When you see a Dr that doesn’t practice in the field of Mental Health and you tell them that you have PTSD (which I personally avoid, but generally am forced to because I also have PNES-Psychogenic Non-Epileptic Seizures so they have to know in case I have a seizure at the OB/GYN). As I was explaining to him one day that I have these types of seizures, he, of course, asked why I have these seizures. I had to explain that I have PTSD. Those dreaded 4 letters. His response, “Well, what happened that caused it?”
I gave him a generic answer and he went about doing his job. How do you explain Complex-PTSD to a non-mental health professional?
While some people can be diagnosed by a single event, i.e. an attempt on their life, a victim of a single-event sex crime, many other situations that warrant diagnosis of PTSD. Let me make this very clear, I am not AT ALL minimizing these types of atrocious crimes and the fall-out that can be caused from them. Please understand that. While these can be “brushed aside” in someone’s mind, perhaps, you think you can, especially if they were non-violent, or, if you think that you’re “strong enough”. I urge you to please don’t wait to see a therapist, even for a short time, to discuss what happened and what symptoms, if any so far, that you have been experiencing. It might save you from exhibiting symptoms, nightmares, flashbacks, etc, later on. I don’t wish this Hell on anyone.
C-PTSD, or, Complex PTSD is a little different. It’s generally trauma that has accumulated over time (put simply), someone who has been abused or neglected in their childhood, someone who has been abused over a lifetime, one relationship after another, sometimes not knowing that there’s any other way to live. The point that I’m trying to make here is that someone with C-PTSD has a lot to “unpack” during therapy and cannot be penciled in for a 12-session set of treatment.
There must be some boundaries and warnings, however. The client must know that homework will be expected to be done every session (therapy is not a lone venture). Much of the work will fall on the client and they need to be informed about this and guided to the material that will work. If at first something doesn’t seem effective, keep trying that method OR change routes, this is why we get paid the big bucks. 🙂
Clients WILL BE HESITANT, especially the deeper down into the issues that the two of you dig. Think of it as a deep-tissue massage for someone with fibromyalgia, it hurts like hell at the time, but, later, it does help. The more often you do it, the less sensitive, the less painful later. I am telling you this because you need to warn your client that it will get worse before it gets better, but it will get better. They need to anticipate this in order to make the commitment to continue with therapy. Some clients will not be ready to commit to this, but, once you’ve laid this foundation and opened the door, they are more likely to come back.
Secondary PTSD is the “newest” form of PTSD that has been recognized by the DSM (Diagnostic and Statistical Manual of Mental Disorders, most often used amongst therapists, psychologists, and psychiatrists to guide diagnosis and treatment of mental disorders and diseases). Essentially, Secondary PTSD occurs when someone witnesses something awful, such as a murder, a job that would put them in the way of learning horrific stories of injustice, neglect, and abuse over and over again (this is part of the reason that therapists burnout so often), a job as an ER nurse where you could witness something that you find to be traumatic.
Here are some specific examples straight out of grad school: An ER trauma nurse witnesses children who were caught in a fire so bad, that their clothes were burned to their bodies and they were screaming in pain. The pain medicine did not seem to help and, later, one of those children died. She began experiencing PTSD symptoms a few weeks later; nightmares, flashbacks, depression, avoiding work or anything related to what she had seen.
Another example: A man works nights for a hotline that caters to former child molesters who have been released from prison/jail. Men (or women), call into the line when they’re feeling “urges” to touch children again. They describe these “urges” in detail to the man on the line, which is supposed to be helpful for rehabilitation. (FYI: There have been new studies done that prove that child molesters can be rehabilitated with a certain Cognitive Behavioral Therapy, or CBT, type model.) To date, nothing widespread has been shown to actually rehabilitate someone who sexually abuses children. I’m of the belief that they cannot be rehabilitated. To go on about the man on the end of the line listening and asking questions to these types of people, he began to exhibit those same symptoms as the ER nurse formerly mentioned. The same symptoms we all exhibit.
I think I’ve covered the differences between one another, however, with other symptoms often displayed (sometimes substance abuse or addiction), the client will be reluctant to discuss past painful events, as they will be a trigger to use the substances. To get past this, you must know what questions to ask and how to phrase them. You can’t just get out your DSM and start asking questions as if it were a checklist (you generally shouldn’t be doing that, anyway). While recent light has come to PTSD and the symptoms surrounding it, PTSD, C- PTSD, and Secondary PTSD all have similar symptoms. The main dominant difference between the diagnoses is the history surrounding the trauma itself and the seriousness of the symptoms.
I want to offer other resources for a) more education and b) for help, in case you need to reach out to someone now, or later. You can always e-mail myself as well at firstname.lastname@example.org, but please know that I generally can’t respond immediately.