Diagnosing and Treating Complex Trauma, Mooren, Trudy

The Need for Utilizing Multiple Approaches for Complex PTSD: No Theory Has It All

Introduction: Complex Clients Need Multiple Approaches

What is Trauma and Who Gets to Define It?

Difficulties in the Study of Complex Trauma

PTSD vs. cPTSD: Important Distinctions

Therapeutic Efficacy and the Therapeutic Alliance

Multiple Treatments, Equal Efficacy

Commonalities Among All Approaches

The Therapy Relationship and Clinical Hypothesis Testing

Negotiating the Beginning of Therapy

Conclusion

References

Chapter Two: How Trauma Stokes Fear: Considerations in Beginning of Therapy

The Neurobiology of Trauma

Evidence for Intergenerational Trauma Effects

Fear: Known, Unknown, and Acted Out

Clinical Hypothesis Testing and Introducing the Concept of Fear

The Unhelpful Link between cPTSD and Personality Disorders

How Trauma Can Lead to Incorrect Diagnoses

Assessing Character Style

Managing Fear in the Beginning of Therapy

Conclusion

Initial Goals in the Beginning of Therapy for People with cPTSD

Chapter Three: Nurturing the Therapeutic Alliance: Mentalizing and Emotional Safety

Characteristics of Therapists Who Have Good Outcomes

-The Effective Therapist Has an Ability to Explain A Client's Distress and Takes the Client's Unique Experience into Account

- The Effective Therapist Is Persuasive About Treatment Ideas And Monitors Progress in An Authentic Way

- The Effective Therapist Can Deal with Difficult Material While Communicating Hope and Optimism

- The Effective Therapist Is Keenly Aware of Their Own Psychology

- The Effective Therapist Stays Aware of Relevant Research and Strives to Continually Improve

Trust and the Mentalizing Therapist

Normalizing and Managing Shame

Creating Safety Though Respecting Avoidance

How Much Should We Encourage the Processing of Memories?

Conclusion

Interventions for Mentalizing and Maintaining Emotional Safety

References

Chapter Four: The Therapeutic Alliance and Maintaining Physical Safety

Trauma, Suicidal Ideation and Deaths of Despair

• How to choose specific therapeutic methods and when to shift techniques
• The neurobiology of trauma and management of fear
• Cultural and ethnic considerations in trauma treatment
• Addressing avoidance and creating a safe therapeutic environment
• Management of dissociation, substance abuse, and anger

Treating Complex Trauma: Combined Theories and Methods serves as a practical guide for clinicians looking to expand their knowledge of approaches for treating complex trauma. It aims to provide clinicians with options for different therapeutic methods, along with the necessary context for them to select the most effective approach in their treatments.

"For the first time in the professional literature we are finally afforded a clear, cogent, and detailed explication of complex trauma and the multifaceted parameters of treatment. Dr. Tamara McClintock Greenberg provides perspicacious insight and clinical wisdom only a seasoned career therapist can yield. Offering sophisticated and nuanced distinctions between complex trauma and PTSD, she shows how treatment is necessarily contextual and tailored to the unique clinical and personality dynamics of the sufferer that is thoroughly client specific within the therapeutic dyad. She dispenses with simplistic and supercilious attitudes that embarrassingly boast a uniform or manualized treatment to trauma, instead carefully taking into consideration polysymptomatic, neurobiological, and socialcultural differences that inform the interpersonal, emotional, and safety milieu from the beginning of treatment to stabilization, the working-through process, and then onto successful recovery. This is a must-read book for those in training and senior clinicians alike."
--Jon Mills, PsyD, PhD, ABPP, Faculty, Postgraduate Programs in Psychoanalysis & Psychotherapy, Adelphi University, NY; author of Treating Attachment Pathology

"Dr. Greenberg has written an invaluable book on treating complex trauma. She delves into multiple approaches, assessing what techniques the client can tolerate at a given therapeutic stage. She covers how to maintain consistency and connection through a flexible approach and avoid pitfalls. This is a must read for clinicians wishing to treat clients with complex PTSD."

--Louann Brizendine, MD, Clinical Professor UCSF; author of The Female Brain