Complex-PTSD Counselling in Singapore

Complex PTSD can affect much more than memories of past experiences. Many individuals experience ongoing emotional overwhelm, hypervigilance, emotional numbness, or difficulty feeling safe even in everyday situations.

Some people may experience:

• emotional flashbacks
• chronic anxiety or feeling constantly “on edge”
• difficulty regulating emotions
• dissociation or emotional disconnection
• intense shame or self-criticism
• fear of abandonment
• unstable or overwhelming relationships
• difficulty relaxing or trusting others
• emotional exhaustion from staying in survival mode

These responses often develop gradually over time after repeated or long-term trauma, especially within emotionally unsafe or unpredictable environments.

Complex trauma can leave the nervous system in a prolonged state of emotional threat. Even when the danger has passed, the brain and body may continue reacting as though they are still unsafe.

This may contribute to:

• hypervigilance
• emotional overwhelm
• difficulty relaxing
• sleep disturbances
• flashbacks or intrusive memories
• feeling emotionally disconnected or numb

Over time, living in survival mode can affect emotional regulation, relationships, self-worth, and the ability to feel grounded or safe.

Trauma-focused therapy can help the nervous system gradually feel less overwhelmed while supporting emotional stability and regulation.

Disclaimer: A formal diagnosis can only be done by an expert such as a psychiatrist.

At Insightful, our counsellors help understand if a person may have Complex Post-Traumatic Stress Disorder (CPTSD), through a careful process that includes:

Initial Talk: The counsellor will have a detailed conversation to understand the person’s experiences and symptoms. They will ask about the person’s history, any traumatic events, current emotional state, and relationships.

Symptom Check: The counsellor will discuss specific symptoms of CPTSD, such as:

– Persistent sadness or depression.

– Feeling emotionally numb or detached.

– Difficulty controlling emotions, like frequent anger or intense sadness.

– Negative feelings about oneself, such as worthlessness or guilt.

– Problems with relationships, like difficulty trusting others.

– Intrusive memories or flashbacks of traumatic events.

– Constantly feeling on edge or having trouble sleeping.

Diagnostic Criteria: The counsellor will use criteria from the International Classification of Diseases (ICD-11) to diagnose CPTSD. They will look for:

– Symptoms of PTSD, like reliving the trauma, avoiding reminders, and feeling on edge.

– Additional symptoms include difficulty managing emotions, negative self-perception, and relationship problems.

Comprehensive Evaluation: The counsellor might gather information from other healthcare providers or review past medical or psychological records.

By following these steps, the counsellor can hypothesis if the client may have CPTSD and develop a treatment plan to help manage symptoms and promote healing.

If needed, they recommend their clients to visit the psychiatrist for a complete diagnosis and medications (if prescribed by the psychiatrist}

Many individuals with Complex PTSD develop coping responses that once helped them feel emotionally safer during difficult or overwhelming experiences.

These responses may include:

• avoiding situations, people, or emotions connected to distress
• remaining constantly alert for danger or conflict
• emotional numbing or shutting down emotionally
• withdrawing from relationships or social situations
• using distractions or unhealthy coping behaviours to manage emotional pain
• trying to control situations to feel safe or prevent harm

While these responses may have once served as protection, they can later create emotional exhaustion, relationship difficulties, or feelings of disconnection. Therapy can help individuals better understand these patterns while developing healthier ways of coping and feeling safe.

Treating Complex Post-Traumatic Stress Disorder (CPTSD) involves various therapeutic approaches to address the emotional, psychological, and physical symptoms. Here are some common treatments:

• Psychotherapy:

Transactional Analysis (TA): TA helps treat CPTSD by examining the interactions and communication patterns that stem from childhood trauma. TA focuses on understanding and changing these learned behaviours to foster healthier relationships and emotional responses.

Cognitive Behavioural Therapy (CBT): Helps individuals understand and change negative thought patterns and behaviours.

• Trauma-Focused Therapies

– Eye Movement Desensitization and Reprocessing (EMDR):

– Uses guided eye movements to help process and integrate traumatic memories.

– Helps reduce the distress associated with traumatic memories.

– Brainspotting:

– Identifies, processes, and releases trauma held in the body.

– Uses focused eye positions to access and process traumatic memories.

– Flash Technique:

– Involves briefly focusing on a traumatic memory while simultaneously engaging in positive, distracting thoughts.

– Designed to reduce the emotional intensity of traumatic memories quickly.

• Somatic Therapies

– Somatic Experiencing: Focuses on body sensations to release trauma stored in the body.

– Sensorimotor Psychotherapy: Integrates body awareness with traditional talk therapy to address trauma.

• Medication

– Antidepressants: Such as SSRIs (Selective Serotonin Reuptake Inhibitors) to help manage symptoms of depression and anxiety.

– Anti-anxiety Medications: To help reduce severe anxiety and panic symptoms.

– Mood Stabilizers: To help manage mood swings and emotional dysregulation.

Important Note: Doctors and psychiatrists can only prescribe medication. We at Insightful Counselling do not prescribe them.

• Mindfulness and Relaxation Techniques

 – Mindfulness-Based Stress Reduction (MBSR): Combines mindfulness meditation and yoga to reduce stress.

– Relaxation Techniques include deep breathing exercises, progressive muscle relaxation, and guided imagery.

• Creative Therapies:

– Art Therapy: Uses creative expression to help process and communicate feelings.

– Music Therapy: Uses music to help individuals explore and express emotions.

• Lifestyle Changes

– Regular Exercise: Helps reduce stress and improve mood.

– Healthy Diet: Supports overall mental health and well-being.

– Adequate Sleep: Essential for emotional and physical recovery.

Combining these treatments can provide a comprehensive approach to managing CPTSD, helping individuals reduce symptoms and improve their quality of life. Each person’s treatment plan should be tailored to their needs and circumstances.

Finding the right therapist to work with CPTSD can significantly impact your healing journey. Here are some steps to help you find the right match:

1. Look for Specialized Experience: Ensure the therapist has experience and training specifically in trauma therapy like certified in EMDR therapy.
2. Check Credentials: Verify their qualifications and certifications.
3. Ask About Therapeutic Approaches: Inquire about their methods, such as EMDR, Brainspotting, or any other method.
4. Consider Personal Compatibility: Choose someone you feel comfortable with and trust.
5. Read Reviews: Look for testimonials or reviews from other clients.
6. Initial Consultation: Schedule a consultation to see if their approach aligns with your needs.