PTSD Diagnostic Criteria C: Question

[Acer]

I don't understand what the diagnostic criteria C means (cut and pasted below). Does anyone have examples of these from personal experience?

I know as a teenager I didn't believe I would live into adulthood. But here I am and I made it so...that doesn't apply to this any longer. I don't avoid conversations about the traumas (my entire childhood). I don't avoid places, because what places? My home? That house was sold long ago and neighborhoods I lived in when I was that young are not even accessible to me (they have changed, been bulldozed or I couldn't find them if I tried). I recall a lot of the trauma I experienced. I know there are parts missing and as I grow older, much of it fades. I am told this is a good thing. I do feel distant from others a lot, but I don't know if this is the same thing as the criteria here. Sometimes I don't feel like I feel the same intensity of love that others do, but I know I have felt SUPER intense loving feelings before. This part really confuses me.



C. Persistent avoidance of stimuli associated with the trauma and numbing of general responsiveness (not present before the trauma), as indicated by three (or more) of the following:

(1) efforts to avoid thoughts, feelings, or conversations associated with the trauma
(2) efforts to avoid activities, places, or people that arouse recollections of the trauma
(3) inability to recall an important aspect of the trauma
(4) markedly diminished interest or participation in significant activities
(5) feeling of detachment or estrangement from others
(6) restricted range of affect (e.g., unable to have loving feelings)
(7) sense of a foreshortened future (e.g., does not expect to have a career, marriage, children, or a normal life span)

 

[2quilt]

my examples

(1) efforts to avoid thoughts, feelings, or conversations associated with the trauma
For me, I disassociate when someone tells an incest joke.


(2) efforts to avoid activities, places, or people that arouse recollections of the trauma

In my case, I refuse to go to the VA hospital because that's where I was sexually assaulted, and the perp still works there.

(3) inability to recall an important aspect of the trauma

I know my father raped me, but I can't remember the actual penetration.

(4) markedly diminished interest or participation in significant activities

I called in sick every year for xmas with my family, and did not celebrate it because the family got terribly drunk and violent when I was a child and knocked over the xmas tree.

(5) feeling of detachment or estrangement from others

stopped communication with all family in 1993.

(6) restricted range of affect (e.g., unable to have loving feelings)

This does not apply to me because I feel all emotions vividly. There are people with PTSD who can't cry.

(7) sense of a foreshortened future
It is very common for PTSD people and incest survivors to feel like they will not live to be 90. I don't know why that is, but it is common. I did not have any investments before I got married because I felt like I should have as much fun now because I would never live to see retirement. Even now, I joke that I have a nice savings nestegg for my husband's next wife to spend! (I won't live to enjoy it myself, in other words).

 

[anthony]

Go to the [DLMURL="http://www.ptsdforum.org/forms/ptsd-diagnosis/"]PTSD Diagnosis[/DLMURL] form, and put your mouse cursor over each question for a detailed viewpoint with examples...

 

[Acer]

thank you for your response 2guilt.
Anthony, thanks for that, I didn't realize that it was interactive like that.
One problem I have with a lot of the criteria is that they assume that the 'event' was a one time thing or that I'd remember what I was like before 'it' happened. 'It' started with violence in the womb (yes, my father tried to abort me in there by punching my mothers belly over and over again) to the incest and molestation all through my childhood (and violence, and moving all the time, etc etc). Many things didn't have a starting point in my mind. Also, when you learn to live with some of it (the memories are always there, they are not intrusive, they just don't go away) because you need to, what is that?

If a person reacts so strongly to triggers, has suffered repeated and prolonged traumas, has anger issues (what other people would consider anger, I don't even know it), it is hard to deny what I would call PTSD, but it seems everything centers around war vets and one time traumas in adults.

 

[Acer]

oh yah, then there is the 'yes I used to have/do that but don't any longer'. Night terrors (inability to regularly sleep at night), recurring nightmares of intruders, inability to have orgasms, etc etc etc, all things have 'fixed' through time, belief in impending doom (I really didn't think I'd live past 18, then 21, then 25, but now that I am 38 I don't seem to have a set time I am sure I'll die anymore). I can't call those symptoms anymore, now can I? If it is true that PTSD isn't curable, but you can deal with and treat some of the symptoms, then in my opinion, the questions should include 'do you or have you experienced a)this or that symptom?'

