Ask the Doc


I am a healthcare practitioner diagnosed with complex PTSD due to childhood trauma. I am doing therapy and taking Prozac. While at my doctor’s for a checkup, the nurse checked what medications I was on and why. When she asked about Prozac, I froze and couldn’t answer her. I was afraid that she would judge me; how can she trust my clinical judgment when I am on psychiatric medication? I also didn’t want to go into my history and my diagnosis with her. Why did I freeze? Why did the question about medication feel so invasive? How can I handle this differently in the future? Prozac has helped me deal with my anxious racing thoughts, but now I am questioning myself and whether I should stay on it. 

Knowledge and self-awareness are the first steps towards healing and taking charge of your health journey. While this article provides general information about living and dealing with complex PTSD, please consult with a trained mental health professional for your specific needs. 

It is important that you understand the four healing building blocks in order to heal from trauma. When you are equipped with these tools, you gain a sense of control over your path, which survivors of trauma often feel they don’t have. 

Complex PTSD is a set of symptoms that are the result of pain and stress that usually begins at a very young age. These early experiences shape your perspective of yourself and the world. In doing self-examination and healing, you start to turn inwards and examine your story and as you gain more tools, you start to gain relief from trauma. Your intention is to become less identified with your trauma and realize you have a greater choice about your future. 

Four Building Blocks Towards Healing From Trauma

  1. Recognition of the Impact of Trauma 

Ask yourself: how have my early years shaped my perspective of myself and the world? How am I identified with my trauma? Below is a breakdown of different areas of your life that you can examine as you ask yourself these two questions.  

Behavioral: Decreased capacity for impulse control; hyperactivity; preference for control; disrupted eating and sleeping patterns. 

Emotional: Increased hypervigilance for potential threats; higher levels of distress and reactivity; difficulties with understanding; expressing and regulating feelings. 

Relational: Lacking trust in others; reluctance to engage in relationships; preoccupation with connection to an adult; difficulties with asking for help and resolving conflicts. 

Cognitive: Difficulties with processing and remembering information; limited attention and concentration; problems with planning and organizing a response to a learning task. 

Self-Esteem: Lower self-esteem; lack of confidence and belief in one’s skills and strengths; higher levels of guilt and shame. 

  1. Safety

Fear and lack of safety causes you to continuously scan your environment for potential threats. This results in you dwelling in the past of what happened, or the future that has not yet happened. This also results in self-criticism, which is a form of maladaptive self-protection. It is important that you establish safety, both internally, and externally. Feeling safe helps bring you to the present moment, mentally and physically. 

Some practices that you can do to establish safety are:

Consider focusing on your breath to help you feel more grounded and present.  

Consider doing a body scan meditation.

Progressive muscle tension and relaxation. 

Take care of your physical needs, such as food, sleep, and rest. 

Take care of your physical space. 

Ask yourself: what do I need right now to feel and be present? Listen to your body cues. 

  1. Building and Finding Trust and Support

Your trust in relationships may also have been damaged. As a child, you looked to an adult to protect you, provide for you and be attuned to your needs. Instead of the relationship being a source of comfort, support and safety, it became a place of terror and fear. But, as a child, you had no option to get out of the relationship. You learned as a child to “put up and shut up” as a go-to coping skill.  As an adult, it becomes hard to find and build trusting relationships with others. You are likely wanting to protect myself, and not feel safe to open up to others.

Therapy can provide vital healing experiences by encouraging safety and trust and providing positive results when you bring up feeling bad about something that happened in session. The therapist is there to help you have what we know as a “corrective experience.” This is where you learn and practice that mis-attunements happen in safe supportive relationships and that they can be repaired. 

Seek out people that you feel understand you and don’t shame you because of your reactions. In other words, find your tribe and let them know how they can support you. 

  1. Empowerment, Voice and Choice

Language and the way you think about yourself, relationships, and the world matter in general, but specifically when it comes to healing from trauma and being a survivor. 

Self-Kindness and Compassion 

When you think of your trauma, practice self-kindness and compassion. Refrain from judging yourself or blaming yourself for what happened to you. Ask yourself: What happened to me? Rather than what is wrong with me? Unfortunately, there is a stigma in society where the survivor feels like they are broken, and in need of fixing. Rather, you are deeply hurt and in need of care. 

Setting Boundaries

In trauma, your boundaries have been violated. Your sense of safety has been taken away. As a result, you feel like you have lost your option of choice and feel helpless. Setting healthy boundaries personally, professionally, and physically are key to reestablishing a sense of control and safety. These boundaries are nonnegotiable. They are integral to your healing. Part of setting boundaries also involves saying “No”. It takes time to get comfortable saying “No”, but in the long run it will support you on your healing journey. “No” is a full sentence. 

Remembering You Have a Choice

At the doctor’s office, remember you have a choice about how much detail you want to go into about your personal history. You don’t have to talk about your history if you don’t feel comfortable and can give yourself permission to let the other person know. You may consider saying something like, “I don’t feel comfortable talking about this now.” 

Advocating for Yourself 

Ask for what you need, whether it be physical or emotional in nature. You probably often disconnect from yourself, and thus your needs. When you become aware of what you need, do not be afraid to communicate it. The first few times may be a little challenging, but after practicing it a few times, it starts to come easier. Get in touch with your needs and verbalize them. Quite often in trauma, you may feel like you want to hide or disappear, just as you describe in your case. The antidote is slowly building trust in yourself and the ability to meet your own needs by advocating for yourself. 

Emotional Regulation

In trauma, you often end up feeling “out of control.” Learning to regulate emotionally sends the message to your nervous system that you are in charge and can provide for yourself what you need. 

Consider learning mindfulness practices, somatic practices such as yoga, and different forms of breathing. You can also work with your therapist on learning dialectical behavioral skills. This is where you learn to practice that you can have two opposing emotions and thoughts, and yet feel ok and be able to be present with the juxtaposition.  

By Dr. Nesrin Aba Ata

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