Cultural or sociocultural differences?

[Sceal]

I might be a little influenced by all this talk of research and authenticity at uni.  But I had a thought... I  havent looked it up online yet, but maybe you guys have some thoughts or have read something?

Does culture and/or socioculture make a difference to how PTSD is "played out" symptomwise? Do different cultures  handle the disorder differently? Does it play a part in recovery?

Notice I am not asking for the cause of PTSD, and neither do I mention the C part as so many places  quite "accept" the Complex part. I also do know that many of you here who suffer do not have the funds or oportunity for therapy treatment. Im not really talking  about that either..

Let me try it this way. Norway  rated this years happiest country in the world. Norwegians are also known to be cold and modest people. And highly individual. And then in contrast there is Italy who is known to be passionate and vocal people where family matters a great deal.  Does the two different  culture and society affecy PTSD, if yes, then how?

[Liminality]

Interesting topic.

I'm not quite sure how to answer, as I don't know anyone else in my country with either PTSD or CPTSD to compare my own symptoms with. I'm also not quite sure if you're asking how PTSD manifests in people with the syndrome, or how the syndrome is understood in our different countries and/or by people who don't have it? But my confusion may be because I still don't get every subtleties of the English language.

In any case I'll be interested to see how other people here answer.

[Sceal]

Interesting topic.

I'm not quite sure how to answer, as I don't know anyone else in my country with either PTSD or CPTSD to compare my own symptoms with. I'm also not quite sure if you're asking how PTSD manifests in people with the syndrome, or how the syndrome is understood in our different countries and/or by people who don't have it? But my confusion may be because I still don't get every subtleties of the English language.

In any case I'll be interested to see how other people here answer.

Your confusion might also lie in the fact that English is not my first language and I'm explaining myself poorly
I think I mean more on how PTSD is understood in our different countries. Both by people who do have and people who doesn't. And whether there is a higher social stigma one place compared to another place for mental illness? Or whether some people treat it as a group/family "problem" rather than leaving the person to deal with it on his/her own? Does various countries/cultures provide various social support?  So many questions!

[Liminality]

Oh! Alright, I understand better now. Thank you for explaining again, and sorry for the confusion.

So uhm, right this moment I'm not comfortable disclosing exactly where I live (it may change later), but it's a first world country. My culture is mostly individualistic, but as my people used to be oppressed by the dominant culture's system (mostly through being deliberately kept in poverty and shamed/kept from having important jobs because of religion and language), there's a tradition of being superficially congenial but really wary/judgemental of outsiders. Basically you can come live with us and we'll be polite, but you'll never really be "one of us" (especially if you don't have the same accent). And that includes people born in the same exact culture but coming from a different city where the accent is a little different, not just immigrants from other countries, because for some reason I can't fathom there used to be random feuds between the big cities. It's a really backward way of thinking, fortunately getting better but not as quickly as it should (and not as quickly as the rest of the world either). And so, my point is that despite the individualist culture, there's also an important undercurrent of "stick with your people" (where "your people" is anyone sharing the same culture and background, and no other).

Now, for your question. From what I gather speaking with people around me, PTSD and CPTSD are two very different things. PTSD is associated with veterans and a "noble" syndrome without too much stigma... unless you get it from assault, and then you get shamed with oh-so-funny comments about not having been to war. Doctors of course are a bit better in that they don't shame you, but every time I've brought up having flashbacks I've been dismissed because my diagnosis isn't PTSD but BPD (aka I never got any help whatsoever), so... yeah.

CPTSD just doesn't exist, virtually nobody heard about it and symptoms are clumped with various PDs, most notably BPD, or if you have huge mood swings they'll consider Bipolar Disorder instead. Unless they have first-hand knowledge (aka, they know someone with a BPD diagnosis or have been mis/diagnosed with it before), most people give you a wide berth when you tell them about it because they've all seen movies with spectacular misrepresentation, and most doctors/nurses/therapists treat you like a difficult patient within five minutes of having met you. The stigma is so ingrained that to prevent patients from feeling stigmatised, the PD-specialised centre I was sent to refused to acknowledge psychiatric diagnosis out loud. "We don't use those words because we treat personal difficulties here, not psychiatric troubles," they said. (But of course when you doubt your diagnosis you're shut down. And misdiagnosis occurs at an alarming rate. A friend of mine was told she was BPD when in fact she was having post-partum depression.)

