Treating Complex Trauma: Combined Theories and Methods

Chapter One

The Need for Utilizing Multiple Approaches for Complex PTSD: No Theory Has It All

Introduction: Complex Clients Need Multiple Approaches

What is Trauma and Who Gets to Define It'

Difficulties in the Study of Complex Trauma

PTSD vs. cPTSD: Important Distinctions

Therapeutic Efficacy and the Therapeutic Alliance

Multiple Treatments, Equal Efficacy

Commonalities Among All Approaches

The Therapy Relationship and Clinical Hypothesis Testing

Negotiating the Beginning of Therapy

Conclusion

References

Chapter Two: How Trauma Stokes Fear: Considerations in Beginning of Therapy

The Neurobiology of Trauma

Evidence for Intergenerational Trauma Effects

Fear: Known, Unknown, and Acted Out

Clinical Hypothesis Testing and Introducing the Concept of Fear

The Unhelpful Link between cPTSD and Personality Disorders

How Trauma Can Lead to Incorrect Diagnoses

Assessing Character Style

Managing Fear in the Beginning of Therapy

Conclusion

Initial Goals in the Beginning of Therapy for People with cPTSD

Chapter Three: Nurturing the Therapeutic Alliance: Mentalizing and Emotional Safety

Characteristics of Therapists Who Have Good Outcomes

-The Effective Therapist Has an Ability to Explain A Client's Distress and Takes the Client's Unique Experience into Account

- The Effective Therapist Is Persuasive About Treatment Ideas And Monitors Progress in An Authentic Way

- The Effective Therapist Can Deal with Difficult Material While Communicating Hope and Optimism

- The Effective Therapist Is Keenly Aware of Their Own Psychology

- The Effective Therapist Stays Aware of Relevant Research and Strives to Continually Improve

Trust and the Mentalizing Therapist

Normalizing and Managing Shame

Creating Safety Though Respecting Avoidance

How Much Should We Encourage the Processing of Memories'

Conclusion

Interventions for Mentalizing and Maintaining Emotional Safety

References

Chapter Four: The Therapeutic Alliance and Maintaining Physical Safety

Trauma, Suicidal Ideation and Deaths of Despair

The Alarming Epidemi