C-ptsd, Never Had Dissociation?

[ghotiff]

I too would like to understand the difference between a "flashback" and "dissociation".

I have had visual images come up where I see his face clearly, but the emotional tagging is basically zero, I simply think "Ugg, didn't need to be reminded of his face".

I also have moments where I zone out. A trigger gets me and I feel like I'm standing just behind and separated from myself. I cease to feel the trigger (ie someones hand on my shoulder) but am locked in an intense fear/freeze response. After a few minutes, I move back into my body and can let go of the immediate intense panic reaction. For the next few hours (at least), I am then very distracted by this event, can't shake the residual fear feelings, and can't concentrate properly.

More rarely, I zone out to the point that I'm not even watching myself, but instead time stops for me...and I come back into the real world later in time, and I'm aware that the conversation has changed since I last was aware of it, and I have also come back and found myself in a different location in the room.

I don't know, are these flashbacks? The later two take me back to the emotional state of fear....and the fear dominates all my mental faculties....but during these I have no memories of the past, just the feeling of fear.

 

[ResaLock]

The fact that the American Psychiatric Association and DSM has not officially listed it yet does NOT phase me at all. Complex Post Traumatic Stress Disorder is caused from prolonged exposure to trauma over a period of time. It does NOT mean I have a personality disorder. Complex Post Traumatic Stress Disorder has many similar symptoms to some personality disorders but it is not a personality disorder. The conflict of having a discernible difference between the two is what makes DSM so stubborn or whatever. Just because it's not written down in a book doesn't mean its not real. If a crime isn't documented did it not happen? Really I did not ask for views on C-PTSD at all. I asked about dissociation. That's all. So please, I respect your opinion. So respect mine. I really don't need to be feeling invalidated right now.

I completely agree with you on this. I am not sure who you were responding to. I am just replying because your comment came after mine. I just want to give you reassurance and confirm I agree with you and did not imply or intend it is a personality disorder. Though it is coded as itself as a personality disorder. It IS a symptom of PTSD. I also believe in C-PTSD, and I believe in many cases there has to be a clear distinction that there is a more severe suffering that is distinguished in C-PTSD sufferings. Also making clear that I believe it does exist. Like I said there are noted Psychiatrist who do recognize it and have diagnosed it. As I mentioned you can find the interviews on line with psychiatrists confirming this. Disassociation; derealizaton and depersonalization are common symptoms of PTSD with severe traumas. What I have described is what dissociation is and I hope it was clear explanation of what it is. As I did my best to answer your question by what I know about it.

Concerning the personality disorders. I agree that it is irrelevant to what you asked for. I personally don't have personality disorders, but I also have conflicting views about those ideas anyway, but like I said its completely irrelevant. So I have not discussed it.

 

[NovemberStar]

@PandaBear12212 - I very very very much relate to what you wrote above. I have felt exactly the same, and about the same issues - you are not alone in this, trust me! I was told I had BPD. Yes I had some of the traits; but I do not believe that was my problem. I have MAJOR issues with the diagnosis of BPD in general - I absolutely believe in all my heart is is a very very very over-used label and I believe it is gender-biased (men with the same symptoms and issues are more likely to be diagnosed with PTSD and / or other diagnoses; whereas if you are a female, have the exact same symptoms, but have been abused, self harm, and are aged under 25 at your first contact with a mental health professional, you will pretty much be diagnosed with BPD, and often to the exclusion of PTSD).

For me, the label BPD meant I was treated as attention seeking; my reaching our for help when feeling suicidal was not taken seriously because to do so was seen to 'feed the problem' and 'give me the attention I was clearly looking for'. It also meant the 'problem' was MY PERSONALITY - something that can't be changed; and it also meant the problem was caused by something inside of me, rather than by things done TO me.

I know you wanted replies to be about dissociation - sorry my post is off topic, but I related so much to what you put and wanted to acknowledge that. (I love your analogies in regards to it also!)

 

[NovemberStar]

The fact that the American Psychiatric Association and DSM has not officially listed it yet does NOT phase me at all. . Just because it's not written down in a book doesn't mean its not real.

Sorry - have to add - I totally agree - and I am willing to bet that at some time in the future it will be recognized. Geez - in the not so distant past, doctors didn't think PMS was real; that women saying they had been raped or sexually abused were 'hysterical' (and lying); and a whole lot of other 'female' dominated conditions were 'in our heads'. But that didn't make those doctors right, and eventually they changed their minds.

 

[Justmehere]

@anthony - I don't think you're in the United States, so I just wanted to let you know something about the mental health care professional culture in the United States

If she has an American mental health care provider who has diagnosed her with complex PTSD this would not be terribly surprising. In the United States the DSM has fallen out of favor with a lot of mental health care professionals because the latest addition was so controversial here in the US. It is still used for insurance purposes but it is used less and less actual practical diagnostic day-to-day treatment purposes. It's very unfortunate that there has been a loss in practical standardization in the US among some care providers. It could be possible that her therapist diagnosed her with complex PTSD because she is one of the many professionals in the United States that doesn't agree with the DSM any longer and is not educated enough to know about what the World Health Organization publishes.

