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C-PTSD: A Diagnosis That Finally Fits

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flashbacks

Nishkaa, may I ask how you experience your flashbacks? I'm not asking you to disclose content, but what they are like. How can you tell you are having one?

I still have difficulty with this. Some, concerning incidents that happened as a young adult, can be accompanied by a visual flash or fleeting associated image. Those are the easiest. Many relate to childhood and seem to be experienced as sensation, or a sensation cluster that might include a rather benign flash of a wall or an interior, but maybe not.

Recently, I realized *why* I would plummet into a ten minute bout of despair when visiting a particilar new doctor's office in a neighboring town. Something had happened in the town 30 years ago! How I figured this out was examining my thoughts and asking *why* *what* triggered the despair, because nothing else seemed suspect or amiss. And the descent was so precipitous and sudden, the thoughts, sensations all a blur.

So I suppose the right diagnosis is critical. Otherwise, I would not frame my discomfort as a *flashback*. Instead it would be treated as a chemical incident and medicated. We know medication or street drugs do not stop flashbacks

Thank you for your kind acknowledgement of my misdiagnosis. Sounds like you have a valuable ally in your social worker. I'm glad. Courage and peace to you on your way.

Penelope
 
Guenhwyvar, welcome to you, too. I read your introduction. Thank you. You seem very brave to me.

Godspeed on your healing journey,

Penelope
 
Hi Penelope,

I'm not sure how to interpret 'felt sensations', as in tactile, as in the body's experiencing, or whether it is the best thing to go into deeper interpretation of it? I think this might make a really fascinating separate thread on the discussion board, to make sure more people see and can respond to it.


I can only speak to it through the limitations of my own experiencing, and I'm vague in other areas. So it's good to get feedback from others, because they may have even greater understanding and knowledge of how to work with the felt sense.

Sometimes the 'felt sense' for me are clues about the body's physiological response to things like anxiety, panic attacks, emotional states of mind, so they can indicate a trigger coming on and sometimes before it takes full hold as in flashback, dissociation. Sometimes they can indicate stored energy to do with fight/flight and freeze responses. And sometimes they do tell us about our emotions and as we get to know them, it can help us identify our emotions earlier before our brains recognize them-- this is powerful stuff to get to know.

For me at this stage in my recovering, I've been steering away from interpreting the felt senses, as I'm just begining to get to know them. I have been getting some insights about them and ways I can use this to my advantage over troublng symptoms.

What I've spend some time doing is to simply observe them, you might want to start to record them in a journal. I started to do that for a bit, with an outline picture of a human form, a "gingerbread woman" figure even :) and I would use crayons to colour in where I feel sensations, and a one word description of it, e.g. tingling, aching, sore, etc.). That might be a really good place to start, if you haven't already re: getting tuned to the felt sense and observing your own tendencies. I photocopied these pictures and I would place the date at the top of the page, so I had started a bit of a journal for body sensations. I think over time of observation, a person can lean how it's own body can communicate with the self, inform on feelings, on danger on pre-flashback panic/hyperarousal.

At my stage of recovery which is still a lot to do with stage one, back at stage one, it's important for me to learn first to relax about what I observe happening in my body, because I need to feel safe, I need to not panic about my body, cause it's my major ally in my recovery :).

The mindfulness meditation and the yoga I've been introduced to, for now is a training about simply observing the body's sensations when they arise, but then to refocus on the breath. I think this is important to get a good foundation of safety with one's body because it can become a very helpful ally to help re-ground from flashback and to keep present to the present moment of experiencing, without going to far off into mind (where we can also start dissociating more, etc.).

I've discovered that he felt sense, to me can be an early warning indicator of early onset of a trigger, before it becomes flashback. "Something's wrong, am I safe right now. . . I need to get someplace where I'm safe", so I can be with myself and observe this and take care of myself. Or if sitting a waiting room, can possibly pull that off safely and discretely

I've been discovering that certain sensations do alert me to a panic attack before even my heart rate goes funky, and if I catch on to it, I can practice mindful abdominal breathing technique and actually prevent a full blown panic attack. I can feel things like tension around my heart, like queezy stomach, constriction in my throat-- they're not flashbacks. But the panic, the physiologial arousal in response to a trigger, can bring on flashbacks-- it's that hyperarousal thing, cluster of ptsd symptoms. The cool thing about the breathing technique is that it can be done discreetly even, in public. I practice it when I'm on a bus or at the bus stop, etc.


That's what I can give you so far about how I'm working with it.

There are some specific therapies that are out there that work more closely with the body, the felt sense, but I think that's better when you have a therapist that's specialized in these methods? I'd also ask the group directly for their imput on this, if you are thinking about exploring that type of therapy? Somatic therapies; "emotional freedom technique", things like that. . .?

The doctor's office experience, sounds like it was possibly an emotional flashback-- I find those confusing to me. I sometimes can't tell what's happening within and separate what's happening around me-- sometimes I've over-doubted myself, so there is something to intuition and trusting that to keep yourself safe.

