Complex trauma or developmental trauma

[Deleted member 38906]

Does anyone get fixated on their diagnosis in therapy?
My T says I have developmental trauma and that kind of bummed me out. I thought I had complex trauma but he says complex trauma is developmental trauma PLUS PTSD and that ppl with complex trauma have a lot of parts. This makes me feel really empty and numb and mad at myself to the point where I think I should hurt myself to punish myself. I feel like I need to have a worse diagnosis to explain things and I feel like I should be punished for thinking I have complex trauma when I don't. This means that things weren't bad enough and I'm just a whiney brat complaining about every little negative thing in my life.

 

[joeylittle]

he says complex trauma is developmental trauma PLUS PTSD and that ppl with complex trauma have a lot of parts.

Hmmm. That doesn't sound quite right; but it's possible you and he weren't communicating clearly. I'd definitely talk with him more about his use of terms.

"Developmental" refers to the age you were when the trauma occurred, and implies that it was recurrent. As I understand it, developmental trauma is one kind of complex trauma. Complex trauma doesn't automatically mean your diagnosis is CPTSD; you can have complex trauma and PTSD. CPTSD isn't integrated into any of the diagnostic manuals yet; it will first come out in the ICD 11, and there are draft versions of the full diagnostic criteria.

(Anyone, please, correct me if I'm behind the times on this info)

Parts are a separate diagnosis; that's related to the spectrum of dissociative disorders. You can have dissociative disorder-like symptoms while having C/PTSD (either/or), or you can have fully integrated "parts" under the theory of structural dissociation (not a diagnosis, a phenomenon) - neither of those is the same as having dissociative identity disorder, with the presence of at least two identifiable and distinct "alter" personalities.

Developmental trauma is connected to a number of different disorders.

 

[Deleted member 38906]

Developmental trauma is connected to a number of different disorders.

It is? What are those disorders?

 

[EveHarrington]

Was he saying you don't have PTSD?

 

[Deleted member 38906]

Was he saying you don't have PTSD?

I think so...cause he said you haven't described anything traumatic to me yet... I've mostly only told him about emotional abuse/neglect and not being seen or heard during childhood.

 

[Sideways]

This makes me feel really empty and numb and mad at myself to the point where I think I should hurt myself to punish myself.

This is the part that concerns me.

So recently, you’ve had the review issue which caused feelings of fairly extreme anger and guilt simultaneously. The feelings you’re describing here seem similarly excessive (your level of suffering isn’t dependent on your diagnosis, nor is the validity of your suffering dependent on your diagnosis).

It’s going to be very easy to start getting caught up in trying to interpret what your T was saying, when simply asking him to explain again, at your next appointment? Is probably the most effective way to find out what your T was trying to say.

What happens in the meantime with your emotions? Do you engage with these very extreme emotions and the feeling that you need to be punished for your diagnosis? Or, maybe this is a good opportunity to recognise “These emotions are getting out of control again” and break out the management techniques that ended up helping you the last time??

 

[Friday]

I would say that either you misunderstood what your therapist said, or your therapist is an idiot.

I have complex trauma in spades. None of it is developmental trauma, nor do I have parts. That doesn't somehow erase my trauma history... Which is complicated. IE Complex.

- Complex trauma also isn't a diagnosis. It's a fast way of saying several different trauma types over -typically- a fairly long period of time..... Or .....The same trauma type repeated for so long, over so many different phases of life in myriad situations/scenarios, that it takes on the character of many different trauma types.

Spoiler: trauma type examples / not a complete list by a long shot

abuse, abduction, armed robbery, assault, attempted murder, bombing, child abuse, climbing accident, combat, domestic violence, fire, gang violence, home invasion, kidnapping, motor vehicle accident (trains, planes, automobiles, helicopters, boats, bikes, etc.), murder, piracy, plague, natural disaster, rape, slavery, suicide, suicide bomber, terror attack, torture, trafficking... Et cetera etc etc.

- Developmental trauma? Similar. A fast way of saying 1 or more traumas that occurred during early childhood development, and fundamentally altered the way that development happened.

@joeylittle My understanding is that developmental trauma is often complex trauma, just by nature of the beast (sorta like combat), but not always; as a single trauma can affect development to the degree of causing either asynchronous development (on the lower end of the spectrum) all the way up to severe developmental disorders (on the far end of the spectrum) with PTSD falling somewhere in the middle range. There's some chicken & the egg stuff with developmental disorders, as to where the trauma caused or merely exacerbated, that I've listened to people debate endlessly. I'm including them, just because exacerbated is enough in my book to nod to the trauma at least... And developmental psych is soooooo soft.

- Severity is another factor that's not really linked to Diagnosis of PTSD vs CPTSD. This is going to take some space, but maybe it will help clarify a smidge.

