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Introducing a Pioneering Diagnosis:

Complex Post Traumatic Stress Disorder  (C-PTSD)

In June 2018, almost 40 years after the controversial but official recognition of Post-Traumatic Stress Disorder as a mental disorder requiring clinical treatment, the World Health Organization issued the ICD-11, including a new diagnosis: Complex Mental Disorder Post-Traumatic Stress Disorder / C-PTSD).


This diagnosis is of great importance for the field of mental health.


Understanding the long-term effects of unresolved early trauma is indeed a global health issue. The attachment trauma, as well as the relational and developmental trauma - found in every culture, religion or society - affects the child's neurobiological development and creates timeless patterns of disorganization in the body, mental functions and relationships. Perhaps a better understanding of the Composite Trauma can help us understand the underlying causes of the disorders that the patients are experiencing,  as well as growing societal challenges such as substance abuse, systemic injustice and violence. A sensitive look at the trauma can give hope to the world.


While Post-Traumatic Stress Disorder greatly evolved in the field of psychology about 40 years ago, those of us who have worked in this field know that there are some limitations to the diagnosis and treatments that address it. Complex Post-Traumatic Stress Disorder helps us deepen our understanding of the trauma. Now that this disorder has been officially recognized, the next step is to find treatments specifically tailored to the complex trauma.


Many of us have experienced confusion or frustration at work with patients who experience complex trauma when treatment is not progressing, as well as with those patients who, as they progress, return to their old patterns of self-sabotage, despair and despair. These are usually the patients we therapists bring to supervision.


The question we repeatedly ask ourselves as NARM consultants is: "How can I help my client more effectively?".


To answer this, let's review the ACEs Study (Adverse Childhood Experiences). This study has a fascinating origin. It was originally designed as a weight loss program, until the program leader, Dr. Vincent Felitti, observed that despite the fact that the participants had significant success in terms of weight loss goals, almost 50% of them left the program. This did not make sense for Dr. Felitti at the time: why did the participants leave the program when they were losing weight and approaching their goals? So the researcher designed a questionnaire to understand this phenomenon and found that the majority of those who left had experienced some trauma in their childhood. Thus began the monumental research project that we refer to today as the ACEs Study.

A fascinating aspect here is the underlying mechanism of self-sabotage. We would imagine that the closer a participant got to his goals, the more motivation he would have to complete the program. But we see so many examples of people who, while approaching health, wellness and success, turn to self-sabotage or self-destructive behaviors, whether it is someone who is starting to lose weight and quit trying, or a student dropping out of school at the last year or for a person who while in substance abuse  returns to their use.


Today we unravel this mystery through the recognition of the "survival" function of shame and hatred. As children, everything revolves around connecting with our caregivers through attachment - something that is essential to our basic survival and well-being. When caregivers or our environment are inadequate or deficient, our basic survival is threatened. The child can not experience himself as a good person in a bad situation. Therefore, unconsciously, the psychobiological mechanisms begin to activate to ensure its basic survival. A basic survival strategy is what we can refer to as shame and self-loathing; that is, the child experiences himself as bad in order to protect himself from the inadequacy of his caregivers and / or environment.


One thing we have noticed in our discussions with many bodybuilding therapists internationally is that despite very effective and vigorous physical work, therapeutic progress is often halted when survival-based developmental strategies are not recognized and are not the focus of treatment. work. As soon as the patients start to get better, they backtrack or repeatedly sabotage themselves in various ways. Returning to the original weight loss program, something seems to be threatening the effort to evolve in one's life gaining more health and well-being. This is how he learned to protect his primary caregivers and the environment, excluding fundamental aspects of himself, even if they are positive such as growth, health and vitality.


So how does this relate to the physically oriented  treatment; What happens when a patient begins to shift toward the development of integration, self-regulation, and empowerment ("upward"), without recognizing the underlying trauma that is based on shame and that leads to dysfunctional strategies, behaviors, and symptoms? Or, for traditional therapists based on verbal therapy, what happens when we process the psychodynamic aspect of shame, self-loathing, and self-sabotage without attempting to change the physical and emotional patterns that trigger restrictive beliefs and behaviors? And what happens when we process the early ligation wound without recognizing our own transference (our own unresolved wound patterns and the factors that trigger them) and how does this affect the healing process?


The Neuroimmune Relationship Model (NARM) is a therapeutic approach designed to work with unresolved trauma and patterns that remain as remnants of early or primary trauma. This integrated, synthetic approach processes the downstream (psychodynamic) and upward (physical) psychobiological patterns of shame and self-loathing within a deeply conscious, relational context. In such a context that identifies developmental traumas from early trauma, patients have the ability to evolve in their lives without being burdened by these unconscious survival strategies that have dominated their lives. Freedom from child trauma is possible.


While research on this topic is still in its infancy, our work at the NARM Training Institute is enhanced by clinical reports and initial research demonstrating how effective the Neurotic Relationship Model (NARM) is in resolving ligation trauma.  as well as relational and developmental trauma.  We have trained thousands of clinical psychologists across North America and Europe, and NARM training programs are rapidly expanding worldwide and online.


If you have patients suffering from unresolved early trauma and want more information on more effective therapeutic support, we invite you to our Neurotic Relationship Model training seminar.  


For more information on this innovative method of dealing with this diagnosis, visit our website at: .



Brad Kammer, NARM Faculty Trainer


Performance by M. Christodoulou, Edited by Z. Sillat

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