When he first said my diagnosis, I couldn't believe it. There must be another PTSD than post-traumatic stress disorder, I thought. I have only heard of war veterans who have served on the front lines and seen the horrors of battle being diagnosed with PTSD. I am a Beverly Hills housewife, not a soldier. I can't have PTSD. Well, I was wrong. Housewives can get PTSD, too, and yours, truly did.
One group of people that get a lot of PTSD are soldiers who have been in combat. You know who gets more PTSD, has higher rates of PTSD? Women who have escaped prostitution. That tells me that the war that men wage against women is actually worse than the wars they wage against each other.
The symptomatology of PTSD. In PTSD a traumatic event is not remembered and relegated to one's past in the same way as other life events. Trauma continues to intrude with visual, auditory, and/or other somatic reality on the lives of its victims. Again and again they relieve the life-threatening experiences they suffered, reacting in mind and body as though such events were still occurring. PTSD is a complex psychobiological condition.
People generally don't suffer high rates of PTSD after natural disasters. Instead, people suffer from PTSD after moral atrocities. Soldiers who've endured the depraved world of combat experience their own symptoms. Trauma is an expulsive cataclysm of the soul. The Moral Injury, New York Times. Feb 17, 2015
People with Complex PTSD suffer from more severe and frequent dissociation symptoms, as well as memory and attention problems, than those with simple PTSD. In addition to amnesia due to the activity of various parts of the self, people may experience difficulties with concentration, attention, other memory problems and general spaciness. These symptoms often accompany dissociation of the personality, but they are also common in people who do not have dissociative disorders. For example everyone can be spacey, absorbed in an activity, or miss an exit on the highway. When various parts of the personality are are active, by definition, a person experiences some kind of abrupt change in attention and consciousness.
Alterations in regulation of affect (emotion) and impulse: Almost all People who are seriously traumatized have problems in tolerating and regulating their emotions and surges or impulses. However, those with complex PTSD and dissociative disorders tend to have more difficulties than those with PTSD because disruptions in early development have inhibited their ability to regulate themselves. the fact that you have a dissociative organization of your personality makes you highly vulnerable to rapid and unexpected changes in emotions and sudden impulses. Various parts of the personality intrude on each other either through passive influence or switching when your under stress, resulting in dysregulation. Merely having an emotion, such as anger , may evoke other parts of you to feel fear or shame, and to engage in impulsive behaviors to stop avoid the feelings.
Rose lived the same life I did, but she doesn't have PTSD. No bad dreams, no missing memories. Sometimes I'm jealous that she seems to deal with everything better than I do. But then I'll catch her with this hollow look in her eyes and think maybe she just disguises everything for my benefit. Maybe she's broken on the inside too.
You have to understand that PTSD has to be an event that you experience, a very traumatic event. And actually, there is evidence that brain chemistry changes during this event in certain individuals where it's imprinted indelibly forever and there's an emotion associated with this which triggers the condition.
The strong version of the adversity hypothesis might be true, but only if we add caveats: For adversity to be maximally beneficial, it should happen at the right time (young adulthood), to the right people (those with the social and psychological resources to rise to challenges and find benefits), and to the right degree (not so severe as to cause PTSD).
When I began writing, I did not realize that the Holocaust would become a critical part of the story. During and after WWII, neither the survivors of the Holocaust nor the combat solders were diagnosed or treated for what is now known as PTSD (Post-traumatic Stress Disorder). Many of the characters in this book were victims of this now well-known disorder.
Moral Injury is differentiated from PTSD in that it directly relates to guilt and shame veterans experience as a result of committing actions that go against their moral codes. Therapists who study and treat moral injury have found that no amount of medication can relieve the pain of trying to live with these moral burdens.
