Complex PTSD & Dissociative Disorders Flashcards

A client with CPTSD demonstrates emotional dysregulation characterized by rapid cycling between extreme emotions and sudden emotional shutdown. This pattern is best understood through which lens?

Answer: Polyvagal theory — oscillation between sympathetic activation and dorsal vagal shutdown

Polyvagal theory explains this cycling as the nervous system shifting between sympathetic fight/flight hyperarousal and dorsal vagal freeze/collapse, both defensive responses to perceived threat.

Which dissociative disorder is characterized by sudden unexpected travel away from home, inability to recall one's past, and confusion about identity or assumption of a new identity?

Answer: Dissociative Amnesia with Dissociative Fugue specifier

Dissociative fugue is a specifier of Dissociative Amnesia in DSM-5, involving purposeful travel, identity confusion, and autobiographical memory loss.

In complex trauma treatment with EMDR, the 'Trauma-Informed Stabilization Treatment' (TIST) model by Janina Fisher emphasizes which core principle for affect dysregulation?

Answer: Helping clients befriend and regulate parts rather than suppress them

Fisher's TIST model uses parts language and mindful awareness to help clients develop a compassionate, curious relationship with their parts, building regulation capacity.

When establishing a Positive Cognition (PC) during EMDR Phase 3 with a CPTSD client, which modification is often necessary compared to standard protocol?

Answer: The PC must be validated by all relevant internal parts before proceeding

With complex and dissociative clients, checking that relevant parts of the self endorse the positive cognition prevents internal conflict that can block installation during Phase 5.

The 'phobia of attachment and attachment loss' in complex trauma refers to which clinical phenomenon?

Answer: Simultaneous craving for closeness and terror of it, rooted in disorganized attachment

Disorganized attachment in CPTSD creates an approach-avoidance conflict where the therapist activates both the attachment need and the threat response simultaneously.

EMDR's Standard Protocol requires a minimum level of client stability before trauma processing. Which Phase 2 resource is considered MOST essential for complex trauma clients before beginning Phase 3-6?

Answer: A reliable and accessible Safe/Calm Place or Container exercise

The Safe/Calm Place installation provides a rapid self-regulation tool that clients can access during or between sessions if processing becomes overwhelming.

Which scoring tool, developed specifically for assessing dissociative symptoms, is most commonly used in clinical EMDR practice to screen for dissociative disorders before beginning trauma processing?

Answer: DES-II (Dissociative Experiences Scale)

The DES-II screens for pathological dissociation; scores above 30 suggest need for thorough dissociative disorder assessment before standard EMDR trauma processing.