Hey everybody! Today I am putting out a video of something that you have asked me a lot about. Complex PTSD What is it? Does it exist? What do we do if we have it? How is it different that PTSD? There’s so many questions I’m going to answer for you right now. (Intro Music) So like I said, today I’m going to talk with you about complex PTSD, and I didn’t know anything about this. Many of you have asked about it. “Kati I had a friend who had this.” or “My doctor talked about this. What is this? I haven’t heard of it. Does it exist?” And I didn’t know. That’s what I love about our community. You all tell me things that are happening, things you’re hearing about, and then I’m forced to research it. Figure it out. So I have all my notes, have my DSM, we’re gonna talk about this. We’re gonna learn together, because I didn’t know that complex PTSD was something that exists. And for the true fact of diagnostic purposes, now the company, I shouldn’t even say company, but that’s what it is. It’s the American Psychiatric Association or the APA. Those are the people who put out the DSM. They create it. They decide what goes in and what doesn’t. And complex PTSD was something that was proposed. That they tried to get into the DSM. And the APA was like “no, PTSD is enough.” We have severe, mild, moderate. We feel that covers it. I understand. They have to make choices. They only add things so often. I mean if you saw the first DSM it was like 10 pages long. And now we have this ginormous book of different diagnosis and different diagnostic criteria. So I hear them. However, after reading about complex PTSD I have to politely disagree with them. I think the APA maybe acted too quickly, didn’t really think about it. Because the most common situation that leads to complex PTSD is coming back from war. And if we as clinicians aren’t ready and able and educated enough to help them manage their complex PTSD, then we’re doing them a huge disservice. And they just put their lives at risk for us, and that just really gets me. So what is complex PTSD? Now I got a lot of my information, because like I said it’s not something that’s in the DSM. I can’t pull up things within the DSM about how it happens, when it occurs, what causes it, you know, how does it run its course I can’t find that in here. I can only find information about PTSD itself, post traumatic stress disorder. So I got information from the VA and the National Center for PTSD, and those are the people who lobbied to the APA to get it into this new DSM. So it’s a proposed disorder, because many people feel that PTSD itself does not fully capture the severe psychological harm that occurs with prolonged and repeated trauma. I want to highlight that: prolonged and repeated trauma. Now people that get PTSD could have just had, I don’t mean just had, but could have had one traumatic event that really was terrible. It was scary. They felt helpless. They worried that their life was in danger. Instead of that anxiety feeling, that feeling of worry and stress that comes after a scary situation instead of it getting better slowly, like we start coming back to our regular self. We don’t have flashbacks as often, but PTSD just gets worse. The people who have complex PTSD, wow say that 10 times fast, have had repeated traumas. Also it’s believed that cases that involve repeated traumas needed special treatment considerations. That’s what they lobbied to the APA for. They feel it needs to be treated differently. Now the biggest concern is our vets, like I said, because of the traumatic nature of their service The fact that they feel scared and potentially helpless almost every day. They don’t know if they can get bombed while they’re sleeping at night. Every time they go out and leave their camp, they’re in another risky situation where they could lose their lives. And a lot of that can feel really helpless. They watch people around them die. This happens over and over and over. It’s repeated trauma. You with me? So other examples, other than vets, because this can happen to a lot of people. Concentration camps, prostitution brothels, long term domestic violence victims, or child physical or sexual abuse. that’s repeated. I know many of you have reached out to me and said, you know “I was sexually abused or physically abused by a family friend or parent from the ages of 6 to 12.” Or some huge chunk of time. That’s repeated trauma. And the VA and the National Center for PTSD think that should be called complex PTSD, so I have a video about PTSD. You can check that out too. I encourage all of you to check that out, so that you understand PTSD as a whole since this video is kind of building on that. How is it different from PTSD? Now this was really interesting to me, because if we’re in repeated trauma versus maybe one situation How does our mind process it differently? Why is it different? Why do we need a new diagnosis? I’m not one for a lot of diagnosis, but I have to say the VA really, they changed my thoughts about it. Now the first is emotion regulation. Many of you have heard me talk about this in my DBT videos. When I talk about better managing maybe our borderline tendencies where we feel like our emotions just overwhelm us. So people with complex PTSD may feel extremely overwhelmed with emotions all of a sudden, really quickly Like boom! All of a sudden they’re very angry and aggressive. I know a lot of the people on the VA website had talked about it and said like “yeah, my husband used to go off the handle, be crying, and then he’s screaming. He couldn’t regulate his emotion.” The second is consciousness. They completely black out or forget the traumatic events. And then