This forward-thinking volume outlines several approaches to therapeutic treatment for individuals who have experienced complex childhood and adult trauma, providing a novel framework for helping patients with a number of challenging symptoms, with clinical hypothesis testing and solid therapeutic relationships as a vital foundation. Responding to the intense disagreement and competition among clinicians championing their own approaches, the book identifies the strengths and limitations of multiple therapeutic approaches, addressing the need for qualified clinicians to be versed in multiple theories and techniques in order to alleviate suffering in their clients.
Among the topics discussed:
- How to choose specific therapeutic methods and when to shift techniques
- The neurobiology of trauma and management of fear
- Cultural and ethnic considerations in trauma treatment
- Addressing avoidance and creating a safe therapeutic environment
- Management of dissociation, substance abuse, and anger
Treating Complex Trauma: Combined Theories and Methods serves as a practical guide for clinicians looking to expand their knowledge of approaches for treating complex trauma. It aims to provide clinicians with options for different therapeutic methods, along with the necessary context for them to select the most effective approach in their treatments.
“For the first time in the professional literature we are finally afforded a clear, cogent, and detailed explication of complex trauma and the multifaceted parameters of treatment. 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. She dispenses with simplistic and supercilious attitudes that embarrassingly
Ilene Ava Serlin –
Treating Complex Trauma: Combined Theories and Methods
Tamara McClintock Greenberg
Springer Publishers
Reviewed by Ilene Serlin, Ph.D, BC-DMT
This is the textbook I wish I’d had or can now recommend to my students.
Dr. Greenberg’s new book manages to be both simple and nuanced, direct yet filled with detailed clinical vignettes. She begins with a clear definition of complex trauma, then considers many crucial related areas. Greenberg covers important issues like the difference between trauma and complex trauma, implications for treatment, related issues of dissociation, substance abuse, etc. Not only does Greenberg cover a number of perspectives on understanding and treatment issues, but she shows the way to develop good clinical judgment about which approach to use and when.
In this way, this book demonstrates how an experienced clinical would weigh diagnostic and treatment options, relevant updated research and make sound clinical decisions through hypothesis testing. Sound clinical decisions include the ability to be flexible, client-centered, compassionate, pivoting when necessary, and secure enough to be not attached to a “one-size fits all” approach to treating complex trauma.
I highly recommend this book to anyone interest in learning about complex trauma. It can give the layperson a helpful roadmap, and the clinician the consulting voice of a wise trauma specialist.
Elizabeth McMahon, PhD –
Dr. Greenberg’s book is a masterful, integrative, and thoughtful discussion of approaching the many challenges encountered when treating complex PTSD. Dr. Greenberg combines wide-ranging intellectual knowledge of the research in this area with deep empathy for her clients’ pain. She discusses various treatment approaches and interventions with respect, emphasizing both their commonalities and their various uses at different stages in treatment. Her balanced approach to theories and treatment of complex trauma is a welcome voice.
This is a valuable addition to the library of any therapist treating clients with complex trauma.
Stanley Krippner –
The bad news is that 70 percent of Americans have experienced a potentially traumatizing event. The good news is that only six percent have been traumatized. The bad news is that this six percent manifest a variety of horrendous symptoms ranging from nightmares to self-harm. The good news is that there are a number of bona fide interventions that can alleviate or resolve these symptoms and that most are about equally effective. The bad news is that no single treatment does not work equally well for all traumatized individuals; one size does not fit all. The good news is that Tamara Greenberg has provided an authoritative guide, Treating Complex Trauma, focusing on complex post-traumatic stress disorder (cPTSD) as contrasted to post-traumatic stress disorder (PTSD). Adults and children with cPTSD have experienced repetitive traumas, suffer from a variety of associated disorders, and have limited inner resources to cope with their condition. This is especially true of refugees and those from minority ethnic and economic backgrounds, both of which are skillfully dealt with by Greenberg, in contrast to many other authors who ignore the social context of these groups. She provides authoritative descriptions of the major bona fide interventions, noting that cPTSD typically requires a combined approach for its treatment. Greenberg’s discussion of the neurobiology of cPTSD is masterful; she pays equal attention to the “body” and to the “mind” of these clients. There is no question as to the authenticity of the case studies she presents, and her client-centered humanistic approach is evident, especially in her discussion of the therapeutic alliance that is paramount. Treating Complex Trauma is clearly written without being simplistic, especially when discussing such complicated issues as suicidality, dissociation, substance abuse, and aggression toward the therapist. As a result, this book can be profitably read by those who are not therapists but who desire to know more about the inner world and outer behavior of people, perhaps family members or friends, of those with a cPTSD diagnosis.
