COMPLEX PTSD (Post-Traumatic Stress Disorder)

Summary

This video delves into complex PTSD, a proposed disorder not yet recognized by the DSM. The speaker discusses its distinction from PTSD, emphasizing the impact of prolonged and repeated traumas, such as those experienced by war veterans or victims of abuse. The video highlights the unique emotional and cognitive challenges faced by those with complex PTSD, including difficulties in emotion regulation, consciousness, self-perception, and interpersonal relationships. It also touches on the importance of specialized treatment and community support for those affected, advocating for understanding and breaking the stigma surrounding mental health.

Takeaways

• 📚 The video discusses Complex PTSD, a condition not officially recognized by the American Psychiatric Association (APA) but proposed for inclusion in the DSM.
• 🤔 There is a debate about whether Complex PTSD should be a separate diagnosis from PTSD, with some arguing that it better captures the psychological harm from prolonged and repeated trauma.
• 🏥 The video mentions sources like the VA and the National Center for PTSD, which have advocated for recognizing Complex PTSD as a distinct condition.
• 💥 Complex PTSD is often associated with situations involving repeated trauma, such as war, concentration camps, long-term abuse, or prostitution.
• 😡 Individuals with Complex PTSD may struggle with emotion regulation, experiencing intense and sudden emotional reactions.
• 😵‍💫 They may also experience consciousness issues, including blackouts or dissociation related to traumatic events.
• 😔 Self-perception issues are common, with feelings of hopelessness, shame, and difficulty reconnecting with society after trauma.
• 🔪 Some individuals may have distorted perceptions of the perpetrator or be preoccupied with revenge, impacting their relationships and mental health.
• 🏠 Isolation and difficulty trusting others are typical, which can strain personal and professional relationships.
• 🌟 The loss of a sense of meaning or hope can be a core issue for those with Complex PTSD, affecting their overall worldview and self-worth.
• 🛠️ Treatment for Complex PTSD involves progressive therapy, focusing on reintegration and interpersonal difficulties, often including family or couples therapy to address trust and communication issues.

Q & A

What is the main topic of the video?

The main topic of the video is complex PTSD, discussing its existence, differences from regular PTSD, and how it is often a result of prolonged and repeated trauma.

Why was the video created?

The video was created in response to community members asking about complex PTSD, as the host was unfamiliar with the term and felt compelled to research and share the information.

What does the American Psychiatric Association (APA) think about complex PTSD?

The APA, who publish the DSM, initially rejected the inclusion of complex PTSD, believing that the existing PTSD diagnosis covers a range of severity from mild to severe.

What are some situations that can lead to complex PTSD?

Situations that can lead to complex PTSD include coming back from war, being in concentration camps, experiencing long-term domestic violence, or enduring child physical or sexual abuse.

How is complex PTSD different from regular PTSD in terms of emotional regulation?

People with complex PTSD may have extreme difficulty regulating emotions, experiencing sudden and intense emotional reactions, unlike regular PTSD where emotional reactions may be more gradual.

What is the significance of consciousness in the context of complex PTSD?

Individuals with complex PTSD may experience complete blackouts or forgetfulness of traumatic events, and then dissociate or relive those events intensely, which is less common in regular PTSD.

How does complex PTSD affect a person's self-perception?

Complex PTSD can lead to feelings of hopelessness, embarrassment, and shame, making it difficult for individuals to reintegrate into society and form relationships.

What are some common reactions to the perpetrator in complex PTSD cases?

People with complex PTSD may either downplay the perpetrator's actions, rationalizing their behavior, or become preoccupied with revenge, focusing their lives around the desire for retribution.

How does complex PTSD impact relationships with others?

Complex PTSD can lead to isolation and distrust, making it difficult for individuals to form and maintain relationships, which can strain marriages and social connections.

What is the core issue with one's system of meanings in complex PTSD?

The core issue is a loss of faith or a sense of hopelessness and despair, indicating a deep disruption in the individual's understanding of their life's meaning and their own identity.

How does the treatment for complex PTSD differ from regular PTSD?

While both conditions involve progressive and grounding therapies, the treatment for complex PTSD places more emphasis on addressing interpersonal difficulties, such as trust issues, revenge focus, and emotional regulation.

Outlines

00:00

🤔 Introduction to Complex PTSD

The video begins with the host addressing the audience's curiosity about Complex PTSD, a topic they were unfamiliar with until prompted by the community. They express their excitement about learning and sharing new information. The host explains that Complex PTSD was proposed for inclusion in the DSM by the American Psychiatric Association (APA) but was rejected, with the APA arguing that the existing PTSD diagnosis covers a range of severity. The host disagrees, believing that the APA may have acted hastily and that Complex PTSD, often resulting from prolonged and repeated trauma, warrants special consideration and treatment, especially for war veterans.

05:04

🔍 Understanding Complex PTSD and Its Distinctions

This paragraph delves into the differences between Complex PTSD and traditional PTSD, emphasizing the unique challenges faced by those who have endured repeated trauma. The host outlines several key areas where Complex PTSD diverges: emotion regulation, where individuals may experience sudden and intense emotional reactions; consciousness issues, including blackouts and dissociation; self-perception problems, leading to feelings of hopelessness and shame; distorted perceptions of the perpetrator, ranging from denial of harm to a preoccupation with revenge; difficulties in interpersonal relationships, often manifesting as isolation and distrust; and a loss of faith or a sense of despair, indicating a deep existential crisis. The paragraph also touches on the treatment approaches for Complex PTSD, which include progressive exposure to triggers and a focus on interpersonal difficulties.

10:11

💪 Supporting Those with Repeated Trauma

The final paragraph shifts focus to the community's role in supporting individuals with Complex PTSD. The host encourages viewers to share the video, raise awareness, and seek understanding about the condition. They highlight the importance of referring those in need to appropriate resources, such as the VA or local therapists, and emphasize the value of simply being there to listen without judgment. The host calls for a collective effort to break the stigma surrounding mental health, allowing those with Complex PTSD to feel seen, heard, and supported in their journey toward healing.

Keywords

💡Complex PTSD

Complex PTSD refers to a proposed psychological disorder characterized by symptoms resulting from prolonged and repeated trauma. It is distinct from PTSD, which can result from a single traumatic event. In the video, the speaker discusses the debate around its recognition and the unique challenges faced by individuals who have experienced repeated trauma, such as veterans, survivors of concentration camps, and victims of long-term abuse.

💡American Psychiatric Association (APA)

The APA is a professional organization of psychiatrists in the United States that publishes the Diagnostic and Statistical Manual of Mental Disorders (DSM). The video mentions the APA's decision not to include complex PTSD in the DSM, which is a central point of contention in the video's discussion about the legitimacy and recognition of the disorder.

💡Prolonged and Repeated Trauma

This term describes the type of stressor that leads to complex PTSD, as opposed to the single-event trauma that can lead to PTSD. The video emphasizes the cumulative effect of ongoing traumatic experiences, such as those faced by soldiers in war or victims of ongoing abuse, and how this differs from a one-time traumatic event.

💡Emotion Regulation

Emotion regulation refers to the ability to manage and control one's emotions effectively. In the context of the video, individuals with complex PTSD may struggle with sudden and intense emotional reactions, which is a key difference between complex PTSD and PTSD and is highlighted as a significant challenge for those affected.

💡Dissociation

Dissociation is a psychological phenomenon where a person disconnects from their thoughts, feelings, memories, or sense of identity. The video script mentions that individuals with complex PTSD may experience complete blackouts or forgetfulness of traumatic events, which is a form of dissociation that is more pronounced in complex PTSD compared to PTSD.

