COMPLEX POSTTRAUMATIC STRESS DISORDER
Complex PTSD is known in clinical terms as a disorder of extreme stress, not otherwise specified (DESNOS) or self-trauma disturbance (Briere, 2002; Pelcovitz, et al., 1997).
So, what is it?
Somewhat differing from the PTSD experienced by victims of car accidents, war, physical/sexual assault, fires, and natural disasters, complex stress effects almost always arise from severe, prolonged, and repeated trauma, often occurring in childhood. Complex-PTSD presentations are relationally-related and include identity disturbances such as the tendency to be involved in chaotic and maladaptive relationships, challenges navigating interpersonal boundaries, and diminished capacity to recognize and convey needs and entitlements to others. Sufferers of complex-PTSD experience chronic difficulties in affect regulation, and often engage in externalized means of reducing distress by engaging in harmful activities to reduce distress. Such behaviours include compulsive or indiscriminate sexual behaviour, self-harm (i.e: cutting), bingeing and purging, attacking others or Self, suicidality, and drug/alcohol abuse. Relational trauma commencing in early life can sometimes be difficult to identify. Rather than the concreteness of physical abuse or neglect, developmental disruptions that impede healthy development can occur when parent-child attachment is inadequate or unpredictably intercepted. An example of this could be if an environmental stressor or depression/illness is impeding a parent from being optimally attuned to the child – the parent may be present physically, but not emotionally. It is common for those engaging in maladaptive coping behaviours to not recognize that relational trauma may be the catalyst for their compulsions.
Complex PTSD looks like:
The good news?
One can heal from relational trauma. Adaptive coping behaviours and self-regulation strategies can be acquired, as well as enhanced connection with Self and with others.
For a great resource on relational trauma, I recommend the book:
Healing developmental trauma: How early life trauma affects self-regulation, self-image, and the capacity for relationship. By Laurence Heller, PhD & Aline LaPierre, PsyD (2012).
~Christine
References:
Banich, M. T., & Compton, R. J. (2017). Cogntive neuroscience (4th ed.). Belmont, CA: Wadsworth, Cengage Learning.
Bisson, J., & Andrews. M. (2007). Psychological treatment of post-traumatic stress disorder (PTSD). Cochrance Database of Systemic Reviews 2007, Issue 2 (Art. No. C003388). Doi: 10.1002/14651858.CD003388.pub3. Retrieved from http://www.ncbi.clm.nih.gov/pubmed/15846661
Briere, J. M., & Scott, C. (2015). Principles of trauma therapy: A guide to symptoms, evaluations, and treatment (2nd ed.). Thousand Oaks, CA: Sage Publications.
Pelcovitz, D., van der Kolk, B. A., Roth, S., Mandel, F., Kaplan, S., & Resick, P. (1997). Development of a criteria set and structured interview for disorders of extreme stress (SIDES). Journal of Traumatic Stress, 10, 3-16.
