The treatment of C-PTSD and dissociative disorders is unique to each person, as each person has their own story, their own experience, and their own struggle with different symptoms. However, there are some common strategies used to cope with and heal these disorders.
The very first stage of treatment must focus attention on managing distressing symptoms. The first area of focus with clients is to help them begin to develop awareness of when they are dissociating or are otherwise triggered. This can include becoming aware of triggers, noticing shifts in your body, and being curious with yourself when you feel an intense mood or sense of detachment come over you, versus just rolling with it. During sessions, I will begin to help clients learn how to ground themselves when feeling dissociative or triggered, and I encourage clients to begin to use these techniques on their own. A common way to cope with dissocation and emotional overwhelm is to use grounding strategies, which can be found on my website.
I will also begin to incorporate ego state therapy in this stage - a parts work therapy. Parts work therapy helps a person begin to recognize that there are shifting states within that hold different moods, have different triggers, and can have very different perspectives on things from one part to another. Being aware of parts of self also enables a person to begin to cope with dissociation. They learn to be curious about why this part functions the way it does, thus opening up internal communication that can result in less inner conflict and more of a sense of being present.
Throughout this first stage, I also focus on helping clients learn to calm their central nervous system. When someone has experienced repeated traumatic events, their nervous system tends to be stuck in fight/flight, freeze, or a mix of both. Using a variety of approaches - yoga, meditation, breathing strategies, connecting with others, and polyvagal exercises - a person can begin to help their body develop a lower baseline in regards to their threat response.
Once a client has gained a good amount of awareness of themselves, and has essentially mastered the use of coping techniques, then we may decide to move into the next stage of treatment. It's at this stage that we would begin to consider doing trauma processing work. This can include EMDR, or could be achieved through parts work. EMDR facilitates trauma processing through the use of bilateral stimulation, which means activating both sides of the brain's hemispheres at once while working through a trauma. Parts work facilitates trauma processing when a person is able to hear the traumatic experience of each part of them, and figure out what each part needs to heal. Many people are familiar with the need to "heal their inner child" - this is a way to describe the goal of part work, except there can be more than one inner child.
The last stage of therapy includes helping a client to create a life of their choosing. It's a time to begin making new connections, forge new paths in a career, and to begin a life that is no longer focused on the trauma of the past.
Of course, therapy is rarely linear, and a person will often find themselves moving back and forth between the stages. I like to use Rick Kluft's advice in treatment - "the slower you go, the faster you get there." What this means in the treatment of C-PTSD is that you may want to get right to trauma processing, but in fact, that can be very harmful if you are not first fully prepared. The foundations that are needed to begin processing your trauma include a trusting therapuetic relationship, stability, and solid coping skills.
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