Complex PTSD occurs as a result of repeated or ongoing traumatic events. While complex trauma can happen at any time in life, this post focuses on attachment trauma related to childhood abuse or neglect. Most often there is a combined wound, in which you experience deficient nurturance from loving caregivers coupled with inadequate protection from dangerous situations or people. Growing up within an environment of fear, chaos, or rejection, and abandonment has significant and long-lasting repercussions on physical and emotional health.
As a result of attachment trauma, you might carry beliefs that you are damaged, not lovable, or that you cannot trust anyone. You might have feelings of shame, unworthiness, or helplessness. Perhaps, you feel plagued by anxiety or believe that you don’t belong in this world.
“Attachment trauma can lead you to withdraw from relationships in order to avoid further rejection or hurt. Or, you might feel overly dependent upon others and fearful of rejection. If you relate to these symptoms, it is important to know that you are not alone. These painful emotions are remnants of your past.” ~Dr. Arielle Schwartz
Many mental health practitioners are trained in the treatment of single traumatic events. However, in the case of complex trauma and dissociative symptoms, clients come to therapy with an extensive history of trauma that often begins in childhood and continues into adulthood with layers of personal, relational, societal, or cultural losses. Clients arrive at the door with profoundly painful histories and well-constructed defense structures to protect themselves from the pain.
Complex PTSD and dissociative symptoms can arise as a result of repeated developmental trauma or neglect and the ongoing social stress such as bullying, discrimination, political violence, or the distress of being a refugee separated from family and country.
“A compassionate approach to treatment understands that dissociation is a learned behavior that once helped the client survive and cope with a threatening environment. Dissociation is a both a built-in physiological survival mechanism and a psychological defense structure. It helps the individual to disconnect from the reality of threatening experiences. However, over time, dissociation can become a well-maintained, dysfunctional division between the part of the self that is trying to live a “normal life” and the part of self that is holding trauma related material.”
Many distressing symptoms of post-traumatic stress are felt in the body—a tightness in the chest, a sinking feeling in the stomach, a familiar knot in the throat, or as a chronic feeling of exhaustion. We now recognize that we must turn toward the body as part of the healing process and as a result we have seen a surge in the use of yoga, mindfulness, tai chi, Qigong, Feldinkreis, massage, craniosacral, nutritional counseling, and acupuncture for the treatment post traumatic stress.
These mind-body therapies help us to be less vulnerable to stress, less reactive, and less impulsive. We increase our awareness of the choices that we have to help us feel grounded and calm. We feel more in control. One way that mind-body therapies work is by stimulating the vagus nerve. Knowledge about how this nerve works provides a fundamental understanding of traumatic stress and facilitates our ability to heal. As a result, the vagus nerve has taken central stage in trauma treatment.
“Mind-body therapies work with the vagus nerve to help you find balance. In this post, you will find a variety of breath and movement practices aimed to stimulate and reset the vagus nerve. Through a process of self-study and mindful body awareness, you can start to learn strategies that help you restore a sense of safety and heal from trauma.”
Healing from trauma does not only involve changes in your brain. Rather, it is equally important to attend to the impact of traumatic events on the body. When it comes to healing from any trauma, it is important to recognize that the body holds memories of what happened. Your body provides tremendous feedback about the impact that traumatic events. You might notice how you carry tension in your body or how your posture might be a reflection of your emotions.
As a result of challenging life experiences, you might notice that you close off your chest to protect your heart from events that occurred years ago. Perhaps, you continue to freeze or collapse in response current events that trigger feelings related to your traumatic past. Or, you might notice how trauma from your past obstructs your willingness to look someone in the eyes, stand up tall, or speak with confidence.
Importantly, yourbody does not just hold the memory of what happened—your body also holds the memory of what wanted to happen. This is an important key to healing from trauma. For example, if you weren’t able to run away from a dangerous situation, you might feel the impulse to move your legs when you think about that situation now. Or, if you weren’t able to protect yourself from an abuser, you might feel an impulse to push through your arms.
“Somatic therapy in trauma treatment allows you to release long-held tension from your body. As a result, you have an opportunity to discover a greater sense of freedom in your body and mind. Your body gives you feedback about when the events of the past no longer define your life in the present. As a result, you reclaim your resilience.”—Dr. Arielle Schwartz
Having a history of trauma can lead to challenges in our relationships. Perhaps you have habitually avoided conflict, withdrawn out of fear, felt intolerant of rejection, or pushed people away when they got too close. These defensive strategies can lead to relationships that are consistently argumentative, disconnected and cold, or painfully superficial.
Trauma recovery helps us to build our capacity to handle conflicts with equanimity. Rather than needing to make yourself or another person wrong, you can learn to work through difficulties in a way that deepens your connections with others. It is important to know that you can work through ruptures of connection and create a positive outcome. Ultimately, it is possible to learn to trust that small amounts of disconnection and conflict can actually can lead to deepened sense of trust and love.
“Healthy conflict requires tolerance for difference, disconnection, and discord. Letting someone know that they have hurt your feelings can feel frightening. Taking responsibility for hurting someone you love can evoke shame. It takes wisdom to refine primal reactions into caring, thoughtful responses.”
Humanistic psychologist, Abraham Maslow introduced self-actualization as the process of fulfilling your potential in the world. It is about becoming who you really are and were always meant to be. This involves the integration of the wounds that may have once been a source of shame or confusion and allows for a coherent sense of yourself. Here, you reclaim a sense of dignity which allows you to walk in the world with the knowledge that you are so much more than your trauma or pain. This opens up the possibility for a deep sense of belonging in the world.