💡Self-Perception

Self-perception involves how an individual views themselves. The video discusses how those with complex PTSD often feel a deep sense of shame, embarrassment, and hopelessness, which affects their ability to reintegrate into society and form relationships.

💡Perpetrator

In the context of the video, a perpetrator is someone who inflicts harm or trauma on another person. The script discusses how individuals with complex PTSD may have distorted perceptions of their perpetrators, either excusing their actions or becoming preoccupied with revenge.

💡Isolation

Isolation refers to the state of being alone or separated from others. The video explains that individuals with complex PTSD often isolate themselves due to distrust and difficulty in forming relationships, which can exacerbate their feelings of loneliness and disconnection.

💡System of Meanings

A system of meanings refers to an individual's beliefs, values, and understanding of the world and their place in it. The video script describes how complex PTSD can lead to a loss of faith or a sense of hopelessness and despair, indicating a profound disruption in an individual's system of meanings.

💡Treatment

Treatment in the context of the video refers to therapeutic interventions for complex PTSD. It is described as a progressive and gradual process that focuses on reintegration into triggering situations and addressing interpersonal difficulties, which is distinct from the treatment for PTSD due to the relational and emotional challenges faced by those with complex PTSD.

💡Stigma

Stigma refers to the negative stereotypes and prejudices associated with a particular condition or group. The video emphasizes the importance of breaking the stigma surrounding mental health issues, especially complex PTSD, to encourage open discussion and support for those affected.

Highlights

Introduction to Complex PTSD and its distinction from PTSD.

The American Psychiatric Association's (APA) decision not to include Complex PTSD in the DSM.

The argument that Complex PTSD requires different treatment considerations due to prolonged and repeated trauma.

Examples of situations leading to Complex PTSD, such as war, concentration camps, and long-term abuse.

The emotional regulation difficulties faced by individuals with Complex PTSD.

The phenomenon of consciousness issues, including blackouts and dissociation, in Complex PTSD.

Self-perception issues and the associated feelings of hopelessness and shame in Complex PTSD.

Distorted perceptions of the perpetrator and the preoccupation with revenge in Complex PTSD.

The tendency for isolation and distrust in relationships due to Complex PTSD.

The loss of a sense of meaning and hope in life for those with Complex PTSD.

The treatment approach for Complex PTSD, emphasizing gradual reintegration and interpersonal work.

The importance of community support and understanding for individuals with Complex PTSD.

The role of the VA and the National Center for PTSD in advocating for the recognition of Complex PTSD.

The need for clinicians to be educated on Complex PTSD to better serve those affected by it.

The call to action for the community to share information about Complex PTSD and support those in need.

The importance of breaking the stigma around mental health and encouraging open conversations.

Transcripts

Hey everybody!

Today I am putting out a video of something that you have asked me a lot about.

Complex PTSD

What is it? Does it exist?

What do we do if we have it?

How is it different that PTSD?

There's so many questions I'm going to answer for you right now.

(Intro Music)

So like I said, today I'm going to talk with you about complex PTSD, and

I didn't know anything about this.

Many of you have asked about it.

"Kati I had a friend who had this." or "My doctor talked about this. What is this? I haven't heard of it. Does it exist?"

And I didn't know.

That's what I love about our community. You all tell me things that are happening, things you're hearing about,

and then I'm forced to research it. Figure it out.

So I have all my notes, have my DSM, we're gonna talk about this.

We're gonna learn together, because I didn't know that complex PTSD was something that exists.

And for the true fact of diagnostic purposes, now the company, I shouldn't even say company,

but that's what it is. It's the American Psychiatric Association or the APA.

Those are the people who put out the DSM.

They create it. They decide what goes in and what doesn't.

And complex PTSD was something that was proposed. That they tried to get into the DSM.

And the APA was like "no, PTSD is enough."

We have severe, mild, moderate. We feel that covers it.

I understand. They have to make choices.

They only add things so often.

I mean if you saw the first DSM it was like 10 pages long.

