The Complex PTSD Workbook

A Mind-Body Approach to Regaining Emotional Control and Becoming Whole

Arielle Schwartz

• Éditeur: Sheldon Press
• Année: 2020
• ISBN:
  9781529312157
• Sujet: Psychology
• Sous-sujet: Post-Traumatic Stress Disorder (PTSD)

Those affected by complex PTSD commonly feel as though there is something fundamentally wrong with them - that somewhere inside there is a part of them that needs to be fixed. Though untrue, such beliefs can feel extremely real and frightening. Difficult as it may be, facing one's PTSD from unresolved childhood trauma is a brave, courageous act - and with the right guidance, healing from PTSD is possible.Clinical psychologist Dr Arielle Schwartz has spent years helping those with C-PTSD find their way to wholeness. She also knows the territory of the healing firsthand, having walked it herself. This book provides a map to the complicated, and often overwhelming, terrain of C-PTSD with Dr. Schwartz's knowledgeable guidance helping you find your way.In The Complex PTSD Workbook, you'll learn all about C-PTSD and gain valuable insight into the types of symptoms associated with unresolved childhood trauma, while applying a strength-based perspective to integrate positive beliefs and behaviours.Examples and exercises through which you'll discover your own instances of trauma through relating to PTSD experiences other than your own, such as the following: * Information about common PTSD misdiagnoses such as bipolar disorder, ADHD, anxiety disorders, major depressive disorder, and substance abuse, among others.* Explorations of common methods of PTSD therapy including somatic therapy, EMDR, CBT, DBT, and mind-body perspectives.* Chapter takeaways that encourage thoughtful consideration and writing to explore how you feel as you review the material presented in relation to your PTSD symptoms. The Complex PTSD Workbook aims to empower you with a thorough understanding of the psychology and physiology of C-PTSD so you can make informed choices about the path to healing that is right for you and discover a life of wellness, free of C-PTSD, that used to seem just out of reach.

CHAPTER ONE

Understanding Trauma

If you were neglected or abused as a child, your primary orientation to the world is likely to be one of threat, fear, and survival. It’s only natural that a childhood experience with untrustworthy parents or caregivers would leave you untrusting or confused about what constitutes a loving relationship. Fear and lack of safety might compel you to continuously scan your environment for potential threats. You may have relied upon coping strategies to survive, such as dissociation, a protective mechanism that disconnects you from threatening experiences. If you can relate to these qualities, you may also identify with related issues such as self-criticism, emotional suffering, and relationship difficulties. If this describes you, it is not your fault and you have not failed. You have a form of post-traumatic stress disorder (PTSD).

Traumatic experiences are, by their very definition, frightening and overwhelming. PTSD is often associated with events such as car accidents, natural disasters, or acts of violence. It is common after experiences like these to feel flooded with powerful emotions such as fear or sadness, and to begin avoiding situations that remind you of the trauma. PTSD refers to the presence of these symptoms well after the event is over. However, there is another kind of post-traumatic stress called complex PTSD (C-PTSD), which occurs as a result of long-term exposure to traumatic stress, rather than in response to a single incident. C-PTSD typically arises as a result of ongoing stress or repeated traumatic events that occur during childhood and is sometimes referred to as developmental trauma disorder (DTD).

Growing up afraid has ramifications on cognitive, emotional, and physical development that can persist into adulthood—until you have the necessary support to heal your wounds. C-PTSD is not a character weakness; it is a learned stress disorder. The good news is this: You can reclaim your life from the costs of childhood trauma. When you are empowered with knowledge and awareness, you can deepen your self-acceptance and reduce the difficult emotions that often accompany developmental trauma. In this chapter and throughout this book, you will develop a greater understanding of complex PTSD and discover ways to mitigate its effects to help you heal. The goals of this workbook are to encourage a compassionate understanding of your symptoms and to provide you with action steps that will help you recover from developmental trauma.

Take comfort in this: C-PTSD is the result of learned ineffective beliefs and behaviors that can be replaced by a positive mind-set and health-promoting behaviors.

