Wednesday, December 13, 2006

Complex PTSD

Recommended DSM diagnostic criteria, per Trauma and Recovery by Judith Herman, c1992 by Basic Books.

  1. A history of subjection to totalitarian control over a prolonged period (months to years). Examples include hostages, prisoners of war, concentration-camp survivors, and survivors of some religious cults. Examples also include those subjected to totalitarian systems in sexual and domestic life, including survivors of domestic battering, childhood physical or sexual abuse, and organized sexual exploitation.

  2. Alterations in affect regulation, including:
    • persistent dysphoria
    • chronic suicidal preoccupation
    • self-injury
    • explosive or extremely inhibited anger (may alternate)
    • compulsive or extremely inhibited sexuality (may alternate)

  3. Alterations in consciousness, including:
    • amnesia or hypermnesia for traumatic events
    • transient dissociative episodes
    • depersonalization/derealization
    • reliving experiences, either in the form of intrusive post-traumatic stress disorder symptoms or in the form of ruminative preoccupation

  4. Alterations in self-perception, including:
    • sense of helplessness or paralysis of initiative
    • shame, guilt, and self-blame
    • sense of defilement or stigma
    • sense of complete difference from others (may include sense of specialness, utter aloneness, belief no other person can understand, or nonhuman identity)

  5. Alterations in perception of perpetrator, including:
    • preoccupation with relationship with perpetrator (includes preoccupation with revenge)
    • unrealistic attribution of total power to perpetrator (caution: victim's assessment of power realities may be more realistic than clinician's)
    • idealization or paradoxical gratitude
    • sense of special or supernatural relationship
    • acceptance of belief system or rationalizations of perpetrator

  6. Alterations in relations with others, including:
    • isolation and withdrawal
    • disruption in intimate relationships
    • repeated search for rescuer (may alternate with isolation and withdrawal)
    • persistent distrust
    • repeated failures of self-protection

  7. Alterations in systems of meaning:
    • loss of sustaining faith
    • sense of hopelessness and despair


Anonymous Anonymous said...


Thanx so very much for posting this excerpt. I have been working towards handling my perceptions of my life and this just helped break open a new direction for my inquiries.

Going to see my therapist tonight, so this hit at the right time.

(I now return to watching the docu-drama called my life.)

Wed Dec 13, 02:54:00 PM  
Blogger G Bitch said...

Judith Herman has been very important in my own therapy work. As mine says, funny how things appear right when you need them.

I'm going to post the DSM-IV guidelines for major depression, too. Stay tuned.

Wed Dec 13, 04:35:00 PM  
Anonymous Anonymous said...

Talked with my therapist last night, and she wants to read this excerpt. She actually agrees with my assessment of childhood as a form of torture in that I was constantly forced into a role that wasn't "mine" to play.

Though things were clearing up for me prior to the Flood, all Hell has broken loose since then: the lies, disregard, helplessness, etc.

This is exactly what my early years were about. In the '50s society a teratology (monster) like myself had to be "corrected" in order for things to be normal (even if I died during the procedures). I also had to be programmed in order for the thing to "take".

BTW- I was told that FEMA will pay for counseling, especially since I can't see a therapist at the VA and must go to a private one. This is a good thing since I'm having to go to sessions twice a month. (will post the details when I've figured it all out.

Fri Dec 15, 05:23:00 AM  
Blogger G Bitch said...

Though I found what I posted online, you can find the proposed DSM category on p. 121 in Trauma and Recovery--Judith Herman, MD (New York: Basic Books, 1992, 1997).

Brainwashing, coercion, doublespeak, gaslighting--the tools of oppression are common whether it is global, local or domestic. If any level of dissociation is in the mix Martha Stout's The Myth of Sanity (NY: Penguin, 2001) is revelatory and comforting. And intellectually stimulating. I so understand your journey..........

Fri Dec 15, 10:39:00 AM  

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