Complex Trauma: Dissociation, Fragmentation, and Self Understanding

For those of us working in the field of complex trauma, one of the most exciting events of 2017 was the release of Healing the Fragmented Selves of Trauma Survivors by Dr. Janina Fisher. The book is a wonderful summary and synthesis of the current state of knowledge in trauma research enlivened with wisdom, insight and deep compassion for the victims of abuse. Dr. Fisher draws together neurobiological research, psychological theory, and a productive, if sometimes painful, process of trial and error in which dozens of committed therapists sought out better ways of helping survivors of trauma. Unfortunately, many people suffering from the after effects of a traumatic childhood have summoned up the courage necessary to start a course of therapy only to be forced to stop because confronting their repressed or partially repressed memories caused a breakdown or personal crisis that made it impossible to continue with therapy. While it can be argued that therapy on the “it must get worse before it gets better” model nevertheless helped many people, the desirability of finding a less painful model is obvious. Dr. Fisher describes both the new, improved model for trauma therapy and the process by which it came about, which is itself a fascinating story. The book is, I believe, required reading for anyone in the psychology profession, but is also aimed at victims of complex trauma, especially those starting therapy, and can be profitably read by anyone who has friends or f...
Source: Psych Central - Category: Psychiatry Authors: Tags: Abuse Caregivers Children and Teens Dissociation Dissociative Motivation and Inspiration Neuroscience Parenting Personality Psychology Psychotherapy Self-Esteem Trauma Treatment Alienation C-PTSD Child Abuse child neglect Source Type: news

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Although key to development of tailored drugs for augmentation treatment of psychotherapy for posttraumatic stress disorder (PTSD), the biological correlates of PTSD remission are still unknown, probably because pre-post treatment studies searching for them are rare. Not even the feedback sensitivity of the otherwise well-studied hypothalamic-pituitary-adrenal (HPA) axis nor arterial blood pressure (BP), which was previously reported to be elevated in PTSD patients, have so far been analyzed during PTSD treatment.
Source: Psychoneuroendocrinology - Category: Psychiatry Authors: Source Type: research
Publication date: Available online 17 October 2018Source: Progress in Neuro-Psychopharmacology and Biological PsychiatryAuthor(s): Boadie W. Dunlop, Andrea WongAbstractQuestions of how altered functioning of the hypothalamic pituitary adrenal (HPA) axis contribute to the development and maintenance of posttraumatic stress disorder (PTSD) have been the focus of extensive animal and human research. As a rule, results have been inconsistent across studies, likely due to a variety of confounding variables that have received inadequate attention. Important confounding factors include the effects of early life stress, biological...
Source: Progress in Neuro Psychopharmacology and Biological Psychiatry - Category: Psychiatry Source Type: research
Conclusions: The present study represents the first examination of variability in symptoms as a predictor of sudden gains. Findings indicated that sudden gains are significantly predicted by intraindividual variability in symptoms, in diverse settings, contexts, and populations. Advantages of this predictor, as well as clinical and research implications are discussed. (PsycINFO Database Record (c) 2018 APA, all rights reserved)
Source: Journal of Consulting and Clinical Psychology - Category: Psychiatry & Psychology Source Type: research
We present a case of a motor conversion disorder comorbid with posttraumatic stress disorder, where we designed a psychotherapeutic approach based on the Bayesian model of brain functioning, specifically, the Bayesian model of functional neurologic symptoms. The model posits that such symptoms are produced as a result of hyper-precise prior beliefs (priors). Priors can be both conscious and unconscious and exist at different levels from perceptual to cognitive. Decreasing their precision/rigidity may then alleviate the related symptoms. In accord with this rationale, we used cognitive, experiential, and behavioral interven...
