COMPLEX PTSD

https://amyjosprague.files.wordpress.com/2011/03/07-details-in-the-fabric-featuring-james-morrison.mp3

COMPLEX PTSD…( DESNOS: disorder of extreme stress not otherwise specified…PTPD:Post-Traumatic Personality Disorder…SURVIVOR)

I’m a survivor of childhood sexual, physical, and emotional abuse.  It began when I was a toddler, when my mother married my abuser (unknowingly), and continued on and off throughout my entire life at home.  I am Bipolar, I have ADHD, I have Dissociative Amnesia, Depersonalization, Anxiety (obviously), Dissociative Fugue, and Complex PTSD.  When the Complex PTSD began to really fester in me (one year ago, though there were ptsd symptoms since ten years ago)–just before I admitted myself to “the bin”–I was also suffering from psychotic episodes and those–now THOSE were mind-shattering and terrifying–like I wasn’t scared enough with the flashbacks and the delusions and the hearing of voices brought on by extreme stress.  Complex PTSD is the mother of them all, except the Bipolar–that’s the only disorder I was not given but was born with.  These words do nothing to explain the loss that occurs and the fragmentation of your identity, self, and soul.  There is no way to ever explain feeling the terror and fear as if you were a little girl again, helpless, alone, and with no way out from the terror.  For a long time (half a year), the psychotic episodes were extreme and growing and multiplying–they overshadowed the Complex PTSD.  I’d get the taste of rubber in my mouth and panic, then I was gripped with something I’ll never be able to explain, except that I had to have someone hang on to me and tell me I was going to live, though it didn’t calm me really but it was someone to squeeze until the psychosis stopped (this psychosis eventually developed into psychotic delusions and began to only occur around my period, so I got on birth control and they stopped–praise the Lord!).  But anyways, before the treatment of the psychosis, I was in the mental hospital A LOT, having flashbacks of blood on my face and blindfolds over my eyes and complete horror.  I am not willing to share (I don’t think it’s necessary) the sexual abuse parts except that it involved either being in or forced to watch a home-recorded porn of me with my step-brother and step-sister when I was four or five.  Anyway, I went through about a year of having completely lost who I was.  I dissociated and depersonalized all of the time, another, different scary thing all together.  I wasn’t even real, just this rumbling mess who kept breaking and re-breaking, losing my faith and hopes, believing the future was gone–I saw nothing, there was nothing.  And I knew the girl I was was dead.  She was gone.  I believed I would be left empty forever.  I thought about suicide a lot.  I thought (during the psychosis) that I would lose control and some force outside of myself would kill me.  I was in danger everywhere I turned.  I lost so much, I lost a year.  We also lost our house, I lost my job, I lost my friends, my fiance left me, and I had to move in with my mother.  And I’m 29. 

I now have my own place, just me and my little girl.  I’m getting better day by day.  Sometimes I feel like I’ve come so far, and sometimes it’s slow motion.  I’ve taken to studying Christianity, Buddhism, and Hinduism.  They all share the same message.  They all bring me to my knees, in utter gratitude that the worst of it has ended.  It’s a new life.  Time to start building.

I’m going to start with a very clinical definition that I just found aside from my other research.  This definition threw me because I hadn’t really realized or seen it in words that what I have (complex ptsd, among others) is a personality disorder.  Honestly for a long time I believed I had Borderline Personality Disorder, though I learned the two are easily confused and misdiagnosed at first. 

From Campbell’s PSYCHIATRIC DICTIONARY: The Definitive Dictionary of Psychiatry; Ninth Edition 2009, Robert J. Campbell, MD; Oxford:

post-traumatic personality disorder   PTPD; complex PTSD, which in DSM-IV is classified as a disorder of extreme stress not otherwise specified (DESNOS).  Complex PTSD is a chronic adaptation to PTSD (post-traumatic stress disorder) that shapes the personality.  The symptoms of PTSD itself are usually described in terms of three domains–re-experiencing, avoidance and numbing, and hyperarousal.  But failure of these initial symptoms to resolve provokes a secondary adaptation to them, complex PTSD or DESNOS.  Adaptation to a chronically aroused fear system requires extreme defensive measures, manifested in such symptoms as severe avoidance, alterations of consciousness and self-perception, identity disturbances, overreliance on dissociation, affect dysregulation characterized by cycling from hyperarousal to hypoarousal, difficulty with interpersonal relationships, and somatization.  Dissociative adaptations, used to escape conflict, may alternate with angry and violent acting out. 

