What exactly Is Complex PTSD?

Feb 06, 2017, 06:03 PM

After reading about complex PTSD,I told my T that's what I thought I had instead of just PTSD,I also told him I don't believe I have a dissociative disorder,that it's all just complex PTSD.

He didn't agree with me.And he behaved as if he hadn't even heard the term before.

Maybe I am misunderstanding what it is?

Trace14 · Feb 06, 2017, 06:08 PM

Quote:

Originally Posted by Terish

After reading about complex PTSD,I told my T that's what I thought I had instead of just PTSD,I also told him I don't believe I have a dissociative disorder,that it's all just complex PTSD.

He didn't agree with me.And he behaved as if he hadn't even heard the term before.

Maybe I am misunderstanding what it is?

Yes, you will get that deer in the headlights look from some Therapist when you mention CPTSD. It's not in the DSM and that's why they are not familiar with it. Though there is a subsection in the PTSD diagnosis that would cover symptoms of CPTSD. A good place to learn about CPTSD is on Pete Walker's site. He is the most knowledgeable on this topic IMHO.
You could even refer your T to Pete Walker's site www.PeteWalker.com I gave my T PW's book to read. She was interested in learning about it.

Feb 06, 2017, 06:53 PM

Thanks but the link you posted isn't the right one.But I did find one,is it the one you meant?

Pete Walker, M.A. Psychotherapy

Parva · Feb 06, 2017, 08:27 PM

Judith Herman is another good source.

This website has a summary of cPTSD. Most cPTSD sufferers have some degree of dissociation.

Complex PTSD - PTSD: National Center for PTSD

This is a fantastic description of flashbacks associated with cPTSD - it might be helpful to share this with your T.

https://www.psychotherapy.net/articl...sd-walker-book

Trace14 · Feb 06, 2017, 08:42 PM

Quote:

Originally Posted by Terish

Thanks but the link you posted isn't the right one.But I did find one,is it the one you meant?

Pete Walker, M.A. Psychotherapy

Yes that's the one. I forgot the - between Pete Walker, sorry.

Trace14 · Feb 06, 2017, 08:45 PM

Then there's a CPTSD forum with a ton of information in it. My Community - Index

xenos · Feb 07, 2017, 11:22 AM

Quote:

Originally Posted by Terish

After reading about complex PTSD,I told my T that's what I thought I had instead of just PTSD,I also told him I don't believe I have a dissociative disorder,that it's all just complex PTSD.

He didn't agree with me.And he behaved as if he hadn't even heard the term before.

Maybe I am misunderstanding what it is?

CPTSD according to Pete Walker is different from PTSD in that PTSD has a visual component for the flashbacks we experience, while CPTSD simply doesn't.

CPTSD is more relevant if we are subjected to a regimented long term abuse, esp family history. Combat veterans for example are subjected to a very stressful situations for a specific time (Not years!) and their symptoms are more relevant to PTSD. They experience visual flashbacks as if they are currently in a war like situation.

CPTSD patient, and according to Pete Walker too, experience non-visual flashbacks where we don't have any idea why we feel so hurt and vulnerable suddenly ( He describes this state of emotions as Abandonment Melange, an amalgam of depression, fear, and toxic shame).

My advice is to stick with Pete Walker knowledge and insight. A lot of us get misdiagnosed by therapists.

Feb 07, 2017, 01:09 PM

Considering my background,CPTSD would definitely be relevant.

I am assuming since it's not in the DSM it's not something my T would ever diagnose me with.

Trace14 · Feb 07, 2017, 01:15 PM

Quote:

Originally Posted by Terish

Considering my background,CPTSD would definitely be relevant.

I am assuming since it's not in the DSM it's not something my T would ever diagnose me with.

Probably not, because of insurance requirements. But there is a subsection under PTSD that would cover it. So a diagnosis of PTSD is probably the best you will get with it. But they may also add in Anxiety issues and depression.

Parva · Feb 08, 2017, 08:06 AM

Quote:

Originally Posted by Trace14

Probably not, because of insurance requirements. But there is a subsection under PTSD that would cover it. So a diagnosis of PTSD is probably the best you will get with it. But they may also add in Anxiety issues and depression.

The ICD-10-CM recognizes cPTSD, so it actually is coverable by insurance. The code is F43.12.

