Complex PTSD and me

Hi guys,

Sorry that I haven't been around, I have been really quite unwell mentally and was admitted to my local psych unit for a week. Although I am not 100% OK, I am pleased that I am feeling better than I was 10 days ago. I have done a lot of thinking over the past few weeks about my issues, and I wanted to share these, in the hope that someone else might not feel as alone.

I have Complex Post Traumatic Stress Disorder (C-PTSD). As the name suggests its more complex than PTSD.  I am not saying that people with PTSD don't suffer because they do. It is thought that complex PTSD arises when the abuse that they have suffered is prolonged, and its not just sexual abuse (although that is the case with me), after all it was first used in South Africa with the violence and civil disturbance!

There is some overlap with Borderline Personality Disorder (and about 75% of people with BPD have suffered from abuse, and that is usually sexual) but they are very different disorders, and should not be used intertwined. BPD as it suggests is a Personality Disorder that until recently people didn't think that it was recoverable, but I am living proof that it is! C-PTSD is an anxiety disorder.

C-PTSD has 6 clusters for diagnosis-
1) Alterations in regulation of affect and impulsivity
2) Alterations in attention or consciousness
3) Alterations in Self perception
4) Alterations in relations to others
5) Somatization
6) Alterations in systems of meaning.

on there own I don't think that they make much sense, but I am going to go through them one at a time. First, however is a quick bit on insomnia. I also need to explain that I can see things intellectually and can understand the issues on this level, but emotionally I am much further behind. I guess the best way to describe it is these two parts are completely separate.

One of my biggest problems it seems, especially since coming out of hospital has been my insomnia. (hence writing this at 3am!). Sleep deprivation is extremely bad for anyone's mental health, you just have to think how grumpy people can be if they don't get enough sleep, but for me (and probably many people) it can either make my hyper (than have a massive crash) or make me extremely low. In DBT (Dialectical Behavioural Therapy a treatment for BPD that I had when I lived in Wales) the need for a proper sleep pattern and sleep hygiene is emphasised, yet I still can't seem to let myself sleep.  It is very difficult for me as I also suffer from extreme nightmares that means that I am absolutely scared of sleep. Whilst insomnia isn't part of the diagnostic criteria for C-PTSD I personally know a lot of people who it affects and that nightmares are part of PTSD. For me it is often reliving the past, and it feels so out of control as it feels like there is nothing I can do to stop them. I just know that I cant go on like this, as it will make me really unwell again, so if anyone has any ideas I would love to hear them.

Alterations in regulation and impulsivity - this involves difficulty in regulating emotions. for me this means that I have chronic depression. I used to have extremes of emotions and going from one to another at a 100 miles an hour. I have worked through that, and since I have started to talk about the abuse that I suffered by my parents (and others) this has become a lot less. I still, at times feel suicidal (which is why I was admitted to the psych unit) and often feel like I have to have the means around me for a safety net (not very safe safety net I must admit), I have attempted to take my own life previously, and it can really scare me when I am overwhelmed by the thoughts of ending it all, it's not that I want to be selfish it is just that there is so much emotional pain an it feels like it is never ever going to end. this part could turn into a post of its own!!! I also self harm through mainly cutting (but my eating disorder in a way is self harm) I get very angry at myself (no one else, and I am not aware of it as its so alien to me) and feel the need to punish myself, but also somehow the blood coming out is evilness coming out of me, something I will explore later. This part of C-PTSD is very similar to BPD, however BPD has much more extreme abandonment issues for example, something that only rears its ugly head very occasionally now.

Alterations in Attention or consciousness - there are three main points to this part of the cluster, amnesia/reliving/dissociation. I have suffered at one time or other all three. I "forgot" the abuse that my father did to me for years and years (even though it was still going on, that leads into the dissociation). I remember it clearly when I began to allow myself to feel safe enough to start remembering, I was in one of my MA seminars and we we're watching "Oranges aren't the only Fruit" (the exorcism scene) and it began. Once it began I couldn't stop it, although at many times I really wish that it would. It didn't come all at once, and to be honest I still think that I have a lot that is yet to come out. It might seem weird to people who haven't been through trauma that you can forget it, but it is a coping strategy, that especially when I was young, my mind knew that I couldn't cope with what was going on and so it split away the part that was experiencing the abuse....our brains are amazing things, as it only allowed me to start to remember when I was strong enough (although it doesn't feel like it at times!!) I relive my abuse on a daily basis, through flashbacks and nightmares. For me they are not just visual, but I am using every sense to the point I think that I am back there, I can feel his body weight on me, I can smell him and so on. This is very very frightening, and it often leads me to dissociate. I dissociate in two main ways, amnesia – where I loose a lot of time, it can be hours. the best way that I can describe this is that have you ever been on a familiar journey and reached your destination? well it is an extreme version of this, and even within this part of my dissociation I do two completely different things, I either completely freeze where I feel locked into my body, or I can appear completely normal, I can go out – this is the dangerous one for me, as this is where I self harm now (rather than being a conscious de scion) and the last two times that I took an overdose I was in this potion. The other type of Dissociation that I suffer from is DID (Dissociation Identity Disorder formally known as Multiple Personality Disorder), As I said earlier my mind split because of the abuse, and that has left me with various personalities within me, they are different ages, different sexes, like and dislike different things, but they all play a part. A very good friend gave me a very good way of looking at it, a chocolate orange, they are all separate segments but together they become a whole. on YouTube there is a very good lecture on DID by a sufferer (http://www.youtube.com/watch?v=0N-cmCGjlnE) that explains it so well. I have only recently began to talk to people about my alters, and I am really scared that people will think that I am crazy but because I suffered such extreme abuse (SRA) as well as the abuse by my father this is the result, once again this could be a post on its own!

