Outline

Post-Traumatic Stress Disorder and ComplexPTSD are different.

• Acute traumatic stress, PTSD, Complex PTSD
• Diagnostic clarification, differential diagnosis and co-morbidities
• Key contributing factors of Complex PTSD
• The common symptoms of Complex PTSD

Post traumatic stress disorder is related to fight and flight.

• Polyvagal Theory
• Stages of trauma response
• Trauma specific psychopharmacology
• Heart Rate Variability and the Social Nervous System
• Interpersonal Neurobiology
• Psychobiological regulation
• Rupture and repair
• Implications of childhood neglect or abuse
• Neuroplasticity and Complex PTSD

It’s a Deeper Understanding for Accurate Assessment of ComplexPTSD.

• Intrusive symptoms and anxiety
• Emotional dysregulation: Outbursts of anger and debilitating shame
• Avoidance symptoms and phobic reactions to traumatic material
• Interpersonal problems and difficulty being close to others
• Dissociation and dysregulation
• Cognitive distortions and compromised meaning making
• Physical health problems, ACE factors and painful somatization
• Preverbal and nonverbal memories
• Disturbing somatic sensations
• Depressive symptoms
• Learned helplessness and shame

There are therapeutic interventions for complex post traumatic stress disorder.

• Psychodynamic and Relational Therapy
• Psychobiological perspectives: Polyvagal Theory
• Cognitive Behavioral Therapy (CBT)
• Dialectical Behavioral Therapy (DBT)
• EMDR Therapy
• Somatic Psychology
• Parts Work Therapy: Work with Ego States
• Complementary and Alternative Medicine (CAM):
  mindfulness, yoga, and integrative healthcare

For an effective treatment plan, it’s important to put it all together.

• A Biopsychosocial Approach: Partner with clients to build a health care team
• Goal of treatment: Memory retrieval vs. trauma recovery
• History taking: Identify chronic, repeated, and/or developmental trauma events
• Cultural factors and Complex PTSD
• Recognize attachment injuries
• Identify parts, ego states and defenses
• Assess for dissociation (“fragmentation”)
• Clinical Vignette #1
• Mutual regulation and relational repair in therapy
• Prepare for trauma processing: Develop resources and stability
• Working with parts of self
• Work through traumatic memories: EMDR and Somatic Psychology
• Clinical Vignette #2
• Grief work in Complex PTSD
• Integrate and Instill positive change

Experiential interventions for clients with complex post-traumatic stress disorder.

• Conscious breathing for self-regulation
• Grounding and sensory awareness
• Containment: Reclaim choice and control
• Build imaginal allies
• Cultivate mindfulness, acceptance, and self-compassion
• Somatic interventions: Titration, sequencing, and somatic re-patterning
• Bilateral stimulation and dual attention in EMDR Therapy
• Potential risks and limitations of mind-body therapies

There are special considerations in trauma treatment.

• Working with Preverbal and Nonverbal Memories
• Working with transgenerational trauma
• Somatization, Chronic Pain and illness
• Gate Control Theory
• Mindfulness, Yoga, and Compassion Based Interventions
• Clinical Vignette #3

Post-Traumatic growth and healing can be fostered with resilience.

• Learn the 6 Pillars of Resilience
• Trauma recovery and the bell curve
• Resilience as a process and an outcome
• Help clients move from learned helplessness to learned optimism
• Post-Traumatic Growth: Help clients reach their potential

Improving client outcomes through effective self-care is called vicarious trauma.

• Identify resources that improve your clinical skills
• In-session self-care to improve focus on the client and therapeutic process
• Burnout prevention techniques