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

[Ecdysis]

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.

Thank you for this information... I have complex PTSD from childhood and whenever I read the statistic/ fact that "PTSD has really good recovery rates" I feel like an idiot/ failure for not recovering "well/ quickly enough", so this makes a lot more sense to me now.

 

[sidptitala]

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

This is the huge benefit I've seen of being diagnosed. Not having to tell a long and sad story over and over and hope the person knows enough about trauma to intuit how that might be affecting you.

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.

Yeah, same for me. I had childhood trauma and then at 20 got hit with a traumatic event that was more of a one time incident. Got hit with several more events and got diagnosed at 30 with PTSD based on those events.

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.

I'm at the point now where I'm really getting a handle on the 'single event' symptoms and moving into the 'how did I end up so predisposed to process events in this way and what can I do about it?' phase

For me, I'm really perceiving a difference in how PTSD and CPTSD are treated. One is that the respect mental health practitioners treat you with when you are seeing them for PTSD stuns me, in my experience. I think there's a perception that CPTSD is harder to treat/relates to inherent personality factors/is somehow 'smaller/less significant' than PTSD. There's a stigma attached to CPTSD that isn't there for PTSD. One factor in this I think is that some people use CPTSD it to describe the cumulative effect of events that would not meet the criteria of being disasters you could get diagnosed with PTSD from, leading to a perception of exaggeration. And others use the acronym to describe repeated occurrances of those disasters. I've met mental health professionals whose opinion of working with me has gone from 'we can fix this' to 'ugh' upon finding the layer of childhood trauma anchoring my war PTSD.

I have a (maybe controversial) thought about why this might be. A lot of PTSD treatments are shortcuts to rationalize injustice. Convince the person that a bomb was planted by those bad terrorists and the good citizens will be protected by the good government/army/police if only they follow the rules? Many privileged people are predisposed to think this way and it's easy enough to convince them of this because they already think it. It is not however, true or fair and does not force the person with PTSD to take injustice seriously. But CPTSD almost always involves being subjected to a serious injustice, whether its abuse, imprisonment, genocide etc or more than one of these things. It's harder to treat because it requires more of the world (measures to end abuse, imprisonment, genocide) and requires at its core a recognition than the injustice is real.

 

[Friday]

Thank you for this information... I have complex PTSD from childhood and whenever I read the statistic/ fact that "PTSD has really good recovery rates" I feel like an idiot/ failure for not recovering "well/ quickly enough", so this makes a lot more sense to me now.

4-6% DO NOT recover. Those are still amaaaaaaaazing stats. But? It’s not like assholes, idiots, & c*nts make up the 8-6% who still suffer symptoms. That’s a good people good things, bad people bad things, core belief. Rather than reality. Where ANYONE can be on the narrow edge of the statistic.

 

[beaneeboo]

I have a very basic understanding of this topic (really interesting thread btw). So please don't read too much into what I say - just thinking out loud. And I may be waaaaay off.

But I've come to think of the broad difference between PTSD and CPTSD in terms of developmental identity trauma. One occurs generally more outside of (separate from) the development of your sense of identity and who you are (PTSD) and one directly impacts (for worse) / changes the development of your identity, and your understanding of who you are (CPTSD). As in, CPTSD literally warps your self perception of your identity and who you are (negatively). It's not that i think that PTSD couldn't impact your identity and your sense of self, but maybe it's less likely to change the course of how it develops over all? Or there may be a definite change from 'I used to be this, then the trauma happened and now I'm this' i.e. there was a clear understanding of who you were at some point. PTSD could have you feeling like you've lost yourself temporarily (or for longer), whereas CPTSD could make you feel like you never knew who you were in the first place, and you don't feel real to begin with. That it was always difficult to define yourself.

