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4 Simple Ways To Help Trauma Survivors Heal

By July 8, 2024Blog
trauma - healing - sam owen - mental health and relationship advice

Trauma, PTSD, CPTSD

Researchers have showcased a key difference between post-traumatic stress disorder (PTSD) and complex post-traumatic stress disorder (CPTSD), highlighting that CPTSD, compared with PTSD, has a unique association with a person’s relationships.

So let’s use this to understand how positive relationships play a role in the healing process for a chronic trauma survivor and how you can better help a loved one, or yourself, heal from CPTSD.

But first, allow me to set the scene and here’s why.

 

Trauma, CPTSD and Relationships With Others

For CPTSD sufferers, feeling safe is a major issue, so talking about relationships is an odd subject.

Whilst PTSD can develop in people who have experienced a one-off traumatic event, CPTSD can develop in those who’ve experienced chronic trauma, i.e. ongoing traumas such as:

  • childhood abuse, childhood neglect, or childhood abandonment;
  • ongoing psychological abuse, physical abuse or sexual abuse;
  • torture; kidnapping;
  • being a prisoner of war;
  • and more.

And these traumas can happen both to people for whom relationships, prior to the trauma, generally had positive connotations or negative connotations depending on their personal history.

If ongoing traumas have led to a deep fracture in a person’s ability to feel trust towards others, either from their childhood or more recently, then they will become hyper-vigilant around others.

And even when they are around their nearest and dearest that they do trust, they may be hyper-sensitive to interactions they have experienced with them recently.

For example, the most inane interactions with loved ones could create anxiety symptoms experienced psychologically and physically such as worry, and palpitations and trembling, respectively.

To progress from that place to feeling calmer around all others (no mean feat), and then return to the original state they were in before they experienced the traumas, they need to be able to interact with others and experience those interactions positively. Safely. To feel safe in those moments, and for the hours that follow, including into the following day(s).

So with that in mind, let’s look at what this study found and then we’ll look at how you can implement positive changes in your life to help yourself or a loved one, to heal from chronic trauma.

 

Trauma, CPTSD and Perceived Social Support

A study involving 246 individuals, 50% male, with an average age of 47.37 years was conducted to understand the link between perceived social support, PTSD and CPTSD [1].

The researchers used both the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) and the International Classification of Diseases ICD-11 (ICD-11), the latter being the only one thus far to officially distinguish between a diagnosis of CPTSD from PTSD, a distinction included in 2018.

For the individual to be diagnosed with CPTSD, they need to meet the PTSD criteria and additionally have at least moderate severity level for the ‘disturbances in self-organisation’ symptoms cluster. This entails the individual giving ratings for:

  • five items reflecting hyper-activation (e.g. when I am upset, it takes me a long time to calm down’);
  • four items reflecting hypo-activation (e.g. ‘I feel numb or emotionally shut down’);
  • four items reflecting negative self-concept;
  • three items reflecting disturbances in relationships.

The first two – hyper-activation and hypo-activation – deal with disturbances in affective dysregulation, ‘defined as the impaired ability to regulate and/or tolerate negative emotional states, and has been associated with interpersonal trauma and post-traumatic stress’ [2].

Of the 246 participants in the study, 187 completed the ICD-11 International Trauma Questionnaire. Of those 187 individuals:

  • 94 participants (50.3%) met the ICD-11 CPTSD diagnosis,
  • 29 participants (15.51%) met the ICD-11 PTSD diagnosis, and
  • 112 participants (59.9%) met the DSM-5 PTSD diagnosis.

And here’s the important part: (a) Individuals with CPTSD tended to have lower levels of perceived social support when compared with those who did not have CPTSD and (b) those with lower levels of perceived social support were likely to meet the CPTSD diagnosis.

 

Which Causes Which

Based on this study, the researchers couldn’t say the direction of cause, i.e. whether a person’s relationships are significantly impacted by CPTSD or whether CPTSD significantly impacts a person’s relationships, or whether the effect goes both ways.

But they did find a significant association between CPTSD and disturbances in relationships.

And the researchers do go on to suggest a few possible reasons for the link but here I am going to discuss with you, my views on this and how you can help trauma survivors, or help heal yourself.

Whether you have CPTSD, suspect you do, or have a loved one who does, what you do will make a world of difference to you.

 

4 Tips To Take You From Relationship Disturbances To Stability

I’m going to give you four tips so that you may better navigate your own, or a loved one’s, difficult journey towards stability.

Positive relationships are powerful and they are great for healing a person who’s suffered from ongoing traumas over a long period so let’s use that to the trauma survivor’s advantage, as well as their loved ones’.

 

1. Be Consistent

Make sure what you are doing is making you (as the trauma survivor) or your loved one (the trauma survivor) feel consistently safe.

As the trauma survivor, think about how your brain perceives the people around you, and the situations you put yourself in.

As their loved one, think about what you’re saying and what you’re doing and how that is being construed by the CPTSD sufferer. Thinking more carefully than you would when dealing with someone who hasn’t lived through chronic trauma.

