Overcoming and Healing Trauma (Developmental Trauma), PTSD, and Complex PTSD

Under medical supervision, a Certified Public Psychologist summarizes, in an easy-to-understand way, how to overcome and treat trauma (complex PTSD). Please read on.

<Created: 2025.9.26 / Last Updated: 2025.9.26>

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		Author of this article Ichitaro Miki Certified Public Psychologist (Japan) BA, Osaka University / MA, Osaka University Graduate School Over 20 years of clinical practice. Specializes in trauma and attachment issues that underlie a wide range of difficulties and “difficulty in living.” Author of books including Developmental Trauma: The True Nature of “Difficulty in Living” (cumulative sales approx. 40,000 copies across all titles). Numerous media appearances, TV drama consulting/supervision, and features in web and print media. Click here for full profile

Author of this article

Ichitaro Miki Certified Public Psychologist (Japan)

BA, Osaka University / MA, Osaka University Graduate School

Over 20 years of clinical practice. Specializes in trauma and attachment issues that underlie a wide range of difficulties and “difficulty in living.” Author of books including Developmental Trauma: The True Nature of “Difficulty in Living” (cumulative sales approx. 40,000 copies across all titles). Numerous media appearances, TV drama consulting/supervision, and features in web and print media.

Click here for full profile

		Medical supervisor for this article Dr. Yoshio Iijima (Psychosomatic Medicine, etc.) In addition to psychosomatic medicine, he is also a clinical psychologist, Kampo (traditional Japanese medicine) physician, and general practitioner, with deep expertise across these fields. He specializes particularly in medically unexplained symptoms and autonomic dysfunction. Click here for full profile

Medical supervisor for this article

Dr. Yoshio Iijima (Psychosomatic Medicine, etc.)

In addition to psychosomatic medicine, he is also a clinical psychologist, Kampo (traditional Japanese medicine) physician, and general practitioner, with deep expertise across these fields. He specializes particularly in medically unexplained symptoms and autonomic dysfunction. Click here for full profile

<Editorial Policy>

・Written and explained by a Certified Public Psychologist, drawing on years of clinical experience and client narratives, especially from the perspectives of attachment and trauma practice.

・References specialist literature and objective data to the best of our ability.

・We strive to update the content with the latest findings whenever possible.

・This article has been translated from the original Japanese using AI. Therefore, it may contain unnatural translations, particularly for specialized terms.

・Overview: Roadmap for Healing Trauma

・Learn What Trauma Is and Notice Your Own Trauma
・Adjust Your Environment (Ensure Safety)
・Restore the Body (including the Autonomic Nervous System)
・Rebuild the Self
・Receive Trauma-Focused Care

→ For related articles on trauma, see below.

▶ What Are Trauma (Developmental Trauma), PTSD, and Complex PTSD? Causes and Symptoms

▶ Is Your Constant Tension a Result of Trauma?

▶ Is Trauma the Hidden Cause of Your Relationship Problems?

▶ When Work Doesn’t Go Well: The Hidden Impact of Trauma

Overview: Roadmap for Healing Trauma

As explained elsewhere on this site, to summarize: trauma is characterized physically as a “stress disorder” and psychologically by “harassment” dynamics. At its core lies the “loss of self,” which drives multiple symptoms. Effective recovery addresses each of these layers.

Many experts have proposed models of trauma care. Here we summarize the process in this order: “Understand and recognize trauma” → “Adjust the environment” → “Restore the body (e.g., autonomic nervous system)” → “Rebuild the self” → “Receive trauma-focused care.”

For more detail, see Developmental Trauma: The True Nature of ‘Difficulty in Living’ (Discover 21 Pocket).

Learn What Trauma Is and Notice Your Own Trauma

・Accurately understand the mechanisms of trauma

It is essential to understand what trauma is and what symptoms it produces. Knowing the mechanisms helps you avoid unnecessary self-blame and choose appropriate responses. Simply understanding the mechanisms often lightens symptoms and “difficulty in living.”

→ For causes and symptoms of trauma, see:

▶ What Are Trauma (Developmental Trauma), PTSD, and Complex PTSD? Causes and Symptoms

・Recognize the trauma you carry

If you believe “I don’t have trauma” or “It has nothing to do with me,” you naturally cannot begin trauma care. The first step is recognizing that you are carrying trauma.

If you’d like to check whether trauma may be affecting you, try the simple screening on the page below.

(Reference) → Trauma (Developmental Trauma) Checklist for Self-Understanding

・See current difficulties as “symptoms”

Your present “difficulty in living,” sense of insufficiency, and various problems can be understood as effects of trauma. People with trauma often equate these with their identity and think “I’ll never get better” or “It’s my fault.” But they are symptoms. That means they are not who you are, and they can improve through treatment and care. Recognizing that current problems are trauma-driven symptoms is a first step toward recovery.

Adjust Your Environment (Ensure Safety)

・Change the environment (environmental adjustment)

When we think about resolving trauma, we tend to focus on therapeutic techniques. However, the first priority is to change the environment in which you spend your daily life.