It is possible to grow from adversity. Traumatic life experiences can help you appreciate the precious gift it is to be alive. Perhaps because of your experience feeling so deeply hurt, your pain has become a source of compassion and wisdom. Maybe you have discovered moments of emotional or spiritual significance.
“Self-actualization is associated with a greater capacity to hold polarities and contradictions. You cultivate the wisdom to know that all relationships will have their challenges, that moments of pain are an inevitable part of life, and that opening your heart to love involves the risk of loss.”-Dr. Arielle Schwartz
Resilience is defined as an ability to flexibly adapt to challenging, adverse, or traumatic life events. This ability to “bounce back” from traumatic events is deeply connected to having the opportunity to work through difficult life experiences. Importantly, resilience is not just a mindset or a set of behaviors. The human body is equipped with an innate physiological resilience system. This is your autonomic nervous system—the part of your nervous system which helps adapt, respond to stress, and return to homeostasis. Moreover, your parasympathetic nervous system holds keys to your health.
Your autonomic nervous system is built around the balance of two opposing actions and can function without you having to think about it consciously. The sympathetic nervous system is associated with the fight or flight response that is the result of the release of cortisol (stress chemicals) throughout the bloodstream. The parasympathetic is associated with relaxation, digestion, and regeneration. For example, your breathing, heart rate, and body temperature are regulated by this system. Ideally, your sympathetic and parasympathetic actions are meant to function in rhythmic alternation, a process that supports healthy rhythms of alertness and restfulness that facilitate physical and mental health. Unfortunately, chronic stress and unresolved trauma interfere with the balance between sympathetic and parasympathetic functions.
Individuals with unresolved PTSD can also resort to a primitive and unbalanced expression of the parasympathetic nervous system. Dr. Stephen Porges (2011) has identified that the parasympathetic nervous system has two presentations that depend upon whether you feel safe or feel threatened. This is due to the complexity of the vagus nerve (Read more here). In times of safety, the parasympathetic nervous system facilitates rest, relaxation, and digestion. However; in times of threat, the parasympathetic nervous system has a defensive mode which can lead to symptoms of fatigue, dizziness, or depression. This is especially the case when there was no way to escape traumatic situation.
“The use of mind-body therapies can help you reclaim a sense of safety in the here and now. You can learn tools to help you access the nourishing benefits of your parasympathetic nervous system. These restorative practices can help you improve digestion, increase immune system functioning, enhance thyroid health, and improve symptoms of depression.” –Dr. Arielle Schwartz
DBT for trauma treatment offers increased self-control and can help you feel grounded in your life, here and now. Dialectical behavior therapy (DBT) was originally developed in the 1980s as a specific type of cognitive behavioral therapy for the treatment of borderline personality disorder. More recently, DBT has been applied to treat other disorders, and has been found particularly beneficial for PTSD. This therapy is founded upon principles of Zen Buddhist philosophy and contemplative practices. For example, the term “dialectical” refers to a synthesis of opposites, which is a core aspect of Zen practices.
The primary dialectic within DBT is the polarity between acceptance and orienting toward change. Here, we recognize that radical self-acceptance of who you are is a necessary condition for change and growth.” –Dr. Arielle Schwartz
In short, neuropsychotherapy refers to the practice of integrating neuroscientific research into psychotherapy. This integrative approach to therapy that explores the connections between your mind, body, environment, and social interactions. A wide range of therapeutic modalities are based in this neurobiological approach to healing including EMDR Therapy, Somatic Psychology, and time-tested relational therapy. Within this post, we will explore six components of trauma recovery based upon neuropsychotherapy: Relating, Resourcing, Reprocessing, Repatterining, Reflecting, and Resilience.
“Reprocessing traumatic memories involves connecting traumatic memories with new information. As a result, distressing images, thoughts, sensations, and emotions associated with traumatic memories can be integrated with new resources. Overall, the neurobiology of trauma recovery helps you to learn how to move out of hopelessness, increase your capacity to feel empowered, and recognize that you are capable of living the life you want and deserve.”
–Dr. Arielle SchwartzContinue reading →
In the Colorado foothills where I live, we have a path that traverses an area of the forest that burned down several years ago. Under the burnt remains of these trees we discover a lush underbrush, bursting with new life that flourishes in the fertile earth. Each time I walk this trail, I am reminded that although traumatic life experiences can be devastating, they can also become a powerful force that awakens us to our aliveness. Painful events inevitably shape who we are; however, it is essential that we learn to look beyond the blackened trees of our internal landscape.
American mythologist, Joseph Campbell, described personal transformation as a hero’s journey. You can imagine the hero who must enter the darkness, face challenges, slay the dragon, retrieve the treasure, and emerge stronger. As applied to trauma recovery, we understand that challenging life events can serve as a call to enter the hero’s journey. You may feel as though you have been thrown into an abyss. The dragons you must slay are the inner demons that remain as a result of the painful memories from your past. You walk into the darkness in order retrieve the treasures that exists within you such as inner strength, wisdom, and hope. You emerge with an enhanced sense of meaning and purpose which become the gifts that you have to offer to the world.
“The work of the Hero’s Journey in trauma recovery is difficult; but, this same work can serve as an initiation into wisdom and an awakening of the heart. You can learn to trust in your capacity for new growth.”
–Dr. Arielle Schwartz