What Are The Symptoms
The symptoms of post-traumatic stress disorder and complex PTSD are similar. But complex PTSD comes with a wider range of difficulties. You go through extreme inner turmoil, and the symptoms last much longer.
The signs dont necessarily manifest all at once. They can appear gradually or be triggered later in life by stressful or upsetting experiences.
Without treatment, C-PTSD lowers the chance of successful reintegration into lifes routines. When you have C-PTSD, typically youll experience devastating symptoms and related mental health conditions that include:
- Emotional detachment and dissociation
- Struggling to regulate negative emotions
- Having thoughts of shame or of being bad
- Flashbacks to memories of trauma
- Intense, overwhelming feelings of helplessness or horror
- Becoming hyper-protective or hyper-vigilant
- Identity disturbance
- Distrust and fear of intimacy
- Difficulty forming relationships
- Alcohol and substance abuse
- Suicidal thoughts and suicide attempts.
Dissociation is a natural coping mechanism. The patients feelings and memories become too much to bear, so they break off from them. As a result, they become emotionally shut off from their past, present and future. Its like theyre living through a thick veil of fog.
C-PTSD is sometimes misdiagnosed as borderline personality disorder or generalised anxiety disorder. This means many people with C-PTSD remain undiagnosed and miss out on the ideal treatment.
Safe And Practical Emdr For Complex Ptsd
Presented By
Complex-PTSD, while not a diagnosis in itself, is thought of as a category of PTSD resulting from multiple traumas, often occurring over time, often within an atmosphere of attachment disordered relationships and neglect. This workshop will provide essential information on the treatment of Complex- PTSD within the 8 phases of EMDR. Gain knowledge of: assessment, coping skill and resource development treatment of traumatic material through paced and titrated EMDR processing designed to keep clients on track with their healing process, provide protection from decompensation integration of gains and adjustment to a life not based on traumas from the past.
About Dr Arielle Schwartz
Dr. Arielle Schwartz is a licensed clinical psychologist, wife, and mother in Boulder, CO. She offers trainings for therapists, maintains a private practice, and has passions for the outdoors, yoga, and writing. Dr. Schwartz is the author of The Complex PTSD Workbook: A Mind-Body Approach to Regaining Emotional Control and Becoming Whole. She is the developer of Resilience-Informed Therapy which applies research on trauma recovery to form a strength-based, trauma treatment model that includes Eye Movement Desensitization and Reprocessing , somatic psychology and time-tested relational psychotherapy. Like , and sign up for email updates to stay up to date with all her posts.
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Is Complex Ptsd A Separate Condition
ICD-11 complex PTSD as a separate condition, though the DSM-5 currently does not. Some mental health professionals are beginning to distinguish between the two conditions, despite the lack of guidance from the DSM-5.
Research has also supported the validity of a separate diagnosis of complex PTSD. At least 29 studies from more than 15 countries have consistently shown the differences in symptoms between traditional PTSD and its complex variation.
One 2016 study that included more than 1,700 participating mental health professionals from 76 countries showed that clinicians could differentiate between the two diagnoses.
A person with complex PTSD may experience symptoms in addition to those that characterize PTSD.
Common symptoms of PTSD and complex PTSD include:
- avoiding situations that remind a person of the trauma
- dizziness or nausea when remembering the trauma
- hyperarousal, which means being in a continual state of high alert
- the belief that the world is a dangerous place
- a loss of trust in the self or others
- report complete amnesia of the trauma.
- Preoccupation with an abuser: It is not uncommon to fixate on the abuser, the relationship with the abuser, or getting revenge for the abuse.
Symptoms of complex PTSD can vary, and they may change over time. People with the condition may also experience symptoms other than the above.
What Is Emdr Therapy
EMDR stands for Eye Movement Desensitization Reprocessing. Its a way for our brains to become emotionally immune to traumatic memories and develop positive beliefs in place of intrusive thoughts caused by trauma. This is achieved through eye movements or other types of side-to-side stimulation.
