literature

THE PLAN

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Treatment of Complex Post-Traumatic Stress Disorder Treatment of Complex
Post-Traumatic Stress Disorder

Herman (1992) divides recovery from CPTSD into three stages: establishing
safety, remembrance and mourning for what was lost, and reconnecting to society.

Before this work can begin, a healing relationship must be established; Herman
believes recovery can come only within a relationship and only if the survivor
is empowered.

Stage One:
Establishing safety
This stage is further subdivided into a series of tasks that must be
accomplished in order for the client to feel safe in therapy. First, the
therapist and client must name the problem. This involves not so much making a
formal diagnosis as acknowledging the trauma and its past and present effects,
both mental and physical.

Next, one must restore a sense of control to the client. This begins with control of the body: controlling physical symptoms by balancing diet, exercise, and sleep and by getting the client appropriate medical care, including medication where it is indicated.

Finally, control moves outward to establishing a safe environment: setting up support networks of caring people, helping the client to protect him/herself from any physical
danger they may face (particularly from an abuser), and developing a plan for
dealing with for future protection, one that takes into account any self-destructive behaviors the client engages in. This includes such things as setting up no-harm contracts (or procedures in case of harm), establishing sobriety, etc.

Herman cautions that there's not easy way to tell when this (or any) stage of
recovery is complete. The first stage in particular is demanding; therapists and
clients must be careful not to push on until safety is well established. Herman
states that when the client has regained some trust in herself and her
environment, when the therapeutic alliance is good, and when the most disturbing
symptoms are controlled and the client knows which people can be relied on in
times of crisis, it is reasonably safe to proceed.


Stage Two:
Remembrance and mourning
The second stage is also divided into sub-stages.

First, the client must reconstruct the story of the trauma. Many times, traumatized person have never been able to put it all together and make it into a narrative. During this
stage, a sense of continuity with the past is reestablished. Herman stresses the
importance of, in this stage, retrieving both the memories and the emotions
attached to them; this corresponds to the view of some practitioners that
free-floating anxiety can be "emotional memories" that have somehow gotten
unstuck from the memories of the events during which they were experienced.
When the narrative reconstruction is complete, Herman says, the traumatic
memories must be transformed using flooding/exposure (as in cognitive therapy)
or testimony techniques. Finally, the losses that resulted from the trauma must
be mourned fully. Only when all of this is accomplished is the second stage
complete.


Stage Three:
Reconnection

The final task for a trauma survivor in Herman's model is to "reclaim her
world." The client must create a future by re-learning how to live. The first
step is learning to defend him/herself, learning to fight for what is important
and to protect her/himself. Reconciliation with the self, identifying and
appreciating what is positive about oneself while recognizing and accepting the
negatives, follows. Then comes reconnecting with others -- becoming part of a
community. Herman also recommends finding a survivor mission -- some work to add
meaning to life.

Herman notes that even after these steps are complete, the trauma may never be
fully resolved; she considers recovery to be a lifelong process. However, at
this point, it becomes on of many factors in a client's life and not the
dominant one.
:blackrose::blackrose::blackrose:

~~ Well here it is - the road map -per the DSM - you see they don't give you a GPS for recovery from this stuff, just a road plan. I don't see any scenic overlooks though -- hmmm -- wait ---there is one --- oh nevermind - . I hope this enlightens you as to what hard work it is to recover from all that someone else and a private hospital corporation did to me. Somehow I don't remember asking for any of this - :blackrose::blackrose:

katti
the black rose :blackrose:
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wizillusions's avatar
THE HOLLIES
"He Ain't Heavy, He's My Brother"
(B. Scott and B. Russell)

The road is long
With many a winding turn
That leads us to who knows where
Who knows when

But I'm strong
Strong enough to carry him
He ain't heavy, he's my brother

So on we go
His welfare is of my concern
No burden is he to bear
We'll get there
For I know
He would not encumber me

He ain't heavy, he's my brother

If I'm laden at all
I'm laden with sadness
That everyone's heart
Isn't filled with the gladness
Of love for one another


It's a long, long road
From which there is no return
While we're on the way to there
Why not share
And the load
Doesn't weigh me down at all
He ain't heavy, he's my brother

He's my brother
He ain't heavy, he's my brother...

I can't say that I enjoyed reading this but it was very informative. I hope that the song lyric above gives you an indication as to where I stand.
:hug: :kiss: