Do you think C-PTSD will make it into the DSM in your lifetime?

[tofubreadcoriander]

As the title says, Do you think C-PTSD will make it into the DSM in your lifetime?

I saw a trauma therapist for a few months whom diagnosed me with C-PTSD, extreme anxiety and dissociation. However, when I asked an official letter for the diagnosis from him, he wrote PTSD and not C-PTSD even though C-PTSD is recognized in ICD-11. When I challenged him about this, he said it shouldn't be a problem when clearly C-PTSD is different from single instance PTSD.

Personally, I don't think it'll make it into the DSM in my lifetime despite me being in my 30s even if there are modalities specifically designed to address it such as somatic experiencing which can address developmental trauma or NARM therapy.

What's your take on it?

 

[tofubreadcoriander]

Not all CPTSD is relational. And, yep. They include all kinds of complex trauma, including the many kinds of relational trauma.

The relationship between a torturer & their victim? Is going to be different than the relationship of a family member and their victim, and will further vary between a chosen relationship (like a battered spouse) and an involuntary relationship (like with a child, or kidnap victim, or child born into a cult, or person kidnapped/trafficked into a cult).

The details of EACH of those -and countless other- types of relational trauma? Will be found in smaller books. Exploring the myriad complexities of each.

Those smaller books? Will rarely be specific to PTSD, as PTSD is just one of MANY end results of trauma. Instead, the spectrum of responses common to those specific traumas/conditions. Helping therapists within their own context. Whether it’s PTSD, or OCD, or Phobias, or Personality Disorders, or a delusional disorder, or mood disorder, or whatever.

I see. I still think C-PTSD given it's due will revolutionize mental health(care) in general as many disorders stem from repeated trauma. When that will happen (point of this thread), the DSM will become a pamphlet. So while it's good that there are 700+ pages covering PTSD, in the DSM, and some cover relational trauma, when the link between childhood abuse and/or repeated trauma and the resulted disorders we see will be made, the DSM and the healthcare industry will be transformed. Would you agree?

I’m probably just being dumb as usual, I get so friggin confused! I need to go and poke the AI again.

How can the treatment be the same when they present quite differently, with cptsd being more relational / similar to bpd would dbt not be indicated over cbt/exposure/emdr etc?

You're not dumb and you're making a good point. @Friday was probably thinking about therapies such as EMDR which can help with both. In relational trauma however, trust has been broken and the therapy has to concentrate a lot on building that. EMDR is not focused (as far as I know) on that aspect from the point of view of the symptoms someone with C-PTSD might present with but instead tries to work with the memories in order to process them by invoking them ("bringing them in to the front"). This may not be enough for someone with relational trauma. Though, you could argue that a good therapist will know that trust needs to be built first before doing the work, so... Here lies in the question, would it be enough with current state of DSM (and implied psychotherapy training they receive)? I'd argue that no because C-PTSD isn't (yet?) recognized - why I made this thread in the first place. I'd go as far to say that with The Body Keeps the Score and the whole trauma awareness movement, failing to get C-PTSD into the DSM 5 TR has been the biggest failure of the field so far.

 

[Friday]

cptsd being more relational / similar to bpd

It’s NOT actually similar to bpd.

It’s similar to ANY/ALL personality disorders.

The complex trauma that’s child abused based? TENDS TO (but not always) presents similar to BPD.

But complex trauma central to OTHER trauma types? TENDS TO (but not always) presents as _____(pick a personality disorder)_____.

Or not even the ICD would have recognised CPTSD, but instead, would have considered a BPD variant instead of a PTSD variant.

 

[Friday]

the DSM and the healthcare industry will be transformed. Would you agree?

Nope.

As about 2/3s of the DSM could be thrown away WITHOUT childhood trauma being a factor in so many peoples lives.

The inclusion in the ICD? Is a good step, certainly, in attempting to find better/different treatment modalities. But? Has made f*ck all difference for anyone with complex trauma to date. As the ICD is the bible in anywhere NOT the USA? I can’t imagine that the DSM inclusion would transform anything… much less the entire medicolegal establishment.

 

[tofubreadcoriander]

I can’t imagine that the DSM inclusion would transform anything… much less the entire medicolegal establishment.

I politely disagree. My experience as stated in my original post is that even with ICD 11 inclusion of C-PTSD, unless it's in the DSM it won't be recognized. If it would be then the healthcare system would be empowered to get educated and change lives, including psychotherapists. For who has money, they can get multiple specialized help like yoga for trauma in parallel with neurofeedback and/or psychedelic assisted therapy and therapy like EMDR or NARM or schema therapy or brainspotting or somatic experiencing - however, for the rest of us, we're left to our own devices, leaving us with a wasted potential. Unless healthcare revilutionizes itself, things will remain the same.

 

[No More]

The complex trauma that’s child abused based? TENDS TO (but not always) presents similar to BPD.

But complex trauma central to OTHER trauma types? TENDS TO (but not always) presents as _____(pick a personality disorder)_____.

Ahhhh lightbulb moment. Thanks

 

[tofubreadcoriander]

Ahhhh lightbulb moment. Thanks

The complex trauma that’s child abused based? TENDS TO (but not always) presents similar to BPD.

