“complicated” - What does this mean?

[brokenpony]

my therapist just told me my case is complicated.

my substitute therapist said my case is complex.

my psychiatrist said my case is complex.

i know my therapist and psychiatrist have diagnosed ptsd but no one has used the phrase “complex ptsd.” i don’t know if that’s what they mean. if that’s what they mean i want them to say it outright.

also afaik none of these people have spoken to each other and have told me this independently. i don’t know how to understand this. when i asked my therapist what he meant, he said something like “it will take a long time...”

how would you interpret this statement that i am “complicated” or “complex”? have you been told this by a therapist?

 

[MyWillow]

I think complex or complicated simply means that there are multiple layers of traumas to address. If these happened in a family environment, for example, you can layer attachment issues over the top. When you address one you can inadvertently trigger something else. So a good T is going to want to move slowly and carefully so as not to destabilise you.

My psydoc said she wasn’t sure what had happened to me (makes 2 of us) but she thought she could help. It was going to be a long, painful road. I was going to get worse before I got better (yeah great ?) There was potential for growth. It would be worth it. She would refer me on if she didn’t think she was helping. That was a lot to take in. I’m a want to fix it yesterday kinda person so that was hard to hear.

 

[Missycat]

I can understand why you feel confused , why couldnt someone just give you a straight to the point answer or an explaination !
I have been told i have complex ptsd due to the trauma i experienced , however my t explained this so i understood why and how, along with the treatment plan. As i don't know your story its hard to say what your t meant . Also everyone is different so complex shouldnt automatically mean difficult or lengthy !

 

[brokenpony]

I think complex or complicated simply means that there are multiple layers of traumas to address. If these happened in a family environment, for example, you can layer attachment issues over the top. When you address one you can inadvertently trigger something else. So a good T is going to want to move slowly and carefully so as not to destabilise you.

My psydoc said she wasn’t sure what had happened to me (makes 2 of us) but she thought she could help. It was going to be a long, painful road. I was going to get worse before I got better (yeah great ?) There was potential for growth. It would be worth it. She would refer me on if she didn’t think she was helping. That was a lot to take in. I’m a want to fix it yesterday kinda person so that was hard to hear.

yeah. that makes sense. i guess i could just take it at face value as the basic definition, and i tried, but because it was in reference to my brain and its dysfunction i am overanalyzing it and wondering if i will ever really truly make it out of this mess. i haven't really told him everything because i can't yet but he knows some of the basic stuff. however, he said this particular thing soon after i told him that i feel a restless anxious dread inside my body, that my body feels contaminated with this creeping rot, and that i want to claw out of my body to escape it. i was trying to describe the difference between regular anxiety and this anxious dread (that no breathing exercise is ever going to help).

 

[MyWillow]

Yeah breathing exercises SUCK when you feel like that. Don’t give up though. There are always tiny steps you can take. You don’t have to leap the tall building in a single bound eh ;)

 

[brokenpony]

Yeah breathing exercises SUCK when you feel like that. Don’t give up though. There are always tiny steps you can take. You don’t have to leap the tall building in a single bound eh ;)

yeah they are never going to work! when i told him about the feeling, he was like "when do you not feel like that?" but it's pretty much never. it lessens if i am talking to someone or doing some other thing that requires my attention, like watching a movie with friends, but once i am alone again in my house the feeling is back full force. what do you do?

 

[Still Standing]

yeah. that makes sense. i guess i could just take it at face value as the basic definition, and i tried, but because it was in reference to my brain and its dysfunction i am overanalyzing it and wondering if i will ever really truly make it out of this mess. i haven't really told him everything because i can't yet but he knows some of the basic stuff. however, he said this particular thing soon after i told him that i feel a restless anxious dread inside my body, that my body feels contaminated with this creeping rot, and that i want to claw out of my body to escape it. i was trying to describe the difference between regular anxiety and this anxious dread (that no breathing exercise is ever going to help).

Yes, it would be best to take the references of "complex and complicated" as simply meaning that you have a history of multiple factors that will need to be addressed slowly and carefully, making sure that you get the best therapeutical help possible. It does not need to be over analyzed. That will just add unneeded stress for you. It would be counter-productive. Many of us here on this forum have histories of multiple trauma histories. I am one of those people. I, too, have had the same references said to me. It is nothing to react negatively to. It meant, for me, that my therapist is fully aware of my need and is willing to tackle my need and help me work through it. It will take time. And like me, it will take you some experimenting to see what therapy approaches work for you and which don't. You have to decide to keep going even when the going gets tough. There is certainly hope of improvement for you. If you were to read some of my past posts, in the last year, you would see that I have had many whining sessions over my therapy but, in the end, I have seen some dramatic improvement.

Like you, I didn't think that the breathing exercises and grounding techniques would work. I thought they were silly and I was embarrassed to try them. Yet, I practiced and practiced and found they do work. I think, for me, I had to decide to be positive about them and give them an honest go at it. Instead of giving in to my fatalistic thoughts of things never getting better and I was too far gone and old to see improvement, I decided if I was going to get better, I had to really, really, be willing to put the work and honesty into it. What things I was not able to verbalize, I wrote out the worst of my traumas and sent it to my psych doc. If I had to tell it to him, I would have shut down and not said a word. So, the hard parts, I write out for him. As we worked on CBT and currently EMDR, I am able to further share details with him, in more detail. Things come out as needed and in time...not all at once. It is all a process.

