What is complex trauma?

[Sandstone]

Two contradictory things at once

I wholly understand this, but I've had trouble getting therapists and others to understand. I always explain it along the lines of a river estuary, where salt and fresh water meet. Apparently, they don't just jumble up together, but separate into two layers ( I forget which is denser ) so the salt water can be flowing inwards up the river at high tide while the fresh is still running out to sea in another layer. Two contradictory layers, both flowing in opposite directions at once, both equally true

 

[NovemberStar]

I consider my trauma complex in that it was multiple traumas over a prolonged period of time, as well as it occurring for almost all my childhood.

As someone else posted - it was living IN trauma. More and more, I have glimpses into how disorganised, chaotic, fearful and dissociated I was on a daily basis. I felt like everything around me was being turned up inside down and inside out; I felt like I was turning inside out and my existence was like being on some awful psychedelic hippie drug trip where little made sense and nothing felt real or constant. I didn't feel real or constant.

Feeling traumatised, dazed, fearful, severe anxious and dissociated was a 'normal' existence to me.

 

[BlueOrange]

There's a great lecture on YouTube, where a scientist is asked "What's the difference between PTSD and Complex PSTD?" And his answer is in two parts. The first part was "Complex PTSD is PTSD that happens to be complicated." The second part is when he talks in medical terms about what 'complication' is - that it's a thing that interacts with the primary diagnosis in ways that makes it more difficult to treat, or more difficult to endure. As such, there is no diagnostic value 'Complex PTSD' just as there is no diagnostic value in saying "Complex physical trauma." However, there can be diagnostic value in saying "Fractured ribs, pneumothroax, and concussion," which is a way of describing a physical trauma that's got a little complexity to it.

So, I would say that I have complicated PTSD, even if there's no such thing as Complex PTSD. I have terrifying memories of being mistreated for crying, of being hated for being emotionally unavailable, of being trained to suppress my symptoms of distress for fear of the psychiatric ward, of my behaviour before I was prescribed medication, and of my behaviour under the influence of medication. My most disabling flashbacks are when I have flashbacks to being completely disabled by flashbacks.

I can only speculate on what it's like to have a 'normal healthy' life taken away from you. It doesn't seem like fun, but the envious side of me says "At least you a concept of normal that you can use to measure yourself with." I don't mean to compete with "straightforward PSTD" (to the extent that it exists), but I know that I've felt happy and safe more and more often in recent times - my reaction has been absolute and pure terror, as I search for the danger that I know instinctively to be there, but am unable to find.

I think that one particular complicating factor that deserves attention is people who have been hurt by those who they legitimately expected to be there to protect or care for them. It's hard to accept the help of someone who claims to be there to help you (as therapists routinely claim) when the claim "I'm here to help" is your most potent trigger.

 

[tryingtobreathe]

I'm here finally, because of the word "complex." I kept dismissing PTSD as not applying to me for the simple reason, the first 3 or 4 questions anybody ever asks or on questionnaires, ruled me out. I was never in combat, and there was not any single traumatic event that I could point to where there was a "before" and "after." I don't have flashbacks - at least I never thought I did, because I was working from a very simplistic definition of "flashback." I thought that was where war veterans thought they were in battle again, or had recurring nightmares about it, or hearing anything like explosions triggered them. I also had no idea what a trigger really was, either.

Then, less than a week ago, a google search brought me to Pete Walker's book about Complex PTSD, and there I found a 100% accurate description of my symptoms and some of my circumstances. So, I do have flashbacks... all the time. That is the intense emotions that I have never been able to find words for, that constantly lurk below the surface. I've been operating in panic mode, hyper-vigilant at all times, all my life. And I'm exhausted.

I'm not superstitious, but if I was, I would probably think I had been born under a bad sign or something, because since at least age 3, it's just been one trauma after another, after another. I'm 46 now and the last one was an abusive relationship that ended about 3.5 years ago.

So, regardless of the different definitions, I think I'm in the right place here. I see a lot of similar situations like mine.

 

[RussH]

@tryingtobreathe
My suggestion would be to see a therapist that specializes in trauma therapy, and get an official diagnosis.

I would also suggest that you, when you are ready, start a thread in introductions to introduce yourself.

 

[tryingtobreathe]

Thanks RussH. I just got approved for some sort of public assistance, so I think I'm going to be stuck with whatever psychiatrist or therapist they give me. I haven't even had a real session with him yet, but when I do, I am definitely going to cross examine him about PTSD - complex or otherwise.

