“speak the unspeakable”

“speak the unspeakable”
complex-ptsd
created by the secret keeper
opening by jennifer kiley
02.13.13
posted 02.14.13

I am publishing this post on Complex-Post Traumatic Stress Disorder for personal reasons but also to bring out into the open a reminder that C-PTSD effects too many people who have suffered severe and traumatic events in their life that lasted over a long period of time and developed into the complex disorder of C-PTSD. Below I have reprinted information from several sites that gives a comprehensive look into what exactly C-PTSD actually is. I am doing this, as I wrote above, for personal reasons which I hope benefits others who are suffering from this disorder. Honesty has always been something I have tried to be on the secret keeper. A great many of what is described in this post, I have experienced. Trying to avoid it, which I have been doing, not always intentionally, but b/c I have been working on trying to bring under control my bipolar without medication, which has been a struggle, I have manifested many of the symptoms of C-PTSD. More recently, they have become more pronounced and my psychotherapist feels we really need to start concentrating on working on the C-PTSD.

Before I will be able to do that, I have several surgeries ahead that I will need my strength for, in order to be able to recover. It is expected the surgical recoveries will take a fair amount of time. So, I have a dilemma. The C-PTSD symptoms are breaking through to my everyday life. I feel my mind’s protection of dissociating and my emotions crumbling from the weight of holding onto the severe trauma I experienced throughout my childhood and into my adult life. The effects of the trauma is sneaking through with symptoms that cause me to question my ability at times to differentiate with what is real and what is a misinterpretation of my sensory perceptions. It is time to get refocused and confront the memories. I have been working on these issues since I was a teenager and have gone through over 15 therapists. There have been times I pulled away from working with a psychotherapist.

I began using marijuana to self medicate when I was a teenager but also started therapy just before I started getting high on drugs. But even younger, I use to go to this bar starting at the age of 15 or 16 with my oldest brother and his friends and drink beer in very large consumptions. I could down a full pitcher of beer without coming up for air. I do not recommend this as a solution to dealing with the psychological, emotional, spiritual and physical traumas you are experiencing. I, also, sometimes did a variety of other mind altering drugs just to keep the memories suppressed and in the interim trying to find enlightenment through using mushrooms, LSD and other mind altering drugs. It kept me ahead of remembering and also buried the truth. Whenever I feel or felt myself getting too close to feeling and remembering the traumas, I would shut down or dissociate.

I am terrified of actually feeling on any level what the abusers did to me. But this week my therapist said in order to stop my mind from playing tricks on me and confusing me about what I am feeling and how I am interpreting reality, I need to really open wide those doors from the past. I even tried doing a Trauma Therapy Group a few years back but my present day psychotherapist told me awhile ago, that when I read what I had written about my abuse, I had no feeling. It was like I was reading the ingredients off a cereal box. The words were there but I felt nothing. And I don’t even remember a great deal of the abuse. It does come back in short clips when I am triggered.

One of the worst reactions today is not being able to trust how people I am close to really feel about me. One minute, everything is great, then something gets triggered from the past, and I am so confused I cannot figure out what is going on or what anyone feels. And the truth is I somehow know that my perceptions are way off but my mind will not let me allow myself to believe the truth. It twists me up inside. The extremes of severe traumatic abuse totally fucks up the way you are able to experience every part of your life. Everything is effected and confusing and flashbacks are at times running rampant in your brain or your body. And I am experiencing a co-morbidity of symptoms. Amongst the disorders that I deal with daily, I have bipolar, anxiety/panic disorder, agoraphobia to just show you an example of what one can end up dealing with everyday and never knowing when anyone of these with be having an effect on you.