Source: Journal of Contemporary Psychotherapy - Category: Psychiatry & Psychology Source Type: research
After the recent hearings regarding Judge Brett Kavanaugh’s nomination to the Supreme Court, the recollection of Dr. Christine Blasey Ford came into question. One conservative pundit, Ben Shapiro, suggested that because we had “two believable testimonies and no corroborating evidence,” we should basically dismiss Blasey Ford’s accusation. But in a disjointed opinion piece published on Newsweek.com, Shapiro confuses the science of memory, and what it tells us about how the brain forms, keeps, or distorts memories. Let’s walk through his claims and what science actually says about memory. Ben S...
Source: World of Psychology - Category: Psychiatry & Psychology Authors: Tags: Brain and Behavior General Minding the Media Psychology Research Violence and Aggression Ben Shapiro Brett Kavanaugh False Memories Sexual Assault Source Type: blogs
Authors: Shiner B, Westgate CL, Gui J, Maguen S, Young-Xu Y, Schnurr PP, Watts BV Abstract OBJECTIVE: Fluoxetine, paroxetine, sertraline, topiramate, and venlafaxine have consistently shown efficacy for posttraumatic stress disorder (PTSD) in meta-analyses of randomized controlled trials. However, no study has compared the effectiveness of these agents in routine clinical practice. We conducted a retrospective comparative effectiveness study of these 5 medications using electronic medical record data. METHODS: We identified 2,931 Department of Veterans Affairs outpatients initiating treatment for PTSD between f...
Source: Journal of Clinical Psychiatry - Category: Psychiatry Tags: J Clin Psychiatry Source Type: research
Conclusion: Evidence-based psychotherapies like IPT-T are needed in CMHCs, where some of the most vulnerable patients receive treatment. With comparable findings for depression, IPT’s superior improvements in social health and PTSD symptoms are cause for optimism. IPT-T should be evaluated in dissemination trials. (PsycINFO Database Record (c) 2018 APA, all rights reserved)
Source: Journal of Consulting and Clinical Psychology - Category: Psychiatry & Psychology Source Type: research
I used to work at a community mental health center. A client could be there totally on his or her own (which was the exception) or could have been referred by any of the following, and sometimes by more than one: state probation and parole (which sometimes included out-of-state referrals), community corrections local probation, federal probation and parole, DUI and drug possession probation, child protective services, adult protective services, juvenile probation, direct referral from various court systems, special justice ordered outpatient care in lieu of inpatient hospitalization, etc. The referral could include an eva...
Source: Psych Central - Category: Psychiatry Authors: Tags: Book Reviews Caregivers Children and Teens Disorders Dual Diagnosis Education Ethics & Morality Family General Medications Policy and Advocacy Professional Psychiatry Psychological Assessment Psychology Psychotherapy Treatm Source Type: news
Authors: Bradley A, Karatzias T, Coyle E Abstract Emotion regulation (ER) difficulties have been identified as an important target for clinical intervention in the treatment of posttraumatic stress disorder (PTSD) symptoms in survivors of childhood sexual abuse (CSA). However, there is limited research regarding the use of specific strategies to regulate specific emotions following exposure to traumatic events. The aim of the current study was to investigate the indirect effects of four trauma-related emotions (anger, sadness, disgust and fear) on PTSD severity via two mediators; derealisation and self-harm. In par...
Source: Clinical Psychology and Psychotherapy - Category: Psychiatry Tags: Clin Psychol Psychother Source Type: research
Our relationships can be our greatest source of pain, and yet without relationships, we cannot heal from pain. For some people, the pain is too overwhelming and avoidance seems the only option. Others may try to be open about their experiences and find themselves feeling too exposed, too vulnerable, and worse off than before. In either case, healing from trauma requires that we find and allow ourselves to experience a healing relationship. In his new book, Trauma and the Struggle to Open Up: From Avoidance to Recovery and Growth, Robert T. Muller, who is also the author of Trauma and the Avoidant Client, takes us inside th...
Source: Psych Central - Category: Psychiatry Authors: Tags: Book Reviews Disorders General Memory and Perception Personal Stories Psychology Psychotherapy PTSD Trauma Treatment books on trauma trauma book Source Type: news
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