So, you are in process. Your complex/complicated situation is not insurmountable. Actually, you are fortunate that you have a team around you who understand and are on board with you to help you in your journey for better mental health. You can do this. And you have all of us, here, to help cheer you on and help where we can, too.

 

[MyWillow]

yeah they are never going to work! when i told him about the feeling, he was like "when do you not feel like that?" but it's pretty much never. it lessens if i am talking to someone or doing some other thing that requires my attention, like watching a movie with friends, but once i am alone again in my house the feeling is back full force. what do you do?

As much as I hate it I just kept practicing stuff - just sitting and noticing without judgement, going to a trauma sensitive yoga class, etc. I cannot believe it but I’m now doing 30 mins TS yoga every morning. Still don’t love it but it calms my nervous system. I train and walk my dogs. Sometimes I drink too much alcohol. Oops.

 

[Sideways]

i told him that i feel a restless anxious dread inside my body, that my body feels contaminated with this creeping rot, and that i want to claw out of my body to escape it.

You’ve described this as a type of anxious dread (feeling) and breathing is definitely the gold standard treatment for an anxiety response. Learning (as in, not something we can do without practice) to control and slow our breathing necessarily has an impact on the physiological reactions that come with anxiety.

But what you’re describing here sounds like it goes beyond a feeling, and is perhaps connected to a bunch of thoughts and core beliefs as well as the anxious feeling you’ve described. For example, ‘feeling like my body is...’ could be re-worded as ‘I believe my body is...’.

If that’s the case? Then there’s potentially some work on your core beliefs and self-concept that might also help to shift the anxious dread that you’ve described. And that skewed self-concept would be pretty textbook complex ptsd. It takes longer to work through than breathing exercises, but if you can start to identify with your T exactly what this anxious dread is about, what beliefs it’s connected to, that has the potential to completely shoft the feeling you have in your body that you’ve described here.

Don’t lose heart. For all that “your case is really complex” sounds a bit like “I have no idea how to fix this!”, it sounds like you might have a treatment team that do know what’s going on and what steps to take:)

 

[brokenpony]

You’ve described this as a type of anxious dread (feeling) and breathing is definitely the gold standard treatment for an anxiety response. Learning (as in, not something we can do without practice) to control and slow our breathing necessarily has an impact on the physiological reactions that come with anxiety.

But what you’re describing here sounds like it goes beyond a feeling, and is perhaps connected to a bunch of thoughts and core beliefs as well as the anxious feeling you’ve described. For example, ‘feeling like my body is...’ could be re-worded as ‘I believe my body is...’.

If that’s the case? Then there’s potentially some work on your core beliefs and self-concept that might also help to shift the anxious dread that you’ve described. And that skewed self-concept would be pretty textbook complex ptsd. It takes longer to work through than breathing exercises, but if you can start to identify with your T exactly what this anxious dread is about, what beliefs it’s connected to, that has the potential to completely shoft the feeling you have in your body that you’ve described here.

Don’t lose heart. For all that “your case is really complex” sounds a bit like “I have no idea how to fix this!”, it sounds like you might have a treatment team that do know what’s going on and what steps to take:)

yes you are right, it kind of does go beyond a feeling probably. another way i described it was a roach infestation. he asked me the color and i said "bile." it's kind of like, this desire to not be with my self, in my body--to escape my body--and the dread is not "something bad is going to happen" or familiar panic but "i have to go on living another day and another day and i dread it." i said i feel trapped.

breathing helps with the panic attacks and baseline anxiety but not with this awful feeling in my body. the anxiety is flight response, like, "i have to get out of this store or some other place i am in space and time." the dread is like "i have to get out of my body because it is continually unbearable to live in it."

but reframing it as belief may be helpful. i believe i am contaminated and used. i believe i lost my self before i could be a self and that my self is not retrievable. i believe i do not belong anywhere and never will. i believe i am unfixable. these are obviously problematic beliefs... i do like my therapist so far i hope i continue to like him and that he is down to work on all this crap with me.

 

[Sideways]

these are obviously problematic beliefs.

Yep, totally. That’s a brilliant post. Consider saving what you’ve just written somewhere because some of us spend a long time trying to put words to those core beliefs, which very often can play out as a physical sensation or visual imagery as often as they come to us as coherent sentences.

Core beliefs like those may well be familiar, but actually the average person doesn’t think about themselves like that. It’s a real hallmark of complex ptsd to think about yourself in really toxic/unloveable/disgusting/etc terms.

Those beliefs can shift with time. And it’s worth the work. Because imagine what it will be like to actually kind of like of yourself one day... like, in those moments when you’re at home, tolerating your own company, and you’re like “I’m actually friends myself”. Life changing. At a really fundamental level. That will happen for you with time:)