Learning Self-Care

By the time I met Diane, her suffering had become unbearable. She reported experiencing debilitating anxiety mixed with feelings of hopelessness and despair. She was married, but her relationship was suffering under the weight of her symptoms. In the past year, she had gained weight, developed migraines, and struggled with insomnia.

Diane was very skilled at avoiding dealing with her traumatic past. To survive, she had learned to bury her painful feelings and memories, preferring not to talk about her childhood. It simply hurt too much. She kept a tight lid on her past, but now her migraines and insomnia made her feel as though she were coming apart at the seams. Diane had lost a sense of choice or control over her emotional life.

I learned that Diane had a history of exposure to domestic violence during her childhood. Her father was an alcoholic and her mother was never really involved in her life, other than to tell her what she was doing wrong. With tears streaming down her cheeks, she said, “They never should have had children; I should have never been born.”

If you can relate to Diane’s story in any way, take comfort in this: C-PTSD is the result of learned ineffective beliefs and behaviors that can be replaced by a positive mind-set and health-promoting behaviors. With the same tools that you’ll find in this book, Diane was able to integrate resources such as mindfulness and relaxation techniques into her life to help her feel more grounded and safe. She explored her history and developed a greater tolerance for facing her painful emotions. Writing about her past allowed her to feel in control of her life now. As a result of her consistent commitment to self-care, she strengthened her self-acceptance and compassion.

After several weeks of practicing the action steps that you’ll learn in this book, Diane had an epiphany: “My parents neglected me, and now I neglect myself by not taking care of my body as an adult. They could not love me the way that I needed, but I can become good at loving myself!”

IN PRACTICE

In what ways can you relate to Diane’s story? Take some time to write down any associations you have.

EMBRACING CHANGE

It is human nature to seek safety and stability. You might say, “This is who I am, and this is who I will always be.” Familiar, repeated routines simplify life and conserve energy. They can help manage stress, because there is comfort in what is known. New situations require more awareness of our surroundings. Some routines may temporarily reduce stress, but can lead to unwanted consequences and unhealthy habits such as obesity, procrastination, self-sabotage, or addictions.

In order to embrace any change, we need to take specific action to challenge behaviors and beliefs that no longer serve us. Research suggests that creating any desired change in life requires the repeated practice of new health-promoting behaviors until they become new habits. Getting regular exercise, eating a healthy diet, and developing positive social connections are among the best things we can do for ourselves to strengthen our resilience. No matter what you have gone through, you have the ability to heal your body and mind.

The tricky part is this: Once you allow yourself to feel your pain—to face it head-on—you can free yourself from it. When you recognize that limiting beliefs are running your life, you can then work to take charge of your mind and begin reclaiming your right to a positive outlook on life.

A Heavy Burden

Fred has been living with anxiety for much of his life. Now an adult, he has two children who depend on him and a job that he can’t afford to lose. After his chest pains started last year, he told his doctor about his ongoing panic attacks and insomnia. He was prescribed anti-anxiety medications, which kept him afloat but left him feeling flat and depressed. Thankfully, his doctor also suggested that he seek psychotherapy. As we explored his past, he spoke of growing up in a chaotic and unpredictable childhood home. He said that after his parent’s divorce, his mother was never the same. Slowly, we unpacked the heavy burden of insecurity that Fred has been carrying all this time.

Complex PTSD is a set of symptoms that are the result of pain and stress that often begin at a very early age—they could be all you’ve known. Naturally, these early experiences shape your perspective of yourself and the world. Healing asks that you turn toward your past to find relief from the weight of trauma. As a result, you become less defined by your history and have greater choice about your future.