EMDR therapy was developed in 1987 by Francine Shapiro and has since grown into a popular trauma treatment approach supported by a lot of research. Its popularity increased even further when Prince Harry of the British royal family revealed that he uses EMDR in his own therapy work.
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Emdr As A Treatment For Single Incident Trauma
If someone has a secure attachment style or doesnt have a trauma historyand then they experience a traumatic event, like a car accident, a robbery or even going to warEMDR may help them to resolve the trauma very quickly. This is because, without a complex trauma history, this person is more likely to already be in a stabilized place from which they can process the trauma, allowing phase 1 and 2 to move quickly.
Emdr And Trauma: What You Need To Know
Do you struggle with a vague feeling of hurt?
Are you feeling stuck in the same job, same pain, fame fear, or same daily grind?
Do you struggle to believe you are worthy or capable of a better life for yourself?
These are self-limiting behaviors and can be a result of trauma. One treatment used to treat these self-limiting behaviors is Eye Movement Desensitization and Reprocessing .
We have seen an increase in patients asking about EMDR lately, which may be in large part due to the treatment being popular in mainstream media. However, these stories dont supply a full understanding of the treatment.
As a trauma-informed, strengths-based, systems therapist, I have firsthand experience providing EMDR. I first received training in EMDR in 2001. As an EMDRIA certified therapist, I am now an EMDRIA Approved Consultant . I am excited to be able to provide consultation for other licensed clinicians who have completed EMDRIA approved training.
I want to share what I know from my professional experience to help more people understand this therapeutic approach.
To understand EMDR, you first need to know a little about how we understand trauma.
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Impact On Marginalized Communities
The number and type of ACEs a person experiences can depend on the persons culture, race, ethnicity, religion, and other identifying factors. Social inequities in the U.S. mean that people from historically marginalized groups can experience more ACEs.
Research shows that 61% of Black non-Hispanic children and 51% of Hispanic children in the U.S. have experienced at least one ACE, compared with 40% of white non-Hispanic children and 23% of Asian non-Hispanic children.
In most regions of the U.S., the prevalence of ACEs is highest among Black non-Hispanic children. Overall, the lifetime prevalence rate of PTSD among Black people is than that of other groups.
Social inequities and inconsistent access to health insurance and treatment also mean that people from marginalized groups
ICD-11 states that a clinician must determine that a person meets all the criteria for traditional PTSD before diagnosing complex PTSD.
In addition, the person must show problems with self-regulation, low self-esteem, a sense of shame or guilt related to past trauma, and problems maintaining relationships with others.
Before the WHO updated its diagnostic criteria to include complex PTSD, clinicians may have chosen to diagnose a person with an enduring personality change after a catastrophic experience or with disorders of extreme stress not otherwise specified. The intention is for the new diagnosis of complex PTSD to replace these old diagnoses.
Options for treatment include:
Emdr As A Treatment For Complex Developmental Ongoing Trauma
Complex trauma is identified by Judith Herman and other leaders in the field of traumatology as the existence of a complex form of posttraumatic disorder in survivors of prolonged, repeated trauma.
Essentially, complex trauma creates a long-lasting trauma imprint or response that impacts your brain and body enough to feel like its a permanent change. Using the example above, the neural pathways of the brain connect the sight of the frown and danger, for instance. For people with complex trauma histories, the mind and body may be in a chronic state of stress and hypervigilance, always waiting for the other shoe to drop. This is why I take a mind-body approach to trauma recovery.
Childhood trauma, attachment trauma and developmental trauma such as abuse or physical or emotional neglect will take longer to process with EMDR or any type of therapy. This is mostly because it takes longer to achieve a foundation grounded by emotional stability. It takes time to establish resources self-care, from which the patient can comfortably and safely process the trauma.
