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C-PTSD: Managing symptoms With Somatic Techniques
Complex post traumatic stress disorder is a highly distressing condition that develops in response to experiencing, or witnessing, ongoing threatening incidents. Examples of these include domestic violence, sexual abuse, or torture. Increasingly, many people seek to manage symptoms of distress through the application of body focused somatic approaches. In this article, I will highlight the nature of C-PTSD, as well as offer some suggestions on somatic forms of treatment, which can be applied under the guidance of a therapist, or as self-care.
Understanding C-PTSD
The assessment of C-PTSD based on ICD-11 criteria includes key PTSD symptom categories. These include re-experiencing, avoidance, perceptions of threat, as well as dissociation. With C-PTSD, these symptoms often manifest more intensely, with three additional highlighted categories: :
Affect dysregulation: Marked by intense emotional reactions to minor stressors, violent outbursts, risky or destructive behaviour, dissociation, and emotional numbness.
Negative self-concept: Involves persistent beliefs about oneself as diminished, defeated or worthless, as well as feelings of shame, guilt or failure related to the trauma.
Interpersonal disturbances: Persistent difficulties in sustaining relationships and in feeling close to others are highlighted here. There may be an avoidance of or little interest in relationships, or, an over dependence on others.
How is C-PTSD diagnosed?
Diagnosing C-PTSD entails a detailed assessment of the aforementioned symptoms, considering the presence and severity of distress resulting from trauma exposure, as well as the impact on daily activities.
Assessing C-PTSD may be challenging for reasons that other conditions may be present. Studies show, for instance, that C-PTSD can co-occur with other mental health conditions such as depression, anxiety, personality disorder, and substance abuse. It can also lead to serious physical dis-ease.
Furthermore, research indicates that there may be a delayed C-PTSD response, with symptoms emerging six months to a year after the traumatic events. There are various reasons for why this may be. Some have suggested that there may be mild symptom presentation, which can intensify over time. I’ve worked with many individuals that have experienced prolonged threatening or horrific events, however, through the use of self-care techniques they are able to manage symptoms, although not without struggle. This delicate balance can persist for many years until a major stressor triggers a sudden escalation of severe C-PTSD.
Healing frm C-PTSD
If you’ve experienced, or witnessed, highly threatening events, which continue to affect you even mildly, then it is best to seek therapeutic support. This is because unresolved trauma can escalate over time, amplifying the severity of symptoms. Effectively healing trauma requires addressing the various types of memories, thoughts, emotions and physiological reactions formed in response to traumatic events.
To embark on the journey of healing, I would recommend exploring different therapeutic approaches by engaging with various therapists. Assessing their methods and determining if they are a good fit is vital. C-PTSD treatment is an investment, both financially and time wise. The process can span anywhere from 12 to 24 sessions, possibly more. Therefore, it is important that you choose the right professional to guide you.
Whilst therapeutic support is integral, it is not the only method for recovery. Applying self-care, as an adjunct to treatment, can also make a difference to your wellbeing. There are numerous self-care methods you can choose from. For the present article however, I would like to share some thoughts and tips on somatic techniques that may help.
Somatic Approaches for Managing Symptoms of C-PTSD
Somatic approaches have gained prominence for trauma treatment, and for good reason. When confronted with a highly threatening situation from which a person is unable to escape, the rapid thought patterns that occur concerning one’s safety, trigger a series of bodily responses. For example, in cases of physical violence, the body may collapse, curl up, and employ protective gestures. Simultaneously, the body’s energy becomes constricted and trapped, causing a sense of being stuck within.
Therefore, healing the complex nature of trauma requires an integrated approach. An approach that addresses not only the cognitions upholding the trapped energy, but also acknowledging and processing the emotions and sensations experienced within the framework of the body.
Options for Choosing Somatic Approaches
A variety of somatic techniques have proven to be effective for managing trauma symptoms, offering individuals diverse options based on their preferences and comfort levels. Some notable techniques include:
Trauma Release Therapy (TRE): A method that utilises physical movements to induce tremors, and release tension stored in the body.
Focusing: Emphasises the exploration of bodily sensations and emotions, and listening to the bodily felt sense to facilitate healing.
Yoga Nidra: A guided meditation technique promoting deep relaxation and heightened body awareness.
Hakomi Method: Integrates mindfulness and body awareness to explore and shift unconscious beliefs.
Dance/Movement Therapy: Utilises expressive movement to process and release emotions stored in the body.
Somatic Experiencing: Focuses on renegotiating traumatic experiences through body awareness and physiological regulation.
Yoga Therapy: Integrates yogic practices to promote physical and mental well-being.
Key Principles of Somatic Approaches
Regardless of the somatic approach, the key is to develop mindful, non-judgmental awareness. Whether sitting, lying down, or engaged in movement, individuals are encouraged to slow down and fully concentrate on their experiences, trying to observe without reaction.
Tailoring Approaches for Severe C-PTSD
Individuals with severe C-PTSD may find focusing on body sensations challenging. In such cases, it is essential to choose a method that feels comfortable and tolerable. While some discomfort may arise, it should not be overwhelming. Engaging in somatic approaches under the guidance of a practitioner, which can include group-based teaching, can offer support through the process.
However, if you would like to learn more about, possibly apply, a basic mindful body awareness and movement exercise, then following is one example:
Mindful Body Scan And Gentle Movement
- Sit or lie down comfortably, with eyes fully or partially closed.
- Notice how you are breathing. If you feel comfortable, take a few deep breaths, gently inhaling and exhaling through the nose. Try to relax the body each time you exhale.
- Next you can choose to practice a body scan. Starting from your feet and then gradually moving towards the head, noticing each body part in any order that feels comfortable. Simply be aware of any sensations, tension or areas of comfort, without judgment.
- If you feel comfortable, you can begin to make gentle movements. This can include rotating the feet, hands, and gently moving the neck; you may tighten the muscles in some or the whole body, or make any other movements that feel comfortable. Again, notice any sensations or anything else that arises, without judgment.
- If you begin to feel overwhelmed or very uncomfortable then try using grounding techniques. This can include placing your hand on your chest and fully focusing on the physical sensation of breath. Or you can press your feet against the ground; bring attention to your environment, noticing what you can see, hear, feel, smell, taste.
- Whilst doing the movements, you can incorporate positive affirmations such as “I’m safe’ ‘I’m in control’ or any other affirmation you feel comfortable with. This can help you feel relaxed and alter negative thought patterns.
- After the movements, take a few moments to sit quietly and notice how your body feels, observing any changes to your mental, emotional and physical state.
Applying a somatic approach can facilitate the management of C-PTSD symptoms experienced in the body. There are numerous techniques to choose from however, which can be applied individually or under the guidance of a practitioner. What is key is to listen to your body, and choose a method that feels most comfortable for you.
I hope you found this article useful. If you have any questions, or to discuss treatment and support options then feel free to get in touch.
With best wishes,
Sadaf
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