 

[linasmom]

If a person reacts so strongly to triggers, has suffered repeated and prolonged traumas, has anger issues (what other people would consider anger, I don't even know it), it is hard to deny what I would call PTSD, but it seems everything centers around war vets and one time traumas in adults.

Hi Acer,

I suffered traumas all throughout my childhood as well, and I've suffered from the confusion of diagnostic criteria at times simply because I do not know who I was prior to the traumas and therefore my symptoms simply seem to be a part of who I am fundamentally (though, I know this is not really true, but complex).

Anyway, I was diagnosed as having Complex PTSD, which has some different criteria than PTSD alone. This diagnosis is not recognized yet in the DSM, but it has become widely accepted among doctors as a valid diagnosis.

I'm no doctor, and I would never diagnose someone, but you may want to check out the criteria for Complex PTSD for your own information.

Best,
Rachel

 

[Acer]

Thanks Rachel. That helps. At least there is some talk about prolonged childhood exposure to trauma. I mean, it is well known how trauma in childhood changes the brain chemistry, and yet so much that is discussed or researched is about adults and vets and the like. I've only seen one comprehensive article out there about child sexual abuse and how it changes the brain, I just wish there were more, and a better understanding of people who have been 'this' way for as long as they remember.

 

[Moonshadow]

I also had a traumatic childhood.

I can remember many times, usually around the time that something traumatic had taken place, when my whole body would feel tingly. My mind would just sort of go blank, and I would get lost in a sort of trance, staring off into nowhere. It was sort of like an out-of-body experience, in that I couldn't feel myself anymore.

In hindsight, it was probably the effect of the cortisone flooding my brain, working as an anesthetic.

I often wonder what I would have been like, had I been able to flourish and feel loved, instead of just trying to survive.
I want to be that other person, though I know she is lost forever.

 

[lrs]

I can relate with where you are at. My story is similar. Hang in there, it can get better.

 

[Cindy]

C. Persistent avoidance of stimuli associated with the trauma and numbing of general responsiveness (not present before the trauma), as indicated by three (or more) of the following:

(1) efforts to avoid thoughts, feelings, or conversations associated with the trauma
(2) efforts to avoid activities, places, or people that arouse recollections of the trauma

(4) markedly diminished interest or participation in significant activities
(5) feeling of detachment or estrangement from others
(6) restricted range of affect (e.g., unable to have loving feelings)


#1 - Not willing to discuss anything about the trauma with anyone! Total avoidance - like when you were first diagnosed and just before.

#2 - I can not go to the dentist. It is a complete trigger in multiple ways. I skipped the dentist for 8 years at one point. Now I only go while sedated. Then will still have nightmares for weeks. My anxiety increases significantly three weeks before the appointment - even for a cleaning. Baby Showers and Weddings can also trigger me.

#4 - Depression. Losing interest in everything you once enjoyed. I also do not participate in Baby Showers due to my traumas.

#5 & 6 - Feeling isolated from the 'normal population', feeling like an outsider,
feeling damaged or so different from anyone else. Not being able to connect with your feelings. Feeling dead inside. Not emotionally responsive to people or situations -- or limited response. Not relating with someone elses expression of joy at their graduation - party - etc...

 

[Lucky Laser]

If a person reacts so strongly to triggers, has suffered repeated and prolonged traumas, has anger issues (what other people would consider anger, I don't even know it), it is hard to deny what I would call PTSD, but it seems everything centers around war vets and one time traumas in adults.

I've thought a lot about this because my traumas don't fit one of the major criteria... "life-threatening." I never faced actual physical death, but it sure felt like I'd died emotionally for awhile. But the rest of the criteria fit! If there is one thing I've learned lately though its that the criteria don't necessarily make the diagnosis. If they did we could just give everyone a copy of the DSM-IV and medical schools could throw out a year's worth of diagnosis classes! I think it is a lot like Anthony's Diagnosis Guide says...

"This form is a Post Traumatic Stress Disorder (PTSD) Diagnosis tool, however; this tool by no means constitutes a diagnosis of PostTraumatic Stress Disorder. This form acts as a guide only in which you may use to discuss with your psychiatrist or physician."

We create criteria to give us some sort of organization, but human beings never really fit into that scheme. I know my job would be a LOT easier if all patients came in with textbook cases of their illnesses... but most of them don't!