Complex PTSD consists of of six symptom clusters, which also have been described in terms of dissociation of personality. Of course, people who receive this diagnosis often also suffer from other problems as well, and as noted earlier, diagnostic categories may overlap significantly. The symptom clusters are as follows: Alterations in Regulation of Affect ( Emotion ) and Impulses Changes in Relationship with others Somatic Symptoms Changes in Meaning Changes in the perception of Self Changes in Attention and Consciousness
when a child is ridiculed, shamed, hurt or ignored when she experiences and expresses a legitimate dependency need, she will later be inclined to attach those same affective tones to her dependency. Thus, she will experience her own (and perhaps others') dependency as ridiculous, shameful, painful, or denied. - Dependency in the Treatment of complex PTSD and Dissociative Disorders 2001 Authors: Kathy Steele, Onno van der Hart, Ellert R. S. Nijenhuis
The victims of PTSD often feel morally tainted by their experiences, unable to recover confidence in their own goodness, trapped in a sort of spiritual solitary confinement, looking back at the rest of the world from beyond the barrier of what happened. They find themselves unable to communicate their condition to those who remained at home, resenting civilians for their blind innocence. The Moral Injury, New York Times. Feb 17, 2015
There is clear evidence from internal investigations in the past that some raters actually see themselves as adversaries to veterans. If a claim can be minimized, then the government has saved money, regardless of the need of the veteran. Just recently, the press exposed an official e-mail from a high-level staff person who stated in essence that PTSD diagnosis was becoming too prevalent and offered ways to delay and deflect ratings in order to save the government money.
I respect journalism. I was always very aware of journalism from a very broad point of view, but I'd say my baptism by fire was doing the Donald Margulies play Time Stands Still. That for me was a real education because I spent a lot of time with some incredible journalists, war reporters particularly - Bob Woodruff, Dexter Filkins - people who were very helpful in painting the picture for me and reading the accounts of people and what they experienced, a lot of PTSD.
But veteran lawmakers torn apart by PTSD don't have a choice about being Exhibit A in the case against Washington politics. When you see what can happen to a page or a junior congressman, it passes on in a very real way, not in a history-class sense, that reality of what political power really is, .. Who are we to impose this emotional albatross on public servants? As a nation, we pretend to elect our leaders. It seems unjust to make them a special class to suffer for our sins over wrongheaded laws, or pay a continuing emotional price for securing their future careers.
I'm reminded of Orville Tethington, inventor of the world's first steam-powered fog machine. He's also the guy who, after the Germans invented the flame thrower in WWI, decided to counteract it with his own creation, the candle thrower. The candle thrower was only battle tested once, and after fifteen minutes the war zone was littered with lit candles. Upon returning home after the war, some of the soldiers suffered such extreme and bizarre cases of PTSD that anytime a civilian lit a match or used their lighter, the soldiers would hit the ground and start singing 'Happy Birthday.
Instead of showing visibly distinct alternate identities, the typical DID patient presents a polysymptomatic mixture of dissociative and posttraumatic stressdisorder (PTSD) symptoms that are embedded in a matrix of ostensibly non-trauma-related symptoms (e.g., depression, panic attacks, substance abuse, somatoform symptoms, eating-disordered symptoms). The prominence of these latter, highly familiar symptoms often leads clinicians to diagnose only these comorbid conditions. When this happens, the undiagnosed DID patient may undergo a long and frequently unsuccessful treatment for these other conditions. - Guidelines for Treating Dissociative Identity Disorder in Adults, Third Revision, p5
James A. Chu
The scientific study of suffering inevitably raises questions of causation, and with these, issues of blame and responsibility. Historically, doctors have highlighted predisposing vulnerability factors for developing PTSD, at the expense of recognizing the reality of their patients' experiences... This search for predisposing factors probably had its origins in the need to deny that all people can be stressed beyond endurance, rather than in solid scientific data; until recently such data were simply not available... When the issue of causation becomes a legitimate area of investigation, one is inevitably confronted with issues of man's inhumanity to man, with carelessness and callousness, with abrogation of responsibility, with manipulation and with failures to protect.
