Sufferer Enough Trauma To Cause Cptsd?

[Aeva]

Hello everybody!

Looking for some help/advice/who knows from PTSD-world.

My life seems to be an endless crusade to figure out just what the heck is wrong with me, physically and mentally. I've been in therapy for the better part of the last 12 years (since I was 10 years old) and nobody ever really attempted to give me a diagnosis until I got labelled with Major Depression a few years ago, and that was pretty much that. But I've always felt there was something more going on, with complex PTSD being the most likely culprit (yes, I know it's not an 'official' diagnosis according to the DSM). My new therapist seems to be hinting at the fact that he suspects this is the case as well, although he is hesitant to say it outright because I've only been seeing him for a few weeks.

My...concern is that what I've experienced in my past isn't "enough" to constitute a trauma serious enough to cause such an issue. So I figured I'd share it with you wonderful folks, and see what you think.

-mom died when I was 2
-molested by a friend (my age) when I was 5
-mild physical abuse from father from age 2 to late teens (he would slap my face/arms/legs, hit me with objects, suffocate me if I cried, pin me against the wall. No severe/lasting physical damage)
-very mild emotional abuse from dad and step-mom (a ton of name calling, mostly using four letter words, manipulation/guilt-tripping)

I had a way longer post describing my symptoms, but I guess in short I'll say that I display a lot of the complex PTSD symptoms, although more on the isolation/introversion/depression side of things than anything else. HOWEVER- I don't have any emotions regarding my past experiences (at least consciously). They don't actively bother me, I can talk about them with complete strangers, I don't remember ever having a flashback or nightmare, although I do have some rare dissociation. Emotionally, I am VERY numb, almost completely lacking affective empathy (although I have incredibly high cognitive empathy and can read body language/facial expression very well).

I feel EXTREME guilt a lot of the time, regarding almost everything and everybody in my life. I feel hesitant to embrace the idea of complex ptsd because I would feel guilty for blaming my parents for my 'broken-ness', even if they had a hand in it. While they may have not been the world's greatest parents, they have also done so many incredible things for me over the years, and have always come to the rescue when I was in serious trouble. I've always had a nice place to live, food on my plate and clothes on my back...I feel like it should negate the bad stuff...but why else am I like this?

Aeva
(sorry for the super long post)

 

[Abstract]

The first thing that occurred to me is if you are generally inclined to take care of others feelings at the expense of your own. Your parents good doesn't somehow delete the bad and neither does the bad delete the good. Even if they did things right and meant well you have a right to process and work through the bad and allow yourself to say it harmed you.

Being suffocated as a means of discipline for example is not ever going to be considered appropriate by anyone. You don't have to have a broken bone for something to be traumatic.

The personality issues that are commonly connected with what is known as CPTSD (and develop as a result of having bad experiences when we are young and still developing) can happen independently of PTSD or with it.

Whether you have PTSD or not is totally dependent on your symptoms in this case. Have you looked at the diagnostic criteria? If you don't fit then it is often classed under an Adjustment Disorder. It might be wise to be properly evaluated by a trauma psychiatrist for a diagnoses. If there are no intrusive symptoms then that would exclude PTSD but intrusions may look a little different from what you think they have to be.

One of the ways I have more recently been able to identify emotional numbing when it comes to bad experiences is objectively lessor experiences used to upset me way more than them. In retrospect the total absence of emotion around negative experiences was obviously not normal.

Even if you don't have PTSD you can be broken by your experiences. That doesn't mean you can't work on healing from them whatever it is though.

[DLMURL]https://www.myptsd.com/c/articles/adjustment-disorders.4/[/DLMURL]

 

[Aeva]

I almost exactly fit the diagnostic criteria & symptoms lists for complex PTSD.

I definitely have flashbacks and intrusive thoughts about my specific phobia (vomiting- myself and other people), and will have minor visual flashbacks when in a specific sexual situation that mirrors my molestation...but I don't generally experience flashbacks or intrusive thoughts during my day to day life, and I struggle to remember a time that they were related to my home life issues.

I'm currently seeing a CBT social worker, primarily to get the emetophobia & depression under control. I have an appointment to see a psychiatrist that he works with in a few weeks so she can do a formal psych eval.

 

[Abstract]

visual flashbacks when in a specific sexual situation that mirrors my molestation.

That is definitely relevant. Do you ever have sudden extreme emotional reactions that are very out of proportion to the present situation? Maybe when faced with sexual stuff or with people being angry etc? How are you if you feel you can't breathe for example? No nightmares about these things?

It's great you are getting a formal psych evaluation! :tup:

You seem to know it already but here is the PTSD criteria: They will also evaluate how often things occur as there are thresholds for each one.

