Blog and Musings

Sometimes when I lead trainings in CPT, I'm asked if it can work for people who experience complex trauma, which has been defined as exposure to multiple, interrelated trauma and the reactions that result from that trauma. My answer is that it can. While measures of complex trauma are still being developed and refined and were not often used in earlier studies, research has included individuals who would meet the definition above. Some examples are people who experienced repeated physical and/or sexual trauma as children, adults who experience intimate partner violence, and people exposed to war and/or ongoing violence. We've also seen a lot of examples in clinical practice. 

One of the reasons people may wonder about CPT and complex trauma is that CPT initially focuses on an "index trauma"---or an event that was experienced as either the earliest or the most difficult experience (one that was associated with the most guilt or shame, or one that is the most haunting). Having a single event to work on as a starting point helps us to make sure that we don't jump from memory to memory without ever fully processing any of them, or that we don't inadvertently avoid the one that is hardest to get "unstuck" from. However, that doesn't mean that you won't deal with other traumatic events or memories in CPT. There's room to work with multiple traumas, as long as you give yourself the time and focus to process the ones that are hardest to face first--after that, some of what you come to understand and realize can be applied to the other events.

Another reason that people wonder about CPT and complex trauma has to do with the fact that CPT doesn't integrate somatic work, which some have suggested is important for trauma work. Over many years, the treatment developers and the hundreds of therapists who now use CPT regularly in their practice and provide training and consultation have found that people can experience recovery without explicitly integrating somatic work. People we work with do sometimes use emotion regulation strategies that work for them such as grounding, mindful breathing, relaxation/body scans, or activities such as yoga in their daily lives. Others find that other forms of physical activity, creative activity, or spending time with their loved ones help them cope effectively with the emotions they are processing. However, these aren't the focus within the therapy sessions. Some studies have shown that the patterns and reactions that people with a history of multiple, interrelated, or complex trauma may experience do in fact change and improve as they go through the process of CPT. People also share their experiences of feeling calmer in general and reacting differently to situations that once would have been very triggering, or that would have provoked emotions that felt impossible to tolerate before. 

So CPT, or the work in our self-guided CPT book, can indeed be helpful and worth spending time on if you have experienced complex trauma.  And as always, what matters most is that people find what works for them, practice consistently, and see the benefits.