PTPD requires a history of severe chronic traumatization beginning in childhood; less severe traumatization is associated with BPD–borderline personality disorder.  In comparison with patients with BPD, those with PTPD have less ability to access positive emotions, have more self negation, and are more avoidant of others.  In their need to avoid conflict, patients with PTPD learn to please, placate, and manage others; dissociation is frequent, not brief and transient as it is in BPD.

 

It’s a very good, but very brief, and very understated explanation.

I like mine.

Complex PTSD is not yet in the DSM-IV, though I believe DESNOS is.  Unlike PTSD, which can occur because of a traumatic time (I should word this better), Complex PTSD is due to a prolonged, repeated, extensive exposure to traumatic events.  This is not to say Complex PTSD is worse, it’s just a different type of trauma with different symptoms (though I believe chronic and involving changes in personality…more on that later).  You’re more likely to experience symptoms of Complex PTSD if your traumatization occured early in your life, was prolonged, and was interpersonal. 

Now, there are 7 (yes, 7) symptoms groups of Complex PTSD (Judith Herman and other sources…again, later) besides the symptoms of general PTSD; this is a brief overview and I will go into detail afterwards:

1. Alterations in regulation of affect (emotion) and impulses

       *chronic affect dysregulation

       *difficulty modulating anger

        *self-destructive or suicidal behaviors

        *difficulty modulating sexual involvement

         *impulsive and risk-taking behaviors

2. Alterations in attention or consciousness (dealing with this part really sucks)

         *amnesia

         *transient dissociative episodes

         *depersonalization (will define at the end)

3. Somatization (how your body holds your trauma…”Your body remembers”)

      *digestive system problems

       *chronic pain

       *cardiopulmonary symptoms

      *conversion symptoms (psychological problems get converted into physical)

       *sexual symptoms

       *panic

4. Alterations in Self-Perception (this one really REALLY screws with you)

      *chronic guilt, shame, and self-blame

      *feeling that you’re permanently damaged

       *feeling ineffective

      *feeling nobody understands you

       *minimizing importance of the traumatic events in your life

5. Alterations in perception of perpetrator (this is not needed for a diagnoses of Complex PTSD). 

      *adopting distorted beliefs of the perp about yourself, others, and what

         happened as true

      *idealizing of the perp/abuser

     *preoccupation with hurting the perp/your abuser

6. Alterations in relation with others

       *inability to trust (not that you don’t want to, you can’t)

       *revictimizing yourself

       *victimizing others

7. Alterations in systems of meaning (how you see life, others, and spirituality)

      *despair, hopelessness

      *loss of beliefs that previously sustained you

Is that all?

….Other tidbits of info…

If you have Complex PTSD, you may have some or all of these personality traits:

-problems with ability to regulate emotions

-find it hard to “stay present” without becoming amnesic (unable to remember), dissociative, depersonalized, or preoccupied with trauma

-may not see yourself as a functioning individual who can avoid feeling helpless, shameful, guilty, stigmatized, alone, special, or full of self-blame (I don’t like the way this is worded because it makes it sound as if we choose to feel these–they are inescapable)

-may not have the ability to separate yourself from your abuser or perpetrator without either being peroccupied with revenge, feeling gratitude, or accepting the perp’s interjects as true

-may not have the ability to have positive, healthy relationships with others without being isolated, withdrawing, being extremely distrustful, failing repeatedly to protect yourself, or constantly searching for someone to rescue you (or for someone you can rescue)…you may even find it impossible to attach at all, your relationships are heywire

