Trauma comes in all shapes and sizes. Some people are fortunate to have a happy upbringing while others may go through years of neglect or abuse. Of course, the latter category is more likely to seek therapy. People can be forever changed by one loss or one accident… but imagine if a trauma keeps happening over and over again. What then?

What Is Complex Trauma?

Trauma can be broadly broken down in two categories: simple and complex.

Simple trauma refers to one-off incidents that generally do not repeat, like a car accident or an assault. As a rule, this kind of trauma is easier to treat since there is a unique event on which the survivor can focus.

Up to 20% of people who experience a simple trauma may develop Post-Traumatic Stress Disorder (PTSD).

Complex trauma, in turn, refers to repeated distressing experiences that occur over a period of time. Childhood abuse, domestic violence, war, torture, incarceration, and other such series of painful events all classify as complex trauma.

Over 3% of people in the United States meet the criteria for complex trauma and resulting Complex PTSD (C-PTSD) – that’s over 8.5 million American adults.

What Is Complex PTSD?

Complex PTSD can be the result of experiencing complex trauma. Not everyone who has been through multiple adverse experiences gets C-PTSD, but for those who do it can be life-changing and extremely limiting.

C-PTSD can be difficult to treat. There are so many instances of similar kinds of trauma, that both survivors and therapists find it difficult to untangle the web of pain.

C-PTSD is not an official diagnosis in the United States where the Diagnostic and Statistical Manual is used for all psychiatric issues. However, the International Classification of Diseases used internationally recognizes C-PTSD as a medical condition.

Symptoms of Complex PTSD

Intrusive memories, thoughts, and images
Deliberate avoidance of reminders of traumatic events
A constant feeling that one is in danger even when there is no threat present
Severe problem with regulating emotion
A negative self-concept
Difficulties in relationships

What is EMDR Therapy?

EMDR stands for Eye Movement Desensitization Reprocessing. It’s a way for our brains to become “emotionally immune” to traumatic memories and develop positive beliefs in place of intrusive thoughts caused by trauma. This is achieved through eye movements or other types of side-to-side stimulation.

EMDR therapy was developed in 1987 by Francine Shapiro and has since grown into a popular trauma treatment approach supported by a lot of research. Its popularity increased even further when Prince Harry of the British royal family revealed that he uses EMDR in his own therapy work.

Can EMDR Therapy Be Used for Complex PSTD?

While EMDR can be used with great success for C-PTSD, there are some caveats. One, the treatment will always take longer with complex trauma, but that applies to all therapies, not just EMDR.

Two, EMDR will be most helpful if the survivor is already seeing or had been seeing a therapist. Prior or concurrent therapy helps you learn skills for regulating your emotions and calming yourself down during trauma reactions.

You can still use EMDR as your sole therapy for complex trauma but expect to do some development of the above-mentioned skills before diving into desensitization and reprocessing.

The third and final caveat is that EMDR can be difficult to do if the survivor dissociates, which can be common with complex PTSD. In order for our brains to reprocess the trauma with EMDR, we have to be “online” and not having an out-of-body experience.

Again, difficult does not mean impossible, it just means that you have to look for an EMDR therapist skilled in working with dissociation.

What To Expect in EMDR for C-PTSD

EMDR therapy is broken down into eight specific phases that can be summarized as follows:

Resourcing

As already mentioned, you can expect to do some “resourcing” or creating self-regulation tools. This is achieved through visualization, embodiment, and eye movements. Your therapist will guide you through several exercises to give you a full toolbox of coping strategies.

The principle behind resourcing is simple: our brains cannot tell the difference between real or imagined experiences if they are engaging enough. If we truly use all of our senses to feel a positive feeling or the calming presence of a loving person, we can call on that resource during tough moments in a therapy session.

History Taking

Another part of EMDR is taking a history of traumatic events, which can be quite an undertaking with complex trauma. The therapist may do resourcing first to make sure you can handle the intensity of recalling painful experiences, although many do history taking first.

You can expect to be asked about early memories and worst memories as well as negative beliefs you hold about yourself because of these events. It’s important to let your therapist know if you are getting triggered so they can help you use your resources to regulate.

Processing

Your therapist will ask you some very specific questions before beginning eye movements. They include asking you to recall the worst image of the memory you are working on and determining how distressing the recollection is. You will also be asked about emotions and body sensations as well as the aforementioned beliefs you hold about yourself.

Then, you will use whatever type of side-to-side stimulation you chose to process the event: eye movements, handheld buzzers, tapping, or others. The therapist will guide you by asking you to take deep breaths and tell them what you are noticing in that very moment.

After-Processing

After your distress reaches an acceptably low level of intensity (usually none), your therapist will invite you to install a positive belief about yourself until you truly hold and embody it. This will be followed by a body scan and instructions on what to expect in-between sessions. At the start of the next session, the therapist will check in on the memory to see if any further work needs to be done.

How Will I Know EMDR IS Working?

You should have an immediate reduction in intensity of the distress you experience when thinking of the target memory. While you may still have some distress, you should feel more neutral emotionally and in your body when recalling the specific incident.

However, it will take a bit longer for you to start experiencing a reduction in overall level of distress since there are so many traumatic events that still need to be processed. Over time, you should see a decrease in hypervigilance and anxiety and an uplift in general mood.

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In conclusion, EMDR can be a potent way to reduce symptoms of Complex PTSD if done with patience on behalf of the survivor and expertise on behalf of the therapist. It’s a worthwhile journey for the resourcing alone, which can give you a lifetime of tools to manage your inner and outer emotional reactions.

Thinking about EMDR can be daunting since you will have to dig into the past but rest assured that a trained EMDR therapist has the skills to guide you through encounters with past trauma while keeping you grounded in the present.

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EMDR can eliminate distress and negative beliefs standing in your way. If you are interested in EMDR therapy, feel free to schedule a free consultation.

EMDR Therapy for Complex PTSD