Let's Learn Together - Treating Complex Trauma by Greenberg

Back • Return Home

	Full Title:	Treating Complex Trauma Combined Theories and Methods
	Author(s):	Tamara McClintock Greenberg
	Publishing / Edition:	Springer, 2020

Click here for the Table of Contents of the book

Chapter 1.

1

Introduction: Complex Clients Need Multiple Approaches 1
What Is Trauma and Who Gets to Define It? 5
Difficulties in the Study of Complex Trauma 7
PTSD vs. cPTSD: Important Distinctions 8
Therapeutic Efficacy and the Therapeutic Alliance 11
Multiple Treatments, Equal Efficacy 15
Cognitive Behavioral Therapies (CBT) 16
Brief Eclectic Psychotherapy (BEP) 17
Dialectical Behavior Therapy for PTSD (DBT-PTSD) 18
Narrative Exposure Therapy (NET) 18
Psychodynamic Therapy 18
Three-Stage Models 19
Commonalities Among All Approaches 19
The Therapy Relationship and Clinical Hypothesis Testing 20
Negotiating the Beginning of Therapy 22
Conclusion 23
References 24

Chapter 2.

29

The Neurobiology of Trauma 29
Evidence for Intergenerational Trauma Effects 32
Fear: Known, Unknown, and Acted Out 34
Clinical Hypothesis Testing and Thinking About Fear with Our Clients 36
The Unhelpful Link Between cPTSD and Personality Disorders 38
How Trauma Can Lead to Incorrect Diagnoses 39
Assessing Character Style 42
Managing Fear in the Beginning of Therapy 44
Conclusion 46
Initial Goals in the Beginning of Therapy for People with cPTSD 47
References 48

Chapter 3.

51

Characteristics of Therapists Who Have Good Outcomes 51
The Effective Therapist Has Sophisticated Interpersonal Skills 52
The Effective Therapist Has an Ability to Explain a Client's Distress and Takes the Client's Unique Experience into Account 52
The Effective Therapist Is Persuasive About Treatment Ideas and Monitors Progress in an Authentic Way 52
The Effective Therapist Can Deal with Difficult Material While Communicating Hope and Optimism 53
The Effective Therapist Is Keenly Aware of Their Own Psychology 53
The Effective Therapist Stays Aware of Relevant Research and Strives to Continually Improve 53
Trust and the Mentalizing Therapist 54
Normalizing and Managing Shame 58
Creating Safety Though Respecting Avoidance 61
How Much Should We Encourage the Processing of Memories? 62
Conclusion 64
Interventions for Mentalizing and Maintaining Emotional Safety 64
References 65

Chapter 4.

67

Trauma, Suicidal Ideation, and Deaths of Despair 67
The Alarming Epidemic of Suicide 68
Avoidance and Therapist Feelings About Suicidal Clients 70
The Trauma of a Suicidal Crisis 73
Risk Factors for Suicide 74
Interventions for Suicidality 76
Crisis Response Plan 76
Conclusion 78
Interventions for Maintaining Physical Safety 79
References 79

Chapter 5.

83

Normal vs. Trauma-Related Dissociation 83
Assessing Excessive Dissociation 85
Controversies Regarding Dissociation: TM vs. SCM 89
A Combined Model of Dissociation? 94
Dissociation of Trauma in the Mental Health Field 96
Treating Dissociative Disorders 99
Conclusion 105
Interventions for Working with Dissociative Clients 105
References 106

Chapter 6.

111

Substance Use Problems: Evolving Social Perceptions and Reality 111
The Increase in Problematic Substance Use 112
Links Between Trauma and Substance Use 113
Combined Vulnerability: Psychological and Biological Models 114
Assessing Substance Use 117
Treatment Approaches for cPTSD and Substance Use 119

Seeking Safety 119
COPE 121

Treatment Approaches Specifically for Substance Use 123
- Twelve-Step Programs 124
- Harm Reduction 125
- Motivational Interviewing 127
Conclusion 129
Interventions for Helping People with Excessive Substance Use 129
References 130

Chapter 7.

135

Effects of Trauma on the Body 135
Links Between Childhood Adversity and Physical Illness 137
Proposed Mechanisms Explaining the Trauma-Illness Connection 139
Relationships and the Buffer Against Illness 140
Research on the Decrease of Physical Symptoms in Therapy 142
Treating People Who Are Somatically Focused 143
Conclusion 148
Interventions for Helping People Who Are Physically Focused 148
References 149

Chapter 8.

153

Anger and Clinical Avoidance 153
Links Between Anger and Trauma 157
Anger as a Result of Feeling Over-Responsible 158
Mind, Body, and Brain: The Neuropsychology of Anger 161
Anger and Problems Regarding Ideas of Transference 164
When the Therapist Is the Focus of Anger 166
Treating Anger and Aggression 168
Conclusion 170
Interventions for Treating Angry and Aggressive Clients 170
References 171

Chapter 9.

173

Culture and the Culture of Avoidance: Thinking About Differences Between Therapist and Client 173
Trauma, Microaggressions, and Race and Class 176
Trauma, Microaggressions, and LGBT Persons 179
Stereotypes and Stereotype Threats 181
Talking About Differences 182
Conclusion 185
References 186

Chapter 10.

191

Compassion Fatigue and the Impact of Vicarious Trauma 191
Too Much Empathy? The Risk of Burnout and Potential Consequences 194
Therapist Vulnerabilities 199
Countertransference and the Importance of Therapist's Emotions 201
Over-responsibility and the Trappings of the Super Therapist 203
Therapist Self-Care 204
Conclusion 207
Self-Care Interventions 208
References 209

213

Content Review

[In Progress...]

Related Resources

• Purchase the PDF/EPUB from Springer $

• The author's website

• The author has also been a guest on several podcasts:

The REAL Recovery Show
+ Episode #28: On Fear, Anger, and PTSD

The Healing Place Podcast
+ Oct. 13, 2023 - Understanding Complex PTSD

The Tegan Osmond Podcast
+ Jul. 4, 2024 - Managing Chronic Illness and Complex PTSD

The Trauma Therapist Podcast
+ Episode #746: Complex PTSD Coping Skills

The Healing Trauma Podcast
+ Oct. 20th, 2023 - Dissociation & Trauma
+ Mar. 17th, 2024 - Caring For Aging Parents Who Did Not Care For You
+ Mar. 18th, 2024 - Coping Skills For Complex PTSD

• Books also about C-PTSD:

Gingrich, Heather. Restoring the Shattered Self. Second ed., InterVarsity Press, 2020.

Foo, Stephanie. What My Bones Know. Ballantine Books, 2022.