Treatment of Complex PTSD

There are a few ways of studies of treatment to complex PTSD, such as clinical treatment. For clinical treatment, it can follow these steps. At first, remove and protection from the source of the trauma or abuse. In cognitive therapy, the therapist will helps you to understand and manage your trauma and its aftermath. You should understand what make you stress and make your symptoms worse.You will learn to identify thoughts about the others and yourself, it is making you feel fear or anxiety. With the assistance of therapist, you will learn to replace these thoughts with more accurate and relax thoughts. You will also learn ways to cope with feelings such as guilt, afraid and conflict. After a traumatic event, you might blame yourself for things you couldn't have changed. For example, a girl may feel guilty by wrapped, but the thing happened lost her control and thinking. 

According cognitive therapy of CBT that helps you understand that the traumatic event you lived through was not your fault. Then, separation of residual problems into those that the victim can resolve, such as personal improvement goals. And those that the victim cannot resolve,such as the behavior of a disordered family member. During this stage, the victim maybe experienced a period of recovery time and treatment, her mood and physical condition have a certain improvement. But there are some problems still in the deep heart, it takes longer to recover. He can try to adjust his own feeling, to develop a new plan, such as positive to life, try to make own feelings peaceful or to avoid irritation. During this time, it also need to fit behavior of family members, learn how to communication with them and decrease the family problem. Apparently, victim cannot control others’ behavior and thinking, so he needs to understand how to get along with family members. 

The third way is focus on to be improved in an individual's life that is under their own control. The victim who is sensitive, can not tolerate thing happened by he can not control. It may cause his injury again and too emotional, can not take care of themselves and so on. So when he tries to improve his life, it must be based on his own circumstances and can bear the scope. More, placement in a supportive environment, where the victim can discover they are not alone. With this stage can use group therapy, you can join a group which a group of people also have been through a trauma and complex PTSD. To talk to someone, maybe you will feel better about your trauma. Group therapy can detect your symptoms and memories of trauma, and recover it. It also  helps you build new relationships. You can learn how to deal with emotions, to build self-confidence and trust. You'll decrease attention of past, to try to find your own life.  As necessary and required,personal therapy to promote self-discovery, prescription of antidepressant medications. 

As we know, sometimes something happened so suddenly, the victim can not control his emotion, so it needs the medicine to reduce fear and mad. Generally, the doctor will give the antidepressant medicine, such as citalopram (Celexa), paroxetine (Paxil), and sertraline (Zoloft). The chemicals will ease the burden, to effect your brain. For example, the victim cannot out of the past experience, always want to kill himself or lost control. At this time he needs help of doctor. After a period of time to treatment, the victim should give the feedback to your doctor, then doctor to according his situation to choose medications treatment for you.

Reference

 Herman, J. (1997). Trauma and recovery: The aftermath of violence from domestic abuse to political terror. New York: Basic Books.

 Ford, J. D. (1999). Disorders of extreme stress following war-zone military trauma: Associated features of Posttraumatic Stress Disorder or comorbid but distinct syndromes? Journal of Consulting and Clinical Psychology, 67, 3-12.

Van der Kolk, B. (2005). Developmental trauma disorder. Psychiatric Annals, 35(5), 401-408.

Roth, S., Newman, E., Pelcovitz, D., van der Kolk, B., & Mandel, F. S. (1997). Complex PTSD in victims exposed to sexual and physical abuse: Results from the DSM-IV field trial for Posttraumatic Stress Disorder. Journal of Traumatic Stress, 10, 539-555.

What is Complex PTSD and How can it be Managed?

Conclusion

Here is a survivor of complex post-traumatic stress disorder - Pete Walker, the one who got complex PTSD and eventually recovered. He was survived childhood in a war zone of a dysfunctional family in New York City. He had escaped from his family and went to Vietnam era army. 

Credit by Cartoon Movement

By the time he was 25, he has found out he was seriously hurting after he had survived from the high risk activity peppered with what actually looked like unconscious suicide attempts. After that, he was spent few decades to explore varied spiritual and psychological approaches in order to heal his trauma and he has shared the unique perspective and tools with his fellow complex-PTSD and PTSD sufferers. Other than that, he has published a book that is about the complex-PTSD as a guide and map for recovering from the trauma.

Pete Walker. Credit by pete-walker.com

We can know from the online article of Pete Walker and above of our blog, the genesis of complex-PTSD mostly associated with long periods of ongoing sexual and/or physical abuse in the childhood. The extremes of verbal and emotional abuse also a factor of complex-PTSD. Not only that, the long-term emotional neglect can cause complex-PTSD and more likely to emotional flashback. In present time, the parents of a dysfunctional families disdain their children for needing attention from them and react contemptuously to baby. It can also cause complex-PTSD to the children.

The emotional flashback of patient can be activated by triggers. Triggers can be internal and external. External triggers are people, things, places, events, facial expression, styles of communication and many more. Here are some example of external triggers: revisiting the place, hearing someone use a parent’s shaming turn of phrase and encounter someone resembles the abuser. The internal triggers can be involved thought and visualization about endangerment for example: visualizing someone being abusive. With the path of recovering, patient can become more cognizant of their triggers, and work quicker to work through incidents of being triggered into a flashback.

