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PTSD and cPTSD - Challenges, Symptoms, and Therapeutic Approaches



 

Experiences translate into physically stored memories. The source of PTSD anxiety is not the experience itself but the memory of it.

(van der Kolk, 2000)


Trauma, both single and complex, has a profound impact on individuals, leading to the development of mental disorders such as PTSD and C-PTSD. As noted by van der Kolk (2000), these experiences become physically stored memories, and the source of anxiety is not the event itself but the memory of it. In this article, we will take a closer look at the symptoms, typology, and co-occurrence of these disorders, emphasizing the importance of understanding and supporting individuals experiencing the effects of trauma.


PTSD (Post-Traumatic Stress Disorder):


PTSD is a mental disorder that can occur in an individual as a result of exposure to a traumatic event or series of events. A key element of PTSD is the occurrence of specific symptoms in response to these experiences. DSM-5 defines PTSD as a disorder that develops due to direct or indirect experience of a traumatic event, associated with a threat to life, serious injury, or a violation of physical integrity.


PTSD Symptoms, according to DSM-5:


❑ Intrusive thoughts, memories, or images related to the traumatic event.

❑ Nightmares, deeply rooted in traumatic experiences.

❑ Psychomotor hyperactivity.

❑ Avoidance of places, situations, or people associated with the traumatic event.

❑ Difficulty expressing emotions.

❑ Increased arousal.

❑ Concentration difficulties.

❑ Excessive irritability or easy provocation.





Complex PTSD (C-PTSD):


Complex PTSD, also known as complex post-traumatic stress disorder, is a form of PTSD that develops as a result of prolonged exposure to trauma, often interpersonal in nature. This particularly challenging experience involves repeated events or series of events, such as domestic violence, torture, or chronic childhood abuse. C-PTSD can lead to lasting changes in an individual's psychological and emotional functioning.


Symptoms and signs of Complex PTSD (C-PTSD):


Complex PTSD differs from classic PTSD by additional symptoms related to prolonged exposure to interpersonal trauma. Symptoms include:


❑ Identity fragmentation

❑ Loss of a sense of safety

❑ Loss of trust in oneself and others

❑ Loss of self-worth

❑ Tendency to re-victimization

❑ Loss of self-coherence

❑ Dysregulation of affect

❑ Difficulty regulating emotions

❑ Changes in consciousness

❑ Changes in self-perception

❑ Changes and distortions in perpetrator perception

❑ Changes in relationships with others

❑ Somaticizing trauma

❑ Loss of a sense of life purpose, changes in value system

❑ Avoidance of trauma-related topics

❑ Substance abuse

❑ Self-harm

❑ Emotional numbness



DSM-5 a Trauma:


In the case of the DSM-5, trauma as a stressor encompasses situations in which a person has been exposed to the confrontation with death, threat of death, serious bodily injury, or the threat of such injury, sexual abuse, or the threat of such abuse in one or more situations.

  • personally experienced the event,

  • was a direct witness to someone else experiencing such an event,

  • the traumatic event affected a close relative or friend (death or threat to life should be associated with violence or a sudden accident),

  • the person experienced repeated or extremely intense events (e.g., constant exposure due to work-related observation of violence, death).


Types of Traumatic Events:


Types of traumatic events include natural disasters, disasters caused by humans, interpersonal violence (structurally organized and political), family and non-family crimes, as well as exposure to trauma related to one's profession.


Trauma Typology:


Trauma can also be classified as Big "T" Trauma, leading to death or threatening physical integrity, leading to PTSD, and Small "t" Trauma (relational trauma), accompanying less overwhelming but repetitive negative experiences. The typology of trauma includes single-event experiences, complex trauma (Type I and II), where Type I trauma is a single event, and Type II trauma is repetitive, multiple events, or series of events. Type III trauma is vicarious trauma, involving experiences of traumatic events indirectly endured, for example, by individuals working with victims.




Co-occurrence of Mental Disorders with PTSD and C-PTSD:


The co-occurrence of other issues with PTSD and C-PTSD is common, making the treatment process more complicated. Individuals experiencing these disorders often grapple with additional challenges related to their mental health. Some possible coexisting problems are outlined below:


Addictions/Eating Disorders:


-Individuals with PTSD and C-PTSD may seek solace in psychoactive substances or food as a coping mechanism for emotions and stress.

-Eating disorders, such as bulimia or anorexia, can be common coexisting problems.


Depression:


-Depressive states often accompany PTSD and C-PTSD, affecting overall mood and psychological functioning.

-Feelings of hopelessness and a sense of life's meaninglessness may be present in both disorders.


Suicidal Ideation:


-Individuals with PTSD and C-PTSD may experience suicidal thoughts or self-destructive tendencies.

-Monitoring and intervention are necessary in the case of the emergence of suicidal ideation.


Dissociative Disorders and Alexithymia:


-Dissociation, or detachment from reality, can occur as a defense mechanism to trauma.

-Dissociative disorders, such as amnesia, derealization, or depersonalization.

-Alexithymia, also called emotional blindness. Alexithymia is a phenomenon characterized by significant challenges in recognizing, expressing and describing one's own emotions.


Somatic Symptom Disorders:


-Physical health problems without an obvious medical basis may be associated with trauma.

-Individuals with PTSD and C-PTSD may experience chronic pain, digestive issues, migraines, or sleep disorders.


Personality Disorders:


-c-PTSD may contribute to the development of personality disorders, such as for example, borderline.

-Defense mechanisms, such as avoidance or excessive control, may be evident in the personality sphere.


Anxiety Disorders:


-PTSD and c-PTSD are often associated with chronic stress and anxiety.

-Anxiety disorders, such as obsessive-compulsive disorder (OCD) or social phobia, may coexist.


 

Psychological Effects of Trauma:


The psychological effects of trauma encompass feelings of abandonment, loss of trust, violation of autonomy, and an assault on bodily integrity. Psychological trauma can lead to a sense of powerlessness.


It is crucial to emphasize that despite the difficulties associated with PTSD and C-PTSD, there are effective therapeutic methods and social support that can help individuals cope with the consequences of trauma. Therapies such as cognitive-behavioral therapy, exposure therapy, or EMDR can bring relief and aid in the healing process. More on this topic can be found here: Reliving it all over again... Why do we replay traumatic memories? (mentalhealth-nath.com)


Equally important is the support and understanding provided by the patient's surroundings. Family, friends, and mental health professionals play a crucial role in the process of regaining emotional balance. The community can be the foundation on which an individual rebuilds their life after trauma.


It is essential for individuals experiencing PTSD or C-PTSD to realize that seeking help does not signify weakness but rather courage and concern for their mental health. Every step toward healing is significant, and the journey may be challenging, but you are not alone. Seeking help, talking to loved ones, and engaging in self-help processes are valuable. The ability to heal and transform trauma is real, and everyone deserves support in their pursuit of better mental health.



More information:


Principles of Trauma Therapy: A Guide to Symptoms, Evaluation, and Treatment, John N. Briere, Catherine Scott

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