"Diagnostic Criteria for 309.81 (F43.10) Posttraumatic Stress Disorder
Note: The following criteria apply to adults, adolescents, and children older than 6 years. For children 6 years and younger, see corresponding criteria.

A. Exposure to actual or threatened death, serious 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) as it occurred to others,
3. Learning that the traumatic event(s) occurred to a close family member or close friend. In cases of actual or threatened death of a family member or friend, the event(s) must have been violent and accidental.
4. Experiencing repeated or extreme exposure to aversive details of the traumatic event(s) (e.g., first responders collecting human remains; police officers repeatedly exposed to details of child abuse).

Note: Criterion A4 does not apply to exposure to electronic media, television, movies, or pictures, unless the exposure is work related.

B. Presence of one (or more) of the following intrusion symptoms associated with the traumatic event(s), beginning after the traumatic event(s) occurred:

1. Recurrent, involuntary, and intrusive distressing memories of the traumatic event(s) Note: In children older than 6 years, repetitive play may occur in which themes or aspects of the traumatic event(s) are expressed.
2. Recurrent distressing dreams in which the content and/or affect of the dream are related to the traumatic event(s).Note: In children, there may be frightening dreams without recognizable content.
3. Dissociative reactions (e.g., flashbacks) in which the individual feels or acts as if the traumatic event(s) were recurring. (Such reactions may occur on a continuum, with the most extreme expression being a complete loss of awareness of present surroundings.) Note: In children, trauma-specific reenactment may occur in play.
4. Intense or prolonged psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event(s).
5. Marked physiological reactions to internal or external cues that symbolize or resemble an aspect of the traumatic event(s).

C. Persistent avoidance of stimuli associated with the traumatic event(s), beginning after the traumatic event(s) occurred, as evidence by one or both of the following:

1. Avoidance of or efforts to avoid distressing memories, thoughts, or feelings about or closely associated with the traumatic event(s).
2. Avoidance of or efforts to avoid external reminders (people, places, conversations, activities, objects, situations) that arouse distressing memories, thoughts, or feelings about or closely associated with the traumatic event(s).

D. Negative alterations in cognitions and mood associated with the traumatic event(s), beginning or worsening after the traumatic event(s) occurred, as evidenced by two (or more) of the following:

1. Inability to remember an important aspect of the traumatic event(s) (typically due to dissociative amnesia and not to other factors such as head injury, alcohol, or drugs).
2. Persistent and exaggerated negative beliefs or expectations about oneself, others, or the world (e.g., "I am bad," "no one can be trusted," "The world is completely dangerous," "My whole nervous system is permanently ruined").
3. Persistent, distorted cognitions about the cause or consequences of the traumatic event(s) that lead the individual to blame himself/herself or others.
4. Persistent negative emotional state (e.g., fear, horror, anger, guilt, or shame).
5. Markedly diminished interest or participation in significant activities.
6. Feelings of detachment or estrangement from others.
7. Persistent inability to experience positive emotions (e.g., inability to experience happiness, satisfaction, or loving feelings).

E. Marked alterations in arousal and reactivity associated with the traumatic event(s), beginning or worsening after the traumatic event(s) occurred, as evidenced by two (or more) of the following:

1. Irritable behavior and angry outbursts (with little or no provocation) typically expressed as verbal or physical aggression toward people or objects.
2. Reckless or self-destructive behavior.
3. Hypervigilance.
4. Exaggerated startle response.
5. Problems with concentration.
6. Sleep disturbance (e.g., difficulty falling or staying asleep or restless sleep).

F. Duration of disturbance (Criteria B, C, D, and E) is more than 1 month.

G. The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.

H. The disturbance is not attributable to the physiological effects of a substance (e.g., medication, alcohol) or another medical condition.

Specifiy whether:

With dissociative symptoms: The individual's symptoms meet the criteria for posttraumatic stress disorder, and in addition, in response to the stressor, the individual experiences persistent or recurrent symptoms of either of the following:

1. Depersonalization: Persistent or recurrent experiences of unreality of surroundings (e.g., feeling as though one werre in a dream; feeling a sense of unreality of self or body or of time moving slowly).
2. Derealization: Persistent or recurent experiences of unreality of surroundings (e.g., the world around the individual is experienced as unreal, dreamlike, distant, or distorted).

Note: To use this subtype, the dissociative symptoms must not be attributable to the physiological effects of a substance (e.g., blackouts, behavior during alcohol intoxication) or another medical condition (e.g., complex partial seizures).

Specify if:

With delayed expression: If the full diagnostic criteria are not met until at least 6 months after the event (although the onset and expression of some symptoms may be immediate)."

CPTSD would fit these and then have the additional personality issues.

