Treating Complex Trauma with Emotion-Focused Therapy

Woman sitting on porch swing, looking at viewMany of us develop emotion regulation skills naturally during childhood and as we mature into our adult years. We learn to down-regulate negative emotions such as anxiety or anger through constructive self-talk, distraction (if there’s nothing to be done about a distressing situation), or reaching out to a supportive person for help.

Complex trauma, as the name suggests is a more complex form of trauma that is caused by prolonged abuse and trauma (Herman, 1993). People who have experienced complex trauma or who grew up in an abusive or stressful environment often did not have the opportunity to learn emotion regulation. Abusive parents often increase negative emotional states in their child rather than offering helpful assistance.

For people with complex trauma, experiences of sadness, fear, or anger may be more intense and last longer. Ongoing negative emotions often seriously interfere with functioning and can cause distress in interpersonal relationships.

Fortunately, emotional regulation can be learned. Emotion-focused therapy (EFT) with a trained EFT therapist can help clients build skills for healthy responses to difficult emotions and learn ways to more effectively regulate their negative emotions.

What Is Emotion-Focused Therapy?

Emotion-focused therapy is an approach to psychotherapy that is based in the understanding that our emotions play a key role in who we are and how we function.

Our emotions are connected to our needs and behavior. Our feelings drive how we select goals and maintain the intensity of commitment to realizing our goals. Emotions inform our decision-making and play a central role in communicating our feelings and intentions to others.

Our emotions are connected to our needs and behavior. Our feelings drive how we select goals and maintain the intensity of commitment to realizing our goals.

Emotions also alert us to danger or unhealthy situations. In this way, they protect, guide, and motivate us. They also help us make sense of ourselves and the world around us (Greenberg, 2004).

Grounded in the theory that emotions are centrally important in human experience, EFT seeks to help clients identify, experience, make sense of, and flexibly manage emotions in order to bring about positive change and live vitally.

The Three Goals of Emotion-Focused Therapy

  1. Increasing awareness of emotion: The first goal of EFT is to increase the client’s ability to identify and name their emotions. While this may seem straightforward, many people, especially those who experienced abuse in childhood or other forms of complex trauma, do not naturally identify emotions. For example, depression may not be felt as sadness or despair, but instead as fatigue or lethargy. Anxiety may manifest as another emotion such as irritability.
  2. Enhancing emotional regulation: Emotional regulation may be thought of as the ability to control the intensity and duration of negative emotions as well as increase the experience of positive emotions.
  3. Transforming emotion: It is possible to transform emotions by changing a maladaptive emotion into more positive feelings.

Cognitive reasoning and the desire to change an emotion are not sufficient to transform one’s emotions. An EFT-trained therapist can teach clients to identify and name emotions, to regulate emotions, and to learn emotion transformation skills.

Using EFT to Overcome Complex Trauma

If you have complex trauma, you may find you have difficulty with heightened and prolonged feelings of sadness, fear, or anxiety. You may be unable to trust people or expect good things to happen in your life. Anger and rage may well up over small upsets, and it may take a long time to calm down afterward.

Given the difficulties in building and maintaining trust, complex trauma sufferers often face serious or prolonged challenges with interpersonal relationships. It may be difficult for your partner to understand your intense emotional states. Additionally, you may have difficulty naming or explaining your feelings and reactions to your partner and even to yourself.

EFT treatment goals are naturally aligned with the needs of many individuals with complex trauma. The goals of EFT are to help the client to identify, regulate, and transform negative emotions as well as to address the core symptoms of their complex trauma.

EFT for complex trauma is empirically supported. One study designed to examine the effectiveness of EFT for adult survivors of childhood abuse (physical, emotional, and sexual abuse) found that those who received 20 weeks of EFT therapy achieved significant improvements with multiple symptoms. The results of EFT have also held up over time. Over nine months after EFT sessions ended, clients were still maintaining improvements gained during therapy (Paivio & Nieuwenhuis, 2001).

If You Have Complex Trauma, There Is Hope

If you have complex trauma, consider meeting with a therapist. A therapist trained in EFT can help you manage and understand your emotional experience. You can develop and maintain healthier and more durable relationships. Emotions do not have to be maladaptive; you can learn to transform your emotions. Difficult feelings can be changed into adaptive and positive states that will enable you to live a higher quality of life as well as improve your overall health and well-being.


  1. Ehring, T., Welboren, R., Morina, N., Wicherts, J. M., Freitag, J., & Emmelkamp, P. M. (2014). Meta-analysis of psychological treatments for posttraumatic stress disorder in adult survivors of childhood abuse. Clinical Psychology Review, 34(8), 645-657. doi: 10.1016/j.cpr.2014.10.004
  2. Greenberg, L. S. (2004). Emotion-focused therapy. Clinical Psychology and Psychotherapy, 1(11), 3-16. doi: 10.1002/cpp.388
  3. Herman, J. L. (1993). Posttraumatic stress disorder: DSM-IV and beyond. Washington D.C.: American Psychiatric Press.
  4. Paivio, S. C. & Nieuwenhuis, J. A. (2001). Efficacy of emotion focused therapy for adult survivors of child abuse: A preliminary study. Journal of Traumatic Stress, 14(1), 115-133. doi: 10.1023/A:1007891716593
  5. Pascual-Leone, A., Yeryomenko, N., Sawashima, T., & Warwar , S. (2017). Building emotional resilience over 14 sessions of emotion focused therapy: Micro-longitudinal analyses of productive emotional patterns. Psychotherapy Research. doi: 10.1080/10503307.2017.1315779

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  • Madeline Nomberg, Ph.D.

    June 10th, 2021 at 10:24 AM

    thank you

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