Self-Help Groups Complex Post-Traumatic Stress Disorder

Welcome, we’re glad you’re here! We are a group (now an association of groups) of people who support each other on the often difficult and complex journey of healing from CPTSD.

We have several groups: online groups, a Berlin group, a reading group, a nervous system regulation exercise group, two reading & exercise groups. The group size is 4-9 participants each. The Berlin group meets in Moabit, all other groups take place online. All times are in CET time zone, and you can join from anywhere around the world.

It is important to us to treat each other with respect, appreciation and consideration. We offer a safe space to support each other on our healing journey. We meet anonymously. Everything remains confidential. We use free, open-source and end-to-end encrypted software. All meetings follow specific group rules, which ensure a safe environment.

The self-help group is no substitute to therapy. You will find that previous therapy experience will help you in this format. We would like to underline that you can only participate, if you know how to regulate your nervous system and you are generally sufficiently stabilized.

If you’re interested, please email us at mail@kptbs.de and we’re looking forward to getting to know you.

Calendar
Group rules
Groups overview
Meeting structure
CPTSD diagnosis
General information on self-help
CPTSD self-help

Calendar

Group Rules

All participants commit to respecting our rules to foster a safe space:

Common sense: all rules follow from the goal of creating a supportive environment and safe space, rules can never be complete or 100% clear.
Personal responsibility: you take responsibility for yourself, your feelings, boundaries and actions. You pay attention to your needs and communicate them carefully with us.
The usual rules of conversation apply: Let people finish speaking, talk to each other respectfully and mindfully.
Everything that is discussed in the group is confidential and does not leave the group. Anonymity: We address each other by our first names.
Disturbances take precedence: anyone who is particularly affected by what is being said interrupts the current speaker and communicate the issue. We do not talk about trauma content and avoid descriptions of any form of violence.
We do not tolerate any form of intolerance, violence and aggression (insults, discrimination, shouting, etc.).
Every member speaks for themselves, avoid generalizations and group-related descriptions. We do not give advice, evaluate or treat each other.
Participation in the meeting under the influence of (and consumption during) legal or illegal drugs is prohibited.
It is not possible for the group to take responsibility for participants in an acute crisis. Those affected must turn to therapists, doctors, crisis hotlines, etc. It is not possible to join and participate if you are actively suicidal.
All members are part of the group because they are affected by CPTSD. There is no leader. The moderation is done by experienced group members, and we strive for everyone to always take on the responsibility of moderation.
Religion and politics have no place in our discussions. This includes for instance any kind of proselytism or voting recommendations. However, this does not include talking about social dynamics and world affairs, such as society’s disregard for environmental destruction.
QAnon, conspiracy theorists, fanatics and extremists are not welcome here. We believe in scientific methods and results. Facts and opinions must be kept separate.
Cameras are always on in online groups/meetings. Microphones are only on when speaking.
Groups with less than 9 people are open to new participants. Bigger groups vote if they want to accept new members.
Anyone who no longer wishes to be part of the group or will be absent for more than three meetings informs the group about it.

Groups overview

English

Title	Date	Location
CPTSD and Racial Trauma Reading Practice Group	Monday, every two weeks, 19:30-21:00	Online

German

Title	Date	Location	Details
Online Group 1	Wednesday, every two weeks, 19:30-21:00	Online
Heller Reading Practice Group	Monday, weekly, 16:00-17:30	Online	Laurence Heller, Aline LaPierre: Entwicklungstrauma heilen (NARM)
Practice Group	Wednesday, weekly, 18:00-19:00	Online
Walker Reading Practice Group	Saturday, weekly, 10:30-12:00	Online	Pete Walker: Posttraumatische Belastungsstörung
Berlin U35 Group	2. + 4. Friday, 18:00-19:45	Berlin, Moabit	Young self-help for people below 35 years

Meeting Structure

We start on time. We decide the specific procedure together in each group individually. We find it useful to take 5 minutes to meditate or start with a nervous system regulation practice to distance ourselves from a potential stressful day. Then we take turns for a fixed amount of time, focusing on one person. For example, sharing what happened, asking questions, discussing a topic or doing an exercise. Alternatively, we choose a topic which we would like to discuss together in the group.