Also, not so much anymore because despite everything I just told you the mental health system is getting better and awareness is slowly rising, but up until 20 years ago if you weren't obviously in a psychotic state then you weren't ill (according to your family). You were "down" or "negative", but you didn't suffer from depression. You were "temperamental" or "a little strange", you didn't have a PD. You were "paranoid" or "an hermit", you didn't suffer from anxiety. And those were considered normal in many families, mostly joked about because everyone had at least one "weird" family member. So that mentality is still there somewhat, in judgemental undercurrents and passive-aggressive humour mostly because people are too polite to say it to your face, until you get yourself to the hospital and come back with an official diagnosis, and then it's either the wide berth I was talking about earlier, or people actually love you enough to give you benefit of doubt (though they still treat you differently).

I think that about sums it up? Of course, this is my own experience, and it's possible people from less abusive families and backgrounds in the same country have better experiences. Actually I really do hope some people in my country don't have it as bad I as do, 'cause if not that would be depressing.

[AphoticAtramentous]

I thiiiiink I understand the question. Hopefully! And hopefully I'll answer it correctly haha.

I live in Australia but my family are of Chinese origin. It's very much a "Do as you're told", "Elders are always right", "Suck it up", kind of living. If you're under 18 and you have a mental problem, it gets swept under the rug. My sister has ADHD and my family does nothing to help, her grades are $%^&# and they just tell her to "Work harder" as if that will fix everything. So yeah, if even just ADHD is something that "doesn't exist", then CPTSD certainly doesn't either. In fact, what I (and most other countries) would label as 'abuse', Chinese culture would label as 'adequate discipline'. I remember crying hard in the car when I was 7 or so years old, nobody was comforting me, instead I was slapped, told to shut up by my grandmother. Isn't that nice...
I don't mean to sound racist but this stuff makes me hate my Chinese origins so much. Parents wanted me to marry an Asian man and I 'noped' out of that. Haha
It's nice to live in a country (Australia) where you can easily get help if needed and not told to just 'suck it up'.

As for PTSD, I'm not sure how that would go.

Also these are just my experiences. Not trying to stereotype the entire country or anything.

[Liminality]

I don't mean to sound racist but this stuff makes me hate my Chinese origins so much.

I relate to this so much. My parents were from two different countries, so I'm trapped between feeling "allegiance" to my non-abusive mother's country (the one I live in) where I've always felt like an outsider and which treated me pretty badly, or to my abusive father's country (the one I've never been to) which I was brainwashed as a child into believing was my "real home" despite never setting a foot there, and is of course closely linked to my abuser.

In my case at least, hating my origins is less a form of racism and more a form of self-hate. I don't hate other people coming from either country, and despite the fact I hate the customs that made me suffer, I can't say I hate everything I was ever taught. There were good things, I just hate what's related to my abuse. Some days it's hard to remember though, especially when I'm in pain.

[Sceal]

Oh! Alright, I understand better now. Thank you for explaining again, and sorry for the confusion.

So uhm, right this moment I'm not comfortable disclosing exactly where I live (it may change later), but it's a first world country.

I can understand that. I don't want to say where I am from just yet either. Although I'll probably let it slip sometimes. (if I haven't already)

Now, for your question. From what I gather speaking with people around me, PTSD and CPTSD are two very different things. PTSD is associated with veterans and a "noble" syndrome without too much stigma... unless you get it from assault, and then you get shamed with oh-so-funny comments about not having been to war. Doctors of course are a bit better in that they don't shame you, but every time I've brought up having flashbacks I've been dismissed because my diagnosis isn't PTSD but BPD (aka I never got any help whatsoever), so... yeah.

When I learned I had PTSD in the first place my ex-T told me there are 3 types of PTSD. Simple PTSD, which is rare, is the PTSD that is develloped after a one-time event and do not have any extra problems. Then there's Comorbid-PTSD which is when you got PTSD and another mental illness like PD, or Depression or another Anxiety problem. And then there is of course Complex PTSD, which is comorbid + multiple traumas. Which, according to him, is the hardest one to heal from.
Isn't it "funny" how we're taught differently already on what it means?

CPTSD just doesn't exist, virtually nobody heard about it and symptoms are clumped with various PDs, most notably BPD, or if you have huge mood swings they'll consider Bipolar Disorder instead. Unless they have first-hand knowledge (aka, they know someone with a BPD diagnosis or have been mis/diagnosed with it before), most people give you a wide berth when you tell them about it because they've all seen movies with spectacular misrepresentation, and most doctors/nurses/therapists treat you like a difficult patient within five minutes of having met you. The stigma is so ingrained that to prevent patients from feeling stigmatised, the PD-specialised centre I was sent to refused to acknowledge psychiatric diagnosis out loud. "We don't use those words because we treat personal difficulties here, not psychiatric troubles," they said. (But of course when you doubt your diagnosis you're shut down. And misdiagnosis occurs at an alarming rate. A friend of mine was told she was BPD when in fact she was having post-partum depression.)

