complex post traumatic stress

Whatever the name, I know that I was happy when I found the discussion of Complex PTSD when I first heard of it. That is because I did not find much of the discussion of PTSD and its treatment relevant to me, since it all seemed to relate to a single or a limited number of traumatic incidents. Up until that time I had not really found much acceptance in the professional mental health community that childhood abuse had anything to do with mental illness. That seemed like just another denial of what had happened in my life. So when I saw some people seeming to admit that abuse happened and that it made a difference, it was a big relief.

I'll give this another shot, and hope that those who tend to not understand me will not argue?

It appears that perhaps what Hermann is striving for is a diagnosis that doesn't include the "near death/fear death" experience? That the ongoing, repeated abuse without that element (which is required for PTSD) is why she's pushing for the complex ptsd diagnosis? I mean, that what it appears to me to be in her definitions and explanations. I don't think that would still cover everyone, for surely there are those who experienced the ongoing abuse issues AND feared death?
However, I stick to the results as being equal...assuming everyone has the element of fear of death as PTSD requires... the resulting symptomolgy is the same, regardless of how many traumas, if one developes PTSD. (As opposed to those who endure trauma without developing PTSD for some reason.) The results and the treatment are quite the "same" for all.

The idea is that everyone with PTSD suffers. Hopefully, no matter what direction the experts go in, it will result in good results for the sufferers. (Such as the discovery of the propanolol results.)
Peace?

I think you are getting a more general idea of it.

With C-PTSD though there can be fear of the "near death/fear death". With repetitive physical, emotional, and sexual abuse, one can easily come to fear physical and psychological anaihilation, however it is a constant and consistent fear that doesn't tend to go away. Like waiting for the other shoe to drop. You never know when the abuser is going to strike you dead, physically or psychologically. This is where the differentiation comes in. It's not in who suffers more or who has been through a worse tradgedy. It's about the length of time of the trauma exposure. Like the difference between having a headache, versus chronic headaches.

This is not to say that the traumatic symptoms of PTSD from a single incident can not last a lifetime, or to say that PTSD is any easier to recover from than C-PTSD. It just has to do with the length of time of exposure to the traumatic stimulus.

The treatments are quite similar, yet still have slightly different elements. I encourage you to visit this site. It might help in your understanding of how the treatments differ.

http://www.ncptsd.va.gov/ncmain/ncdo...plex_ptsd.html

Take care.

actually - no. the point is that the resulting symptomology is *not* the same, and the treatment is also different too.

the links elysium and orange posted earlier explain the differences in quite some detail. i would encourage you to read it over (again?). i am getting quite frustrated and upset that you keep repeating the same thing over and over - that ptsd and c-ptsd are the same. that is like saying ptsd and social anxiety disorder are the "same" merely because they are both anxiety disorders.

ptsd does not, by any stretch of the imagination, cover my symptomology profile. c-ptsd does. being diagnosed with c-ptsd has led to a better level of care for me, because therapists are aware of the extra issues to address.

like doc john said, this thread (and forum, in general) is for support - not to argue about the validity of a diagnosis with people who identify with it. if you would like to discuss ptsd in another thread, then by all means do so. but this thread is about c-ptsd and it is really invalidating for you to keep coming back insisting there is no difference (or making the difference out to be one of trivial detail, which is wrong in any case anyway).

Ok so i keep worrying about the diagnosis and i think i am a bit ashamed of it. I'm in denial about the diagnosis so im still having time to work things out in my mind. it definatly sounds like what i have and on the sanity score i got a high score for ptsd.

I read on one website that ptsd should go away if treated properly, and on another website i read that ptsd is long term illness that doesnt go away. Does anyone know what is right. I dont want to have ptsd forever! what type of treatments work best for ptsd?

