The emotional pain or neglect felt by adults with Complex Post Traumatic Stress Disorder (C-PTSD) was often inflicted by an attachment figure, a person with whom s/he had an emotional bond with, or by those who held the person captive giving the victims a sense that they are defective and that others can’t be trusted. It can also be caused by jobs that continually deal with traumatic situations.
This disorder isn’t included in the Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR, the manual mental health professionals use diagnose psychological disorders. Dr. Judith Herman, the pioneer in C-PTSD, coined the term in her book, Trauma and Recovery, and has made proposals for its criteria and inclusion in the DSM-V.
The Effect of Attachment Figures on People with C-PTSD
Children have parents, caregivers and/or older siblings as people with whom they have emotional bonds. Adults also have significant others as attachment figures. Survivors yearn for and may seek an emotional relationship that would make them feel safe and secure. There may be a sense of loss for something that other people take for granted which they never had. Too often, people with C-PTSD fall into the trap of victimization and subconsciously chose significant others or friends who will perpetuate the abuse.
People who develop C-PTSD after being held hostage may also develop the Stockholm Syndrome. Hostages may exhibit signs of loyalty to their captors, despite risks or dangers in which they were placed. The syndrome is named after the bank robbery in Norrmalmstorg Sweden when the thieves held employees hostage for six days. The victims became emotionally attached to their captors and defended them after they were released.
Herman’s Proposed Criteria for Adult C-PTSD
The six symptoms suggested are:
- Restricted or constricted impulses and exhibited behaviors which include facial expressions and vocal inflection expressing emotions. There may be problems with regulating emotions including chronic sadness, suicidal ideation and hidden or explosive anger.
- Variations in consciousness, such as repressing, suppressing or reliving traumatic events or dissociation, detachment from mental or physical processes
- Alterations in self-perception including feelings of helplessness, shame, guilt and/or being different from others
- Differences in relationships with others which can be isolating, looking for a rescuer and/or mistrust. People with C-PTSD may view the perpetrator as all powerful or be obsessed with the relationship which may be accompanied by thoughts of revenge.
- Somatization, a subconscious process in which psychological distress is expressed as physical symptoms. One of the most common examples is a tension headache when stress is manifested physically.
- Changes in systems of meaning which can be felt as a loss of faith, despair and/or hopelessness.
Why C-PTSD and Proposed Criteria Should Be Included in the DSM-V
The current classifications of Post Traumatic Stress Disorder, PTSD, and Disorders of Extreme Stress Not Otherwise Specified (DESNOS) aren’t sufficient to describe the symptoms of C-PTSD. PTSD is caused by a traumatic incident that is life-threatening or a crime against a person. The latter is a catch-all term for anxiety disorders that don’t fall into existing categories.
People with C-PTSD don’t have a valid diagnosis and may wonder why they feel despair, powerless and other unpleasant emotions associated with the disorder. The inclusion of C-PTSD would help them understand these feelings and heal and offer therapies specific to the disorder.
Articles Related to Proposed Criteria for Adult C-PTSD
People who found this article interesting may want to read What is Complex Post-Traumatic Stress Disorder? and What is Post-Traumatic Stress Disorder (PTSD)?
Sources:
- Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR, American Psychiatric Association, (American Psychiatric Association, 2000).
- NCPTSD.va.gov
Jill Stefko - I'd rather deal with the paranormal than human abnormal - having dealt extensively with both.
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