So please, anyone who has experienced severe trauma or knows anyone who has or anyone who has lived through domestic violence or is still experiencing any of the following experiences, hopefully what is contained in this post will help direct or help explain what Complex-Post Traumatic Stress Disorder is exactly. The information was put together from different sources and there is a book I discovered in my investigating that I purchased for myself to read which already has begun to help me. I wrote about that and included an evaluation and where you can locate that book. I hope this is helpful. Complex-PTSD is often overlooked. Those who suffer from it are often forgotten. Even the new DSM-V, the Diagnostic Manual that is used to determine what may be what someone with a Mental Health problem may have as their diagnosis. They added 250 more diagnoses. Complex-PTSD was put forward to be included in this new version but as of now I have been made aware that it is not included. Once again overlooked. Everything else is, including if you mourn too long for the death of a loved one, you might just be diagnosed with a mental disorder. But that’s for another post. Please take the time to read what I include in this post. If not in one sitting, return to read more. Also, refer anyone you might know that could benefit from what I have posted. Thank you. jk the secret keeper…

Complex Post Traumatic Stress Disorder (C-PTSD)

Definition:

Complex Post-Traumatic Stress Disorder (C-PTSD) – Complex Post-Traumatic Stress Disorder is a psychological injury that results from prolonged exposure to social or interpersonal trauma, disempowerment, captivity or entrapment, with lack or loss of a viable escape route for the victim.

C-PTSD Introduction:

Complex Post Traumatic Stress Disorder (C-PTSD) is a condition that results from chronic or long-term exposure to emotional trauma over which a victim has little or no control and from which there is little or no hope of escape, such as in cases of:

*domestic emotional, physical or sexual abuse.

*childhood emotional, physical or sexual abuse.

*entrapment or kidnapping.

*slavery or enforced labor.

*long term imprisonment and torture.

*repeated violations of personal boundaries.

*long-term objectification.

*exposure to gas-lighting & false accusations.

*long-term exposure to inconsistent, push-pull, splitting or alternating raging & hoovering behaviors.

*long-term taking care of mentally ill or chronically sick family members.

*long term exposure to crisis conditions.

When people have been trapped in a situation over which they had little or no control at the beginning, middle or end, they can carry an intense sense of dread even after that situation is removed. This is because they know how bad things can possibly be. And they know that it could possibly happen again. And they know that if it ever does happen again, it might be worse than before.

The degree of C-PTSD trauma cannot be defined purely in terms of the trauma that a person has experienced. It is important to understand that each person is different and has a different tolerance level to trauma. Therefore, what one person may be able to shake off, another person may not. Therefore more or less exposure to trauma does not necessarily make the C-PTSD any more or less severe.

C-PTSD sufferers may “stuff” or suppress their emotional reaction to traumatic events without resolution either because they believe each event by itself doesn’t seem like such a big deal or because they see no satisfactory resolution opportunity available to them. This suppression of “emotional baggage” can continue for a long time either until a “last straw” event occurs, or a safer emotional environment emerges and the damn begins to break.

The “Complex” in Complex Post Traumatic Disorder describes how one layer after another of trauma can interact with one another. Sometimes, it is mistakenly assumed that the most recent traumatic event in a person’s life is the one that brought them to their knees. However, just addressing that single most-recent event may possibly be an invalidating experience for the C-PTSD sufferer. Therefore, it is important to recognize that those who suffer from C-PTSD may be experiencing feelings from all their traumatic exposure, even as they try to address the most recent traumatic event.

This is what differentiates C-PTSD from the classic PTSD diagnosis – which typically describes an emotional response to a single or to a discrete number of traumatic events.

Difference between C-PTSD & PTSD

Although similar, Complex Post Traumatic Stress Disorder (C-PTSD) differs slightly from the more commonly understood & diagnosed condition Post Traumatic Stress Disorder (PTSD) in causes and symptoms.

C-PTSD results more from chronic repetitive stress from which there is little chance of escape. PTSD can result from single events, or short term exposure to extreme stress or trauma.

Therefore a soldier returning from intense battle may be likely to show PTSD symptoms, but a kidnapped prisoner of war who was held for several years may show additional symptoms of C-PTSD.

