Date of Award

Spring 5-21-2022

Document Type


Degree Name

MA - Master of Arts


Expressive Therapies


Carla Velázquez-García


Empirically based therapies for posttraumatic stress disorder (PTSD) have been found to be less effective in treating more severe trauma presentations such as complex PTSD (CPTSD). Neurobiological investigation provides a framework for examining the physical and psychological effects of trauma on brain and nerve structures and provides insight into how to effectively treat CPTSD. This literature review examined symptomology of CPTSD resulting from complex trauma in childhood, neurobiological effects of trauma and their implications for treatment, and the efficacy of the current treatment models, primarily those of eye movement desensitization and reprocessing (EMDR), narrative exposure therapy (NET), and somatic psychotherapies. Significant findings revealed that symptomology can be generalized into three treatment constructs: exposure, regulatory, and attachment techniques, and that all three must be included into treatment models for maximum efficacy. However, few models address all areas of symptomology in one cohesive treatment model and combining treatment methods requires special attention to the neurological processes underlying the presentation of symptoms found in CPTSD. The author offers an original, 4-phase model which combines these elements into one cohesive treatment model utilizing the expressive arts therapy (ExAT) modality: 1) Regulation of affect and arousal states, 2) exposure to traumatic memories and experiences through artistic expressions, 3) re-processing and re-writing personal narratives through artmaking, and 4) sharing arts products for compassionate witnessing. Further research into the CPTSD diagnosis, symptomology, and the hypothesized therapy offered is recommended, with special emphasis on investigating the effects of the proposed treatment model on neurobiological processes.

Creative Commons License

Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.




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