A couple of things you might want to check out: 1) there's a Pete Walker article in the "Articles" section on this board to do with C-PTSD and Emotional Flashbacks, that might help you out a bit more.

Another thing that's kind of trippy are "psychic flashbacks", I read about that I think in a Babette Rothschild book, something about 8 Keys. . . re: helpful for ptsd recovery-- sorry, I don't have the exact title handy at the moment. But those are also kind of trippy.

I remember one quite clearly now, but I didn't have a concept for it at the time, but it wasn't too long ago, but it was picking up on the slightest of gestures I percieved in a flash moment in a person's expression. I 'read it', it created panic in me, I went on to experience flashbacks afterwards. I kept myself safe and grounded and alert while dealing with this person, keep present to what's going on, deal with my feelings later.

The freaky thing was, is that I percieved it correctly, a flash, instant insight and I know this because I had a chance to talk to that person afterwards and I just told her what I was picking up on, it wasn't a new issue, but I had thought it was resolved. It's been an issue that's been hurtful (jealousies, it hurts me, I expect further attacks and there are situations those jealousies have prompted violence towards my self or another person-- so it does flip me out). A "psychic flashback' and I thought I was going totally insane, it really freaked me out. But it was a completely accurate perception of that person, in that moment.

Jealousy is pretty intense energy, just like rage is. She was trying to keep it down and I also felt that effort as well. And a slight very miniscule curl of the lip. It's freaky. It was difficult because we were working on a group project and then I'd be at the project site, and than energy travels, she'd get mad at her boyfriend, he'll over-compensate and treat me bad, then because he's the head-hauncho, it spreads to the other workers, some are male, and I had also a bad experience before at this event related to that. . . and I'll just stop there for now, but men who think it's okay to dominate and take, pick up on mysogynist energies take to objectification of me. . . it's gross. Sorry. I don't dislike men, there are many really good men, more so than the occaisional psychotic/sociopath for example. And I had no interest in her geezer boyfriend whatsoever (he wouldn't even bother wearing his teeth :) ), no attraction there-- it's all to do with her own insecurity, abandonment issues, etc. and it's really intense for her. She's a good person though, it's just hard for her, her old wounds coming forth and current insecurities. It's just a trigger reaction for her that's just really difficult for her to deal with. I always dressed down, kept my clothes baggy, even churchy, and even held back on participating, I'd introduce new ideas to her, not in front of her boyfriend. . . kind of stressful.
 
Nishkaa,

Some people esp. those traumatized are/become hyper-vigilant. That curl of the lip or whatever
Really wonderful to have your reading of the situation validated. I find that doesn't always happen. I can tend to get a bit paranoid :( Fortunately I have a few people I trust and can talk with, and my self-talk has become more helpful.

I think by sensation I mean recognizing a group of sensation as flashback. Maybe put that my reaction to input/sensation interpreted through a past-tense filter. The terms emotional flashback and psychic flashback...I'll look them up. I have Babbitt's book (one of them). I stashed them for awhile. Sometimes I need a break, and it might be time to dust them off.

My shrink wants me to attend a mindfulness group. Good idea, I think. I attended an eight week course last year. Afterwards it became too difficult to practice alone. I would become overwhelmed at any random time. I needed a group to hold me together. At the time I felt great shame over that need and told no one, but I found out a group is available! Yes!

Boy, you sound like you are working it. Good for you! It is pretty much life or death, isn't it?

Thank you for the suggestions and information, and most of all for describing your experience. That is very helpful. I wish you continuing success and happiness, too.

Penelope
 
Hi Penelope,

Yes, I was going a bit overboard, as if my "life depended on it" :) I'm feeling much better myself too. :) I get really frustrated with my illness but then on the other hand, that just motivates me to try push forward, work on it, face it.

Nishkaa,

I think by sensation I mean recognizing a group of sensation as flashback. Maybe put that my reaction to input/sensation interpreted through a past-tense filter. The terms emotional flashback and psychic flashback...I'll look them up. I have Babbitt's book (one of them). I stashed them for awhile. Sometimes I need a break, and it might be time to dust them off.

I think that is really interesting and totally possible. Okay and it does make sense more in the context of processing post-an-experience-- that is where insights can bubble up in.

My shrink wants me to attend a mindfulness group. Good idea, I think. I attended an eight week course last year. Afterwards it became too difficult to practice alone. I would become overwhelmed at any random time. I needed a group to hold me together. At the time I felt great shame over that need and told no one, but I found out a group is available! Yes!

I think the mindfulness group will be a great assistance-- that's good stuff, IME, IMO. Don't feel ashamed re: it being difficult to practice on your own. Well, at least I can say, I've fallen behind in my practice, while I know it's something that's good for me and I should be keeping up with it. I'm still fall off track and routines are still really difficult for me as a result. But that's when it's just time to pick up again, see if I can get better at protecting my routines. Everything is learning experience, some things more challenging that others. It's still staying fresh, I'm still able to recall things I've learned, so that's a case of the "glass being half full" :) I took the MBSR course-- and that one really helped me re: starting to re-connect with my body (it's been separate from my mind for a long time lol :) ), and it helps, like in the work you are doing re: cluster of sensations, could they be flashback-- it's a good question to keep open to, and see what you observe about it over time.[/QUOTE]

I like you, Penelope-- I think you've got some good smarts about you, in-tuned insights and it's cool too that you are as well really embracing your recovery, looking at the challenges, being engaged with your experiencing and your healing process.