Similarly, a child who witnesses a friend’s death in an accident may exhibit some symptoms of PTSD but a child who grows up in an abusive home may exhibit the additional C-PTSD characteristics shown below:

C-PTSD – What it Feels Like:

People who suffer from C-PTSD may feel un-centered and shaky, as if they are likely to have an embarrassing emotional breakdown or burst into tears at any moment. They may feel unloved – or that nothing they can accomplish is ever going to be “good enough” for others.

People who suffer from C-PTSD may feel compelled to get away from others and be by themselves, so that no-one will witness what may come next. They may feel afraid to form close friendships to prevent possible loss should another catastrophe strike.

People who suffer from C-PTSD may feel that everything is just about to go “out the window” and that they will not be able to handle even the simplest task. They may be too distracted by what is going on at home to focus on being successful at school or in the workplace.

C-PTSD Characteristics:

How it can manifest in the victim(s) over time:

Rage turned inward: Eating disorders. Depression. Substance Abuse / Alcoholism. Truancy. Dropping out. Promiscuity. Co-dependence. Doormat syndrome (choosing poor partners, trying to please someone who can never be pleased, trying to resolve the primal relationship)

Rage turned outward: Theft. Destruction of property. Violence. Becoming a control freak.

Other: Learned hyper vigilance. Clouded perception or blinders about others (especially romantic partners) Seeks positions of power and / or control: choosing occupations or recreational outlets which may put oneself in physical danger. Or choosing to become a “fixer” – Therapist, Mediator, etc.

Avoidance – Avoidance is the practice of withdrawing from relationships with other people as a defensive measure to reduce the risk of rejection, accountability, criticism or exposure.

Blaming – Blaming is the practice of identifying a person or people responsible for creating a problem, rather than identifying ways of dealing with the problem.

Catastrophizing – Catastrophizing is the habit of automatically assuming a “worst case scenario” and inappropriately characterizing minor or moderate problems or issues as catastrophic events.

“Control-Me” Syndrome – “Control-Me” Syndrome describes a tendency that some abuse victims and some people who suffer from personality disorders have to nurture relationships with people who have a controlling narcissistic, antisocial or “acting-out” nature.

Denial (PD) – Denial is believing or imagining that some factual reality, circumstance, feeling or memory does not exist or did not happen.

Dependency – Dependency is an inappropriate and chronic reliance by one adult individual on another for their health, subsistence, decision making or personal and emotional well- being.

Depression (Non-PD) – Depression is when you feel sadder than your circumstances dictate, for longer than your circumstances last – but still can’t seem to break out of it.

Escape To Fantasy – Escape to Fantasy is sometimes practiced by people who routinely shun transparency with others and present a facade to friends, partners and family members. Their true identity and feelings are commonly expressed privately in an alternate fantasy world.

Fear of Abandonment – Fear of abandonment and irrational jealousy is a phobia, sometimes exhibited by people with personality disorders, that they are in imminent danger of being rejected, discarded or replaced at the whim of a person who is close to them.

Hyper Vigilance – Hyper Vigilance is the practice of maintaining an unhealthy level of interest in the behaviors, comments, thoughts and interests of others.

Identity Disturbance – Identity disturbance is a psychological term used to describe a distorted or inconsistent self-view.

Learned Helplessness – Learned helplessness is when a person begins to believe they have no control over a situation, even when they actually do have the power to change their circumstances, leading them into an unnecessary state of depression, where initiative, action or investment is deemed futile.

Low Self-Esteem – Low Self-Esteem is a common name for a negatively-distorted self-view which is inconsistent with reality. People who have low self-esteem often see themselves as unworthy of being successful in personal and professional settings and in social relationships. They may view their successes and their strengths in a negative light and believe that others see them in the same way. As a result, they may develop an avoidance strategy to protect themselves from criticism.

