Dear Katie:

I asked you about the Trauma in your daughter’s diagnosis of PTSD. You answered that your daughter suffered abuse by her father starting at about the age of six: she witnessed him “smashing objects.. punched holes in walls”, “talk very loudly in the house… screamed in her face, ‘If you don’t stop crying, I’m going to punch you in the f’n face!'”, and  she witnessed him verbally and physically abusing her mother.

PTSD was included in the third Diagnostical and Statistical Manual, DSM-3, in 1980, to  include the lingering effects of combat stress suffered by a large number of American combat veterans of the Vietnam War. Later on, the concept of Complex PTSD was developed and submitted to the DSM-4 and DSM-5 committees, but it was not approved. Nonetheless, CPTSD is used in the context of professional psychotherapy in the treatment of children and adults who have suffered repeated trauma (chronic maltreatment, abuse, neglect, witnessing domestic violence, etc.)  in childhood, by a parent or parents (psychology. wikia. org/ cptsd).

For these children, PTSD and the treatment for it is not adequate because the complexity of chronic, or repeating trauma during childhood, by a parent, during the time the brain is forming (multiple connections take place) – cause damage that is significantly more complex than damage caused by trauma during adulthood outside the childhood home.

The complexity of damage, as described in the website I mentioned is about damage in seven domains (the following are quotes, except for what’s in parentheses):

1. Attachment- uncertainty about the reliability and predictability of the world, distrust and suspiciousness, social isolation, interpersonal difficulties, difficulties attuning to other people’s emotional states and points of view.

2.  Biology- hypersensitivity to physical contact, analgesia (ex., being hit but not feeling the pain), somatization (vague physical complaints), increased medical problems.

3. Affect or emotional regulation- easily aroused, high intensity emotions, difficulty deescalating (difficulty calming down), difficulty describing feelings and internal experiences, chronic and pervasive depressive mood or sense of emptiness and deadness, chronic suicidal preoccupation, overinhibition or excessive expression of anger.

4. Dissociation- distinct alterations in states of consciousness, amnesia, depersonalization and derealization.

5. Behavioral control- poor modulation of impulses, self destructive behavior, aggressive behavior, sleep disturbances, eating disorders, substance abuse, oppositional behavior, excessive compliance.

6. Cognition- difficulties in attention regulation and executive functioning, problems focusing on and completing tasks, difficulty planning and anticipating, learning difficulties, problems with language development.

7. Self concept- lack of continuous and predictable sense of self, low self esteem, feelings of shame and guilt, generalized sense of being ineffective in dealing with one’s environment, belief that one has been permanently damaged by the trauma”.

Does this match your daughter’s symptoms?

anita

• This reply was modified 3 years, 11 months ago by .

Dear Katie:

I googled the book you mentioned, I wanted to read quotes or excerpts from it. The Comfort in “No Comfort Zone” refers to that the absence of Normal before the childhood trauma, and therefore no Normal to return to.

“Now they have to break the connections their brains made”- more like add new connections to the old, strengthening the new connections through practice, building on them, expanding them, and over time all that expansion takes over/ become more powerful than the old connections- a very gradual, slow process leading the CPTSD sufferer to a Comfort Zone, a Normal, for the first time in her life.

Did your daughter ever practice slow, mindful yoga or Tai Chi (a very slow motion form of martial arts)? These physical practices literally slow down that rushing of the brain- that mental/ emotional rushing that leads to (a) getting overwhelmed and withdrawing from any activity that causes stress, and (b) impulsive/ self destructive behaviors.

anita

Dear Katie:

Glad to read you are back to the treadmill. Did I mention to you that I have a treadmill too? Funny how I got it: a neighbor’s wife used to take the daily walk outside that I take. One day she was chased by a bear and got so scared that she didn’t dare do the walk anymore. So, her husband bought her a treadmill. Some time later she died and he offered the treadmill to me one day while I was  on my walk. Later he died (they were both elderly) and I still use their treadmill- their legacy in my life!

I am not expecting yoga classes in-person to resume any time soon, not at the height of the pandemic. But when classes do resume, if I was you, I would sign your daughter to a class and make it a condition for her living with you- to attend that class. I can’t see any other way to motivate her to try something new.

Regarding “bf” who is still contacting you to tell you that he dreams about you and thinks about you when he wakes up- how do you feel about it, does it feed your hope? And .. does he say anything else???

anita

Dear Katie:

“it feels good that he thinks of me”- I can’t argue with feeling good, we all need to feel good from time to time, otherwise, life is an unbearable drag. Maybe feeling better after taking him recently motivated you to go back to the treadmill (?)

I am curious about what is happening in his therapy: are you sure that he is still attending therapy? And.. you have no clue whatsoever about what has been happening there?

anita