Trauma & complex PTSD
An area of specialist focus of The York Centre
Post Traumatic Stress Disorder (PTSD), or trauma for short, and Complex Post Traumatic Stress Disorder (CPTSD) happen when an individual experiences one or many overwhelming, terrifying and distressing events.
When an event is overwhelming, parts of the brain including the brain's normal memory processing centre shuts down. This leaves the memory ‘trapped’ or elevated as an active emotional threat, rather than it being filing it away safely as narrative history or memory.
We estimate that about 1 in 10 people will experience trauma at some point in their lives. Rates are significantly higher among individuals who have survived prolonged childhood adversity, military combat, domestic abuse, assault or severe physical accidents, for example. We see it as a core area of support we can offer clients at the Centre.
PTSD is recognised by the DSM v5 (Diagnostic and Statistical Manual of Mental Disorders). The DSM does not currently recognise complex PTSD (or CPTSD) although the ICD (International Classification of Diseases) published by the World Health Organisation does recognise CPTSD and is largely referenced by mental health practitioners in the UK and is generally recognised by the NHS.
How you may be experiencing it
People can experience the impact of trauma through vivid, distressing flashbacks where you feel like the event is happening all over again, terrifying nightmares, sudden panic spikes, emotional numbing and a constant state of hypervigilance (always looking out for danger). It can also involve intense emotional or physical triggers caused by ordinary sights, sounds, or smells that remind the brain of the original event.
Emotionally and psychologically, it can significantly damage a person's ability to trust others, their identity and self worth. It can severely restrict their daily life, as people avoid certain places or social situations. It can make it difficult to maintain a steady job, form intimate relationships or feel comfortable in your own skin, trapping you in a state of survival rather than living a life in positive balance.
An evidence-based, safe approach, nationally endorsed
We use a range of different approaches which we have found to be effective through research and practice.
We can share the psychoeducation of trauma, the understanding of how the brain, body and nervous systems works when we experience trauma. We know that this knowledge and insight can help people to make sense of their experiences and access a resource called their ‘observing self’, a degree of detachment where emotional arousal can lower and people can understand and have greater agency over what has happened in a more clear thinking way.
Our approach includes compassionate and appropriate emotion processing of events, when a therapist in partnership with the client assess that this will help to lift the impact of what has happened. Therapists work sensitively and in highly skilled ways to support sense making, a holistic understanding and mindful capacity to move through events and their impact which clients feedback can be fundamental to lifting trauma.
We do not advocate a detailed reliving of traumatic events in sessions as evidence is clear that this carries a serious risk of re-traumatising people and reinforcing their trauma, the opposite of why people came for help. We also recognise the fragility of memory and the importance of safe practice so that therapists do not suggest what may have happened in a way that then creates further trauma, distress and confusion for our clients.
Core to our therapeutic work is the safe and highly effective Rewind Technique. Unlike older trauma therapies, you do not have to talk about the details of your experience out loud. Through deep relaxation, we guide your brain to quickly process the memory from a safe distance, filing it away into long-term narrative memory. This stops the amygdala from firing, calming your nervous system, lowering the intensity of emotions associated with the experience, This helps people to move on with their lives, to shift from avoidance to engagement in everyday life and from hypervigilance to a more relaxed and calm state of being. Clients also report that this work can help them in their identity and confidence in themselves.
In addition, we use the human needs framework to help someone to better meet their physical and emotional needs, to help in goal setting and very practical daily action that can make a positive difference.
Therapeutic work to lift PTSD may take only a few sessions. With CPTSD, therapeutic work may be more long term due to the impact on a person's self worth, the complex emotions that can be involved such as guilt or shame, and the focus on rebuilding - or building for the first time - healthy, sustaining relationships with others.