The toughest part in the path of recovering is the patients will keep feeling blaming and shaming on themselves every time they have a flashback. It is a thinking of all-or-none, the recurrence of fear, depression and feeling shame is interpreted as meant that nothing changed even they have been a while not over-activated. It is very hard for them to overcome and recover from an overwhelmingly painful experience.

Since there is no prevention for complex post-traumatic stress disorder and the symptoms will give the victims a very long-term torture even through their whole life. Therefore, we should have to avoid ourselves to be one of the instigator of the domestic violence, bully event, sexually abuse and et cetera. We have to heed our behavior and verbal toward others to prevent discrimination and hostility. If you know someone who around you has complex-PTSD would you like to offer your help and show them your kindness? Give them a little hope? If yes, how would you do and what should you do? If you giving them help in a wrong way it will just make it worse. Here is some tips for you about what to do to let the patient of complex-PTSD feel the warmness of humanity: 

- give them support, a shoulder to cry on
- offer sympathy
-lend them an ear

Be patient and put your attention on them when they tell because they always feel insecure when they surround with people. Therefore, when they try to communicate with you, please take a minute to listen and understand them. Never push your own agenda and tell them just get over it because you do not ever know how tough they have been gone through and how many effort they have put.

Your little help, little love and a little time can make their life DIFFERENCE.

Credit by NakedPastor

References:

Thowfeek, T. & Thowfeek, T. (2015). Complex Post Traumatic Stress Disorder (C-PTSD). Out of the FOG. Retrieved 29 September 2016, from http://outofthefog.website/toolbox-1/2015/11/17/complex-post-traumatic-stress-disorder-c-ptsd

Pete. W. (n.d). COMPLEX-PTSD ARTICLES. Pete Walker. Retrieved 11 October 2016, from http://pete-walker.com/index.htm

    The Causes of Complex Post Traumatic Stress Disorder   

•  It is chronic, cumulative, inescapable.
• Usually occurs interpersonally, involve direct harm, betrayal, violating and exploitation by another person.
•  Occurs during developmentally vulnerable periods of life (such as childhood which is the critical periods of brain development and personality formation)

Examples                                                          

1  1 .  Childhood abuse

        ♦  Physical abuse: Any injury resulted on a child by intentional force.

§          ♦ Sexual abuse: Any sexual intercourse, and forcible rape between adult and children. *(The age of sex consent is 16 years old according to Section 375 of the Penal Code)

§         ♦ Emotional abuse: Psychological abuse, humiliating or threatening actions that caused an emotional distress.

§         ♦ Neglect: failed to provide basic needs to children such as protection, nutrition, hygiene, clothing.

                 International statistic:

Around the world, 40 million children were being abused each year.

 National statistic: (UNICEF, 2010)

Year	Reported child abuse cases in Malaysia
2006	1,999
2007	2,279
2008	2,780

Based on the report in 2008, the highest cases of child abuse in Malaysia is neglect. The statistic followed by physically abuse, sexual abuse. (UNICEF, 2010)

§  Neglect : 952 cases

§  Physically abuse : 863 cases

§  Sexually abuse: 733 cases (72% were incest)

2.   Domestic violence

   Experience long-term battering by intimate partner (Both physical and sexual  assaults) 

  *(referred to Domestic Violence Act 1994) 

    

  Statistic of reported cases of domestic violence against women in Malaysia: 

    (WAO, n.d)

Year	Reported domestic abuse cases in Malaysia
2000	3,468
2001	3,107
2002	2,755
2003	2,555
2004	3,101
2005	3,093
2006	3,264
2007	3,756
2008	3,769
2009	3,643
2010	3,173
2011	3,277
2012	3,488
2013	4,123
2014	4,807

3. Long-term bullying

         Bullying at school such as daily taunts, teasing, and harassment.                    (Both physical and verbal abuse)

          

Statistic of school bullying cases in Malaysia: (Mohsen, 2016)

Year	Reported school bullying cases in Malaysia
2012	4,159
2013	4,120
2014	2,906
2015	3,011

3.      Torture, entrapment or kidnapping, prisoner of war camps and etc.

References:

The United Nations Children's Fund (UNICEF) (2010). Child Abuse In Malaysia. Retrieved        from: http://www.unicef.org/malaysia/GetonBoard-Factsheet-Child-Abuse-in-Malaysia.pdf

Women’s Aid Organisation (WAO) (n.d.). Police Statistics on Violence against Women in Malaysia (2000-2014).Retrieved from: http://www.wao.org.my/Police+Statistics+on+Violence+Against+Women+2000-2014_99_6_1.htm

Mohsen, A. S. (2016, May 9). Statistics show drop in disciplinary issues among school students. TheSunDaily. Retrieved from: http://www.thesundaily.my/news/1794969

Symptoms of Complex PTSD

Although many of the symptoms of complex PTSD are frightening and crazy, but actually they can help you survive to from the tragedy when you are facing a trauma. However, these symptoms of complex PTSD can be troublesome when you need them to go away but they are still hanging around (Goulston 2008).