juli fraga –
Dr. Greenberg’s book takes a new angle on the important topic of complex ptsd (c-ptsd) integrating psychodynamic theory, mentalization theory, and clinical examples from her own work, which provides novel ways to help traumatized patients heal. Unlike previous research papers on this topic, Dr. Greenberg makes a case that outlines why c-ptsd sufferers should not always be asked to share their traumatic memories. As a full professor at UCSF, a seasoned clinician and expert author, Dr. Greenberg’s words will mentor those in medicine and healthcare who seek to expand their understanding of trauma therapy.
John S –
This is a wonderful, informative, and inspiring book that combines a great depth of research with the author’s own wide-ranging clinical experience, both of which inform her larger understanding of complex trauma (as distinct from PTSD and from the more “baked in” pathology of personality disorders) and how to address it clinically. As a therapist, I appreciate the nuanced distinctions the author has made here in teasing out diagnoses and their practical consequences. I also appreciate the many lenses she applies to the concept of complex trauma, including questions of neurobiological underpinnings; the relevance of the concept of mentalization; how to respond to the frequent manifestation in traumatized individuals of suicidality, dissociation, substance abuse, and somatic concerns; and the impact of sociocultural beliefs on the perception of traumatized clients and their view of themselves. The author’s thorough examination of the topic from a wide variety of stances grants a very multidimensional understanding of the therapeutic endeavor with traumatized clients, and her relation of her own clinical vignettes, complete with the unfolding process of insight and therapeutic transformation, help the reader to access a great depth of felt experience in the field.
As both a therapist and a teacher of psychotherapeutic concepts to training clinicians, I am particularly inspired by the other story being told in this book, as we learn not only more about a sophisticated clinical approach to complex trauma but a sophisticated philosophy of therapy itself—with all clients—that could be described as integrative with a solid psychodynamic foundation and yet is also very nuanced and personal to this author. She does not fall back on one camp of therapeutic orientation or technique, and escapes internecine battles or the drive for theoretical/ideological purity, while focusing instead on serving the client with all the tools and systems of knowledge available. She pursues great clinical flexibility that follows from a very sensitive listening to the experience of the client, not only to their history, fantasies, character, or unconscious, but to their reaction to the form of treatment itself and their potential need for different styles of guidance. Finally, there is great humility in her approach which I believe is so necessary given the vulnerabilities in the room and the power dynamic that inevitably emerges in a therapist/client relationship; she comes from a stance of vulnerable transparency and pursues the collaborative development of clinical hypotheses while still remaining sensitive to what can be taken in by the client at any given time.
I highly recommend this wonderful book.
Ankhesenamun Ball, PsyD –
Dr. Greenberg has done it again. Treating Complex Trauma is a wonderful resource for both novice and seasoned clinicians. Dr. Greenberg provides clinical insight, guidance, and space for personal reflection to support the reader in better understanding the impact of complex trauma on our clients. Differentiating between PTSD and CPTSD, she guides the reader through the development of challenging behaviors, insecure attachments, and distorted perceptions within this population. Her thoughtful writing is both clear, concise, and thoroughly supported by the data. Case material is used to further educate the reader in understanding how theory and concepts come to life in the hour. Chapters 4 (suicidality) and 5 (dissociation) are brilliant and necessary topics that require a fresh look and better presence of mind from the clinical community on how trauma underscores these particular challenges. If you are truly interested in becoming well-versed in the treatment of complex trauma, I would highly recommend having this book in your arsenal.
alinaa marineez –
This is a valuable addition to the library of any therapist treating clients with complex trauma.
colivin –
I will recommend him to all my friends dr