About PTSD, Complex PTSD and Dissociation:
How I understand and approach trauma as a therapist
Living with PTSD is like being stuck in an invisible loop, one that often feels like everyone else can see it but you. The past replays over and over in the form of your relationship patterns, personal (and potentially self-destructive) habits, and your emotional responses to different circumstances. Healing is seeing the loop you've been stuck in, and then breaking free from it over time.
PTSD, Complex PTSD & trauma-related Dissociative Disorders develop from the wounds left behind from how you survived the unthinkable. The impact of traumatic experiences linger as fleeting shadows in the mind, where conscious memories of trauma are typically fragmented and fuzzy. However, we often expect to remember traumatic events with more clarity than other memories unrelated to trauma; falsely assumming that the intensity and profound impact of a traumatizing experience would surely be remembered with exceptional clarity. Instead, the opposite is true. Traumatic memories are primarily stored somatically in the body. This is a direct result of how the brain automatically defaults to a protective and survival based state in response to a traumatic experience in real-time. When this natural and universal human response to trauma lingers for months or years afterwards; traumatic memories remain unprocessed, and can manifest as the constellation of complex and confusing symptoms associated with PTSD. Over time and using a variety of therapeutic methods, a major part of effective trauma therapy is integrating past traumas into your conscious memory. Eventually, these traumatic memories are slowly released from the body and, over time, integrated into your autobiographical narrative.
For Dissociative Disorders specifically, symptoms are typically unconsciously hidden as part of the function of the Dissociative Disorder itself. Particularly for individuals living with Dissociative Identity Disorder (DID), this obviously complicates the process of getting an accurate diagnosis as well as the therapeutic work that follows.
While current diagnostic standards in the US (using the DSM-5-TR) do not differentiate between PTSD and Complex PTSD, I do in my own practice as a therapist. For many individuals diagnosed with PTSD, there is a singular traumatic event with a distinct before and after in relation to their mental health. The people I see with Complex PTSD, in general, do not relate to the experience of a singular event prompting their symptoms of PTSD. Often there are traumatic experiences that were on-going throughout childhood, with additional traumas as an adult that compounded a pre-existing wound. There is typically little to no time, opportunity and/or support to process each traumatic experience into one's own autobiographical history. Instead, in Complex PTSD, the individual is forced into a prolonged physical and emotional state focused primarily on how to survive their current circumstances. This differs from the more "traditional" depiction of PTSD, where living in a state of survival reflects the symptoms of PTSD itself, and not in response to ongoing and very real threat.
Lindsay Sherman, LCPC
(she/they)
Practice Owner, Psychotherapist & Art Therapist
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Frequently Asked Questions:
Do you see clients for issues unrelated to trauma?
Yes! I work with adults struggling with a range of challenges related to mental health. It is very common for clients to have other mental health conditions and/or symptoms that need attention in therapy, even when the primary focus is trauma/PTSD and/or Dissociative Disorders. The best way to determine if we would be a good fit to work together is to schedule a phone consultation using the "Request Appointment" link. You can also email me with any questions at lindsay@resiliencecounselingllc.com
Do you offer a sliding scale or reduced fee counseling?
I have a limited number of clients on my caseload that I reserve for clients paying out of pocket experiencing financial hardship. For questions related to current availability and reduced fees, please email me at lindsay@resiliencecounselingllc.com
Do you offer court-mandated counseling?
No, unfortunately I do not offer counseling services when mandated through the court/judicial system.
How often do clients typically come to therapy?
The frequency that clients attend counseling varies significantly, and is something we discuss when starting therapy; and as needed throughout our work together. Typically I encourage clients to attend counseling once a week if possible, especially when first beginning therapy. In out-patient settings, weekly therapy is conceptualized as "active treatment"; meaning we are able to actively address the issues you want to work on in therapy. Bi-weekly is considered "maintenance", meaning we are focused on maintaining progress previously attained. I only see clients on a monthly basis who are getting ready to be discharged from therapy. Or, clients who have achieved their primary goals for therapy but still benefit from regular (though more infrequent) sessions. Since once a month therapy is too infrequent to see tangible progress from as a new client, I do not accept new clients seeking to meet on a monthly basis only.
Do you see couples or families for therapy?
No, I only offer individual couseling with adults at this time. I do not offer relationship/couples counseling, family counseling, or individual counseling with minors (under 18 yrs. old).
How much will sessions cost with my insurance?
Everyone's health insurance plan is different. When a new client schedules an intake appointment, we do check with your insurance plan to inquire about your coverage and estimated out of pocket costs. This information is then emailed to you before we meet for the intake appointment. To find out this information in advance, please call the member services number on the back of your insurance ID card and inquire about your coverage for individual psychotherapy (out-patient/office setting or telehealth).
What is Art Therapy?
Art Therapy, at it's core, means integrating the art-making process into the therapeutic process. You do not need to have experience or feel particularly skilled in making art to participate in Art Therapy!
Art Therapy can look like many different things, and is not particularly fixed/rigid in how it is practiced. Sometimes I will give clients specific prompts to make art exploring topics that encourage reflection on areas or struggles that we're focusing on in therapy. This could also be a long-term project completed over multiple sessions, and/or in between sessions over time. Other times this could be an art project we explore together during a single session. Some clients also simply enjoy being able to make art during session as a self-soothing and grounding activity, while we engage in talk therapy simultaneously. I often think of Art Therapy as simply using another language in therapy, using images and the process of art-making as an alternative means of self-expression.
