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Severe, lifelong trauma can sometimes heal rapidly when therapy focuses on the present moment.

Healing doesn’t always require reliving past trauma.

In the first part of this series, I presented research suggesting, perhaps for the first time, that therapy focused on changing how people feel in the here-and-now can be incredibly helpful even without extensive explorations of the past. But how do you heal past wounds in real time by focusing on the present? I’d like to share a case of a woman I treated who was suffering from severe, lifelong traumas to bring some of the newer techniques to life, as well as some exciting new research.

A few years ago, I decided to teach a weekly TEAM CBT class for Stanford psychiatric residents, featuring live therapy with trauma patients. The idea behind TEAM is radical but simple; in many cases, an entire course of therapy can be completed in a single session.

I invited faculty to refer patients who had suffered severe trauma and had been difficult to help. Each week, I treated one patient while the residents observed, followed by a discussion. This was novel, since most of their teaching emphasized that severe depression takes months—or years—to resolve.

One woman, let’s call her Maggie, had come to Stanford after her private psychiatrist of 20 years died. She said this was a devastating loss, since he had become her only real friend in the world. When therapy becomes a long-term paid friendship, it raises a red flag in my mind. Does therapy involve meeting our patients' needs for intimacy, or giving them the skills they need to develop greater intimacy?

Maggie was in her late 60s and had lived through what clinicians call "complex trauma"—not one catastrophe but many, stretched across a lifetime. One sibling suffered from a severe developmental disorder. As a teenager, Maggie........

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