We often hear that “talking about it” helps. It is a cultural mantra – put your pain into words, and healing will follow. But when it comes to trauma, this belief is not always true. The limits of talk therapy become clear when speech is used without regulation or safety.
While talking can bring temporary relief, words alone are not always therapeutic. In fact, in the context of unresolved trauma, talking can sometimes deepen the wound rather than heal it. Because healing is not just about telling your story. It is about being witnessed in your experience with safety, presence and connection.
The Origins of Talk Therapy: A Rational Mind in a Dysregulated World
While traditional psychoanalysis has faded from mainstream therapy, the “talking cure” still dominates. Most modern approaches are based on the belief that speaking about trauma – often in vivid detail – will help people process and move on.
This belief underpins many contemporary models, particularly Cognitive Behavioural Therapy (CBT), which is now widely taught and practiced across the world.
CBT was developed in the 1960s, during a time that prioritised logic, behaviour and measurable change. Initially designed to treat specific phobias like fear of spiders or flying, it focused on comparing irrational fears with reality.
Gradual exposure or “flooding” techniques were used to de-sensitise the client until the fear response weakened. This model proved effective for treating anxiety and behavioural habits, but when applied to trauma, the results have been mixed at best.
According to Bessel Van Der Kolk, only about one in three participants with PTSD who complete CBT-based studies show any significant improvement. Those who finish treatment may experience fewer symptoms, but full recovery remains rare.
Many still struggle with mental health, relationships or day to day function. In the largest published CBT study for PTSD, over a third of patients dropped out due to adverse effects, and only 15 percent no longer met the criteria for PTSD three months later.
The Limits of CBT Focused Talk Therapy
CBT has its place. It can be very effective for re-framing negative thoughts and shifting behavioural patterns. It is structured, measurable and often covered by insurance. But its strength lies in tools, not relationship. Unlike relational or somatic therapies, CBT does not require a deep emotional bond between client and therapist.
Instead, it focuses on cognitive strategies: worksheets, reframes and tracking patterns.
Many of my clients have completed CBT before working with me. They often say it helped in the moment. Things improved for a while. But when the therapy ended, old patterns returned. The tools made sense logically, but something deeper had not shifted.
CBT often works like a crutch; it helps you move while something underneath remains unresolved. But it does not necessarily heal the source of the pain. So when the crutch is removed, the limp returns. This often leads clients to believe that therapy has failed or that something is wrong with them.
But the issue is not with the client.
The problem is that CBT focuses primarily on thoughts.
Trauma does not live in thoughts.
It lives in the body.
The Neuroscience of Trauma: When Words Cannot Reach the Wound
In The Body Keeps the Score, Bessel van der Kolk explains something that most trauma survivors know intuitively. Trauma does not live in the part of the brain that speaks.
It resides in the limbic system, the area responsible for emotion and survival. When a trauma response is triggered, Broca’s area, the brain region responsible for speech, can shut down. That is why people often lose their ability to speak when overwhelmed.
This is where the limits of talk therapy become most visible – when words are used without safety or somatic awareness.
If someone is speaking about trauma while still activated, they are not resolving it. They are reliving it. The body remains stuck in survival mode. And without awareness, even a well meaning therapist can unintentionally re-traumatise a client by encouraging them to speak before their body feels safe.
Retelling Is Not Releasing
Clients often arrive having repeated their trauma story many times.
To friends, family and other therapists. And yet, little has changed.
This is because without emotional presence and safety
The story becomes rehearsed.
Instead of being alive.
It is being performed.
This is the risk when language replaces embodiment – when words are used without connection to what the body is holding. The more a story is told without emotional regulation, the more it reinforces the trauma loop. The nervous system never exits the pattern. There’s no resolution; only repetition, rumination, and emotional disconnection.
True healing begins when someone is not just heard, but felt. To be witnessed is to be held in presence, especially when the body begins to tremble, when the voice falters, when the breath shortens.
It is not about analysis. It is about being met.
In those moments, the nervous system softens.
There is no performance. No need to explain.
Just the safety of being seen.
The Role of Somatic Therapies
This is why somatic approaches are essential for trauma healing. Modalities like Somatic Experiencing, EMDR, Breathwork, Polyvagal Theory, Sensorimotor Psychotherapy, Internal Family Systems and other body based integration practices all begin with safety.
They focus on titration : introducing small, manageable trauma material into awareness, gradually building the window of tolerance for traumatic memories.
The goal is not to dive into the memory.
It is to help the body trust again.
When that happens, the story begins to emerge.
But now, it is connected to the body.
Memories long forgotten begin to emerge.
And they can be processed and released.
Distorted Memories and the Body’s Truth
Trauma doesn’t just affect emotions; it also distorts how memory is stored and retrieved. During overwhelming moments, the brain shifts into survival mode and stops processing experiences in a linear way. The hippocampus shuts down. The amygdala records fragments of fear and sensation.
This is why trauma memories are often fragmented, sensory, and difficult to explain. The body becomes frozen in a moment that never fully passed – locked in a loop the mind can’t resolve.
Trauma survivors may not remember what happened clearly.
But their body holds the imprint.
They feel the freeze. The dissociation. The tension.
They begin to doubt themselves – not because they’re wrong, but because their memory doesn’t follow a logical sequence. This is where the limits of talk therapy becomes evident.
This isn’t a flaw in memory – it’s the brain’s protective mechanism doing its job under stress. Healing means feeling safe enough to hold the fragmented truths. Not to force them into coherence, but to honour them for what they are: survival responses that once kept us safe.
From Storytelling To Embodiment
Healing is not about emotional release or repeating your story until the feelings fade. It’s about gradually returning to the body, helping it feel safe enough to stay present. When a sensation rises, you stay. When the emotion surfaces, you breathe. That’s where integration begins.
The story changes.
Not because you repeat it.
But because you finally feel it.
Talking has a place. But only when the body is ready to join the conversation. Without safety, words can become a performance. Real healing unfolds in presence – in relationship – in the quiet space where nothing needs to be fixed, only felt.
Speak less.
Listen deeper.
Especially to what the body already knows.
