Fact Sheet V: Getting Treatment for Complex Trauma and Dissociation

Trauma can cause lasting problems. This can be the case whether the trauma was a single event, or was ongoing, whether it occurred in childhood, or in adulthood. People who have post-traumatic symptoms need help and support.

Because of the differences between single incident trauma and complex trauma, therapy for complex trauma may be a little different. The first part of therapy – learning emotional regulation, reducing symptoms, and creating safety – can take longer. Most likely, there will be a bigger focus on relationship difficulties and learning to trust others than there is in treatment of single incident trauma.

Complex trauma therapy can also focus more deeply on concerns around identity and self-esteem. People with complex trauma are more likely to have other problems such as substance abuse, dissociation, self-harm and suicidality. These are also dealt with in therapy.

Symptoms of complex trauma and dissociation can be a struggle to live with. However, with the correct treatment, you can gain significant relief.

Treatment should:

  • Focus firstly on helping you stay safe and manage your feelings.
  • Help you understand your symptoms and the causes of them.
  • Help you build and improve emotional and relational skills so you can manage your life and your inner experiences more effectively.
  • Be respectful of you as person, and respect your goals in therapy.
  • Provide a pace that is just right, so you do not get overwhelmed. You and your therapist will discuss your pace and find ways to keep therapy manageable and safe.
  • Help you manage and reduce trauma-related symptoms, including dissociation and dissociative parts of self (if this applies to you).
  • Work through traumatic memories, when you are ready, and in a way that is manageable for you.

It is normal for many people to feel reluctant about therapy, even scared, and some naturally find it hard to trust a therapist. Afterall, most people with complex trauma were not safe with care-takers in the past. However, a sensitive therapist will understand that and will support you to take your time and find ways to work in a collaborative way.

Treatment can be lengthy and at first it might seem like progress is slow, but small steps build together to make a big difference over time.

Finding the Right Therapist

It is important to find a therapist with specific training and expertise in treating these disorders. If you live in a smaller town or a rural area it might not be possible to find a therapist with experience in your disorder. If this is the case it is important to find a therapist who is willing to get training and to consult with another experienced therapist.

Survivors often find it expensive and disheartening to try therapist after therapist. It is reasonable to make brief contact with a therapist before making an appointment and ask them some general questions to see if they might be a good fit. Some questions you might like to ask include:

  • Have you treated my condition before?
  • Can you tell me a bit about your treatment approaches?
  • What training do you have in treating my condition?
  • Do you get supervision or consultation?

Also ask about fees, insurance coverage (if applicable), and any funding available to help cover the costs of therapy. It is important to find therapy that is within your budget.

This initial contact may help you decide if you want to book an appointment. It is important that you feel comfortable with your therapist. However, it can take a number of sessions to get over initial nerves and decide if the therapist ‘feels right’ for you.

ISSTD Find a Therapist Database

ISSTD has a database of therapists with a special interest in treating complex trauma and dissociative disorders. You can search for a therapist in your area here.

Other Helpful Sources of Information

ISSTD Fact Sheets

ISSTD also has a number of Fact Sheets in addition to this one. They can be located here.

Support and Information for People Living with Complex Trauma and Dissociation

There are many organizations which offer support and information to people living with complex trauma and dissociation, as well as their families and friends. It is not possible to mention every organization. However, some key organizations that may be helpful are:

USA

Australia/New Zealand

UK

Books

It is not possible to recommend specific books as different individuals find different books helpful. Many of the organizations listed above will have lists of books and resources that may be helpful.

To download a PDF of this Fact Sheet click here.

Due to the COVID-19 situation, ISSTD Staff is working remotely at this time. Phone lines will be open from 1:00–4:00pm Eastern Daylight Time Monday through Friday. Email is being monitored during normal business hours.