From trauma to healing: How therapy complements medication in mental health treatment plans

Trauma therapy is more than just talk – it’s an evidence-backed process that helps patients reframe, process, and recover from life-altering events. 

Whether stemming from early childhood adversity, combat exposure, or interpersonal abuse, trauma leaves long-term imprints on both the mind and body. As our understanding of mental health deepens, it’s become increasingly clear that the most effective treatment plans combine both psychotherapy and pharmacotherapy.

Understanding trauma: The neurobiology of adversity

Trauma isn’t just “in your head”. It causes physiological and neurological changes. Neuroimaging studies show that individuals with post-traumatic stress disorder (PTSD) exhibit increased amygdala activity (associated with fear response), decreased medial prefrontal cortex activity (involved in regulation), and altered hippocampal volume – affecting memory consolidation (Shin et al, 2006; Bremner, 2007).

This biological impact helps explain why two individuals might respond differently to the same event. One may recover quickly, while the other experiences chronic symptoms like hypervigilance, flashbacks, and dissociation. The variability reinforces why trauma treatment must be personalised.

Where medication fits in

Medications, particularly SSRIs and SNRIs, are often first-line interventions for trauma-related disorders. Research from the APA suggests that pharmacotherapy can help reduce the severity of PTSD symptoms, particularly depression, anxiety, and insomnia (Davidson, 2001). Drugs like sertraline and paroxetine have been FDA-approved for PTSD, demonstrating efficacy in stabilising mood and arousal levels.

However, medication alone cannot address maladaptive cognitive patterns or unresolved emotional experiences. It modulates symptoms, but doesn’t facilitate emotional processing. This is where trauma-focused psychotherapy becomes essential.

The role of trauma therapy in integrated care

Trauma therapy encompasses a range of modalities, including Eye Movement Desensitisation and Reprocessing (EMDR), somatic experiencing, trauma-focused Cognitive Behavioral Therapy (CBT), and Internal Family Systems (IFS). These approaches are designed to help patients reprocess traumatic memories, reduce avoidance behaviours, and improve emotional regulation.

A meta-analysis by Bisson et al (2013) found that trauma-focused CBT and EMDR showed significant effectiveness in reducing PTSD symptoms, particularly when paired with pharmacological support. The integration of both approaches allows for neurochemical stabilisation alongside emotional restructuring.

Clinical case snapshot: A combat veteran’s progress

One of my patients – a decorated combat veteran – had successfully reintegrated into civilian life on paper. He held a job and supported a family. But he experienced daily hyperarousal, night terrors, and shame-driven isolation. Medication helped reduce the intensity of his nightmares, but it wasn’t until we introduced EMDR that he began to reframe his internal narrative. The flashbacks no longer defined him; they became part of a broader, processed memory system.

A synergistic approach: Combining therapy and medication

Recent studies underscore the importance of integrated care. A 2020 report in The Journal of Clinical Psychiatry found that patients with major depressive disorder and comorbid trauma histories responded better to combined treatment than either medication or psychotherapy alone (Cuijpers et al, 2020). The dual approach offers stabilisation (via pharmacotherapy) and insight (via therapy).

In one case, a patient recovering from an abusive marriage began with fluoxetine for major depression. When her symptoms plateaued, we introduced weekly trauma therapy sessions. Over six months, she developed healthier boundaries, reduced dependency patterns, and restored circadian sleep rhythms.

Why talk therapy alone isn’t always enough

Talk therapy is valuable, but for patients with dysregulated nervous systems, it can fall short. Trauma is stored not just as narrative, but as somatic experience. That’s why body-based therapies like somatic experiencing or sensorimotor psychotherapy are gaining traction. When combined with medication, which helps calm the fight-or-flight response, these methods can yield meaningful, sustained recovery (Van der Kolk, 2014).

It’s not a linear journey

Trauma recovery is rarely linear. Patients often revisit memories or experience symptom flare-ups during therapy. But as neuroscience shows, this reactivation is not regression: it’s a sign of the brain reprocessing safely. As clinicians, it’s crucial we help patients view these moments as part of their healing arc, not a failure.

Choosing the right trauma therapist

For effective results, trauma-informed care must be practiced by clinicians trained in evidence-based methods. Key questions patients should ask include:

• Are you certified in EMDR, trauma-focused CBT, or IFS?
• How do you assess progress?
• What’s your experience with complex trauma?

Therapeutic alliance remains one of the strongest predictors of outcome success (Wampold, 2015). A sense of emotional safety and mutual trust is non-negotiable.

Final thoughts: Healing is possible

Patients living with trauma aren’t broken, they’re responding to overwhelming experiences with adaptive survival strategies. With the right mix of evidence-based therapy, pharmacologic support, and a trusting clinical environment, healing is not only possible – it’s expected.

As practitioners, we must continue to move away from siloed care models and toward integrative, patient-centred mental health treatment. Trauma affects both neurobiology and belief systems; therefore, treatment must do the same.

About the author

Steven Kilmann began his medical career after earning his degree from the University of Southern California. After years as a physician at Cedars-Sinai and his own lived experience with burnout and recovery, he pursued his Master’s in Psychology at Antioch University. Today, he works as a licensed therapist with a trauma-informed and evidence-based approach to mental health.