Treating Complex Trauma: Combined Theories and Methods

ISBN-13: 9783030452872 / Angielski / Miękka / 2021 / 215 str.

Tamara McClintock Greenberg

Recenzje

"The merits of this book are many, the most important being to make a serious and pervasive disorder such as complex trauma more understandable and therefore more treatable, providing clinicians with a wide framework of concepts and therapeutic tools, and a sustained example of how to build one's own personal toolbox for these often difficult, long and challenging psychotherapies." (Monica Luci, Psychoanalytic Psychotherapy, May 28, 2021)

Spis treści

Chapter One

The Need for Utilizing Multiple Approaches for Complex PTSD: No Theory Has It All

Introduction: Complex Clients Need Multiple Approaches

What is Trauma and Who Gets to Define It?

Difficulties in the Study of Complex Trauma

PTSD vs. cPTSD: Important Distinctions

Therapeutic Efficacy and the Therapeutic Alliance

Multiple Treatments, Equal Efficacy

Commonalities Among All Approaches

The Therapy Relationship and Clinical Hypothesis Testing

Negotiating the Beginning of Therapy

Conclusion

References

 

Chapter Two: How Trauma Stokes Fear: Considerations in Beginning of Therapy

            The Neurobiology of Trauma

            Evidence for Intergenerational Trauma Effects

            Fear: Known, Unknown, and Acted Out

            Clinical Hypothesis Testing and Introducing the Concept of Fear

            The Unhelpful Link between cPTSD and Personality Disorders

            How Trauma Can Lead to Incorrect Diagnoses

            Assessing Character Style

            Managing Fear in the Beginning of Therapy

            Conclusion

            Initial Goals in the Beginning of Therapy for People with cPTSD

            References

 

Chapter Three: Nurturing the Therapeutic Alliance: Mentalizing and Emotional Safety

            Characteristics of Therapists Who Have Good Outcomes

                        -The Effective Therapist Has Sophisticated Interpersonal Skills

-The Effective Therapist Has an Ability to Explain A Client’s Distress and Takes the Client’s Unique Experience into Account

- The Effective Therapist Is Persuasive About Treatment Ideas And Monitors Progress in An Authentic Way

- The Effective Therapist Can Deal with Difficult Material While Communicating Hope and Optimism

- The Effective Therapist Is Keenly Aware of Their Own Psychology

- The Effective Therapist Stays Aware of Relevant Research and Strives to Continually Improve

 

Trust and the Mentalizing Therapist

            Normalizing and Managing Shame

            Creating Safety Though Respecting Avoidance

            How Much Should We Encourage the Processing of Memories?

            Conclusion

            Interventions for Mentalizing and Maintaining Emotional Safety

References

 

Chapter Four: The Therapeutic Alliance and Maintaining Physical Safety

                       

Trauma, Suicidal Ideation and Deaths of Despair

The Alarming Epidemic of Suicide

Avoidance and Therapist Feelings About Suicidal Clients

Risk Factors for Suicide  

The Trauma of a Suicidal Crisis

Clinical Management of Suicidality

Crisis Response Plans

Conclusion

Interventions for Managing Suicidality

References

 

Chapter Five: Dissociation: Controversies and Clinical Strategies

            Normal vs. Trauma Related Dissociation

Assessing Excessive Dissociation

Controversies Regarding Dissociation: TM vs. SCM

A Combined Model of Dissociation?

Dissociation of Trauma in the Mental Health Field

Treating Dissociative Disorders

Conclusion

Interventions for Working with Dissociative Clients

References

 

Chapter Six: The Need to Numb: Substance Abuse and Therapeutic Management

 

Substance Use Problems: Evolving Social Perceptions and Reality

The Increase in Problematic Substance Use 

Links Between Trauma and Substance Use

Combined Vulnerability: Psychological and Biological Models

Assessing Substance Use

Treatment Approaches for cPTSD and Substance Use

Treatment Approaches Specifically for Substance Use

 

 

Conclusion

Interventions for Helping People with Excessive Substance Use

References

 

Chapter Seven: When Trauma is in the Body: Managing Physical Concerns

Effects of Trauma on the Body

Links Between Childhood Adversity and Physical Illness

Proposed Mechanisms Explaining the Trauma Illness Connection

Relationships and the Buffer Against Illness

Research on the Decrease of Physical Symptoms in Therapy

Treating People Who are Somatically Focused

Conclusion

Interventions for Helping People who Are Physically Focused

References

 

Chapter Eight: When Fight Impulses Dominate: Managing Anger

           