Panic Attacks – Panic Attacks are short intense episodes of fear or anxiety, often accompanied by physical symptoms.

Perfectionism – Perfectionism is the practice of holding oneself or others to an unrealistic, unsustainable or unattainable standard of organization, order or accomplishment in one particular area of living, while sometimes neglecting common standards of organization, order or accomplishment in others.

Selective Memory and Selective Amnesia – Selective Memory and Selective Amnesia is the use of memory, or a lack of memory, which is selective to the point of reinforcing a bias, belief or desired outcome.

Self-Loathing – Self Loathing is an extreme self-hatred of one’s own self, actions or one’s ethnic or demographic background.

Tunnel Vision – Tunnel Vision is the habit or tendency to only see or focus on a single priority while neglecting or ignoring other important priorities.

C-PTSD Causes:

C-PTSD is caused by a prolonged or sustained exposure to emotional trauma or abuse from which no short-term means of escape is available or apparent to the victim.

The precise neurological damage that exists in C-PTSD victims is not well understood.

C-PTSD Treatment:

Little has been done in clinical studies of treatment of C-PTSD. However, in general the following is recommended:

*Removal of and protection from the source of the trauma and/or abuse.

*Acknowledgement of the trauma as real, important and undeserved.

*Acknowledge that the trauma came from something that was stronger than the victim and therefore could not be avoided.

*Acknowledgement of the “complex” nature of C-PTSD – that responses to earlier traumas may have led to decisions that brought on additional, undeserved trauma.

*Acknowledgement that recovery from the trauma is not trivial and will require significant time and effort.

*Separation of residual problems into those that the victim can resolve (such as personal improvement goals) and those that the victim cannot resolve (such as the behavior of a disordered family member)

*Mourning for what has been lost and cannot be recovered.

*Identification of what has been lost and can be recovered.

*Program of recovery with focus on what can be improved in an individuals life that is under their own control.

*Placement in a supportive environment where the victim can discover they are not alone and can receive validation for their successes and support through their struggles.

*As necessary, personal therapy to promote self discovery.

*As required, prescription of antidepressant medications.

What to do about C-PTSD if you’ve got it:

Remove yourself from the primary or situation or secondary situations stemming from the primary abuse. Seek therapy. Talk about it. Write about it. Meditation. Medication if needed. Physical Exercise. Rewrite the script of your life.

What not to do about it:

Stay. Hold it in. Bottle it up. Act out. Isolate. Self-abuse. Perpetuate the cycle.

What to do about it if you know somebody else who has C-PTSD:

Offer sympathy, support, a shoulder to cry on, lend an ear. Speak from experience. Assist with practical resolution when appropriate (guidance towards escape, therapy, etc.) Be patient.

What not to do about it if you know somebody else who has it:

Do not push your own agenda: proselytize, moralize, speak in absolutes, tell them to “get over it”, or try to force reconciliation with the perpetrator or offer “sure fire” cures.

Out of the Fog Complex-Post Traumatic Stress Disorder
This is the site I discovered all this information about C-PTSD. They also have an extensive collection on other pscyh diagnoses plus the forum that I have mentioned below. Click on the names. They are linked into Out of the Fog and all they have to offer and referrals to other information available out there on things psychological.

Out of the Fog Forum

A book I would highly recommend:

Trauma and Recovery: The Aftermath of Violence–from Domestic Abuse to Political Terror

Trauma and Recovery: The Aftermath of Violence–from Domestic Abuse to Political Terror — By Judith Herman
Available in Kindle for $9.21

Dr. Judith Herman came up with the term Complex-PTSD (Complex-Post Traumatic Stress Disorder). She has tried to have it included in the new DSM-V, feeling the PTSD does not include those who have experienced severe and chronic traumatic experiences over a prolonged period of time. I was so impressed with what I read from those who have read and reviewed this book that I purchased a copy for myself. It is so brilliantly written. I have never heard anyone express what I experienced from the time I was an infant with such understanding. I have only just begun reading the book so I will add a review from someone who has. jk the secret keeper

Review: 5.0 out of 5 stars—An Essential Contribution to Trauma Psychology

I wrote a glowing review on this book four years ago, but now that I have more formal education in trauma psychology I wanted to provide a more nuanced perspective.

