What is PTSD

PTSD is a collection of difficulties that may develop following exposure to an extremely threatening or horrific event, or series of events. It is characterized by all of the following:

• Re-experiencing the traumatic event or events in the present. This might happen in the form of vivid intrusive memories, flashbacks, or nightmares. These are typically accompanied by strong or overwhelming emotions, particularly fear or horror, and strong physical sensations.
• Avoidance of thoughts and memories of the event or events, or avoidance of activities, situations, or people that might be reminders of the event or events; and
• Persistent experiences of heightened threat in the present, for example, high levels of vigilance and watchfulness, or being very startled and jumpy in response to certain sounds, sights, smells, etc.

To meet diagnostic criteria for PTSD, the difficulties above will have been happening for at least several weeks, and will be causing significant difficulties in personal, family, social, educational, occupational or other important areas of life

What is Complex Posttraumatic Disorder (C-PTSD)

Complex PTSD arises from exposure to harmful or threatening situations where escape was difficult or impossible. These events typically occur repeatedly over a long period, often during childhood, and involve a lack of care and protection that should have been provided.

Examples of C-PTSD

• Childhood abuse -sexual, emotional and physical.
• Neglect – having parents who were emotionally unavailable.
• Prolonged exposure to Domestic Violence.
• Torture
• Slavery
• Genocide

Symptoms beyond PTSD

Individuals with C-PTSD experience all the symptoms of PTSD (re-experiencing trauma, avoidance, hypervigilance) alongside additional difficulties.

• Emotional Dysregulation -Difficulty managing and controlling emotions.
• Negative Self-Perceptions – Feelings of worthlessness, shame, guilt or being permanently damaged.
• Relationship Issues -difficulty forming and maintaining close relationships.

Diagnosis and Impact

Similarly to PTSD C-PTSD symptoms must be present for several weeks and significantly impact daily functioning in various aspects of life (personal, family, social etc) for diagnosis.

Dissociative Disorders

Dissociative Disorders occur alongside complex forms of trauma, and range from experiences of Depersonalisation and Derealisation, to Dissociative Identity Disorder. They are a group of merntal conditions that involve disruptions in consciousness, memory, identity, perceptions, emotions, behaviour or sense of self.

Depersonalization and Derealization

Depersonalization is one of these dissociative disorders whereby people experience themselves as feeling strange or unreal. They might feel detached, or as though they are an outside observer of their own thoughts, feelings, sensations, body, or actions. Sometimes they may feel like they are in a dream,or that they are watching a movie of their own life. Others may feel emotionally numb, or that their body is not their own.

One or two people in a hundred may experience depersonalisation or derealisation disorder.

Dissociative Identity Disorder

Dissociative Identity Disorder, (previously known as Multiple Personsality Disorder) is believed to be caused by severe and persistent trauma often experienced in early childhood.

The mind creates separate identities (sometimes called alters) as a way of compartmentalising and coping with overwhelming experiences.

Each alter has its own unique characteristics such as thoughts, feelings, behaviours and even physical attributes.  Alters can take control of the persons actions and interactions, sometimes with memory gaps during these transitions.  Shifts in identity can be accompanied by changes in how the person perceives the world, feels emotions and moves their body.

Usually the individuals with DID have no memory of the time that their alter has been present and active.