Research Dissociation: An Insufficiently Recognized Major Feature Of Complex Ptsd

[SimplyComplex]

http://www.onnovdhart.nl/articles/jts_complex_ ptsd.pdf

If this has been posted, please feel free to delete

Abstract
The role of dissociation in (complex) PTSD has been insufficiently recognized for at least two reasons:
the view that dissociation is a peripheral, not a central feature of PTSD, and existing confusion regarding
the nature of dissociation. This conceptual paper addresses both issues by postulating that traumatization
essentially involves some degree of division or dissociation of psychobiological systems that constitute
personality. One or more dissociative parts of the personality avoid traumatic memories and perform
functions in daily life, while one or more other parts remain fixated in traumatic experiences and
defensive actions. Dissociative parts manifest in negative and positive dissociative symptoms that
should be distinguished from alterations of consciousness. Complex PTSD involves a more complex
structural dissociation than simple PTSD.

 

[Lady of Longbourn]

A little confused because complex PTSD ( CPTSD) is not longer a recognized diagnosis.

 

[SimplyComplex]

Many people in the trauma research community consider c-PTSD to be a usable diagnosis. It isn't in the manual but the manual is very controversial.

 

[SimplyComplex]

the author of this paper is Onno Van der Hart and is a respected and important researcher in trauma.

 

[justLogan]

Still here and thank you

 

[Zef]

Whether Complex PTSD is in the book or not is immaterial. It is a term that describes a set of people accurately and better than any other term yet proposed. . .therefore it is useful.

The disassociation structure that the author presents is interesting and could lead to more defined treatments, but it is also evident that there is a limited amount of research using this structure.

So, wait and see, but looks good enough to justify further research.

 

[anthony]

It is a term that describes a set of people accurately and better than any other term yet proposed. . .therefore it is useful.

Incorrect, as DESNOS is far superior to more accurately describe the older ideals of CPTSD. DESNOS looks like gaining approval as a recognised disorder, as it accurately describes complex trauma, without trying to create confusion with existing diagnoses.

It also fits more aptly with the new trauma and stressor category approved for the DSM V release next year, where CPTSD was more focused on the dissociative aspects, not dissociation as a byproduct due to the trauma, combined with other major symptomatic experiences. CPTSD just got too creative trying to jump into far too many existing diagnoses that better cater diagnostic criterion.

 

[Red Feather]

I don't care what it is called, as long as it is treated. I am personally not really happy that it is such a difficult process to get a diagnosis, which definitely can be helpful in finding the proper treatment. Here in Germany, the doctors in the clinic I was in didn't even see that I was suffering from trauma because I wasnt having visual intrusive flashbacks and just diagnosed me as having an "emotional and instable personality disorder"... Geez... and then I got sent off to the closed psychiatry wing because I was having derealizations and was so instable. Now I am having "real" flashbacks too, and so I can be put into the PTSD category, now that the little box has a check mark in it. :x3: (frustrated...)

I have major dissociations and can't talk to my doctor about it. He doesn't want to hear about my symptoms, because he is afraid of me getting triggered. :cautious:

 

[Zef]

Anthony,
Thank You. I had forgotten about DESNOS when I posted. After giving it some thought, I have to agree with you. Given the way that DSM V is going, it does seem more practical and it really does accurately describe the disorder.

Plus, it is much easier to say and sounds cooler. :)

 

[Girl3]

With any list of descriptors, there will still be a need for a qualified diagnostician to further refine the diagnosis. Whatever will make that initial process more reliable will ultimately help those who need it.

Going back to the original phenomenon of 'multiple personality disorder' - what a terrific extreme. But it still only really described an effect. Someone wound up with MPD, but the real underlying process was ignored.

Dissociation isn't black or white, and the causes of it are more than just trauma or genetics.

 

[Red Feather]

My theory is this (sorry for generalizing): Doctors can only see black and white lines, but we can see many shades of grey and color tones too. And it is frustrating because we would like doctors to see all the colors and shades we are seeing, but they can not. They can only see black and white.

Sometimes it seems like doctors wait for symptoms to get really really black so that they can see them. But I guess it is good to ask the question... even if a doctor makes the right diagnosis, how much does it really help? What would be the ideal treatment? Everybody is different and so their trauma is different and therefore the best treatment. And really the patient knows quite often much more than anyone else what he or she needs.

I just thought if my symptoms keep getting worse like they seem to be, I might have to go back to the hospital. I don't know how to get stable and I'm just a mess. For the last 3 mornings, I remained literally frozen in my bed for at least 3 hours. I couldn't move at all. This is scary. And just now I was triggered into a dissociation phase, I thought I was going crazy. I have been dissociating since I was a kid, and now I see why I never could get my life in order. My bank account is in negative and I couldn't even pay for my medication. And sometimes it doesnt even bother me that things have been like this for months.

And it always has to get so dramatic, and I have to be in severe crisis to do anything about it. If this is because I have been dissociating so badly, and inable to face reality, then I would be really glad to find a doctor that would recognize this as a problem. I mean in the end it is the question of whether I live just to be medicated and spoon-fed in the psychiatry ward, or if I can grow and learn to become independant and serve society in some way.

It would be nicer, if things didn't have to get so extremely bad before they get better.:unsure:

 

[anthony]

I was reading a very interesting aspect of medicine going forward, with its potential for superior coverage of the globe with better accuracy than doctors give.

Many people blame doctors, however; doctors are human. Whilst medicine has changed significantly, the one factor that has not is the human component. Humans are prone to errors. Reading recent statistics, it seems the human component of doctoring statistics for accuracy hasn't changed much in the last decade, with around 45% of treatment being incorrect.

Again... you could blame doctors, however; being human is also being prone to making incorrect assessments.

Continuing this though, doctors actually aren't this bad at all. When further statistics are added into the equation, it is more around 25% inaccuracy as the human component, as the rest is made up from the patients providing incorrect or misleading symptoms. The problem with current tests is also expense and time.

Many developments have changed / are going to change this. There are paper tabs now in which you can put one drop of blood upon and it gives a range of common issues by the colour it changes the paper. This has taken blood testing from a time intensive and expensive operation with labs to a few cents per blood test and can be performed there and then within a minute. The same with urine... technology is changing medicine to remove more inconsistency from the human equation, being our mouth converting emotions and such into incorrect symptoms that don't help a doctor accurately diagnose.

It will be very interesting with Watson coming online into the medical field. Basically, Watson is being taught everything medical at present, which when combined with a phone app on every persons phone globally will be able to more accurately diagnose a person on the spot than a physician could. This would not remove a physician, but it would certainly curb the doctor lines from a lot of nonsense and can also transpose into many cases being handled by a physician through video chat vs. actual visits, taking diagnostic medicine to a 24/7 instant approach and reducing medical nonsense, opening hospitals and doctors offices to only those that absolutely need the human component added into it. Scripts would even be SMS'd to you on the spot in the very near future for minor issues.

Medicine is going to change dramatically, including mental health.