What is Trauma?
"Trauma is an emotional response to a terible event like an accident, rape or natural disaster. Immediately after the event, shock and denial are typical. Longer term reactions include unpredictable emotions, flashbacks, strained relationships and even physical symptoms like headaches or nausea. While these feelings are normal, some people have difficulty moving on with their lives. Psychologists can help these individuals find constructive ways of managing their emotions." ~American Psychological Association
What is PTSD?
Trauma can result in prolonged distress, known as Posttraumatic Stress Disorder (PTSD).
According to the DSM-5, symptoms of PTSD include:
- Exposure (direct or indirect) to actual or threatened death, serious injury, or sexual violence
- Re-experiencing of the trauma (e.g., traumatic nightmares, intrustive memories, flashbacks, triggers)
- Avoidance of trauma-related thoughts, feelings, or external reminders
- Reactivity (staying on alert, easily startled, irritable, self-destructive, sleep or concentration problems)
- Negative changes in Thoughts or Mood
- Symptoms that last for at least 1 month and cause problems with functioning (e..g, work, social)
What is Complex PTSD?
While the DSM-5 only recognizes PTSD, leading experts in the field of trauma recognize that there is also something called, "Complex PTSD." When exposure to trauma is repeated and chronic, it can cause far-reaching symptoms across multiple domains that extend beyond PTSD:
Impairment in Children:
3. Affect Regulation
5. Behavioral Control
7. Self- Concept
Impairment in Adults:
1. Relationship to others
2. Somatization/medical problems
3. Regulation of affective impulses
4. Attention and consciousness
5. Perceptions of the perpetrator
6. Symptoms of meaning
Complex Trauma defined:
"Children's experiences of multiple traumatic events that occur within the caregiving system--the social environment that is supposed to be the source of support and safety in a child's life. Typically complex trauma exposure refers to the simultaneous or sequential occurrences of child maltreatment--including emotional abuse and neglect, sexual abuse, physical abuse, and witnessing domestic violence--that are chronic and begin in early childhood."
The aftermath of complex trauma is quite devastating and far-reaching. Because the DSM-5 does not formally recognize Complex PTSD as a diagnosis, children and adults often end up receiving multiple diagnoses due to the many areas of impairment that complex trauma contributes to, such as:
- Self-regulation, attachment, anxiety, and affective disorders
- Addictions, aggression, social helplessness and eating disorders
- Dissociative, somataform, cardiovascular, metabolic, and immunological disorders
- Sexual disroders in adolescence and adulthood
- Borderline personality disorder
How to Treat Complex PTSD?
There is consensus among leading experts and researchers in the field that a Phase-Based Approach, or sequential approach, is recommended to treat complex trauma in children and adults alike. (Treatment guidelines for children are available through the National Child Traumatic Stress Network, and treatment guidelines for adults are available through the International Society for Traumatic Stress Studies.)
What are the Phases in a Phase-Based Approach to complex trauma treatment?
Phase 1: Establishing safety, stabilization, and skill-building to reduce symptoms and improve emotional and social coping
Phase 2: Processing unresolved trauma and making meaning about past events which allows for positive views of self and hope for the future
Phase 3: Enhancing resiliency and fostering greater engagement in relationships, social networks, work, education, and community life
Reaching HOPE's unique family systems model to complex trauma treatment allows for families to gather, with the support of the treatment team, to learn how to support one another through the healing process during all phases of treatment.