Structure of the practice groups

We first have a short welcome round. The person who brought an exercise introduces it briefly. We then practise the exercise together (whether directly guided by the person or through an audio or video or text). Afterwards, we reflect on how we experienced the exercise. “Practice” can really be anything; it’s about experiencing in the moment or reflecting. The focus is our nervous system regulation, but anything related to CPTSD is possible. We will not do any trauma exposure exercises. Some exercises will be more challenging than others, and we will support each other with any challenges. Anyone is welcome to take a break at any time and not participate in an exercise. There should be an interest in trying and looking for new exercises.

Structure of the reading practice groups

We then read a paragraph/half page of a trauma book and establish the connection to ourselves in conversation: what are our experiences, what does what we have read do to us, how can we apply what we have read on our healing path, etc.? We then repeat these two steps. From experience, the speaking part is significantly greater than the reading part. The aim is not to read a lot and quickly, but to learn as much as possible from it for ourselves. There is no homework, and it is not a problem to be absent or to start in the middle of a book, as it is about the content, topics and us and not about the structure of the book. Imagine an ordinary self-help group where the topics of discussion are predetermined by the book.

Books we are currently reading:

Books we finished:

Peter Levine: Sprache ohne Worte: Wie unser Körper Trauma verarbeitet und uns in die innere Balance zurückführt

CPTSD diagnosis

Complex Post-Traumatic Stress Disorder (CPTSD) was defined for the first time in ICD-11 as an independent diagnosis (6B41).

The first version of the ICD-11 was written in 2011, the final version in 2018. The WHO, which publishes the ICD (International Classification of Diseases), has recommended using the ICD-11 since 2019. In Germany, the ICD-11 has been legally valid since 2022-01-01.

Unfortunately, it will be many years before therapists, psychiatrists, doctors and health insurance companies are familiar with the ICD-11 and CPTSD and thus until it is diagnosed. The reasons for this are that (as of 2024) ICD-11 has not yet arrived in teaching and training. Only a few specialists are continuing their own training in this area. IT systems have not yet been updated to ICD-11 and there is no deadline by which ICD-11 is mandatory. Therefore, ICD-10 - which is outdated from a scientific perspective - will be used in most cases in the foreseeable future, resulting in frequent misdiagnoses. This is dramatic because an incorrect diagnosis makes successful treatment much less likely. At present (2024), most of those affected still come across the diagnosis by chance (through books, videos, articles, etc.), and for the reasons mentioned above, it is difficult to obtain a reliable diagnosis from a doctor or psychologist. In general, Dr. Google is not recommended, and a reliable diagnosis is not yet possible online. However, if you suspect that you have PTSD, it can be helpful to familiarize yourself with the topic and the diagnostic criteria to find the motivation to seek out trained specialists.

Good luck with your search, you will need it.

Here are the ICD-11 CPTSD diagnostic criteria.

Complex post traumatic stress disorder (Complex PTSD) is a disorder that may develop following exposure to an event or series of events of an extremely threatening or horrific nature, most commonly prolonged or repetitive events from which escape is difficult or impossible (e.g. torture, slavery, genocide campaigns, prolonged domestic violence, repeated childhood sexual or physical abuse). All diagnostic requirements for PTSD are met. In addition, Complex PTSD is characterised by severe and persistent 1) problems in affect regulation; 2) beliefs about oneself as diminished, defeated or worthless, accompanied by feelings of shame, guilt or failure related to the traumatic event; and 3) difficulties in sustaining relationships and in feeling close to others. These symptoms cause significant impairment in personal, family, social, educational, occupational or other important areas of functioning.

The criteria for PTSD must therefore be met, but the challenge with the diagnosis is that CPTSD and PTSD sometimes differ significantly in terms of symptoms and CPTSD is therefore not recognized.