Alterations in self-perception - In a way this is the most self explanatory of all of them, it can include chronic sense of helplessness shame guilt etc. This one is also very relevant for me. My Dad and the group of men have made me feel that I am evil, as this was their explanation of why they did what they did, a massive alteration in my own self perception from a very early age!! I also blame myself as I in some ways wanted it – I hate talking about this, but it is important – it was the only affection that I got so craved it, although I hated the physical pain! this has lead me to feel really guilty and ashamed, and a chronic feeling that I must have asked for it, also because that it went on till I was 27, I think that I should have been able to stop him. If I do my pretending the situation is someone else (And this is the only way that I can do it) I wouldn't blame them, I would see that they were a little girl when it started and that it is a natural reaction to want human touch, and that she was groomed to stay in that abusive relationship as it was all she really knew. I wish that I could change the way that I feel, but I honestly don't know how to, and what would be left if I did. its not that I want to be seem as a victim all the time, I just still need to discover myself, which I am learning to do, I can see that I am (hopefully) caring and willing to help. slowly my confidence is building, although I have recently had several knock backs to it. Changing core beliefs and feelings around them will take time, but I am chipping at it slowly and methodically.

Alteration in relations to others - This from what I have read around the subject relates to the perpetrator and my relationship with him, as well as people around me. I find this so difficult as I think I love him, after all he is my dad, and it wasn't all bad, he read us (me and my brother) bed time stories, and was really kind and loving at times. this really messes with my head. I know that all people are a mixture of good and bad, and no-one is evil (except me :/ but I find it so hard to work out him when it was such extremes. He does have power and control over me, even now, in fact they both do, with holding my sentimental belongings hostage and mum refusing to remove herself as nearest relative (a legal position in mental health law). but also they have managed it with the emotional abuse and how my self perception is screwed! I still completely believe what they told me, I can only remember one time that my mum praised me (the day that I got my degree results) so continue to feel like I am a complete failure. I know that I can see the problem, but after 27 years of this, I think that it is going to take time for me to change this...I just wish there was a magic wand!!! I also think of revenge, but I am not completely consumed by it as some people may be, my revenge was going to be through the courts however because it was historical before I  had the strength (with the help of everyone around me - thank you) to go to the Police, there was not enough evidence as there was no forensic evidence I never got to get my revenge in a public way, however as many people have pointed out to me people will guess why he hasn't been at work, and that it will affect him.
In terms of relationships with others, I have worked on this a lot since I was at Lavender Lodge, before that I was very chaotic in both how I was and how I related to others – not a good combination, and I am truly sorry to those who knew me then! I do still withdraw and isolate myself especially when my mood is low, even though I know that it is a maladaptive coping strategy and is likely to make things worse. The other thing that I do is around trust. It takes me a lot to trust someone but when I do I trust them wholeheartedly, whether they deserve it or not, and this has, in the past, led me getting in really nasty situations (such as being on-line stalked!)

Somatization -  My understanding of this is  having somatic physical symptoms in response to emotional issues although it does confuse me a little so please forgive me if I have got this wrong. it is not someone making it up for attention or being a hypochondriac, the symptoms feel very real, and I, know this because its happened to me. One way that this happens to me is my asthma, with the flashbacks and the pressure I feel on my chest invokes me asthma, but part of it, I realise now that a lot of it was because of my anxiety. The other way it manifests its self in me is pain. I find emotional pain so difficult to deal with that my body turns it into physical pain. This makes it difficult for me now that I realise that this does go on, as I don't know how to work out whether I’m in pain because of something physical or emotional.

Alterations of systems of meaning - this can  manifest itself in various ways such as loosing faith, which I guess that I did, but I was quite young when this happened. Because of my dads position within the church, for me the association of church and religion in general has major negative connotations for me, Also because of the black magic involved the whole idea of organised religion scares the hell out of me (they were also clergy in the church) and therefore I have no sense of faith. I also feel at times a sense of hopelessness and despair that leads to the suicidal thinking.

Luce xxx