Good luck with the evaluation!

 

[InsideAWord]

You can only have a psychiatrist diagnose you after some evaluations if you want to be sure. They use the criterion that @Abstract listed in addition to the length of the trauma. Any prolonged trauma, such as childhood abuse, could fall under C PTSD.

However, C PTSD was not added to the DSM V so you'll probably just receive PTSD if your psychiatrist determines you have PTSD.

 

[scout86]

How much does it matter what you call it? If there are things that are problems in your life NOW, isn't that enough to justify trying to improve things?

My therapist likes to say the "Communication is what the receiver receives, not what the sender sends." So, maybe it's not useful to look at this as some kind of bar your parents had to cross to make your childhood "bad enough" to justify you having "problems". It's enough that you have problems and want to improve things. For example, no matter what their actual behavior WAS, if you perceived it as "unpredictable and mean" when it should have been "predictable and safe", that's enough to create problems.

I work with horses for a living. For a lot of years, I trained them. I often saw people doing things that THEY thought were going to produce a desired result, while the horse could make no sense of it at all and decide people were "unpredictable, mean, and not to be trusted." It made NO difference to the horse how well intentioned the person was, and they often were very well intentioned. You still ended up with a mess. I think children are pretty much the same way. The parent can be very well intentioned and still "wrong".

You might find it interesting to look up "alexithymia". It could relate to your apparent lack of emotions about your past experiences. And, I was just reading this morning, some people think there are at least 2 forms of PTSD, a "reactive" form where you experience a LOT of "feelings" like stuff that happened in the past is actually happening now and a more "dissociative" form where your experience is more of detachment. I think the whole area is far from understood and there aren't really clear cut lines between things. That means "reality" might be inconveniently messy. The diagnostic criteria is probably more relevant to insurance companies than anything else.

Just my opinion, but what ever YOU experience is real for you and that's what matters most. "Why" is a question that may not even have an answer. It might be more useful to focus on "What now?".

Welcome to the forum!

 

[Stanley Shi-Yume]

You're not wrong!

You are suffering from the effects and aftershock of extreme emotional neglect.

What do you mean by "enough"? Has there ever been a time in your life that you were treated like you were special, and deserved success?

Based on the information you gave, it feels like you and I are very similar. Because the root of the problems with sense of self, connection/belonging, and similar is almost impossible to perceive on your own, very complex PTSD can develop.

My advice is to have a look at the trauma diary part of the forums. This has been the biggest impact for me, to gain understanding of what I'm actually going through from an external field of vision.

 

[Stanley Shi-Yume]

And you should get the book Running on Empty by Jonice Webb as soon as possible. What you're describing is a key quality in emotional neglect - the fatal flaw... that guilt you described when you have hesitation to accept the idea of PTSD or that there is even a problem that's external to you.

 

[Aeva]

Scout- Alexithymia is definitely not my issue. I am a supremely logical person. For me, everything is in my head, but there's a disconnect between my head and my heart. I am very good at recognizing my own emotions and describing them to others. I am also very good at recognizing emotion in others (I would say far better than most people) and knowing how to handle it. I just don't actually feel anything for them. I can connect easily with people on an intellectual level, and enjoy doing so...but the suffering of others has absolutely no effect on me (other than to make me feel guilt for being privileged).

 

[intothelight]

Welcome to MyPTSD forum! :)

 

[Aeva]

That is definitely relevant. Do you ever have sudden extreme emotional reactions that are very out of proportion to the present situation? Maybe when faced with sexual stuff or with people being angry etc? How are you if you feel you can't breathe for example? No nightmares about these things?

Since researching emotional flashbacks, I've been wondering if I've been experiencing them all along and didn't realize. For example, my step-mother (who has been in my life since I was 6) has always enjoyed teasing/mocking/embarrassing me, especially in front of other people. I'm now 22, but I still react disproportionately when she does these things, even when it's something so slight others wouldn't notice. I usually struggle to hold back tears and immediately curl into a little ball and hug a stuffed animal or one of my cats as tight as I can.

My main 'overreaction' is guilt. I will often have so much guilt that it feels almost the same as when I'm on the verge of a panic attack- nausea, increased breathing & heart rate, skin crawling, inability to keep still, etc.

I VERY rarely have nightmares, I would say once every few years. However, with the exception of 3 specific instances that I can remember, every dream I've ever had has been about death. They are not scary (I have always been very comfortable with death & dying, even before I saw it almost daily at work), they're just all about people being killed around me. Sometimes in the dreams I am apathetic towards it, sometimes I enjoy it. Sometimes it's even a turn-on (yupp, I'm screwed up).

 

[Lady of Longbourn]

Welcome. :)