Research Dissociation: An Insufficiently Recognized Major Feature Of Complex Ptsd

[Meadowsweet]

Regarding the paper tabs and symptoms of physical disorders, technology seems great.

But I can't imagine doing without human observation when it comes to mental health assessment. Partly because its very difficult for patients to communicate in words what is going on, and also to minimise the fear of a messed up mind, I think its common to minimise symptoms.

Sometimes when a patient is minimising, it can be the physical observation that gives a better picture of the extent of the issues the person is facing. I think in the UK, its standard practise to note down the physical appearance and body language of a patient presenting with mental health issues.

I can't imagine that kind of human judgement being replaced.

 

[Red Feather]

I understand that doctors are only human and make mistakes, and that patients also can give the wrong impressions of themselves for whatever reason. But 45% misdiagnosis is huge. It means to me that the system for whatever reason is already very problematic and dysfunctional. For me there was nothing human about the inner agents at work at the psychiatry ward I was in. There is also nothing human about a system that promotes hierarchy in such a way, that a misdiagnosis can not be questioned. And also nothing effective about a time schedule that only allows a doctor 15 minutes to speak with a patient.

Unfortunately when I was in the hopsital I was having a relapse of some kind, and reverted to a real passive and scared person I used to be five years ago. I was completely terrified to speak about my symptoms, because I was afraid of being locked up in the acute psychiatry... which eventually happened anyways. And the scariest part is that I was almost willing to give up my life and sanity just to be able to remain victimized.

I don't think this is about blame at all but more about power structures. And I think techniques like these paper tabs can be good news if they are really used in a real human way.

 

[TeelRain7]

I have PTSD. I experience dissociation sometimes. Mostly in public places, like work. My therapist and I work on grounding methods to reduce my symptoms and it seem to be effective at times.

 

[Girl3]

One of the things I have come to realize in my own diagnosis, is that the animal of PTSD changes its shape over years. Symptoms that were very prominent when I was young have now been smoothed down. When I fill out those many 'tests' they give in PTSD studies, I always note that some of the things they ask about were things that I had 30-40 years ago. Other things are symptoms that come and go.

Nadia, I'm not sure how it is in Germany, but in the US there is no power structure outside of academic hospitals. If you're at a teaching hospital and an attending makes a diagnosis, then the residents who work/learn under that attending might be very reluctant to change the diagnosis.

In the world of private practice, it is more likely to be a laziness factor. If a patient comes to me with a medical diagnosis - lets say Factor 5 Leiden deficiency - I can either just write that down and treat the patient based on that, or I can do what I normally do, which is to ask further questions about symptoms, events etc and see if I agree with the diagnosis. Even with what seems like straightforward medical problems, there is wiggle room in diagnosis.

In my own life, I know that I caused my own misdiagnosis because I only told doctors about my depressive symptoms. I didn't want to be thought of as psychotic or schizophrenic so I never discussed any symptoms relating to hallucinations, dissociation, rage, etc. (Of course, the diagnosis of PTSD had just entered the DSM the year I saw my first psychiatrist - and it was for war vets only.)

Just in the last 3 years have I been open about what happened to me. The psychiatrist that made my diagnosis only had a small piece of the puzzle but he was very astute. But he also only wanted to put me on medication to manage my symptoms. So I researched PTSD - I began with contacting Judith Lewis Herman, MD after I read her book. That step put me on the right road.

 

[Trish36]

As I said before I was diagnosed with PTSD, Major Depressive Disorder (with suicidal tendencies), Panic Disorder, Anxiety Disorder, and I was also diagnosed with Personality Dissasociative Disorder (due to being who others wanted me to be all my life and not finding who I am).

So where would this fit in, just PTSD or the c-PTSD? Should all of this be grouped together or separate like it is now? The depression is now just regular depression (which is inherited), Panic issues have not shown itself for a few years (since I stopped associating with my family and not shown it's ugly head even in the worst of times), Anxiety is still very high (tends to control me at times and also inherited), and still trying to find myself but not sure how and taking very small steps.

So should they all be grouped together or kept separate like they are since some are caused by the PTSD and some only enhanced by it? I would be a real mess if they were all grouped together since they are all from different aspects and causes.

Most times I am grateful for being diagnosed but others I'm not, because here in America, where it's just starting to be used, it is grouped together with war vets, and most people who get help (like me) are discriminated against, especially in courts.

I know it's coming out in the DSM V, but with it being so generalized I don't feel it really matters because it will take years before it's accepted and courts will stop taking womens children thinking they will abuse or kill them because of this diagnosis.

 

[anthony]

I know it's coming out in the DSM V

What is coming out in the DSM V? CPTSD? No it isn't. The APA have clearly rejected it as a diagnostic term due to its inadequacies in sufficiently citing the correct aspects of complex trauma.

DESNOS is hopefully to appear in the DSM V, which is different again and far more accurate as a broad brush, however; it is more about the trauma, not the diagnosis as to whether it is complex or not.

If you have severe dissociative personality aspects that have been diagnosed, then it is likely you fit within the complex trauma range. It is still PTSD, except you have PTSD + Dissociative disorder that is by itself sufficiently debilitating you, hence why a comorbid diagnosis.

 

[^^FlyingSolo^^]

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.

Kudos for this. ;)

 

[crazytrain]

"it will take years before it's accepted and courts will stop taking womens children thinking they will abuse or kill them because of this diagnosis.

Yeah, it isn't just women, believe me! I have not been allowed to even speak to my children (whom I have raised and been the primary caregiver to for the past 8 years) in more than 2 1/2 months. To a 5 year old (and this 40 year-old) that is a lifetime. Courts are very slow and inefficient, and unfortunately the more people get involved the less it becomes about the people involved. Know what I mean?

 

[crazytrain]

DESNOS is hopefully to appear in the DSM V, which is different again and far more accurate as a broad brush, however; it is more about the trauma, not the diagnosis as to whether it is complex or not.

Anthony, thank you for again sharing your insight and wisdom here! I now know what DESNOS is and it actually fits me better than the straight PTSD diagnosis. I will talk to my T about it this week!

 

[anthony]

Courts are very slow and inefficient, and unfortunately the more people get involved the less it becomes about the people involved.

I have experienced this first hand in my last marriage, and let me just say... the longer the kids were away from me due to awaiting the bureaucracy nonsense, the more time it gave the kids with their mother, thus the courts didn't want to impede the children any further than they had already endured, thus even as the primary caregiver, I still lost out due to the very system itself falling short due to time issues.

 

[crazytrain]

Yeah, that's kind of the part I am worried about. We HAD great relationships and strong bonds before all this nonsense started. Now, I am not so sure...

 

[crazytrain]

Anthony, I did not seem to mention that I am not worried about the custody part; my wife and I are committed to seeing this through and getting our family back together. I do share your pain about the system, though. It is a flawed system run by flawed people, unfortunately! I have some sort of peace about the whole thing just knowing that the important people that are being affected: my wife, kids and myself; are all committed to one another and can't wait to be together again. That's a little bit of hope for me in a dark time, for sure!