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Confused About Complex Trauma

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I am very sorry Mercy for what you have been through. That innocent child is a beautiful soul to be nurtured and cared for-it exists in each one of us, sometimes we work so hard to re-connect yet there is always hope.

I suppose the labels and terms are important to me because they help me to communicate with others more effectively. Also, there also seems to be some difference in therapy depending on origination (exposure for fear/anxiety based-not for shame based). I need to understand what I have and how treatment works.
 
Hi brat,

If you're looking for labels, then I can refer to what the mercy had been said as DID(Dissociative identity disorder)

Sometimes doctors misdiagnose Patients as having posttraumatic stress disorder.

In psychological terms "parts" are defined as "ALTER PERSONALITIES". The following information is the short summary from the book( Dialogues With Forgotten Voices: Relational Perspectives On Child Abuse Trauma And The Treatment Of Severe Dissociative Disorders) about the "part" or "ALTER" and SHAME AND SELF-HATE and its functioning in DID.You can be familiar with some aspects of this disorder and what mercy has actually meant.

Putnam (1989) succinctly defines alter personalities as "highly discrete states of consciousness organized around a prevailing affect [and] sense of self (including body image) with a limited repertoire of behaviors and a set of state dependent memories"
Fine (1999) views alter personalities as personified adaptational strategies that may be representations of conflicts, fears, and/or wishes, ultimately representing a traumatized child's desire to not face overwhelming experiences alone.

Children build their alter personalities from the raw materials available to them, but their multiple identities are shaped as they mature by influences in the larger society: DID patients may absorb values, attitudes, and stereotypes from family, race, religion, ethnic and other communities, the media (Kluft, 1994), and even from their own individual histories in the mental health system.

Such a complex dissociative defense as the development of alter personalities is not put into place after one traumatic episode; however, the personality fracturing arising from a single event may create the preconditions—malleability and dislocations in both personality and brain chemistry. The more severe and continuous the trauma, the more challenges to the victim, the more complex the dissociative defenses must become.

Victims end up with too many identities, each and all of which are insufficient to anchor them in time, space, and relationship. Most highly dissociative individuals are quite uncomfortable about being seen switching from one to another and will not acknowledge the process even to therapists until real trust is developed (Kluft, 1994). Many actually generate strategies to mask switching from themselves, including the design of special alters to cover the multiplicity in general and the switching phenomena in particular.

Multiplicity exists on a continuum, and according to Kluft (1988b) the degree of multiplicity experienced by any one individual depends on the amount and severity of the trauma, the degree of dysfunction, the amount and quality
of the internal communication among part-selves, and the degree to which the different alters or "parts" cooperate. Networks of alter personalities can vary greatly in their size, their permeability, and in the way aggression is distributed among them to serve developmental functions, trauma containment, and the self-hatred that keeps much of the system running.

One part-self can have a totally loving, deferential, idealizing bond with a parent and refer to him as "my" father while another calls the same man "the" father or "her" father or a "parental unit" or "that other person who does what the adults want." Some alters may hate that parent and some do not know him at all.

In extreme cases of possession or dissociated will, DID patients report feeling like the passive and obedient instrument of the will of another
Negotiating tangled ownership of responsibility is one of the most difficult aspects of treatment

Types of Alters:
Goulding and Schwartz (1995) organize alters by roles, conceptualizing three groups—exiles, firefighters, and managers.
Exiles contain needs or traumatic memories and embody sensitivity and fears; often child-identified and
frozen in time, they perpetually relive the trauma as if it is happening in the moment.

Firefighters, invested with a "negative specialness" that Briere(1989) calls the power to do bad, are assertive, high-energy, highly a utomatic,controlling parts who relate primarily on the basis of distrust and oneupmanship,
act out impulsively and destructively, identify with the perpetrator, and adopt unwise, expedient protective behaviors

Managers permit the individual to function on a daily basis and maintain a facade of normalcy and unity ; devoted to work and cunningly manipulative, they actualize high ambitions, tend to be hypomanic, obsessive-compulsive, and socially ingratiating, fear psychological work and cannot tolerate intimacy, and kill off spontaneity by distracting, placating, rationalizing, and avoiding
Ross (1997) addresses these phenomena under the umbrella of "host resistance" (p. 276), whereby a conscientious, victimized, and often tearful, pathetic host personality entreats the therapist's help in learning about
him/herself and getting better—but completely decompensates any time other alters speak or reveal memories. Such a host is enacting the collaborator message "not to communicate" and "not to know" entrenched in the pathogenic family system. And when that host covertly reinforces the rapid switching and acting out on the part of his / her alters, Ross (1997) concludes that the problem is not that the alters come out uncontrollably, but that the host decides to let them out, again enacting the dissimulation, avoidance, irresponsibility, and inconsistency that took place throughout childhood. Ross's worst host-resistance scenario occurs when the host purposefully renders false (increasingly horrendous and extravagant) memories to distract from the real work of therapy, such that the more s/he reveals, the less is actually known

And somethings about SHAME AND SELF-HATE
In children, chronic shaming leads to chronic dissociation, and chronic reliance on dissociation inevitably leads victims back to experiencing chronic shame.In severe dissociative disorders, shame is so pervasive that the continuous psychological struggle to repress and dissociate it seriously depletes the patient's life energy.