I am way more relaxed today than I have been for the week. I pushed through the storm and I learnt a lot of new things from being here and even that it's such a short time I've been here. Your questions are great, and they helped me to think things through that I'd otherwise avoid or not be able to get to for a while ;-) So, it's awesome you are here. All the Best to You. Keep us updated on the mindfulness course, when you get the chance to. Your fearlessless in addressing things, inspired some fearlessness and determination in me. It's great gift.
 
After 36 years of suffering, 3 years diagnosed with Major Bipolar Disorder (and 30 meds later), my therapist began to feel about 9 months ago that my Dx was wrong. She fought tooth and nail to get my PNHP to treat my panic/ anxiety and she refused. She didn't think that I had PTSD of any form. Neglecting to remember my chart and that I had trauma experiences in the womb.

I am more than happy to carry the CPTSD Dx. I will take therapy for the next five years than being on all of that nasty medication. It has been an incredible lesson to me; I now want to go into Mental Health Advocacy. I know that I can't stop every misdiagnosis of BP (the whole anti-depressant trick actually DOES NOT WORK for sufferers like us).

If you go to the CPTSD page on here, it explicitly states that a patient that had a presentation of trauma BEFORE the onset of any BP symptoms cannot be Dx's with BP. Also, if you experience Lithium toxicity or any signs of the drug NOT working, you do not have Bipolar. The AD thing was based on SSRI's and how they effect brain chemistry. The unfortunate part is that patients with CPTSD already have chemicals that have altered themselves over the course of years, starting in infancy. We develope a dependency on Dopamine and Adrenaline. Those two chemicals adversely react to SSRI's and show a presentation of Hyper- Arousal (very similar to mania, but not even close in intensity). So, the reliance on testing for BP with an SSRI is unreliable and the DVSM will be calling for an end to that practice.

That's the other hang up, the symptoms almost mirror each other. It takes a good Pdoc, GP or PNHP (or for that matter, a really good therapist) to recognize that what was originally thought as the correct dx isn't.
My therapist (notice that I go to nurse practitioners and not actual docs, I started off that way for a year and a half and fired both of them). So, she may not have extensive experience in CPTSD, but she has a collegue in her office that is an expert and I gave permission to consult on my case.

I have my MD, therapist and NP all working together. That is essential, it is incredibly important that your health support know everything that is going on and that they all consult each other at least every other week. I am very staunch about that.

Now for the memory work that I have been trying to do for 15 years (15 therapists and 6 Pdocs). I now have made more progress knowing that my issue wasn't something that was uncontrollable (in my eyes) to something that I knew that I could do, heal myself.

When you look at the grander scale, you'll see that sacrificing a year or two more isn't that much in comparison of being miserable, scared and hyper- vigilant for years. I will gladly take the momentary pain of remembering something that has repeatedly effected my life, my relationships and my own self. To be able to think that I am even on a road to becoming a functional wife and mother. Yes, I broke the odds. I've been married almost eight years and we have a seven year old son. These two are my reason for even getting out of bed in the morning. If I can have a successful, happy, loving, supportive and stable marriage, I can do anything.

The same goes for all of you! Just believe in yourselves. You've made it this far with all of that pain, don't you think that you deserve some happiness finally after all of the suffering. It may be scary, but it's worth living life, maybe for the first time ever without fear.
 
Hi Penelope

I know what you mean about the sense of futility and emptiness. Sometimes it's as if I don't know what there is to look forward to because I have spent so long looking backwards. In my experience a lot of conventional councelling, including CBT, can involve a lot of discussion about the past, but there is considerable evidence that reliving the traumas can cause more harm than good. This is so especially if you relive the experiences in an emotionally aroused state, something that some therapists seem to encourage in order to get us to 'spill'.

Personally, I wouldn't do this. Try to look forwards rather than backwards and build a picture in your mind of your life as you would like it to be. After all, we can't change the past, only the present and the future. I like to picture my future as being full of friends, music, laughter and general silliness - fun in other words. Then, take small but sure and certain steps towards achieving that goal. Each tiny victory can give you a tremendous sense of fulfillment. We can change ourselves and it is empowering and life-enhancing to do so. There are 'solution-based' therapists who work to solve your current problems and they spend minimal time dwelling on the past. It may be worth seeking out one of these. I have a lovely therapist who works in this way and she has helped me enormously.

I fail a lot of the time too, and it seems sometimes and then it seems I have made little progress. But if I look at what I have achieved over a longer period of time I see that there is evidence that things have improved and that helps me stay on track.

Good luck to you on your journey back to health. It is a journey and that can be exciting. Make the world work for you for a change. Remember that you are as worthy and valuable human being as anyone else, and you are utterly unique and special.

Nicola
 
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