Complex PTSD can develop in individuals who have experienced protracted and severe interpersonal trauma (parents/primary caregivers) at critical stages in their psychological development whilst growing up. As the name of the condition suggests, both its causes and effects are highly complex and interactive.
Diagnosing the condition is also complex, particularly as (at the time of writing) it remains so far unlisted in DSM (Diagnostic and Statistical Manual of Mental Disorders). However, psychologists and psychiatrists have various tools at their disposal, including self-report inventories (questionnaires). One of the most general of these questionnaires is called, simply enough, The Symptom Checklist (SCL-90) and it includes ninety questions (the clue’s in the abbreviated name) These ninety questions cover eight domains or, as referred to in the title of this article, EIGHT PSYCHONEUROTIC DIMENSIONS (in other words, eight psychological problems causing mental pain that can be present in those unfortunate enough to be suffering from complex PTSD). I list all eight below:
THE EIGHT PSYCHONEUROTIC DIMENSIONS OF COMPLEX PTSD ACCORDING TO THE SCL-90:
- SLEEP DISTURBANCE
- COGNITIVE DEFICITS
- INTERPERSONAL SENSITIVITY
Various treatments are used to treat complex PTSD and there is no ‘one size fits all. They include:
- TIME PERSPECTIVE THERAPY
- DIALECTICAL BEHAVIOUR THERAPY
- EYE MOVEMENT DESENSITIZATION AND REPROCESSING THERAPY
- COGNITIVE BEHAVIOURAL THERAPY
- SOMATIC EXPERIENCING THERAPY AND HEALING THE DYSFUNCTIONAL NERVOUS SYSTEM
- MINDFULNESS MEDITATION
- A WEEK’S NEUROFEEDBACK EQUIVALENT TO A YEAR’S ZEN MEDITATION
- COMPASSION FOCUSED THERAPY
- NEUROGENIC TREMORS
- EMOTIONAL FREEDOM TECHNIQUE
- TRAUMA-SENSITIVE YOGA
- SCHEMA THERAPY
- MENTALIZATION BASED THERAPY
- TRANSFERENCE FOCUSED PSYCHOTHERAPY
- ACT AND COMMITMENT THERAPY
Leading researchers (e.g. Bessel van der Kolk) recommend a combination of top-down (treatments that address thinking and cognition) and bottom-up (treatments that focus on alleviating stress stored in the body) therapies. Before an individual undergoes treatment in earnest it is important that s/he has established an appropriate degree of stability (e.g. Herman, 1992). It is also of crucial importance that the individual’s feelings in relation to his/her traumatic interpersonal experiences during childhood are sensitively and compassionately validated.
Herman, J., Trauma and recovery: the aftermath of violence – from domestic abuse to political terror, New York: BasicBooks, ISBN 9780465087303.
Pearson: Symptom Checklist-90-Revised”. Pearson: Clinical Psychology. Pearson Education, Inc. 2016
Van der Kolk, B., The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma. Viking, 2014. ISBN 9780670785933.
David Hosier BSc Hons; MSc; PGDE(FAHE).