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Introducing the Journal of the Complex Trauma Institute: Opening Dialogues on Trauma

Section I - Perspectives on trauma
1.What is complex trauma?
Michael Guilding
2. Growing strong in limbo: Evaluating the impact of a short term dramatherapy intervention with an adolescent client seeking asylum
Sasha Nemeckova
3. We need to talk: differential understandings and responses to domestic abuse and violence
Dermot Brady
4. Towards a systemic lens in trauma work
Arlette Kavanagh & Auður Guðmundsdóttir
5. Socially excluded, disadvantaged, exposed to trauma: It is time to look beyond the label
Dr Diane Harrison
6. The Survive/Thrive Spiral:A visual integration of Polyvagal Theory and Internal Family Systems
Ruth Culver

Section II - Complex trauma in practice
7. Reconstructing self and personhood when the assumptive world is shattered by trauma
Karla Dolinsky
8. Holding on to hope - A practitioner’s experience of working with children who have experienced sexual abuse trauma.
Sarah Palmer
9. When worlds collide - The process of embodied experience
Roderick Aungier
10. Working with a five year old child’s nightmares: A short/brief case study
Valerie Long
11. Working creatively to manage high levels of negative emotions
Isa Julgalad


Abstracts
1. What is complex trauma? by Michael Guilding.
Diagnostic criteria relating to trauma, in ICD-11 and DSM 5, are presented as lists of symp-toms with no attempt at understanding the mechanisms of trauma, or at seeing them in the context of human biological and social systems. This seriously limits their usefulness to the psychological therapist. This paper is an attempt at such an understanding, starting from the perspective of the biological fear system. It argues that trauma is an autonomic nervous system dysfunction in which fear responses cannot de-activate, and that complex trauma is the chronic failure of fear system de-activation and the impact of this failure on a wide range of other systems with detrimental consequences for physical and mental health and social integration.

2. Growing strong in limbo: Evaluating the impact of a short term dramatherapy intervention with an adolescent client seeking asylum by Sasha Nemeckova
The purpose of this paper is to examine and evaluate the impact of a short-term dramather-apy intervention with an adolescent client seeking asylum. An overview of literature of recent writing in psychoanalysis, psychology, intercultural therapy and dramatherapy provides a brief summary of the psychological impact of forced migration on the adolescent asylum seeking population, highlighting in particular the simultaneous impact of the upheavals of identity asso-ciated with adolescence, migration and trauma. A narrative case study provides a rich descrip-tion of the intervention. Qualitative content analysis was used to identify prominent themes related to client difficulties, coping strategies and engagement with dramatherapy techniques. The results of this analysis are discussed in light of prominent dramatherapy literature and the co-relation between core dramatherapy processes and the increase in the client’s coping abilities are evaluated. The study concludes that the short-term dramatherapeutic intervention was able to contribute to the enhancement of the client’s resilience, however highlights the necessity of involvement of multiple agencies in addressing the complex needs of separated asylum seeking children.

3. We need to talk: differential understandings and responses to domestic abuse and violence by Dermot Brady
This article summarises a presentation to the Complex Trauma Institute (CTI) in July 2020 and a subsequent online seminar. Domestic abuse is a common theme when considering complex trauma, as Herman (1989) noted and addressed by more recent researchers and commen-tators (see, e.g. Van Der Kolk, 2015). Domestic abuse is a site of knowing and not knowing, denial and action. While we can work with people who have experienced violence and abuse in their intimate relationships, the field is contested and politicised. Differential understand-ings, processes and professional remits concerning domestic abuse are addressed. In the development of responses to domestic abuse and complex trauma, early writers and activists saw their work as grounded in wider social movements. Over time neoliberal discourses and practices have become dominant, replacing the idea of social change as the part of remit of the state with the concept of government as a minimalist actor supporting free markets. Ne-oliberalism is arguably inimical to the delivery of public services and this has implications for those who have experienced complex trauma. An understanding of the different professional languages, research and practices in use, in tandem with an understanding of the importance of how services are funded, designed and delivered have implications for both practitioners and more broadly in Herman’s terms, those in need of safety, remembering and mourning, and commonality.

4. Towards a systemic lens in trauma work by Arlette Kavanagh & Auður Guðmundsdóttir
Research and treatment in the context of trauma are situated largely within the context of an individual. This article invites practitioners working in trauma care and treatment to incorporate a systems lens into their practice. It offers a bringing together of ideas, both of individual treat-ment and the wider consideration of the family system and the relational aspects of trauma. The article offers some ideas and tools that could easily be applied to an individualised model to bring a systemic lens to trauma work.