I guess maybe the type of trauma maybe makes a difference too? Repested shame-inducing traumas when you're young can essentially alter the course of who you believe yourself to be (e.g 'bad' / 'not worthy') which then goes on to effect how you interact with yourself and others your whole life. This is more in line with CPTSD. Compare that to someone who experiences a horrific car crash, and if shame comes from that it likely won't impact on that person's sense of over all identity and who they are as much.

This is a really complex topic! I'm not explaining myself well - just my opinion and I may be wrong!

 

[Friday]

But I've come to think of the broad difference between PTSD and CPTSD in terms of developmental identity trauma.

Nope. It’s more common in combat vets than victims of child abuse.

Which is a gold star special TO you, rather than dimishing. Most child abusers? Simply repeat the same thing over and over. Yours? We’re, apparently, creative -or- were just the start of things to come.

As in, CPTSD literally warps your self perception of your identity and who you are (negatively). It's not that i think that PTSD couldn't impact your identity and your sense of self, but maybe it's less likely to change the course of how it develops over all?

Yep. Again. Though. Having a sense of identity to be destroyed = more destructive than an evolving sense of identity, adapting to a new hell.

I guess maybe the type of trauma maybe makes a difference too?

Absolutely.

Repested shame-inducing traumas when you're young can essentially alter the course of who you believe yourself to be (e.g 'bad' / 'not worthy') which then goes on to effect how you interact with yourself and others your whole life. This is more in line with CPTSD

Contrast that with someone. Like a POW / Torture Survivor/ Combat Vet who has had their identity complex shattered. Rather than an idea of themselves like an MVA victim who “thinks” they would do XYZ, but finds themselves doing ABC. 1 point of cognitive dissonance versus 10’s of thousands of points of cognitive dissonance.

Would you ever rape someone?
Would you rape someone to save your own life?
Would you rape someone to save their life?
Would you rape someone to save their life & 10 others?
Would you rape someone to save your life AND 10 others from being raped?
Would you rape someone to save 10 people from being raped. And 1,000 people’s lives?

^^^ Is this all imaginary / what you HOPE you would do, or is it something you have actually done??? And the decisions you live with??? ^^^

Most survivors of torture have been faced with these questions, and answered in action. As adults. Not children. Not developmental trauma. Not what ifs, but reality. Complex as hell, no?

 

[beaneeboo]

Nope. It’s more common in combat vets than victims of child abuse.

Which is a gold star special TO you, rather than dimishing. Most child abusers? Simply repeat the same thing over and over. Yours? We’re, apparently, creative -or- were just the start of things to come.


Yep. Again. Though. Having a sense of identity to be destroyed = more destructive than an evolving sense of identity, adapting to a new hell.


Absolutely.


Contrast that with someone. Like a POW / Torture Survivor/ Combat Vet who has had their identity complex shattered. Rather than an idea of themselves like an MVA victim who “thinks” they would do XYZ, but finds themselves doing ABC. 1 point of cognitive dissonance versus 10’s of thousands of points of cognitive dissonance.

Would you ever rape someone?
Would you rape someone to save your own life?
Would you rape someone to save their life?
Would you rape someone to save their life & 10 others?
Would you rape someone to save your life AND 10 others from being raped?
Would you rape someone to save 10 people from being raped. And 1,000 people’s lives?

^^^ Is this all imaginary / what you HOPE you would do, or is it something you have actually done??? And the decisions you live with??? ^^^

Most survivors of torture have been faced with these questions, and answered in action. As adults. Not children. Not developmental trauma. Not what ifs, but reality. Complex as hell, no?

So interesting.... and sooo complex .. it's just all such a head f*ck ...

So I guess what we're saying is, all trauma has the capacity to change the person's identity on some level... whether that be never allowing it to develop healthily in the first place, or by breaking it even if it was a healthy identity in the first place

 

[KayW]

I'm at the point now where I'm really getting a handle on the 'single event' symptoms and moving into the 'how did I end up so predisposed to process events in this way and what can I do about it?' phase

Yes and I think what you've said here shows how treatment for single event PTSD and treatment for complex trauma (with or without PTSD) is different.