I went through the shame thing - mental illness - eek! but you know what? now I just want ot be healed -

Is it ever over... geez I hope so! there have been some posts here from people who have gotten better - so yes it can for some - each person has a different time frame though and everyone is different in thier ability to heal - dont give up hope i am a lot better than I was 2 years ago - I've prob had 1 years therapy out of that - tried CBT, EFT, Hypnosis, Mindfulness, meditation, EMDR, now looking into DBT on a forum here and still seeing a T. (changing T's son as she leaves )

Its a hard road but its worth it

Yes Crystalrose,

You can heal from PTSD and C-PTSD. Like P7 said, everyone heals at different rates. For some people, their symptoms will get better, and may even resolve, and then something can happen and the symptoms will be re-triggered.

BUT...you are not damned, by any means. The most important things are to learn about the disorder. Let it sink in and move toward acknowledgment and acceptance. Do your therapy work so you can process your traumas and learn some healthy and positive coping skills. this way, if the symptoms get worse again or come back once they have resolved, you will be armed and ready and be in a better position to deal with it.

I know it is difficult to think of having this disorder, or any psychological disorder. I try and think of it this way...You wouldn't expect someone who is living with Diabetes or Heart Disease to be ashamed of their diseases. Sometimes their symptoms will bother them, sometimes they won't, but when they do, if they educate themselves they will be ready for them.

YES...we can recover, but everybody recovers at their own pace.

If you look up complex PTSD via Google you will see a lot of results. Wikipedia, for instance, says:

A differentiation between the diagnostic category of C-PTSD and that of post traumatic stress disorder (PTSD) has been suggested. C-PTSD better describes the pervasive negative impact of chronic repetitive trauma than does PTSD alone.[7][8] PTSD descriptions fail to capture some of the core characteristics of C-PTSD. These elements include captivity, psychological fragmentation, the loss of a sense of safety, trust, and self-worth, as well as the tendency to be revictimized, and, most importantly, the loss of a coherent sense of self. It is this loss of a coherent sense of self, and the ensuing symptom profile, that most pointedly differentiates C-PTSD from PTSD.[9]

And:

Complex trauma means complex reactions and this leads to complex treatments. Hence treatment for C-PTSD requires a multi-modal approach.[40] It has been suggested that treatment for C-PTSD should differ from treatment for PTSD by focusing on problems that cause more functional impairment than the PTSD symptoms. These problems include emotional dysregulation, dissociation, and interpersonal problems.[41]

I don't know about the DSM but in the UK Complex PTSD has been around for a while particularly with treating children who have endured long term abuse. Therapy is the answer for PTSD and Complex PTSD although the therapy for the latter requires great sensitivity and generally longer. The belief being that if a child endures long term abuse that it alters cognition also and a core inability to trust. Also PTSD is not just an anxiety disorder, it usually has a whole bunch of symptoms with it that have come from trauma. Anxiety, depression and flashbacks.

Hugs all PTSD and complex PTSD is treatable although it may take a long time.

I like how you wrote complex anxiety disorder, thats what i think that c-ptsd and ptsd is.

PTSD is a hard diagnosis for me to accept so i am happy to get the support of everyone

I have been in therapy for 15 months with a psychologist who uses EMDR, considered a cutting edge therapy. I am an adult survivor of long term child abuse with its co-attendant symptoms of an inability to trust others--particularly those with power over me, like supervisors at work, for example.

I just returned from a seminar that combined a number of alternative methods, movement, inner focusing, and work with a partner on inner focusing and a form of sitting meditation using the breath as a focus.

I find these techniques to be the correct medicine for me at this time. I have just had an extraordinary experience of being able to bring forth memory of being loved, and deeply listened and attended to withiin my own body.

One of the things EMDR does, and all PTSD work should do, is establish safety and bring in self-soothing and self awareness techniques.

In retrospect, I understand the challenges I have personally gone through in the last few weeks in general to arise out of not having a deep enough base or foundation of these essential feelings of safety on a body sensation level to proceed further into trauma reduction through bringing down the emotional intensity of flashback and memory.