Bessel A. van der Kolk
Blame is a Defense Against Powerlessness Betrayal trauma changes you. You have endured a life-altering shock, and are likely living with PTSD symptoms- hypervigilance, flashbacks and bewilderment-with broken trust, with the inability to cope with many situations, and with the complete shut down of parts of your mind, including your ability to focus and regulate your emotions. Nevertheless, if you are unable to recognize the higher purpose in your pain, to forgive and forget and move on, you clearly have chosen to be addicted to your pain and must enjoy playing the victim. And the worst is, we are only too ready to agree with this assessment! Trauma victims commonly blame themselves. Blaming oneself for the shame of being a victim is recognized by trauma specialists as a defense against the extreme powerlessness we feel in the wake of a traumatic event. Self-blame continues the illusion of control shock destroys, but prevents us from the necessary working through of the traumatic feelings and memories to heal and recover.
Sandra Lee Dennis
Somatic Symptoms: People with Complex PTSD often have medical unexplained physical symptoms such as abdominal pains, headaches, joint and muscle pain, stomach problems, and elimination problems. These people are sometimes most unfortunately mislabeled as hypochondriacs or as exaggerating their physical problems. But these problems are real, even though they may not be related to a specific physical diagnosis. Some dissociative parts are stuck in the past experiences that involved pain may intrude such that a person experiences unexplained pain or other physical symptoms. And more generally, chronic stress affects the body in all kinds of ways, just as it does the mind. In fact, the mind and body cannot be separated. Unfortunately, the connection between current physical symptoms and past traumatizing events is not always so clear to either the individual or the physician, at least for a while. At the same time we know that people who have suffered from serious medical, problems. It is therefore very important that you have physical problems checked out, to make sure you do not have a problem form which you need medical help.
Conviction rates in the military are pathetic, with most offenders going free AND THERE IS NO RECOURSE FOR APPEAL! The military believes the Emperor has his clothes on, even when they are down around his ankles and he is coming in the woman's window with a knife! Military juries give low sentences or clear offender's altogether. Women can be heard to say 'it's not just me' over and over. Men may get an Article 15, which is just a slap on the wrist, and doesn't even follow them in their career. This is hardly a deterrent. The perpetrator frequently stays in place to continue to intimidate their female victims, who are then treated like mental cases, who need to be discharged. Women find the tables turned, letters in their files, trumped up Women find the tables turned, letters in their files, trumped up charges; isolation and transfer are common, as are court ordered psychiatric referrals that label the women as lying or incompatible with military service because they are 'Borderline Personality Disorders' or mentally unbalanced. I attended many of these women, after they were discharged, or were wives of abusers, from xxx Air Force Base, when I was a psychotherapist working in the private sector. That was always their diagnosis, yet retesting tended to show something different after stabilization, like PTSD.
Secondary structural dissociation involves one ANP and more than one EP. Examples of secondary structural dissociation are complex PTSD, complex forms of acute stress disorder, complex dissociative amnesia, complex somatoform disorders, some forms of trauma-relayed personality disorders, such as borderline personality disorder, and dissociative disorder not otherwise specified (DDNOS).. Secondary structural dissociation is characterized by divideness of two or more defensive subsystems. For example, there may be different EPs that are devoted to flight, fight or freeze, total submission, and so on. (Van der Hart et al., 2004). Gail, a patient of mine, does not have a personality disorder, but describes herself as a "changed person." She survived a horrific car accident that killed several others, and in which she was the driver. Someone not knowing her history might see her as a relatively normal, somewhat anxious and stiff person (ANP). It would not occur to this observer that only a year before, Gail had been a different person: fun-loving, spontaneous, flexible, and untroubled by frightening nightmares and constant anxiety. Fortunately, Gail has been willing to pay attention to her EPs; she has been able to put the process of integration in motion; and she has been able to heal. p134
Elizabeth F. Howell