Wednesday, October 15, 2008

Complex Post Traumatic Stress Disorder

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Most victims of Malignant Narcissists/psychopaths- suffer Complex Post Traumatic Stress Disorder ( PTSD)

In my opinion if you aren't sure you have been abused by a Narcissist or a Psychopath.. ask yourself this -- have you been in a domestic violence relationship- or a target of the abusers within the system- or have you been the target of an alienating parent- or are you a child/adult child of divorce that was alienated from one of their parents ... then more likely than not you have been the target of either a malignant Narcissist or a Psychopath-- and should read on ...


"When the trauma is inflicted by another person, is especially intense, or the traumatized person is extremely close to the trauma, the severity of traumatization may be especially profound"


Robert C Scaer, MD, Author, The Body bears the Burden:



Trauma, Dissociation and Disease

Definition:

Post Traumatic Stress Disorder (PTSD) is a natural emotional reaction to a deeply shocking and disturbing experience. It is a normal reaction to an abnormal situation.

Post Traumatic Stress Disorder (PTSD) is defined in DSM-IV, the fourth edition of the American Psychiatric Association's Diagnostic and Statistical Manual. For a doctor or mental health professional to be able to make a diagnosis, the condition must be defined in DSM-IV or its international equivalent, the World Health Organization's ICD-10.

In the previous version of DSM (DSM-III) a criterion of Post Traumatic Stress Disorder was for the sufferer to have faced a single major life-threatening event; this criterion was present because a) it was thought that PTSD could not be a result of "normal" events such as bereavement, business failure, interpersonal conflict, bullying, harassment, stalking, marital disharmony, working for the emergency services, etc, and b) most of the research on PTSD had been undertaken with people who had suffered a threat to life (eg combat veterans, especially from Vietnam, victims of accident, disaster, and acts of violence).

In DSM-IV the requirement was eased although most mental health practitioners continue to interpret diagnostic criterion A1 as applying only to a single major life-threatening event. There is growing recognition that Post Traumatic Stress Disorder can result from many types of emotionally shocking experience including an accumulation of small, individually non-life-threatening events in which case the resultant PTSD is referred to as Complex PTSD.

DSM-IV diagnostic criteria for Post Traumatic Stress Disorder (PTSD)

The diagnostic criteria for Post Traumatic Stress Disorder (PTSD) are defined in DSM-IV as follows:

A. The person experiences a traumatic event in which both of the following were present:

1. the person experienced or witnessed or was confronted with an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others;
2. the person's response involved intense fear, helplessness, or horror.

B. The traumatic event is persistently re-experienced in any of the following ways:

1. recurrent and intrusive distressing recollections of the event, including images, thoughts or perceptions;
2. recurrent distressing dreams of the event;
3. acting or feeling as if the traumatic event were recurring (eg reliving the experience, illusions, hallucinations, and dissociative flashback episodes, including those on wakening or when intoxicated);
4. intense psychological distress at exposure to internal or external cues that symbolise or resemble an aspect of the traumatic event;
5. physiological reactivity on exposure to internal or external cues that symbolise or resemble an aspect of the traumatic event.

C. Persistent avoidance of stimuli associated with the trauma and numbing of general responsiveness (not present before the trauma) as indicated by at least three of:

1. efforts to avoid thoughts, feelings or conversations associated with the trauma;
2. efforts to avoid activities, places or people that arouse recollections of this trauma;
3. inability to recall an important aspect of the trauma;
4. markedly diminished interest or participation in significant activities;
5. feeling of detachment or estrangement from others;
6. restricted range of affect (eg unable to have loving feelings);
7. sense of a foreshortened future (eg does not expect to have a career, marriage, children or a normal life span).

D. Persistent symptoms of increased arousal (not present before the trauma) as indicated by at least two of the following:

1. difficulty falling or staying asleep;
2. irritability or outbursts of anger;
3. difficulty concentrating;
4. hypervigilance;
5. exaggerated startle response.

E. The symptoms on Criteria B, C and D last for more than one month.

F. The disturbance causes clinically significant distress or impairment in social, occupational or other important areas of functioning.

