All the C-words getting stuck in front of PTSD......

[Freddyt]

So this came from another thread i didn't want to take off topic for the OP.

Soooooo many C-words!

Childhood
Combat
Chronic
Complex

Silly question but - do we make it more confusing because we like using the "cptsd" label rather than the clinical DSM 5 descriptors of our traumas?

I used to repair some pretty complex equipment for a living and you had to understand how the machine worked to understand the manual to understand what was wrong when it broke. And when it broke you never really fixed it until you understood why it broke. I would think the same applies to "fixing" ptsd, that until you understand how the damage was done it's difficult to fix it......

In other words, the DSM 5 descriptor should be more important then the words we stick in front of PTSD - no?

 

[Charbella]

In other words, the DSM 5 descriptor should be more important then the words we stick in front of PTSD - no?

That’s interesting.

I’d say the problem with the analogy is that there’s no fixing us, there’s learning to live with all those descriptors in a way that makes them move to the background instead of consume us. But also with the analogy, yes. If we don’t understand the system that created the mess we can’t understand how to make it less of a mess. It’s why part of therapy is educating us. If we don’t understand that triggers are caused because of trauma then getting the trigger to calm is nearly impossible. If all we do is fight to stop the flashbacks instead of understanding them, they seem more frequent.

Personally I think all the CPTSD diagnosis did was open up those who diagnose us to throw people into a bucket because our childhoods weren’t perfect instead of understanding what caused our cluster of symptoms to give an actual diagnosis.

 

[arfie]

i respect the human authorities and their willingness to officiate such disputes, but my healing doesn't happen inside any book or webpage. sadly. it strongly appeals science training to find definitive answers in a single location, but i don't often get to do that with my tech toys, much less nature's gifts/curses.

when i slide into healing mode, i keep it personal and focus on the person in front of me. i go with whatever my sib-in-healing calls ^it^. i leave the officiating to the officials. i don't keep a copy of the DSM on my bookshelf. one name for ^it^ is as good as another.

every case of ptsd is unique, regardless of what the authors of whatever official document imply.

 

[Freddyt]

Where I would have a problem is in changing practitioners.

They don't share notes as their notes are specific to themselves and how they work. BUT given the correct general and specific diagnoses, by DSM they could have a good idea of your trauma history before you open your mouth to tell them.

I would think that in many cases where you can't speak for yourself that could do a lot of speaking for you, as well as giving someone information they need without the specific personal information.

 

[Friday]

I have PTSD.
I have complex trauma.

On that? “Everyone” agrees.
As there is zero difference in treatment?
That’s all I care about.
Okay! Dealing with PTSD & Complex trauma. Check check! Let’s sort this shit!

 

[Freida]

My t explained like this...
PTSD - something happens and you need help processing it by seeing a trauma therapist because it has stayed stuck in your "today" brain. It might be multiple events of the same thing, but at the core it's one trauma that you need help with processing and learning coping skills for how to live with the damage it causes to your life.

Complex ptsd - something happened, then something else totally different happened, then another totally different thing happened, and so on. It's complex because there is not one "core event" that can be worked on. Instead it's an onion that has layer after layer of events that all have to be addressed as their own "thing".

Complex ptsd just means its going to take more time to do that because the events have to first be untangled from each other, then treated as individual events. So while someone with ptsd may recover in six months, someone with complex ptsd might take six years.

Combat ptsd -- something happened in combat so the VA will cover the costs of treatement

Chronic ptsd - the treatement may take a long time to succeed because it's a condition that continues longer than a "typical incident of ptsd."

The treatment for all of them is basically the same no matter how you got the ptsd - move the bad from "today" brain to "yesterday brain" and develop coping mechanisms for day to day life while you do it.

Basically the addition of the "C" to PTSD gets insurance companies to keep paying for treatment and that's a huge deal here in the US where medical care is a for-profit cluster. If the therapist can give a diagnosis that implies a lengthy recovery time up front they can usually get insurance to cover it. Which is really kind of sad.

 

[Sideways]

In other words, the DSM 5 descriptor should be more important then the words we stick in front of PTSD - no?

The descriptions are incredible important. Not enough ‘therapists’ are actually aware of all the important nuances that go along with the condition, and instead rely very heavily on simplified dot point over-views.

I would think the same applies to "fixing" ptsd, that until you understand how the damage was done it's difficult to fix it......

Yes.

An analogy: the radiator hose blows off while you’re driving, and the car overheats. You have to fix it to keep driving.

Understanding this problem in its simplest form, you’ll lift the hood, and reconnect the hose. And very likely, for a few minutes, you’ll get back in the car feeling like a bit of a mechanical whiz.

But, with even a modicum of understanding about how that radiator actually works, and what’s happened to it with the hose blowing off, you’re going to take a slightly different approach. You’ll reconnect the hose, but then you’ll probably do something else - maybe run the engine for a while with the radiator cap off to get the air out of the system before trying to drive off.

It will take a bit longer, but it will be the difference between driving away successfully, and driving away and having the car overheat again 2 minutes down the road.

There’s noteable differences between ptsd and its variants, which are very relevant to likely success of treatment.

