Complex PTSD: From the Inside Looking Out

I check my stats page for this blog every day, and when I check, I look to see which articles seem to be most popular.  So far, the article titled “Complex PTSD: Does It Exist?” has been read more times than the others.  When I wrote the article, I didn’t expect it to be this popular.  In fact, I wasn’t sure that anyone would want to read it because it struck me as being somewhat dry and academic.  However, now I know that the topic appeals to you, my readers, and I will do my best to address the topic more often.  In the meantime, here are two articles I found recently which you might find helpful:
 
• http://knowledgex.camh.net/amhspecialists/specialized_treatment/trauma_treatment/first_stage_trauma/FirstStageTT_ch6/Pages/criteria_complex_ptsd.aspx
• http://drkathleenyoung.wordpress.com/2010/03/10/complex-ptsd/

If you read the two articles listed above, you will have a good idea as to the hallmarks of C-PTSD.  You will, at least, have a good idea as to the nature of C-PTSD as the practitioners and researchers see it.  You may not, however, get much of an idea from the articles as to how the problem appears to those who live with the disorder every day—those of us who find ourselves in a C-PTSD cage and are trying to get out and join the rest of the world.

Each person who battles C-PTSD experiences the disorder differently because each person is uniquely different from any other person.  Thus, when you read my description of my experience in the articles I’ve written for this blog, it’s important to remember that my experience of C-PTSD is unique to me.  There are, though, certain common threads that run through the tapestry of each person’s experience of the disorder.

One such thread is the presence of typical PTSD symptoms—flashbacks, dissociative episodes, numbing of emotions, etc.  The presence of these symptoms has interfered with my life to the point where I have long known I needed and wanted to do something to alleviate them.  That’s the main reason why I am presently in therapy, and it’s the main reason why I have attempted to get help in the past.  At present, I can say that I have actually tamed the symptoms to the point where they don’t bother me every day, and I can ride public transportation without being knocked off kilter by the symptoms.  Possibly, if I had the “non-C” PTSD, I would be finished with therapy by now.  I would be thrilled if I were ready to leave therapy because therapy is hard work that takes a lot of my time and thought.  That time, however, has not yet arrived.  I know it will arrive someday, but it is not here yet.

The problem is that C-PTSD is, as the name says, “complex.”  If my parents had wanted me, had been understanding and nurturing and had listened to me with empathy when I was a child, and if I had grown to be a mature adult with all the attributes of an emotionally mature adult and had been raped one night when I was in the wrong place at the wrong time, then very possibly I would have been diagnosed with PTSD.  I probably could have finished therapy a long time ago because I would have had sufficient ego strength to go through a course of EMDR or one of the other therapies found effective for healing PTSD.  I don’t know this for certain, but it’s likely.
 
In my case, though, the factors mentioned above did not apply to me.  I was not wanted, was not understood, was not given the parental attention I needed, was not treated with respect, and was sexually abused and abused in other ways.  When I reached the age of adulthood, I did not have the ego strength I needed to be an effective and mature adult.  And then I married a man who continued the treatment my parents gave me.  So over a long period of time, forty-two years in my case, I endured the sort of treatment that leads to C-PTSD and thought my life was normal, that every woman endured what I endured and that there was no alternative. The threads of prolonged exposure to abuse and neglect run through my tapestry as they run through the tapestries of most others who are trapped in C-PTSD.  The material from which the threads in my tapestry are spun may not be identical to that of other people who have C-PTSD, but the basic threads themselves are present.
 
So what, in my opinion, is the most telling factor, the factor that brings me up short and causes me to recognize and acknowledge the C-PTSD elephant in my own living room?  It’s the seemingly interminable nature of the healing process.  Like Sisyphus, I roll the stone almost to the top and think, “Success!  I’m there!” only to stand with mouth agape in amazement as I watch the stone roll back down and wait for me to roll it uphill again.  I manage to reduce the intensity of my PTSD symptoms, for example, only to discover in the process that I have some developmental gap that I need to investigate, understand, and fill if I am to truly enjoy relief from my symptoms. The process doesn’t seem to end, and that fact tells me that I’m dealing with C-PTSD and not the “non-C” PTSD.
  
If the process of breaking out of the C-PTSD cage seems so interminable and is so discouraging, why do I continue trying?  I continue because as I work in therapy, the bars are beginning to become less rigid and more flexible.  For example, I can sit on a bus calmly and without dissociating now when somebody gets on, tries to avoid paying the fare, and then argues loudly with the driver.  I may become irritated at the delay and the fact that somebody is so crass as to attempt to bully the driver into letting him ride free, but I don’t let the voices raised in anger and the menacing or threatening demeanor of the bully allow PTSD symptoms to take over my mind as I would have done a year ago.  My present response to a situation that in the past would have laid me low for the better part of a day tells me that slowly the cage bars are weakening and freedom is possible.  The little signs of progress comprise the carrot on the stick that causes me to plod along toward my goal, in other words.

What would I suggest a person have available to aid in his or her escape from the cage of C-PTSD?  Here is my list of necessary equipment:• A realistic VISION of what life may be like without the present constraints of C-PTSD;
• The necessary RELATIONSHIP with a therapist who specializes in trauma work;
• The MOTIVATION to do the job;
• COMMITMENT to one’s self and to one’s goal;
• A RECOGNITION of one’s progress, no matter how tiny the increment;
• The HOPE that springs from recognizing progress;
• A sense of HUMOR to help get one’s perspective back when times are bleakest;
• The FAITH in the process needed to keep plodding along no matter what!
 
The above is my list.  You will have your own list, no doubt, but maybe my list will remind you of something you forgot to put on your list.  And my list above may not contain everything I need, but it does contain the equipment most important to me right now. 

To conclude, I’m no learned expert on C-PTSD.  I’m not a trained mental health professional—I have a graduate degree in adult education and a graduate degree in rhetoric, neither of which qualifies me as an expert on C-PTSD.  I do, however, have something many of the experts may lack, a diagnosis of C-PTSD, and that diagnosis places me on the inside of the cage looking out.  I hope that whatever I say to you as I write “from the inside out” is useful and inspiring and facilitates your rending the bars of your cage and making your way to freedom.