The PTSD diagnostic criteria according to (6B40):

Post traumatic stress disorder (PTSD) may develop following exposure to an extremely threatening or horrific event or series of events. It is characterised by all of the following: 1) re-experiencing the traumatic event or events in the present in the form of vivid intrusive memories, flashbacks, or nightmares. Re-experiencing may occur via one or multiple sensory modalities and is typically accompanied by strong or overwhelming emotions, particularly fear or horror, and strong physical sensations; 2) avoidance of thoughts and memories of the event or events, or avoidance of activities, situations, or people reminiscent of the event(s); and 3) persistent perceptions of heightened current threat, for example as indicated by hypervigilance or an enhanced startle reaction to stimuli such as unexpected noises. The symptoms persist for at least several weeks and cause significant impairment in personal, family, social, educational, occupational or other important areas of functioning.

General information on self-help

What is self-help?

Finding one’s own in others, personal initiative and self-determination

The essence of self-help is mutual help on the basis of equal concern. Self-help means taking your own problems and their solutions into your own hands and becoming active within the scope of your own possibilities.

Self-help groups bring together people who share a common theme and who suffer from the same illness, disability or emotional conflict situation. Relatives of those affected also organize themselves in self-help groups.

Self-help groups and organizations are also forums in which sick people, patients and users of healthcare facilities can acquire the knowledge and skills they need to better cope with their illness, but also to better assert themselves as ‘consumers’ in the healthcare market. They partially eliminate the isolation of patients from providers and cost bearers. In self-help initiatives, sick people organize their own lobby structures.

Groups and organizations, e.g. of chronically ill people, are therefore now accepted and sought-after partners of professional care in the healthcare system. They provide important complementary services, or they provide a part of the information, help, care and health promotion that the institutional and professional sector is not willing or able to provide.

Self-help groups

Are discussion groups of a manageable number of people

are self-determined, i.e. the content and working methods of the group are determined by the members
require active and continuous participation from their members
are not usually led by professional helpers
meet regularly on fixed dates (e.g. weekly, fortnightly or once a month)

In joint discussions at the regular group meetings

individuals experience relief and support from the other members and
see that they are not alone with their problem
they learn to recognize their difficulties, deal with them and overcome them
The focus of the group work is on sharing experiences and information

In health or illness-related self-help groups, members inform each other, e.g. about treatment options for their illness, medication and side effects or also about issues relating to disability law or care and health insurance.

Self-help groups are voluntary associations of people whose activities are primarily geared towards the wishes and needs of the group members. The focus is on overcoming the common problem within the group. Although this support is more inward-looking, the members not only help themselves, but also help each other in exchange.

How do self-help groups work?

By working together in a self-help group, social, psychological and/or illness-related stresses can be overcome more easily. The essence of self-help is “finding oneself in others” and thus, above all, community.

Members of self-help groups can:

meet and exchange ideas on an equal footing
support each other in overcoming their difficulties
acquire new knowledge about their personal problem situation
develop different ways of dealing with the problem
Reduce social isolation and fears
undertake joint activities
learn to deal confidently with professionals (e.g. doctors)
develop new life contents and perspectives and
better identify and represent common concerns and interests
encourage each other to assert their rights.

Many members of self-help groups have found that they are better able to cope with stress. They often deal with their problems more independently and self-confidently than other people in comparable situations.

What can’t self-help groups do?

Self-help groups are forms of support by lay people for lay people. They are therefore not suitable for people in acute crises, who generally need professional and competent help.

The positive effects of group work do not appear overnight. It takes time for positive changes to become noticeable through active participation in the self-help group. People in an acute crisis do not have this time. In addition, acute crises of individuals could overwhelm the group.

Self-help groups cannot replace medical or psychotherapeutic treatment, but they can usefully supplement or support it.

It is important that the members participate continuously and actively in the group process. Self-help groups are associations from which those affected can obtain experience and request material. However, they are usually completely overwhelmed if they are used exclusively as a source of information and help. The groups can only function if there is mutual give and take.

Self-help groups arise from the self-determined and independent commitment of those affected or their relatives. The motivation for this is based on the desire to change one’s own situation and to exchange experiences with people who have similar problems. Members of self-help groups communicate on the same level as those affected and thus enable authentic mutual understanding. This is not usually possible for professional helpers.

Self-help initiatives are therefore an essential complement to professional help. Above all, they compensate for psychosocial deficits.

