Specialist work
Shock trauma and PTSD
Psychotherapeutic work with the aftermath of severely threatening or overwhelming experiences.
What "shock trauma" means
By "shock trauma" we mean reactions that can follow an event or situation experienced as severely threatening, sudden or overwhelming. That may be an accident, violence, a medical procedure, a loss, a natural disaster, or another experience in which a person faced intense fear, helplessness or danger.
Not every difficult experience leads to post-traumatic stress disorder, and not every strong emotional reaction means PTSD.
What PTSD is
Post-traumatic stress disorder (PTSD) is a specific mental health condition that can develop after exposure to a traumatic event. The diagnosis does not follow simply from having lived through something severe.
The reactions described under it can include:
- intrusive memories or nightmares;
- strong reactions to reminders of what happened;
- avoidance of places, conversations or situations;
- heightened alertness;
- disturbed sleep;
- changes in mood and in how a person sees themselves or the world.
Reactions like these can have different causes. Where a diagnostic assessment is needed, it should be made by a suitably qualified professional.
After a recent traumatic event
Strong reactions immediately after a severe event do not automatically mean PTSD. In the first days and weeks, reactions can change considerably. Where symptoms are severe, persistent or getting worse, it is sensible to seek a professional assessment.
After the event
After a deeply shaking experience, some people recover gradually without developing a lasting disorder. For others the reactions persist, or begin to interfere with everyday life, relationships, sleep, work or a sense of safety.
A person may know rationally that the danger has passed and still react strongly to particular sounds, places, situations or bodily sensations.
Traumatic stress can also show itself in the body — through tension, a racing pulse, changes in breathing, freezing, trembling, an impulse to flee, or other automatic reactions.
How the work goes
Diana Ginova has specialist training in Bodynamic Shock Trauma Therapy and in work with traumatic reactions. In individual work, attention can go to thoughts, emotions and memories as well as to bodily reactions, resources, boundaries and the capacity for regulation.
How the work proceeds depends on the particular person and their state. Not every session involves a body-oriented intervention, and there is no fixed protocol applied to every client.
At the start, what matters is judging what support and preparation this person needs, so that the work can go at a suitable pace.
What is known about treating PTSD
International guidance — from the World Health Organization, from NICE in the UK, and from the ISTSS — gives the strongest support to trauma-focused psychotherapies and to EMDR. Effective psychological treatments for PTSD do exist, and many people achieve a substantial reduction in symptoms and improvement in functioning.
The body-oriented training Diana works with is not the same thing, and we do not present it as a proven first-line treatment for PTSD. It can be a useful perspective on how a traumatic stress reaction is understood and followed.
If another treatment would suit your situation better, we will say so and, where we can, refer you.
You do not have to tell everything at once
You do not need to describe the traumatic event in detail in the first session. What comes first is what is happening now, and what way of working would suit.
Some therapeutic approaches do work with memories and reminders of the event, in a structured way. That is not an uncontrolled reliving of what happened.
Body-oriented work and consent
Work with traumatic reactions does not necessarily involve physical contact. Where a body-oriented intervention or touch is proposed, it is explained first and used only with your consent.
You can decline or stop any particular intervention at any point.
How long it takes
That depends on the situation, the goals, the person's state and the way of working. It can be discussed after the first sessions, but it cannot be promised in advance.
Prolonged and repeated experiences
Where traumatic experiences were prolonged or repeated, the clinical picture can be more complex. ICD-11 also has a separate diagnosis of complex PTSD. Whether it applies to a particular person is a matter for professional assessment, not for a description on a website.
When other or additional help is needed
Where there is immediate risk to life or health, severe disorientation, an acute psychotic state or another medical or psychiatric emergency, a psychotherapy session is not a substitute for emergency care.
For some conditions, psychotherapy can run alongside psychiatric or medical care. If you take medication, or need an assessment for it, that is discussed with a doctor or psychiatrist. A psychotherapist does not change prescribed medication.
Group work with shock trauma
Integria also runs specialist group formats for work with shock trauma. They have a different structure and different requirements from individual therapy, and they are not a group treatment for PTSD.
Only people who are currently in individual psychotherapy are admitted to the group.
Questions people ask
I have been through something severe. Does that mean I have PTSD?
No. PTSD is a specific diagnosis and it does not develop in everyone after a traumatic event.
Do I have to tell everything in the first session?
No.
Will I have to live through it again?
Not in the sense of an uncontrolled reliving. How the work proceeds is agreed between you, and depends on the therapeutic approach.
Does the work involve touch?
Not necessarily. Where physical contact is proposed, it happens only after it has been explained and with your consent.
Do you work with people who take medication?
Yes. Psychotherapy and medication can run alongside each other, and changes to medication are made by a doctor.
How do I know whether working with Diana is right for me?
The first session is partly for that. If needed, another practitioner or another kind of treatment can be recommended.