Chronic humiliation and scorn generate profound feelings of defectiveness, weakness, and unworthiness (Nathanson, 1987), leading eventually to a turnoff of all affects and the erection of an empathic wall against exposure to and being overwhelmed by other people's emotions. (Empathic walls are part of what sustains separations between alter personalities.) Child-abuse survivors, like most oppressed groups, experience the particularly entrenched form of shame that comes out of the prolonged distress of forced helplessness and powerlessness. Victims often hate themselves for their vulnerability (and not their perpetrators), and their self-hatred can become a perverse home-base, one they are reluctant to leave in spite of its suffocating
limitations:" even though they understand at some (entirely separate) intellectual level that they could not have prevented or changed tilings in any way, they feel tremendous shame for their complicity and incapacity to halt the
abuse and end their subjugation. And this shame is profoundly silencing— victims feel complicated allegiance to their victimizers as a function of dynamics ranging from traumatic attachment to mind control.


The compounded shame of the dissociative trauma survivor leads to psychic imprisonment and sense of exile from humanity because it is based on multiple interlocking and overlapping sources. Shame comes from:
• the pain, humiliation, betrayal, and degradation endured during thetrauma;
• the inability to have protected the self and stopped the traumatic event(s) from taking place, the inability to prevent their impact and avoid experiencing loss of control, and (in some cases) the inability to have preempted the abuse of others;
• the coerced violation of your own ethics or moral principles, the betrayal/ violation of others in order to survive;
• the symptoms of posttraumatic stress disorder and the societal response to those symptoms, including psychiatric labels, diagnoses, and misdiagnoses;
• the fragmentation, intrusion, inconsistency, and incompleteness of memories, and the constant challenge to their reality from skeptics in media, academic, medical, and psychotherapeutic settings;
• the feeling of not being like other people, not belonging, and the loss of a sense of kinship with humanity;
• the feeling of being marked, damaged, and transparent—the feeling that others can see right through you and know what you have done or what has been done to you;
• the social stigma of being an abuse survivor and the internalization of
society's contempt, incredulity, and impatience with the vicissitudes
of recovery ("just get over it already"), and the labeling of your therapist
(perhaps the only person you trust) as a quack;
• the internalization of hateful, degrading messages from the perpetrators)
and from society's blame-the-victim/ pull-yourself-up-by-yourown-
bootstraps rhetoric, and the harboring of "dirty" secrets thatcannot be shared;
• the harboring of hateful, vengeful, destructive thoughts (and /or partselves);
• the perversion of your sexuality and the residue of bizarre, unusual,or utterly absent sexual needs and desires;
• the awareness that you welcomed feelings of specialness or actualprivileges conferred by the perpetrator(s);
• the inability to forgive perpetrators in a culture that insists on and romanticizes
forgiveness;
• the vulnerability to experiencing certain normal activities as triggers (e.g., films, holidays, gatherings), such that they cannot be enjoyed;
• the history of self-destructive acting out, and the accrued costs of the effects of trauma in terms of vocational, financial, medical, and interpersonal functioning;
• the chronic out-of-control feelings and the knowledge that other people
do not walk around leaking profound losses, sensitivities, and
vulnerabilities "like someone with a bladder problem—only this one's emotional";
• the psychological and physiological damage that will never heal in spite of your own (and others') best efforts
 
Hi brat, If you're looking for labels, then I can refer to what the mercy had been said as DID(Dissociative identity disorder)

Yes, Mohsen. That's what I have. I understand that people with DID are a bit like the constellations, each with his or her own arrangement of stars.

Children build their alter personalities from the raw materials available to them, but their multiple identities are shaped as they mature by influences in the larger society: DID patients may absorb values, attitudes, and stereotypes from family, race, religion, ethnic and other communities, the media

I remember being an early reader and sitting in a Dr's exam room, bored. There was a print of a scroll on the wall so I decided to try to read the shortest sentence. It was 'Thou shalt do no harm.' I vowed that vow. All the parts vowed it. I knew that it would protect me from becoming like one of them and none of us did! That is my victory. They couldn't make me be like them.