-may not have the ability to find meaning in your life and maintain faith, hopefulness, and a sense of the future without feeling despair and hopelessness (more like feeling like you’re certainly going to die and that there is no God–yes I believe in God but no I didn’t at my worst)

(from The PTSD Workbook; cited at the end):

Do you feel you have lived in a war zone for most or all of your life? Do you have a hard time even thinking you have a sense of self?  Do you generally feel unsafe and untrusting, and believe that personal power is an illusion? Do you lack good self-esteem and positive intimate relationships?  Are you isolated, without connections to others?  Do you find it hard, if not impossible, to attach to others?  Do you find it difficult to monitor how you act or to stop yourself before you act in an impulsive way that sometimes hurts you?”

“A person who has experienced type II traumas (prolonged, repeated.) tends to either be too dependent on others in an intimate relationship or is so terrified by any intimate connection that he/she flees from a relationship to aloneness (I’m the latter).  However, when alone, the survivor often feels an unbearable sense of ABANDONMENT and again longs for connection.  So the survivor tries to connect and again becomes terrified of rejection and abuse.  His or her relationshiops begin to take on a pattern of being too close and running away.  Can you keep a clear sense of who you are when you are with others or with a partner or spouse (God I wish, I’ve been like that for years)? Can you self-soothe?  When you’re very emotional can you still make good decisions?”

“…if you were repeatedly traumatized, you may have developed learned helplessness in order to endure abusive situations; that is, you learned that it was useless to try to get away.  Later, even if you could have escaped, you may not have done so, or you went from one abusive situation into another.”

“…Exposure to repeated trauma, type II trauma, may prevent you from ATTACHING in a healthy way to others.  It may cause you to be unable to control your emotional arousal…you may also find you don’t have enough trust in others or yourself to allow yourself to develop a stable relationship.”

(this one hits home) “Your capacity to regulate your own internal emotional states, your body sense, and your response to external stress helps to define who you are.  If you were a victim of type II trauma, you may LACK A PREDICTABLE SENSE OF YOURSELF, have a poor sense of separatness from others, have a disturbed body image, have poor impulse control, and become suspicious and distrusting in social situations.”

It does get better.

Don’t give up.

…to be continued…

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19 thoughts on “COMPLEX PTSD

  1. Amy is my sister, my amazingly strong and beautiful sister. She is stronger than anyone I know, more beautiful than anyone I know. Beauty is fighting like hell for your life. Beauty is letting yourself trust again. Beauty is loving your daughter without question, always kissing her goodnight, laughing with her. Beauty is facing your fears, your hell, working through them, deciding you and your life matter and matter enough to have the life that was taken away from you,having a life that YOU want.

    Beauty is working through and overcoming your childhood. Beauty is writing to help yourself and others going through that hell.

    Beauty is Amy.

    I can’t write like my sister, that’s her gift. But I wanted to share about Amy, share what she doesn’t/can’t always see about herself.

    My life is so much better because she is in it.

    For every Nikki out there, I hope there’s an Amy. Nikki’s need Amy’s too.

    Liked by 1 person

  2. I truly appreciate what you have written. I will share with you something I have written re: PTSD not yet published.

    “…four letters, an acronym, an acronym for long drawn out fear, fear without the consequence of death, as would be the natural order of things, it’s a disorder. A disorder of the universe, your mind escaped a horrible trauma your body should not have, years and years of torture, war, abuse. The planets have been miss-aligned and we get left with an acronym, and the option to pour pills down our throats to realign them. “

    Liked by 1 person

    1. This is so brilliantly said! “…Fear without the consequence of death…disorder” exactly! You’ve truly captured the he’ll of PTSD and so elegantly. Thanks so much for sharing and so much for reading! Keep writing! I swear writing is what saved me.
      Amy

      Liked by 1 person

  3. Hi,

    I think I have this. No one wants to admit it’s worse than just PTSD, but… how do you get help when you’re still spinning? and feel out of control? I can’t afford therapy..and don’t have insurance. I graduated college with PTSD and couldn’t get a job thereafter. I’m just stuck with all the debt and all the psychological barriers keeping me from resolving anything or becoming anything in my life…. how do you get out of here? how do you get better? and feel human again?