I was also misdiagnosed Borderline PD. I fought for years to get that removed because I felt I didn't fit all the criteria. But because I was young at the time, and I did SI, they decided that was it. It was incredible stigmatising. If I needed help with physical issues I was usually just given a relaxant, because "It's all in your head". Similarly here, the mental health system and knowledged has improved greatly the past 10 years alone. (unless it's now a product of having the right diagnosis?) Socially though there's alot going on in the media about reducing stigma for certain diagnoses like anorexia, anxiety and schitzophrenia. They've yet to cover what depression really means, or PTSD, or any of the PD. There's articles here and there about how "everyone" with PD's are manipulative and dangerous. I'll admit that pisses me off. They've reduced the whole "The killer is mentally ill." "The killer suffers from [this or this] psychiatric illness", which I think is quite helpful. There is an enormous amount of coverage of SA in the media this past two years, but never mention of PTSD, or the after-effects of such a trauma. Maybe that will come soon?

I think that about sums it up? Of course, this is my own experience, and it's possible people from less abusive families and backgrounds in the same country have better experiences. Actually I really do hope some people in my country don't have it as bad I as do, 'cause if not that would be depressing.

maybe it also differes from clinic to clinic on how PTSD are recognized and accepted amongst T's?

[Sceal]

I thiiiiink I understand the question. Hopefully! And hopefully I'll answer it correctly haha.

I am notorously known for explaining myself poorly. But from your answer I think you got it too

I live in Australia but my family are of Chinese origin. It's very much a "Do as you're told", "Elders are always right", "Suck it up", kind of living. If you're under 18 and you have a mental problem, it gets swept under the rug. My sister has ADHD and my family does nothing to help, her grades are $%^&# and they just tell her to "Work harder" as if that will fix everything. So yeah, if even just ADHD is something that "doesn't exist", then CPTSD certainly doesn't either. In fact, what I (and most other countries) would label as 'abuse', Chinese culture would label as 'adequate discipline'. I remember crying hard in the car when I was 7 or so years old, nobody was comforting me, instead I was slapped, told to shut up by my grandmother. Isn't that nice...
I don't mean to sound racist but this stuff makes me hate my Chinese origins so much. Parents wanted me to marry an Asian man and I 'noped' out of that. Haha
It's nice to live in a country (Australia) where you can easily get help if needed and not told to just 'suck it up'.

As for PTSD, I'm not sure how that would go.

Also these are just my experiences. Not trying to stereotype the entire country or anything.

I've heard that chinese culture is very much about being productive and have the "correct behaviour", and it seems from what you say here that is still rather accurate.
It must be such a huge problem for the suffering population when it isn't recognized on any level so they have a chance of getting better, and be more integrated within themselves and into society.

It's good to hear you now live in a place where you can get help when you need it.

[I like vanilla]

I  understood the question, but then I am also an abstract thinker

I am still unfortunately unsure of the answer as I do not know enough people with CPTSD, especially enough to compare across cultures. My sense, however, is that you might be on to something. I can think of an analogy from a book 'the sociopath next door' by Martha Stout.

Yes, I recognize that ASPD (anti-social personality disorder, the new name for psychopaths and sociopaths) is a personality disorder and CPTSD is an anxiety disorder. I also recognize, as does Stout, that having a PD in no way equates to being a violent killer (though being a violent killer often equates to having ASPD). But for the purposes of a thought exercise in response to the question here goes...

Using data from the literature, Stout shows that rates of ASPD are fairly consistent across human populations no matter the cultures of the people involved (if I remember correctly Stout cites about 4% of people have ASPD). Stout then compares responses and outcomes of people with ASPD across cultures. Those with ASPD thrive on the admiration and approval of those around them. So, they are able to learn to adapt their behaviours to cultural ethos in which they live.

Stout argues (again from the literature) that in highly individualistic societies (she uses the U.S., likely because that is the place where much of the research is done, but other countries certainly match that ethos) those with ASPD thrive and are 'allowed' and able to wreak all kinds of havoc on those around them - no, not 'just' being serial killers but along the full scale from career criminal to garden-variety bully/abuser. I live in a highly individualistic society and regularly hear excuses for bullies and abusers because there is such an emphasis on individual expression people seem almost unable to say 'no, that behaviour is wrong even if it is individual expression!' 

In contrast, Stout then looks at societies that are more communally oriented. If I remember correctly, the example was villages in India. The are apparently, the same rates of those with ASPD in these communities as in the highly individualistic ones. However, the damage that those with ASPD is much more limited in the communally-oriented societies. In communally-oriented societies, those with ASPD (and everyone really) quickly learn that acting in ways that harm one equates to harming all and is taboo. Wanting (needing) the approval of those around them, and wishing to avoid their disapproval, those with ASPD learn to control their baser instincts and act in more acceptable community-oriented ways.

