Therapy for Complex Trauma and Dissociative Disorders
What is Complex Trauma?
When psychological trauma happens repeatedly, such as in situations of long-term child abuse or intimate partner violence, a person is affected in different ways than they would by a single incident of trauma, like a car wreck or a natural disaster. This ongoing, chronic type of trauma, as well as other types of severe traumatic events, encompass what is called complex trauma.
As if complex trauma weren’t hard enough to live through, if it happens at an early age, it can contribute to developing a dissociative disorder. While many different types of trauma therapy modalities are well known and used often to treat trauma, it is important that those with complex trauma or dissociative disorders receive therapy that incorporates the unique needs they have as a result of complex trauma or chronic dissociation.
How Does Complex Trauma Affect Someone?
According to Courtois & Ford (2009) who are experts in the field of complex trauma. complex trauma:
What is Therapy for Complex Trauma?
Therapy for complex trauma follows a number of principles, such as the following:
It follows three phases. Safety / stabilization (phase 1), processing (phase 2), and integration (phase 3)—to ensure that treatment gradually builds on itself in a way that is tolerable and does not overwhelm the client (Kezelman & Stavropoulos, 2019).
Phase 1 covers topics such as safety, regulating emotions, improving relationships, and improving overall functioning.
Phase 2 involves directly processing past trauma, what the trauma meant to the person, and the grief that arises.
Phase 3 involves incorporating the gains made and connecting with life and others in a deeper way.
Pacing is very important in treatment of complex trauma. We make sure the client gets to determine how quickly the therapy moves along, and we step back from difficult material for periods as needed, working on present-day concerns or other areas until the client feels stable and ready to address more challenging material.
A variety of therapy modalities can be used as part of therapy for complex trauma.
People who face chronic dissociation, such as those with dissociative identity disorder (DID), often face challenges similar to those with complex trauma, but they face unique challenges as well. The International Society for the Study of Complex Trauma and Dissociation (ISSTD; 2011) also advises using a three-phase model to treat DID. What makes therapy for those with DID unique is a more direct inclusion of parts of self, or alternate identities, into the various phases of therapy.
For example, part of phase one involves building communication and cooperation between alternate parts of self, as this is a foundational part of the work.
Phase 2 involves parts of self working together to heal from the past.
In Phase 3, the client feels less inhibited by dissociation and more able to live life as someone would who does not have a dissociative disorder.