Controversy about the cptsd diagnosis or not, many many trauma specialists, including those even at Harvard, use that diagnosis in the states. Hopefully the next edition of the DSM will be improved, updated, more modern and more widely accepted here in the States. Or, a different standard will come out that mental health professionals will trust and use more.

But as for the DSM right now, it has fallen so out of favor and use that even the National Institute of Health, NIH, the major central research arm for the federal government here, has issued statements that they are gearing research away from the diagnostic standards in the DSM about a year ago. I didn't ever read them switching to the WHO standard.

Just wanted to let you know that info.

I personally have no opinion about the DSM being good or bad (but I do think a standard is needed.). I have been diagnosed on paperwork to my insurance company with all of the following: PTSD, complex PTSD, dissociation nos, PTSD with dissociative features, anxiety, depression, "cyclothmia that will resolve with trauma treatment"... so many things that for me, I've long given up sorting it out the best diagnosis for me... but that's a whole other topic.

You are right no formal standard uses complex PTSD. It's still very often given as a diagnosis in the US, which is admittedly confusing, as I have read of different criteria being used for it. But that's another topic too.

Back to the discussion about what dissociation is...

 

[Justmehere]

One last thought.

Suffering is suffering.

I personally would not say suffering from PTSD is better or worse than cPTSD. I would not say cPTSD is worse or better than PTSD.

I believe some people appropriately push back on the validity of cPTSD being a whole new diagnosis when it is used as a comparison to say they suffer worse than someone with PTSD.

It is very dangerous to start comparing which major mental health condition is worse to experience than any other. PTSD alone is hell.

I think it is very safe and very valid to say possible cPTSD may include additional symptoms to PTSD and their may typically be different paths to healing - But not that the suffering with PTSD is any better or worse than for those with cPTSD.

This is one area where I think all standards fall apart. Everyone has their own horrible experience and it's dangerous to start saying mine is worse than yours.

Everyone with lingering effects from trauma is suffering way more than should be.

Everyone has their own experience with PTSD and all of them are really awful.

I personally have been told I have cPTSD but I do not believe I suffer worse than people with PTSD. I have such a hard time accepting I have PTSD at all!

I know people with single event PTSD who are way more debilitated than my multiple event related PTSD. I know people with cPTSD and PTSD who are much less debilitated by it than what I experience.

Can we agree on one thing? Trauma is awful. PTSD in it's many forms is awful. It's a horrible thing to suffer from.

I may be putting my fort in my mouth or speaking way out of turn on all of this - and if I am, I'm sorry.

 

[Deleted member 1860]

Why does everyone have their panties in a bunch over what Anthony said? He merely stated it wasn't an OFFICIAL diagnosis and he is 100% correct. It's not. No official document will list CPTSD as a diagnosis; not for insurance purposes and not for government purposes. If its listed, insurance payments WILL be rejected as will any requests for government aid and such. Like it or not, that is the official diagnosis of everyone here who has been officially diagnosed. Don't like it? Put your money where your mouth is and don't take unfair advantage of the insurance system and pay everything out of pocket!

Nothing was said about particular symptoms not existing, as i think thats where the controversy comes in. Please don't compare CPTSD to PMS as its like apples and kumquats. Not the same AT ALL! In that case it was the symptoms themselves that were denied. Now its just a matter of semantics. People (for some reason) think that the ptsd label isn't good enough so now we need CPTSD as well? Why don't we keep going and give every type of trauma its own diagnosis? Like it or not, this is what we must work within for the time being.

And back to the original question.... If you don't experience dissociation, you don't have PTSD, let alone CPTSD. And playing devils advocate, lets say that CPTSD is a diagnosis (its not). You STILL wouldn't have it because CPTSD has a level of dissociation that is by far above and beyond the dissociation in PTSD per "criterion" 2... Alterations in attention and consciousness leading to amnesias and dissociative episodes and depersonalization.

A LOT of practitioners slap this fake diagnosis on anyone who had ongoing trauma, but not in a well thought out sort of way. That is, without much thought and examination into each and every symptom. I balk at it because its been INCORRECTLY applied to me more than once. Since it has no official set of criterion, it can be applied in a wishy-washy, haphazard of way. If it ever becomes official, i have a feeling that a lot of people who were told they have CPTSD won't qualify. I know I wouldn't because I hardly ever have dissociation outside of flashbacks and when I do, its only when i get into the nitty-gritty of the trauma. I even took a dissociation test that said my level of dissociation is on par with normal non-ptsd people. So see how its just thrown around? (I know I' not the only one!)

