Trauma Therapy in Dubai | Dr Millia Begum
Dr Millia Begum is a Consultant Psychiatrist and trauma specialist with more than two decades of experience working with PTSD, Complex PTSD, dissociation and the effects of developmental and attachment trauma.
Her work draws on a range of trauma-focused approaches, including EMDR, Deep Brain Reorienting (DBR) and Internal Family Systems (IFS). The choice of therapy depends on the person’s presentation, ability to regulate emotions, levels of dissociation, and current stability.
What Is the Difference Between Top-Down and Bottom-Up Trauma Therapies?
Many psychological therapies involve interactions between conscious understanding, emotional experience and bodily responses. The key differences can be from where we begin the process.
Top-Down Therapies
Top-down approaches may begin with reflection and appraisal: exploring how you interpret an experience and how its meaning connects with your emotions, bodily responses and behaviour. Therapy may involve examining beliefs, considering different perspectives and trying new ways of responding.
Bottom-Up Therapies
Bottom-up approaches place greater emphasis on attending to sensory and bodily experiences as they unfold. Through sustained internal attention, the person may become more aware of automatic responses, associated emotions and changes in their conscious understanding. New insights and shifts in perspective may emerge through this process.
Examples include Somatic Experiencing (SE), Deep Brain Reorienting (DBR), and Mindful Awareness in Body-oriented Therapy (MABT).
Can Therapies Involve Combined Processes?
Yes. Many therapies combine aspects of both, although they may begin from different points in a person’s experience. Here are some examples of therapies that have both components.
Internal Family Systems (IFS)
In the Internal Family Systems (IFS) model, people experience different parts of themselves, including protective parts and parts carrying emotional pain or vulnerability.
Parts may be experienced through thoughts, emotions, bodily sensations or impulses. Within the IFS model, therapy combines attention to emotional and bodily experience, while supporting a more compassionate relationship between Self and parts.
Explore Internal Family Systems Therapy
Eye Movement Desensitisation and Reprocessing (EMDR)
EMDR works with distressing memories and their associated beliefs, emotions and bodily sensations, using a structured approach that includes bilateral stimulation, often guided eye movements.
Processing may involve changes in bodily and emotional responses alongside new insights and perspectives. EMDR therefore involves both direct experience and conscious understanding, rather than fitting neatly into a purely top-down or bottom-up category.
Deep Brain Reorienting (DBR)
DBR focuses on early physiological responses associated with traumatic experiences. Within the DBR model, attention follows orienting tension, shock when present, and the emotional responses that unfold.
Although the starting point is bodily experience, new understanding and shifts in perspective may emerge during processing. DBR therefore illustrates how attention to physiological responses can also involve changes in conscious meaning.
Explore Deep Brain Reorienting (DBR)
Mindful Awareness in Body-oriented Therapy (MABT)
MABT develops interoceptive awareness: the ability to notice, access and sustain attention to internal bodily sensations.
Through guided attention, people learn to explore bodily experiences and how these connect with emotions and personal understanding. Somatic appraisal—reflecting on what is noticed in the body—links this awareness with conscious meaning and everyday choices.
MABT illustrates how an approach beginning with bodily sensations can also involve reflection and shifts in perspective.
How Can Top-Down and Bottom-Up Approaches Be Used in Trauma Therapy?
Therapy may begin by exploring how you understand an experience: what you believe about it, what it means to you and how this influences your responses. This reflects a top-down emphasis.
Alternatively, attention may begin with bodily sensations or automatic responses, exploring the emotions and meanings that emerge. This reflects a bottom-up emphasis.
During therapy, attention can move between these starting points. A bodily sensation may lead to an emotional experience and a new understanding; reflecting on a belief may change how you feel emotionally and physically. How this unfolds depends on the therapy and your individual needs.
Which Type of Therapy Is Right for You?
The choice depends on your difficulties, goals, preferences, previous experiences of therapy and the evidence for treating your condition.
Whether an approach is described as top-down or bottom-up is only one consideration. Assessment can help clarify which treatment may be appropriate, and your therapist should explain its aims, evidence and what sessions involve.
Together, you can agree on an approach and review how it is working for you over time.
Discuss therapy options with Dr Millia
Frequently Asked Questions About Trauma Therapy in Dubai
How do I choose a trauma therapist in Dubai?
It can be helpful to look at the clinician’s professional qualifications, experience working specifically with trauma, and training in recognised trauma-focused therapies.
The approach should also fit your particular difficulties rather than assuming that one type of trauma therapy is suitable for everyone.
What is trauma-informed therapy?
Trauma-informed therapy recognises that overwhelming experiences can affect emotions, relationships, bodily responses and a person’s sense of safety in the present.
It means working in a way that takes these experiences into account while avoiding unnecessary overwhelm.
What kinds of trauma can therapy help with?
People may seek trauma therapy after a single traumatic event, repeated trauma, childhood trauma, attachment-related experiences, traumatic loss or longer-standing difficulties associated with Complex PTSD.
The treatment approach depends on the person’s symptoms, history and current circumstances.
You can read more about Complex PTSD and complex trauma.
Can childhood trauma still affect me as an adult?
Yes. Earlier experiences can continue to influence emotional responses, relationships, self-perception and how a person responds to stress.
The effects vary considerably between individuals, so therapy begins by understanding how those experiences are affecting the person now.
Do I need to talk about everything that happened in trauma therapy?
Not necessarily.
Different trauma therapies involve different levels of direct discussion. Some approaches involve more detailed processing, while others can work with aspects of the experience without requiring a full retelling.
Which trauma therapy is best?
There is no single trauma therapy that is best for everyone.
Approaches such as EMDR have a strong evidence base for PTSD, while other therapies may be considered depending on the person’s presentation, including dissociation, attachment difficulties and complex trauma.
You can read more about EMDR therapy in Dubai.
Can trauma therapy help with dissociation?
Trauma-related dissociation may improve when treatment helps a person understand their triggers, increase present awareness and gradually work with experiences that continue to feel overwhelming.
When dissociation is significant, careful pacing may be important before more direct trauma processing.
You can read more about dissociation symptoms and treatment.
Do I need a diagnosis before starting trauma therapy?
No. You do not necessarily need to know whether you have PTSD, Complex PTSD or another trauma-related diagnosis before seeking help.
An initial assessment can explore what you are experiencing and whether trauma-focused therapy may be appropriate.
Should I see a psychiatrist or psychologist for trauma therapy?
Both psychiatrists and psychologists may provide psychotherapy if they have appropriate training.
A psychiatrist can additionally assess diagnosis, medication and other psychiatric conditions where relevant. The more important question is whether the clinician has appropriate trauma-specific training and experience for your needs.
How do I book trauma therapy in Dubai?
An initial assessment is usually the first step.
This allows you to discuss what has been happening, what you would like help with and which therapeutic approach may be most appropriate before treatment is planned.