Dr. Judith Herman is one of the most important voices in the field, and she was in fact a member of the committee that defined PTSD as it is listed in the Diagnostic and Statistical Manual – IV. Her contribution to the understanding of trauma psychology has been essential to understanding how trauma becomes PTSD and how that is manifested in the sufferer. She brings an incredible depth of compassion to her writing, making this book seem less like a compilation of research material and more like a courageous willingness to be a witness to unspeakable horror.

Dr. Herman specializes in sexual abuse and incest, but the book is meant to draw all sufferers of repeated trauma, from prisoners of war to victims of domestic violence, together under a single umbrella. She identifies what she believes to be a form of Complex-PTSD that is more pervasive and personality-oriented as a result of repeat trauma and captivity. Symptoms of this condition include an unstable sense of self, profound changes in system of meaning (such as loss of faith in God or basic goodness of humanity), sudden and unexpected changes in mood, fears of abandonment, fears of catastrophic world devastation, feelings of inherent badness, etc. In the book, Herman suggests that symptomatic overlap with Borderline Personality Disorder may indicate BPD is, in many cases, actually a form of complex trauma. While I believe there is some evidence to support this argument (such as the fact that the vast majority of those diagnosed with BPD suffer from childhood sexual trauma), her case is hardly universally accepted by the psychiatric community. Some clinicians will diagnose Complex PTSD and some will not.

One of the most interesting and useful messages of her work is the idea that the goal of treatment for the trauma survivor is to “speak the unspeakable.” She emphasizes the importance of taking the shattered, incoherent pieces of the trauma and deliberately, painstakingly weaving them into a cohesive narrative. She provides evidence to suggest that traumatic memories are neurochemically stored in a different way than traditional narrative memory, and that those with PTSD are hard-wired and chemically coded to reexperience trauma when triggered.

At the time she wrote the work, evidence-based research on PTSD was in its early stages, but her words about “speaking the unspeakable” have become startlingly prescient. Everything we know about PTSD to date suggests that it is caused by avoiding reminders of the traumatic event. This is because thought-suppression usually results in those distressing thoughts and memories re-emerging at highly inconvenient times. The best way we know to treat is literally to “speak the unspeakable” –over and over — until we learn that the monster we feared is so much smaller than we imagined. This is called prolonged exposure, and at certain clinics it is showing a treatment effectiveness rate of 80%.

Dr. Herman does not discuss prolonged exposure because (AFAIK-as far as I know) it didn’t exist yet… but she was correct that the way to heal from trauma is to say that which you are sure you cannot… to do, as Eleanor Roosevelt said, “The thing you think you cannot do.”

None of this is easy, and in fact, if you are a sufferer of repeated trauma, this might be one of those books you wait to read until you are in a stable place. It is compassionate, but very clinical, and seeing your psychology broken down into such concrete, analytical and frankly bleak pieces can be really unsettling. It is crucial, however, for all trauma survivors to understand that they are not alone, and the reactions they perceive as “crazy” or “bad” are in fact such typical reactions to objectively horrific events that they have been canonized into a moving and thought-provoking body of literature entitled “Trauma and Recovery.” You will find, if you were a child of abuse or victim of domestic violence, that you have more in common with torture victims and prisoners of war than you ever imagined.

This book cannot heal you, but it can point in the right direction, and it will help you understand yourself.

