The Complex Trauma Podcast

If you've been diagnosed with more than one thing, and it feels like every provider is treating each piece in isolation, this episode is for you.
Complex PTSD doesn't just show up as one condition. For many people, CPTSD symptoms include a stack of co-occurring diagnoses that are deeply connected at the nervous system level but rarely treated that way. In this episode, I break down exactly what might be happening underneath seven of the most common conditions that show up alongside complex trauma, and why understanding the connection changes everything about how healing can work.
In this episode you'll learn:
What the window of tolerance is and how complex PTSD shrinks or collapses it
The faux window of tolerance: the nervous system concept that explains why behaviors like restriction, compulsions, and substance use are so hard to give up
A quick nervous system primer covering sympathetic activation, dorsal vagal shutdown, and the vagus nerve
How CPTSD and eating disorders are connected at the nervous system level, including restriction, bingeing, and purging
The research-backed link between complex trauma and OCD, including a documented posttraumatic subtype
Why substance use, workaholism, chronic pain, dissociation, and emotional dysregulation are all nervous system adaptations in people with complex PTSD
Why treating these complex PTSD symptoms in isolation so often stalls, and what integrated trauma-informed treatment actually looks and feels like
The three phases of healing: stabilization, the thaw, and integration
Whether you're early in understanding your CPTSD symptoms or years into treatment and still feeling like something is missing, this episode offers a framework that finally puts all the pieces in the same room.
Free Resource: Dysregulation Toolkit for CPTSD
Thanks for listening to The Complex Trauma Podcast!
Be sure to follow, share and give us a review on your favorite podcast platform.
Follow on Instagram: @sarahherstichlcsw 
Follow on TikTok: @sarahherstichlcsw
Learn more about EMDR & trauma therapy in Pennsylvania with Reclaim Therapy
This podcast is for educational and informational purposes only. It is not intended as a substitute for professional medical, psychological, or nutritional advice, diagnosis, or treatment.
Remember, I'm a therapist, but I'm not your therapist. Nothing in this podcast is meant to replace actual therapy or treatment. If you're in crisis or things feel really unsafe right now, please reach out to someone. You can call 988 for the Suicide and Crisis Lifeline, text them, or head to your nearest ER.
The views expressed by the host and guests are their own and do not represent the opinions of any organizations or institutions. Reliance on any information provided by this podcast is solely at your own risk.

If you've spent your life being told you're "too nice," "a people-pleaser," or that you just need to "set better boundaries," this episode is for you. 
Fawning is the fourth trauma response, and for most folks with complex PTSD, it's been... a thing... for decades. 
In this episode, Sarah unpacks what fawning actually is (hint: it's not a personality flaw), how it gets built in childhood, what it can feel like in the body, and three small experiments to begin the work of coming home to yourself.
This is one of the most requested topics on The Complex Trauma Podcast. Sarah brings together the foundational work of Pete Walker, current research on complex trauma and emotional neglect, parts work and structural dissociation from Janina Fisher, polyvagal theory, and somatic experiencing into one  conversation about why so many of us learned to disappear into other people, and how we begin to find our way back.

In this episode, you'll learn:
The difference between fawning and people-pleasing, and why the distinction matters for healing
How fawning develops as a brilliant survival adaptation in childhood, often before you have language to remember it
Why the latest research shows emotional neglect is the strongest predictor of complex PTSD
Seven somatic markers of fawning, including the rehearsing, the scanning, the voice change, and the disappearance
How blended states (sympathetic activation plus dorsal shutdown) explain why fawning leaves you exhausted and wired at the same time
The reframe that changes everything: you are not a fawner. You have parts of you that fawn.
Three small, sticky experiments you can try this week: The Body Audit, The 1% Honest Answer, and The Tiny No
Why titration (slow, tiny, repeated) is the only way trauma responses actually unwind
Mentioned in this episode:
Complex PTSD: From Surviving to Thriving by Pete Walker
Fawning by Dr. Ingrid Clayton
Embracing our Fragmented Selves by Janina Fisher
Waking the Tiger and In an Unspoken Voice by Peter Levine
The CDC-Kaiser ACE Study
Why Regulation Feels So Hard with CPTSD (previous episode)
Sarah's conversation with Janina Fisher (previous episode)
Thanks for listening to The Complex Trauma Podcast!
Be sure to follow, share and give us a review on your favorite podcast platform.
Follow on Instagram: @sarahherstichlcsw 
Follow on TikTok: @sarahherstichlcsw
Learn more about EMDR & trauma therapy in Pennsylvania with Reclaim Therapy
This podcast is for educational and informational purposes only. It is not intended as a substitute for professional medical, psychological, or nutritional advice, diagnosis, or treatment.
Remember, I'm a therapist, but I'm not your therapist. Nothing in this podcast is meant to replace actual therapy or treatment. If you're in crisis or things feel really unsafe right now, please reach out to someone. You can call 988 for the Suicide and Crisis Lifeline, text them, or head to your nearest ER.
The views expressed by the host and guests are their own and do not represent the opinions of any organizations or institutions. Reliance on any information provided by this podcast is solely at your own risk.

