New Trauma Therapy Model Offers Hope for Veterans with PTSD
- Jun 21
- 4 min read
By Dr. Brian Livesay, Ph.D. Licensed Clinical Psychologist, Director of Clinical Research Arise Alliance
An innovative new psychotherapy is gaining attention for its promise in treating military veterans and service members living with trauma and stressor-related disorders like posttraumatic stress disorder (PTSD). Known as Critical Memory Integration™ (CMI), this approach, developed by the ARISE Alliance Institute, offers a refreshing alternative to conventional trauma therapies, one that instead emphasizes deep, embodied healing that goes beyond symptom management.
While many conventional trauma psychotherapies approach symptom reduction through cognitive restructuring for maladaptive thinking patterns or managing sensations and behaviors through habituation and response prevention, CMI™ takes a different path. The CMI clinician invites their clients to connect with their body’s internal signals, which include physical sensations, feelings, and emotions, and to engage in an expansive, experiential process wherein the survival patterns formed during high-stress or life-threatening experiences that underpin these signals can be integrated with the client’s co-occurring sense of agency, connection, and stability.
“In CMI, we don’t try to override, diminish, or regulate emotions, and we don’t look for a way to compensate for them either. Rather, we invite clients to engage them directly,” explains Dr. Brian Livesay, PhD, Director of Clinical Research at ARISE Alliance and staff psychologist at the Cheyenne VA Medical Center. “CMI leverages a mechanism of change that Memory Reconsolidation Theory defines; here, the idea is simply about our ability to make malleable some existing structure of how I remember, how I proceed, or how I operate, and then to update it.”
Reframing Trauma: From Pathology to Adaptation
A key principle of the CMI modality is that trauma responses are not signs of psychological dysfunction but rather functional adaptations to deal with overwhelming or life-threatening experiences. For veterans, who may have spent years in high-stress environments, these adaptations often persist long after returning home.
The hypervigilance that once kept a soldier alive on the battlefield may now lead to insomnia, anxiety, or outbursts. Emotional numbing, a tool for surviving grief and loss, may create barriers to intimacy and connection in civilian life. CMI doesn’t pathologize these reactions; it validates them and helps individuals safely engage with their places of origin.
“Veterans often carry unintegrated experiences and even when they can’t find the words,” says Dr. Livesay “CMI gives them a framework to understand and approach those internal conflicts by embracing what the body has been trying to communicate through complex feelings.”
How CMI Works
CMI sessions begin by cultivating a safe, connected environment. From there, therapists use “Invitation” to guide clients to explore internal sensations, feelings, emotions, metaphors, and memories using another CMI technique called “Sensory-Emotion Expansion.” These initial steps help the client activate and identify the constituent parts of their critical memories that may have once protected the individual but are now causing distress.
By working directly and experientially with these critical memories, clients begin to reintegrate parts of themselves that have been disconnected. “What we are seeing is that CMI increases their capacities for agency, connection, and stability when complex sensations, emotions, and thoughts arise.” Says Dr. Livesay. “For the client, having a greater awareness of their internal world and a deeper relationship to it…this can lead to a restored sense of identity and significant changes in how they engage with themselves and others on a daily basis.”
CMI has shown promise in treating PTSD, complex trauma, combat-related stress injuries, experiences with morally injurious events, symptoms of depression and anxiety, and relational and identity challenges that so often amplify following the service member’s discharge from the military.
Why Does This Matter for Military Communities?
The mental health challenges facing veterans are significant and well-documented.
According to the U.S. Department of Veterans Affairs, between 11% and 20% of veterans who served in Operations Iraqi Freedom and Enduring Freedom experience PTSD symptoms each year. For Vietnam veterans, that number remains around 15%.
“What concerns me most is the data we have on treating things like PTSD, where as many as two-thirds of Veterans who engage with treatment also fail to receive an effective dose.” Dr. Livesay stated, “We need to rethink how we conceptualize these problems, and we must change our approach to solving them.”
What sets CMI apart is its emphasis on empowering individuals through connection rather than correction. It acknowledges the intelligence of the body and the integrity of the survival responses veterans have carried sometimes for decades.
Looking Ahead
As research and clinical trials continue, ARISE Alliance hopes to expand CMI’s availability to more veterans and service members across the country. The model is also being adapted for use with first responders, survivors of childhood trauma, adoptive and foster children, and others with complex post-traumatic stress.
“We are still early in the development cycle of CMI, which means empirical support for CMI is still being gathered; what we do have is a firm understanding of the mechanisms of action in CMI, and for these, the existing evidence is strong.” Says Dr. Livesay. “There is also no formal endorsement by the VHA for Critical Memory Integration at this time.”
For service members who have found conventional talk therapy or medication-based approaches to be incomplete, CMI may offer the renewed sense of hope they’ve been seeking, a path forward that doesn’t demand forgetting or silencing the past, but instead fosters the courage to understand and integrate it fully.
To learn more about Dr. Brian Livesay and the CMI model, visit arisealliance.org.
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