- Moderator
- #25
Sideways
VIP Member
Couple of things:
There’s not really any “subtle” criteria A trauma that might give rise to ptsd. Your wife threatening you with a knife, for example? Is a criteria A trauma. There’s nothing subtle about experiencing someone threatening you with a kitchen knife.
Complex PTSD is not a ‘subtle’ form of ptsd. It’s the opposite: PTSD + additional symptoms that arise out of repeated exposure to criteria A trauma.
So, to have complex PTSD, you get diagnosed with PTSD. Then, as the therapy process runs its course and it becomes apparent that (a) you were repeatedly exposed to a criteria A trauma, AND (b) you have additional symptoms, on top of meeting the ptsd diagnostic criteria, which point to complex ptsd, then your T might start looking at complex PTSD as being in the picture.
It absolutely sounds like you’ve had a rough life, and it makes perfect sense to me that you’re now struggling with mental health issues, and that is causing a level of suffering for you that absolutely warrants treatment.
If someone qualified to make a diagnosis has told you “This isn’t ptsd”, then the answer likely lies elsewhere. Loads of mental illnesses are caused by traumatic experiences and extended periods of suffering and distress. They are no more or less than, in any way, to having ptsd. Ptsd isn’t worse, or more legitimate. Just different.
Proper diagnosis is important for your clinician. With PTSD, we know that Criteria A, which sets out the forms of trauma that can give rise to ptsd is important, because criteria A trauma can sometimes impact the way your amygdala functions, and the number of times your amygdala gets activated by your hypothalamus. When someone gets diagnosed with ptsd, it’s because the traumatic experience has impacted your brain function in that specific way.
With other mental illnesses, such as Anxiety, mood disorders, or adjustment disorders, different things are going wrong with the brain, which informs heaps of stuff from appropriate adjunct therapies like emdr, dbt or cbt, as well as the type of medications that are best to trial.
Psychological abuse is hell on earth. It very often gives rise to mental health issues, and clinical forms of mental illness. But, you’d know from your own experience that there’s something different about experiencing chronic psychological abuse, and the moment when someone threatens to kill you with a knife. When things have calmed down, you can reflect that the psychological abuse, and being threatened with a knife, are different. Your brain thinks so too.
With psychological abuse, higher functioning parts of your brain, rather than your amygdala (which is leftovers of the most primitive part of the brain), are being traumatised and damaged. So the consequent mental illness from chronic psychological abuse is different. Different parts of the brain have been damaged, and that will inform the way your T approaches treatment. Dealing with, and emotionally processing that psychological abuse? Will usually be part of your treatment, because it’s still the root cause of the mental illness. Even when the resulting diagnosis is something other than ptsd.
So, correct diagnosis is relevant to your T because it helps inform the specific way that your mental illness is causing your brain to function differently. It is not the case that Trauma + mental illness = PTSD.
And if it’s not PTSD, then it’s not complex ptsd (in the same way that it’s not chronic ptsd, or combat ptsd, or developmental ptsd, etc).
It’s common to have something other than ptsd (like anxiety) but also relate to the symptoms described by complex ptsd. Complex ptsd doesn’t have a monopoly on those symptoms. For example, someone suffering an anxiety disorder from chronic psychological abuse? Will very often have a diminished self concept, or believe that their abuser was always right about everything. That’s common. Those symptoms are common to lots of mental illnesses. But it remains true that, not matter how well complex ptsd might describe your internal experience, without ptsd, you don’t have complex ptsd either.
But, that’s not to say you haven’t suffered serious trauma. Or that your consequent mental health symptoms aren’t directly caused by your traumatic past. Or that what you’re going through is less than, or less legitimate than someone with ptsd. It just means that trauma has impacted your brain in a different way.
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