5. Socially excluded, disadvantaged, exposed to trauma: It is time to look beyond the label by Dr Diane Harrison
Research into the subject of probation is often limited to professional perspectives and it rarely portrays the views of the service user. Harrison (2020) conducted a qualitative study looking at access to mental health services, education and vocational training by those supervised by probation. The study conducted twelve in-depth semi-structured interviews with young men aged 18-25 who were being supervised by the probation service. Findings from this study pro-vided an insight into the participants’ lives and their experiences of accessing these services. Additionally, the study recognised a high prevalence of childhood trauma; 90% of the par-ticipants had experienced multiple adverse childhood experiences. Excerpts/qualitative data from the Harrison (2020) study, demonstrate the range of adverse childhood experiences that those who become involved with the criminal justice system have been exposed to. Further-more, discrimination and ostracisation are discussed to highlight the impact of rejection and social exclusion that these young men experience. In this article, I advocate for these young men not to be labelled and discriminated against but to be treated as individuals who are sur-vivors of trauma and who can be supported to move forward toward positive life outcomes, by ensuring appropriate services are provided.

6. The Survive/Thrive Spiral: A visual integration of Polyvagal Theory and Internal Family Systems by Ruth Culver
Polyvagal Theory (Porges, 2011) and Internal Family Systems (Schwartz, 1995) are two mod-els gaining significant attention within the growth in awareness of complex trauma and its profound and simultaneous effects on the mind and body. This article introduces ‘The Sur-vive/Thrive Spiral’ (referred to in the text as ‘Spiral’) - my infographic exploring the parallels between two of our primary systems of protection: the nervous system, viewed through the lens of Stephen Porges’ (2011) Polyvagal Theory, and the psychological system, represented by Richard Schwartz’s (1995) Internal Family Systems Therapy (IFS). The ‘Spiral’ offers a reference tool for exploring how trauma affects the psyche and facilitates mindful awareness of the brain–body connection. It illustrates how these two protective systems are interdepend-ent, each constantly reflecting and influencing the other. This article outlines how the graphic came into being and offers case studies demonstrating how it can support clients to develop increased calm and self-compassion.

Part II
7. Reconstructing self and personhood when the assumptive world is shattered by trauma by Karla Dolinsky
Healing complex trauma often involves many layers of therapeutic processing. At times, the trauma event can be processed, and the client reports feeling better or ‘healed from the event’, yet symptoms may linger. The author presents an intervention of a series of questions aimed at reconstructing the sense of self and personhood when the assumptive world is shattered by trauma.

8. Holding on to hope - A practitioner’s experience of working with children who have experienced sexual abuse trauma by Sarah Palmer
This experiential article discusses my work as a National Society for the Prevention of Cruelty to Children (NSPCC) practitioner with children who experience complex trauma due to sexual abuse. The article discusses my initial thoughts and expectations around working with this client group and how my assumptions were challenged by my experiences with the children I worked with.
Using an example from practice, the article illustrates the importance of understanding phys-ical, emotional and relational transference and countertransference to help children process and give voice to emotions and experiences that they are unable to verbalise. The article also looks at the emotional and physical impact of working with children who have experienced sexual abuse upon me and outlines the importance of self-awareness, good supervision, and self-care to understand my own needs and practice safely and effectively.

9. When worlds collide - The process of embodied experience by Roderick Aungier
As humans, we have undergone constant evolution in body, mind and culture. As therapists, we broadly accept psychoanalytic, behavioural and humanistic/existential paradigms as the three forces operating currently within a psychotherapeutic approach. Nestling within the hu-manistic/existential approach is the idea of embodiment and embodied approaches. I present a short overview of the (process-oriented) embodied approach and the principles it has adopt-ed since it emerged on the scene. An extract from an embodied session is used to illustrate the approach and highlight the elements involved in the interaction. In particular, the idea of field theory is discussed as an important element within the embodied context.

10. Working with a five year old child’s nightmares: A short/brief case study by Valerie Long
This paper outlines the integration of the systemic, experiential, embodied reprocessing (SEER) method of trauma-informed therapy (Karpuk, Stoneham, and Davies, 2019) into my clinical practice as a Person-Centered counselor by introducing a case study in which I worked with a child’s nightmares. The case study outlines the therapeutic intervention, illustrating a creative and embodied way of working with childhood trauma.

11. Working creatively to manage high levels of negative emotions by Isa Julgalad
This paper describes the creative and sensory methods I use in my practice when working with people who have experienced trauma. One part of this article outlines emotional stress in the context of trauma and the second part describes different techniques I use for emotional regulation.

Coming Soon

Monthly

Conference on Virtual International & Multidisciplinary Perspectives on Complex Trauma and its Treatment.
Following the success of our first conference 'International & Multidisciplinary Perspectives on Complex Trauma and its Treatment' (July 2019) we are delighted to announce our second one-day conference as part of a collaboration between the Complex Trauma Institute (CTI) and the Complex Trauma Therapists’ Network UK (CTTN) and the University of York (3rd April 2020).

The conference will offer a combination of keynote presentations and workshops facilitated by UK-based and International professionals in the field of complex trauma. We will have clinicians sharing their experience from Germany, Canada, Ireland and the UK.
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The conference will provide a forum for practitioners working with different issues around complex trauma with a view to share perspectives, best practices, improving mutual understanding of complex trauma and further collaboration. You will also hear about our successful collaboration with academics from the University of York and why it is important to engage academia in research around different issues of complex trauma.

