I think that learning to regulate is quite a step because, therapists that don't have an understanding of this nervous system effects that trauma has on people, might re-traumatize them, not because they're mean, but because they're clueless. I think that, generally speaking, people can benefit more from therapy if they are a bit more regulated, or even better, if they find a therapist who knows how to work with regulation.
Yes indeed, it really seems that way. Sad thing being that the less regulated you are, the moe easily discouraged you are, the less of your prefrontal cortex and left hemisphere are online to help you protect yourself while searching for a good therapist, or muster the courage and motivation to do so, etc. It's quite a puzzling bind, by appearances. "To him who has, more will be given. From him who has not, even what he has will be taken away." Or however exactly that Bible quote goes. Matthew 13:12, looks like. Of course the context of that is different in the text.
There is a segment in "The Body keeps the Score that's directly relevant to what you wrote, which I was planning on quoting here anyway. But before quoting that, I want to relate it to Oxajil's question and study:
Talking out? Is she talking about a specific therapy? Which recent knowledge? (Asking out of curiosity!) Trauma therapy can trigger a lot of emotions, but with continuous sessions those strong emotions should subside. For example, I talked to someone who had PTSD (she was abused multiple times in childhood and adulthood) who told me that she almost got angry with her therapist because she didn't like the trauma therapy and that she had to think back to those events, but she stuck with it and is doing much better now and is finishing up her internship and starting work soon.
And just to show, despite symptoms getting worse temporarily for some people undergoing trauma therapy, in the end they still benefited:
Source
Page 73 is the end of a chapter called "Running for your life: the anatomy of survival". Bessel van der Kolk outlines some brain anatomy and studies he was involved in that illustrate how trauma rewires the brain by causing certain regions to be less active and other to be more, and how those patterns relate to the functions of those brain regions.
Just after talking about how some people respond to trauma by "blanking out" (dramatically decreased brain activity in more or less all regions during a trigger episode, rather than the fight-or-flight conscious or unconscious "reliving" that many others experience), he closes out the chapter with this:
p.73
LEARNING TO LIVE IN THE PRESENT
The challenge of trauma treatment is not only dealing with the past but, even more, enhancing the quality of day-to-day experience. One reason that traumatic memories become dominant in PTSD is that it's so difficult to feel truly alive right now. When you can't be fully here, you go to the places where you did feel alive -- even if those places are filled with horror and misery.
Many treatment approaches for traumatic stress focus on desensitizing patients to their past, with the expectation that reexposure to their traumas will reduce emotional outbursts and flashbacks. I believe that this is based on a misunderstanding of what happens in traumatic stress... We must most of all help our patients to live fully and securely in the present. In order to do that, we need to help bring those brain structures that deserted them when they were overwhelmed by trauma back. Desensitization may make you less reactive, but if you cannot feel satisfaction in ordinary things like taking a walk, cooking a meal, or playing with your kids, lift will pass you by.
So it sounds like maybe we need to be a little careful and make sure that when studies report a "reduction in symptoms", they aren't unwittingly reporting that the patients are developing a desensitized mode of living. "Competent but dead inside". I'm not assuming that was the case for that particular study, it's just a thought to keep in mind.
One thing to note about Dr. van der Kolk is that he got his medical training in the late 1960s, and began on the path of studying trauma in 1978 or so. in other words, besed on his descriptions, it sounds like trauma has been his primary focus during pretty much the entire span of modern trauma research. He was there for the whole thing, and in fact contributed to a fair share of it, by the sound of it. He was one of the first to witness the dramatic and hope-inspiring effects of Prozac, but also the way in which that initial hope gave way to an overbearing money-driven system based on the "brain chemical imbalance" model of mental illness, which medicates and enables coping but often does not heal its patients.
The book is also very readable so far, an impressive dynamic blend of personal narrative, historical context, and scientific data, without filler. I'm very much thinking this is a candidate for the main reading list.
I'm coming to realize that none of the trauma-related books currently recommended seem to give quite the overview that this book seems to offer (as well as "Complex PTSD: from Surviving to Thriving", which I'll read next). Nor do they really give a comprehensive enough picture for someone like myself to feel like a had an idea what to do or where to start, having read them. (To be clear, I read "The Narcissistic Family", "The Myth of Sanity", "In an Unspoken Voice", "Healing Developmental Trauma", "Fear of the Abyss", "Thinking Fast and Slow", "The Adaptive Unconscious", "Writing to Heal", "Political Ponerology", "The Anatomy of Violence", and "Inside the Criminal Mind", with at least one or two others).
It might be bold of me, but I think we lack a synthesis that unites our healing materials. Personally, I've had motivation issues for a number of years, plus problems with beating myself up over it (consciously or not, I think, "trying not to" isn't the best approach, I'll report, haha). Since I like to learn, I've been able to accumulate a decent amount of knowledge (at least "first pass knowledge"), including tools and concepts. Eiriu Eolas, Pennebaker's Writing to Heal concepts, cold therapy, references to various therapies one can do with a professional.
Trouble is, to do those, one has to be able to reach a state of a certain amount of self-regulation in the first place, to "make the hop" to action. Or at least it seems, tentatively, that's part of the picture. This is where I think Anna Runkle's emphasis on regulation strategies, and recommendation of these two books, is very valuable. It provides a starting point that is more reachable and enables/potentiates the next steps.
Or so I think.