CPTSD Self-help

Possible topics

Reparenting, emotional neglect, dissociation, exposure techniques, psychosomatics, childhood trauma, attachment trauma, self-compassion, therapy experience, transference dynamics, body awareness, vulnerability, transgenerational trauma, mindfulness, stabilization techniques, boundary setting, resilience, guilt, trust, sleep disorders and nightmares, loss, resources, meaning in life, perpetrator projects, flashbacks, Shame, misdiagnosis, inner critic, Somatic Experiencing, emotional intelligence, grief, NARM, gratitude, skills, EMDR, self-worth, compassion, inner child, relationship healing, social anxiety, polyvagal theory, co-dependency, triggers, depression, perfectionism, grief work, anger, crying, introspection, empathy, re-experiencing, avoidance, hypervigilance, affect regulation, self-esteem, closeness, neurogenic tremor

Challenges with CPTSD self-help groups

Triggers: Group members can unintentionally set off triggers by sharing experiences, which can lead to emotional overload.
Group dynamics: Conflicts between group members can have a negative impact on the group climate. Power imbalances can arise, for example if one member is dominant or unconsciously controls the group.
Boundary setting: Difficulties in maintaining personal boundaries can occur, especially if participants have difficulty recognizing and enforcing them due to previous trauma.
Inconsistent healing: Progress in overcoming trauma is highly individualized and non-linear, which can lead to envy or frustration among participants who feel that others are progressing faster.
Emotional intensity: The nature of discussing trauma can lead to a very emotionally charged atmosphere, which can be difficult for some participants to handle.
Fluctuation of participants: Changes in the composition of the group can affect stability and feelings of safety.
Limitations of group therapy: Self-help groups are not a substitute for professional trauma therapy, which can lead to unrealistic expectations of the group’s healing power.
Unclear path: It is usually unclear which approaches are helpful and which are not, and continued trial and error is often very frustrating. Participation in the group can also be frustrating.
Lack of taking responsibility: The group can only become as good for you as you manage to bring yourself and your issues into the group. This takes a lot of courage.
Insecurity in interpersonal relationships: Due to attachment trauma, it is difficult for those affected to trust others and enter into secure interpersonal relationships.
Fear of closeness and abandonment at the same time: Conflicts between the need for closeness and the fear of being hurt or abandoned can affect participation in the group.
Regulation of closeness and distance: Finding an appropriate level of closeness and distance in the group can be particularly challenging for people with attachment trauma.
Self-image shifts: Feelings of inferiority and shame can lead to people not openly communicating their own needs and opinions in the group.
Projection and transference: Affected individuals may project past negative relationship experiences onto other group members or the group as a whole.
Need for control: Some people with attachment trauma develop a strong need for control as a coping strategy, which can trigger conflicts in the group.
Dissociative episodes: As a result of attachment trauma, people may dissociate, especially if they are triggered by the group or the subject.
Abruptly leaving the group: Fear of confrontation or deep mistrust can cause members with attachment trauma to leave the group suddenly and without explanation. Breaking off contact is often triggering for the remaining group members.
Parallel dynamics to previous relationship experiences: The self-organized structure of self-help groups can reflect relationship patterns from the childhood of people with attachment trauma, which can lead to repetitive dynamics.
Role behavior in the group: Members with attachment trauma may tend to take on extreme roles, such as constant giving and helping or being passive and expecting help.

Opportunities with CPTSD self-help groups

Those who are not deterred by the many challenges and are willing to face them proactively will be rewarded with the chance to take significant steps towards healing from CPTSD. According to current research, attachment trauma can practically only be healed through corrective relationship experiences. A safe place, with full understanding of the disorder, attentive and appreciative interaction, which allows people to try out new social behaviors without judgment and to have corrective experiences with others, exists virtually nowhere else. In theory, trauma therapy groups could also offer this, but unfortunately they do not yet exist.