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    1. Sami, boy oh boy are you in a bind. I don’t know what you can do without therapy except one key thing I did on my own that helped me–educate yourself on PTSD and read the books oon it and do the workbooks. I’m so sorry you can’t afford/or can’t get insurance. Therapy truly is a must I believe. Are there any counceling services around you that go based off your income? Another thing that helps is writing–write/journal as much as you can. Here are a couple of books and a workbook that REALLY helped me do some of the work on my own:
      the workbook: The PTSD Workbook: simple, effective techniques for overcoming traumatic symptoms (half the book is dedicated to complex ptsd) by Mary Beth Williams, Ph.D, LCSW, CTS and Soili Poijula, PhD.; a New Harbinger Self-Help Workbook.
      books: Trauma and Recovery by Judith Herman, M.D.; The Body Remembers; *****Alan Watt’s The Book: The Taboo on Knowing Who You Are (something like that, but mainly called The Book)–this book will blow your mind.
      There’s lots of books out there that are extremely helpful. I wish you the best and keep in touch. If you ever need to talk or vent or be scared or need someone, we can email each other, I’d love to be there for you. It’s so scary when your in the thich of it, but I believe knowledge and facts help the spinning. My email is amysprague1184@yahoo.com Love and take care, Im here for ya.
      Amy

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  4. y’know i contacted my perp my other a fewe weeks ago and we[‘ev been seeing eachother for a while. yesterday, although she said sh was sorry fo all the thigns that have ahppneed, she balmd my psychosis and my memory for which she said I was exagerating, and left it like that.

    I feel better and sane now that she’s told me she’s sorry, but I can’t help thinking at what price? I mean, she has told me that it was my ‘fault’ that somehow I had predormal psychosis and that was why she hurt and abused me. – isn’t that the mark of an abuser? someone that tells you that it is your fault and that things never happened?

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    1. Wow that’s BULLSHIT! Your condition is her damn excuse? That’s not an apology, it’s a cover-up. You deserve more than that. Way more and so much better!!!!!!

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  5. Hey Amy. Here is a great book,for c-PTSD and dissociation the kingpin of symptoms. This stuck parts of us in childhood makes sense.

    From Coping with Trauma Related Dissociation:

    People with dissociative disorder often have related problems of time distortions. They experience time passing by much too slow or fast; perhaps more time has passed than they thought, or an hour seems like an entire day. Some parts of the personality are often quite confused about where they are in space and time, believing they are still in the past.

    When people with a dissociative disorder are alienated from their body, they may be insensitive to physical pain or lack sensation in parts of their body. Some people report that they do not always always properly register heat and cold, cannot feel whether they are hungry or tired, or feel numb in their body. Again, it is typically the case other parts of the self do feel the physical pain., the hunger, or other bodily sensations.

    There are many different symptoms of depersonalization, but in every case it seems to be a way of avoidance or attempting to regulate overwhelming feelings or experiences. Depersonalization symptoms may be temporary or chronic.

    Parts of the personality that hold traumatizing experiences:

    Younger parts
    Most people with a dissociative disorder who experienced childhood trauma will have parts of personality that experience themselves as younger than the persons actual age: adolescents , child parts of primary school, or even toddler and infant parts. It is as though these parts are stuck in various developmental time periods of the past. They often hold trauma memories, distressing, painful emotions or sensations, but sometimes also have positive memories. They typically are unresolved feelings of longing, loneliness, dependency, and need for comfort

    Helper Parts
    Some people but certainly not all, have helper parts in their inner world that take care of the well being of other parts, an inner form of regulation that can be a resource and basis for leaning further self soothing skills. Sometimes helper parts are modeled on a kind person from the past or an appealing character from a book or movie or television. These parts are the traumatized child’s attempt to soothe and comfort himself or herself. For some people, the major part of the personality who functions in daily life can learn to be quite empathetic and helpful for inner parts as well.