And now we have this ginormous book of different diagnosis and different diagnostic criteria.

So I hear them.

However, after reading about complex PTSD I have to politely disagree with them.

I think the APA maybe acted too quickly, didn't really think about it.

Because the most common situation that leads to complex PTSD is coming back from war.

And if we as clinicians aren't ready and able and educated enough to help them manage their complex PTSD, then we're doing them a huge disservice.

And they just put their lives at risk for us, and that just really gets me.

So what is complex PTSD?

Now I got a lot of my information, because like I said it's not something that's in the DSM.

I can't pull up things within the DSM about how it happens, when it occurs, what causes it, you know, how does it run its course

I can't find that in here. I can only find information about PTSD itself, post traumatic stress disorder.

So I got information from the VA and the National Center for PTSD,

and those are the people who lobbied to the APA to get it into this new DSM.

So it's a proposed disorder, because many people feel that PTSD itself does not fully capture the severe psychological harm that occurs with prolonged and repeated trauma.

I want to highlight that:

prolonged and repeated trauma.

Now people that get PTSD could have just had, I don't mean just had,

but could have had one traumatic event that really was terrible.

It was scary. They felt helpless. They worried that their life was in danger.

Instead of that anxiety feeling, that feeling of worry and stress that comes after a scary situation

instead of it getting better slowly, like we start coming back to our regular self.

We don't have flashbacks as often, but PTSD just gets worse.

The people who have complex PTSD, wow say that 10 times fast, have had repeated traumas.

Also it's believed that cases that involve repeated traumas needed special treatment considerations.

That's what they lobbied to the APA for.

They feel it needs to be treated differently.

Now the biggest concern is our vets, like I said, because of the traumatic nature of their service

The fact that they feel scared and potentially helpless almost every day.

They don't know if they can get bombed while they're sleeping at night.

Every time they go out and leave their camp, they're in another risky situation where they could lose their lives.

And a lot of that can feel really helpless.

They watch people around them die.

This happens over and over and over. It's repeated trauma.

You with me?

So other examples, other than vets, because this can happen to a lot of people.

Concentration camps, prostitution brothels, long term domestic violence victims, or child physical or sexual abuse.

that's repeated.

I know many of you have reached out to me and said, you know "I was sexually abused or physically abused by a family friend or parent from the ages of 6 to 12."

Or some huge chunk of time. That's repeated trauma.

And the VA and the National Center for PTSD think that should be called complex PTSD,

so I have a video about PTSD. You can check that out too.

I encourage all of you to check that out, so that you understand PTSD as a whole

since this video is kind of building on that.

How is it different from PTSD?

Now this was really interesting to me, because if we're in repeated trauma versus maybe one situation

How does our mind process it differently?

Why is it different? Why do we need a new diagnosis?

I'm not one for a lot of diagnosis, but I have to say the VA really, they changed my thoughts about it.

Now the first is emotion regulation.

Many of you have heard me talk about this in my DBT videos.

When I talk about better managing maybe our borderline tendencies where we feel like our emotions just overwhelm us.

So people with complex PTSD may feel extremely overwhelmed with emotions all of a sudden, really quickly

Like boom! All of a sudden they're very angry and aggressive.

I know a lot of the people on the VA website had talked about it and said like

"yeah, my husband used to go off the handle, be crying, and then he's screaming. He couldn't regulate his emotion."

The second is consciousness.

They completely black out or forget the traumatic events.

And then many times it will switch over and then they'll be reliving them as if they're right back there.

A lot of people dissociate, which is also a component of regular PTSD.

But the complete blackouts, the forgetting, isn't as common.

Another is self perception.

They'll feel hopeless. They're embarrassed. They have so much shame about the fact that they're struggling.

That they feel like they can't incorporate back into life.

They don't know how to have relationships, communicate with people, connect with people.

And that to me is so hard.

Because they talk about the stigma. Feeling different from everyone else.