The focus of the DSM-IV definition of Post Traumatic Stress Disorder is a single life-threatening event or threat to integrity. However, the symptoms of traumatic stress also arise from an accumulation of small incidents rather than one major incident. Examples include:

repeated exposure to horrific scenes at accidents or fires, such as those endured by members of the emergency services (eg bodies mutilated in car crashes, or horribly burnt or disfigured by fire, or dismembered or disembowelled in aeroplane disasters, etc.)


repeated involvement in dealing with serious crime, eg where violence has been used and especially where children are hurt breaking news of bereavement caused by accident or violence, especially if children are involved repeated violations such as in verbal abuse, physical abuse, emotional abuse and sexual abuse

regular intrusion and violation, both physical and psychological, as in bullying, stalking, harassment, domestic violence, etc

Where the symptoms are the result of a series of events, the term Complex PTSD (formerly referred to unofficially as Prolonged Duress Stress Disorder or PDSD) may be more appropriate.

Whilst Complex PTSD is not yet an official diagnosis in DSM-IV or ICD-10, it is often used in preference to other terms such as "rolling PTSD", "PDSD", and "cumulative stress". See the National Center for PTSD fact page on Complex PTSD.

Causes of PTSD

PTSD resulting from accident, disaster, war, terrorism, torture, kidnap, etc has been extensively studied and literature is available elsewhere. The first written reference to PTSD symptoms comes from the sixth century BC; Post Traumatic Stress Disorder is nothing new - and neither is the willingness of some people to discredit and deny the existence of the disorder.

This section of Bully OnLine focuses on PTSD and Complex PTSD resulting from bullying, primarily in the workplace, however anyone suffering PTSD (however caused) will find this page enlightening.

Most of the information on this page and web site is relevant to other types of bullying, eg at school, in relationships (including domestic violence), by families, by neighbours or landlords, in the care of the elderly, in the armed services, etc. Bullying is behind harassment, discrimination, prejudice and persecution, therefore targets of repeated sexual harassment or racial discrimination or religious or ethnic persecution will also identify with the symptoms. The insight about bullying on this web site is therefore also relevant to more serious issues including physical abuse, repeated verbal abuse, sexual abuse, violent crime, kidnap, abduction, rape, war, terrorism, torture, and denial and abuse of human rights. Those exploring Contact Experience may also find this page helpful.

PTSD, Complex PTSD and bullying

It's widely accepted that PTSD can result from a single, major, life-threatening event, as defined in DSM-IV. Now there is growing awareness that PTSD can also result from an accumulation of many small, individually non-life-threatening incidents. To differentiate the cause, the term "Complex PTSD" is used. The reason that Complex PTSD is not in DSM-IV is that the definition of PTSD in DSM-IV was derived using only people who had suffered a single major life-threatening incident such as Vietnam veterans and survivors of disasters.

Note: there has recently been a trend amongst some psychiatric professionals to label people suffering Complex PTSD as a exhibiting a personality disorder, especially Borderline Personality Disorder. This is not the case - PTSD, Complex or otherwise, is a psychiatric injury and nothing to do with personality disorders. If there is an overlap, then Borderline Personality Disorder should be regarded as a psychiatric injury, not a personality disorder. If you encounter a psychiatrist, psychologist or other mental health professional who wants to label your Complex PTSD as a personality disorder, change to another, more competent professional.

It seems that Complex PTSD can potentially arise from any prolonged period of negative stress in which certain factors are present, which may include any of captivity, lack of means of escape, entrapment, repeated violation of boundaries, betrayal, rejection, bewilderment, confusion, and - crucially - lack of control, loss of control and disempowerment. It is the overwhelming nature of the events and the inability (helplessness, lack of knowledge, lack of support etc) of the person trying to deal with those events that leads to the development of Complex PTSD. Situations which might give rise to Complex PTSD include bullying, harassment, abuse, domestic violence, stalking, long-term caring for a disabled relative, unresolved grief, exam stress over a period of years, mounting debt, contact experience, etc. Those working in regular traumatic situations, eg the emergency services, are also prone to developing Complex PTSD.

A key feature of Complex PTSD is the aspect of captivity. The individual experiencing trauma by degree is unable to escape the situation. Despite some people's assertions to the contrary, situations of domestic abuse and workplace abuse can be extremely difficult to get out of. In the latter case there are several reasons, including financial vulnerability (especially if you're a single parent or main breadwinner - the rate of marital breakdown is approaching 50% in the UK), unavailability of jobs, ageism (many people who are bullied are over 40), partner unable to move, and kids settled in school and you are unable or unwilling to move them. The real killer, though, is being unable to get a job reference - the bully will go to great lengths to blacken the person's name, often for years, and it is this lack of reference more than anything else which prevents people escaping.