 

[Chava]

Our particular complexities would be our own, but like you suggested, it can be hard to untangle. I have traumas from very early (very serious medical, hospitalized away from family), traumas I don't remember, traumas I remember in snippets or still shots, or just feel in my body.

Complex refers to multiple traumas, over a period of time, so for kids in their developmental years, that can encompass a range of other problems that don't fit just PTSD...personality, somatoform, dissociative stuff gets in here. The symptoms can be far ranging. So the symptoms are complex, the diagnosis might be complex, and the treatment is complex (though not so much if you have therapist willing to treat a case of complex trauma, even if it's not in the DMS V). But for example, without the "complex" part, I could easily have PTSD with avoidant personality and somatization disorder and probably depression....maybe even ADHD. My therapists see this all through the complex trauma lens. My particular symptoms are very somatic (anorexia, panic attacks, chronic pain, etc). But the somatic pain is complex in itself since some is trauma stuff and others are just long-lasting ways of "feeling" when I can't have emotions. I have physical sensations instead. I feel pain instead of bad emotions. My pain is containing stuff I don't know how to deal with. For another C-ptsd person, they might be dealing more with dissociation. Because of so many different traumas, especially if they happened in early years, it simply becomes "complex" because we present with what seems like seven different major problems.

I don't have flashbacks except for recent, adult traumas. My worst traumas were just encoded somewhere in my body and have somehow also shaped my personality. I wish they'd figure out the labels better. I'd relate better to C-PTSD better than PTSD with a side of pain disorder. C-PTSD seems more comprehensive of somatoform and dissociative issues because we pick those up through enduring traumas, not typically one-time traumas. They become a way of living.

Not sure if I answered your question. But I do see a difference and it would be helpful if the people in charge of the DSM could get it together so we could move along with differentiated treatment

 

[JustBe]

My Diagnosis is Chronic PTSD. My Dr. said it's because of multiple traumas over many of my childhood /teenage years.

I don't know if that is the same as Complex Trauma, but much of what I've been reading in this thread rings true for me.

 

[anthony]

My Diagnosis is Chronic PTSD

Don't worry, I think a lot of people confuse being told they have Chronic PTSD with CPTSD... not that either are actually a diagnosis / sub-type any more though.

Chronic and Acute used to be DSM IV sub-types... they are no longer. It is now just PTSD, or PTSD with delayed onset, or PTSD with dissociative / depersonalisation sub-types. Chronic and Acute got tossed out, as they referred to duration of symptoms experienced, and had no real use. Acute was one month, Chronic 3 months, I think from memory. Chronic may have been six months... don't remember, but irrelevant still now under current diagnostic criterion.

Everyone can only have PTSD at this given time, officially, so I wouldn't worry about it.

 

[cupfish]

C-PTSD is in my opinion signficantly worse than PTSD. I am going to say something controversial: when I hear about adults who have gone through trauma and are suffering from PTSD I think I had experienced their total trauma events by about age 4. I am very proud that I am as whole as I am today. We am probably tougher than the soldiers, the accident victims, all the adult sufferers because we were robbed of childhood and emerged victorious in spite of having our minds twisted from the crib. This is where the most suffering lies, with the people who were brutalized as children. One person's opinion.

 

[Recovery4Me]

C-PTSD is in my opinion signficantly worse than PTSD

We am probably tougher than the soldiers

I am also going to say something controversial, (but in my opinion) I have never seen such a black and white statement from a mental health expert concerning combat service people having less trauma or being less tough.

I find the presumptions within the above quotes degrading to their service, self indulgent and perhaps indicative of never having been on the front line or watching people die in war up close and personal.

 

[The Albatross]

It is a spectrum... being a vet, though not a combat veteran, I don't find it offensive though rather short sighted. Like trying to split the difference between a tomato and a pineapple (apple, orange, kiwi, etc.) when they are both "fruit". I expect though that some combat veterans would take some pretty strong exception to both of these statements.

Off topic but interesting factoid about the tomato as fruit: "Botanically-speaking, the tomato is a fruit and can be further classified as a berry since it is pulpy and has edible seeds.

Most of us use the tomato as we do vegetables, primarily in savory dishes.

In 1893, an importer claimed the tomato as a fruit in order to avoid vegetable import tariffs imposed by the United States. This dispute led to the Supreme Court ruling for taxation purposes that the tomato be classified as a vegetable, since it was primarily consumed in the manner of a vegetable rather than a fruit which was usually used in desserts.

Other botanical fruits classified as vegetables include squash, cucumbers, green beans, corn kernels, eggplants, and peppers."