I'm integrating the experience now, and I sincerely wish you and all others the best in your healing journey. I think it would be lovely to hear more success stories and personal insights as we all go about the business of getting well.

Take care,

sky dancer

I was wondering what the dx would be for someone say who had "only" ONE debilitating life threatening event, but didn't receive immediate treatment for it. It appears the long term treatment explained for "complex" only applies to complex, from what I'm reading here. Just wondering how that works. (and please quit assuming this is about me )

^ that would (presumably) be ptsd. i think you are confusing the difference between c-ptsd and ptsd.

both can have long term treatment. both treatments can be intensive. etc.

the difference is that with c-ptsd, you may have an altered sense of self (e.g., i perceive myself as a "bad person"), you will have difficulties trusting others (in most, if not all, aspects of life), you may dissociate frequently, have a tendency to be revictimised etc.

the chances of someone who had "only" one life threatening event developing the above symptoms are considerably lower than for someone who has had repeated traumatic events occur. obviously, someone who has been held at knife point during a bank robbery, will not likely tend to get into similarly traumatic scenarios in the future. but we all know that chronic childhood abuse sufferers do tend to end up with abusive partners in the future.

so someone with ptsd (the bank incident) will not need therapy that addresses core identity, trust and safety issues. someoen with c-ptsd (child abuse) will. both may be long term treatment, both may be intensive, but obviuosly the diagnosis of c-ptsd will require more breadth in what gets addressed.

p.s. sky, you have a link at the bottom of your posts to (presumably) your blog. are you a registered dr in any way?

_Sky,

I think you explained it pretty good here. I found it to be very interesting when I read it before. Not sure if this is what you're looking for.

Complex PTSD is probably coming in the future, as it refers to trauma that is ongoing. extreme stress ... exposure to prolonged traumatic circumstances .. not a "simple case of tramatic incident"

http://forums.psychcentral.com/showt...tic#post130708

Complex PTSD never goes away... PTSD can be quelched quite a bit so that the triggering subsides substantially even to the point where it's not an issue in day to day living.

http://forums.psychcentral.com/showp...99&postcount=2

lets all be supportive as Doc said ((ty))((((everyone)))))))))))))

Untreated trauma, delayed treatment even for that one event, not just repeated trauma, can have those same effects. They are not mutually exclusive to those who bear repeated abuse per se, or even secondary traumas. I keep trying to include people, not exclude them. Peace.

I'm not arguing here about validity of your complex ptsd. I'm informing that what appears to be considered here as "only" to c ptsd, is not quite accurate, according to the listings. It is unfortunate that just because my information isn't exactly the same as others, that it isn't accepted, even though it isn't my idea and is given in support. Peace folks. tc

sky,

can we please turn this thread back to a support thread. discussions about whether someone is classified as ptsd or c-ptsd can go elsewhere, if you would like to pursue them.

but this thread is for c-ptsd and to gain support in receiving/living with/seeking treatment for that diagnosis. it is difficult to create an accepting and safe environment here when this thread keeps getting derailed into arguments about diagnosis validity. i have responded to your posts, so i am guilty too.

i'm just asking that if people want to continue the c-ptsd/ptsd argument, that it gets taken elsewhere.

please.

First i would just like to say i dont know anything,........ but have read this thread with interest, to gain understanding & insight for my own situation, i had no intention of butting in & posting anything, but i am confused, ive "only" had "one" incident, yet i have got to the point where i dont know who i am anymore, i have an "altered state of myself", i "dissociate" most days, which i have no control over, i am a stranger to myself, a passenger in this body, i cant bear people around me, im angry at everything & everyone, i trust no one, i feel guilt, shame, & believe i am a bad person, i see danger everywhere, & in everyone, it has effected every part of my life, my T has told me i will never be the same person again, or what i thought was "normal", so what do i have?

