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

[joeylittle]

I'm starting this thread to contain a sidebar discussion from this thread: (Lets Create A Ptsd Diagnosis), because i think it's interesting and worthy of it's own thread.

I struggle with this often, and maybe other people do as well..

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A. Direct exposure to actual or immediate threat of death, catastrophic injury, or sexual violence. (Does not apply to exposure to electronic media, television, movies, or pictures, unless the exposure is work related for a period of longevity.)

It says the same thing, adding direct to the beginning. Whether it happened to you, or you witnessed it, the exposure was direct, not third hand. What holes exist in that?

Actually, I think 'direct exposure to actual or immediate threat of' shifts it to be more oblique; now, direct exposure can mean more things than just experiencing or witnessing. The one that jumps to mind is in fiction: you could say that you were directly exposed to threat of death because your character in an RPG was threatened with death. By breaking it out into the specifics - experiencing or witnessing - it does introduce hard limits.

For a period of longevity probably needs to address frequency and duration more clearly: 'unless the exposure is work-related, and of significant frequency and duration'. Could do:

A. Direct exposure (via experiencing or witnessing) actual or immediate threat of: death, catastrophic injury, and/or sexual violence. (Does not apply to exposure via electronic media, television, movies, pictures, or text unless the exposure is both work-related, and of significant frequency and duration.)

'Significant' is being left open for interpretation, but no-one would mistake significant for one week, or two viewings.

 

[lostforgottensoul]

unless that exposure is under duress.)

Thats what i was getting at earlier but @joeylittle had advised that being forced (or under duress) is threat which is already in there at the top, what im having trouble with is:

"Direct exposure to actual or immediate threat of death"

As that doesnt go into violence that doesnt include death or thinking one may die.

I have plenty of examples of that where by itself it is enough to cause PTSD.

I suppose one would think "i may die" would cross ones mind, but it doesnt always in severe violence. And "threat of death" does that mean that someone has to threat to kill me within the violence? If so that only happened a few times in the full 13 yrs.

I understand there are other things but just that one is bothering me as just that one could cause PTSD so i think it should be reword of something like:

Direct acute violence for a long period of time [or can re-word the long period of time] or Direct exposure to actual or immediate threat of death.

This would include severe violence were a threat of death isnt there but the violence is enough to have caused PTSD.

 

[lostforgottensoul]

In addtion to my above post, Id like to say (sorry if this is off topic) that I love that we are simplifing PTSD & CPTSD as it confuses me as it is, most especially CPTSD & to have a simple 'dignosis' is great!

Also for @anthony to include our inputs and thoughts into an article I find really awesome, and now that I understand the thread, I understand what were are supposed to be focused on, I understand the need to have it be very well focused on one thing at a time.

Anyway, @anthony or @joeylittle or both; any thoughts on my post right above this one?

When you come online that is lol.

 

[joeylittle]

"Direct exposure to actual or immediate threat of death"

As that doesnt go into violence that doesnt include death or thinking one may die.

No, but catastrophic injury covers that. This is also why not every traumatic event actually creates PTSD. What is important (I think) is the 100% belief that something irreversible (death, catastrophic injury, rape) is about to occur.

I suppose one would think "i may die" would cross ones mind, but it doesnt always in severe violence. And "threat of death" does that mean that someone has to threat to kill me within the violence? If so that only happened a few times in the full 13 yrs.

Part of the thing with intense fear is that it is not always accompanied by rational thought. So you might not remember thinking 'I may die' - you could remember believing you would not make it through, or believing that the violence would never stop. And no - threat of death isn't literal threatening to kill, it's that from your perspective, death was possible and imminent. That it only happened a few times doesn't matter. It only needs to happen once.

Spoiler: personal example not relevant to main conversation

I'm very clear with myself, for example, about when I was 'coping' during my trauma (either desensitized, dissociated), and when I was not. Some things that would seem horrible, I coped with. I'm still traumatized by them. But the brain-changing moments, they are seared into my synapses in a very different way.

