Other Actual Or Immediate Threat Of Death Or Injury: How Does It Work?

[joeylittle]

I guess I started to understand it all a bit better until someone threw it "catastrophic injury" being physical only and now Im just all confused again, I think moreso.

I really think you are mixing up three totally different concepts.

There's the DSM diagnostic criteria - which is a lot of stuff, not just criterion A. Criterion A describes the types of situations that can cause PTSD. And even, if you have experienced a criterion A, you might not develop PTSD. You have to fit into a lot of other boxes, too.

Then, there's the concept of catastrope - catastrophic, bad. And the concept of injury. Not as they are used in criterion A, just as words to describe things.

And then, there's coersion - being forced, or being under duress, or being made to do something....lots of synonyms for it.

The reality is, every situation that can fit into a trauma context is incredibly nuanced - and as the person who experienced it, you actually don't always have the whole picture. This is also why self-diagnosis is usually problematic, because we don't always know how to look at what happened with an objective eye. Memory affects how we interpret events, as does coping....and it's frustrating sometimes to not be able to know exactly what was going on in an exact moment, or to wonder if your response is wrong, or you didn't feel something you should have felt, or you did feel something you shouldn't have felt.

A big reason I started this offshoot thread is just because I'm having a hard time really understanding why I have so many memories of fighting to stay alive at the last minute, even though my overwhelming memory, the thing that was going on much more often, was that I wanted to stop living. I didn't want to wake up - but then, suddenly, I did. Or I apparently did - I don't remember those conscious thoughts, the wanting to live thoughts, I only remember my body fighting to breathe.

Psychologically, if I were going to analyze myself, I think that there's something going on for me about needing to be able to understand every moment, because I was so confused then. Most of my black-or-white thinking habits source back to that time. Either I wanted to live, or I wanted to die. I don't allow for the inbetween - the notion of survival, which I'm not sure is tied to living or dying, in the moment that it happens.

Anyway - those are just my thoughts.

 

[scout86]

the thing that was going on much more often, was that I wanted to stop living. I didn't want to wake up - but then, suddenly, I did. Or I apparently did - I don't remember those conscious thoughts, the wanting to live thoughts, I only remember my body fighting to breathe.

Did you "want" to stop living, or "want" to stop suffering? In the moment, maybe the words/thoughts what ever weren't that nuanced and it SEEMED like you wanted to stop living because that was the only way that came to mind of stopping suffering. Even though, as you said, in a non black & white world, there were other options. Sometimes, it seems like we "just want something to stop" and the simplest way to picture that is to die. But, if you had the ability to examine the "want" a little better, you DON'T actually want to die, you just want out of the current situation. (Somehow it seems like I didn't make that very clear.... :confused:)

 

[joeylittle]

But, if you had the ability to examine the "want" a little better, you DON'T actually want to die, you just want out of the current situation.

No, you explained that really well. And I do think you are right, for some things. I know that something I thought about in my 'down' time was how I had no options. I couldn't conceive of being released, because I didn't know where I'd go. And thinking about it made me panic. I also know that the 'just kill me' times were mostly when I was being killed, or pushed close to it. There wasn't always pain, then. It was just relentless.

You're making a great point, though. I don't know that I can remember all the times when I might have just wanted relief. Usually, that level of detail comes up when I'm actually doing the processing work, in session (thankfully). It's something I can ask my therapist, too, I think he's got a better handle on the overview than I do.

 

[lostforgottensoul]

I really think you are mixing up three totally different concepts.

I think the whole thing confuses me, but then again I guess thats why we have therapists lol.

I think you are right. I think im going off of just Criterion A cuz thats what we are talking about but reading about PTSD, im all mixed up and confused after reading like 1/4 of it.

understanding why I have so many memories of fighting to stay alive at the last minute, even though my overwhelming memory, the thing that was going on much more often, was that I wanted to stop living. I didn't want to wake up

Yes you did, as did I and suicidal people dont want to die, we all want and wanted the same thing, for the pain & suffering to stop.

Its the reason that my 14 yr old mind thought that the better way to end it was to carry out a murder suicide plot that I planned out for MONTHS, instead of just telling someone cuz I was terrified out of telling. So I thought that was the better way to just make it stop.

I got talked out of what the person thought was just a suicide plan and what he still doesnt know today (my Mentor at the time that I recently got back in touch with) is he saved 3 lives that day.

No one really wants to die and I would even throw in the terminally ill/"mercy killings" as they dont want to die, they just dont have a choice.

We all just have that survival instict and I guess I could say (hopefully one day believe) that i did all that i did as a kid to survive, though today I judge it, if I could go back to my child mind, I could probably say that I was scared they were going to kill me during their "punishments" and I guess I could say (though often very pissed at myself for it) that when presented with "a way out", a loaded gun, though suicidal since age 8 and I was then 14, I turned it down because i didnt really want to die...i just wanted it to stop.

...now if i could just myself to believe all of that....

But you, perspective from the outside, I agree 100% w/ @scout86 and say you didnt actually want to die, you just didnt want to suffer anymore and I 100% identify with that feeling then and now.

 

[RussH]

I dont know, I guess I started to understand it all a bit better until someone threw it "catastrophic injury" being physical only and now Im just all confused again, I think moreso.

Personally I would disagree that a catastrophic injury being physical only. I think of the vets who have not suffered any physical injury, but are incapacitated because of the emotional / mental injury they have suffered from combat.

