I have been working with an Army veteran who has a different form of Post-Traumatic Stress Disorder (PTSD). He has never been to combat, has never been beaten, or had a single event that, by definition, might have caused him to have PTSD, even though he has most of the PTSD symptoms. Steven is a 35-year-old Army veteran with a tough childhood. Steven was a military brat whose father was in the Navy and always gone on long deployments. Steven was left at home with his alcoholic mother who left him alone with a babysitter who locked him in the basement and fed him little food while his father was deployed, and mother was partying. Steven has a lot of holes in his memory and does not remember much of his childhood. It appears Stevens PTSD symptoms come from his childhood but exacerbated by the military. This upbringing has caused him to have a different form of PTSD called complex PTSD (C-PTSD). Instead of a single event that can cause PTSD, C-PTSD is a series of traumatic events, or one prolonged event, it appears Stephen fits that bill.
Presently the American Psychiatric Association (APA) does not recognize C-PTSD as a diagnosis. This does not allow mental health therapist to “officially” diagnose a client with C-PTSD. Recently C-PTSD has been accepted by mainstream psychological therapist even though the APA does not accept it as a diagnosis. Many clinicians accept the diagnosis because of all the trauma we see in our practices that does not meet the official diagnosis of PTSD. The Diagnostic and Statistical Manual (DSM) covers the (APA)’s recognized disorders and is slow to adapt to this new diagnosis. This leaves a lot of Americans with C-PTSD to not be diagnosed or incorrectly diagnosed, at times with personality disorders. However, C-PTSD is recognized by the World Health Organization and made the decision to include C-PTSD as its own separate diagnosis in 2018.
Combatting C-PTSD is comparable to treating PTSD. The complexity of C-PTSD adds different layers to the disorder and treatment, but it is similar. Steven has a lot of trauma in his life but no single incident that can be defined by one traumatic event required for a PTSD diagnosis. He has a lot of smaller traumatic incidents that have built up over time making it more like CPTSD and not PTSD. In the United States there is a lot of childhood trauma not meeting the criteria for PTSD but match the requirements for C-PTSD. Steven has a lot of trauma to unpack, but it can be done. According to the International Classification of Diseases revision 11 (ICD-11), in addition to experiencing all of the normal symptoms of PTSD, people with C-PTSD may also experience:
Difficulty Controlling Emotions
Experiencing an emotional flashback. This is when you have intense feelings that you originally felt during the trauma, such as fear, shame, or sadness.
Experiencing severe depression, thoughts of suicide, or have difficulty controlling your anger.
Detachment from Trauma (Dissociation):
Dissociation is the mind's way of coping with an intensely traumatic experience. Those who experience dissociation may feel detached from their surroundings, their actions, and their body.
Experiencing gaps in their memory surrounding the original trauma or an everyday task that reminds them of the trauma they experienced.
Changes in Self-Perception
Complex PTSD can cause a person to view themselves in a negative light. This negative self-image can include feeling as if they are different from other people and feelings of helplessness, guilt, or shame.
Preoccupation with Perpetrator
It is not uncommon for people with C-PTSD to become fixated on their abuser. This can include becoming obsessed with the abuser, dissecting their relationship with the abuser, and becoming preoccupied with revenge.
Difficulty with Personal Relationships
Someone with C-PTSD may develop unhealthy relationships because they find it difficult to interact with and trust others.
Changes in Beliefs
People exposed to chronic or repeated traumatic events may lose faith in humanity and previously held beliefs.