There are two methods for brining about change. The first is creating tools to manage symptoms. This includes such things as learning relaxation techniques, visualization, creating a safe place, a container to help manage thoughts, and developing a support network, etc. This is necessary in the initial work that is done in therapy. The second method is processing the past to bring about a different perception of the self and your environment. It is possible to process the past cognitively, however it is a very slow method, and I have never known it to be completely effective. I agree with much of current theory that trauma is held in the body as well as in the brain and has a tremendous impact on emotions. By connecting the cognitive process with the bodies memory of trauma and the emotional response one has to the environment it is much easier to bring about effective long term change. This can be done with somatic work, Eye Movement Desensitization and Reprocessing (EMDR), and other methods. I have experienced success using the creative process with exercises like creating a path from where one is to the identified goals as a tool that is often useful in initiating change and in maintaining direction. When processing past memories and the responses associated with them, long term change can occur that fundamentally changes ones relationship with the self and the world around us.