It's Here! The Official Diagnosis For Complex Post Traumatic Stress Disorder

[nycpeach1]

Hi Anthony,

I made a mistake and apologized- I also posted further information. If you look up Dr. Lori Pearlman, you'll find her dissertation on CPTSD as well. Van der Kolk has continued his research at the trauma center and is currently lobbying for it's inclusion. Again, apologies to all those negatively effected.

Sarah

 

[anthony]

As a new member @nycpeach1, you could have just restructured your title into a question, instead of a statement, which was untrue. We all make mistakes... no big issue. Live and learn, and maybe ask questions instead of telling people what isn't true, next time! A lot of members here have done their own research to validate the facts that are here, which have already been highlighted above.

When things change, and they become factual... we will have some sort of quality reference, such as the DSM or ICD, or associated panel for either which are discussing the issue.

 

[Upside Down Eagle]

Hey, welcome to the forum @nycpeach1 , I just want to say you made an honest mistake and already apologized for it :-) I hope you have a good time on the forum and don't be shy to share any further info with people here, just ask around to be sure of the info!

See you around on here!

 

[Chava]

I'm more interested in the hope of ongoing research. "ptsd" diagnosis for a particular 20-something trauma did not encompass my long-standing stress issues and self-destruction, which probably had more to do with my suicidal responses to the incident. Standard talk therapy, whether we were addressing it as ptsd, "desnos", "cptsd" didn't help because most of my trauma is fragmented or non-existent memories and not isolated incidents I can work on clearly. The important part is the trauma perspective for me. I'm glad the research continues. I had many years of whack-a-mole treatment and lots of shame for feeling fundamentally f*cked up. Personally, I like Judith Herman's proposed cptsd more than something fuzzy like DESNOS (Herman's proposed criteria are pretty specific and they are all validating). At this point I don't personally care what is in the DSM because I feel like I've finally ended up on a better treatment route. But for everyone else still suffering without the right help, I hope the research and overall understanding and treatment options for trauma continues (ptsd, complex or otherwise). The right help is life-saving and also offers extremely important validation and hope.

thanks for the correction/update @anthony

 

[anthony]

People should not confuse "the right help" with a diagnostic label. This is where issues arise... people think a label equals the right help, when the right help equals a good therapist who can see the issues and directly help you with them, regardless of the attached labels. Labels are for legal purposes, not so much treatment purposes. Yes, it helps other therapists quickly ascertain what is wrong, though its no uncommon to have a label, see another therapist, and they disagree and change it based on what they see / hear.

Labels are for insurance payouts and legal disability claims, more often than not. They also provide a readily and easily identifiable system for use between therapists as a person changes between physicians. They don't offer much more than that. Anyone who chases a label for its name, has far bigger issues to deal with IMHO.

This is why people really need to question their therapists when they use labels that are off the book... because are they treating you based on what you present and your best interest, or are they treating you based on an agenda?

 

[Chava]

I agree a "label" doesn't mean everything, but the trauma lens is really important because something that really might be complex trauma can be diagnosed as something completely other (like the therapist who suggested I have ADHD...I don't...and that's entirely different therapy and medication). Without the research and growing understanding of trauma, it certainly can present like too many other things. Believe me, I've been through treatments, psych wards, therapists, all somewhat helpful in treating certain symptoms, but never getting at the root of it because none of these people recognized combination of early traumas as possibly connected (granted, most of which I never talked about). I do regret that and what sometimes felt liked added shame.

My therapist has been much more helpful than past ones. I know you're referring to assumptions broadly Anthony, but you also sort of sound "experty" where you don't know people's situations and I'm not sure if you're a trauma specialist or not. I'm not being treated "off the book". I'm being treated by a "good therapist who can see the issues directly" (so it seems like you are saying two different things here)...and, also if speaking broadly, it seems like one of those posts directed at me, but calling me "people" to avoid the directness. Or just school all of us on how to handle therapy. ? That's fine, whatever. I have a load of trauma (criterion "A" since i now that's really important with you, even if diagnosis maybe isn't). And I have a therapist who is trauma specialist. Logical stuff. It's not very complicated. But I'll admit this whole thing, my body, my symptoms, my recovery, sucks. But at least something finally makes sense. I don't need to "question" it anymore, but that's okay if you want to.

 

[user27357]

i

It is a double edged sword, this labeling a disorder. It may open some doors for better treatment for some, it may cause some to assume that they will now suffer the disorder in it;s worst forms just because it is now in the realm of bona fide possibility.

t is a bit silly isn't it? In the rough and tumble world of EMT medicine there is no time or extra energy spent on a diagnosis, just flat out hurry up and stabilize the symptoms and dot the i's and cross the t's later. I guess I always kind of laughed at the diagnosis part of starting in with a new therapist because it made no difference in my treatment, ever.