 

[lostforgottensoul]

@RussH thats how i was seeing it too, for vets as well as others but now im just all super confused.

But im just sorta hang back and watch and see if it starts to come together for me again.

 

[dnp]

Personally I would disagree that a catastrophic injury being physical only. I think of the vets who have not suffered any physical injury, but are incapacitated because of the emotional / mental injury they have suffered from combat.

Everyone who has PTSD is emotionally incapacitated, not just vets. That's why it's PTSD and not just "dealing with shit", it's debilitating and incapacitating. We are talking about what caused the PTSD in the first place (ie the combat--threat to life and limb), not what it is like to live with PTSD afterwards, which is again hell for everyone, not just vets. My issue with requiring catastrophic injury is it makes more sense for non-interpersonal trauma. Minor injuries are usually no big deal if caused accidentally but when caused deliberately it can be a whole different ballgame depending on the context. There are some sick, twisted individuals out there and being a prisoner of one of these psychos and the calculated pain and torment they inflict on you over a long period of time can easily screw up your limbic system, as you live in terror from moment to moment for years at a time. Oftentimes they target minor body parts. Again, it's about the pain, not about the degree of injury.

 

[lostforgottensoul]

There are some sick, twisted individuals out there and being a prisoner of one of these psychos and the calculated pain and torment they inflict on you over a long period of time can easily screw up your limbic system, as you live in terror from moment to moment for years at a time.

But you seem to be contracidting yourself, the way im reading it anyway.

Remembering im dyslexic and not all smart (im my opinion at all but especially about legal and medical terms) but what you say here and your entire post is, to me, stating that you dont have to have physical injuryies to have catastrophic injury...but here:

If you can find me a solid source that includes psychological injury as part of catastrophic injury, point me to it and I'll absolutely consider it.

You are saying it must be physical.

Which is it?

Layman's terms to what you are saying please because apparently im not quote following any of it.

Again, i may just back out for a bit and watch because the more i participate in the last day or so the more im getting confused; i thought I was understanding Criterion A a bit better with the simplier way of defining it but now not so sure.

 

[joeylittle]

There are some sick, twisted individuals out there and being a prisoner of one of these psychos and the calculated pain and torment they inflict on you over a long period of time can easily screw up your limbic system, as you live in terror from moment to moment for years at a time. Oftentimes they target minor body parts. Again, it's about the pain, not about the degree of injury.

And it can also be about the fear of the immediate next action, or consequence, not just the pain. Pain is blinding. When you are in that kind of pain it is very hard, especially if you've never experienced it before, to tell yourself 'this isn't going to cause me an actual injury, and I'm not going to die.

I honestly think the criterion, as it is written right now, and even how it is edited in the thread over in Discussion - that criterion absolutely covers extreme physical pain that results in minimal injury.

Spoiler: a personal example

The first time I was shocked not just on one point, but on a connected current - I could not see exactly what they were doing. I had previously been shocked by something much smaller. I knew there were more things on my body. I knew there was a box. But I couldn't see. And when it happened, I absolutely believed my legs had been blown off. I heard a noise, it sounded like a shotgun in my mind, I could not feel anything below my waist and I was now hanging, not standing. I had very small burns when it was all said and done. They didn't even scar. That's the sort of thing that I understand caused extreme pain, resulted in no injury, but I thought I had no legs. It remains one of my strongest and most difficult physical flashbacks, and it can persist for a few hours if I don't get on top of it right away.

I know I'm not a research base of one - but I certainly know what I was thinking when I had a lot of pain with little damage. I think this phenomenon shifts, the more desensitized someone gets to the pain, and the more you learn what it's going to feel like. You learn you can live through it. But that's not right away.

 

[dnp]

@lostforgottensoul I'm not contradicting myself. There is the cause of PTSD and the effect of PTSD, two different things. Then there are terms that have legal effect and those that don't. Having legal effect means that the definition of the term matters greatly to insurance companies and the government because it determines how much they will have to spend to pay for insurance claims and pension. For such terms you must be very careful about how you define them, because there could be legal consequences.

When we talk about "catastrophic injury" we are talking about the CAUSE of PTSD not the EFFECT of PTSD. We are also talking about a term that has legal impact on insurance companies and the government. So this term will be defined carefully by a PANEL OF EXPERTS who will look at the way the term is currently being used in legal statutes and by the AMA.

When I say people are psychologically harmed who have PTSD I mean the EFFECT of PTSD not the CAUSE of PTSD. Also being "psychologically harmed" will not be an issue for insurance companies and the government. Instead they will investigate whether someone has specific symptoms reflecting psychological harm.

I am not sure how else to explain it.

 

[lostforgottensoul]

@joeylittle just thought id give you a :hug:

Sorry for going off topic, just felt the need to do that, for many reasons.

 

[lostforgottensoul]

When we talk about "catastrophic injury" we are talking about the CAUSE of PTSD not the EFFECT of PTSD.

But thats what the other thread is talking about, the cause.

Also being "psychologically harmed" will not be an issue for insurance companies and the government. Instead they will investigate whether someone has specific symptoms reflecting psychological harm.

Symptoms vary and my insurence company has a therapist of their own. By law, my therapist has to tell me what they talk about. They talk about what caused it, not the effect of it as much.

They do talk about effect too, but the cause is the many topic and the effect is secondary and not as important.

Just to throw that in.