Complex PTSD

Great question Mem!

There are some great terminology graphics that we will include in our resources section that address your very valid concern including:

This fabulous graphic from the Childhood Adversity Narratives

You can also check out the San Francisco Adolescent Health Working Group Trauma & Resilience Toolkit, page 3- Spectrum of Trauma, and pages 19 and 20 that address PTSD vs Developmental Trauma Disorder.

And we have also included this issue in the "Whatever Your Interest" bubble in our ACEs Connection Overview graphic on page 1.

Thank you Alicia for your response. 

I understand that there are SO many labels touted as appropriate and therefore ACEs is the best way to cover them all, yet I feel somewhat disappointed that there isn't such a simple single banner/label such as complex PTSD, as to me it cuts to the core and allows everyone 'out there' to be somewhat on the same page. And it will take a long time for everyone to immediately have some grasp as to what this 'condition' means in terms of understanding in the general public's eyes.

I think the ACEs structure and resiliency test enables this general understanding in terms of numbers.  That is such an excellent start.  How to proceed after this is less clear to me, and therefore probably less clear for those not working in the health field in the varying capacities. Indeed in my experience with therapists, many seem to not know about how to go forward, and have much to learn in the understanding of trauma based therapy etc let alone the general public.

I'm not trying to push any agenda at all, I'm simply passionate about improving lives in society as soon as possible.  Everyone who posts here does seem to be pretty much on the same page, so I'm trying to reach out to all of you for a wider discussion.  Or have you all got to the point where you bypass such a discussion as deemed necessary as ACEs and trauma based therapy covers it more succinctly and effectively?

I think I'm being too convoluted... Simple question really:

How does one disseminate this information so that it is readily available to the public?

Mem,

You are asking some really important questions that most people, organizations, systems, and communities need to go through the process of discussing before deciding how to act. Different terms may work better for different people and systems. Pediatricians often uses toxic stress, criminal justice often uses polyvictimization, mental health professionals often use complex trauma. For the general public, some prefer childhood trauma, however there are polls that have discovered that people associate childhood trauma with a single event, like a car accident or school shooting, and not the chronic repeated trauma that ACEs may be able to address. There is also the need for the extended ACE survey, that addresses structural violence such as poverty, racism, and sexism.

Please check out our parent handouts for a good starting point for information dissemination. Folks have posted and distributed these handouts in clinics, churches, and schools. Please let us know how we can support your efforts. If you would like to start an ACEs Connection group in your community, we can provide you with more info on how to do so.

Many thanks and looking forward to following your posts.

Hi Mem, 

The DSM is unfortunately a political organization.  Diagnoses are built based on voting consensus, not on any diagnostic tool.  Complex PTSD was to go into DSM-4 (under the name of disorders of extreme stress NOS -- unanimously voted for, but when the manual was published, the diagnosis disappeared --- this according to a lecture I listened to by Dr Bessel van der Kolk).  

Complex PTSD can have the developmental dimension, however, I see it as being any chronic set of traumas which can begin at some time during development (thus developmental trauma) or can occur chronically starting as an adult or encompass both time frames, as we know children traumatized by their parents often become re-traumatized and re-victimized adults.  I feel that no one who actually considers this fairly or logically  (without just using an emotional gut level response) could believe that the brain changes in developmental trauma are the same as adult onset, single incident PTSD.  Even the research studies and neuro-imaging studies are showing these two different mechanisms of injury to the brain are in no way the same.

One is occurring chronically to a developing brain, changing the very structure and development of the brain.  

The other is a psychic trauma visited on the adult, fully-developed brain.  If that brain developed under the circumstance of positive childhood experiences than that brain will likely heal easily (likely with EMDR).  If that trauma occurred to an already traumatized brain (from developmental trauma) well then this single onset adult trauma (acute on chronic developmental) will be much more difficult to heal.

If the DSM were to acknowledge trauma - actually what medication could you prescribe??? 

I think it is all political and of course names matter that is what Bessel van der Kolk says in all his lectures (names matter to us patients/those affected who understand what happened to us is not as simple as a one time injury that occurred during adulthood to an already developed brain and names need to matter to professionals who need to know and understand the extent of this injury so they can help and not re-traumatize us, as the names they use, determine the treatment offered).  But alas, this, I believe, will remain a political battle like anthropogenic global warming until all of us raise our voices in unison and say.... "There are too many kids we're letting slip through the cracks only to grow up to commit suicide, go to jail, become homeless or raise children that they hurt too... Enough is enough!  Developmental (Complex) trauma is real, it is preventable and ALL KIDS MATTER!!!  We no longer accept the status quo."

Thank you for your insight on this question Tina! On a similar note regarding the politics of the issue, I recently heard Dr Van der Kolk talk about a study on how yoga was more effective than prescription drugs in treating depression and anxiety and how unfortunately the study was buried in the journals and never received the press it deserved. We have a lot of work to do!

"If the DSM were to acknowledge trauma - actually what medication could you prescribe?  

Well that's a very interesting question!  I'm starting to see a little wider.  All this takes a while to digest.

I was kinda attached to complex ptsd as a label for adult difficulties stemming from childhood trauma.  But yes, one needs to look wider.  

Judith Herman is such a clever insightful extremely articulate woman that you're probably familiar with.  Was the founder really of trauma in its various forms.  Bessel van der Kolk followed later, I think... Have a look at the link below and see how many symptoms you tick!  Surely it's more evidence (and the world does like evidence particularly data  - can't see why ACEs hasnt taken over in the western world in regard to collecting data.  May be it's a case of, ok have data, now what do we do with it, which comes back to your question Tina: what will be prescribed?!

Appreciate your efforts Alicia and Tina.

https://traumainform.wordpress...rmulation-of-c-ptsd/

I just found a discussion "What is your common language?" October 2014 that pretty much addresses my question. So it would appear ongoing. Interesting, but I'll leave this topic now!