Complex Post Traumatic Stress Disorder

Adult Psychotherapy
A basic definition of Trauma is… any event or experience, including witnessing, that is physically and or psychologically overwhelming to the exposed individual.  Complex trauma encompasses multiple and repeated experiences of interpersonal trauma, typically beginning in childhood, often becoming chronic. It involves overlapping layers of traumatic experience  ‘stacked on top of” and as a consequence of  attachments to the primary caregivers.

Chronic trauma takes many faces, the obvious ones are physical, and sexual abuse and violence.  Most easily observed are lack of proper physical care, not getting enough to eat, not having decent and clean clothes and not being taken to the doctor or dentist when ill or for regular check- ups. A less apparent , although damaging form of Trauma is emotional  and psychological  neglect where and individual or child is physically provided for, but their emotional , education and social needs are ignored.  Both forms are damaging to the victim and require on-going attention and treatment.

Types of Trauma

• Impersonal– Random occurrences or “Acts of God”
• Interpersonal Trauma- Deliberately caused and or committed by one or more people that is planned and premeditated (abuse, neglect, assault, sexual abuse.
• Attachment Trauma or (Relational Trauma)- neglect, emotional , physical sexual abuse, domestic violence which occurs in a caretaking relationship or a romantic partnership.
• Betrayal Trauma-  Domestic Violence
• Secondary Trauma-  The protector doesn’t protect the victim (rape )
• Institutional Trauma-  The traumatic event is covered up and ignored, or the victim is punished. (abuse by clergy)
• Identity Trauma- discrimination, violence due to gender, race, ethnicity….

Some of the more common emotional reactions to trauma and complex trauma are;

Fear/Terror                            Alienation
Anger                                      Anxiety
Panic                                       Resentment
Disgust                                   Mistrust
Depression                            Shame and Guilt
Sadness                                 Self-Contempt/Self-Hatred

Treatment of Complex Trauma:

Trauma -Informed care
Trauma-informed Care is the philosophy and approach  I use in treatment  based on the fact that many (if not most) individuals receiving treatment with mental health /addiction disorders have a history of trauma that relates directly to their present-day distress.  At your initial consultation and screening I will ask about past trauma along with  weaving educational information about trauma and its impact on you throughout the treatment process.  Secondary symptoms of the original untreated effects of trauma can include, addictions, chronic depression, severe anxiety, anger management issues, chaotic lifestyles….  These issues require treatment and stabilization first, before the underlying trauma can be  explored in detail.

Treatment for complex PTSD include the impact on the individuals identity and self -worth, the ability to identify and regulate emotions and ability to trust and relate to others in healthy and intimate ways. Complex PTSD can further result in dissociation, physical illness and a loss of life meaning, spirituality and overall life satisfaction Typically these symptoms do not get recognized as trauma-related, meaning they are often misunderstood, overlooked and untreated.

A primary challenge for most complex trauma survivors involves recognizing, accepting and modulating, communicating about and even embracing their emotions.  The good news for survivors ,of all trauma, is that survivors  can learn to use their emotions in healthy ways- most importantly as a primary means of discerning their needs, their uniqueness and their identity.  Another primary task in treatment and in order to heal, is to learn how to feel, identify and healthfully process  emotions.