Top-Down vs Bottom-Up Healing
When it comes to trauma therapy, the order matters.
A top-down approach starts with the thinking brain (neocortex). Cognitive Behavioural Therapy (CBT) is a good example—reframing thoughts to shift behaviour.
But here’s the challenge: when you’re triggered, your thinking brain goes offline. It’s hard to talk yourself through a trauma response when your body is in fight-or-flight.
That’s where bottom-up healing comes in.
We start with the body—the brainstem and limbic system. This approach helps us gently process the trauma that’s stored in our nervous system.
I use Gendlin’s Focusing to safely access these deeper layers. It allows us to be with the old pain without being in it. We create a bridge between past threat and present safety.
As the body becomes a safe place again, we unlock energy for life, connection, and healing.
Want to go deeper? Van der Kolk’s The Body Keeps the Score is a must-read.
Have you tried bottom-up healing before? Share your experience below.