    Parts that Imitate who hurt you:
    Usually their are parts of the personality that hold anger and rage that are unacceptable or very frightening to other parts. Some may resemble people from the from the past who were abusing. These parts shame, threaten, or punish other parts inside, or they may direct their anger to other people in the outside world. Although the behavior of these parts can be quite frightening or shameful, as well as unacceptable, it is important for you to understand that these parts have good reason to exist and are representations, and thus not the same as the people who hurt you.They originally developed to protect you by containing many distressful experiences of anger, helplessness, and sometimes guilt. or shame. Furthermore, their function often is to prevent other parts behaving in a way that, in the past, evoked fear or shame. Over time it is important to appreciate why they exist, even though their “methods: that is, their behavior and attitudes, may not be acceptable. Your fear and shame about about me parts must be overcome in order for you to heal. These parts like all parts of yourself, need to become part of an internal “team” that collaborate and represent you as the whole person and your own history. And once they do so, you will be surprised at what tremendous help they will be to you.

    Fight Parts

    Some angry parts are stuck in a fight defense against threat. They have the explicit function of protecting the individual by means of fight responses, either toward other people or towards parts inside that in some way evoke a sense of threat. Fight parts often believe that they are strong, have not been hurt, and are capable of carrying out strong aggressive reactions to perceived threat or disrespectful behavior. Often they view themselves as a tough child or teenager or a large strong man.

    Ashamed Parts
    Shame is a major emotion that maintains dissociation. Some parts of the personality are especially avoided and reviled because they hold experiences, feelings,or behaviors that you, or some part of you have labelled as shameful or disgusting. You will need to be especially empathetic and accepting toward these parts of yourself.

    A central problem for people who have a dissociative disorder is that parts of the personality avoid each other and their painful memories and experiences, or they tend to have strong conflicts with each other. In the literature this has been described as phobia of dissociative parts. Parts typically feel fearful, ashamed, or repulsed by other parts. In particular dissociative parts that function in daily life want as little as possible to do with dissociative parts that are fixed in traumatic experiences. Parts stuck in trauma-time often feel abandoned and neglected by the parts that try to move on without them in daily life.

    These ongoing inner conflicts can be painful.and frightening, and they cost a person with a dissociative disorder a tremendous amount of energy. As we said before, all parts need to learn to accept and cooperate with each other. After all, in order to adapt and be our best, we must learn to accept ourselves and all our aspects. Only in acknowledgment sand accepting are we able to make positive changes in ourselves.

    However we are aware that getting to know yourself and working more cooperatively internally can be a long difficult process. you cannot expect yourself to immediately function differently when parts have spent a lifetime avoiding each other or. Wing in conflict. lease remember that you will need much patience and self acceptance in this work and go at your own pace. Remember to be empathic and accepting of yourself as awhile person.

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  6. Stuck parts explains how we feel conflicted at times. many of these battles are at the subconscious level.

    Also we can have stuck emotions. Anger scared me ecause I was not allowed to ever express mine as a kid.

    Explains many things and the book is a must for complex PTSD people.

    Dissociation is like DID sort of personalities, we do not split but parts fight and are still child like.

    I will pull up the series I did on this.

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  7. “Some dissociative parts of the personality, living in trauma time, may experience the same emotion no matter the situation, such as fear, rage, shame, sadness, yearning and even some positive ones just as joy.
    *
     Other parts have a broader range of feeling.  Because emotions are often held in certain parts of the personality, different parts can have highly contradictory perceptions, emotions, and reactions to the same situation.”
    *
    This explains many feelings, emotions, and doubts about the unknown haunting us at times.
    *
    Awareness and discovering the inner world may help, tremendously.


    Negative core beliefs:
    Chronically traumatized people often suffer from persistent core beliefs.  These are deeply rooted convictions that typically involve all-or-nothing thinking without balance or nuance.
    *
    “Things never work out for me,” “People always try to hurt me,” I am completely stupid and unlovable,” or ” There is no safe place.”.
    *
    These beliefs often contain words like always, never, or none.  Such thoughts and beliefs can profoundly influence, reinforce, and intensify negative emotions.
    *
    Negative core beliefs are reinforced over time by negative emotions, perception, and predictions, and by additional negative life experiences.
    *
    The same is true for positive core beliefs and attendant receptions, emotions, and experiences.