Until recently, little (or no) attention was paid to the psychological harm caused by bullying and harassment. Misperceptions (usually as a result of the observer's lack of knowledge or lack of empathy) still abound: "It's something you have to put up with" (like rape or repeated sexual abuse?) and "Bullying toughens you up" (ditto). Armed forces personnel faced threats of being labelled with "cowardice" and "lack of moral fibre" (LMF) if they gave in to the symptoms of PTSD. In World War I, 306 British and Commonwealth soldiers were shot as "cowards" and "deserters" on the orders of General Haig in an act which today would be treated as a war crime - see separate page on this injustice.

In the UK at least 16 children kill themselves each year because they are being bullied at school. This figure is established in the book Bullycide: death at playtime. Each of these deaths is unnecessary, foreseeable, and preventable. The UK has one of the highest adult suicide rates in Europe: around 5000 a year. The number of adults in the UK committing suicide because of bullying is unknown. Each year 19,000 children attempt suicide in the UK - one every half hour. in the UK, suicide is the number one cause of death for 18-24-year-old males. Females also attempt suicide in large numbers but tend to use less successful means.

Since Andrea Adams first identified workplace bullying and gave it its name in 1988, recognition of adult bullying has grown steadily. Tim Field's UK National Workplace Bullying Advice Line has logged over 8000 cases in seven years; in the majority of cases (over 80%), the caller is a white-collar worker who has become the prey of a serial bully whose behaviour profile suggests a disordered personality. Callers refer to predecessors who have had stress breakdowns, taken early or ill-health retirement, or been dismissed on grounds of ill-health - all caused by the same individual. Sometimes callers refer to suicides of fellow employees.

Mapping the health effects of bullying onto PTSD and Complex PTSD
Repeated bullying, often over a period of years, results in symptoms of Complex Post Traumatic Stress Disorder. How do the PTSD symptoms resulting from bullying meet the criteria in DSM-IV?

A. The prolonged (chronic) negative stress resulting from bullying has lead to threat of loss of job, career, health, livelihood, often also resulting in threat to marriage and family life. The family are the unseen victims of bullying.
A.1.One of the key symptoms of prolonged negative stress is reactive depression; this causes the balance of the mind to be disturbed, leading first to thoughts of, then attempts at, and ultimately, suicide.
A.2.The target of bullying may be unaware that they are being bullied, and even when they do realise (there's usually a moment of enlightenment as the person realises that the criticisms and tactics of control etc are invalid), they often cannot bring themselves to believe they are dealing with a disordered personality who lacks a conscience and does not share the same moral values as themselves. Naivety is the great enemy. The target of bullying is bewildered, confused, frightened, angry - and after enlightenment, very angry. For an answer to the question Why me? click here.

B.1. The target of bullying experiences regular intrusive violent visualisations and replays of events and conversations; often, the endings of these replays are altered in favour of the target.
B.2. Sleeplessness, nightmares and replays are a common feature of being bullied.
B.3. The events are constantly relived; night-time and sleep do not bring relief as it becomes impossible to switch the brain off. Such sleep as is achieved is non-restorative and people wake up as tired, and often more tired, than when they went to bed.
B.4. Fear, horror, chronic anxiety, and panic attacks are triggered by any reminder of the experience, eg receiving threatening letters from the bully, the employer, or personnel about disciplinary hearings etc.
B.5. Panic attacks, palpitations, sweating, trembling, ditto.
Criteria B4 and B5 manifest themselves as immediate physical and mental paralysis in response to any reminder of the bullying or prospect of having to take action against the bully.