The conference pack includes a combination of international presentations.
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The line-up of speakers is as follows:

1. 'Complex Trauma Viewed through the Perspective of the Biological Fear System'
Presenter: Michael Guiding (Psychotherapist and Clinical Supervisor in Private Practice)

2. 'Working Systemically with Adoptive Families'
Presenter: Hugh Palmer (Systemic Family Psychotherapist- SFT- work with families who have adopted children)

3. 'We need to talk; differential understandings and responses to domestic abuse and violence. '
Presenter: Dermot Brady (Senior Lecturer Social Work Kingston and St. George’s University of London)

4. 'It’s all in the Label: Trauma & Mental Health in Offenders.'
Presenter: Diane Harrison (Psychological Wellbeing Practitioner, & Counselling Psychologist in Training, The University of Manchester)

5. 'Complex Trauma and Pain'
Presenter: Dr. Jonathan Egan (Deputy Director DPsychSc Programme in Clinical Psychology, NUI Galway School of Psychology Ireland)

6. 'Embodied Reprocessing for working with complex trauma: dealing with Internalised Voices'
Presenters: Dzmitry Karpuk, (CTTN) Trainer, Supervisor, Consultant & Systemic Family Psychotherapist & Celia Dawson, (CTTN), Trainer & Person-Centred Psychotherapist, Certifying Coordinator at the International Focusing Institute (USA)

7. 'Essential Preparatory Work for Processing Complex Trauma: Techniques'
Presenter: Isa Julgalad (Psychologist, Systemic Therapist, Germany)

8. 'Nightmares and the Ethics of Trauma Memory'
Presenters: Professor Tom Stoneham or Dr. R A Davies (University of York)

9. 'Reconstructing ‘Personhood’ When the Assumptive World is Shattered by Trauma'
Presenter: Karla Dolinsky (Counsellor and Psychotherapist in Private Practice & EMDR Therapist, Crime Victim Assistance Programme (CVAP), Victoria, British Columbia, Canada)

The Complex Trauma Network is delighted to let you know that we have responded to requests to provide online supervision groups.

Recommendations to maintain optimum standards for complex trauma therapy include clinicians participating in both individual supervision and group supervision.

Group supervision provides the facility for a variety of perspectives of the clinical picture, for discussion and sharing of relevant research and theory and for the group to provide a creative and enabling support system for therapists.

Our work is intensely human and personal in nature, but we are guided by
skill, experiences and resources that are continually being updated.
What we are offering in these monthly sessions are collaborative
discussions with peers from all levels and areas of practice. The
intended format of these monthly sessions will include reference
materials and an introduction to the month's topic. Upon
pre-registration, you will be provided with resources that introduce you
to the topic. The Learning Session will begin with Karla presenting a
short summary of the topic or issue (you will later receive a copy of
this powerpoint). After the introduction, the session is open to all
participants to engage in the discussions, facilitated by Karla. We all
learn differently, so your level of engagement is up to you. You may
self-select whether you wish to have your video or microphone on to
enter the discussion, or you may prefer to remain more as an audience
member to learn from the panel of participants and their exchanges.

These are 'stand-alone' sessions with registration required for each.
Please keep open the morning of October 10, as we will be sending more
information regarding on-line registration in the weeks to come.

These sessions will offer you learning opportunities that will keep you
updated, keep you connected, and keep you thinking in new ways so that
you can offer your clients fresh insights into their challenges.

Once you click on 'Purchase' the website will redirect you to our CPD workshop booking page.

All of our courses are experiential. Experiential learning is powerful since the collaboration and personal learning from each other element accelerates learning and ownership of the subject matter. Many of our previous participants have remarked on how powerful, but gentle, this approach is and how much it has helped them in their own lives.

Following the Covid-19 outbreak we have been facilitating all of our CPD workshops and training online. We use Zoom to deliver our online training. When you register and pay for your CPD workshop, you will receive further joining instructions.

We advise anyone who is interested in joining this group to attend our Stage 1 course first.

This module focusses on how to further support trauma recovery when trauma survivors of Single or Multiple trauma are ready for Trauma Processing of Intrusive Memory Experiences. This programme helps you to develop additional techniques and strategies essential to healing traumatic life situations presented by many clients. This is based on Phase 2 of Herman’s model, where safety and internal resources are in place so that work on the actual trauma can be done by using Systemic , Experiential, Embodied approaches. This is a stage where we support safe re-integration of traumatic experiences.

Trauma is a “stuck” process in the body and we utilise embodied, experiential and systemic techniques to resolve blocks so that traumatic memory can be integrated into our normal memory system. We use indirect imaginal exposure processing which avoids re-triggering clients (e.g. narrative is the one of the main triggers) so that they are more likely to stay within the therapeutic window of tolerance (Briere and Scott, 2006).

We are always keeping in mind the fact that CPD workshops are an extended part of our participants’ support system. All of our workshops incorporate a self-care dimension and, it is also worth saying that, all of our workshops are experiential. This means that our participants learn through reflecting on the experiences they get from doing different exercises.

From here to there – losing and finding your way with embodiment (An exploration of working body to body in a therapeutic field environment)