Spoiler: Severity & Diagnosis

> Single Trauma - Severe PTSD
> Single Trauma - Moderate PTSD
> Single Trauma - Mild PTSD
> Single Trauma - * No PTSD

> Multiple Trauma - Severe PTSD
> Multiple Trauma - Moderate PTSD
> Multiple Trauma - Mild PTSD
> Multiple Trauma - * No PTSD

> Complex Trauma - Mild PTSD
> Complex Trauma - Moderate PTSD
> Complex Trauma - Severe PTSD
> Complex Trauma - * No PTSD

> Complex Trauma - Mild cPTSD
> Complex Trauma - Moderate cPTSD
> Complex Trauma - Severe cPTSD
> Complext Trauma - * No cPTSD


* No PTSD doesn't mean that they're 100% fine, although it's possible. They could have a whole host of other disorders (caused by, or made worse by trauma)... They just don't also have PTSD on top of whatever else they have. Take 10 people, put them through the exact same thing, and you can very easily have 10 different diagnoses.

 

[Deleted member 38906]

I would say that either you misunderstood what your therapist said, or your therapist is an idiot.

I ha...

So what's the difference between CPTSD and complex trauma? And what are developmental disorders?

This is the part that concerns me.

So recently, you’ve had the review issue which caused feel...

i think what happens is that i blend with my emotions and feel really overwhelmed. shortly after the session i felt very self destructive and wanted to do something risky. ive tried using my 'management skills' which includes talking to people about it on hotlines and writing about it but nothing's really worked all that well. i think knowing that i wont see my T for another two weeks (on vacation) to ask him to explain things exacerbates my feelings. all ive been thinking about is climbing a crane. ive been resisting this urge hard but today i finally gave up and climbed up the side of a bridge instead. i have this burning need for risk and danger that i cant seem to shake off. maybe i should go apply to work at a circus or something..i know cirque du soleil is touring and maybe hiring at the moment.

 

[Friday]

So what's the difference between CPTSD and complex trauma?

Complex trauma = what happened.
CPTSD = One possible result of what happened.

And what are developmental disorders?

There are a couple different categories of them.
1 - Learning disorders, language disorders, motor disorders, processing disorders.<<< This is a HUGE list of dozens of individual disorders & conditions. = Mostly what people mean when they say developmental disorders // Most narrow definition

Also sometimes included if the definition is opened up
2 - Neurodevelopmental Disorders (from Autism & ADHD & Tourettes; to TBI, FAS, etc.)
3 - Personality Disorders / Axis Disorders (which usually begin in early childhood... But they have to be enduring and persistent through to adulthood... And are nowhere near as stable as other disorders that present in childhood. Kids brains are super plastic/malleable, and symptoms of personality disorders in adults actually equal normal stages of development for kids, so this is one of those things that can really only be looked back on as seeing certain stages of development either didn't go away, or never happened.)

 

[Deleted member 38906]

Complex trauma = what happened.
CPTSD = One possible result of what happened.

got it. im pretty sure i didnt misunderstand my T. he said complex trauma involves more parts. if he doesnt know the difference, how can i possibly continue to see him? my logical mind says you could still benefit from seeing him bc he has trained under attachment and trauma experts (janina fisher/ diana fosha etc) but the black & white mind says drop him because his definitions are wrong and there he cannot be trusted.

 

[Friday]

my logical mind says you could still benefit from seeing him bc he has trained under attachment and trauma experts (janina fisher/ diana fosha etc) but the black & white mind says drop him because his definitions are wrong and there he cannot be trusted.

I would personally talk with him, before making any kind of decision.

It's a lot easier to misunderstand, or misspeak, when talking face to face... Especially in an emotionally charged environment... Than it is to be able to write things down & refer back.

Just as an example? We've all sort of assumed that he meant parts-parts (dissociative disorder style) from what you wrote, but read another way? Complex trauma involves more parts, could just as easily refer to there needing to be different kinds of trauma / different parts of their trauma history... And is a completely different statement than people with complex trauma have lots of parts.

So did he mean that
- complex trauma involves lots of different pieces / different traumas?
- people with complex trauma have 'parts' ?

The only way to know is to ask him.

 

[Sideways]

but the black & white mind says drop him because his definitions are wrong and there he cannot be trusted

Seems more than black/white thinking here. If he’s done that kind of training, it seems more likely that you may have misunderstood, than he doesn’t have a clue. And how trust came into it at all I’m not sure.

Over-analysing a short sentence drove you sharply downhill with the review issue. Doing that again? With a T that sounds qualified? To me, there’s self-sabotage going on here perhaps.

The analysis of the words he used seems to be damaging, rather than helpful. We are now down to analysing what he meant by the word “parts”. I can’t see how that’s helpful, when the only way to actually know what he meant is to simply ask him. Everything else here is mere conjecture and seems to be sending you downhill rather than helping...