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Services
Trauma and autonomic dysregulation are physiologically connected. The same nervous system that runs the cardiovascular response to standing also runs the response to threat — and a system that has been held in defence for long enough, for any reason, often shows up in both places at once. For many people in the dysautonomia pathway, the trauma story sits inside the medical story.
Some of that trauma is medical itself. Years of unexplained symptoms, dismissive consultations, emergency-department visits that produced fear rather than help, the cost of repeatedly not being believed — these are not minor experiences and they leave traces. Some is relational or developmental, predating the autonomic picture but interacting with it now. Some is post-viral, in the more recent sense — the body changed shape after an illness, and the nervous system has been holding the shape ever since.
Trauma therapies in this pathway are the work of addressing that layer carefully. Modalities used include EMDR (eye movement desensitisation and reprocessing), Somatic Experiencing, Cognitive Processing Therapy, Compassion-Focused Therapy and others — chosen against the picture in front of the clinician, not against a fixed model. The work is delivered by clinicians who understand chronic-illness populations, which matters: trauma work in a body that already has limited autonomic capacity is not the same as trauma work in a body that does not.
This service is for adults in the dysautonomia pathway with a trauma layer — medical, relational, developmental or post-viral — that is shaping the autonomic, sleep, mood or relational picture. It is not the right starting point in acute mental-health crisis; in acute risk, mental-health emergency services are the right first call.
The first session reads the picture. What the person is bringing, what has been tried, what the current autonomic and mental-health load looks like, what the therapy is being asked to do. The aim is to know whether trauma therapy is the right work right now, or whether other parts of the plan need to settle first.
The modality is matched to the picture. EMDR where reprocessing of specific events is the right move. Somatic Experiencing where the trauma sits primarily in the body. Cognitive Processing Therapy where structured cognitive work fits. Slower relational work where the picture calls for it. Where multiple modalities will be used across the work, that is named openly.
Trauma work in a dysautonomic body is paced. Sessions are matched to autonomic tolerance, not pushed past it. Where post-exertional malaise is part of the picture, the work fits inside the energy envelope. The aim is for therapy to be something the nervous system can use, not another demand it has to manage.
The work is held inside the biio. record so the rest of the team — autonomic medicine, medication, OT, exercise physiology — can see what is happening. Trauma work can move the autonomic picture; coordination matters.
Progress is reviewed against the goals the person named at the start. Where the work is moving, it continues; where it is not, the approach changes before the goal does.
Trauma work in chronic-illness populations often runs across longer time-scales than acute trauma work. Sessions move from active processing to integration to ending, and may be returned to later when life events bring the picture back.
When the trauma therapy work is going well, the autonomic picture often loosens alongside the trauma picture. Defensive baseline drops. Sleep arrives more easily. The body becomes less reactive to ordinary stress. Relationships — including the relationship to medical care — become possible to be in without bracing.
Trauma therapy does not, by itself, treat dysautonomia. The autonomic dysregulation has its own drivers, only some of which are trauma-related. What trauma therapy can do, where the picture supports it, is take one source of nervous-system load out of the picture so the rest of the work has somewhere to land.