Whether PTSD or Complex, Trauma is Relational and Unique

Trauma – and trauma therapy – is incredibly personal and subjective. People cope with all kinds of psychological traumas: physical, sexual, and/or emotional traumas; one-time PTSD traumas, such as an accident, natural disaster, or terrorism; and complex relational traumas which occur over time, and are often connected with childhood attachment relationships. Because you are unique, and because your traumatic history is unique, there is no ‘blueprint’ to your trauma therapy treatment. In general, therapy with a trauma therapist tends to be relationally-oriented and intuitive, with an emphasis on clear boundaries and communication.

PTSD

Post-Traumatic Stress Disorder (PTSD) is a formal diagnosis given when trauma survivors display symptoms including trauma flashbacks, fear, severe anxiety and agitation, and insomnia.  On the other hand, people with PTSD can also experience numbness and dissociation in the form of symptoms such as emotional detachment, depersonalization (not feeling like yourself), and anhedonia (reduction in the ability to feel pleasure). PTSD often occurs when a person was unable to properly process their traumatic experience(s). When you work with a PTSD trauma therapist, an emphasis is placed on working through and integrating traumatic memories, and managing symptoms as this process occurs.

Complex Trauma

However it is important to understand that you do not need to meet the criteria for PTSD to be suffering from traumatic effects.  Complex trauma, also known as complex relational trauma, refers to the harmful psychological effects that occur from repeated ‘small t’ (small trauma) experiences, most often in childhood attachment relationships.  Although a grisly metaphor, one can imagine this as ‘death by a thousand cuts.’  These kinds of ‘small t’ traumas could include verbal abuse and psychological manipulation (e.g. gaslighting).  Complex trauma can also include ‘large t’ trauma, such as sexual and physical abuse, and extreme neglect.

Why is Childhood Trauma Harmful?

Because these forms of long-term abuse usually happen in a childhood home environment, the effects can be particularly damaging. The reason for this is that children and young teens are especially vulnerable to traumatic effects in their capacity to: trust their own perception (reality-testing); regulate their emotions; have appropriate levels of trust and boundaries in relationships; and develop a healthy self esteem and integrated self identity.  Attachment relationships influence the development of ‘attachment styles‘, or templates for how we experience ourselves in relationships.  Insecure attachment styles can impair our ability to be in healthy relationships, whether with others or our ourselves.  Intergenerational transmission of trauma means that this type of traumatically-influenced insecure attachment is often passed on across generations until it is processed and resolved through healthy empathic relationships or with a relationship trauma therapist.

Our Approach to Trauma Therapy in Philadelphia

We follow a phase-oriented model of trauma therapy.  Our Philadelphia trauma therapists initially work on developing a strong, secure treatment relationship built on trust. This is the foundation and ultimately one of the most curative aspects of trauma therapy treatment.

The Stabilization Phase of Trauma Therapy

Integral to this stabilization phase of trauma treatment is building security and consistency in the treatment process. A stable treatment frame – knowing what to expect and feeling safe in this knowledge – is an important component. During this phase of work, we work on strengthening your alliance and rapport with your trauma therapist; and accessing, developing, and cultivating positive internal resources.

As broken and damaged as you may possibly feel, we believe that you have incredible strengths that you may or may not be aware of. Harnessing and utilizing these strengths becomes a vital anchor in working through trauma. We also work on containing and modulating overwhelming and dysregulated affect, and re-grounding and anchoring from dissociative experiences.

‘Working Through’ PTSD and Complex Trauma Memories

Working through traumatic memories can be another important phase of PTSD trauma therapy.  This phase of therapy happens when the therapeutic rapport has been consistently established, a client feels safe in therapy, and internal resources have been developed and utilized to ground and anchor from negative trauma symptoms.

During ‘working through’, a trauma therapist often integrates experiential trauma techniques into treatment.  This facilitates accessing and re-imagining traumatic memories for the purpose of creating new perspectives and re-wiring affective and somatic responses.   These trauma techniques include methods such as hypnosis, EMDR, somatic therapy, and narrative exposure therapy.

Examples from such approaches might include imagining a healthy attachment figure (real or imagined) or wise/mature self-state as a companion or guide during the traumatic memory; creating a symbolic imaginary device (e.g. bubble, shield, computer) to shift one’s experience or perception of their trauma; or developing somatic tools (e.g. hand warming, feet grounding, face stroking) to change the way that traumatic fear and shame lives in the body.

Using the Therapy Relationship to Heal Trauma in the ‘Here and Now’

The extent to which and how we delve into traumatic memory is highly subjective. It is possible that as treatment progresses we may help you on ‘working through’ painful traumatic memories in ways that access your strengths and re-build the neural networks associated with your memories. An emphasis is often placed on mastery, new understanding, and cultivating neuroplasticity. We believe strongly in the concept of ‘post-traumatic growth’ and work with our clients to build this growth through thoughtful work.

It is important to note, however, that for some clients explicitly revisiting past traumatic memories is not as vital to the work. Trauma has a way of living in the present through contextual and somatic cues, triggers and re-experiencing of trauma. There is plenty of important present-centered work that happens in trauma therapy treatment without any specific focus on past memories.

Rewiring Trauma

The final phase of trauma treatment involves a ‘rewiring’ of trauma.  This is not a technique that is ‘done’ to a client by their therapist.  Rather, it is a process-oriented series of therapeutic changes that happen through healthy experiencing and relating (with self and other).  As part of this rewiring, clients become more aware of signs that they are healing from trauma, and signs that their bodies are releasing trauma.

Trauma Therapists for You

Whether you are searching for trauma therapy in Philadelphia, or online therapy wherever you are located, we will help you meet a ‘trauma therapist near me’ on our staff who is the right fit for you.  Since this work is so personal and relationship-based, we understand how important it is to find a skilled and attuned PTSD trauma therapist who can help you through your journey of healing and transformation.