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What Is Complex Ptsd
PTSD is usually related to a single event, while complex PTSD is related to a series of events or prolonged events. Some examples of complex PTSD are:
- Childhood neglect
- Physical or sexual abuse early in life
- Witnessing domestic violence
- Exposure to traumatic events while serving in the military
- Being a refugee or living in a wartorn region
People with complex PTSD may experience difficulties with relationships. They tend to avoid others and may feel a lack of connection to others.
The Progressive Approach To Emdr Group Therapy For Complex Trauma And Dissociation: A Case
- 1Department of Psychiatry, University Hospital Coruña, A Coruña, Spain
- 2Assistens Clinic, A Coruña, Spain
- 3Biomedical Research Institute, A Coruña, Spain
- 4EMDR Europe Association, Schaffhausen, Switzerland
- 5EMDR Spanish Association, Madrid, Spain
- 6Faculty of Psychology, Universidad Nacional de Educación a Distancia, Madrid, Spain
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Eye Movement Desensitization And Reprocessing
Eye movement desensitization and reprocessing is a technique that may help people with PTSD or complex PTSD.
After preparation and practice, the therapist will ask the person to recall the traumatic memory. The therapist will move a finger from side to side, and the person will follow the movement with their eyes.
When effective, this process helps to desensitize the person to the trauma so that they can eventually recall the memory without having a strong adverse reaction to it.
EMDR is controversial because the exact mechanism by which it works is unclear.
However, several guidelines, including those of the American Psychological Association, recommend EMDR as a treatment for PTSD under certain conditions.
They caution that confirming the effectiveness of EMDR for trauma will require more research.
How Does Emdr Therapy Work
Eye movement desensitisation reprocessing therapy is commonly used by clinical psychologists to treat conditions such as complex trauma and phobias. Its a highly effective form of therapy that changes how you respond to past events.
The brain stores traumatic experiences in a unique way. These negative episodes are imprinted in our memory as vivid perceptions. But our brain can also adapt trauma imprints if we are exposed to appropriate sensory interventions.
Helping patients to stay in the present moment through mindfulness techniques and talking therapy is an essential part of preparing to work with EMDR therapists.
EMDR works by stimulating the brain through eye movement therapy or similar sensory stimuli. This aims to unlock the trauma in your mind by examining the cause of your most pressing issues. The therapist acts like a witness during EMDR sessions so you are not reliving anything distressing on your own. This enables you to process and find relief from disturbing memories and related feelings.
We support you to feel relaxed and safe, without needing to be on guard for something dangerous you believe could happen. By making sense of your past in a positive and self-compassionate way, we help you come to terms with your negative thoughts.
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Symptoms Of Complex Ptsd
A person with complex PTSD may experience symptoms related to their condition that are similar to PTSD. These symptoms include:
- Hyperarousal, or being in a state of high alert
- Loss of trust in oneself or others
- Difficulty sleeping or concentrating
- Being startled by loud noises
- Issues with emotional regulation
- Detachment from the trauma
Aside from these symptoms, people with complex PTSD might also engage in behaviors related to their trauma. Examples of these behaviors include:
- Abusing alcohol or drugs
- Lashing out at minor criticisms
Engaging in these behaviors develops as a way to cope with the trauma and emotional pain. Once the trauma has passed, a person may rely on these behaviors whenever they feel emotional distress. A person with complex PTSD can learn to replace these behaviors with more positive and constructive ones.
Combining Emdr And Schema Mode Therapy For Complex Posttraumatic Stress Disorder
What is Eye Movement Desensitization and Reprocessing?
Eye Movement Desensitization and Reprocessing was developed by Francine Shapiro in 1989 as a method of treatment for Posttraumatic Stress Disorder .
Over time, researchers and therapists expanded the use of EMDR to include several other mental health diagnoses besides PTSD. It was discovered that not only did EMDR eliminate the impacts of acute memories leading to PTSD, but it also eliminated the negative impacts and irrational self-perceptions caused by nonacute memories and bad experiences in general. This is particularity true with individuals who have a history of repeated abuse or repeated traumatic incidences causing Complex Posttraumatic Stress Disorder .
