Grieving and Complex PTSD

In 1980, the American Psychiatric Association (APA) added PTSD to the third edition of its Diagnostic and Statistical Manual of Mental Disorders (DSM-III) nosologic classification scheme (2). Although controversial when first introduced, the PTSD diagnosis has filled an important gap in psychiatric theory and practice.

Since 1980 questions that remain about PTSD include: Are there other subtypes of PTSD; what is the distinction between traumatic simple phobia and PTSD; and what is the clinical theory of prolonged and repeated trauma?  With regard to the latter, Judith Herman, J.L. (1992) in her book Trauma and recovery has argued that the current PTSD formulation fails to characterize the major symptoms of PTSD commonly seen in victims of prolonged, repeated interpersonal violence such as domestic or sexual abuse and political torture. She has proposed an alternative diagnostic formulation, “complex PTSD,” that emphasizes multiple symptoms, excessive somatization, dissociation, changes in affect, pathological changes in relationships, and pathological changes in identity. (PTSD History and Overview).

Complex Post Traumatic Stress Disorder (C-PTSD) differs slightly from the more commonly understood & diagnosed condition Post Traumatic Stress Disorder (PTSD) in causes and symptoms.  C-PTSD trauma cannot be clearly defined in the same way as PTSD.  Every person has a different tolerance level to trauma and symptoms are widely varying so the amount of exposure to trauma does not make C-PTSD more or less severe.

Below is an excerpt from an article by Pete Walker, M.A., M.F.T on his take on grieving and Complex PTSD.

“This article explores the role of grieving in treating childhood trauma and Complex Post-traumatic Stress Disorder.  Insight, as crucially important as it is, is never enough in recovery. No amount of intention or epiphany can bypass one’s need to learn to lovingly care for himself when he is suffering from the emotional flashbacks of C-PTSD.

Emotional flashbacks are regressions that take the survivor back to the excruciating states of fear, humiliation, abandonment, helplessness and hopelessness that he nearly drowned in during childhood. Grieving is an irreplaceable tool for metabolizing and resolving the overwhelming feelings that arise during emotional flashbacks.

Grieving aids the survivor immeasurably to work through the innumerable death-like experiences of being lost and trapped in emotional flashbacks. Grieving also supports recovery from the many painful, death-like losses caused by childhood traumatization. Recoverees need to grieve the death of safety and belonging in their own childhoods – the death of their early attachment needs. They need to mourn the myriad heartbreaks of their frustrated attempts to win approval and affection from their parents. As the grieving process therapeutically evolves, survivors typically uncover a great deal of unresolved grief about the deadening absence of the nurturance they needed to develop and thrive.”  (You can view the full article here).

C-PTSD sufferers may “stuff” or suppress their emotional reaction to traumatic events without resolution because they believe each event by itself doesn’t seem like such a big deal or because they see no satisfactory resolution opportunity available to them. This suppression of “emotional baggage” can continue for a long time either until a “last straw” event occurs, or a safer emotional environment emerges and the damn begins to break.

A great website to consider while navigating your C-PTSD journey is Out of the Fog which offers a forum for people to connect and support one another (visit the forum here).

Complex PTSD a relatively newly recognized condition, there’s still some debate about how it should be treated because the symptoms are variable.  However grieving is still a major component of the healing process.  Become a member of The American Academy of Bereavement today to find more resources on grief.

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