Complex Trauma or Complex Post-traumatic stress disorder (C-PTSD) is a mental health condition that can develop after repeated or prolonged traumatic events. A single traumatic event can lead to PTSD symptoms and may need therapy to deal with the aftermath. Complex trauma can lead to a whole host of trauma symptoms which can include emotional disturbances, physical symptoms and psychological issues. Unlike single incident PTSD, complex trauma involves multiple traumatic experiences, often including childhood trauma and may include:
Complex post-traumatic stress disorder (C-PTSD) is a diagnosis in the International Classification of Diseases, 11th Edition and has 6 symptom clusters.
These symptom clusters are:
These symptoms make you feel like you are re-living the event and include flashbacks, nightmares and painful memories. These symptoms are often accompanied by changes to our nervous system where we feel high levels of arousal, fear, distress etc. The symptoms themselves can be very distressing. These symptoms can also manifest as physical symptoms such as sleep problems, fatigue and body aches.
Avoidance symptoms include urges and/or efforts to avoid triggers of the traumatic memories which can include external stimuli such as places, people, sensory information (smells, sounds etc) and environments as well as internal stimuli such as the traumatic memories themselves and certain thought patterns. We may avoid triggering stimuli physically, though we also may escape through changes to our nervous system, such as through dissociation where our mind detaches or disconnects from present internal or external experiences.
Hypervigilance means our nervous system is on high alert as if something threatening is about to happen even when there is nothing threatening in our environment. This means we feel hyper aware of our environment and/or ourselves and feel on edge and can’t relax.
Emotional dysregulation means we struggle to identify, understand and regulate our emotions. Compounding this may be emotional hyper sensitivity or reactivity where when triggered emotions escalate very quickly. We may struggle to manage very specific emotions and/or all emotions. We may also turn to unhelpful or destructive ways to manage or escape painful emotions.
Complex trauma makes relationships hard. The trauma may have led to unhelpful beliefs about relationships such as “others are unsafe” or “others will abandon me”. We may unconsciously act out patterns related to our trauma in our relationships which can sabotage or undermine our connections to others.
Complex trauma impacts our sense of self and can lead to painful changes in our relationship with ourselves. For example trauma can leave us with a deep sense of shame and self loathing. We can feel inadequate, defective or not good enough. The impact of these changes is far reaching and can flow through to our mood, our ability to function day to day and our relationships with others. Complex trauma can also lead to low self esteem which affects our mood and ability to function day to day.
At Cova Psychology our approach combines evidence based techniques with individualised treatment. For complex trauma we use a range of therapies to work through 3 stages of treatment which include:
A trauma psychologist in Melbourne can work with you through these stages of treatment, in-person and Telehealth.
This stage of treatment involves helping clients to stabilise their emotional state by increasing emotional regulation and distress tolerance skills. Clients may learn a range of skills including relaxation, mindfulness, grounding, self soothing and skills for managing high emotion and experiences of dissociation.
Often the skills learned in safety and stabilisation are part of the next stage, trauma processing. In this stage clients target traumatic memories in therapy to reduce the emotional charge and shift unhelpful beliefs that may be stored in the memory.
This stage involves helping clients achieve the goals and milestones they have been unable to reach due to Complex PTSD. These may be goals related to work and vocation, reaction and leisure, socialising and relationships or other areas of life that have been impacted by the trauma.
A trauma psychologist in Melbourne can help you through these stages.
Our Melbourne psychologists use a range of evidence based therapies to work through the three stages of complex trauma treatment. These therapies include:
Cognitive behavioural therapy (CBT): Cognitive behavioural approaches involve helping clients identify unhelpful or destructive thought patterns, perpetuating behaviours and painful emotional states. The therapy helps clients move to more helpful and self enhancing ways of thinking, feeling and behaving.
Eye movement desensitisation reprocessing (EMDR): EMDR Therapy is a type of therapy specifically designed to treat PTSD but we also use it to treat anxiety disorders more broadly. EMDR involves targeting traumatic memories whilst engaging in bilateral stimulation where the client’s eyes are directed to move from side to side. Through this process the emotional charge of the memory is reduced and unhelpful beliefs are modified. Cova Psychology is a leading provider of EMDR in Melbourne and all our psychologists are trained in this form of trauma therapy.
Mindfulness-based interventions:
These include Mindfulness based Cognitive Therapy and Acceptance and Commitment therapy (ACT). They focus on being present and letting go of unhelpful ways of thinking and attending to values based activities in the here and now.
Schema Therapy: Schema therapy is an advanced form of CBT which targets unhelpful ways of thinking that are often linked to childhood or attachment trauma.
Acceptance and Commitment Therapy (ACT): ACT is a type of therapy which combines mindfulness strategies, connecting with one’s values, accepting and regulating emotional states and committing to engaging in values aligned behaviours.
Compassion-based and attachment-based therapies: These therapies focus on developing self compassion and understanding past relationships and their impact on current behaviour and emotions.
Dialectical Behaviour Therapy (DBT): This therapy helps clients learn valuable coping skills which are often an important part of the safety and stabilisation phase of trauma treatment. These skills help regulate emotions and tolerate distress so clients can access and process their traumatic memories safely.
Cognitive Processing Therapy (CPT): CPT is a form of CBT and is a structured approach where clients process traumatic events linked to PTSD through a cognitive behavioural approach. This is often done by writing down or recording recollections of trauma memories.
Prolonged Exposure Therapy: This therapy is also a form of CBT which teaches clients to gradually approach trauma memories and either triggers or environments associated with trauma. Clients are taught coping skills to do this work safely.
Our Melbourne psychologists will work with you to develop a treatment plan which may include one or more of these therapies based on a comprehensive psychological assessment which looks at your current mental health, your preferences and your history. We offer trauma therapy in Melbourne with options for in-person and telehealth appointments.
If you or a loved one is experiencing Complex Trauma our Melbourne psychologists and clinical psychologists can help. We are located in the Melbourne CBD and offer in-person and telehealth appointments. Recognising trauma symptoms is the first step in the therapeutic process and our psychologists can help you through it. Contact our friendly reception team to book an appointment by:
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Acknowledgement of Country
Cova Psychology acknowledges the Traditional Owners of the land where our Melbourne CBD practice is located—the Wurundjeri Woi-wurrung and Bunurong/Boon Wurrung peoples of the Kulin Nation. We pay respect to their Elders, past and present, as well as the Elders of other Aboriginal communities in Melbourne and beyond.
We would like to acknowledge the Traditional Owners of the land on which the practice is located. We pay our respects to their Elders, past and present, and the Aboriginal Elders of other communities who may be here today.