And when we talk about people who had repeated trauma my heart goes out to those people.

I just like, ahhhh, I feel for them. It's terrible.

And then the feeling that even after it stopped. So the trauma stopped, then they still feel like they can't connect.

They're not part of, they're not the same as other people.

They're embarrassed. They're shame filled because of what happened to them, which is something that they had no control over.

Something they were completely helpless to.

Now the fourth, and there's just a couple more. There's only six.

Is distorted perceptions of the perpetrator or preoccupation with revenge.

A lot of people will either, and they talk about two different instances,

where someone can either be like "but it wasn't their fault. They didn't mean it."

People who had been repeatedly physically or sexually abused are like but like "they were confused"

or let's say a cousin or a family friend or they're like "but they're family and I know they didn't mean to."

They try to cover it up or pretend that it wasn't a big deal or that they didn't know any better.

And then there's the reverse where people are preoccupied with revenge.

They're like 'that motherfucker is gonna get it.'

They get really focused on that, and their whole life revolves around revenge.

That can be really hard for the other people in relationships with them, to deal with.

The other, the fifth is, like I was just talking about relationships with others.

They isolate. They don't trust people very easily.

As so you can see how maybe that makes maybe marriages really difficult.

Someone comes back from war and they're distrustful of you and they isolate. They don't want to see family or friends.

They don't want to go out. They want to stay at home. They want to just do their thing.

Leave me alone.

It can be really hard.

And the last is one's system of meanings; they have a loss of sustaining faith or sense of hopelessness and despair.

So this was the hardest for me to read about, because it's almost like the core of who they are,

what the meaning in life is, what the meaning of themselves is was lost.

And that is just so hard to hear that people are feeling that way. That people are going through that.

And we're not even recognizing this as a diagnosis. Bleh! Makes me feel sick.

So, why does this happen? What is this? What do we do?

What's the treatment like?

It's pretty much the same as PTSD where we do a lot of reintegration into situations that may be triggering.

That may trigger any kind of flashback or dissociation. We ground ourselves. It's a progressive treatment.

We do it little by little.

We don't just throw you in there in the deep end and be like fix this, figure it out.

I don't care if you're having a panic attack, you're freaking out, we're just gonna try and do this.

It's a slow progressive therapy.

But the difference with complex is that they work a lot on interpersonal difficulties.

So all of those things: the distrust, the focus potentially on revenge, the pretending the perpetrator didn't really mean to,

or their struggle with emotion regulation and lashing out, being really scary potentially to the people in their life

We work a lot on that.

And that's how the treatment differs.

There's a lot of relational work. There's a lot of couples or family work

that's integrated into this, because when someone has repeated trauma it can be really hard for them to move past it. Really hard to communicate

And to completely trust and love and get back into the relationships they had before the trauma started happening.

And so I want you all to consider those around you who may have had repeated trauma

Maybe you could share this video with them

Maybe you could work and seek to understand.

Refer them to the VA or other facilities that can offer help. Refer them to therapists in the area.

Be there to listen and seek to understand, because a lot of it, sounds like they just feel shame filled.

They don't know what to do. They're embarrassed of their situation.

They don't know how to reintegrate back into life after these terrible things have happened to them,

so we as a community can help better support these people.

We can share this video. We can like this video.

We can talk about complex PTSD and how different it is from regular PTSD, because it's important for people to feel understood.

That's the whole reason I love our community is because we're all in this together. Right?

We're working together.

Everyone's situation is a little bit different, but we're all working to share and shed light on the information that's important about mental health.

To break through the stigma, so people don't feel so shame filled and hide in the shadows isolating.

They know they can they can speak up. They can talk about it, and we're here to listen.

And we're here to better understand their situation,

so please share. Please comment. Please give it a thumbs up!

Let people know that this stuff is important.

We need to talk about it, because people are struggling and we know the more support and information we can put out there the better.