C. Physical numbness (toes, fingertips, lips) is common, as is emotional numbness (especially inability to feel joy). Sufferers report that their spark has gone out and, even years later, find they just cannot get motivated about anything.
C.1. The target of bullying tries harder and harder to avoid saying or doing anything which reminds them of the horror of the bullying.
C.2. Work, especially in the person's chosen field becomes difficult, often impossible, to undertake; the place of work holds such horrific memories that it becomes impossible to set foot on the premises; many targets of bullying avoid the street where the workplace is located.
C.3. Almost all callers to the UK National Workplace Bullying Advice Line report impaired memory; this may be partly due to suppressing horrific memories, and partly due to damage to the hippocampus, an area of the brain linked to learning and memory (see John O'Brien's paper below)
C.4. the person becomes obsessed with resolving the bullying experience which takes over their life, eclipsing and excluding almost every other interest.
C.5. Feelings of withdrawal and isolation are common; the person just wants to be on their own and solitude is sought.
C.6. Emotional numbness, including inability to feel joy (anhedonia) and deadening of loving feelings towards others are commonly reported. One fears never being able to feel love again.
C.7. The target of bullying becomes very gloomy and senses a foreshortened career - usually with justification. Many targets of bullying ultimately give up their career; in the professions, severe psychiatric injury, severely impaired health, refusal by the bully and the employer to give a satisfactory reference, and many other reasons, conspire to bar the person from continuance in their chosen career.

D.1. Sleep becomes almost impossible, despite the constant fatigue; such sleep as is obtained tends to be unsatisfying, unrefreshing and non-restorative. On waking, the person often feels more tired than when they went to bed. Depressive feelings are worst early in the morning. Feelings of vulnerability may be heightened overnight.
D.2. The person has an extremely short fuse and is often permanently irritated, especially by small insignificant events. The person frequently visualises a violent solution, eg arranging an accident for, or murdering the bully; the resultant feelings of guilt tend to hinder progress in recovery.
D.3. Concentration is impaired to the point of precluding preparation for legal action, study, work, or search for work.
D.4. The person is on constant alert because their fight or flight mechanism has become permanently activated.
D.5. The person has become hypersensitized and now unwittingly and inappropriately perceives almost any remark as critical.

E. Recovery from a bullying experience is measured in years. Some people never fully recover.
F. For many, social life ceases and work becomes impossible; the overwhelming need to earn a living combined with the inability to work deepens the trauma.

Common symptoms of PTSD and Complex PTSD that sufferers report experiencing

hypervigilance (feels like but is not paranoia)
exaggerated startle response
irritability
sudden angry or violent outbursts
flashbacks, nightmares, intrusive recollections, replays, violent visualisations
triggers
sleep disturbance
exhaustion and chronic fatigue
reactive depression
guilt
feelings of detachment
avoidance behaviours
nervousness, anxiety
phobias about specific daily routines, events or objects
irrational or impulsive behaviour
loss of interest
loss of ambition
anhedonia (inability to feel joy and pleasure)
poor concentration
impaired memory
joint pains, muscle pains
emotional numbness
physical numbness
low self-esteem
an overwhelming sense of injustice and a strong desire to do something about it

Associated symptoms of Complex PTSD

Survivor guilt: survivors of disasters often experience abnormally high levels of guilt for having survived, especially when others - including family, friends or fellow passengers - have died. Survivor guilt manifests itself in a feeling of "I should have died too". In bullying, levels of guilt are also abnormally raised. The survivor of workplace bullying may have develop an intense albeit unrealistic desire to work with their employer (or, by now, their former employer) to eliminate bullying from their workplace. Many survivors of bullying cannot gain further employment and are thus forced into self-employment; excessive guilt may then preclude the individual from negotiating fair rates of remuneration, or asking for money for services rendered. The person may also find themselves being abnormally and inappropriately generous and giving in business and other situations.

Shame, embarrassment, guilt, and fear are encouraged by the bully, for this is how all abusers - including child sex abusers - control and silence their victims.

Marital disharmony: the target of bullying becomes obsessed with understanding and resolving what is happening and the experience takes over their life; partners become confused, irritated, bewildered, frightened and angry; separation and divorce are common outcomes.

Breakdown

The word "breakdown" is often used to describe the mental collapse of someone who has been under intolerable strain. There is usually an (inappropriate) inference of "mental illness". All these are lay terms and mean different things to different people. I define two types of breakdown:

Nervous breakdown or mental breakdown is a consequence of mental illness

Stress breakdown is a psychiatric injury, which is a normal reaction to an abnormal situation

The two types of breakdown are distinct and should not be confused. A stress breakdown is a natural and normal conclusion to a period of prolonged negative stress; the body is saying "I'm not designed to operate under these conditions of prolonged negative stress so I am going to do something dramatic to ensure that you reduce or eliminate the stress otherwise your body may suffer irreparable damage; you must take action now". A stress breakdown is often predictable days - sometimes weeks - in advance as the person's fear, fragility, obsessiveness, hypervigilance and hypersensitivity combine to evolve into paranoia (as evidenced by increasingly bizarre talk of conspiracy or MI6). If this happens, a stress breakdown is only days or even hours away and the person needs urgent medical help. The risk of suicide at this point is heightened.