Information about the book:

When Trauma and Recovery was first published in 1992, it was hailed as a groundbreaking work. In the intervening years, Herman’s volume has changed the way we think about and treat traumatic events and trauma victims. In a new afterword, Herman chronicles the incredible response the book has elicited and explains how the issues surrounding the topic have shifted within the clinical community and the culture at large.Trauma and Recovery brings a new level of understanding to a set of problems usually considered individually. Herman draws on her own cutting-edge research in domestic violence as well as on the vast literature of combat veterans and victims of political terror, to show the parallels between private terrors such as rape and public traumas such as terrorism. The book puts individual experience in a broader political frame, arguing that psychological trauma can be understood only in a social context. Meticulously documented and frequently using the victims’ own words as well as those from classic literary works and prison diaries, Trauma and Recovery is a powerful work that will continue to profoundly impact our thinking.

I hope that this post has been informative and enlightening and will help with allowing those who have suffered severe traumatic experiences to not feel so alone and will bring them to a place to seek out or to continue to endure in working through their severe traumas. We are not alone. And for those who know of others who have gone through or are still experiencing severe traumatic experiences, that they will find the compassion to offer support and guidance to find the help they need to work on recovering from their nightmares. jk the secret keeper…

Here is a video I discovered hours after I finished putting this post together that I feel will be moving. There is no speaking. Just some piano and quotations of a meaningful nature that may help to understand somewhat of how it feels to have lived through severe traumatic experiences over a long period of time. In my own life, the trauma has continued. Has it ever stopped? No. The effects are in every moment that I live. The pain is like waves as the weather changes so do the level and intensity of the waves and the intensity of the pain follows that pattern, also.


complex post traumatic stress disorder as a senior project

While reviewing this post before publishing I discovered the video below that is a very sensitive young woman who talks about the the symptoms and treatment. Some I do not believe were mentioned in the above written material. One in particular stands out is the the amnesia and specifically the short term memory problem. I suffer from that to an extreme extent. Maybe if a certain person I know listens to this video she will believe me more when I say that I really do not remember what she said and that I have a difficult time concentrating. She thinks I don’t listen but that is not it at all. I hope that others out there will gain something for all of what I have offered on this post. jk the secret keeper ps. at the end I am going to list a few books that I have found helpful for me in dealing with what I have been writing about here.


C-PTSD Symptoms and Treatment

Orange Petals in a Storm
Dr. Niamh Clune


The Coming of the Feminine Christ

Dr. Niamh Clune


Every Child Is Entitled to Innocence

An Anthology of Happy and Sad Stories From Childhood

These are all available through Amazon and reasonably priced. I have them all in my collection. They will give you insight and inspiration. The intelligence of the two books by Dr. Niamh Clune are brilliant to genius. Dr. Clune’s books are all Five Star. The first is a novel about a young girl who is living in the middle of a nightmare but how she deals with it is what makes the book so amazing. I am reading it again and finding that it is helping me to deal with my emotions that are coming up. The book has a magical way of grounding me. It is what you would describe as a combination of metaphysical and magical realism. Read the first chapter and you will be hooked.

The second book by Dr. Clune is a true story. The Coming of the Feminine Christ took years to write. A great deal of research went into pulling together exactly in what way Dr. Clune would convey the revelation she received while walking through a rain forest in Canada, not alone, and meeting face to face with an angel who gave her a very strong message about this planet and humankind. It is more than about this confrontation. You just need to check out the reviews and read some of the book that Amazon offers as a Look Inside option. It mystifies everyone that has read it. I have read through and go over many passages again and again. Each time I learn something new or understand something in a more profound way. It does also help dealing with recovery and healing.

The last book is a collection of stories that adults have written about their childhoods. Some are happy and some are sad. It is a perfect book for someone who has C-PTSD or someone that knows of anyone who has suffered when they were a child. It is for anyone. We have all been children and have had our own experiences of childhood. This book and the other two books were published by Plum Tree Books. All are available in kindle. Click on the Titles and you will be taken to the page where you can check these books out and where you will be able to purchase them if you so desire. jk the secret keeper…