 

[dnp]

A. Exposure to actual or immediate threat of death, catastrophic injury, or sexual violence in one (or more) of the following ways:

1. Directly experiencing the traumatic event(s),
2. Witnessing, in person, the event(s) immediately as it occurred to others.

What if someone were taken prisoner and tortured in ways that were calculated to maximize pain and minimize injury, like bamboo under the fingernails, electric shock, waterboarding, kept in a squatting position, etc. They never experience immediate threat of death though they believe everyday that they might one day die under torture or be killed. However the torture is so unbearable that if they got their hands on a sharp object or a rope they would kill themselves without hesitation. Let's say one day their captor puts a gun to their head and instead of feeling fear they feel relief. They are far beyond the point where the fear of death even registers. They don't meet this trauma criterion, so would they have Adjustment Disorder instead of PTSD?

 

[lostforgottensoul]

No, but catastrophic injury covers that.

I got yeah there, I was going off of:

So at the moment we're at:


A. Direct exposure to actual or immediate threat of death, catastrophic injury, or sexual violence. (Does not apply to exposure to electronic media, television, movies, or pictures, unless the exposure is work related for a period of longevity.)

or believing that the violence would never stop.

This def so I get what your saying, so even if i dont remember feeling like i was going to be killed, just the fear i had covers that, right?

Just trying to understand.

A. Direct exposure (via experiencing or witnessing) to actual or immediate threat of: death, catastrophic injury, and/or sexual violence. (Does not apply to exposure via electronic media, television, movies, pictures, or text, unless the exposure is of significant frequency and duration.)

I like this, maybe add some sort of wording that would discribe significant like horrific sort or type but i also understand that the threat of violence, "dont look away or else" sort of thing would be in the violence area, right?

Also trying to understand, and add if possible.

Edited to add: I missed "catastrophic injury" so violence w/ fear of severe injury and/or death. That covers my issue. Sorry for missing that part.

 

[lostforgottensoul]

They don't meet this trauma criterion,

I think they do, the fear of death is there before the 'relief of dying' and the violence/torture is there too.

 

[dnp]

I think they do, the fear of death is there before the 'relief of dying' and the violence/torture is there too.

But under this hypothetical definition, you need "immediate threat of death" or "catastrophic injury." A general fear of death or violence wouldn't fit.

 

[lostforgottensoul]

A general fear of death or violence wouldn't fit.

Why wouldnt it taken in account this: (sorry for the long quote)

Edited to add: I dont think your example is a "general fear" of any sort in my opinion

Part of the thing with intense fear is that it is not always accompanied by rational thought. So you might not remember thinking 'I may die' - you could remember believing you would not make it through, or believing that the violence would never stop. And no - threat of death isn't literal threatening to kill, it's that from your perspective, death was possible and imminent. That it only happened a few times doesn't matter. It only needs to happen once.

Wouldnt it fit under that explaination?

 

[dnp]

In my example there's never any "immediate threat" of death while the person still has the emotional capacity to fear death. Having bamboo under your fingernails or any number of other tortures will never cause you to die or cause catastrophic injury, it's calculated to cause extreme pain without overly damaging the body.

 

[joeylittle]

What if someone were taken prisoner and tortured in ways that were calculated to maximize pain and minimize injury, like bamboo under the fingernails, electric shock, waterboarding, kept in a squatting position, etc. They never experience immediate threat of death though they believe everyday that they might one day die under torture or be killed.

I was tortured. Although the methods are designed to not kill you, and to generally not cause catastrophic injury (so you can live to be tortured some more), the person being tortured doesn't experience them as such. Experientially, they are extreme, the pain is extreme, and it is hard to think anything at all except that you can't make it.

I don't mean to speak for all people who have been tortured in these ways, but I think I'm right enough to answer your question. Threat of death or catastrophic injury is inclusive of the perspective of the person enduring it, not limited to a neutral perspective.

 

[KwanYingirl]

Sometimes people in hell just want a drink of water...