Often the cause of negative stress in an organisation can be traced to the behaviour of one individual. The profile of this individual is on the
serial bully page. I believe bullying is the main - but least recognised - cause of negative stress in the workplace today. To see the effects of prolonged negative stress on the body click here.

The person who suffers a stress breakdown is often treated as if they have had a mental breakdown; they are sent to a psychiatrist, prescribed drugs used to treat mental illness, and may be encouraged - sometimes coerced or sectioned - into becoming a patient in a psychiatric hospital. The sudden transition from professional working environment to a ward containing schizophrenics, drug addicts and other people with genuine long-term mental health problems adds to rather than alleviates the trauma. Words like "psychiatrist", "psychiatric unit" etc are often translated by work colleagues, friends, and sometimes family into "nutcase", "shrink", "funny farm", "loony" and other inappropriate epithets. The bully encourages this, often ensuring that the employee's personnel record contains a reference to the person's "mental health problems". Sometimes, the bully produces their own amateur diagnosis of mental illness - but this is more likely to be a projection of the bully's own state of mind and should be regarded as such.

During the First World War, British soldiers suffering PTSD and stress breakdown were labelled as "cowards" and "deserters". During the Second World War, soldiers suffering PTSD and stress breakdowns were again vilified with these labels; Royal Air Force personnel were labelled as "lacking moral fibre" and their papers stamped "LMF". For further commentary on this issue, click
here. It's noticeable that those administrators and top brass enforcing this labelling were themselves always situated a safe distance from the fighting; see the section on projection.

The person who is being bullied often thinks they are going mad, and may be encouraged in this belief by those who do not have that person's best interests at heart. They are not going mad; PTSD is an injury, not an illness.

Sometimes, the term "psychosis" is applied to mental illness, and the term "neurosis" to psychiatric injury. The main difference is that a psychotic person is unaware they have a mental problem, whereas the neurotic person is aware - often acutely. The serial bully's lack of insight into their behaviour and its effect on others has the hallmarks of a psychosis, although this obliviousness would appear to be a choice rather than a condition. With targets of bullying, I prefer to avoid the words "neurosis" and "neurotic", which for non-medical people have derogatory connotations. Hypersensitivity and hypervigilance are likely to cause the person suffering PTSD to react unfavourably to the use of these words, possibly perceiving that they, the target, are being blamed for their circumstances.

A frequent diagnosis of stress breakdown is "brief reactive psychosis", especially if paranoia and suicidal thoughts predominate. However, a key difference between mental breakdown and stress breakdown is that a person undergoing a stress breakdown will be intermittently lucid, often alternating seamlessly between paranoia and seeking information about their paranoia and other symptoms. The person is also likely to be talking about resolving their work situation (which is the cause of their problems), planning legal action against the bully and the employer, wanting to talk to their union rep and solicitor, etc.

Transformation

A stress breakdown is a transformational experience which, with the right support, can ultimately enrich the experiencer's life. However, completing the transformation can be a long and sometimes painful process. The Western response - to hospitalise and medicalize the experience, thus hindering the process - may be well-intentioned, but may lessen the value and effectiveness of the transformation. How would you feel if, rather than a breakdown, you viewed it as a breakthrough? How would you feel if it was suggested to you that the reason for a stress breakdown is to awaken you to your mission in life and to enable you to discover the reason why you have incarnated on this planet? How would it change your view of things if it was also suggested to you that a stress breakdown reconfigures your brain to enable you to embark on the path that will culminate in the achievement of your mission? [
More More]

Differences between mental illness and psychiatric injury

The person who is being bullied will eventually say something like "I think I'm being paranoid..."; however they are correctly identifying hypervigilance, a symptom of PTSD, but using the popular but misunderstood word paranoia. The differences between hypervigilance and paranoia make a good starting point for identifying the differences between mental illness and psychiatric injury.

