Dr. Herman's "Three Stages of Recovery": The Case of Mrs. P

Papers should be 2-4 double-spaced pages (1” margins; 12 pt Times New Roman).
Assignment Questions
Instructions: Please answer the following questions using complete sentences, not bullet points. The case summary for Mrs. P is attached after the questions. ALL text must be your own words/analysis unless directly quoting or citing the assigned book or another source. Citations must be included for any quotes or paraphrased material. You do not need a reference page for the assigned books, but if you use any other sources to assist you with these papers, you must include a reference page with the source information.
Question 1: Use Case Summary on Page 2
In Judith Herman's chapter entitled “Terror,” she describes three categories of symptoms that make up post traumatic stress disorder. Please name and define these three categories. Within each category, please identify two symptoms (from that category) that Mrs. P is exhibiting.
Question 2:
Discuss the difference in impact of complex trauma on children versus adults, making sure to address the impact on the development of the sense of self. List at least two effects of complex trauma on each age group (children vs adults).
Question 3: Use Case Summary on Page 2
In Dr. Herman’s chapter entitled “Child Abuse”, she discusses two important psychological adaptations that children often employ when they are the victims of chronic childhood abuse – Doublethink and Double self. Define these adaptations and cite one example of how Mrs. P demonstrates each of these psychological defenses.
Question 4:
In her chapter entitled “A New Diagnosis,” Dr. Herman discusses that people with histories of chronic trauma are frequently misdiagnosed. Please name the three most common diagnoses that are erroneously applied to people with histories of chronic trauma. Additionally, please identify and briefly describe the “New Diagnosis”.
Question 5:
Dr. Herman discusses “three stages of recovery.” List and explain these three stages. Based on the summary of areas of focus in Mrs. P’s current treatment, what “stage of recovery” is Mrs. P in? Cite two of the current interventions utilized with Mrs. P to support your answer.
Question 6:

Please present your own thoughts about the proposed diagnosis of Complex PTSD. Do you agree this should be a formal diagnosis? Why or why not? What are the implications if the diagnosis of Complex PTSD is formalized vs not formalized ?
Mrs. P Case Summary:
Demographic information:
Mrs. P is a 39 year old, Caucasian female. She lives in a wealthy urban community. Her highest level of education is college and she is self employed as an artist. She is married and has two children. She identifies as cis-gendered and heterosexual.
Mrs. P’s symptoms:
Mrs. P first presented seeking therapy and medication to help her with high levels of anxiety, irritable mood, and difficulty maintaining close relationships. Further evaluation revealed that Mrs. P also suffers from the following symptoms and maladaptive behaviors:
 Extreme mood swings from intense irritability and sadness to euphoria
 When Mrs. P is reminded of her past she dissociates and feels as if she is not real and the world around her is not real
 Difficulty remembering her past
 Excessive alcohol use
 Avoidance of intimate relationships
 Nightmares
 Intrusive memories from her past which make it difficult for her to concentrate
 Fits of rage
 Chronic headaches
 Episodes of intense shaking of her limbs without underlying neurological cause
 Chronic suicidal thoughts
 Self hatred
 Difficulty making decisions
 Difficulty setting limits with others
 Pattern of sacrificing of her well being for others, even those who treat her poorly
 Chronic second guessing of her intentions and whether she is a good or bad person
 Chronic feelings of intense guilt about being a bad mother despite being consistently nurturing to her children
Trauma History:
Mrs. P has a history of chronic physical and emotional abuse by her father and neglect by her mother. Mrs. P’s father was physically and emotionally abusive beginning when the patient was an infant until her late adolescence. Her mother was an alcoholic and did not provide safety or protect Mrs. P from her father's abuse. Despite this abuse and neglect, Mrs. P is the primary caregiver for both of her parents.
Current Treatment:
Currently, in treatment, Mrs. P is working on feeling trusting of the therapist’s ability to help her. Mrs. P has a hard time being consistent with her sessions because she is not sure that they can be helpful. She also is fearful that the therapist may hurt her and let her down. Therapy is focused on establishing a regular schedule for sessions, reviewing the goals and objectives for treatment, working on relaxation techniques to decrease anxiety and improve sleep.
Medication is also being utilized to improve anxiety and sleep and to reduce urges for excessive alcohol use.