If you've ever sat in your therapist's office and thought "I sort of just want you to take care of me" and then felt embarrassed for even thinking it, this episode is for you.
Listener Laurie wrote in after the "I Finally Stopped Shrinking" episode asking why being truly seen by a therapist can feel so activating, why grounding doesn't always hit the way her therapist intends it to, and why part of her just wants her therapist to show up more parentally even though she knows that's not the answer.
We took her question and ran with it.
Today I'm joined by Katie Fries, LCSW, RPT, founder of All of You Therapy in Philadelphia, to talk about what's actually happening in the nervous system when the therapy relationship itself becomes the source of activation, and why that's not a sign something is wrong with you.
In this episode we cover:
Why wanting your therapist to parent you is not pathology, it's your nervous system doing exactly what it learned to do
Why being truly seen can trigger a threat response for people with complex trauma
When grounding can actually widen a rupture instead of helping
What needs to happen before any regulation tool can land
What co-regulation really looks like in the therapy room
Why the therapist's own nervous system regulation matters more than most people realize
What relational repair actually looks like in practice
How to bring a rupture into the room even when it feels terrifying
How to know if this is a healing edge or a therapist fit issue
About Katie Fries: Katie Fries, MSW, LCSW, RPT is the founder of All of You Therapy, a group therapy practice in Center City Philadelphia serving clients throughout Pennsylvania and New Jersey. Katie works from a relational, body-oriented, experiential lens with a deep specialization in early relational trauma, attachment, and parent-child relationships. She is trained in AEDP, IFS, Gestalt, Theraplay, EMDR, and Psychedelic Somatic Interactional Psychotherapy among many others. Katie also offers clinical and business consultation.
Learn more about her therapy practice: allofyoutherapy.net 
For theraists looking for consultation: katiefries.com
Thanks for listening to The Complex Trauma Podcast!
Be sure to follow, share and give us a review on your favorite podcast platform.
Follow on Instagram: @sarahherstichlcsw 
Follow on TikTok: @sarahherstichlcsw
Learn more about EMDR & trauma therapy in Pennsylvania with Reclaim Therapy
This podcast is for educational and informational purposes only. It is not intended as a substitute for professional medical, psychological, or nutritional advice, diagnosis, or treatment.
Remember, I'm a therapist, but I'm not your therapist. Nothing in this podcast is meant to replace actual therapy or treatment. If you're in crisis or things feel really unsafe right now, please reach out to someone. You can call 988 for the Suicide and Crisis Lifeline, text them, or head to your nearest ER.
The views expressed by the host and guests are their own and do not represent the opinions of any organizations or institutions. Reliance on any information provided by this podcast is solely at your own risk.

If you've ever wondered why the harshest voice in your head won't quiet down, this episode might help you reframe the why's behind it.
This week I sits down with Emily Pagone, LCPC, founder of Authentic Growth Wellness Group and host of The Inner Critic Podcast. Emily specializes in IFS therapy, EMDR, and somatic approaches with a particular focus on complex trauma and neurodivergent trauma recovery.
We talk about what the inner critic actually is through an IFS lens, why it developed, and why trying to silence it usually backfires. We get honest about our neurodivergent nervous systems, masking, and the shame that builds when your brain was never really understood growing up.
If parts work is new to you, this is a great place to start. If you've been in it for a while, there's still something here.
Find Emily at the Inner Critic Podcast on Apple and Spotify, and on Instagram at Emily @emilypagone. Learn more about her therapy practice, Authentic Growth Wellness Group here.
Listen to The Inner Critic Podcast on Apple Podcasts 
Listen to The Inner Critic Podcast on Spotify
Thanks for listening to The Complex Trauma Podcast!
Be sure to follow, share and give us a review on your favorite podcast platform.
Follow on Instagram: @sarahherstichlcsw 
Follow on TikTok: @sarahherstichlcsw
Learn more about EMDR & trauma therapy in Pennsylvania with Reclaim Therapy
This podcast is for educational and informational purposes only. It is not intended as a substitute for professional medical, psychological, or nutritional advice, diagnosis, or treatment.
Remember, I'm a therapist, but I'm not your therapist. Nothing in this podcast is meant to replace actual therapy or treatment. If you're in crisis or things feel really unsafe right now, please reach out to someone. You can call 988 for the Suicide and Crisis Lifeline, text them, or head to your nearest ER.
The views expressed by the host and guests are their own and do not represent the opinions of any organizations or institutions. Reliance on any information provided by this podcast is solely at your own risk.

You did the work. You stopped shrinking. You let someone in. And it still ended with you feeling invisible.
So what do you do with that?
In this episode I'm responding to a message from a listener going through a divorce. She didn't shrink. She showed up fully. And it still ended in abandonment.
 Her question was simple and devastating: how do you reconcile that? And, how do you ever trust again?
On today's episode I get into why adult relationships can reopen old wounds rather than heal them, what your nervous system is actually doing when someone starts pulling away, the difference between a trigger and a real present wound, and what rebuilding trust actually looks like from the inside out.
This one is for anyone who thought they'd finally broken the pattern only to find themselves right back in the wound.
Thanks for listening to The Complex Trauma Podcast!
Be sure to follow, share and give us a review on your favorite podcast platform.
Follow on Instagram: @sarahherstichlcsw 
Follow on TikTok: @sarahherstichlcsw
Learn more about EMDR & trauma therapy in Pennsylvania with Reclaim Therapy
This podcast is for educational and informational purposes only. It is not intended as a substitute for professional medical, psychological, or nutritional advice, diagnosis, or treatment.
Remember, I'm a therapist, but I'm not your therapist. Nothing in this podcast is meant to replace actual therapy or treatment. If you're in crisis or things feel really unsafe right now, please reach out to someone. You can call 988 for the Suicide and Crisis Lifeline, text them, or head to your nearest ER.
The views expressed by the host and guests are their own and do not represent the opinions of any organizations or institutions. Reliance on any information provided by this podcast is solely at your own risk.