complex-ptsd

Recovery can take place only within then context of relationships; it cannot occur in isolation. In her renewed connection with other people, the survivor re-creates the psychological facilities that were damaged or deformed by the traumatic experience. These faculties include the basic operations of trust, autonomy, initiative, competence, identity, and intimacy.Just as these capabilities are formed in relationships with other people, they must be reformed in such relationships.The first principle of recovery is empowerment of the survivor. She must be the author and arbiter of her own recovery. Others may offer advice, support, assistance, affection, and care, but not cure.Many benevolent and well-intentioned attempts to assist the survivor founder because this basic principle of empowerment is not observed. No intervention that takes power away from the survivor can possibly foster her recovery, no matter how much it appears to be in her immediate best interest.

When you notice someone does something toxic the first time, don't wait for the second time before you address it or cut them off. Many survivors are used to the "wait and see" tactic which only leaves them vulnerable to a second attack. As your boundaries get stronger, the wait time gets shorter. You never have justify your intuition.

First, the physiological symptoms of post-traumatic stress disorder have been brought within manageable limits. Second, the person is able to bear the feelings associated with traumatic memories. Third, the person has authority over her memories; she can elect both to remember the trauma and to put memory aside. Fourth, the memory of the traumatic event is a coherent narrative, linked with feeling. Fifth, the person's damaged self-esteem has been restored. Sixth, the person's important relationships have been reestablished. Seventh and finally, the person has reconstructed a coherent system of meaning and belief that encompasses the story of trauma.

In situations of captivity the perpetrator becomes the most powerful person in the life of the victim, and the psychology of the victim is shaped by the actions and beliefs of the perpetrator.

People with Complex PTSD suffer from more severe and frequent dissociation symptoms, as well as memory and attention problems, than those with simple PTSD. In addition to amnesia due to the activity of various parts of the self, people may experience difficulties with concentration, attention, other memory problems and general spaciness. These symptoms often accompany dissociation of the personality, but they are also common in people who do not have dissociative disorders. For example everyone can be spacey, absorbed in an activity, or miss an exit on the highway. When various parts of the personality are active, by definition, a person experiences some kind of abrupt change in attention and consciousness.

Changes in Meaning:Finally, chronically traumatized people lose faith that good things can happen and people can be kind and trustworthy. They feel hopeless, often believing that the future will be as bad as the past, or that they will not live long enough to experience a good future. People who have a dissociative disorder may have different meanings in various dissociative parts. Some parts may be relatively balanced in their worldview, others may be despairing, believing the world to be a completely negative, dangerous place, while other parts might maintain an unrealistic optimistic outlook on life

Alterations in regulation of affect (emotion) and impulse:Almost all people who are seriously traumatized have problems in tolerating and regulating their emotions and surges or impulses. However, those with complex PTSD and dissociative disorders tend to have more difficulties than those with PTSD because disruptions in early development have inhibited their ability to regulate themselves.The fact that you have a dissociative organization of your personality makes you highly vulnerable to rapid and unexpected changes in emotions and sudden impulses. Various parts of the personality intrude on each other either through passive influence or switching when your under stress, resulting in dysregulation. Merely having an emotion, such as anger, may evoke other parts of you to feel fear or shame, and to engage in impulsive behaviors to stop avoid the feelings.

Changes in the Perception of Self:People who have been traumatized in childhood are often troubled by guilt, shame, and negative feelings about themselves, such as the belief they are unlikable, unlovable, stupid, inept, dirty, worthless, lazy, and so forth. In Complex Dissociative disorders there are typically particular parts that contain these negative feelings about the self while other parts may evaluate themselves quite differently. Alterations among parts thus may result in rather rapid and distinct changes in self perception.

Recovery unfolds in three stages. The central task of the first stage is the establishment of safety. The central task of the second stage is remembrance and mourning. The central focus of the third stage is reconnection with ordinary life.

Complex PTSD consists of of six symptom clusters, which also have been described in terms of dissociation of personality. Of course, people who receive this diagnosis often also suffer from other problems as well, and as noted earlier, diagnostic categories may overlap significantly. The symptom clusters are as follows:Alterations in Regulation of Affect ( Emotion ) and ImpulsesChanges in Relationship with othersSomatic SymptomsChanges in MeaningChanges in the perception of SelfChanges in Attention and Consciousness

Changes in Relationship with others:It is especially hard to trust other people if you have been repeatedly abused, abandoned or betrayed as a child. Mistrust makes it very difficult to make friends, and to be able to distinguish between good and bad intentions in other people. Some parts do not seem to trust anyone, while other parts may be so vulnerable and needy that they do not pay attention to clues that perhaps a person is not trustworthy. Some parts like to be close to others or feel a desperate need to be close and taken care of, while other parts fear being close or actively dislike people. Some parts are afraid of being in relationships while others are afraid of being rejected or criticized. This naturally sets up major internal as well as relational conflicts.

...repeated trauma in childhood forms and deforms the personality. The child trapped in an abusive environment is faced with formidable tasks of adaptation. She must find a way to preserve a sense of trust in people who are untrustworthy, safety in a situation that is unsafe, control in a situation that is terrifyingly unpredictable, power in a situation of helplessness. Unable to care for or protect herself, she must compensate for the failures of adult care and protection with the only means at her disposal, an immature system of psychological defenses.

Survivors who don__ stand up for themselves often develop physical and emotional illnesses. Many become depressed because they feel so hopeless and helpless about being able to change their lives. They turn their anger inward and become prone to headaches, muscle tension, nervous conditions and insomnia.

Physical symptoms such as muscle tension, back problems, stomach distress, constipation, diarrhea, headaches, obesity or maybe even hypertension can be caused by suppressing your emotions. Suppressed anger may also cause you to overreact to people and situations or to act inappropriately. Unexpressed anger can cause you to become irritable, irrational, and prone to emotional outbursts and episodes of depression.

The traumatic stress field has adopted the term __omplex Trauma_ to describe the experience of multiple and/or chronic and prolonged, developmentally adverse traumatic events, most often of an interpersonal nature (e.g., sexual or physical abuse, war, community violence) and early-life onset. These exposures often occur within the child__ caregiving system and include physical, emotional, and educational neglect and child maltreatment beginning in early childhood- Developmental Trauma Disorder

Beneath the surface of the protective parts of trauma survivors there exists an undamaged essence, a Self that is confident, curious, and calm, a Self that has been sheltered from destruction by the various protectors that have emerged in their efforts to ensure survival. Once those protectors trust that it is safe to separate, the Self will spontaneously emerge, and the parts can be enlisted in the healing process

Closeness was the promise of suffering and pain

But on Kwajalein, the guards sought to deprive them of something that had sustained them even as all else had been lost: dignity. This self-respect and sense of self-worth, the innermost armament of the soul, lies at the heart of humanness; to be deprived of it is to be dehumanized, to be cleaved from, and cast below, mankind.