Hmmm... in skimming that over it occurred to me that in highly individualistic societies we have created a setting where those with ASPD are able to thrive and be "happy" (as much as anyone with that disorder can feel happy), while making everyone else miserable. In community-oriented societies the one with ASPD might be less "happy" and able to thrive, but everyone else is better off (though I fear perhaps for the spouse and/or children of those with ASPD in communally-oriented societies as the narcissistic supply must be met and there one of the only places to gain it would be in the privacy of one's own home). Food for thought... and a different thread.

OK, so getting back to the original question. I am unsure how different cultures affect the context/healing/lack of healing for those with CPTSD. But, from the analogy of those with ASPD I would think that culture would necessarily also affect those with CPTSD. But what would it look like? Would communally-oriented societies be more supportive, or, for example, would emotional deregulation be a frowned-upon behaviour? (I suppose it would depend on the understanding people have of or meaning that they put on emotional deregulation). Certainly, and anecdotally, it is difficult to have CPTSD in a individualistic society as too few are willing to lay blame at the foot of the abuser, and really at the dog-eat-dog world that created the context in which the abuse happened.

Interesting question. I need to head out for an appointment. But maybe later I will do some scholar googling on it.

[Sceal]

Very interessting thoughts, Vanilla!
I am a little under the weather cognitively these days, so it might take me a while to respond properly to this. Just wanted you to know I've read your post!

[RedRat]

I do live in a country that is very diplomatic and usually frowns individualistic behaviour that is shown too openly. It is still in Western Europe but has a long history of different ethnic, linguistic and religiously different groups "collaborating". Meaning to dislike on another but not showing it too openly as we depend on each other (the large national states surrounding us used to be the bigger threat). It is rather important not to stick too much out compared to more outgoing people such as Germans or Italians.
We are not living in large thigh knitted family groups and the collaboration level certainly differs from rural India. In the alpine village I lived for several years collaboration was a huge thing as you had a good chance to be cut off for a week and in the neighbouring village you could easily be stuck for a month or so during winter (so you better want your neighbours to like you). In the larger cities at the other hand foreigners often complain that we are cold and distant what is certainly true. Yet we have high levels of community activities especially social clubs for sports, music or social volunteering compared to other countries. So it's individualistic but too a more limited extent.

Yet, the behaviour of my parents doesn't seam to differ from what people in the US or Australia experience with their parents. It is even frighteningly similar. That goes down even to very specific behaviour like the ways we were punished or the ridiculous children's clothes my mother forced me to wear as a teenager. My father was an open narc and behaved like one. Big cars, big sunglasses, lots of bragging about money (often falsely) despite the fact that in my country speaking (or beware bragging!) about money is possibly one of the biggest taboos there is. He couldn't care less.
I would rather assume that they only use culture as an advantage if it suits them. My brother and I like to watch Korean and Japanese crime movies and thrillers. It's horrifying how Narcs and Psychopaths are depicted. It seems they are every bit the same as in our culture while everybody else around them differs much more in their behaviour.

Regarding the cultural reaction of everyone else. Well,  here they don't thrive as directly but they have other advantages: the community has a strong sense of how things are supposed to be in order for the community to thrive. Nobody wants that shared dream shattered. So it's not a Narc's haven regarding bragging but definitely for abuse behind closed doors as everyone assumes that bad things only happen in other countries. Be diplomatic in every situation and don't point at others (at last not directly, passive aggression is fine). We are not one of the worlds best known tax havens for nothing, We are good with skeletons in the closet.

Regarding my own C-PTSD. I don't know if it is just me behaving strangely. I grew up as a scapegoat. So I am aggressive and rebellious. I am behaving completely contrary to the stereotypes and social norms of my country. Rebels and overly individualistic behaviour is very rare here. To put that in to perspective: a recent study found out that people from my country would much more often uncontentiously play dumber to make themselves appear to be more average than anyone else in the Western Hemisphere.
So predictions of how I would turn out as a child of a narcissist are more accurate than what one would guess from my passport. Mute and diplomatic? Not a bit.

Also I suppose there is a reason why people in this forum seem to understand one another so well. We have all kinds of cultural and social backgrounds. There should be much more bickering and misunderstandings. Yet things are almost suspiciously smooth. Technically Narcs and Psychopaths lack empathy. They have their set of tricks but they don't have a high EQ. So they are strangers in our society and I suspect they behave as such no matter the cultural make up. But I admit that this is just my own conclusion.

I have to say it gives me the creeps when I read about a Narc from the US or Mexico behaving according to the exact same text book as my parents despite the huge cultural gap in between. That sort of shouldn't be possible.