Paranoia = P

Hypervigilance = H

P = paranoia is a form of mental illness; the cause is thought to be internal, eg a minor variation in the balance of brain chemistry


H = is a response to an external event (violence, accident, disaster, violation, intrusion, bullying, etc) and therefore an injury

P = paranoia tends to endure and to not get better of its own accord


H = wears off (gets better), albeit slowly, when the person is out of and away from the situation which was the cause

P = the paranoiac will not admit to feeling paranoid, as they cannot see their paranoia


H = the hypervigilant person is acutely aware of their hypervigilance, and will easily articulate their fear, albeit using the incorrect but popularised word "paranoia"

P = sometimes responds to drug treatment


H= drugs are not viewed favourably by hypervigilant people, except in extreme circumstances, and then only briefly; often drugs have no effect, or can make things worse, sometimes interfering with the body's own healing process

P = the paranoiac often has delusions of grandeur; the delusional aspects of paranoia feature in other forms of mental illness, such as schizophrenia


H = the hypervigilant person often has a diminished sense of self-worth, sometimes dramatically so

P = the paranoiac is convinced of their self-importance

H = the hypervigilant person is often convinced of their worthlessness and will often deny their value to others

P = paranoia is often seen in conjunction with other symptoms of mental illness, but not in conjunction with symptoms of PTSD

H = hypervigilance is seen in conjunction with other symptoms of PTSD, but not in conjunction with symptoms of mental illness

P = the paranoiac is convinced of their plausibility


H = the hypervigilant person is aware of how implausible their experience sounds and often doesn't want to believe it themselves (disbelief and denial)

P = the paranoiac feels persecuted by a person or persons unknown (eg "they're out to get me")

H = the hypervigilant person is hypersensitized but is often aware of the inappropriateness of their heightened sensitivity, and can identify the person responsible for their psychiatric injury
P = sense of persecution

H = heightened sense of vulnerability to victimisation

P = the sense of persecution felt by the paranoiac is a delusion, for usually no-one is out to get them

H = the hypervigilant person's sense of threat is well-founded, for the serial bully is out to get rid of them and has often coerced others into assisting, eg through mobbing; the hypervigilant person often cannot (and refuses to) see that the serial bully is doing everything possible to get rid of them

P = the paranoiac is on constant alert because they know someone is out to get them
the hypervigilant person is on alert in case there is danger the paranoiac is certain of their belief and their behaviour and expects others to share that certainty


H = the hypervigilant person cannot bring themselves to believe that the bully cannot and will not see the effect their behaviour is having; they cling naively to the mistaken belief that the bully will recognise their wrongdoing and apologise

Other differences between mental illness and psychiatric injury include:

Mental illness

Psychiatric injury

Illness = the cause often cannot be identified

Injury =the cause is easily identifiable and verifiable, but denied by those who are accountable


Illness =the person may be incoherent or what they say doesn't make sense

Injury =the person is often articulate but prevented from articulation by being traumatised

Illness = the person may appear to be obsessed

Injury =the person is obsessive, especially in relation to identifying the cause of their injury and both dealing with the cause and effecting their recovery

Illness =the person is oblivious to their behaviour and the effect it has on others

Injury =the person is in a state of acute self-awareness and aware of their state, but often unable to explain it

Illness =the depression is a clinical or endogenous depression


Injury =the depression is reactive; the chemistry is different to endogenous depression

Illness =there may be a history of depression in the family

Injury =there is very often no history of depression in the individual or their family

Illness = the person has usually exhibited mental health problems before

Injury =often there is no history of mental health problems

Illness = may respond inappropriately to the needs and concerns of others

Injury =responds empathically to the needs and concerns of others, despite their own injury

Illness = displays a certitude about themselves, their circumstances and their actions

Injury =is often highly sceptical about their condition and circumstances and is in a state of disbelief and bewilderment which they will easily and often articulate ("I can't believe this is happening to me" and "Why me?" - click here for the answer)

Illness = may suffer a persecution complex

Injury =may experience an unusually heightened sense of vulnerability to possible victimisation (ie hypervigilance)

Illness = suicidal thoughts are the result of despair, dejection and hopelessness

Injury =suicidal thoughts are often a logical and carefully thought-out solution or conclusion

Illness =exhibits despair

Injury=is driven by the anger of injustice

Illness =often doesn't look forward to each new day

Injury =looks forward to each new day as an opportunity to fight for justice

Illness= is often ready to give in or admit defeat

Injury =refuses to be beaten, refuses to give up

Common features of Complex PTSD from bullying

People suffering Complex PTSD as a result of bullying report consistent symptoms which further help to characterise psychiatric injury and differentiate it from mental illness. These include:

