Trauma Dynamics: Treatment for Complex PTSD

By Alexandria Hayes, MA, LPC, NCC

Photo by Richard McCulley, FreeImages.com

Photo by Richard McCulley, FreeImages.com

Trauma Dynamics is a therapy method for treating complex post-traumatic stress disorder (PTSD). PTSD results from an unresolved experience that was or felt life threatening. Simple PTSD results from a single incident, such as a car accident, assault, fire, or natural disaster. Complex PTSD results from repeated or ongoing incidents, such as childhood abuse, multiple combat deployments, or captivity. The reason for the distinction is that the impact of trauma can be cumulative, making complex PTSD much more complicated to treat than simple PTSD.

The Evolution of Trauma Treatment

For many years, clinicians and researchers believed that PSTD was a mental disorder. However, we now know that PTSD is the result of our normal – and highly efficient – autonomic nervous system (ANS) response to threat and is not limited to affecting mental functioning. PTSD impacts all aspects of a person: physiological, psychological, emotional, and spiritual.

The field of trauma treatment has developed over many years and in a number of philosophical camps. Much like the mythical blind men and the elephant, each camp holds a different theory about PTSD and how to treat it, and each has contributed important insights into our understanding of trauma and its treatment. But none – until now – has been particularly effective in treating complex trauma.

Photo by Erik Araujo, FreeImages.com

Photo by Erik Araujo, FreeImages.com

The Attachment camp observed that traumatic experience, like early attachment wounds, requires resetting – or even developing for the first time – healthy boundaries. The Somatic camp, through studies of mammals in the wild, recognized that traumatic experience is held in the body (see Where are You on the Trauma Map? Snapshot) and developed techniques for releasing stored activation. The Psychoanalytic camp postulated that at the heart of trauma are relationship issues, which can be addressed in therapy through work with transference and countertransference. Finally, advances in neuroscience have helped us understand how trauma impacts the brain and how memories are created, stored, and recalled.

Trauma Dynamics is unique among therapeutic modalities in that it integrates the knowledge and techniques from these disparate camps – each effective for part of the needed work, but alone insufficient for complete recovery from complex trauma – into a coherent, comprehensive protocol that effectively treats the whole human being.

Complex PTSD Treatment

The Trauma Dynamics approach to treating complex PTSD educates and prepares clients and then helps them process past trauma using a multi-step protocol:

  1. Resource Development
  2. Boundary and Trust Development
  3. Somatic and Transferential Processing
  4. Integration

Following is a simplified description of each of these steps as you might experience them.

  1. Resource Development

The first step in trauma treatment is developing resources to establish safety and create tools you can use to recognize and reduce your nervous system reactivity. This is a critical foundation for enabling deeper processing, which is often destabilizing.

  1. Boundary and Trust Development

Photo by Michal Zacharzewski, FreeImages.com

Photo by Michal Zacharzewski, FreeImages.com

Because complex traumatic experience usually degrades a person’s ability to set boundaries and to trust others, Trauma Dynamics incorporates practices that redevelop these relational skills. This enables you to strengthen your ability to set and hold appropriate boundaries. Specifically, you learn how to say “no” and “yes” at appropriate times and in healthy ways.

  1. Somatic and Transferential Processing

Somatic Processing

The next step in treatment is consolidating the shattered memory of the traumatic experience. Traumatic memories are stored differently than everyday experiences in that they are not integrated into a whole piece with the attendant thoughts, emotions, sensory input, and sense of time that occurred during the original event (see The Shattered Experience). Instead, bits of the memory are scattered and “unhooked” in time, emerging unexpectedly when triggered by similar situations.

Image courtesy of Stuart Miles at FreeDigitalPhotos.net

Image courtesy of Stuart Miles at FreeDigitalPhotos.net

For instance, unconsolidated combat memories can trigger flashbacks and intrusive thoughts in response to noises or smells reminiscent of the battlefield. The body – specifically the nervous system – isn’t aware that the danger has passed and behaves as if it were happening now.

Consolidating traumatic memories involves releasing incomplete autonomic trauma responses from the body, while attending to thoughts, sensations, and emotions. This is accomplished through a technique called containment. Containment entails controlling the voluntary – and often unconscious – movements we make to relieve stress (such as toe-tapping, yawning, or lip-biting) to allow the involuntary movements that were trapped in the body during trauma to emerge. As the body releases this stored energy, the thoughts, sensations, and emotions that occurred at the time are also re-experienced and consolidated into a coherent memory. Once the memory is consolidated, the memory bits no longer emerge in response to triggers because they are no longer free-floating; instead the mind and body recognizes them as part of a coherent memory of a past event.

Transferential Processing

When trauma occurs within a your family of origin or involves those with whom you’re in relationship, the processing phase requires working with traumatic transference. Transference can be understood as projecting the relationship from your past onto the therapist or other people in your present day life.

Photo by Damiana Carvalho, FreeImages.com

Photo by Damiana Carvalho, FreeImages.com

When we are faced with a perceived life-threatening event, we attempt to make sense of it by imagining what the other people in the scene are thinking and feeling. This process of projecting onto others, first identified by Psychoanalysis, is called transference (the therapist’s projection of thoughts and feelings onto the client is called counter-transference).

When transferential roles experienced during a trauma are not resolved, they are (unwittingly) recreated in day-to-day life. For example, if you were abandoned as a child, you will tend to choose partners who abandon you. Even if you choose partners who do not abandon you, you may – again unwittingly – push them into abandoning you to recapitulate your earlier experience(s) (see Drawn to Danger).

Healing traumatic transference is accomplished through relationship containment, wherein you and the therapist maintain eye contact during somatic processing. This enables you to project onto the therapist the roles you experienced during your traumatic experience (transference) and the therapist to play counter-point. By re-inhabiting the roles you subconsciously took on during the trauma, you are able to integrate the experience from all points of view and break the pattern of recapitulation.

  1. Integration

As traumas are processed and symptoms are relieved, your life may look and feel quite different. For example, if you were highly traumatized and unable to leave the house much of the time, your significant other may have been your umbilical to the outside world. When your fear and anxiety diminish and you begin to venture out, your partner may feel overly protective or confused or no longer useful. Integration helps you work through the challenges that may arise as you begin to rediscover and re-experience who you are without PTSD symptoms. Although integration is ongoing throughout trauma therapy, it becomes more the focus toward the end of treatment and is a critical part of the process.

Positive Results

In a preliminary study of Trauma Dynamics’ effectiveness in treating PTSD, 93% of subjects found the treatment helpful. As a trained and practicing Trauma Dynamics clinician, I have seen clients achieve impressive results using this method after struggling for years with symptoms. To learn more about Trauma Dynamics and the protocol summarized here, visit www.TraumaDynamics.com.

If you are suffering from symptoms of PTSD – depression, anxiety, addiction, sleep disturbance, among others – or identify negative patterns repeating in your life, contact me for a complimentary initial consultation to see if Trauma Dynamics is the right approach for you.

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Alexandria Hayes

 

Alexandria Hayes is a therapist with The Labyrinth Institute specializing in the treatment of trauma. You can reach her at alex@lab-inst.com or 720-588-3639.