Treatment for PTSD and Complex Trauma

Those who experience trauma struggle with a combination of problems due to unwanted, abusive, and/or traumatic experiences. After trauma, survivors may experience depression, anxiety, PTSD, trouble caring for themselves, and relationship issues.

Recovery from trauma does not necessarily result in being “free” of the traumatic events that affect you, but the opportunity to live in the present without feeling flooded with thoughts and feelings from the past. Trauma is not a mindset, but rather a physical, emotional, and spiritual illness.

In Bessel Van Der Kolk’s, The Body Keeps the Score: Brain, Mind, and Body in the Treatment of Trauma, he explores the biological effects of traumatic stress on the body including how trauma rewires the brain. As Van Der Kolk describes, “Trauma is not the story of something that happened back then. It’s the current imprint of that pain, horror, and fear living inside people.” For those struggling with PTSD the trauma continues to live in their body after the event(s). Trauma affects us psychologically, physically, emotionally, behaviorally, cognitively, relationally, and spiritually. With that said, psychotherapy needs to be holistic and incorporate mind-body therapies.

Dr. Nadine Burke Harris, who wrote The Deepest Well, explores how adverse childhood experiences can have lasting effects on human health. Childhood adversity changes human biology, which results in increased rates of heart disease, diabetes, asthma, and other illnesses. When our brain is constantly in fight-or-flight we produce toxic stress in our bodies. This toxic stress affects our mental health as well as our physical health. Given this, treating trauma requires an integrative approach.

Survivors of trauma can exhibit the following symptoms:

Hyper-vigilence: looking out for danger, trouble sleeping, easily startled, angry outbursts
Avoidance: of certain spaces, thoughts, people, or objects
Reliving: nightmares, flashbacks, and triggers
Dissociation: feeling disconnected from the body and/or amnesia
Feelings of shame and problems with mood

Other symptoms of complex trauma may include:

Difficulty regulating emotions: feeling “out of control” when experiencing strong emotions
Trouble remembering large parts of personal history
Low self-worth, chronic feelings of shame or guilt, and negative self-talk
Not feeling a sense of self, or sense of self is dependent on another person

Trauma bonding, which is a strong attachment between an abused person and their abuser formed as a result of the cycle of abuse.

Emotional numbing
Self-harming
Addictions

Healing from trauma is possible. Occasionally, individuals may experience post-traumatic growth in the final stages of recovery. Working with a skilled and experienced therapist who incorporates a mind-body approach is essential to recovery. There are three stages of recovery in trauma therapy explored below, which are adapted from Judith Herman’s Trauma and Recovery.

Safety and Stabilization

The first step in this stage is developing an understanding of the effects of trauma and treatment. There are three main types of safety that are strived for in this stage:

Feeling safe in our bodies
Feeling safe emotionally
Feeling safe in our environment

This work includes learning new coping skills and learning how to manage overwhelming emotions. This stage practices living in the here-and-now. Survivors are learning to remember trauma as opposed to reliving it. This involves developing a safe living situation, a safe and stable job, and a support system. Creating safety is the foundation for future stages of trauma work.

Overcoming Traumatic Memories

There is grief related to experiencing and overcoming trauma. In this stage, we process trauma by putting words to experiences and emotions. It is not necessary or required to discuss details of traumatic events, however, memory processing can help eliminate triggers we continue to experience related to specific memories. Many survivors find Eye Movement Desensitization and Reprocessing (EMDR) helpful for reducing disturbing images, thoughts, and body sensations while increasing feelings of resiliency, confidence, and belonging. Also in this stage, mind-body therapies are the most effective because trauma lives in our bodies as well as in our minds. When we make space and time to grieve our experience we can move past it to live more fully in the present.

Integration and Living in the Present

Over time, we begin to develop shame resilience and create meaningful lives. At this stage, survivors start to reconnect with the present moment and make choices about how to engage in their lives. Survivors challenge themselves in healthy ways to increase resiliency and create meaning in their experience.