So if dissociation isn't a prominent feature, sorry to say but you were misdiagnosed with an unofficial disorder!

 

[Justmehere]

So instead of focusing on what terms my therapists and I choose to use during my personalized treatment, please just offer me the help I asked for in defining dissociation. I have absolutely no questions, comments, concerns, or doubts about my own diagnosis. Just about dissociation. For those of you who offered insight and help on dissociation and its symptoms, thank you.

You mentioned the diagnosis and that your providers seemed surprised you had the diagnosis but report no dissociation. It is in the title too. "cPTSD, never had dissociation?"

This title topic that invites discussion between the relationship of the diagnosis and dissociation. The content and title suggest a correlation between the diagnosis and an experience of dissociation that you have felt you do not have.

I think that's what multiple were responding to when speaking of the diagnosis.

You didn't even ask for feedback on experiences of dissociation until your second post in the thread.

You sound frustrated with people for responding to the aspect of your post that appeared to be the main topic. If you just wanted to know what just dissociation is, then in the future, I suggest refining and narrowing your topic to asking about dissociation and perhaps a title like "what is dissociation?" And don't mention the diagnosis that you don't want any feedback on in the title of the post. And to ask for that feedback in the original post. Then people might be more helpful to you and not talk about things you didn't want feedback on.

I understand you feel invalidated and I can understand why. I don't think anyone was trying to invalidate you. The way you phrased your own original post seemed like you were unsure of having cPTSD and no dissociation in spite of the diagnosis.

I am glad you have clarified that now -thanks.

 

[lukesa]

My shrink told me once, 'luke stop worrying about your diagnosis specifics, its just vernacular for a theraphist to look at your file and get a headstart on knowing whats up.

Your job will be to work with the symptoms, since those wont chage along with me changing the diagnosis. Your diagnosis isnt what brought you here it was your symptoms so lets help you with those before you stress on changing an acronym or two on your file "

Good advice i thought

 

[PandaBear12212]

@Justmehere I had to make the second post because I forgot to clarify in my first post that it was what I was looking for. Really I just want to focus on dissociation because I don't understand it and websites don't really clarify it well. I am very frustrated and I'm sorry if I seemed volatile. It's very aggravating when I ask a question about something and instead of getting an answer I get told that I'm wrong, that my diagnosis "doesn't exist" and that I have a personality disorder when I really don't.

As I said above I've seen seven different trauma therapists within the past week and they all agree that though the symptoms of C-PTSD are also symptoms of personality disorders, that I do not have a personality disorder. So not only did I have a second opinion, but a third, forth, fifth, and so on. I mean you could go onto say WebMD's symptom checker and type in your symptoms and a lot of symptoms would be shared between two or more diseases. But it doesn't mean you have more than one of them.

 

[Justmehere]

I totally hear you. Which is why I tried to explain to Anthony the DSM is out of favor in the US. So even though it's not in the DSM, it is still legit diagnosis your professionals gave you. And you did clarify what you were looking for.

I'm sorry it got off track from what you were hoping for.

I'm curious, did any of the ways other people dissociate ring true for you? You don't have to answer if you don't want to.

 

[PandaBear12212]

Well sometimes I go into a blank stare but that's because I'm having a flashback. But I haven't ever felt emotionally numb. In fact my emotions just like my awareness are always hyper-aroused. Recently I learned I've been having Partial Complex Seizures due to severe malnutrition, stress, and a complete lack of sleep (now less than 30 minutes a night). Because of this I am having extreme memory loss. And if you read up on partial complex seizures, the patient goes into a blank stare, but they aren't conscious, and they perform autonomous tasks like picking at clothes or mumbling but they're not conscious. This is what is happening to me lately. My doctors said because the seizures are non-convulsive they aren't as worried about it, they just told me to eat more and sleep more (like I wasn't trying that already).

I do remember one specific time when I had such a strong flashback I was completely out of where I was, and I actually believed that I was back in that night I was having the flashback of. Even after coming out of the flashback I was dazed and confused and panicking, mumbling words and looking around frantically.

I can't say that I've ever felt like the world seemed surreal. Although when I get to such an extreme point of exhaustion from such a great lack of sleep I do get extremely confused, like I know I haven't fallen asleep but I cant pay attention to anything and it all gets blurry and time passes really quickly and I feel almost drunk: a fumbling, dizzy, disoriented mess.

I don't know if my memory problems could also be my brain sort of dissociating as well, or if it is just physically caused by the seizures which are known to cause memory loss.

Lately I've been having this weird thing where I can not tell people apart. It feels like everyone I talk to is just the same person. I can't remember anyone's names, all the conversations seem to just blur together.

@ghotiff I understand your triggers about being reminded of his face. Whenever I see someone with a similar facial feature or scent or if I hear someone with a similar voice, it triggers a flashback and I become extremely afraid of that person even when they post absolutely no harm to me.