Video 100 Recovering from complex PTSD

Use this solution 

There is no one solution for complex PTSD.  It requires patience, imagination, tenacity and the ability to forge a trusting therapeutic relationship as well as being able to deploy a range of protocols and interventions.

Originator

The many who have developed the EMDR protocols.

Video production

Matthew Davies Media Ltd, Llanidloes, Powys.
www.matthewmedia.com

What this covers

This is a true story about a woman called Helen.  The video describes her history - one of childhood sexual, emotional, physical abuse and neglect, and includes an interview in which she tells of her experience with EMDR therapy.  In the third part of the video, her therapist describes the process from his perspective, including the various protocols and interventions used.

How long

23.30 minutes.

Related videos

See all Videos from 001 to 008; plus others yet to be filmed.

Go to ‘Take-away’?

For links to important references and reflection on key lessons to be learned.


Take-Away Section

+ Wrap-up

• Use of Ketamine in Post-traumatic Stress Disorder: There is considerable research going on into find a pharmaceutical treatment for PTSD. This paper describes one such approach linked to the process of memory consolidation. View Article

• Dr David Blore’s Blind to therapist protocol. This is useful where the client is very unwilling to describe what has happened because it’s too embarrassing and uncomfortable, e.g. woman who has experienced severe/bizarre sexual abuse with a male therapist:

https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=4&ved=2ahUKEwjz4rfr5MrgAhXnQRUIHXGFDe0QFjADegQIAxAC&url=http%3A%2F%2Fwww.davidblore.co.uk%2Fclinician-resources%2Fhandouts%2FHANDOUT-60.5.ppt&usg=AOvVaw2RE3PVjherK4oiHj4brqqf

• EMDR-PRECI The EMDR Protocol for Recent Critical Incidents and Ongoing Traumatic Stress(EMDR-PRECI). This protocol is useful for critical incidents related to stressful events that continue for an extended periods and where there is not a post-trauma safety period for memory consolidation:

http://www.sfemdr.com/wp-content/uploads/2016/11/AEMDR-PRECI-JUN-24-2016.pdf

• Janina Fisher’s Modified EMDR Resource Development and Installation Protocol.

https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=1&cad=rja&uact=8&ved=2ahUKEwi086yg6MrgAhUMyRoKHXJxBAAQFjAAegQIChAC&url=https%3A%2F%2Fjaninafisher.com%2Fpdfs%2Fmodemdr.pdf&usg=AOvVaw0UTZOnaCowsmUjrCLrymOZ

• Zander, R.S., Zander, B. (2002). The Art of Possibility. Penguin Group (USA).

+ Aide-mémoire for reflections on a complex process

You can copy and paste this text into a Word document, and can edit it, adding any additional text you might find helpful.

  1. There will be some clients for whom the therapeutic relationship will not be a significant factor in their recovery. However, for Helen and many others it will be crucial, as Helen said. This is not surprising, given that clients with such long standing difficulties often feel they will never get better, and so suffer doubts about the process and/or therapist. In such cases there will be several things that a therapist can/should do to help build the relationship: being respectful by giving the client time to listen closely to their story; being flexible in matching the client’s ability to make appointments and session times; showing understanding of their difficulties and not minimising them; and being hopeful without being unrealistic about recovery.

  2. Taking into account the demands of the work in arranging session frequency and length will contribute to the client feeling cared for and of significant value as a human being. Most clients will appreciate being treated as a human being rather than as a ‘problem to be fixed’. We started off with sessions of one and a half hours once a week. When issues became very complex and progress slow, we shifted to meeting twice a week for a total of 3 hours with one day between sessions. That seemed to help Helen better manage the after effects of the therapy and allowed us to speed up the process. As things got better, we were able to revert to meeting once a week and then towards the end, every two weeks.

  3. Involve the client in making decisions about the therapy, if possible. When things got stuck, I would write to her and suggest possible ways forward with reference to past events in her life, asking her opinion of these. This helped build trust and contributed to better decision making in some instances. Writing to her between sessions, sometimes with advice on how to address a problem such as poor sleep or a new worry, helped strengthen the therapeutic relationship and her confidence that she would not be abandoned however difficult things became.

  4. As the therapist be sure you have sources of support and advice to see you through those times when things seem just too difficult to sort out and even overwhelming. I, as Helen’s therapist, am fortunate in that I work in a Partnership, and am a member of a Supervision group, both of which provide me with support and sound advice; and finally, I have enough experience of how wonderfully effective EMDR therapy is, to hold on to that saying we hear in training, ‘Trust the process’.