(((laura)))

you're not butting in . obviously, no one here can offer a diagnosis over the internet. it is not a requirement of c-ptsd that you have had multiple traumas, it is just more likely that someone with multiple traumas will develop c-ptsd than someone with a single event. but that is kind of like saying that it is more likely that someone over 50 will get breast cancer - it still happens to younger women, too!

if you think this is a diagnosis that could explain your symptoms, then i'd encourage you to bring it up with your T. as for myself, i had never heard about c-ptsd when i started treatment, and i related to a lot (but not all) of the criteria for borderline personality disorder, so bringing that up with my pdoc was what led me to be diagnosed with this instead.

i am sorry that you are going through everything you described. clearly, the important thing is that you receive treatment for all of those aspects, regardless of what diagnosis you officially receive.

being given the diagnosis has proven useful and informative for me. if i hadn't known, for example, that seeing yourself as a "bad" person was part of the clinical profile, i doubt i would have ever brought up that core self-concept with my pdoc - i would have been too scared that it was true, and i didn't want the confirmation. but knowing that it is part of the disorder helped me separate that from myself, a little bit. now on good days i don't think of myself that way.

before I begin I just want to put a thought out .

I wonder what it would take for an infant to experience the threat of loss of life. Not bieng fed or held maybe. ?

Hi Sky,

I want to say it depends on what that one type of trauma is . But maybe not.
Maybe it in the untreatment , the lack of acknowledgement and help that one does not get that has an effect on an individual as they grow up . and interact with others.

Its real easy to see how a young girl who was brutaly raped or had her life theratened by her father might end up becoming a hooker who inturn gets abused and used and at times have her life threatened,

( Thinking about the recent Craigs list killler whos father was a

Dentist..( LOL) sorry , inside joke.. )

and does a craigs list in her own way. this one time event becomes many more and becomes CPSTD over time .

If this same child was in a fire but pulled out of the house and had a few burns but was okay . And no one talked to her about it . Life went on as usual everyone happy singing . What kind of complexity woud come from that.

This started because Crystal rose feels shame about being diagnossed with either PSTD or Complex PSTD and admidst to some emotional deregulation . Not sure she wants the diagnosis of either .

Crystal Im not sure what this shame is about or is coming from .

Sky you mentioned a label doesn't really matter as far as what a person experiences . In theory this sounds good ., But in the real world labels do lots of harm .

Patricia

In reality, no. If the symptoms differ, then one is not the dx. Which has been my point all along. Not everyone has all the symptoms, but the symptoms (effects) are the same for both.

Deli -
I also find CPTSD very interesting. I first read that it is similar to Borderline Personality Disorder but that BPD includes more of a diffuse sense of self and other. Then I read that it may also include a diffuse sense of self and other when they are considering it for the new DSM.
**********
I wrote the above paragraph before I read what you wrote here:
I don't know about you, but I find BPD to be an abomination of a label. It is actually traumatizing to feel like I fit in this diagnosis because of how these patients are regarded. I also have a diagnosis of BPD/PTSD (I'm not sure if my T indicated CPTSD or not, but it fits). Now that there is more information about BPD I would love to see this label gone.

Take care!

Sky...

Everybody here knows that you disagree with the scientific data out there that accurately states the differences between the etiologies, symptoms and treatment of PTSD and Complex PTSD. This is fine. I don't think anyone has an issue with it. If you want to believe in these inaccuracies that's cool. There is PLENTY of scientific research and data that does validate Complex PTSD and that's enough for me.

You have every right to post here but this is a thread on COMPLEX PTSD. Can we please keep on this topic and not hijack the thread with inaccurate information. You have created a thread on PTSD and can post your opinions and information there, or if you choose you can post it on your blog. Please let's stay on topic?

Thanks

I'm just giving an accurate response to a question given in this thread. I am keeping with the topic, and it's unfortunate that those who don't want to hear accurate information continue to attack me, here and in a separate thread that had nothing to do with "complex" ptsd.

