Complex PTS

Complex Post Traumatic Stress may develop following exposure to an event or series of events of an extremely threatening or horrific nature, most commonly prolonged or repetitive events from which escape was difficult or impossible. (e.g. repeated child sexual physical, emotional abuse & neglect, prolonged domestic violence)

Complex trauma means complex reactions and this leads to complex treatments.

Hence, treatment for C-PTS requires a multi-modal approach. We at Psympatico provide this approach.

C-PTS relates to the trauma associated with chronic sexual, psychological and physical abuse and neglect, chronic intimate partner violence, victims of kidnapping and hostage situations, indentured servants, victims of slavery and human trafficking, sweatshop workers, prisoners of war, concentration cam survivors, residential school survivors, and defectors of cults or cult-like organisations.

Situations involving captivity/entrapment (a situation lacking a viable escape route for the victim or a perception of such) can lead to C-PTS like symptoms, which can include prolonged feelings of terror, worthlessness, helplessness, and deformation of one's identity and sense of self.

Six symptoms which have been suggested for the diagnosis of C-PTS

• alterations in regulation of affect and impulses

• alterations in attention or consciousness

• alterations in self-perception

• alterations in relations with others

• somatization

• alterations in systems of meaning

Experiences in these areas may include:

• Changes in emotional regulation, including experiences such as persistent dysphoria, chronic suicidal preoccupation, self injury, explosive or extremely inhibited anger(may alternate), and compulsive or extremely inhibited sexuality (may alternate).

• Variations in consciousness, such as amnesia or improved recall for traumatic events, episodes of dissociation, depersonlisation /derealisation, and reliving experiences (either in the form of intrusive PTS symptoms or in ruminative preoccupation).

• Changes in self-perception, such as a sense of helplessness or paralysis of initiative, shame, guilt and self-blame, a sense of defilement or stigma, and a sense of being completely different from other human beings (may include a sense of specialness, utter aloneness, a belief that no other person can understand, or a feeling of nonhuman identity).

• Varied changes in perception of the perpetrators, such as a preoccupation with the relationship with a perpetrator (including a preoccupation with revenge), an unrealistic  attribution of total power to a perpetrator (though the individual's assessment may be more realistic than the clinician's), idealisation or paradoxical gratitude, a sense of aspecial or supernatural relationship with a perpetrator, and acceptance of a perpetrator's belief system or rationalisations.

• Alterations in relations with others, such as isolation and withdrawal, disruption in intimate relationships, a repeated search for a rescuer (may alternate with isolation and  withdrawal), persistent distrust, and repeated failures of self-protection.

•  Changes in systems of meaning, such as a loss of sustaining faith and a sense of hopelessness and despair.