But complex trauma central to OTHER trauma types? TENDS TO (but not always) presents as _____(pick a personality disorder)_____.

Honestly, I'd argue that that disorder *is* complex PTSD.

 

[Sideways]

I still think C-PTSD given it's due will revolutionize mental health(care) in general as many disorders stem from repeated trauma.

There’s 2 parts to this statement. I wholeheartedly agree with the second part. Repeated trauma does have an incredibly important role in the development of a whole range of mental health disorders.

There’s a lot of study going on all around the world into that, and I think when we start to have a better understanding of the role of trauma on mental health, it will help us generate better treatment, as well as better prevention strategies.

But that’s got very little to do with cptsd in my mind. Because that’s just one disorder that chronic trauma can lead to. One of many.

And sometimes, chronic trauma doesn’t cause a mental health disorder at all.

Including cptsd in the dsm doesn’t help with the understanding of the role of chronic trauma on mental health disorders. All it does it create awareness about how to diagnose that one disorder.

Tbh, since cptsd was included in the ICD, the misunderstanding of what it is seems to have blown up. Even here on the forum, we get a lot of people who misunderstand what it is, and in particular, think that Chronic Trauma = Cptsd. That is absolutely not the case.

More broadly, there isn’t good agreement on what the diagnostic criteria for cptsd should be. Not surprising, since the concept of cptsd, as a distinct form of ptsd, is only 30 years old. We need to not jump the gun - adding things into the DSM, before we understand them, causes pain and suffering. That’s fact. Homosexuality is probably the best example, but certainly not the only example.

I have cptsd. There is no doubt in my mind that although the extra bits cause a boatload of my distress, it is the underlying neurological changes of ptsd (to my amygdala and hippocampus in particular) that are actually responsible for my distress and dysfunction.

 

[tofubreadcoriander]

There’s 2 parts to this statement. I wholeheartedly agree with the second part. Repeated trauma does have an incredibly important role in the development of a whole range of mental health disorders.

There’s a lot of study going on all around the world into that, and I think when we start to have a better understanding of the role of trauma on mental health, it will help us generate better treatment, as well as better prevention strategies.

But that’s got very little to do with cptsd in my mind. Because that’s just one disorder that chronic trauma can lead to. One of many.

And sometimes, chronic trauma doesn’t cause a mental health disorder at all.

Including cptsd in the dsm doesn’t help with the understanding of the role of chronic trauma on mental health disorders. All it does it create awareness about how to diagnose that one disorder.

Tbh, since cptsd was included in the ICD, the misunderstanding of what it is seems to have blown up. Even here on the forum, we get a lot of people who misunderstand what it is, and in particular, think that Chronic Trauma = Cptsd. That is absolutely not the case.

More broadly, there isn’t good agreement on what the diagnostic criteria for cptsd should be. Not surprising, since the concept of cptsd, as a distinct form of ptsd, is only 30 years old. We need to not jump the gun - adding things into the DSM, before we understand them, causes pain and suffering. That’s fact. Homosexuality is probably the best example, but certainly not the only example.

I have cptsd. There is no doubt in my mind that although the extra bits cause a boatload of my distress, it is the underlying neurological changes of ptsd (to my amygdala and hippocampus in particular) that are actually responsible for my distress and dysfunction.

So you would like to see C-PTSD in the DSM. Do you think it'll make it in your lifetime?

 

[Sideways]

So you would like to see C-PTSD in the DSM. Do you think it'll make it in your lifetime?

No, I don’t really care if it’s in there or not. It will make zero difference to my treatment whether it gets added to the DSM.

It’s interesting that was the thing you took from that post!

 

[tofubreadcoriander]

No, I don’t really care if it’s in there or not. It will make zero difference to my treatment whether it gets added to the DSM.

It’s interesting that was the thing you took from that post!

I see. You've every right to believe and stand by your point. For me, personally, and in my opinion, chronic repeated trauma will always result in C-PTSD (disorders like eating disorders, personality disorders, depression, anxiety, dissociation etc.). Having it in the DSM will allow individuals to get the help they need and communities to flourish thus changing societies and countries, and ultimately, the world.

 

[Sideways]

chronic repeated trauma will always result in C-PTSD (disorders like eating disorders, personality disorders, depression, anxiety, dissociation etc.

Um…eating disorders, personality disorders, mood disorders and anxiety disorders are wildly different illnesses to cptsd. That’s not opinion, unless you’ve taken the label cptsd, which has a particular meaning, and just given it your own definition.

And chronic trauma absolutely doesn’t always result in mental illness. So far as we know, chronic trauma doesn’t usually cause mental illness, not the other way around.

Based on that post, you seem to not have the foggiest idea what cptsd actually means.

So yeah, you’re entitled to your opinion as well. It appears to be an utterly ignorant opinion, but hey, opinions are like arses. Everyone’s got one.

 

[Sideways]

This might help:What is CPTSD anyway?

This is, after all, a PTSD Forum. Knowing what that is (and isn’t) is definitely relevant here.