            Anger and Clinical Avoidance

Links Between Aggression and Trauma

Anger as a Result of Feeling Over-Responsible

Mind, Body and Brain: The Neuropsychology of Anger

Anger And Problems Regarding Ideas of Transference

When the Therapist is the Focus of Anger

Treating Anger and Aggression

Conclusion

Interventions for Treating Angry and Aggressive Clients

References

 

Chapter Nine: Sociocultural Consideration in Trauma Treatment

 

Culture and the Culture of Avoidance: Thinking about Differences Between Therapist and Client

Trauma, Microaggressions and Race and Class

Trauma, Microaggressions and LGBT Persons

Stereotypes and Stereotype Threats

Talking about Differences

Conclusion

References

 

Chapter Ten: Vicarious Trauma and Self Care for the Trauma Therapist

 

            Compassion Fatigue and the Impact of Vicarious Trauma

            Too Much Empathy? The Risk of Burnout and Potential Consequences

            Therapist Vulnerabilities

Countertransference and the Importance of Therapist’s Emotions

Over-Responsibility and the Trappings of the Super Therapist

Therapist Self-Care

Conclusion

Self-Care Interventions

References

 

O autorze

Tamara McClintock Greenberg, Psy.D., M.S., is a clinical psychologist in private practice in San Francisco, CA, where she specializes in treating adults with depression, anxiety, relationship issues, trauma, and those who are coping with medical illness, either as a patient or affected family member. She has been practicing psychology in San Francisco since 1997.

As a Full Clinical Professor of Psychiatry at the University of California, San Francisco, Tamara spent over 12 years seeing medical patients and their families in the UCSF hospitals and clinics and has spent the last 22 years supervising psychiatry residents, psychology interns and students in a number of different training centers.

Tamara received a post-doctorate master’s degree in Clinical Psychopharmacology from Alliant University/California School of Professional Psychology in 2004, her Doctorate Degree in Clinical Psychology from Argosy University/Minnesota School of Professional Psychology, Minneapolis, MN in 1997.

She received the Jacob Markovitz Memorial Scholarship toward her graduate school studies. Her APA-approved predoctoral internship was at the Veterans Affairs Medical Center in North Chicago, IL from 1996-1997. She has been licensed as a clinical psychologist in the state of California since 1999 (PSY 16206).

Her publishing has focused on care taking, health psychology, psychodynamic psychology, women’s issues and trauma, with the aim of helping people navigate complex physical and/or psychological issues.

Tamara has written for multiple publications, including The Huffington Post, Psych Central, Psychology Today, The Good Men Project, Maria Shriver’s website, The San Francisco Chronicle, and has been quoted as an expert in Forbes, USA Today, Newsweek, Next Avenue (PBS), The Washington Post and more. She has been interviewed by numerous radio stations, including several NPR stations and affiliates.

Tamara lives in San Francisco with her husband and two pugs, Roscoe and Rufus.

Blurb

This forward-thinking volume outlines several approaches to therapeutic treatment for individuals who have experienced complex childhood and adult trauma, providing a framework for helping challenging patients and emphasizing the importance of maintaining good therapeutic relationships. Responding to the intense disagreement and competition among clinicians championing their own approaches, the book identifies the strengths and limitations of multiple theories of treatment, addressing the need for qualified clinicians to be versed in multiple theories and techniques in order to best benefit their patients.

 

Among the topics discussed:

• Difficulties in diagnosing cPTSD among other similarly presenting disorders
• Cultural and ethnic considerations in trauma treatment
• Addressing avoidance when talking to patients
• Maintaining the therapeutic relationship with aggressive patients

Treating Complex Trauma: Combined Theories and Methods serves as a practical guide for therapists looking to applying multiple approaches in their practice, with the aim of providing the most effective treatment strategy possible for each individual.

 

 

"Dr. Tamara McClintock Greenberg provides perspicacious insight and clinical wisdom only a seasoned career therapist can yield.  Offering sophisticated and nuanced distinctions between complex trauma and PTSD, she shows how treatment is necessarily contextual and tailored to the unique clinical and personality dynamics of the sufferer that is thoroughly client specific within the therapeutic dyad."

--Jon Mills, PsyD, PhD, ABPP, Faculty, Postgraduate Programs in Psychoanalysis & Psychotherapy, Adelphi University, NY; author of Treating Attachment Pathology

 

"Dr. Greenberg has written an invaluable book on treating complex trauma. She delves into multiple approaches, assessing what techniques the client can tolerate at a given therapeutic stage. She covers how to maintain consistency and connection through a flexible approach and avoid pitfalls. This is a must read for clinicians wishing to treat clients with complex PTSD."

--Louann Brizendine, MD, Clinical Professor UCSF; author of The Female Brain