Complex Post Traumatic Stress Disorder (C-PTSD)
Definition:
Complex Post-Traumatic Stress Disorder (C-PTSD) - Complex Post-Traumatic Stress Disorder is a psychological injury that results from prolonged exposure to social or interpersonal trauma, disempowerment, captivity or entrapment, with lack or loss of a viable escape route for the victim.
Complex Post Traumatic Stress Disorder (C-PTSD) is a condition that results from chronic or long-term exposure to emotional trauma over which a victim has little or no control and from which there is little or no hope of escape, such as in cases of:
- domestic emotional, physical or sexual abuse
- childhood emotional, physical or sexual abuse
- entrapment or kidnapping.
- slavery or enforced labor.
- long term imprisonment and torture
- repeated violations of personal boundaries.
- long-term taking care of mentally ill or chronically sick family members.
- long term exposure to crisis conditions.
When people have been trapped in a situation over which they had little or no control at the beginning, middle or end, they can carry an intense sense of dread even after that situation is removed. This is because they know how bad things can possibly be. And they know that it could possibly happen again. And they know that if it ever does happen again, it might be worse than before.The degree of C-PTSD trauma cannot be defined purely in terms of the trauma that a person has experienced. It is important to understand that each person is different and has a different tolerance level to trauma. Therefore, what one person may be able to shake off, another person may not. Therefore more or less exposure to trauma does not necessarily make the C-PTSD any more or less severe.C-PTSD sufferers may "stuff" or suppress their emotional reaction to traumatic events without resolution either because they believe each event by itself doesn't seem like such a big deal or because they see no satisfactory resolution opportunity available to them. This suppression of "emotional baggage" can continue for a long time either until a "last straw" event occurs, or a safer emotional environment emerges and the damn begins to break.The "Complex" in Complex Post Traumatic Disorder describes how one layer after another of trauma can interact with one another. Sometimes, it is mistakenly assumed that the most recent traumatic event in a person's life is the one that brought them to their knees. However, just addressing that single most-recent event may possibly be an invalidating experience for the C-PTSD sufferer. Therefore, it is important to recognize that those who suffer from C-PTSD may be experiencing feelings from all their traumatic exposure, even as they try to address the most recent traumatic event.This is what differentiates C-PTSD from the classic PTSD diagnosis - which typically describes an emotional response to a single or to a discrete number of traumatic events.
Difference between C-PTSD & PTSDAlthough similar, Complex Post Traumatic Stress Disorder (C-PTSD) differs slightly from the more commonly understood & diagnosed condition Post Traumatic Stress Disorder (PTSD) in causes and symptoms.C-PTSD results more from chronic repetitive stress from which there is little chance of escape. PTSD can result from single events, or short term exposure to extreme stress or trauma.Therefore a soldier returning from intense battle may be likely to show PTSD symptoms, but a kidnapped prisoner of war who was held for several years may show additional symptoms of C-PTSD.Similarly, a child who witnesses a friend's death in an accident may exhibit some symptoms of PTSD but a child who grows up in an abusive home may exhibit the additional C-PTSD characteristics shown below:
C-PTSD - What it Feels Like:People who suffer from C-PTSD may feel un-centered and shaky, as if they are likely to have an embarrassing emotional breakdown or burst into tears at any moment. They may feel unloved - or that nothing they can accomplish is ever going to be "good enough" for others.People who suffer from C-PTSD may feel compelled to get away from others and be by themselves, so that no-one will witness what may come next. They may feel afraid to form close friendships to prevent possible loss should another catastrophe strike.People who suffer from C-PTSD may feel that everything is just about to go "out the window" and that they will not be able to handle even the simplest task. They may be too distracted by what is going on at home to focus on being successful at school or in the workplace.
C-PTSD CausesC-PTSD is caused by a prolonged or sustained exposure to emotional trauma or abuse from which no short-term means of escape is available or apparent to the victim.The precise neurological damage that exists in C-PTSD victims is not well understood.
C-PTSD TreatmentLittle has been done in clinical studies of treatment of C-PTSD. However, in general the following is recommended:
- Removal of and protection from the source of the trauma and/or abuse.
- Acknowledgement of the trauma as real, important and undeserved.
- Acknowledge that the trauma came from something that was stronger than the victim and therefore could not be avoided.
- Acknowledgement of the "complex" nature of C-PTSD - that responses to earlier traumas may have led to decisions that brought on additional, undeserved trauma.
- Acknowledgement that recovery from the trauma is not trivial and will require significant time and effort.
- Separation of residual problems into those that the victim can resolve (such as personal improvement goals) and those that the victim cannot resolve (such as the behavior of a disordered family member)
- Mourning for what has been lost and cannot be recovered.
- Identification of what has been lost and can be recovered.
- Program of recovery with focus on what can be improved in an individual's life that is under their own control.
- Placement in a supportive environment where the victim can discover they are not alone and can receive validation for their successes and support through their struggles.
- As necessary, personal therapy to promote self-discovery.
- As required, prescription of antidepressant medications.
What not to do about it:Stay. Hold it in. Bottle it up. Act out. Isolate. Self-abuse. Perpetuate the cycle.What to do about it if you know somebody else who has C-PTSD:Offer sympathy, support, a shoulder to cry on, lend an ear. Speak from experience. Assist with practical resolution when appropriate (guidance towards escape, therapy, etc.) Be patient.What not to do about it if you know somebody else who has it:Do not push your own agenda: proselytize, moralize, speak in absolutes, tell them to "get over it", or try to force reconciliation with the perpetrator or offer "sure fire" cures.
C-PTSD LinksUse the following links to learn more about C-PTSD and get support:PTSD Forum Contains a Wiki page and Active Support Forum.Psych Forums PTSD Forum.http://healmyptsd.com/ - Resources & info about recovery from PTSD & C-PTSD
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