many times it will switch over and then they’ll be reliving them as if they’re right back there. A lot of people dissociate, which is also a component of regular PTSD. But the complete blackouts, the forgetting, isn’t as common. Another is self perception. They’ll feel hopeless. They’re embarrassed. They have so much shame about the fact that they’re struggling. That they feel like they can’t incorporate back into life. They don’t know how to have relationships, communicate with people, connect with people. And that to me is so hard. Because they talk about the stigma. Feeling different from everyone else. And when we talk about people who had repeated trauma my heart goes out to those people. I just like, ahhhh, I feel for them. It’s terrible. And then the feeling that even after it stopped. So the trauma stopped, then they still feel like they can’t connect. They’re not part of, they’re not the same as other people. They’re embarrassed. They’re shame filled because of what happened to them, which is something that they had no control over. Something they were completely helpless to. Now the fourth, and there’s just a couple more. There’s only six. Is distorted perceptions of the perpetrator or preoccupation with revenge. A lot of people will either, and they talk about two different instances, where someone can either be like “but it wasn’t their fault. They didn’t mean it.” People who had been repeatedly physically or sexually abused are like but like “they were confused” or let’s say a cousin or a family friend or they’re like “but they’re family and I know they didn’t mean to.” They try to cover it up or pretend that it wasn’t a big deal or that they didn’t know any better. And then there’s the reverse where people are preoccupied with revenge. They’re like ‘that motherfucker is gonna get it.’ They get really focused on that, and their whole life revolves around revenge. That can be really hard for the other people in relationships with them, to deal with. The other, the fifth is, like I was just talking about relationships with others. They isolate. They don’t trust people very easily. As so you can see how maybe that makes maybe marriages really difficult. Someone comes back from war and they’re distrustful of you and they isolate. They don’t want to see family or friends. They don’t want to go out. They want to stay at home. They want to just do their thing. Leave me alone. It can be really hard. And the last is one’s system of meanings; they have a loss of sustaining faith or sense of hopelessness and despair. So this was the hardest for me to read about, because it’s almost like the core of who they are, what the meaning in life is, what the meaning of themselves is was lost. And that is just so hard to hear that people are feeling that way. That people are going through that. And we’re not even recognizing this as a diagnosis. Bleh! Makes me feel sick. So, why does this happen? What is this? What do we do? What’s the treatment like? It’s pretty much the same as PTSD where we do a lot of reintegration into situations that may be triggering. That may trigger any kind of flashback or dissociation. We ground ourselves. It’s a progressive treatment. We do it little by little. We don’t just throw you in there in the deep end and be like fix this, figure it out. I don’t care if you’re having a panic attack, you’re freaking out, we’re just gonna try and do this. It’s a slow progressive therapy. But the difference with complex is that they work a lot on interpersonal difficulties. So all of those things: the distrust, the focus potentially on revenge, the pretending the perpetrator didn’t really mean to, or their struggle with emotion regulation and lashing out, being really scary potentially to the people in their life We work a lot on that. And that’s how the treatment differs. There’s a lot of relational work. There’s a lot of couples or family work that’s integrated into this, because when someone has repeated trauma it can be really hard for them to move past it. Really hard to communicate And to completely trust and love and get back into the relationships they had before the trauma started happening. And so I want you all to consider those around you who may have had repeated trauma Maybe you could share this video with them Maybe you could work and seek to understand. Refer them to the VA or other facilities that can offer help. Refer them to therapists in the area. Be there to listen and seek to understand, because a lot of it, sounds like they just feel shame filled. They don’t know what to do. They’re embarrassed of their situation. They don’t know how to reintegrate back into life after these terrible things have happened to them, so we as a community can help better support these people. We can share this video. We can like this video. We can talk about complex PTSD and how different it is from regular PTSD, because it’s important for people to feel understood. That’s the whole reason I love our community is because we’re all in this together. Right? We’re working together. Everyone’s situation is a little bit different, but we’re all working to share and shed light on the information that’s important about mental health. To break through the stigma, so people don’t feel so shame filled and hide in the shadows isolating. They know they can they can speak up. They can talk about it, and we’re here to listen. And we’re here to better understand their situation, so please share. Please comment. Please give it a thumbs up! Let people know that this stuff is important. We need to talk about it, because people are struggling and we know the more support and information we can put out there the better.