Chapter 14 - Working with Complex Trauma and Dissociation in Schema Therapy

Summary

Schema therapy is a model designed for adverse childhood experiences and is well suited as a treatment framework for complex post-traumatic stress disorder cases. Schema therapy can provide a middle path between trauma-focused and phase-based approaches. Rather than focusing on stability before moving to trauma processing (primarily via imagery rescripting), the focus is on the client’s emotional needs. Schema therapy does not primarily focus on stability as a core treatment process. Instead, trauma-processing imagery and other experiential exercises are encouraged to commence early in treatment, focusing on creating corrective emotional experiences for the client involving experiences of getting their needs met (e.g., for safety, validation etc.). There are two main ways to conceptualise schema therapy for complex PTSD: 1) as a ready-made approach that incorporates imagery rescripting as the primary trauma-focused approach; and 2) a broader integrative approach, where a range of trauma-focused interventions (e.g., EMDR) can be embedded within a schema therapy conceptualisation.