Complex post-traumatic stress disorder, C-PTSD, is an extreme stress-based disorder that stems from intimate partner violence. Typically, C-PTSD it is treated with conventional medicine like psychotherapy and medications. In many cases, those therapies are not beneficial. Additionally, sometimes they may have adverse effects. Thus, further types of treatments may be sought.

My academic research focuses on complex PTSD and how hypnosis within the context of the mind-body medicine model and positive psychology coaching can support post-traumatic growth and recovery from C-PTSD.

Complex PTSD is an extreme stress syndrome that can be caused by long-term trauma like intimate partner violence (Walker, 2013). Complex posttraumatic stress disorder develops out of response to danger, perceived or actual (Crittenden & Heller, 2017). The body develops a response of either keeping the information on the danger (association) or dismissing the information on the danger (dissociation) (Crittenden & Heller, 2017).

When the person closest to the individual is the threat, which is often the case, the body develops shortcut reflex responses to deal with the trauma (Crittenden & Heller, 2017).

These shortcuts and responses over time develop into C-PTSD (Crittenden & Heller, 2017). Women are twice as likely as men to get C-PTSD, yet less likely to get diagnosed or often misdiagnosed (Simmons, 2007). The trauma, happening over time, causes the person to enter survival mode.

Survival mode can mean that any event may be perceived as a threat (Elkins, 2017). Because the victims are always in self-defense mode, the nervous system rarely gets a break. The continued burden on the nervous system can lead to mental, physical, and emotional issues over time; thus, close relationships are often threatened (Lehrer et al., 2008; Elkins, 2017).

Hypnosis is an altered, focused, receptive state of attentiveness that leads to suggestibility (Yapko, 2019; Hammond, 1998). Hypnosis focuses on the client’s innate abilities to uncover solutions and overcome challenges (Yapko, 2019).

Research within the hypnosis field has revealed that hypnosis, in the context of ego-state therapy and exposure therapy, can be supportive to people with complex trauma or C-PTSD (Elkins, 2017).

Because hypnosis is considered a part of positive psychology, it can also help clients, particularly with other mind-body medicine tools, deal with trauma (Moss, 2003; Yapko, 2019).

These tools can help support posttraumatic growth (PTG). Posttraumatic growth can be achieved through neuroplasticity, which is the brain’s ability to adapt and change (Elkins, 2017).

Hypnosis can help support women with C-PTSD through ego- strengthening, safety and stabilization, and enhanced relaxation (Elkins, 2017; Foa et al., 2009).

Additionally using ego-state therapy within the hypnosis context can be benefit in working through traumatic material. Furthermore and visualization within the hypnosis setting therapy can also be beneficial to support postrraumatic growth and aid in goal setting (Elkins, 2017). Visualization can be particularly beneficial for those who experience disassociation, to anchor the here and now (Poon, 2009). Visualization or pictures can be the building block for words, and thus language for self reflection (Poon, 2009).

Alizamar et al. (2018) conducted single-subject research (SSR) method study to determine the effect of hypnosis in reducing stress-based conditions like C-PTSD. The authors used the Depression Anxiety Stress Scale (DASS) to set up measurement. The authors’ found that stress levels decreased in the group given hypnosis. Thus, hypnosis can be very beneficial for stress-based disorders like C-PTSD.

Clinicians who work through traumatic stimuli with client should do so with care and consideration (Elkins, 2017). Additionally, working with trauma requires sensitivity and should come from a trauma informed clinician (Yapko, 2019).

Ego-state therapy is a form of hypno-analytic therapy that views the mind as polypsychic (Elkins, 2017, p.147). Parts of the ego, or personality parts, are formed during development and can be affected during complex trauma (Elkins, 2017). Working with ego state therapy can be supportive to those suffering with C-PTSD by using these stages of ego-state therapy include but are not limited to:

• Psychoeducation
• Also referred to as emotional literacy; this can help normalize

feelings and help clients to feel heard. It can help prepare them for

further aspects of ego-state therapy.

  • Safety and Stabilization

• Reducing the symptoms by suggestions of safety and stabilization can help the client. Additionally supporting client with setting boundaries with others is a part of safety and stabilizations.

  • Assessing the Trauma Material

• A clinician may or may not choose to assess the trauma material

depending on the clients needs and where they are in the safety and stabilization process. However, when this is done it can break the trauma bonds and allow healing to take place.

• Reassociation and Integration
• Reassociate of the emotional experiences and the reintegration of

these experiences is attempted at this stage of the therapy.

The brain that has experienced long term trauma is wired to see danger in everyday situations (Sapolsky, 2004). Understanding and recognizing signs of the trauma and understanding neurobiology can help the clinician develop a plan to help the brain adapt and change. This adaptation is referred to as neuroplasticity and can lead to the patient experiencing post-traumatic growth (Krippner et al., 2012).

Hypnosis can help patients discover their strengths, build self- esteem, find safety and stabilization methods (Elkins, 2017).

Additionally, hypnosis can help increase positive automatic thoughts, support subjective well-being, and lead to posttraumatic growth (Yapko, 2019). These aspects of hypnosis can support the recovery of C-PTSD. Choosing a trained practitioner in hypnosis and the mind-body medicine model who understands trauma, can minimize complications.

Kelli Hughart, PhD Candidate

References

Alizamar, A., Ifdil, I., Fadli, R. P., Erwinda, L., Zola, N., Churnia, E., Bariyyah, K., Refnadi, R., & Rangka, I. B. (2018). The effectiveness of hypnotherapy in reducing stress
levels. Addictive Disorders & Their Treatment, 17(4), 191–
195. https://doi.org/10.1097/adt.0000000000000140

Elkins, G. R. (Ed.). (2017). Handbook of medical and psychological hypnosis. Springer Publishing Company.

Erickson, M. H. (2009). Further clinical techniques of hypnosis: Utilization techniques. American Journal of Clinical Hypnosis, 51(4), 341–362. https://www.asch.net/portals/0/journallibrary/articles/ajch-51/51-4/ericksonclinical51-4.pdf

Gupta, A., & Sidana, A. (2020). Clinical hypnotherapy in grief resolution – a case report. Indian Journal of Psychological Medicine, 42(2), 193–197. https://doi.org/10.4103/ijpsym.ijpsym_476_19

Hammond, D. (Ed.). (1998). Hypnotic induction & suggestion. American Society of Clinical Hypnosis.

Jensen, M. P. (Ed.). (2017). The art and practice of hypnotic induction. Denny Creek Press.

Landry, M., Raz, A., & Elkins, G. R. (2017). Neurophysiology of hypnosis.
Moss, D. (2003). Handbook of mind-body medicine for primary care (1st ed.). Sage Publications, Inc.

Poon, M. (2009). Hypnosis for complex trauma survivors: Four case studies. American Journal of Clinical Hypnosis, 51(3), 263–271. https://doi.org/10.1080/00029157.2009.10401676

Spiegel, E. B. (2016). Attachment-focused psychotherapy and the wounded self. American Journal of Clinical Hypnosis, 59(1), 47–68. https://doi.org/10.1080/00029157.2016.1163658

Swales, M. A. (Ed.). (2018). The oxford handbook of dialectical behaviour therapy. Oxford University Press. https://doi.org/10.1093/oxfordhb/9780198758723.001.0001

Yapko, M. D. (2019). Trancework (5th ed.). Taylor & Francis.