2017 ICD-10-CM Diagnosis Code F43.12 : Post-traumatic stress disorder, chronic

Feb 08, 2017, 02:11 PM

Quote:

Originally Posted by Parva

The ICD-10-CM recognizes cPTSD, so it actually is coverable by insurance. The code is F43.12.

2017 ICD-10-CM Diagnosis Code F43.12 : Post-traumatic stress disorder, chronic

It says chronic PTSD on that,but not complex PTSD

Feb 08, 2017, 02:18 PM

Quote:

Originally Posted by Trace14

Probably not, because of insurance requirements. But there is a subsection under PTSD that would cover it. So a diagnosis of PTSD is probably the best you will get with it. But they may also add in Anxiety issues and depression.

I have been diagnosed with PTSD and a dissociative disorder.I was just confused why my T didn't even seem to know what CPTSD was,but since it's not in the DSM,it makes sense why now.

I haven't been diagnosed with anxiety or depression.I'm pretty sure they go along with having PTSD.

Parva · Feb 08, 2017, 03:22 PM

Quote:

Originally Posted by Terish

It says chronic PTSD on that,but not complex PTSD

There might be handful of people that differentiate complex v chronic, but the core of them both is the long-term nature of traumatic stress. I suppose the biggest definitional difference would be the traumatic stress induced by a primary caregiver (complex PTSD) vs other forms of chronic traumatic stress (i.e., POW). I don't know for sure if the new DSM will split those two apart. Anyway, I get insurance reimbursal for that diagnostic code, and I'm a card-carrying member of the cPTSD social club.

Trace14 · Feb 08, 2017, 05:48 PM

Quote:

Originally Posted by Terish

I have been diagnosed with PTSD and a dissociative disorder.I was just confused why my T didn't even seem to know what CPTSD was,but since it's not in the DSM,it makes sense why now.

I haven't been diagnosed with anxiety or depression.I'm pretty sure they go along with having PTSD.

Oh yes they in fact do. I expect one day CPTSD will be in the DSM, and once that happens more "T's" will be trained in it. But for now our best resource is Pete Walker.

Parva · Feb 08, 2017, 07:47 PM

Quote:

Originally Posted by Trace14

Oh yes they in fact do. I expect one day CPTSD will be in the DSM, and once that happens more "T's" will be trained in it. But for now our best resource is Pete Walker.

Geez Trace, are you getting royalties from Walker's books??

Kidding. When I started having emotional flashbacks, it was brutal. My T understood them, and was the one that pointed it out to me, but it incredibly hard for me to understand what was happening. His blog about it was so re-assuring and accurate. It really helped me sort out when I would turn my T into someone I did not trust at all.

Hey, I just started wondering about flashbacks and maternal transference in T. I wonder if I had to get deeply into maternal transference before flashbacks started, i.e., there needed to be a focus of the flashback? Does that make sense?

Sorry to get off topic, but it's still part of cPTSD.......

Trace14 · Feb 08, 2017, 08:42 PM

Quote:

Originally Posted by Parva

Geez Trace, are you getting royalties from Walker's books??

Kidding. When I started having emotional flashbacks, it was brutal. My T understood them, and was the one that pointed it out to me, but it incredibly hard for me to understand what was happening. His blog about it was so re-assuring and accurate. It really helped me sort out when I would turn my T into someone I did not trust at all.

Hey, I just started wondering about flashbacks and maternal transference in T. I wonder if I had to get deeply into maternal transference before flashbacks started, i.e., there needed to be a focus of the flashback? Does that make sense?

Sorry to get off topic, but it's still part of cPTSD.......

LOL I have no idea what you are talking about

As far Pete Walker books, he was the best source of accurate information I could find on CPTSD at the time I was searching. There's probably more info out now. I have seen some good websites and now there's a CPTSD workbook. So things have changed since then, but I still think he has the best understanding of CPTSD.

Moiraine · Feb 19, 2017, 04:43 PM

What little I have heard about CPTSD, therapists often confuse it with BPD. Is this true?

Parva · Feb 20, 2017, 08:47 AM

Quote:

Originally Posted by Moiraine

What little I have heard about CPTSD, therapists often confuse it with BPD. Is this true?

I think it's REALLY easy to confuse. The core elements of BPD - fear of abandonment, anger, affect dysregulation - manifest in most/all cPTSD.

