2/13/2019 0 Comments My Disabilities: Complex PTSDCPTSD is a subset of PTSD which occurs because of long-term trauma, rather than a single event. This diagnosis is not officially recognized by the DSM-V, but plenty of practitioners are familiar with it and the basic concepts behind it.
My CPTSD was caused by long-term emotional and verbal abuse from my parents. Most people with long term childhood trauma would fall under the CPTSD umbrella. It’s different from traditional PTSD in that there is no one singular moment to process; it’s a lifetime of abuse and neglect that has to be healed. (I should note that C-PTSD is not limited to child abuse/neglect, but any instance of long-term trauma like domestic/spousal abuse or a series of one-event traumas over a longer period of time.) As children, our behaviors and thought patterns develop because of the environment we are raised in. When children feel safe and loved, they develop healthy attachment to family and friends, they can process emotion better, and they don’t need coping mechanisms to make it from day to day. Children who feel unsafe and unwanted struggle to form healthy attachments (clinging to the wrong people or pushing good ones away), are prone to depression and anxiety, prone to substance abuse and self-harm/suicide attempts, and form maladaptive coping mechanisms which become roadblocks to adult life later on. One example of this is dissociation. It’s kind of like daydreaming, except that it blocks out the painful experience a person is going through. For me, the only way to handle my abusers was to make myself as small as possible and remain stoic and silent. (The C-PTSD community often refers to this tactic as "grey rocking," in which the victim makes themselves boring and stoic to avoid feeding their abuser.) Because of two full decades of grey rocking, I have a habit of slipping into dissociation when I'm overwhelmed, upset, or feel threatened. "Feeling" threatened and being threatened are two totally different things though: I often dissociate in the middle of debates that start to get too heated, or when two other people are fighting for whatever reason, even if I'm not involved. In some ways, this is one of the most impactful symptoms of all my disabilities. My husband refers to it as me "shutting down." For a person who still needs this coping mechanism, it can provide a safe refuge for your brain to go when you are trying to avoid trauma. But for a healthy relationship, it can feel like you're keeping the other person out and that you perceive them as a threat. Another example is hypervigilance. This is when a person is almost too aware of their environment, to the point that they become paranoid and sometimes obsessive. For some people, it's primarily sounds (this is my primary focus, since making sound was so heavily punished when I was growing up), while for others it could be smells, visual information, or that hair-on-the-back-of-your-neck feeling. Usually it's a combination of a lot of factors, all of which make the affected person feel as though they have to "stand guard" in case of danger. I learned to walk silently, breathe silently, and listen carefully for noises in the house. I could identify the footsteps of any of my family members in the house, as well as their emotional state. This helped me survive, at the time, but now it just makes me take too shallow of breaths and be overly aware of the world. I can't sleep without earplugs because every tiny sound will wake me. I get paranoid when I hear the neighbors move around or make noise, and I get paranoid about making noise that they might hear. It's a terrifying state to be in, even if it is useful at times. The last example I'll give is emotional flashbacks. I'm not sure that it's truly a coping mechanism so much as a brain function as a result of trauma. Essentially, these are like the flashbacks we see in movies and on TV. The critical difference though is that you don't usually see or hear anything to accompany it. It's this disembodied feeling that sneaks up on you, often out of nowhere. I occasionally have olfactory hallucinations with them, which means that I smell things that aren't there. The smell is impossible to describe because it only existed in that particular situation, so it's hard to check if it's real or not. And since I'm hypersensitive to smell because of SPD, the smells are especially intense and stressful (or maybe it's why I remember them in the first place?). The flashback is truly comprised of the emotions that you felt when the trauma occurred. But since they come on by themselves, with no visual or auditory cues to give you an idea what they mean, it can cause you to misconstrue your flashback with feelings related to the real world. If I have a flashback while I'm at the grocery store, for example, I might associate the feeling of fear and paranoia to being at the store or out in public. That’s part of the reason why I'm mildly agoraphobic and sometimes struggle to leave the house. Overall, C-PTSD is a jumble of slightly-related symptoms which all stem from the brain trying to process trauma, protect itself from harm, and cope with reality. When a person is out of the abusive environment, sometimes the brain just continues these patterns for years because it assumes trauma may return at any time. Traditional CBT and talk therapies haven't proven to be overly useful for most people with this form of PTSD, because the trauma changes the nature of memories and thought patterns--it's not like treating typical depression, anxiety, and paranoia. EMDR seems to be one promising therapy, along with somatic experience therapy. I currently am still searching for a therapist and method that works well for me, but I supplement my current therapy with medication, social skills practice with my husband, and reading books like Pete Walker's Complex PTSD: From Surviving to Thriving. The Body Keeps the Score by Bessel van der Kolk, M.D. is another popular one.
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