June – Revisiting PTSD
“We are all of us exceedingly complex creatures and do ourselves a service in regarding ourselves as complex. Otherwise, we live in a dream world of nonexistent, simplistic black-and-white notions which simply do not apply to life.” Theodore Rubin cited in Complex PTSD: From Surviving to Thriving by Pete Walker
“Developments in the neurosciences have started to make significant contributions to our understanding of how the brain is shaped by experience, and how life itself continues to transform the ways biology is organized. The study of trauma has probably been the single most fertile area within the disciplines of psychiatry and psychology in helping to develop a deeper understanding of the interrelationships between emotional, cognitive, social, and biological forces that shape human development. Starting with PTSD in adults, but expanding into early attachment and coping with overwhelming experiences in childhood, our field has discovered how certain experiences can “set” psychological expectations and biological selectivity. Research in these areas has opened up entirely new insights in how extreme experiences throughout the life cycle can have profound effects on memory, affect regulation, biological stress modulation, and interpersonal relatedness.” Bessel van der Kolk, MD, PTSD and the Nature of Trauma at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3181584/
I have written bits about trauma, trauma responses and symptomatology throughout this website. One such post, mostly on the physiology of trauma, is: Notes on Polyvagal Theory and Trauma Responses (posted on 11-1-2016). Today however, I’d like to revisit this topic by sharing two Being Well podcasts on Complex Post Traumatic Stress Disorder.
1) The most recent episode at: https://www.youtube.com/watch?v=FHRgPA_jagE includes a conversation on Complex PTSD where Forrest Hanson talks with his partner Elizabeth Ferreira, who as he says is both dealing with her own history of complex trauma and helping other people do the same, since she is currently earning hours toward her license. In brief, on this podcast it is suggested that PTSD can originate from a single, painful, highly traumatic event, while complex PTSD is often the result of chronic traumatic experiences, typically, but not always ones that have their roots in childhood. As mentioned in the talk “These experiences include everything from physical or emotional abuse to inconsistent or neglectful parenting, to resource scarcity, to needing to manage the emotions of your parents as a child – that’s a big one….. PTSD often arises from the slow accumulation of many, many small injuries over time.” Complex PTSD can include typical symptoms of PTSD like intense traumatic flashbacks, low self-esteem / sense of worth, hyper and hypo arousal, the avoidance of stimuli related to the event, and others, as well as, difficulty with emotional regulation, intense feelings of guilt or shame, dissociation and selective amnesia around traumatic events.
Elizabeth talks about her personal and the intergenerational traumas of the family system, the definition of trauma that resonates with her, which is that it’s anything that as a child one might have found overwhelming and couldn’t process through it, couldn’t reach a level of resolution and as a result the activation stayed in the body. She tells us about her own growth journey through therapy, relationships and studies in Somatic Psychology to become a psychotherapist, and other topics like her undergraduate experience, where she was being triggered by her graduate program, the support she seeked and received, an unhelpful experience with EMDR and the necessity to work with an attuned therapist that you can trust. She says that “EMDR did not work for me at all; it made my symptoms worse, because it felt too intense, it was too direct, it felt like someone was, like a laser was being pointed at me and burning me or something, it was just, it was too much. And one of the things that I’ve noticed, because there’s some people I work with that the power of just being really soft and sweet, and giving a lot of space, and not being directive, because if you have CPTSD, you can tell when people have an agenda, you can feel when someone is uncomfortable with what you’re saying, you can tell…”
At some point she mentions that her sweetness and wanting to do things differently resulted in her being considered sort of the black sheep of her extended family. She says: “…sweetness was viewed as something to be teased and taunted in my family. It was viewed as naive or too vulnerable. And I think I’ve learned that sweetness can be very fierce and kind of potent because everyone in my family has experienced childhood trauma. And so you have this little kid that’s just, by nature, extremely sweet and tender, and what that does is then it brings up all the welling inside of yourself that you’ve had to pack down and not allow yourself to feel that sweetness…”
2) The second podcast link I’d like to share is: https://www.rickhanson.net/being-well-podcast-complex-ptsd-and-developmental-trauma/, where Complex PTSD is discussed with Pete Walker, author and psychotherapist, who specializes in helping adults who were traumatized in childhood. Complex PTSD is defined as a “developmental trauma disorder”. Themes covered in this interview are the fact that the absence of good experiences can also be traumatic; the importance of empathy and healthy anger and how to become a support to your own self, the work required to deal with our inner critic and internalized abusers, the lifelong process of recovery and growth, the importance of corrective emotional experiences and the re-parenting of the inner child, the managing of the relationship with those that have harmed us, what forgiveness might look like, and the message we would like to give our younger self waiting in our childhood bedroom.
Pete Walker’s book: Complex PTSD: From Surviving to Thriving can also be read for free online.