C-PTSD can be the result of the following types of experiences:

• Childhood relationships with parents or caregivers that are frightening, unpredictable, and/or overwhelming

• Ongoing or repeated experiences of neglect or physical, verbal, or sexual abuse

• Growing up with exposure to domestic violence

• Being raised by a caregiver who has an active addiction or untreated mental illness

• Experiencing abuse at especially vulnerable times of development, such as early childhood or adolescence

• Facing severe social stress such as bullying, disability, or exposure to traumatic events within your community without support by a caregiver who protects and cares for you

• Being discriminated against or feeling disempowered without a caregiver who helps advocate for you or takes responsibility for your needs

However painful it might seem at first, unpacking the burdens of your traumatic history can be thought of as profound self-care. As if moving into a larger, more spacious home, you are unpacking the painful memories of the past, and making room for more positive emotions. In the process of unpacking, you want to pace yourself so you do not get overwhelmed. You bring stories of pain out of hiding into the light of your awareness. By allowing each memory to find its right place, each one can be reviewed, understood, and worked through.

COMMON MISDIAGNOSES

Many people with a history of complex PTSD and dissociation have been misunderstood, misdiagnosed, and inappropriately medicated. Here are some reasons why:

1. C-PTSD is not included in the DSM-5: Despite much deliberation, neither C-PTSD nor DTD was added to the latest version of the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition) used by clinicians. The diagnosis listed for PTSD most closely matches the symptoms and effects of C-PTSD, because more than 90 percent of the symptoms are the same.

2. Co-occurring diagnoses can mask C-PTSD: Accurate diagnosis sometimes is difficult because disorders can exist simultaneously, known as co-occurrence. For example, children who were neglected or abused are at higher risk for anxiety disorders, depressive disorders, and learning disabilities. Children with these disorders are also at greater risk for abuse.

3. C-PTSD symptoms look like other disorders: The symptoms of C-PTSD can mimic symptoms of other disorders. For example, a child or teen who has been abused or neglected might appear impulsive, anxious, angry, and/or depressed. But if a thorough family history is not understood, it can lead to inaccurate diagnoses of bipolar disorder, anxiety disorder, or major depressive disorder.

Here are some common mistaken or co-occurring diagnoses:

• Borderline personality disorder or other personality disorders

• Bipolar disorder

• Attention deficit hyperactivity disorder (ADHD)

• Sensory processing disorder

• Learning disabilities

• Anxiety disorders

• Major depressive disorder or dysphoria

• Somatization disorders (experiencing psychological disorders as physical symptoms)

• Substance abuse or dependence

An essential component of healing involves working with a psychotherapist, psychiatrist, or medical doctor to determine an accurate diagnosis. A proper diagnosis is not meant to cause shame; rather, it is meant to point you in the right direction for recovery and healing.

Eight Contributing Factors to the Development of C-PTSD

Why will two people with similar histories have different outcomes? Why is it that multiple children can grow up in the same household, but only one feel traumatized? The development and expression of C-PTSD is multifaceted, and is not just influenced by exposure to childhood trauma. Let’s look at why some people may be more susceptible to developing an adverse reaction to trauma than others:

1 Intensity, duration, and timing: Needless to say, the longer the abuse or trauma continues and the greater its intensity, the greater the likelihood you will develop C-PTSD. It is also important to consider the timing of the traumatic stress. Children are most susceptible to the impact of such stressors during critical growth periods, such as the first three years of life when the nervous system is extremely fragile and during adolescence when they are forming their identity.

2 Genetics: Research indicates that anxiety disorders, including PTSD, tend to run in families. While not a direct cause of PTSD, having a parent with PTSD is associated with a greater risk for the development of PTSD after exposure to a trauma. Research suggests that there is a biological predisposition among these children.

3 Environment: Parents with PTSD respond differently to their children, resulting in greater disruptions in care and attachment. Mothers with PTSD tend to be both ...

Table des matières

• Cover
• Title Page
• Dedication
• Contents
• How to Use this eBook
• Foreword
• Introduction
• Chapter One: Understanding Trauma
• Chapter Two: Treating Complex PTSD
• Chapter Three: Renee’s Story: Healing Avoidance Symptoms
• Chapter Four: Daniel’s Story: Healing Invasive Symptoms
• Chapter Five: Kathy’s Story: Healing Depressive Symptoms
• Chapter Six: Supporting Long-Term Growth
• Glossary
• Resources
• References
• Acknowledgments
• About the Author
• About the Foreword Author
• Copyright