PTSD can occur when someone experiences a single traumatic event. But what happens when a person is exposed to a traumatic environment over a long period of time?
Healing from PTSD is challenging enough, but a person with a history of trauma who is re-traumatized is often likely to develop what’s called complex PTSD.
Patricia Resick, PhD and her colleagues studied the potential for healing in women with an extensive history of trauma who were diagnosed with complex PTSD as a result of rape.
She randomly assigned them into cognitive-processing therapy, prolonged exposure, or a wait-list control.
Results showed that even when someone has endured prolonged trauma, there is still time to heal.
Measures taken at the end of the intervention and 9 months later showed improvement in depression and PTSD symptoms compared to the control group.
I love when science shows it’s never too late to heal.
But complex PTSD comes with its own set of issues.
Judith Herman, MD is the psychiatrist responsible for coining the term “complex post-traumatic stress disorder” and I’m pleased to let you know that we’ve been able to arrange a special bonus webinar with Dr. Herman as we finish up the 2012 Trauma Webinar Series.
We made a short, 1 minute video highlighting the webinar − take a look below.
If you have not yet signed up for a Gold Membership, there’s still time.
Here’s the link to check out our latest series on the treatment of trauma.
What has been your experience treating patients with complex PTSD? Please leave a comment below.
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I am writing a paper on trauma and would like to know is rape a complex trauma and can the victim recover from the incident.
I hope this isn’t the second response you receive,because my first disappeared.
I was very excited to see the brief video about Dr. Judith Herman’s work on “complex trauma”. I have been struggling to figure out my intense feelings of trauma. Though I have read some books on trauma and followed your website’s series, nothing has quite fit with my experience. Since I can find no events to work through, I continue to feel the trauma, frustration, and confusion. I am so grateful to learn of something that better describes my experience. It’s like the expression “death from a thousand cuts”. I am not a professional therapist, just a seeker of help that I haven’t found in counseling.
Is there any way I could see this one webinar without becoming a Gold member, or would it be best to go straight to Dr. Herman’s book?
I am thankful for your website and I am very appreciative of the value and clarity of information you offer. Thank you, Ardella Culp. ardelladc@gmail.com
Over the last ten years I have been Sr. Group Therapist at Thalians in Los Angeles. Now the inpatient and outpatient units are closed. Reflecting and writing for a couple of months, I again thank Peter Levine and others in the field for elucidating the organism’s response to thwarting. Thwarting is what happens when you can’t change, stop, or get through what you need to do. The trauma can be big or little; the thwarting reaction sets us up for re-enactment. I taught trauma and recovery in the morning in preparation for the afternoon’s process and mindfulness groups. People could empathize with their own complex stress reactions to seemingly minor daily thwarting situations. Often in the “group body” they could recognize their reactions, drop some shameful isolation, and get interested in healing. They might experience less fragmentation or fixation, and experience some peace and play in the relative safety of the social milieu. As we would agree, if you can accept or accomplish these moments on an inpatient unit, you can do it anywhere. Thank you Ruth.
Thanks for your comment about ‘thwarting’ – great word to describe experiences very familiar to those with Complex PTSD.
Jan,
I just stepped into this blog tonight which is after a long time after the event. The Trauma subject caught my attention and especially the complex ones. I am a person working on self healing, I do not have a therapist or working much with therapist , w/o illustrating the details of why here to keep it simple. I like to find out more In which work or book of Peter Levine, he explain the Thwarting Process? And where I might be able to find any group as such that are not too costly in LA that you know of? I do not know how this panel work after my posting , if you can get my notes to you through an email to notify you.
thanks very much
To say I am excited that Dr. Herman has been added to the trauma series would be a major understatement.
Her identification of complex trauma meant that those clients often identified as resistant, hysterical, difficult and difficult to treat could now be better understood within the context of theory. Her ideas provided a way to view unpredictable symptom clusters that defied a single label. Research continues to show that complex PTSD is a phenomenon to be reckoned with if we are going to indeed help, and not further harm, those clients who have often suffered for decades in the chaotic aftermath of Complex PTSD.
My experience has taught me that Dr. Dan Siegel’s work provides an enormously helpful framework in working with these clients. The attachment work of Bowlby, Main and others and the affect regulation work of Dr. Schore underpins more recent research on the effect of early ongoing trauma on the developing infant brain. Trauma to a brain that has not acquired language, but is still laying down non-narrative memory, results in symptoms and behaviors that often seem inexplicable to the survivor and those around them.
I have found that there is great danger of retraumatization of the client in therapy. The inherent power differential in the therapeutic relationship can easily trigger emotional states first created in an abusive early environment, hampering therapeutic progress. Respect for the client’s adult status is critical to lasting healing. Educating clients on the affects of early trauma, including the existence of implicit non-narrative memory and its impact on affect regulation, is both respectful and empowering. These clients may never remember the events that created their inability to regulate their emotion – but they can understand that ‘something’ happened and they can understand the impacts of that something. This results in shame reduction and the ability to work on affect regulation in a way that does not make the client feel like a misbehaving child.
Finally, in my experience, neurotherapy is highly effective in ‘switching off’ the supercharged nervous system – allowing the client to experience and maintain a baseline that does not make them feel as if a tiger is on their tail 24×7. Neurotherapy can produce very significant results in just a few sessions.
Dr. Herman was my first teacher on this subject through her book on trauma and recovery. Her work provided a turning point for me and made sense of the confusion. I can’t wait to hear what she has to say.
My personal experience and my professional experience agree that the body is always about healing. It isn’t just the cut on your finger that gets healed. Sometimes it can take more time and support than we’d like but our wonderful bodies will heal from everything if we are patient and loving of ourselves and can teach our clients to do the same. I have found that the hard truth is that to truly heal you sometimes have to revisit the muck so it is vital to have support and safeguards in place so that can happen w/o retraumatization. I have been using tapping since Gary Craig first introduced it and so am very pleased that APA finally recognized its value.
I have found tapping works really well too. I didnt want to believe it– too simple but I cant argue with results.The thing I love is thatt the client learns to take care of herself using that method…our work in healing is also creating independence which raises self-esteem noticeably and tapping is a method that helps clients ride into their own lives without the training wheels (us, the therapist).. Roger Callehan predates Gary and it looks like Callehan doesn’t get credit for his work…it also looks likeEMDR emerged from his work as well. I was surprised to see the eye thing in Callehan…I always say thank our foremothers ad fathers.
I also use tapping as an effective part of my therapy with clients. However, it is not true that APA has recognized it. This was a rumor that got started based on the announcement of some very significant research and good news about EFT.
I agree that EFT is a wonderful tool, however the APA has not approved it. Rather, an article will be coming out, authored by David Feinstein, that cites enough studies to have it be considered for acceptance, but the acceptance has not been granted to date.
J Maxwell is right, APA has not approved tapping for continuing education credit. David’s a careful, wonderful writer and his article will be very helpful but more research needs to be done – especially carefully designed, randomized controlled studies.
Ruth
I would like to have seen EMDR as part of the study Judith Herman did for PTSD.