What is the Best Online Therapy for Trauma? Can You Heal Complex PTSD?


Trauma impacts many of us in ways we don’t even understand. Therapy has long been deemed as a successful way to treat trauma, especially diagnosed post-traumatic stress disorder (PTSD). But can these therapies work online, and more importantly, can they work for complex trauma?

Online therapy has been gaining a lot of traction lately, even before the Covid-19 pandemic. The flexibility and affordability that online therapy platforms like BetterHelp.com offer, has made many people use these options for getting therapy. However, for trauma victims, there are several therapies that often have a very specific protocol. Many therapists are now delivering even those therapies fully virtually. 

To understand whether online therapy can work for trauma victims, one should first understand trauma and PTSD. 

What is Trauma?

Trauma or psychological trauma is the emotional response to a scary or terrible incident like a car accident, rape, violence, or natural disaster. While the official definition includes such terrible events that have a negative impact on the person, trauma can result from anything that a person may find or perceive as threatening or frightening. 

Trauma, as it’s used in psychology, is different from the trauma used in medical lingo. That trauma refers to a physical injury, whereas psychological trauma isn’t physical. You can’t really see it with the naked eye. 

There are many symptoms of trauma, including fear, anxiety, anger, confusion, sadness, and even withdrawal. 

There are essentially three main types of  trauma:

  • Acute Trauma: This results from an isolated event and is often also called single trauma. 
  • Chronic Trauma: This results from repetitive exposure to trauma over the course of time. For example, physical abuse throughout childhood or the death of several loved ones over the years. 
  • Complex Trauma: This results from multiple traumatic events that may be similar or different in nature. 

What is PTSD?

PTSD is a mental disorder caused as a result of a traumatic event that is frightening or disturbing in nature. It’s marked by stress and anxiety, which is why it’s also categorized as a type of anxiety disorder

The symptoms can vary from person to person but are similar to those of trauma victims in general. 

A person with PTSD may have flashbacks of the traumatic event, often as a result of a trigger. For example, seeing something linked with that unfortunate event. Similarly, they may feel isolated or alone, be easily irritable, or even have sleep issues like insomnia. In fact, one study suggests that upwards of 70 percent of PTSD patients face sleep disturbance. 

The symptoms of PTSD can range from mild to severe, but in both cases, impact the lifestyle and relations of the person negatively. This is why the treatment of PTSD is highly important for a healthy, functional life. 

What are the Best Therapies for Treating PTSD?

Research has time and again shown that psychotherapy can do wonders for people with PTSD. There are several therapies that specifically target PTSD and trauma. Most of these are essentially cognitive behavior therapies (CBT). 

Here are the best therapies for trauma, all of which can be done online, some even without a therapist:

Cognitive Processing Therapy

Cognitive processing therapy (CPT) is a type of CBT that mainly comprises talk therapy. It helps the victim process their trauma with the assumption that they were not able to process it (which is often the case). 

It’s a 12-week therapy with each weekly session lasting for 60 to 90 minutes. During these sessions, the therapist will talk to you about the traumatic event while helping your process your thoughts and feelings about it. It can teach people how to live with the trauma and see it in a new light that doesn’t cause anxiety. 

This therapy also involves writing about the trauma event, which essentially helps the person connect with their thoughts about it and put it on paper. 

One major goal of this therapy is to remove self-blame, which many trauma victims do. 

As CPT mostly involves communication, it can easily be done online with a therapist. BetterHelp, for instance, has many therapists who can provide CPT completely online at affordable rates.

Prolonged Exposure Therapy

Avoidance is typically the main coping mechanism for PTSD patients. Prolong Exposure (PE) therapy basically helps the victim confront the memories of the event and face them. 

As remembering these events can be triggering, therapists also use breathing exercises to manage the anxiety. The therapy also involves focusing on things people avoid as a result of PTSD and actually doing them, one at a time. 

There’s a lot of homework in this kind of therapy, but it’s found to be effective for chronic trauma as well

PE therapy online works pretty much the same way as it does in person. This therapy expands over 15 sessions, 90 minutes each. 

Eye Movement Desensitization and Reprocessing

Eye Movement Desensitization and Reprocessing (EMDR) is one of the best therapies for treating PTSD, especially that resulting from acute trauma. While it has a specific protocol and requires therapist intervention often, many EMDR therapists are successfully delivering EMDR online

There are virtual EMDR tools as well that people can use at home without needing to go into a therapist’s office. 

What makes EMDR different is that it doesn’t really require the victim to openly talk about the trauma but think about it while paying attention to external stimuli. It is why self-administered EMDR has recently grown in popularity although we still recommend to go through your first session with a certified specialist. A study in Frontiers in Psychology showed that EMDR can be highly beneficial for treating and controlling PTSD symptoms. 

Online Therapy for Complex PTSD

Complex PTSD or CPTSD is often marked by barriers to recovery that take time and effort to break. However, CPTSD is treatable and curable, especially using a combination of therapies. For multiple trauma victims showing classic symptoms of CPTSD, therapists often use CBT and EMDR. 

Although EMDR is typically used with single trauma victims, combining it with CBT can help immensely with CPTSD patients. Medication may also be used, but that’s prescribed by a psychiatrist, which a therapist can refer to if they consider there’s a need for medication as well. 

While therapies like PE or EMDR last for a few months, treating CPTSD can take even longer. It mainly involves working through the pain of the past and focusing on individual trauma at a time. 

Online therapy can work for CPTSD patients as well as the main therapies designed for PTSD are all deliverable through virtual communication modes. While there’s not much research into online therapy for PTSD or CPTSD, in particular, the similarities between in-person and online do show promise. 

Considering, people with CPTSD require therapy constantly, and for a longer duration, online therapy may even be a more manageable and convenient option for them. 

Conclusion

The best online therapy for trauma may include cognitive behavior therapy or neurological ones like EMDR. These therapies can last for a few months and can treat acute PTSD and chronic PTSD as well. A platform like BetterHelp can be a cost-effective way to get these therapies with a licensed professional. 

Even for complex PTSD, these therapies may work. Your therapist will know best what approach to take based on your symptoms and goals. Whether you choose to work with a therapist in-person or online, this kind of PTSD is treatable and should be treated to prevent further complications. 

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