Validation of complex trauma experiences: Self-help groups for CPTSD offer a platform where the complexity and long-term effects of trauma are recognized and understood, which is not always the case in general therapeutic settings.
Dealing with feelings of shame and guilt: In a trusting group atmosphere, deep-seated feelings of shame and guilt that often accompany CPTSD can be shared and gradually reduced through the understanding and acceptance of the group.
Promoting identity development: People with CPTSD often struggle to build a coherent identity. The support group can be a mirror in which they can recognize and develop aspects of their true self.
Stabilization of emotions: The group can teach and practice strategies for emotion regulation that are specifically tailored to the fluctuations of CPTSD.
Working through attachment trauma: By working together in a safe environment, members can gain new attachment experiences and learn to build trusting relationships, which can positively influence their attachment style.
Recognizing triggers and dealing with dissociation: Members can learn to recognize their individual triggers early on and develop effective strategies for coping with dissociation.
Resource orientation and resilience: Self-help groups often emphasize the individual strengths and resources of each member and thus promote resilience to stress-inducing factors.
Promoting a routine of “safe” social interactions: The regularity of group meetings can provide a fixed anchor in the week and help participants to bring structure to their daily lives and maintain “safe” social contacts.
Establishing interpersonal boundaries: Mechanisms for setting boundaries can be learned and practiced in the group, which strengthens awareness of one’s own needs and boundaries.
Help in dealing with everyday challenges: The exchange with other affected persons offers concrete tips and assistance for coping with everyday problems that are made more difficult due to CPTSD symptoms.
Building a deeper understanding of one’s own reaction patterns: As CPTSD is often associated with persistent and complex reaction patterns, the group can help to recognize and address these patterns.
Gaining positive experiences: Through the validation and recognition of the group, participants can gain positive relational experiences, which is particularly important for CPTSD sufferers with early childhood trauma.
Reflection and re-evaluation of attachment behaviors: Group work can help participants reflect on and understand their own attachment behaviors. Participants learn how early imprints influence their current relationship behavior.
Modeling healthy relationships: Group members can learn through interactions with others what constitutes healthy relationships and how to build and maintain them.
Developing trust and safety: Through regular group meeting and the reliability of other members, expectations of consistency and dependability are reshaped, helping participants to solidify trust in relationships.
Recognizing coping mechanisms: Members can develop identification and understanding of their own defenses and coping strategies resulting from attachment trauma in the group.
Improvement of intersubjectivity: The ability to understand and respond to the perspectives and feelings of others can be improved through sharing and feedback in the group.
Acknowledgment of needs and desires: The group setting provides an opportunity to articulate one’s own needs and feelings and acknowledge what has been suppressed by a lifetime of attachment trauma.
Developing self-compassion and self-care: Through sharing in the group, individuals with attachment trauma can be encouraged to develop self-compassion and provide themselves with the care they did not receive as children.
Celebrating small progress: Recognizing and celebrating small successes and steps in the group can be very important for self-esteem and continuing the healing journey.
Experimenting with new behaviors: The group can be a safe experimental space where members can try out new behaviors and explore their effects.
Corrective experiences: Building reliable, supportive relationships within the group can serve as a corrective emotional experience, helping individuals to strengthen and heal their ability to bond.
Healing through coherence: The group environment allows for the sharing of life stories, which can help develop a coherent life story - an important step in healing from developmental trauma.
Developing body awareness: Often developmental trauma is associated with alienation from one’s own body. Support groups can promote techniques such as mindfulness and body-oriented practices that strengthen body awareness.
Building ego strength: Participants can learn to activate and strengthen their inner resources, which increases psychological resilience.
Developing and practicing interpersonal skills: The group provides a framework to learn and strengthen interpersonal skills such as trust building, conflict resolution and empathic communication.
Revision of internalized beliefs: Members can question and revise dysfunctional beliefs and self-images shaped by developmental trauma in the mirror of the group.
Creating feelings of safety: In the protected space of the group, participants can experience that safety is possible and positive emotional experiences can be gained that strengthen the feeling of safety in everyday life.
Development of emotional resilience: - By sharing and validating emotions in the group, members can improve their emotional resilience and cope better with emotional stress.
Contact and sharing: Interaction and engagement with others who have experienced similar challenges can contribute to a sense of not being alone, which is a powerful counterbalance to feelings of isolation and ostracism.
Encouraging self-care: Participants can learn techniques to help take care of their own mental and physical health.

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