What is the best kind of treatment for Complex PTSD?

Question:

What is the best kind of treatment for Complex PTSD? I also have autism. I have had emotional abuse since the age of six by my step Father. I have recently found out he’s not the person that I thought he was. I was never allowed to be myself growing up and it has created caused me much heartache in coming to term that my step dad is emotionally dead to me. I believe that he is NPD traits as I have done much research and I’m convinced. I now suffered from emotional intimacy issues and find it impossible to have trusting relationships. At the moment I’m getting CBT treatment. But I’ve heard that it can be damaging to people with autism because many psychologist and psychotherapist are not fully aware of abuse and the implications of NPD and the full trauma impact it has on the individual. -A

Dear A:

It sounds like you have survived a seriously difficult childhood, and I would like to commend you for your strength and persistence in reaching this point. But now, you have been doing your research and have found some conflicting ideas, so it is difficult to be confident about your choice of therapist. You are wise to be careful and I hope I can help a bit.

Finding the right therapist and therapy for your particular issues can be a real challenge. It is true that many therapists don’t have specific training regarding working with people on the Autism spectrum, which makes it even harder for you. If your counsellor is interested, I can provide some great articles to help, if they email me.

I have a few suggestions that may help you to feel more confident in the process of therapy.

First of all, if your therapist is a psychologist, or a registered counsellor (With a Masters degree in psychology or counseling), you can know that they have specific training in trauma, abuse, PTSD, and the negative impact of personality disorders (including Narcissistic Personality Disorder) because they cannot be registered without it. These are some of the most important, and commonly discussed, topics in the world of psychology.

Secondly, CBT (Cognitive Behavioral Therapy) is the type of therapy with the best record of success for people on the Autism spectrum. It is not perfect, and will not always help with deep pain, but I am not aware of any serious risk of damage.

Most importantly, these are questions you should feel welcome to discuss with your therapist. There is no one “best” treatment for PTSD. Even if I believe that EMDR (Eye Movement Desensitization and Reprocessing) or Traumatic Incident Reduction or Somatic experiencing or the Rewind technique is the best approach, (and all of those have good records of effectiveness), I have clients who can’t connect with each of them.

The best treatment is the one that helps you, and a good therapist can usually offer you a variety of choices, and help you find the one that fits.

Good therapy is often more of an art than a science, and even with all of your research, you may not be able to find the answers without experiencing them.

If you feel that your therapist listens, and cares, and is not forcing or manipulating you to do anything you don’t feel right about, then maybe you are in the right place. Practising trust with your therapist may be the first step to becoming comfortable with trust in intimate relationships again.

Healing from so much pain and injury is going to take time. I hope your therapist will be good company and real help on the journey to wellness.

Colleen Fuller, M.A, RCC

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