From the same resource that was quoted by some to supposedly support complex ptsd, it says: Because results from the DSM-IV Field Trials indicated that 92% of individuals with Complex PTSD/DESNOS also met criteria for PTSD, Complex PTSD was not added as a separate diagnosis. Complex PTSD may indicate a need for special treatment considerations.

http://www.ncptsd.va.gov/ncmain/ncdo...=d&echorr=true

The question asked was if the symptoms and effects are the same, and the above says yes. What some members feel I am invalidating, and I am not, is if the causes are different. Yes, in a sense. I'm not saying that a death feared experience is required, though the current media does. What I'm reading about "complex ptsd" push is that it isn't required for those who endure long-term, repeated abuse. And I have no opinion on that. I am merely saying that yes, according to the current experts documentation, the symptoms and the effects are the same.
(BTW, I did read here where some say that only those with repeated abuse experience "the difference is that with c-ptsd, you may have an altered sense of self (e.g., i perceive myself as a "bad person"), you will have difficulties trusting others (in most, if not all, aspects of life), you may dissociate frequently, have a tendency to be revictimised etc., have a diffused sense of self, or dissociate." I can assure you that those who do not have the horrible repeated abuse issues also experience those things. In Hermann's list she does not state that those symptoms are for "c ptsd" only, btw.

So you can see, I hope, why I'm not seeing the difference other than the repeated cause. I've not been flippant in my posting, but realize that some when triggered might act out against information they don't want to hear.

I think someone reposted something I said in the past, and that shows that I am not against the possible upcoming of the new dx of complex ptsd. But to say that the symptoms and effects are different just isn't quite accurate, with the only one being changed by J Hermann I think is that with c-ptsd and the repeated trauma one doesn't have to fear for their life. (If that's a true statement, well, then I disagree with it but whatever. I don't see where ongoing abuse would remove that fear!)

((((hugs))) to you all. I'm not against you.

Note: Some have spread it about that mods removed my other posts, which is not the case. Mods did not even ask me to do so, I immediately removed my own posting when it was obvious members weren't understanding my phrasing in them.

oh gosh. i'm glad someone else feels this way . when i did finally bring up possible BPD with my pdoc (in the most roundabout way possible), i was absolutely petrified that he would confirm it. at that time, he just reassured me that it didn't fit - he didn't know about my trauma history then, so c-ptsd didn't come up.

i spoke with him about it again last week, and he says that c-ptsd fits for me and bpd doesn't. he actually does believe that some people have bpd, and he has diagnosed and treated patients for it, so apparently it's not just a reluctance to use the label for him.

i'll try to dig up some info on the differences if i can, later tonight. personally, i don't think i know enough about BPD to have an opinion on whether it should stay or go or not. i have certainly spoken to many people in 'real life' who have been given the bpd diagnosis, and found it really helped them make sense of their experiences, and helped focus their treatment. i was able to speak to 3 of them about it in more depth (we are friends, so it was ok to sort of go there) but all of them deny having a trauma history. they did identify early problems with attachment though.

i found that interesting, because i thought that most ppl diagnosed with BPD had a trauma history of some sort. but that could possibly also be because c-ptsd is not in the current DSM, and bpd might be its closest cousin in capturing some of those symptoms.

did read a journal article a few weeks ago where the author suggested classifying CPTSD as a personality, not anxiety, disorder - so complex post-traumatic personality disorder. i thought that was an interesting suggestion also, but i don't know enough about how personality disorders are categorised to have an opinion on that suggestion. i couldnt find any sort of follow up comments on that article, so couldn't figure out what other professionals thought about it.

did find an awesome review article by a recognised leader in the field of trauma which traces the history of PTSD, and the differences between it and C-PTSD. it also goes into diagnosis and treatment issues. it's too large to attach here as a pdf, but i'll see if i can upload it elsewhere and maybe put a link in, if anyone is interested.

sorry, long post! i've been reading up on this heaps lately as i just recently got triggered in a major way again and am desperate for some amount of control over what is happening, and how to deal with it .