Those who have long been in unjust settings—harassment, inadequate caregiving—often internalize responsibility and remain in harsh workplaces or households, telling themselves they must not flee and must overcome it, without realizing the cause lies in the environment.

There are also cases with financial constraints that prevent independence, situations where ties with parents in inadequate caregiving environments cannot be severed, or codependent relationships with partners.

To resolve trauma, with professional support, you need to gradually distance yourself from harmful environments. In some cases, ceasing contact, relocating, or changing jobs is necessary.

・Home is not always a “safe base”

We often assume “home is where we relax,” but that can be a mistake. Home can be a place of anxiety and agitation.

This is true not only when you physically live with someone who causes harassment or stress; even when living alone, it’s common to ruminate on bad memories, worry about the future, or repeatedly mentally rehearse stressful scenarios.

For many, home is a place of temporary rest but not a safe base. Truly safe conditions often exist out in society. To maintain a sense of safety, getting out and interacting with others at a reasonable pace is important.

・Environmental adjustment is an act of self-care

Changing external conditions may look superficial, but its essence is “valuing yourself.” With that lens, environments are chosen more naturally. As you adjust your environment, self-efficacy and self-acceptance recover. When adjusting the environment, proceed with the guiding perspective of “valuing myself.”

　

Restore the Body (including the Autonomic Nervous System)

・Get sufficient sleep and nutrition

The most important foundations are nutrition and sleep. Therapy or medication alone will not help if these are inadequate. If your diet or sleep is poor, start there. Aim for three balanced meals a day.

Sleep often improves by revisiting nutrition and habits. For example, time-nutrition research shows that eating protein rich in tryptophan in the morning and getting daylight during the day increases melatonin at night (source: Shigenobu Shibata, Introduction to Chrono-Nutrition, Kodansha Bluebacks).

If you have trouble falling asleep, try eating dairy or soy products at breakfast—e.g., yogurt, natto—and bananas. Many notice benefits quickly.

Other ways to improve sleep include:

・If you nap, keep it under 20 minutes and avoid napping after about 3 p.m. (late naps often worsen sleep onset).

・Limit caffeine in the afternoon if possible.

・Dim the lights at night and wind down gradually.

・Avoid screens (smartphones/TV) for an hour before bed.

If sleep remains difficult despite efforts, consult a physician about sleep medications to ensure you can benefit from restorative sleep.

・Do aerobic exercise

Exercise has gained strong evidence in recent years, showing significant benefits for mental disorders including trauma. Proven effects include increased neurogenesis (animal studies show 3–4× increases), enhanced synaptic plasticity and transmission efficiency, and improved circulation of neurotransmitters. Exercise also restores bodily awareness and supports recovery of autonomic, immune, and endocrine function.

You don’t need vigorous workouts: 30 minutes of walking 2–3 days a week is enough. If going out is hard, yoga or Pilates is effective. You can follow YouTube videos at home. Mindfulness also helps across trauma-related symptoms—immune response, blood pressure, depression, chronic pain, emotion regulation, amygdala overactivity, interoception, cortisol, and more.

→ See related article:

▶ “What Is Mindfulness? Methods Explained by a Certified Psychologist”

Point

Aerobic exercise is not just a placebo or moral advice. It offers very high effectiveness, is a must-do self-care step for everyone, and is crucial in trauma treatment.

References: John J. Ratey, Spark (NHK Publishing); Bessel van der Kolk, The Body Keeps the Score (Kinokuniya), etc.

Rebuild the Self

・Treating symptoms alone is not enough—self-reconstruction is essential

Trauma symptoms are not like machine parts you simply “fix.” If the self remains lost, symptoms persist—especially stubborn shame and self-denigration flashbacks, or rumination on painful past events common in developmental trauma. Targeting only symptoms hits a ceiling.

The self needs to be rebuilt from the outset—not only after symptoms subside. Approaches that keep self-reconstruction in mind from the first stage show markedly better outcomes than those that don’t.

・Know that your true self is okay—notice false responsibilities and false roles

People with trauma have often been conditioned in unjust environments to feel “You’re bad” or “You’re wrong.” This is not fact; it’s stress imposed from outside. Self-denigration is not your true self. To break free of negative suggestions, it is vital to know: “I am not guilty; my true self is fundamentally okay.”

・Think and feel in the first person

A common tendency with trauma is to preemptively mind-read others. Seemingly your thoughts start with “How will they feel/think?”—and your subject often becomes “others,” blurring your own agency.

To change this and rebuild the self, a practical method is to consciously add the subject “I” to thoughts and speech. Practice for five minutes a day while walking: “I see…,” “I thought…,” “I like….” Your thoughts and feelings become clearer, and it trains self–other boundaries.

・Feel and express emotions

Many with trauma view emotions negatively and suppress them, not wanting to be “emotional” like those who hurt them. This is especially true for anger or envy. Compulsions to avoid harming others (harm-avoidance) and fear of rejection (abandonment anxiety) also play a role.

