In the past, psychological issues were invisible. Their causes were—and often still are—interpreted through the study of behavior and through clients’ own interpretations of their environment and internal experiences. Many therapies are developed based on earlier assumptions or theories, and their effectiveness is interpreted. But that tells us very little about the degree of true healing on a neurobiological level.

Thanks to modern neuroscience and a deeper understanding of neurobiology, we can now make trauma visible. What does a traumatized brain look like? What isn’t happening that should be happening? And what does a person need in order to create real transformation in the brain?

For more information about what makes a traumatized brain different from a “safe” brain, please visit this page.

For more information about how trauma develops, how it can manifest, and how it becomes visible through neurology, please visit the page: Trauma & Dissociation.

There is currently a lot of focus on the autonomic nervous system (ANS). In the world of therapy, we’ve shifted from “understanding everything” to “regulating the body.” The body has become the new and absolute entry point, with the ANS in a leading role. After all, The Body Keeps the Score, and the Polyvagal Theory shows that safety begins in the body—so if you regulate the ANS and stimulate the vagus nerve, the rest will follow. Right?

Not quite.

Neither Van der Kolk’s book nor the Polyvagal Theory actually say that. They describe the ANS as a detection system—a messenger, not a director. It gathers information from the body and the environment (like heart rate, digestion, breathing, hormonal shifts) and sends that input via afferent nerve pathways to the brainstem.

In the brainstem, that raw input is combined with other signals: what you see, hear, feel, your hormonal state, your spatial orientation. A first assessment is made: is this safe or not? That assessment then moves to the limbic system, where emotional meaning is added based on past experiences. Only after that does the ANS respond with action: speeding up, slowing down, tightening, releasing.

So the ANS follows the brain’s interpretation. It’s part of the response, not the conductor—and therefore not the key to healing on its own.

Neuropsychiatrist Ruth Lanius adds another layer: according to her, trauma arises primarily from a loss of integration between the brainstem, the limbic system, and the cortex. These three areas become disconnected, breaking the coherence between sensation, meaning, and bodily awareness. You know something, but don’t feel it. You feel something, but don’t understand it. Regulating the ANS helps only to a certain extent, because the system as a whole isn’t integrated.

Regulation needs to happen at the level of the brainstem.

That’s why I don’t work primarily with the autonomic nervous system, but with how your entire system gives meaning to what you experience. Because that’s where survival adaptations arise—and where healing begins.

In exposure therapy, the idea is that you gradually get used to and learn to cope with memories of traumatic events by retelling or reliving them in a safe setting. But in practice, this often backfires for people with trauma. You’re being exposed to the content of what happened—but not always in a way your system can actually handle. These memories are often “contaminated” with the overwhelming emotions and responses from the past—the very things you couldn’t manage at the time.

Researchers have shown that traumatic memories are often not stored in a chronological or logical way. They are fragmented across the brain: as isolated images, bodily reactions, and emotions without words. When someone is asked to tell the full story “in order,” the system often becomes overwhelmed. The prefrontal cortex—the part responsible for structure and language—tends to shut down, and the survival brain takes over. At that point, you’re not processing—you’re surviving again.

That’s why exposure therapy can actually reinforce trauma instead of healing it—especially if it’s introduced too early in the process, or without taking dissociation and neurobiological safety into account.

Healing doesn’t begin with telling the whole story. It begins with being able to stay present, here and now—so your system can even begin to tell the difference between this is now and that was then.

Because trauma doesn’t take place in language or knowledge.

What we call trauma isn’t a memory you can simply retell. It’s stored in the deeper layers of your system: in images, sounds, snapshots, intense emotions, physical reactions, tension, absence. Often, there are no words—or the story doesn’t match what the body is communicating. That’s exactly how trauma organizes itself: thinking and feeling are disconnected.

Traditional talk therapy mostly works from the cortex: understanding, explaining, analyzing. That can offer temporary relief, but it doesn’t change how your system automatically responds. The parts of the brain responsible for language and insight are often less active when trauma is triggered. In those moments, the survival brain takes over—and it doesn’t speak language.

Without addressing those deeper layers, and without first creating neurobiological safety, you’re just talking about what happened, without your system being truly present. And if you do access the trauma without the right foundation, you quickly become overwhelmed—or shut down. Your brain perceives that as unsafe. That’s why there’s often resistance to therapy; you never know when the flood might hit.

That’s why talking alone usually doesn’t work—it’s simply not the right place.

Finding Solid Ground (FSG) is a new therapy based on years of neurobiological and neurological research on trauma. It was developed by Hugo Schielke, Bethany Brand, and Ruth Lanius. On this page, you’ll find more information about FSG.

For more information about the therapies and tools I use, please visit this page. You’ll also find an overview of what sessions and the overall therapy process typically look like. For details about my education and training, I invite you to visit my LinkedIn profile.

You will find the document here