The more severe and continuous the trauma, the more challenges to the victim, the more complex the dissociative defenses must become.

That is true. The forensic psychologist I worked with and I tried to figure out the least likely number of 'guests/ gentleman callers' I could have had over the 10 to 12 years of intermitant captivity. We figured that if I was available for 1/2 the year and rented out only 1/2 of that time and had only one guest a day( not always the case) it came to 90 occasions a year. Since this organization was highly structured it wasn't too hard to learn the different roles they sold me for.

Most highly dissociative individuals are quite uncomfortable about being seen switching from one to another

This is very true. It feels like some kind of self betrayal to be found out.

Multiplicity exists on a continuum, and according to Kluft (1988b) the degree of multiplicity experienced by any one individual depends on the amount and severity of the trauma.

This is true too. This whole posting is clear and well thought out. Thank you.

Types of Alters:
Goulding and Schwartz (1995) organize alters by roles, conceptualizing three groups—exiles, firefighters, and managers.
Exiles contain needs or traumatic memories and embody sensitivity and fears; often child-identified and
frozen in time, they perpetually relive the trauma as if it is happening in the moment.

(the bold italics I put in.) That is also so true but with therapy, the frozen in time part can soften as the trauma is worked out. For me, collages were helpful. I could believe myself if I made it. It was my story. Nobody was influencing me as I worked. I couldn't 'catch a thought' like a cold from a sneeze.

Firefighters, invested with a "negative specialness" that Briere(1989)

For me, I would have chosen to call these parts as protectors, the ones who knew the stories and choose the correct child with the memory bank needed for that entertainment.

Managers permit the individual to function on a daily basis and maintain a facade of normalcy and unity

I don't experience these parts as manipulative or complusive. For me, they are the everyday kids who went to school and church and passed the cheese and crackers at dinner parties. They held a really lot of denial. It was a dance that took years to complete. Then the day comes when you know what you know, and you know you know it. Denial is eventually faced down with the truth. This took many years.

Chronic humiliation and scorn generate profound feelings of defectiveness, weakness, and unworthiness (Nathanson, 1987),

True

(Empathic walls are part of what sustains separations between alter personalities.) Child-abuse survivors, like most oppressed groups, experience the particularly entrenched form of shame that comes out of the prolonged distress of forced helplessness and powerlessness.

True, again. For me, the mind control was deliberate and was another rental service. This was during the 50's and 60's when such things were being intensively studies. Pavlov's dogs and all that.

Thank you for writing your well researched post. It is good for all of the forum folks. To emphasize what Anthony has said on the forum, please do not try to diagnose yourself. The diagnosis of DID takes a lot of time and work for the right therapist to establish. I think that Complex PTSD and PTSD with DID are the same thing??

Judith Herman in Trauma and Recovery presents this material with a partially different point of view. This book is on Anthony's reading list.
 
Thanks, I appreciate your thinking. I didnt know that ptsd and did were often confused. From my background, did consists of alters and therefore would not show the containment of feelings for
 
Thanks, I appreciate your thinking. I didnt know that ptsd and did were often confused. From my background, did consists of alters and therefore would not show the containment of feelings for

For me, the frozen children all have symptoms of PTSD, exagurated startle responses, anxiety/terror, hypervigilance, triggers specific to each one's experience, individual responses to their personal triggers. The "Empathetic walls of separation' as you rightly call them served to contain each trauma or repeating traumatic senarios so that i survived. All parts functioned to protect life.

Therapy over a very long time has allowed those walls to fall. The inner children are all unfrozen now and know they are safe. The downside is that I, mercy, am the everyday person now and have all the triggers and symptoms as well as knowing my history. My greatest victory recently has been to forgive myself for every thing. It so easy for children to accept the blame and guilt. Much harder to shed it.

Thanks again
 
Mercy you have come a long way and I am so glad to hear of your achievement-its a huge achievement. I agree-it is so easy for children to take on the shame and guilt. I have been writing down every memory I have from childhood (and I remember a lot) some good, funny, sad, scary, etc. I am looking at the themes that have come back to haunt me and are part of me today.

One theme that I recently discovered was centered around food (all needs but food in particular). The root is "undeserving" but I discovered how many times I was punished both for being hungry and for eating. Makes me wonder how I escaped without a major eating disorder (anorexia, bulemia, or over-eating).