Consistency allows the trauma survivor to rewire their brain to remain, when appropriate, consistently calm rather than consistently or frequently hyper-alert for threats.

Consistency helps the trauma survivor to build trust with that person.

Consistency results in less psychological and physical distress in the form of symptoms such as worry, irritability, body aches, and chest pains.

 

2. Be Gentle

trauma healing quote - Sam OwenA really interesting finding in the study was that higher levels of perceived social support were significantly linked to the presence of the ‘affective dysregulation’ cluster [1].

And whilst the researchers suggest a few possible explanations of their own, in my experience, this is most likely down to the lack of safety and trust the CPTSD sufferer is experiencing.

So, as I said in the beginning, even interactions with those the trauma survivor does trust, can be vulnerable to much emotional upheaval, quite needlessly, and this may simply be a consequence of the affect dysregulation symptom of CPTSD and/or the chronically broken trust the trauma survivor has experienced.

So, be gentle.

Be gentle with trauma survivors. The goal is to rewire, not to retraumatise.

For example, whilst you may want your loved one to associate a certain place with a positive feeling, don’t expect that to happen overnight, it will take repeat encounters during which you consistently pair that place with a new positive association such as a positive thought or feeling.

Furthermore, if you create a positive association with that place one day, but then create a negative association with that same place the very next day, guess which association and ensuing psychological, neurological and physiological reactions you will generate in the trauma survivor. Hint, not good ones.

Plus, if you retraumatise or keep retraumatising them as a result, you can undo months of their hard work. Months of agonising repair work, all unraveled, accidentally. Not only is that an extremely painful outcome for the trauma survivor, it’s also difficult for their loved ones.

And always be gentle with yourself as you rewire your own brain for new meanings, new associations, or perhaps, as you rewire back to the old meanings and the old associations you had with people, places and things before you were traumatised.

Rewiring doesn’t have to take long, but it doesn’t happen overnight.

 

3. Focus On Emotion Regulation

Given that emotion dysregulation (to use more common language) is a symptom of CPTSD, it’s so important to focus on, or encourage your loved one to focus on, undertaking healthy activities that help regulate their emotions from negative back to positive such as positive self-talk, transcendental meditation, physical exercise, being in nature, dancing, and so on.

Focusing on this can prevent you, as the trauma survivor, from feeling like you’re drowning in those challenging moments you face in your relationships, whether your body is hyper-activated from something that truly was threatening that you have intuitively sensed, or whether you have brought painful memories from your past into your present when they don’t actually belong there.

 

4. Respect The Trauma Survivor’s Insights

CPTSD healing quote - Sam OwenIf you think a trauma survivor has impaired ability to spot real threats simply because they have experienced trauma and may be experiencing hyper-arousal as a daily symptom, you’re doing them a disservice.

Trauma survivors aren’t less intuitive as a result of their trauma, if anything, many become more intuitive because they had to hone that skill in order to stay as safe as possible, and maybe even to survive.

What you may see in your loved one as hyper-arousal or hypo-arousal may actually be ‘hyper-intuition’.

So, pay respectful attention to what someone with CPTSD is bringing to your attention. They may be highly valuable insights for you, them, or both.

For example, just because someone decides they no longer want a (close) relationship with someone they’ve known their entire life, doesn’t mean it’s because of their CPTSD symptoms. It might well be. But it might actually be because they’ve seen from a mile off what you are yet to notice about how dangerous someone is to their, or your mutual, mental/physical health and wellbeing.

And equally, don’t dismiss your own intuitive hunches as mere CPTSD symptoms in the form of emotion dysregulation or relationship disturbance. When your mind and body are warning you about something or someone, pay attention.

It might be that you have a painfully intense emotional response, psychologically and physically, but it may still be a valid warning.

In fact, it might be that the intensity is your brain telling you, ‘Look, I know I need to up the strength of the alarm on this one because I’m frequently sounding the alarm these days, so here you go, THIS one you have to pay attention to.’ And you should.

Rather than merely a trigger that reminds you of the past, it’s most likely a real, immediate or incoming threat in your present.

 

People Power

Chronic trauma survivors can suffer a huge amount on the inside even if they show none of this on the outside. So anything you can do to help alleviate their suffering is always helpful. It can be the difference between that person engaging in self-care instead of self-harm.

Your consistent kindness can also help them to feel valued.

Your patience can help them to feel less panicky.

Your love can give them hope.

You may never understand how your kindness helps, but it helps. It helps them so much.

 

References

1. Simon, N., Roberts, N. P., Lewis, C. E., van Gelderen, M. J., & Bisson, J. I. (2019). Associations between perceived social support, posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD): implications for treatment. European Journal of Psychotraumatology, 10(1), 1573129. https://doi.org/10.1080/20008198.2019.1573129

2. Dvir, Y., Ford, J. D., Hill, M., & Frazier, J. A. (2014). Childhood maltreatment, emotional dysregulation, and psychiatric comorbidities. Harvard Review of Psychiatry, 22(3), 149–161. https://doi.org/10.1097/HRP.0000000000000014

 

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