Tag Archives: Causes Of Ptsd

Complex PTSD

 

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Complex PTSD:

There has been some controversy regarding the difference between post traumatic stress disorder (PTSD) and complex PTSD amongst researchers.

During the early 1990s, the psychologist Judith Herman noted that individuals who had suffered severe, long-lasting, interpersonal trauma, ESPECIALLY IN EARLY LIFE, were frequently suffering from symptoms such as the following:

– disturbance in their view of themselves

– a marked propensity to seek out experiences and relationships which mirrored their original trauma

– severe difficulties controlling emotions and regulating moods

– identity problems/the loss of a coherent sense of self (click here to read my article on identity problems)

– a marked inability to develop trusting relationships

and, sometimes:

– adoption by the victim of the perpetrator’s belief system

Furthermore, some may go on to become abusers themselves, whilst others may be constantly compelled to seek out relationships with others who abuse them in a similar way to the original abuser (i.e. the parent or ‘care-taker’)

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It is most unfortunate that, prior to the identification of the disorder that gives rise to the above symptoms, now referred to as complex PTSD, those suffering from the above symptoms were NOT recognized as having suffered from trauma and were therefore not asked about their childhood traumatic experiences during treatment. This meant, of course, that the chances of successful treatment were greatly reduced.

Research has now demonstrated that the effects of severe, long-lasting interpersonal trauma go above and beyond the symptoms caused by PTSD.

Complex PTSD Symptoms :

The main symptoms of complex PTSD are as follows:

1) severe dysregulation of mood

2) severe impulse control impairment

3) somatic (physical) symptoms (e.g. headaches, stomach aches, weakness/fatigue)

4) changes in self-perception (e.g. seeing self as deeply defective, ‘bad’ or even ‘evil’)

5) severe difficulties relating to others, including an inability to feel emotionally secure or empowered in relationships

6) changes in perception of the perpetrator of the abuse (e.g. rationalizing their abuse/idealization of perpetrator)

7) inability to see any meaning in life/existential confusion

8) inability to keep oneself calm under stress/inability to ‘self-sooth’

9) impaired self-awareness/fragmented sense of self

10) pathological dissociation (click here to read my article on DISSOCIATION)

The DSM IV (Diagnostic and Statistical Manual IV) first named  complex PTSD as: DISORDER OF EXTREME STRESS NOT OTHERWISE SPECIFIED (DESNOS). Now, however, complex PTSD is listed as a SUB-CATEGORY of PTSD.

Whilst it is certainly true that there is an OVERLAP between the symptoms of PTSD and complex PTSD, many researchers now argue that PTSD and complex PTSD should be regarded as SEPARATE and DISTINCT disorders.

DIGITAL BOOK THUMBNAIL 1 1 - Complex PTSD

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David Hosier BSc Hons; MSc; PGDE(FAHE).

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Copyright 2014 Child Abuse, Trauma and Recovery

How Does PTSD Develop?

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childhood trauma and ptsd

WHAT IS THE DEVELOPMENTAL PROCESS OF POST TRAUMATIC STRESS DISORDER (PTSD)?

The psychologists Foa et al developed the following model to illustrate the psychological process through which PTSD develops.

When a person experiences something which is very traumatic the memory becomes enmeshed into the brain’s circuitry – in essence, a FEAR STRUCTURE becomes incorporated into the brain.

THE FEAR STRUCTURE can be divided into 3 individual units. These are as follows :

a) STIMULI of the trauma. This refers to things which my trigger memories of the trauma. Stimuli my gain access to the brain via any of the 5 senses (ie sight, hearing, smell, taste and touch). To use a simple example, someone traumatized by being injured in an explosion in a war may have the trauma response triggered by loud bangs such as fireworks going off (the loud bang being the stimuli).

b) RESPONSES to the traumatic event. This includes both physiological responses (eg racing pulse, hyperventilation) and psychological responses (such as a feeling of terror).

c) MEANINGS ATTRIBUTED TO THE STIMULI AND RESPONSES (eg this means I must be in great danger).

When somebody suffering from PTSD experiences an event which triggers the original memory of trauma, laid down in the brains circuitry, they feel intense distress. Typically, in response to this distress, they will take evasive action (ie try to evade, or get away from, the event which is triggering the traumatic response). It is the meaning aspect of the fear structure ( c, above) which creates the most anguish. The problem lies in the fact that they find it exceptionally difficult to reconcile their old (pre-trauma) beliefs about events and their new (post trauma) beliefs about events (doing this successfully, which therapy can help them, eventually, to do, is known as the PROCESS OF ACCOMMODATION).

An example of pre- and post- traumatic beliefs, which, if the process of accommodation has not taken place, would be in opposition with one another are :

PRE-TRAUMA – the world is a pretty safe place in which I can generally feel relaxed in

POST-TRAUMA – the world is very dangerous and unpredictable and I must always be on my guard against threats which seem to be coming at me from every direction (at worst, leading to clinical paranoia)

COMPULSION TO MAKE SENSE OF THE TRAUMATIC BELIEF

The individual who suffers from PTSD will often try , obsessively, to make sense of the traumatic event which occurred to him/her. This arises because s/he finds it impossible to square what has occurred with pre-trauma beliefs.

THE DEEP PSYCHOLOGICAL PAIN OF TRYING TO MAKE SENSE OF THE TRAUMATIC EVENT

Whilst the individual suffering from PTSD feels driven to make sense of the trauma, constantly thinking about it creates feelings which are both terrifying and overwhelming. THIS CREATES A TERRIBLE PSYCHOLOGICAL TENSION IN THE MIND – there is the PULL TOWARDS ATTEMPTING TO MAKE SENSE OF WHAT HAPPENED ON THE ONE HAND, BUT ALSO THE PULL OF TRYING TO STOP THINKING ABOUT IT ON THE OTHER.

Foa and her colleagues have put forward the theory that it is the tension, created by having one’s thoughts pulled powerfully in two directly opposing directions, which leads to the extreme HYPERAROUSAL (intense anxiety).

The two opposing views of the world the individual tries desperately to fit together (‘safe world’ versus’ unsafe world’) is rather like trying to FIT TWO PIECES OF JIGSAW TOGETHER, ONE OF WHICH HAS BEEN DAMAGED, SO IT NO LONGER FITS.

Therapy can lead to a resolution of this dilemma, leading to a compromise belief, linked to the two opposing beliefs, such as :

THE WORLD IS GENERALLY SAFE FOR ME BUT NOBODY HAS A COMPLETE GUARANTEE, OCCASIONALLY BAD THINGS HAPPEN.

TREATMENTS :

COGNITIVE BEHAVIOURAL THERAPY IS AN EFFECTIVE TREATMENT FOR THE EFFECTS OF TRAUMA – there is a lot of research evidence to support this.

Also, hypnotherapy can provide relief from many of the symptoms of trauma (eg anxiety, fear etc).

TO FIND OUT MORE ABOUT HYPNOSIS, HERE IS A LINK TO A RECOMMENDED HYPNOTHERAPY BLOG TO WHICH THIS SITE IS AFFILIATED : http://www.hypnosisdownloads.com/blog/feed/?a=5719!blog

I hope you have found this post of use.

Best wishes, David Hosier BSc Hons ; MSC ; PGDE(FAHE).

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Copyright 2013 Child Abuse, Trauma and Recovery