By Jerry Boriksin, PhD
The logic is easy but seems to elude the most brilliant of minds: Some complicated conditions require multiple approaches delivered skillfully and in the proper sequence. A single solution, no matter how powerful, tends to fail when up against sufficient intensity and complexity. To put this into simpler language: If a tornado leveled your home, you wouldn’t rebuild by simply calling a plumber. You would need to call in a team of craftspeople – in the right sequence – in order to repair the damage. Calling in the roofer before restoring the walls would be absurd.
Individuals who have sustained severe emotional damage or multiple traumas, or who had their foundations damaged by early childhood neglect or abuse, tend not to do well with singular, well-intended, or even well-delivered therapeutic approaches. Repeated attempts and failures reinforce the hopelessness and futility that are central to the inner beliefs of those who suffer. Essentially, they believe they are broken beyond repair. This is what we refer to as nihilism (i.e., “I am hopeless and there is no meaning, no escape… nothing will work”). The result is often a resumption of self-medicating: indulging in drugs, alcohol, risky sexual behavior, bad relationships, etc. Addiction is a frequent cohort of pain, futility, and hopelessness.
Researchers have been trying for decades to develop singular, powerful treatments for the cure of PTSD. Whereas the treatments are better, even the best treatment techniques fail when facing complex PTSD with co-occurring conditions. Very often, immersion in a safe, sane environment is needed in order to gain some traction. This is why we often need a higher level of care to start the process of rebuilding.
The very first foundations are:
- Sobriety
- Restored sleep cycle
Once this foundation is secure, additional techniques can be employed. However, it is important to recognize that we are dealing with complex problems. We need multiple approaches – delivered skillfully, cooperatively, and rationally – with several specialty artists who can work comfortably with the necessary complexity, honesty, and skill.
While science has helped and will help us further, no magic, medicine, or technique will rebuild the damage inflicted by severe childhood abuse, war, and subsequent disasters. We need to utilize a team with a wide range of tools and skills. We need to embrace the complexity, rather than deny its reality. So, sobriety first, sleep second; then the rebuilding can begin. Do not minimize how much structural work is needed; almost any building can be rebuilt, but it requires a team with many disciplines and several tools, all used in a synthetic, not simplistic, fashion.
