EMDR Therapy for C-PTSD: What You Need to Know
Complex Post-Traumatic Stress Disorder (C-PTSD) is a specific type of post-traumatic stress disorder that arises as a result of prolonged abuse or exploitation. People with C-PTSD have been exposed to chronic and repeated trauma over an extended period of time, such as childhood abuse, intimate partner violence, captivity, human trafficking, or forced confinement. C-PTSD can be distinguished from other types of post-traumatic stress disorder by the presence of specific diagnostic criteria and the duration and nature of the traumatic experiences. Many people who go through prolonged trauma struggle for years with anxiety, depression, social isolation, insomnia, self-destructive behavior, and paranoia. If you’ve experienced prolonged trauma from any source—including domestic violence or other forms of exploitation—you might be at risk for C-PTSD.
What Are the Symptoms of C-PTSD?
People with C-PTSD experience symptoms from each of the three diagnostic categories of post-traumatic stress disorder. In addition, people with C-PTSD may experience symptoms specific to their circumstances, such as shame and guilt related to the abuse. The first diagnostic category for post-traumatic stress disorder is re-experiencing the trauma, which can manifest as intrusive thoughts, nightmares, flashbacks, or other dissociative phenomena. People with C-PTSD may also experience intense physiological arousal in response to triggers associated with their trauma, including increased heart rate and difficulty breathing. The second diagnostic category for post-traumatic stress disorder is avoidance. People with C-PTSD may avoid thinking or talking about the trauma, as well as places or people who trigger painful memories. They may also avoid activities that trigger painful emotions related to the trauma. The third diagnostic category for post-traumatic stress disorder is increased arousal, including difficulty sleeping, restlessness, irritability, reckless or self-destructive behavior, and difficulty concentrating. People with C-PTSD may also experience dysfunctional emotions such as shame, guilt, and self-blame.
How is C-PTSD Diagnosed?
C-PTSD is a complex disorder, and it can be difficult for a mental health provider to determine if a patient’s symptoms meet the diagnostic criteria. In order to be diagnosed with C-PTSD, a patient must have experienced prolonged trauma, been exposed to repeated and extreme stressors, and have been unable to find a way to avoid or escape the situation. The diagnostic criteria for C-PTSD differ from other types of PTSD in that they require the presence of three clusters of symptoms: 1) re-experiencing the trauma, 2) avoidance of reminders of the trauma, and 3) increased autonomic arousal (elevated heart rate, rapid breathing, etc.). People with C-PTSD may also experience symptoms specific to their circumstances, such as shame and guilt related to the abuse.
EMDR Therapy for C-PTSD
EMDR therapy is a trauma-focused treatment that has been proven effective in the treatment of PTSD and other disorders. With EMDR therapy, you will discuss and process the traumatic experiences that contributed to C-PTSD. Your therapist will help you identify and challenge negative beliefs about yourself and your world, and work to replace them with new and positive ones. The goal of EMDR therapy is to help you heal from the trauma and move forward with your life. When selecting an EMDR therapist, be sure to choose someone who has experience treating C-PTSD with EMDR therapy. Ideally, they will have completed specific training in the treatment of C-PTSD with EMDR therapy. If you have C-PTSD and are seeking therapy, consider letting your therapist know that you would like to use EMDR therapy to address the trauma. Many therapists have no experience using EMDR for treating C-PTSD, although it is one of the most effective treatment modalities available. If your therapist is unfamiliar with EMDR, let them know that C-PTSD requires a special approach to treatment.
EMDR for Intrusive Memories of Trauma
When working with traumatic memories, your therapist may encourage you to use “rewind” and “revive” techniques. In the rewind technique, you imagine the traumatic memory as if it is happening in slow motion, like a film reel that is being rewound to the beginning. You might imagine yourself as an outside observer, watching the scene play out. This technique allows you to gain distance from the memory and interrupt the flood of emotions associated with it. In the revive technique, you imagine the traumatic memory as if it is happening in real time, as if you are experiencing it again in the present moment. This technique can help you process the emotions and sensations you experienced when the event happened.
EMDR for Hyperarousal and Arousal
People with C-PTSD often experience persistent feelings of hyperarousal, or extreme anxiety and fear, long after a traumatic event has ended. Hyperarousal can be associated with memories of the traumatic event, but it can also occur in the absence of any specific memory. In order to treat hyperarousal, your therapist may ask you to focus on a calming image during your EMDR sessions. During these sessions, you might imagine yourself in a place that makes you feel safe and relaxed, such as a peaceful beach or a quiet forest. You might also imagine yourself interacting with loved ones or pets in a way that makes you feel calm and cared for. The goal of this exercise is to experience a sense of calm during the session, which can help reduce ongoing hyperarousal.
EMDR for Self-Destructive Behavior
People with C-PTSD may engage in self-destructive behavior, such as substance abuse, self-harm, or excessive risk-taking. In order to treat these behaviors, your therapist may ask you to focus on positive experiences during your EMDR sessions. You can use these positive experiences to replace the self-destructive behaviors with something new and better for your life. For example, you might imagine yourself engaging in a healthy activity that brings you joy or feeling a sense of achievement after completing a task. During these sessions, you might imagine doing something you enjoy, such as dancing or playing sports. You might also imagine feeling a sense of connection to other people or the world around you. The goal of this exercise is to experience a sense of meaning or purpose during the session, which can help reduce self-destructive behaviors.
EMDR for Depression and Shame
People with C-PTSD often struggle with feelings of shame and guilt related to their traumatic experiences, as well as depression. In order to treat these emotions, your therapist may ask you to focus on positive emotions such as joy, gratitude, or creativity during your EMDR sessions. You can use these positive emotions to replace shame, guilt, and depression with a sense of positive energy in your life. For example, you might imagine yourself feeling joy or creativity as a way of ending painful feelings of shame and guilt. During these sessions, you might imagine yourself doing something creative, such as painting or writing. You might also imagine feeling a sense of gratitude toward other people in your life. The goal of this exercise is to experience a feeling of positive energy during the session, which can help reduce shame, guilt, and depression.
Final Words: Beating the Monster of C-PTSD
The complex trauma associated with C-PTSD can be difficult to treat, as it often involves a wide range of symptoms and experiences. Fortunately, modern therapy is increasingly tailored to specific needs and experiences. If you have been diagnosed with C-PTSD and are struggling to heal, consider trying EMDR therapy. This powerful treatment can be tailored to address the specific symptoms of C-PTSD, helping you overcome the trauma and move forward with your life.