Psychotherapy, or so-called “talk therapy”, can reveal insights that victims of complex post-traumatic disorder (CPTSD) may not be consciously aware of. CPTSD is a complicated condition with several symptoms that appear to be identical, yet seem to exist separately and simultaneously in the same person. Defining these identical symptoms, why they co-exist and how they interact, is a core characteristic of psychotherapy.
CPTSD consists of several main elements:
- Traumatic events and exposures that cause the disorder
- Reactive emotions like anxiety, anger, shame and sadness
- Recurring memories and a preoccupation with past events
- Deep-seated dilemmas like insecurity and unstable social skills
- Events or situations that trigger severe reactions and responses
- Coping mechanisms like behaviour and substance use disorders
Traumatic experiences can be a series of distressing events, or long periods of exposure to a situation that caused high levels of ongoing stress, or combinations of both. These often lead to different types and intensities of symptoms and comorbidities being semi-fused into the patient’s psyche.
CPTSD victims often display reactions such as resentment and frustration. Questions like why they were singled out as victims of horrific events, are common. Reactions can also include short and long term feelings of anger, shame, guilt, low self-esteem, helplessness, anxiety and depression.
Exposure to trauma usually results in recurring memories and intrusive thoughts that cause patients to fear a repetition of harmful events and to be constantly alert to potential threats. The persistent distrust and hypervigilance cause mental exhaustion and several other problems.
Victims of CPTSD may try to avoid anguish by shunning emotional discussions and disconnecting from their own feelings. They may avoid intimate bonding with partners and family members and distrust society in general. They may become emotionally blunted and unable to feel happiness.
CPTSD sufferers are often unaware of some disorders that are deeply rooted in their psyche. When patients are not consciously aware of underlying emotions, they rationalise and erroneously connect their anguish with what they perceive to be the reason for it, when the real cause may lie elsewhere.
When conscious thought fails to produce reasons for distressing feelings, CPTSD victims may adapt by accepting it as unavoidable character traits and continue to suffer the anguish it causes. Often they alleviate the anguish with unhealthy behaviours that provide them with temporary rewards, or by suppressing it with unhealthy self-medication.
To summarise; CPTSD victims are subjected to a number of different elements, some of which have the same symptoms attached to them. These symptoms can operate independently or inter-actively and can be triggered by different events.
How specialists unravel CPTSD
Therapists usually conduct a detailed assessment of a patient’s symptoms prior to starting treatment. Apart from the standardised CPTSD tests, they may also utilise the initial therapy session to establish a bond of trust and to get to know a patient better.
Experienced psychotherapists can detect the independent, yet interactive array of issues presented by each of the elements of CPTSD by discussing a patient’s past and present and being aware of important random remarks that crop up during the conversations. Sometimes they prompt patients for more information.
Skilled therapists notice when patients digress about seemingly unrelated, yet relevant events. They can also detect when patients start confusing different events and triggers with specific feelings and responses. This enables the therapist to build a profile that consists of different layers. Each layer has its own cause-and-effect issues. The patient can then be healed, layer by layer, with an integrated, orderly process, until the entire spectrum of issues have been dealt with.
Once a patient is educated about the different elements, and made aware of the issues related to each element, they are better equipped to identify and cope with specific triggers and emotions when they are confronted by them. A personalised plan with a clear understanding of the issues, will also help patients to improve their social and interpersonal bonding skills.
Some symptoms can steal the focus of less informed observers and prevent identification of other powerful, but less obvious, symptoms. If all the underlying issues are not addressed with a single, broad treatment plan, the patient may relapse repeatedly. Treating issues on separate occasions, with long intervals, can result in the untreated issues reactivating the previously treated issues and leaving a patient in a perpetual, revolving door situation.
With specialist treatment, long-term healing is certainly possible. It requires dedication and intense work by both therapist and patient, but given the impact on a patient’s life, the potential results are worth it. Trauma echoes a human response to past adversity through present maladaptive behaviours.
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