Survivors of extreme trauma often suffer persistent anxiety, phobias, panic, depression, identity and relationship problems. Many times, the set of symptoms the individual presents with are not connected to the original trauma by those providing treatment (as certainly was the case for me in the early years of my treatment, necessitating me to undertake my own extensive research, of which this blog is partly a result) and, of course, treatment will not be forthcoming if the survivor suffers in silence.
Any treatment not linked to the original trauma will tend to be ineffective as THE UNDERLYING TRAUMA IS NOT BEING ADDRESSED. Also, there is a danger that a wrong diagnosis may be given; possibly the diagnosis will be one that may be interpreted, by the individual given it, as pejorative (such as a personality disorder).
Individuals who have survived protracted and severe childhood trauma often present with a very complex set of symptoms and have developed, as a result of their unpleasant experiences, deep-rooted problems affecting their personality and how they relate to others. The psychologist, Kolb, has noted that the post-traumatic stress disorder symptoms survivors of severe maltreatment in childhood might develop ‘may appear to mimic every personality disorder’ and that ‘severe personality disorganization’ can emerge.
Another psychologist, Lenore Terr, has differentiated between two specific types of trauma: TYPE 1 and TYPE 2. TYPE 1 refers to symptoms resulting from a single trauma; TYPE 2 refers to symptoms resulting from protracted and recurring trauma, the hallmarks of which are:
This second type of trauma response has been referred to as COMPLEX POSTTRAUMATIC STRESS DISORDER (COMPLEX PTSD) and more research needs to be conducted on it; however, an initial questionnaire to help in its diagnosis has been developed and I reproduce it below:
COMPLEX PTSD QUESTIONNAIRE :
Which of the following apply?
1) A history of, for example, severe childhood trauma
2) Alterations in affect regulation, including
– persistent dysphoria
– chronic suicidal preoccupation
– explosive or extremely inhibited anger (may alternate)
– compulsive or extremely inhibited sexuality (may alternate)
3) Alterations in consciousness, including
– amnesia or hypermnesia for traumatic events
– transient dissociative episodes
– reliving experiences, either in the form of intrusive post-traumatic stress disorder symptoms or in the form of ruminative preoccupation
4) Alterations in self-perception, including
– a sense of helplessness or paralysis of initiative
– shame, guilt and self-blame
– sense of defilement or stigma
– sense of complete difference from others (may include a sense of specialness, utter aloneness, belief no other person can understand, or nonhuman identity)
5) Alterations in perceptions of the perpetrator, including
– preoccupation with relationship with perpetrator (includes preoccupation with revenge)
– unrealistic attribution of total power to the perpetrator (although the perpetrator may have more power than the clinician treating the individual is aware of)
– idealization or paradoxical gratitude
– sense of special or supernatural relationship
– acceptance of belief system or rationalizations of the perpetrator
6) Alterations in relations with others, including
– isolation and withdrawal
– disruption in intimate relationships
– repeated search for rescuer (may alternate with isolation and withdrawal)
– persistent distrust
– repeated failures of self-protection
7) Alterations in systems of meaning
– loss of sustaining faith
– sense of hopelessness and despair
Why Is Complex PTSD Becoming More Common?
And the incidence of complex PTSD is increasing. What are the possible reasons for this increase in the prevalence of this very serious psychiatric disorder?
First, it is possible that as the general population and clinicians become more aware of the existence of the disorder and its link to childhood trauma it is becoming increasingly reported and diagnosed. However, there are several other possible explanations and I examine these briefly below :
POSSIBLE REASONS FOR THE INCREASE IN PREVALENCE OF COMPLEX POST TRAUMATIC STRESS DISORDER (Complex PTSD) :
1) Growing up in unstable environments :
More and more young people are growing up in unstable environments. Increasing rates of divorce and separation mean that a higher and higher number of children and adolescents are growing up in single-parent households
2) Reduction in social support systems :
Research shows that a lack of social support makes individuals much more vulnerable to the adverse effects of stress. And, today, children tend to have less access to others who could provide them with emotional support than has been the case in the past due to, for example :
- communities that are not as close-knit as in the past
- less contact with wider family (e.g. aunts, uncles, grandparents) than in the past as wider family members are becoming more geographically dispersed than in past
3) Increase in the number of working mothers :
This can lead to infants having inconsistent early care as they may be shuttled around from day-care to nursery care to babysitters and so on possibly leading to a variation in the quality of care and less opportunity for the infant to develop his/her bond with the mother
4) Parental preoccupation with their careers :
In a ‘go-getting’ society, in which status and wealth are of fundamental importance to many people, individuals are becoming very driven, even obsessively driven, in connection with their careers, sometimes leading to workaholism; this leaves such persons with less time to interact in any really meaningful way with their offspring or leads to such exhaustion that they simply do not have enough energy left over for such meaningful interactions.
5) Unhelpful effects of media :
Young people are becoming increasingly obsessed with media, such as computer games and so on, which leaves them with less time for psychologically nourishing face-to-face interaction with friends and family.
6) Unhelpful effects of living in a consumer society :
Society has become increasingly obsessed with acquiring consumer goods and the accumulation of these is often linked in people’s minds to their ‘status’ and ‘worth as a human being.‘ Such attitudes may lead young people to develop false values which in turn may aggravate psychological problems.
Anyone who feels their condition may be reflected by the above is urged to seek professional intervention at the earliest opportunity.
Above eBook, Childhood Trauma And Its Link To Complex PTSD, now available on Amazon for immediate download. Click here.
David Hosier BSc Hons; MSc; PGDE(FAHE).