Chronic ptsd: simplified, ptsd that doesn’t seem to want to heal in the usual timeframe. Over 10% of the population will get ptsd at some point in the life, but most will recover in months. So, the person with chronic ptsd has something more complicated going on, and is at greater risk of other specific complications - around here, we’ll often see that as more pathological forms of depression and anxiety, but physical health will also likely suffer.

Combat ptsd: treatment specifically targeted at combat veterans with ptsd is more effective, both in terms of recovery times, and overall success. It can be treated with the usual treatment modalities, but the success of that treatment drops away sharply if its not being approached with an understanding of the nuance of how that specific kind of trauma plays out on individuals, and the types of psychosocial issues that are most often going to piggyback on that form of ptsd. It’s even more important in terms of even just getting sufferers through the door - there’s much less chance of a sufferer with combat ptsd seeking out mainstream treatment without any kind nuanced support.

Complex ptsd: we’re still very much in the infancy of understanding this condition. Unlike ptsd, which has a good recover rate in the general population, complex ptsd has a pretty appalling recovery rate. Physiological changes are significant - the incidence of particular kinds of physical illness that accompanies the complex version start rocketing off the charts. Suicide rates are (easily) 4 times higher than that of general population, and safety planning is less effective. There are significant alterations to the concept of self and, particularly if it’s developmental trauma, significant differences in the size and functioning of key areas of the brain. The response to stressful stimulus also becomes more complicated - whereas with straight ptsd, you can almost set you clock by the hyperactive amygdala, complex ptsd will often do the opposite in response to trauma-related stressors, with emotional blunting and dissociation. The things going on for that person both in their brain, and around their body, is physically different than ptsd. There’s also emerging evidence that the brain of a person with complex ptsd functions differently to the brain of a person with ptsd even when at rest.

We have ‘treatments’ for ptsd which have great results statistically. EMDR and CBT in particular. But the effectiveness of both of these treatments starts to drop away substantially for each of the C variants listed above - combat, chronic and complex. Practitioners with a good understanding of the nuances of those specific variants are going to be better skilled at adapting their therapeutic approach in order to boost the chances of success for their patient.

 

[Freddyt]

Complex ptsd: we’re still very much in the infancy of understanding this condition. Unlike ptsd, which has a good recover rate in the general population, complex ptsd has a pretty appalling recovery rate. Physiological changes are significant - the incidence of particular kinds of physical illness that accompanies the complex version start rocketing off the charts. Suicide rates are (easily) 4 times higher than that of general population, and safety planning is less effective.

......and if you have it prepare to hear the question "how are you sill alive?" from almost every mental health professional that helps you............

 

[KayW]

Silly question but - do we make it more confusing because we like using the "cptsd" label rather than the clinical DSM 5 descriptors of our traumas?

Diagnosis can be useful to communicate a set of symptoms that people with PTSD share.

In my case, I experienced complex trauma and can see now how that affected me before PTSD. But I didn't have symptoms of PTSD until I was in my 30s. So effects of complex trauma and PTSD are 2 separate things in my mind.

It was helpful to understand PTSD symptoms when I first experienced them, but now it's more helpful for me to look more at the effect of trauma on how I developed and how that effects my life.

The effects of multiple different trauma is complex. I think diagnostic criteria becomes confusing when we try to use it to explain trauma because it doesn't. It's just a cluster of symptoms that some people that have experienced trauma might get.

 

[Freddyt]

In my case, I experienced complex trauma and can see now how that affected me before PTSD. But I didn't have symptoms of PTSD until I was in my 30s. So effects of complex trauma and PTSD are 2 separate things in my mind.

i found that for me - despite having a "ptsd crises" 45 years after the fact that the tracks it left across my life were there all along. In my early 30's I developed a chronic illness and a lot of the symptoms are the same between the two. So that got blamed up to the point it was obvious there was something else wrong.

 

[Freida]

......and if you have it prepare to hear the question "how are you sill alive?" from almost every mental health professional that helps you............

and to be utterly baffled by why they are asking that question!

 

[jimbo029]

So this came from another thread i didn't want to take off topic for the OP.

Silly question but - do we make it more confusing because we like using the "cptsd" label rather than the clinical DSM 5 descriptors of our traumas?

I used to repair some pretty complex equipment for a living and you had to understand how the machine worked to understand the manual to understand what was wrong when it broke. And when it broke you never really fixed it until you understood why it broke. I would think the same applies to "fixing" ptsd, that until you understand how the damage was done it's difficult to fix it......

In other words, the DSM 5 descriptor should be more important then the words we stick in front of PTSD - no?

Oh it's clear how and when the damage was done to me. Extreme emotional and physical abuse as a child over a long period of time. DSM 5 does not recognize CPTSD but I would bet the next DSM will, as it's a relatively new "diagnosis". From my research, PTSD can be caused by 1 event, a car crash that left you hospitalized for example. CPTSD is trauma that is inflicted repeatedly over a period of time, especially childhood and the abuse usually comes from a parent or relative. I won't go into the details but my abuse began at age 7 and continued until I graduated high school and moved out. Daily trauma. This has led to a life of difficulty with relationships, difficulty holding jobs, a bitter divorce, alienation from former friends and a realization that I have to live like this the rest of my life. Although I'm on Zoloft, my brain will never recover because all the stress during my formative years affected the development of my amygdala, prefrontal cortex and hippocampus. So I live day to day. Nasty disorder. Wish I was never born.