There is a growing body of research on this. If you're in to primary literature, try these out:

DISTINGUISHING PTSD, COMPLEX PTSD, AND BORDERLINE PERSONALITY DISORDER: A LATENT CLASS ANALYSIS Distinguishing PTSD, Complex PTSD, and Borderline Personality Disorder: A latent class analysis | Cloitre | European Journal of Psychotraumatology

Complex PTSD, affect dysregulation, and borderline personality disorder
https://bpded.biomedcentral.com/arti.../2051-6673-1-9

Moiraine · Feb 20, 2017, 12:32 PM

Thank you. That is helpful. I had a crazy childhood, but a lot of my trauma came as an adult, and was continuous. I think I am more depression and PTSD.

reb569 · Feb 22, 2017, 03:26 AM

I have read somewhere (can't remember where) that often CPTSD is classified as Reaction to severe stress, unspecified, F43.9

Parva · Feb 22, 2017, 08:37 AM

Quote:

Originally Posted by reb569

I have read somewhere (can't remember where) that often CPTSD is classified as Reaction to severe stress, unspecified, F43.9

That's a definition in the ICD, which is produced by the World Health Organization. It is an international manual and was around long before the DSM.

The DSM is an American reference manual. Some things, like cPTSD, are not yet in the DSM, so the symptoms of cPTSD end up, often for insurance purposes, being shoe-horned into ICD diagnoses like 'reaction to severe stress unspecified', or, as earlier in this thread, 'PTSD chronic'.

I would imagine other times, it's simply the choice of the diagnosing therapist what to call the symptoms and which reference manual to adhere to. A lot will change when the new DSM comes out with complex PTSD.

Parva · Feb 22, 2017, 08:05 PM

Quote:

Originally Posted by Parva

That's a definition in the ICD, which is produced by the World Health Organization. It is an international manual and was around long before the DSM.

The DSM is an American reference manual. Some things, like cPTSD, are not yet in the DSM, so the symptoms of cPTSD end up, often for insurance purposes, being shoe-horned into ICD diagnoses like 'reaction to severe stress unspecified', or, as earlier in this thread, 'PTSD chronic'.

I would imagine other times, it's simply the choice of the diagnosing therapist what to call the symptoms and which reference manual to adhere to. A lot will change when the new DSM comes out with complex PTSD.

Odd to respond to my own post, but I just learned today that the ICD is what most insurers require. I guess the DSM is in the process of becoming obsolete? Also - I asked my T today about complex v chronic PTSD. She didn't seem worried about the distinction in terms of insurance.

Moiraine · Feb 22, 2017, 08:51 PM

Hmm, I wouldn't really mind if the DSM became obsolete.

reb569 · Feb 23, 2017, 04:33 AM

Quote:

Quote:
Originally Posted by Parva

That's a definition in the ICD, which is produced by the World Health Organization. It is an international manual and was around long before the DSM.

The DSM is an American reference manual. Some things, like cPTSD, are not yet in the DSM, so the symptoms of cPTSD end up, often for insurance purposes, being shoe-horned into ICD diagnoses like 'reaction to severe stress unspecified', or, as earlier in this thread, 'PTSD chronic'.

I would imagine other times, it's simply the choice of the diagnosing therapist what to call the symptoms and which reference manual to adhere to. A lot will change when the new DSM comes out with complex PTSD.

Odd to respond to my own post, but I just learned today that the ICD is what most insurers require. I guess the DSM is in the process of becoming obsolete? Also - I asked my T today about complex v chronic PTSD. She didn't seem worried about the distinction in terms of insurance.

All correct. I studied the DSM-IV in college, a long time ago, The ICD is where the billing codes come from. I do believe in DSM V there is a section that relates very broadly to CPTSD, but it is not called that. It is a sub-disorder to PTSD. The term used is similar to what the ICD uses I think. I'd have to look into it a little more. I'm not sure about the DSM V becoming obsolete though. From what I've read though version 5 has a lot of issues.

Trace14 · Feb 23, 2017, 02:51 PM

Quote:

Originally Posted by reb569

All correct. I studied the DSM-IV in college, a long time ago, The ICD is where the billing codes come from. I do believe in DSM V there is a section that relates very broadly to CPTSD, but it is not called that. It is a sub-disorder to PTSD. The term used is similar to what the ICD uses I think. I'd have to look into it a little more. I'm not sure about the DSM V becoming obsolete though. From what I've read though version 5 has a lot of issues.

This conversation is interesting. I've heard of the DSM but not the ICD.

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What exactly Is Complex PTSD?

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