For me, I'm really perceiving a difference in how PTSD and CPTSD are treated. One is that the respect mental health practitioners treat you with when you are seeing them for PTSD stuns me, in my experience. I think there's a perception that CPTSD is harder to treat/relates to inherent personality factors/is somehow 'smaller/less significant' than PTSD.

I wonder if this could be due to the type of trauma. In society there is a lot of respect for veterans and this could carry forward in to treating PTSD in veterans. I'm not a veteran, my adult traumas have been from relationships and I think there is a lot of victim blaming that exists for my traumas, so I've not experienced the respect that you may have as a combat vet.

 

[Freddyt]

There's a stigma attached to CPTSD that isn't there for PTSD. One factor in this I think is that some people use CPTSD it to describe the cumulative effect of events that would not meet the criteria of being disasters you could get diagnosed with PTSD from

It's a problem in all the world of mental health. Like when someone shows up with their GP's diagnoses of PTSD......which is in no way a diagnoses, its a guess. There lies what I think is the biggest issue with PTSD diagnoses. I see an endocrinologist to manage my chronic illness. I see an opthalmologist for eye care. Why in the world would I accept a mental health diagnoses from anyone but a mental health professional?

And CPTSD.....has a specific subset of factors that cause it, most of which are prolonged events. I was nearly two years into therapy before we got to that point. And lots of people use the complex tag when they have a series of simple traumas - which are mis-diagnosed as complex instead of multiple.

 

[Midnightmoon]

I'm UK based so the ICD 11 does differentiate between the 'complex' part of the diagnosis or not for us getting a label via NHS. I really value the 'C' part of mine, mainly for my own understanding that I'm not cured after a few months of CBT. Acceptance is a long and hard road, but i get a weird level of reassurance that by it's very nature, it wouldn't be called 'complex' if it was so easy and quick to sort out...

What I'm noticing recently though is how for some healthcare professionals the C part seems to be an 'undercover' assumption that it's EUPD with a different name, and the stigma that goes with it. PTSD definitely doesn't have the same reaction. I guess we are a PITA for healthcare as we (usually) are a long term, higher need patient group. If it's not quick, there is a level of frustration and blame placed firmly at the patient for not trying hard enough. Will be interesting to see what happens with the 'C' part over the next few years...

 

[KayW]

@Midnightmoon I'm in the UK also, but was diagnosed long before the CPTSD classification and I dropped out of the NHS system to avoid pd labels and because it would have been another 18 month wait with no better treatment at the end if it.

I'm curious to hear if that C gets any better treatment on the NHS nowadays?

 

[beaneeboo]

.I'm curious to hear if that C gets any better treatment on the NHS nowadays?

Me too.

 

[Midnightmoon]

@Midnightmoon I'm in the UK also, but was diagnosed long before the CPTSD classification and I dropped out of the NHS system to avoid pd labels and because it would have been another 18 month wait with no better treatment at the end if it.

I'm curious to hear if that C gets any better treatment on the NHS nowadays?

I think its still very new to identify amongst MH teams... (Mines about a year old, no previous diagnosis, now looking at DID too- but that's private) Where as PD they almost like to give ANYONE who is a 'problem' to them and doesn't fit in a nice box, bonus points if you're female. I don't have any NHS involvement, mainly because it's my main trauma trigger, but also because like you the waits are so long, for very limited service, it seemed totally pointless. If you fall in the meantime, you end up with a PD label anyway.

What's available on the NHS, virtually nothing...

There is a complex trauma service in some trusts, but they are often an all in one catch all that I'm convinced doesn't really suit anyone, and again, furthers the stigma. Private therapists, I'm unsure if it's 'leaked' through to their thinking yet, but I certainly felt a shift when I was looking recently. The 'C' seems to send people into a panic before you've even finished the sentence.