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  8. http://ptsdawayout.com/2012/05/21/dissociation-and-feedback-loops-coping-with-trauma-realted-dissociation/

    http://ptsdawayout.com/2011/09/19/more-symptoms-alterations-in-regulation-of-affect-emotion-and-impulses/

    http://ptsdawayout.com/2011/09/19/more-symptoms-changes-in-relationship-with-others/

    http://ptsdawayout.com/2011/09/19/c-ptsd-somatic-physical-symptoms/

    From the book Coping with Trauma-Related Dissociation: Skills Training for Patients and Therapists by Suzette Boon, Kathy Steele, Onno van der Hart:
    These ongoing inner conflicts can be painful, and frightening, and they cost a person with a dissociative disorder a tremendous amount of energy. As we said before, all parts need to learn to accept and cooperate with each other. After all, in order to adapt and be our best, we must learn to accept ourselves and all our aspects. Only in acknowledgment and accepting are we able to make positive changes in ourselves.
    However we are aware that getting to know yourself and working more cooperatively internally can be a long difficult process. You cannot expect yourself to immediately function differently when parts have spent a lifetime avoiding each other or. Wing in conflict. Please remember that you will need much patience and self acceptance in this work and go at your own pace. Remember to be empathic and accepting of yourself as a whole person.

    Amy. On the right under Coping with Trauma Related Dissociation, all these posts from this book are filed. I highly recommend this book.

    Marty

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  9. One more

    From the book Coping with Trauma-Related Dissociation: Skills Training for Patients and Therapists by Kathy Steele and Onno van der Hart:
    People with complex dissociative disorder were often confronted as children with situations that evoke extreme and overwhelming emotions. Generally younger children learn from their caregivers how to understand and regulate emotions.  People with dissociative disorder often grew up in families in which it was not acceptable to show or discuss certain emotions.
    In some cases it was actually dangerous to express feelings, resulting in punishment, ridicule or complete disregard.  Parents or caregivers of people with complex dissociative disorder typically had a problem with emotions themselves and were thus unable to teach children adaptive and healthy skills to deal with emotions.  These children learn to avoid or disregard their own feelings.  They also have difficulty reflecting, that is, accurate reading other people’s emotions and intentions in the present, generally assuming something negative rather than positive.

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  10. Now consider when a trigger explodes this is what we face.

    “Freedom From Fear” by Peyton Quinn. 
    1. Tunnel Vision: One’s field of vision narrows and tunnels into the perceived threat.
    2.Auditory Exclusion: The hearing tends to shut off.
    3. Loss of fine motor skills: Often only gross motor functions are possible under the adrenal state.
    4. Tai-chi-Psyche:  Everything seems to move in slow motion.
    5. Increased heart rate, blood pressure and respiration.
    This is the environment PTSD places us when we are triggered.  Our skills have deteriorated along with our ability to respond to a delusion threat.  This is why we have a daily practice, so we can stay present and observe this phenomena correctly.

    So as our stuck parts battle, some avoid some confront and we feel conflicted.

    this is why mindfulness works. Focus on the breath can withstand the fear around the trigger event. Develop the ability to stay present when the trigger explodes and our stuck parts integrate to present. not all at once but gradually with daily practice. Worked for me and others.

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  11. I’ve been doing a lot of projecting lately since I’ve cut the junk food out of my life (I’m alcoholic, a junk-foodaholic, bipolar, with complex-PTSD from severe child abuse, and a Christian. We are very similar. Have you ever dealt with this aspect of mental illness? Projecting? It makes me feel like I’m in a day mare that I can’t get free of. Like I’m living in the twilight zone. It could be flash-backing but I think it’s more than that. It’ mixing up the present with the past in a horrible mixture of guck.

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