What Factors Make The Symptoms Of Complex PTSD Even More Serious?
We have seen from several other articles that I have published on this site that the experience of a traumatic childhood is linked to the development of complex PTSD later on in life.Whilst all cases of complex PTSD are extremely serious, certain factors are thought to increase the risk that we will develop an especially severe form of the disorder. These are as follows :
the person responsible for causing the trauma was a parent / primary carer (this worsens the effect of the trauma because of the emotional devastation caused by being harmed and betrayed by the very person whose responsibility it was to care for us and protect us)
how protracted the experience of the trauma was (on average, the longer the trauma lasts, the worse the effect will be ; tragically, some people experience pretty much ongoing trauma of one form or another (some of which may overlap and occur simultaneously) from birth to eighteen years which may, potentially, have a particularly adverse affect upon multiple stages of brain development and upon the young person’s development in general.
the individual is isolated during the period of trauma (this worsens the effect of the trauma due to the fact that emotional support from significant others (such as members of the wider family, teachers, therapists etc) have a protective effect on mental health ; this protective effect is unavailable to those who experience their trauma in isolation.
the earlier in life the traumatic experience occurs, the more psychological harm it is likely to do. This is because the young brain is especially ‘plastic’ / malleable and, therefore, more vulnerable to being damaged by the experience of protracted, high levels of stress / fear / anxiety.
the person responsible for causing the trauma is still in contact with the traumatized individual.
In order to help clarify the differences between the two conditions and help show how they are distinct from one another, this article is about a research study which sought to delineate these two very serious psychiatric conditions.
What Are The Differences In Symptoms Between Those Suffering From Borderline Personality Disorder (BPD) And Those Suffering From Complex Posttraumatic Stress Disorder (Complex PTSD)?
A study into the different symptoms displayed by sufferers of borderline personality disorder (BPD) and complex posttraumatic stress disorder (complex PTSD) involving the study of two hundred at eighty adult women who had experienced abuse during their childhoods and published in theEuropean Journal of Psychotraumatologyin 2014 compared the symptoms of those suffering from BPD with those suffering from complex PTSD.
The following results from the study were obtained :
SYMPTOMS SHARED APPROXIMATELY EQUALLY BETWEEN THOSE SUFFERING FROM BPD AND THOSE SUFFERING FROM COMPLEX PTSD :
Some symptoms were found to be shared approximately equally between those suffering from borderline personality disorder (BPD) and those suffering from complex posttraumatic stress disorder (complex PTSD). The symptoms that fell into this category were as follows :
AFFECTIVE DYSREGULATION (ANGER) i.e. frequent feelings of intense rage that the individual cannot control (regulate)
However, some symptoms were found to be significantly more prevalent amongst those suffering from borderline personality disorder (BPD) than amongst those suffering from complex posttraumatic stress disorder (complex PTSD) as shown below :
SYMPTOMS THAT WERE FOUND TO BE SIGNIFICANTLY MORE PREVALENT AMONGST THOSE SUFFERING FROM BORDERLINE PERSONALITY DISORDER (BPD) THAN AMONGST THOSE SUFFERING FROM COMPLEX POSTTRAUMATIC STRESS DISORDER (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’)
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.
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.
ALL OTHER ARTICLES RELATED TO COMPLEX PTSD :
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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 perjorative (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 TYPE2. 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:
– emotional numbing – dissociation – cycling between passivity and explosions of rage
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
1) A history of, for example, severe childhood trauma
2) Alterations in affect regulation, including – persistent dysphoria – chronic suicidal preoccupation – self-injury – explosive or extremely inhibited anger (may alternate) – compulsive or extremely inhibited sexuality (may alternate)
3) Alterations in consciousness, including – amnesia or hypernesia for traumatic events – transient dissociative episodes – depersonalization/derealization – 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 sense of specialness, utter aloneness, belief no other person can understand, or nonhuman identity)
5) Alterations in perceptions of perpetrator, including
– preoccupation with relationship with perpetrator (includes preoccupation with revenge) – unrealistic attribution of total power to 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 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) :
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 number of working mothers :
This can lead to infants having inconsistent early care as they me be shuttled around from day-care to nursery care to babysitters and so on possibly leading to a variation in 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 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.