To recover your feelings, allow yourself to feel them—including the negative ones—without suppressing them, and do so in the first person. Say “I don’t like this,” or “I am angry.” If telling someone feels unsafe, start by acknowledging this internally or write it in a notebook. Allowing feelings supports emotion regulation.

・Remove the impact of foul language and chronic badmouthing

Living with family members who constantly spew insults can be traumatizing. Hearing relentless negativity at meals or during TV creates deep damage—lowering confidence and trust in others. Those words accumulate inside like sludge in a river.

If this is ongoing, clearly say “Please stop,” or create physical distance.

・Notice the impact of “local (fake) rules”

When “difficulty in living” doesn’t improve, the cause often lies in “local (fake) rules.” These are others’ deficits dressed up as norms or morality and forced upon you within closed relationships, as if they were public rules—e.g., “It’s for your own good,” or “Because we’re family.” Rejecting “morality” gets you labeled as wrong, so you swallow it, and then cannot expel it because it’s tied to moral language.

Start by learning that such “local (fake) rules” exist and analyze the structure of what feels off to you. You’ll see others’ deficits behind what you took for granted.

・Understand the structure of harassment

Harassment is a major psychological feature of trauma. In cases of prolonged suffering, harassment dynamics are almost always present.

Research traces back to anthropologist Gregory Bateson’s “double bind,” where contradictory messages block free mental activity.

He proposed it as a cause of mental disorders. Examples include parents, partners, or superiors attaching plausible reasons to self-serving behaviors to make the other comply (fake rules).

Even when the body senses the injustice, the conscious mind is swayed by “reasonable” logic and submits. Harassment is the repetition of this pattern. Victims gradually lose trust in their own senses, are isolated from society, and become controlled.

For self-reconstruction, a deep understanding of these harassment structures is essential.

▶ What Is Harassment (Moral Harassment)? — Causes and Characteristics

・Create a deliberate “rebellious phase”

To reclaim your own values, it helps to negate others’ values embedded within you. Try the steps below.

1) In daily life—work and private—list the rules and prohibitions in your head (“I must…,” “I must not…,” “It has to be…”) and the sweeping generalizations (“All X are…,” “It must be…”) you’re making. Most of these are others’ values.

2) Next, temporarily refute all these adopted values. “You say I must do X—but aren’t there exceptions?” “Isn’t that an overgeneralization?” For work values like “You must wake early and work” or “You must work while others rest,” counter with “Rested work is better,” “People have different chronotypes; I’ll work in my style.” For daily life: “I must always put others first,” “I’m the kind of person others dislike,” counter with “By putting myself first I can afford to help others,” “How many actual cases are there? Compared to others?” “Liked and disliked go together; those never disliked are never truly liked.”

3) After fully refuting, decide your own optimal views and values. Gradually you relativize “others’ values” and build “your own values.”

Receive Trauma-Focused Care

If symptoms or “difficulty in living” are strong, receiving trauma-focused care is necessary. Approaches include exposure therapy, EMDR, Somatic Experiencing, FAP therapy, and other trauma modalities. Specialists in trauma (physicians and counselors) are still few; please search for clinics or counseling centers with trauma expertise and choose what fits your situation.

・Major approaches

Among many clinical approaches, we introduce three broad categories:

1) Top-down (primarily cognitive approaches)

Cognitive Behavioral Therapy (including exposure), Interpersonal Therapy, Internal Family Systems, FAP therapy, other trauma care, etc.

2) Bottom-up (primarily somatic approaches)

Yoga, Mindfulness, Somatic Experiencing, TFT, Body Connect Therapy, EMDR, Brainspotting, Brain Gym, Hakomi, Neurofeedback, TS Protocol, Ego State Therapy, Holographic Memory Resolution, etc.

3) Pharmacotherapy

Medication is used to alleviate core and comorbid symptoms; SSRIs are central. There is no drug that directly resolves PTSD itself yet, but some are effective for flashbacks.

Psychiatrist Joji Kandabashi reported that the Kampo formulas Shimotsu-to and Keishikashakuyaku-to, taken 1–2 times daily (3 times in severe cases), significantly reduce flashbacks within 1–2 months; for those who dislike Kampo, aripiprazole or periciazine can help. Dr. Toshio Sugiyama also notes micro-doses of aripiprazole, risperidone, lithium carbonate, and ramelteon can be effective for mood instability or aggressive behavior.

References: Kandabashi, “Treatment of PTSD,” Clinical Psychiatry 36(4), 2007 (Ark Media); Sugiyama, Treatment of Developmental Trauma Disorder and Complex PTSD (Seishin Shobo)

→ For related articles on trauma, see below.

▶ What Are Trauma (Developmental Trauma), PTSD, and Complex PTSD? Causes and Symptoms

▶ Is Your Constant Tension a Result of Trauma?

▶ Is Trauma the Hidden Cause of Your Relationship Problems?

▶ When Work Doesn’t Go Well: The Hidden Impact of Trauma