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Post-traumatic Stress Disorder is a chronic condition that occurs following a traumatic experience. Information processing models of PTSD focus on integrating situationally triggered sensory-emotional memories with consciously accessible autobiographical memories. Review of the nature of implicit memory supports the view that sensory-emotional memories are implicit in nature. Dissociation was also found to be associated with the development and severity of PTSD, as well as deficits in autobiographical memory. Moreover, disorganized attachment (DA) was associated with greater degrees of dissociation and PTSD, and like the defining neural activation in PTSD, was found to be associated with basal ganglia activity. In addition, subcortical neuroception of safety promotes a neurophysiological substrate supportive of social engagement and inhibition of fear-based responses. Furthermore, activation of representations of co-created imagined scenes of safety and secure attachment are associated with increases in this neurophysiological substrate. Repeated priming of secure attachment imagery was associated with modification of internal working models of DA along with reductions in dissociation and recovery from complex PTSD. In conclusion, it is posited that adequate recovery from extensive trauma experiences requires more than conscious elaboration of traumatic autobiographical memories and that the application of implicit nonconscious memory modification strategies will facilitate more optimal recovery.

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This issue of the American Journal of Clinical Hypnosis (AJCH) focuses on increasing recognition that exposure to trauma results in a range of consequences beyond Post-Traumatic Stress Disorder and that many trauma-focused interventions are of limited benefit regarding these other trauma damages. Herman (1992) introduced the concept of Complex PTSD (CPTSD) noting that prolonged, repeated trauma is associated with more complex, diffuse, and tenacious symptoms, deformations of relatedness and identity, and survivors' vulnerability to repeated harm. Ford and Courtois (2020) note that "complex trauma compromises attachment security, self-integrity, and ultimately self-regulation" (p. 8). Moreover, Herman (2020) cites Dorrepaal et al. (2014), who found in a metanalytic study that participants with child abuse-related Complex PTSD were less likely to benefit from exposure versus affect management protocols, and that the latter were associated with more favorable recovery, improvement rates, and lower dropout rates. These authors and others (Ford & Courtois) noted the need for identification of interventions that will address the consequences of prolonged and complex trauma more specifically.Whereas manualized cognitive-behavioral trauma-focused interventions such as prolonged exposure and cognitive processing therapy are widely available to clinicians and trainees, these interventions are designed to modify symptoms of simple PTSD. They do not address the range of CPTSD adaptations to complex trauma. Among these adaptations are insecure attachments along with disruptions in self-organization, impaired affect regulation, and relational skill deficits (Brown & Elliott, 2016;Ford & Courtois, 2020;Gold, 2020). This issue of the AJCH touches on increasing awareness of the varied settings and presentations of trauma consequences, the importance of repairing the developmental deficits and autonomic nervous system changes associated with complex traumatic stress disorders, and alternative and complementary hypnotic and non-hypnotic approaches to facilitate adequate recovery. What follows is a brief summary of what the readers will find in this issue.Drs. Gold and Quinones open the issue with their article, "Applicability of Hypnosis to the Treatment of Complex PTSD and Dissociation." They note the high incidence of CPTSD, review the developmental deficits associated with it, and outline a hypnotic treatment approach to repair such deficits. Moreover, they note that adequate repair of these developmental deficits often results in adequate resolve of the PTSD symptoms and that trauma-focused interventions may not be needed in many cases.In "The Mindfulness-Based Phase-Oriented Trauma Therapy (MB-POTT): Hypnosis-Informed Mindfulness Approach to Trauma," Dr. Otani reviews the phase-oriented model of trauma treatment and mindfulness. He expands our options for promoting trauma mastery in our clients and outlines the use of mindfulness and hypnosis. He demonstrates the application of his MB-POTT model with a case example that assist...