Unless it is important to my therapist, I got no interest in wether I am labeled CPTSD, PTSD, DES/NOS, PTSD-DS, whatever. To me it is the equivalent of saying head injury-dashboard, head injury-big rock, head injury-baseball bat. We are all looking for relief from symptoms here and lining out the treatment differently because of a name in a book is, well, pointless in my estimation.

 

[violetclouds]

I am a little concerned that someone was so quick to suggest that anyone here is doesn't belong here and should go start another forum - kind of 'not safe' sign - just makes me a little uneasy about sharing here if people feel like that if I am 'not like' them then I should not be here - because I am not like 'anyone' - we are ALL different.

 

[Justmehere]

@violetclouds - I can't speak for Solara, but I took her suggestion as a sarcastic suggestion to make a point, one that such division would be counterproductive, not to actually imply that people with complex trauma histories should post here. That's how I took it.

People with ptsd from complex trauma (like me) are very welcome here just like everyone with ptsd from other types of trauma. There is even a forum for complex trauma.

No place is completely safe on the interwebs. There is always a risk, however, I think you are amoung a very accepting group of folks here overall. You will likely get diverse and honest feedback, and everyone is free to take what fits and discard the rest. (Including this very post of mine here! :D)

 

[Justmehere]

@violetclouds not to actually imply that people with complex trauma histories should post here.

Opps, this was supposed to say, "not to actually imply that people with complex trauma histories shouldn't post..."

Sorry about my error. My grammar and spelling is always in need of improvement!

 

[Hashi]

I do think a label can help us find the right treatment to an extent. For example, it helped me a lot more to have a PTSD diagnosis and see a somatic therapist and a trauma psychotherapist than when my only diagnosis was clinical depression and I was sent away with a book on CBT.

As I understand it DESNOS makes a point of not being a form of PTSD, although it can be comorbid with PTSD. The proposed DESNOS criteria are not intended to deal with symptoms like flashbacks. What they might help me with are effects like my world view, self view, dissociation, interractions with people and attachment issues. Having said that, personally I find my response to these to be very different from most people's when they talk about complex trauma/DESNOS - often the opposite of most people's, which makes me wonder how helpful it could be for me.

At any rate, when it comes to having PTSD and working on PTSD symptoms, I feel like there's still something else needed to take into account some of the effects of complex trauma. I've experienced complex trauma and I think that as a result the PTSD treatments/approaches that are most appropriate for me might be different from someone with, say, single incident adult trauma. That includes the fact that I've experienced traumatic amnesia and that I have no natural baseline of feeling safe underlying any work that I do. So telling me to grit my teeth and do some serious exposure therapy is probably only going to result in psychosis, whereas some other approaches are really helpful for processing trauma.

I feel some additional "label" is needed, other than PTSD and other than DESNOS, to get the right help for PTSD in that context. In fact I realised it for myself and devised my own approach but I realised the hard way - by trying some of the standard things and discovering they weren't right for me and for my trauma history. I think it would be helpful to both clients and therapists to have a label for it that would be taken into consideration when thinking about treatment.

Edited to add - my understanding might not be right. I find the whole complex PTSD/DESNOS stuff confusing. If you want to correct me, please do because I want to get my head round it - just please do it kindly! Thank you.

 

[anthony]

I find the whole complex PTSD/DESNOS stuff confusing.

Its actually very simple. PTSD is the only legal diagnostic label at this date of writing. You then have the Herman followers, pushing various versions of her original CPTSD "proposed" diagnostic criterion. It failed entry into both the DSM IV and ICD 10 at that time. Van Der Kolk, a counterpart and fellow complex trauma expert of the Herman camp, tried another route, by going the DESNOS way, trying to shift away from so much crossover between Axis I and Axis II disorders. It had better chances, however; it also had little validity at the time of last publications, little trial evidence and well... it failed and people haven't really adopted it over still trying to CPTSD.

As at right now, and actually until at least the ICD 11 is published in 2017, PTSD is the only diagnosis that exists in either mental health manual, and is the only diagnosis legally definable with agreed criterion and application.

CPTSD and DESNOS neither have any legal validity OR agreed criterion and application at this time. Again, the ICD 11 does have a blank page for CPTSD, but it redirects to a personality disorder, which is not what the proposed criterion was trying to achieve, and in fact, the proposed criterion since Herman started all this... is nothing like what the ICD currently are pointing towards. Put it this way... if the current ICD linked personality diagnosis remains under the label of CPTSD, then it would be classified as a personality disorder and thus not suitable for this forum, and in fact those with such a diagnosis would be more applicable to personality disorder forums. That is based on the current position. The ICD may simply drop the blank page altogether, as the DSM didn't adopt it. They may choose to go it alone and adopt similar criterion Herman has proposed.

Wait and see on that one, but PTSD is the only legal diagnosis right now, this date of posting.