Treating Complex Post-Traumatic Stress Disorder (C-PTSD)
Treating C-PTSD requires a multifaceted and compassionate approach, often integrating various therapeutic modalities to address the complex layers of trauma. Dialectical Behavior Therapy (DBT), Internal Family Systems (IFS), and Somatic Experiencing (SE), integrated within an Attachment framework, provides an approach that can offer significant healing.
Dialectical Behavior Therapy (DBT)
DBT is highly effective for C-PTSD due to its focus on emotion regulation, distress tolerance, and interpersonal effectiveness – areas often significantly impacted by complex trauma. DBT teaches practical skills through four main modules:
- Mindfulness: Learning to be present and aware without judgment, helping individuals observe their thoughts and feelings rather than being overwhelmed by them.
- Distress Tolerance: Developing strategies to cope with intense emotions and difficult situations without resorting to destructive behaviors.
- Emotion Regulation: Identifying and understanding emotions, reducing emotional vulnerability, and increasing positive emotional experiences.
- Interpersonal Effectiveness: Improving communication skills, setting boundaries, and navigating relationships more effectively.
DBT provides concrete tools for managing the overwhelming emotional and relational challenges associated with C-PTSD, offering a structured framework for building resilience and stability.
Internal Family Systems (IFS)
IFS is a non-pathologizing, evidence-based approach that humans are complex beings with multiple facets of personality and composed of various “parts” – not in a dissociative sense, but as aspects of personalities with unique beliefs, feelings, and memories. These parts include:
- Managers: Protective parts that try to keep us safe and functional by controlling our internal and external worlds (e.g., perfectionism, people-pleasing, self-criticism).
- Firefighters: Reactive protective parts that jump in to put out emotional “fires” with impulsive or addictive behaviors (e.g., substance abuse, disordered eating, self-harm).
- Exiles: Parts that carry pain, shame, fear, or other difficult emotions from past trauma. They are often pushed away or hidden by other parts.
- Self: Self is NOT a part, rather it is the essence or core of who we are, characterized by qualities like curiosity, calm, clarity, compassion, courage, creativity, connectedness, and confidence.
In IFS therapy for C-PTSD, the goal is to help individuals access their “Self” energy and build a compassionate relationship with their internal parts, particularly those that have been exiled by trauma. By befriending and unburdening these parts, the individual can integrate their experiences and release the emotional burdens they carry. This approach is gentle and empowering, allowing the pace of healing to be guided by the client’s internal system.
Somatic Experiencing (SE)
Originally developed to treat trauma held in the nervous system, Somatic Experiencing is particularly effective for Complex PTSD due to its focus on physiological regulation, embodied safety, and repairing the body’s innate capacity for resilience. C-PTSD often leaves individuals feeling chronically unsafe, emotionally overwhelmed, and disconnected from their bodies. SE addresses these challenges by working directly with the body’s survival responses.
SE supports healing through core principles such as:
- Nervous System Awareness: Learning to notice and track subtle bodily sensations helps individuals recognize when they are shifting into fight, flight, freeze, or collapse states — and how to gently move back toward regulation.
- Pendulation and Titration: Rather than diving into overwhelming material, SE helps clients move slowly and safely between states of activation and calm, allowing trauma to resolve without retraumatization.
- Completion of Survival Responses: Traumatic experiences often leave the body stuck in incomplete defensive actions (like fleeing or protesting). SE helps discharge this energy, freeing the system from chronic dysregulation.
- Restoration of Embodied Safety: By gently reconnecting with internal sensations, individuals can begin to feel grounded and safe in their own bodies, which is essential for repairing attachment injuries and building secure relationships.
Somatic Experiencing offers a foundational path for healing from C-PTSD, supporting clients in moving from physiological survival mode to a sense of presence, connection, and choice.
Attachment-Based Therapy
Attachment theory focuses on the profound impact of relationships on an individual’s sense of self, their ability to regulate emotions, and their patterns in adult relationships. In C-PTSD, relational trauma often leads to insecure attachment styles (anxious, avoidant, or disorganized). Attachment work in therapy aims to:
- Understand attachment patterns: Helping individuals recognize how their early experiences shaped their current relational dynamics.
- Process relational wounds: Grieving the absence of secure attachment in childhood and addressing the pain of betrayal or neglect.
- Develop earned security: Through the therapeutic relationship (which can serve as a secure base), individuals can learn to internalize a sense of safety and develop healthier ways of relating to themselves and others.
By integrating IFS, DBT, and SE within the attachment framework, individuals with C-PTSD can embark on a holistic healing journey.
HOW CAN WE HELP YOU?
Our dedicated team is committed to supporting clients and their families throughout their therapeutic journey.