Fatigue with symptoms of or similar to Chronic Fatigue Syndrome (formerly ME)An anger of injustice stimulated to an excessive degree (sometimes but improperly attracting the words "manic" instead of motivated, "obsessive" instead of focused, and "angry" instead of "passionate", especially from those with something to fear)

An overwhelming desire for acknowledgement, understanding, recognition and validation of their experience

A simultaneous and paradoxical unwillingness to talk about the bullying (click here to see why) or abuse (click here to see why)

A lack of desire for revenge, but a strong motivation for justice

A tendency to oscillate between conciliation (forgiveness) and anger (revenge) with objectivity being the main casualty

Extreme fragility, where formerly the person was of a strong, stable character

Numbness, both physical (toes, fingertips, and lips) and emotional (inability to feel love and joy)

Clumsiness

Forgetfulness

Hyperawareness and an acute sense of time passing, seasons changing, and distances travelled

An enhanced environmental awareness, often on a planetary scaleAn appreciation of the need to adopt a healthier diet, possibly reducing or eliminating meat - especially red meat

Willingness to try complementary medicine and alternative, holistic therapies, etc

A constant feeling that one has to justify everything one says and does

A constant need to prove oneself, even when surrounded by good, positive peopleAn unusually strong sense of vulnerability, victimisation or possible victimisation, often wrongly diagnosed as "persecution"Occasional violent intrusive visualisations

Feelings of worthlessness, rejection, a sense of being unwanted, unlikeable and unlovableA feeling of being small, insignificant, and invisible

An overwhelming sense of betrayal, and a consequent inability and unwillingness to trust anyone, even those close to you

In contrast to the chronic fatigue, depression etc, occasional false dawns with sudden bursts of energy accompanied by a feeling of "I'm better!", only to be followed by a full resurgence of symptoms a day or two later

Excessive guilt - when the cause of PTSD is bullying, the guilt expresses itself in forms distinct from "survivor guilt"; it comes out as:

- an initial reluctance to take action against the bully and report him/her knowing that he/she could lose his/her job

- later, this reluctance gives way to a strong urge to take action against the bully so that others, especially successors, don't have to suffer a similar fate

- reluctance to feel happiness and joy because one's sense of other people's suffering throughout the world is heightened

- a proneness to identifying with other people's suffering
a heightened sense of unworthiness, undeservingness and non-entitlement (some might call this shame)


- a heightened sense of indebtedness, beholdenness and undue obligation

- a reluctance to earn or accept money because one's sense of poverty and injustice throughout the world is heightened

-an unwillingness to take ill-health retirement because the person doesn't want to believe they are sufficiently unwell to merit it

- an unwillingness to draw sickness, incapacity or unemployment benefit to which the person is entitled

- an unusually strong desire to educate the employer and help the employer introduce an anti-bullying ethos, usually proportional to the employer's lack of interest in anti-bullying measures
a desire to help others, often overwhelming and bordering on obsession, and to be available for others at any time regardless of the cost to oneself


- an unusually high inclination to feel sorry for other people who are under stress, including those in a position of authority, even those who are not fulfilling the duties and obligations of their position (which may include the bully) but who are continuing to enjoy salary for remaining in post [hint: to overcome this tendency, every time you start to feel sorry for someone, say to yourself "sometimes, when you jump in and rescue someone, you deny them the opportunity to learn and grow"]

Fatigue

- The fatigue is understandable when you realise that in bullying, the target's fight or flight mechanism eventually becomes activated from Sunday evening (at the thought of facing the bully at work on Monday morning) through to the following Saturday morning (phew - weekend at last!).

- The fight or flight mechanism is designed to be operational only briefly and intermittently; in the heightened state of alert, the body consumes abnormally high levels of energy. If this state becomes semi-permanent, the body's physical, mental and emotional batteries are drained dry. Whilst the weekend theoretically is a time for the batteries to recharge, this doesn't happen, because:

the person is by now obsessed with the situation (or rather, resolving the situation), cannot switch off, may be unable to sleep, and probably has nightmares, flashbacks and replays;

sleep is non-restorative and unrefreshing - one goes to sleep tired and wakes up tired this type of experience plays havoc with the immune system; when the fight or flight system is eventually switched off, the immune system is impaired such that the person is open to viruses which they would under normal circumstances fight off; the person then spends each weekend with a cold, cough, flu, glandular fever, laryngitis, ear infection etc so the body's batteries never have an opportunity to recharge.


