Physical Ailments with CPTSD - Part 2

[Kizzie]

It speaks volumes doesn't it that we have 6 pages about physical issues and will likely fill another 5 or more?

I know I am having difficulty accepting that aging is making my body very unhappy and I have a laundry list of things that plague me.  It's especially hard knowing that my CPTSD played a BIG role in this and that medical doctors and mental health practitioners don't seem to get this, at least that's been my experience.

I've written a piece about this for Section III of the anthology we're writing and I'm going to be working on a project with the Complex Trauma SIG in the New Year to get more about Complex Trauma in medical school education if we can.  My son is in year 3 and had one three hour class, that's it.   

[Lakelynn]

All change in the medical field takes decades. What is obvious to us here, is still fairly novel and new to many physicians, social workers and other helpers. It occurs to me that once again, it is up to us to educate others and empower ourselves by constantly bringing it up and maybe working it into a preface for conversations.

I had one and only one outstanding provider in my life, from Sept 2011 until November 20222. During that time, I may have had only one or two visits where I specifically mentioned my family and the way my early years impacted my life. Reading your post Kizzie, changes my view of my own responsibility to keep this issue in front of the new provider I'll be seeing before Christmas. Although health care is often sold as a "partnership" we need to face reality and carry more than our share of the load.

[Blueberry]

My old GP was actually really good at figuring out what most of my physical problems really meant. He knew before I did that most was due to psychological stuff, even before it was clear cptsd was the problem. I went to him for over 20 years. I was undoubtedly very lucky to find him.

[Lakelynn]

Blueberry,

I'm glad to hear you've had an ally, even though that's a new word for new times. It's good to be known so completely and over such a long period of time. Even though he could never be replaced, I hope that there are some people in your "care circle" that are getting to know you just as well as he did. And of course, you can also know yourself. To me, that's the hardest part.

[Kizzie]

All change in the medical field takes decades. What is obvious to us here, is still fairly novel and new to many physicians, social workers and other helpers. It occurs to me that once again, it is up to us to educate others and empower ourselves by constantly bringing it up and maybe working it into a preface for conversations.

Well said Lakelynn   One of the main reasons our health care physicians in North America don't know much if anything about Complex Trauma is that Complex PTSD and Developmental Trauma Disorder are not yet in the APA's diagnostic manual. It's what professionals use here mainly, while in Europe it's the WHO ICD which does have Complex PTSD. I don't think the ICD has DTD yet but I could be wrong.

Bessel van der Kolk points to politics in America as keeping the APA from accepting CPTSD as an official diagnosis and I think if you add in the fact that relational trauma is unthinkable for most, that we are shamed into silence and that it will cost untold $$$ to prevent, intervene and treat, it's no wonder we're kept invisible.   

In any event if survivors like us keep bringing up Complex Relational Trauma and Complex PTSD with healthcare practitioners we will eventually educate them from the bottom up. I like to think that pushing upwards will help with gaining attention and then action from the top down. 

Ever hopeful.
 

[tofubreadchillicoriander]

All change in the medical field takes decades. What is obvious to us here, is still fairly novel and new to many physicians, social workers and other helpers. It occurs to me that once again, it is up to us to educate others and empower ourselves by constantly bringing it up and maybe working it into a preface for conversations.

Well said Lakelynn   One of the main reasons our health care physicians in North America don't know much if anything about Complex Trauma is that Complex PTSD and Developmental Trauma Disorder are not yet in the APA's diagnostic manual. It's what professionals use here mainly, while in Europe it's the WHO ICD which does have Complex PTSD. I don't think the ICD has DTD yet but I could be wrong.

Bessel van der Kolk points to politics in America as keeping the APA from accepting CPTSD as an official diagnosis and I think if you add in the fact that relational trauma is unthinkable for most, that we are shamed into silence and that it will cost untold $$$ to prevent, intervene and treat, it's no wonder we're kept invisible. 

In any event if survivors like us keep bringing up Complex Relational Trauma and Complex PTSD with healthcare practitioners we will eventually educate them from the bottom up. I like to think that pushing upwards will help with gaining attention and then action from the top down.

Ever hopeful.
 

I think the failure to include C-PTSD in DSM is the biggest blunder of traumatologists in the 21st century.

I agree that we should do our part in educating health workers, though it feels so futile when you mention C-PTSD and then single instance PTSD is talked about. One member (moderator) from another forum dedicated to both PTSD and C-PTSD even said to me that the DSM has 700+ pages on PTSD and that it includes aspects regarding relational trauma, BUT (and it's a big but) they (APA) couldn't list also the relational as symptoms that cause PTSD because (drum roll) the list would get too long. Can you believe this? I was shocked and left that forum. Clearly the moderators are NOT trauma informed otherwise they'd know the distinction. At least on this forum it's clearly stated that people are not professionals and I enjoyed the emphasis on the relational aspect of C-PTSD.

I personally believe that the APA members have shame due to childhood abuse and they simply are in denial, otherwise they'd have accepted the diagnosis in DSM-V-TR

[Kizzie]

Honestly Tofu+ it was a shock to the members of the original group of mental health professionals when the APA denied it for the DSM in 2015 according to Bessel van der Kolk. He would agree with you that it was a shameful omission because it was all about politics or control rather. It seems that the APA leadership is a very controlling bunch.  I recently read in an article about Judith Herman that she faced a lot of misogyny and backlash and it hurt her mental health for many years.

I doubt any of them (APA committee) lose sleep over any of that or us, the millions around the world needing a proper diagnosis who have languished for decades for no good reason.

Tis the season so bah humbug to all of them.   

[tofubreadchillicoriander]

Do you think it'll be included when there'll be a new generation at the helm of APA?

Don't get me wrong, it's good that there are available therapies out there, though would be nice to have the infrastructure in the healthcare available for people who suffer from C-PTSD. I honestly don't understand why a nation would turn a blind eye to making itself more resilient. Yes, it'll cost, but how much does it cost to waste a lot of potential?

My former trauma therapist told me, in session, that I've C-PTSD, however when I asked for an official letter of my diagnosis he wrote PTSD. When I asked him why he wrote PTSD instead of C-PTSD (as C-PTSD, like you said, Kizzie, is in ICD-11), he said "it shouldn't make a difference and it's not recognized in the manual". This is in Europe. So even here, in some countries, they're looking to the DSM. I know that in the UK, the NHS recognizes C-PTSD. I think more countries should do that. But yeah, as you said, ICD-11 fails to encompass the entire spectrum of C-PTSD. More work needs to be done.

[Kizzie]

I have heard through the grapevine at the International Society for Studies in Traumatic Stress Complex Trauma Special Interest Group (phew, bit of a mouthful) of which I am a member and former co-chair, that the APA is considering accepting as official and credible but heaven knows how long that might take.  As you say, the likely impetus is fresh blood and no longer being able to ignore the loads of research affirming the WHO ICD-11 diagnosis. We shall see. 

[tofubreadchillicoriander]

From a website

The exact release date of the DSM 6 has not been announced yet. However, the American Psychiatric Association (APA), the organization responsible for publishing the DSM, typically releases new editions every 10-15 years. The previous edition, the DSM-5, was published in 2013, so it is reasonable to expect the DSM 6 to be released sometime in the next few years.

Fingers crossed it's sooner rather than later and that C-PTSD will be given it's due. As Tim Fletcher said, if it will be given proper due, the DSM will shrink to the size of a pamphlet.

That goes to show how much many of the diagnosis we see today are just symptoms of complex trauma.