Symptoms of complex PTSD is much more hard to handle than a simple PTSD because the survivor from a complex PTSD can be said that they had undergo a prolonged trauma thana survivor from simple PTSD. This can lead them to a trauma forever if those symptoms are not being treated. The people with complex PTSD may experience one or more of the symptoms, depend on how severe conditions they are.

Wild mood swings and out-of-control emotions

Complex PTSD will make someone feel confuse about their emotions because they are not able to regulate and control them. Just give you a simple example, if a person had undergo sexual abuse, when she is recalling her bad memory about the abuser, she may suddenly react emotionally such as throwing plates or want to commit a suicide.

Credit by Cartoonstock

People who suffering with complex PTSD will have some out-of control behavior as well, such as:



start a one-night stands relationship with a stranger





gambling away large amounts of money





shoplifting

talk part in risk behaviors such as speeding

Credit by Gify

Dissociation

The people with complex PTSD will feel that they are detached from their bodies or themselves after that experienced a serious form of numbing in their emotion and imagine that that bad experience was happening to someone else instead of themselves.

It is in their minds saying that, "It is fine. It is not me. It is happening to someone else."

Credit by Gify

However, this condition will make the people who suffer in complex PTSD have a feel that they are only the shadows of the others instead of being a human.

Disturbances in how you feel about yourself and your body

People with complex PTSD will have a negative feeling towards themselves. They will feel guilt or shame, and not willing to tell their feeling to the others therefore lead them to a condition of helplessness. Prolonged exposure to the negative feelings can cause them have some negative behaviors such as hurting themselves by knocking their heads to the wall or have some eating disorder such as Anorexia and Bulimia.

Credit by Gify

Distorted feelings about the person who perpetrated your trauma

Stockholm syndrome is a special result that comes along with complex PTSD. The is the condition when a person is being abused but he or she is trying to protect the abuser from arresting.

Stockholm syndrome is named because of a bank robbery which happen in Stockholm. The hostages involved in the bank robbery were emotionally attached to the captors and tried to protect them although they were in a safety condition.

Credit by Gify

Alterations in your feelings toward other people

People with complex PTSD will trust nobody and feel afraid to expose their life to other people because they feel shame about themselves. In other condition, some of them may be overly needy and always need your accompany because they are scare of being alone.

Credit by Gify

Loss of meaning in your life

People who suffer in complex PTSD will always feel despair and feel hopelessness. This can cause them to think a lot and start to think for ending their lives since there are no meaning in their life.

Credit by Gify

References

Goulston, M. (2008). Post traumatic stress disorder for dummies. Hoboken, N.J.: Wiley. Pg 49.

Biopsychosocial Model

Biopsychosocial model is a model which results from a combination of biological, psychological, and social factors affecting an individual, to examine and identify how and why disorders occur.

Adapted from http://www.physio-pedia.com/Biopsychosocial_Model

The Biopsychosocial model not only used by psychologists; but in many applications in different fields because of how inclusive it is of different factors that influence human behaviour.

Biological Factors

The biological aspect of the biopsychosocial model refers to the body's physiological, adaptive    responses to fear. It also include an individual’s genetic traits and history of trauma.

The more extreme the traumatic event and the more the individual was made sensitive by previous traumata and/or the higher the genetic vulnerability, the easier it is for this mechanisms to become pathologically unbalanced (Tavel, 2016).

For example, let's say Joan grows in an abusive home that leaves her with scars and injury on her body. This biological change might influence how she feels about herself, which could lead to development of depression or anxiety.

Psychological Factors

The psychological component of biopsychosocial model examines thoughts, emotions, and perceptions about our experiences, our environment, or behaviours. These cognitive patterns affect our perceived sense of control over the environment and cause depression. Psychological factors influencing depression include low coping skills, negative patterns of thinking and judgement problems (Anon,2016).

                    

For instance, Joe experienced domestic violence during his childhood and being abused by his stepfather without the helping of his mother. As he engages in these behaviors, he starts to have a strong rejection towards women and have a negative feeling towards women that looks like his mother. He will suspect the target and torture them which causes the victim to suffer from complex PTSD.

.

Social Factors

The social aspect of biopsychosocial model plays a role in examines factors that might influence the health of an individual. Social factors include socioeconomic status, culture and religion (Anon, 2016).

For instance, James taking revenge against the bullies who had made school miserable for him. He planned a school shooting and attack the target of his rage: students and faculty. The victims that experienced the school shooting may exhibits symptoms of complex PTSD.

References

Anon. (2016). Boundless. Retrieved from https://www.boundless.com/psychology/textbooks/boundless-psychology-textbook/stress-and-health-psychology-17/introduction-to-health-psychology-85/the-biopsychosocial-model-of-health-and-illness-326-12861/

Anon. (2016). Mentalhelp.net. Retrieved 12 October 2016, from https://www.mentalhelp.net/articles/current-understandings-of-major-depression-biopsychosocial-model/

Tavel, P. (2016). Rediviva.sav.sk. Retrieved 12 October 2016, from http://www.rediviva.sav.sk/55i4/185