.
NET helps people to put traumatic events they have experienced into the context of their lives. Often when people experience trauma, particularly when people may have experienced multiple traumas over time, the memories of what has happened can become frozen, fragmented and confusing in people’s minds. This is because during the traumatic event, our brain becomes focused on survival and the parts of our brains responsible for date-stamping events in our memories are switched off. This can lead to feelings of confusion and dissociation later on, as well as experiencing flashbacks and nightmares where someone may feel they are reliving events from the past in the present.
Narrative Exposure Therapy supports people to piece together a coherent, chronological narrative of their lives, including and focusing on the traumatic events they have experienced. The therapy sessions initially focus on talking through a timeline of events in someone’s life, both negative and positive in the order that they happened. Subsequent sessions are focused on talking through events in order and in detail within an overall biography of someone’s life to develop a coherent narrative account. This concentrates mainly on traumatic events but also incorporates talking through positive experiences. Creating and reflecting on the narrative during therapy can support people to understand more clearly what happened and when as well as how traumatic experiences may have impacted on their lives. Recognising an account of what has happened can also support people to develop a coherent sense of identity and to create a testimony acknowledging their human rights.
Team
We are a specialist team of mental health professionals.
Our senior staff are psychoanalytically trained and trauma-informed in their practice. Many staff are also trained in a variety of other modalities suitable for trauma work including trauma-focused Cognitive Behavioral Therapy, Eye Movement Desensitization and Reprocessing (EMDR), Narrative Exposure Therapy, and so on.
Our trainees are experienced and senior clinicians from a variety of backgrounds including psychiatry, psychology, social work and psychotherapy.
This service is available at Tavistock Centre, 120 Belsize Lane, London, NW3 5BA
Adults who have experienced trauma.
We accept referrals from GPs, counsellors, IAPT services and secondary care.
Please email us to find out more at ACN-referrals@tavi-port.nhs.uk.