When activated, the body's fight or flight response results in the digestive, immune and reproductive systems being placed on standby. It's no coincidence that people experiencing constant abuse, harassment and bullying report malfunctions related to these systems (loss of appetite, constant infections, flatulence, irritable bowel syndrome, loss of libido, impotence, etc).

The body becomes awash with cortisol which in high prolonged doses is toxic to brain cells. Cortisol kills off neuroreceptors in the hippocampus, an area of the brain linked with learning and memory. The hippocampus is also the control centre for the fight or flight response, thus the ability to control the fight or flight mechanism itself becomes impaired.

Most survivors of bullying experience symptoms of Chronic Fatigue Syndrome - see health page for details.

Complex post traumatic stress disorder (complex ptsd, pdsd, shell shock, nervous shock, combat fatigue), symptoms and the dif...

6 comments:

mikemathew said...

Complex Post-Traumatic Stress Disorder (C-PTSD) is a clinically recognized condition that results from prolonged exposure to prolonged social and/or interpersonal trauma, including instances of physical abuse, emotional abuse, sexual abuse, domestic violence, torture, chronic early maltreatment in a caregiving relationship, and war. Van der Kolk and Courtois (2005) suggest that C-PTSD better describes the pervasive negative impact of chronic trauma than does Post traumatic stress disorder, as PTSD fails to capture some of the core characteristics of C-PTSD. These include psychological fragmentation, the loss of a sense of safety, trust, and self-worth, as well as the tendency to be revictimized, and, most importantly, the loss of a coherent sense of self. This loss of the coherent sense of self, and the ensuing symptom profile, is what most pointedly differentiates C-PTSD from PTSD. C-PTSD is under consideration for inclusion in the next revision of the Diagnostic and Statistical Manual (DSM-V) as a formal diagnosis.
_________________________
mikemathew
white hat seo

chessiakelley said...

Thank you for this intelligent article on PTSD. I work for and organization called Survivor Corps that addresses many of the symptoms to which you are referring and provides support networks, testimonials, and ways to give back. We believe it is a very positive outlet to deal with traumatic events that split your life into "before" and "after".

Additionally, I thought you might be interested in the upcoming Gulu Walk which supports abandoned children in Northern Uganda. GuluWalk was inspired by the gripping tale of the night commuters, and will be happneing on Oct. 25 in most American cities.

Anonymous said...

I read the article and thought "wow, thats me".

Then today I get the custody evaluation which says I am paranoid. Gee, now why would I be paranoid? I have an actual documents that state that I was going to commit domestic violence against my ex, an attorney in the future and that marching in public with a sign is domestic violence.

The documents are not a figment of my thinking they are real. So, now is it a figment of my imagination the so called paranoia thinking that since the legal system granted a dvo against me for marching in public with a sign is domestic violence??

Louise Uccio said...

Dude (above) All I can say is WE ARE NOT paranoid!

However, if I may offer a word of advice that may help you out..

Get an INDEPENDENT psych eval- OUTSIDE of the court appointed circle-- things are bad in the courts and it appears the court appointed evaluators are willing to work with the courts to find us (insert diagnosis word here)so that it works with their money making scam!

I WAS a very trusting person - until my politically connected estranged husband had be raked over the coals with bogus evaluations from the connected family court services evaluator et al..

Good luck!

Anonymous said...

Louise,

You will appreciate this. I took a closer look at the evaluation. . .

Okay, first know that I have PRO SE kicked the a@@ of the whole region of child protection agency for fraud, failure to provides services, in administrative hearings. This was finalized in December 2007.

A social worker from the district knowing that there was a conflict of interest the size of a mountain went ahead and did a consultation with the evaluator in May 08. I just found out about this today.

Oh, just so you know; there is an order that no one child protective services is allowed to speak with me only general counsel. Not because I am paranoid and crazy- but because they know they are going to be sued. The complaint already has almost a hundred exhibits and 33 pages single spaced.

I wasn't going to do RICO, but now I think I will.

Timothy F. Murphy said...

Suffering traumatic stress can affect your emotions as well as your body and the two are so connected that it can be hard to tell the difference. For instance, traumatic stress can cause you to lose concentration, forget things, or have trouble sleeping. It may be difficult to determine on your own whether these symptoms are because you do not feel well physically or because you are still upset. http://www.xanax-effects.com/