Due to the many complexities found in the assessment and treatment of Complex PTSD, EMDR treatment required added interventions and assessment tools. These tools can be found in Schema Therapy and one of its interventions called Schema Mode Therapy. This article explains how EMDR and Schema Mode Therapy can be combined for increased speed and effectiveness for treatment of individuals suffering from Complex PTSD.
EMDR and Neurobiology
EMDR and the Two Primary Positive Treatment Reactions
During EMDR treatment, which is administered by a psychotherapist, a client responds to the neurobiological process described above and experiences two primary reactions to a traumatic memory. First, there is a distancing from the memory
What Is Schema Therapy?
Schema Modes
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What To Expect In Emdr For C
EMDR therapy is broken down into eight specific phases that can be summarized as follows:
Resourcing
As already mentioned, you can expect to do some resourcing or creating self-regulation tools. This is achieved through visualization, embodiment, and eye movements. Your therapist will guide you through several exercises to give you a full toolbox of coping strategies.
The principle behind resourcing is simple: our brains cannot tell the difference between real or imagined experiences if they are engaging enough. If we truly use all of our senses to feel a positive feeling or the calming presence of a loving person, we can call on that resource during tough moments in a therapy session.
History Taking
Another part of EMDR is taking a history of traumatic events, which can be quite an undertaking with complex trauma. The therapist may do resourcing first to make sure you can handle the intensity of recalling painful experiences, although many do history taking first.
You can expect to be asked about early memories and worst memories as well as negative beliefs you hold about yourself because of these events. Its important to let your therapist know if you are getting triggered so they can help you use your resources to regulate.
Processing
After-Processing
Emdr Therapy For Ptsd
June is National PTSD Awareness Month. PTSD stands for posttraumatic stress disorder, a condition that some people experience after one or several traumatic events. EMDR therapy is shown to be one of the most effective treatments for PTSD. Common questions we receive about PTSD are:
- What is trauma?
- When does the experience of trauma cross the threshold into becoming PTSD?
- How does EMDR therapy help?
What is Trauma?
Trauma is an event or experience of an event that overwhelms our ability to make sense of what is happening to us. Trauma affects many people. The American Psychological Association states that approximately one-half of all individuals will be exposed to at least one traumatic event in their lifetime.Some estimates state 70 percent of the population will experience trauma.
What is PTSD?
PTSD symptoms generally fall into four areas:
- Re-living symptoms: flashbacks or nightmares.
- Avoidance symptoms: staying away from activities, people, or places that are reminders of the trauma.
- Cognition and mood symptoms: negative thoughts about self and world, extreme guilt, or lack of interest in things that used to be enjoyed.
- Increased arousal symptoms: startling easily, having angry outbursts, and difficulty sleeping.
EMDR Therapy for PTSD
-Susanna Kaufman, EMDRIA Staff
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Complex Trauma: Yes Emdr Can Help But Its No Quick Fix
Fourteen years ago, when I was first trained in EMDR therapy, there was less of an understanding of its benefits, as well as a lot of confusion about what eye movement desensitization and reprocessing actually was. One thing its never been is a quick fix. And while I make it a point to educate people about this reality, I have found there is another layer to that common misunderstanding: lack of awareness that the existence of complex trauma, as opposed to single-incident trauma, can make EMDR an even longer-term treatment.
When working with those with single-incident traumaa survivor of a car accident, for examplethe standard eight-phased, three-pronged EMDR protocol has the potential to guide the treatment process in a relatively straightforward manner. Treatment can also be more clear-cut and focused when there are multiple traumas that can be grouped into the same category. Someone who reports being raped at various times in their life would be an example of this. Neurologically, the traumas can travel down a similar track when processed.
The majority of those who are engaging in ongoing therapy have symptoms driven by foundational experiences, developmental traumas that impact their worldviews. These experiences affect their ability to feel safe, not only physically but also emotionally. These people are seeking to heal from a history of complex trauma.
Reference:
Herman, J. . Trauma and Recovery. New York: HarperCollins.