All my life I have gone all day without eating and then ate dinner at 5 or 6. There was a period of time that I came to honor my needs and I was a grazer when my kids were growing so I ate very healthy all day long. Eventually, my guilt and shame returned little by little and I deferred my needs once again. (I had addressed co dependency but not ptsd)

Eating is just one little part of it of course, but the return of shame and guilt of course has gradually led me down hill in every aspect of my life and it has effected my health. Right now I feel very helpless and hopeless. I think because I have honored my needs and achieved and been healthy in the past-I feel guilty for allowing this to happen and am no longer satisfied with this existance. Yet Im so worn down and tired and dont know where to begin. In addition, I think I fear that if I do all the things to invest in myself-I can loose it again at the drop of a hat, with something out of my control such as an accident.
 
Right now I feel very helpless and hopeless. I think because I have honored my needs and achieved and been healthy in the past-I feel guilty for allowing this to happen and am no longer satisfied with this existance. Yet Im so worn down and tired and dont know where to begin. In addition, I think I fear that if I do all the things to invest in myself-I can loose it again at the drop of a hat, with something out of my control such as an accident.

Dear Brat,
What a hard place to be. It is amazing how much embeded shame and guilt we have through no fault of our own. You deserved to have been fed consistantly and well as a child. It sounds like you did a good job with your kids.

Helplessness and hopelessness are also symptoms of depression. Could you be having a menopausal biochemical deficiency? Maybe there is a medical need that can be considered as part of how you are feeling now? Just thinking out loud, maybe you have this well in hand.
 
I think that Complex PTSD and PTSD with DID are the same thing??

Judith Herman in Trauma and Recovery presents this material with a partially different point of view. This book is on Anthony's reading list.
Complex trauma is complex trauma. PTSD is PTSD. DID is DID. There is no such thing as complex PTSD, and people need to kick that term from their head. Judith Herman was the person who tried to get a diagnosis in that does not exist... but there is no diagnosis, hence they are not the same thing.

Whilst I understand what your getting at, they are still not the same. Complex trauma sufferers "typically" endure heavily in the dissociative symptoms, however; not all... vs. some stem heavily into psychotic symptoms... again, some are heavy in the personality symptoms.

This is why people need to get away from the term of complex PTSD, because there is no diagnostic criteria to establish the term too... and its initial proposals all got rejected and DO NOT exist, hence why these struggles appear when the use of such terms are tossed about vs. just using the correct terms, being: the person has PTSD due to complex trauma, which immediately explains their comorbid diagnoses comprising Dissociative disorder, mood disorder, personality disorder... the list goes on.

This is exactly why the APA hasn't included CPTSD, because the sheer variation between each sufferer is not standard, or close to standard, and each one suffers typically more in one comorbid area than the next.

Judith Herman got it spot on the mark because she talks about the trauma type and the symptoms suffered, as she is a complex trauma sufferer herself, so she has that immediate relation to what she feels, which will be similar to others.

Again though... people need to get away from the term, CPTSD, because this is exactly what happens when its used... confusion about comorbid diagnostic areas.
 
Thanks, Anthony. That clears things up well. No wonder confused is part of the name of this thread.

For me, the frozen children all have symptoms of PTSD, exagurated startle responses, anxiety/terror, hypervigilance, triggers specific to each one's experience, individual responses to their personal triggers.

Oh, well that's just how it goes for me. Everybody here has their own story and how it differently PTSD affects their lives.
 
Thanks Anthony-that does clear it up. I indeed did start using the term c-ptsd myself even though I knew it was not a diagnosis but thought it would be in the new DSM.
There are things that I knew about ptsd, did, complex trauma, etc before I was diagnosed. I am finding that what I knew was only the tip of the iceburg on ptsd and trauma.
Thanks again
 
Thanks Mercy. Actually I do have some hormone problems and was using a bio-identical treatment. Then another family crisis came along last fall and I didnt refill. That may be part of it. However, I know I dont get proper nutrition. This sounds really dumb but I buy fruits and veggies still out of habit from raising kids (empty nest now). I pour unopened mild out every week.

I accept that my behavior is self destructive. I may not be acting in high risk such as drug/alcohol/sexual/etc but smoking a lot, and I only think of eating when I get dizzy or nausea late in the day. (I am becoming more aware that the message I learned early in life that even basic needs were not important for me.) I am hoping to change that but it doesnt happen overnight. Then I do have physical pain from an accident. Hormone deficiency. Lack of family support or any support system. I know that my lack of motivation to change is not good for me. Like put the cigarettes down and go to an exercise class-which changes brain chemistry for the good, helps sleep problems. I know what I should be doing. Im feeling like I am in this stuck place that I need to get past.

We either believe that the world controls our lives or we are in control. I use to believe that I was in control. When so many things happened in a few year period, (some big, some just daily stressers), I have reverted back to childhood thinking-which is that attitude of why bother giving up the cigs and going to the exercise class, something bad will just happen and ..... I know I have to do it. I think this comes from the complicated trauma that caused shame and showed lack of worth as child.
 
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