Complex Post Traumatic Stress Disorder in Children

In today’s society, there’s a significant number of individuals who are exposed to traumatic events. In the book, Trauma and Recovery, author Judith Herman, who is an influential clinical psychiatry known for her studies on traumatic stress, demonstrates the concepts of Complex Post Traumatic Stress Disorder (C-PTSD) with an emphasis on child abuse.

Judith Herman argued convincingly in his book Trauma and Recovery that a single exposure traumatic event can happen anytime while prolonged complex trauma, by contrast, occurs only in circumstances of captivity. C-PTSD is an extension of Post Traumatic Stress Disorder, which it focuses on ongoing abuse instead of single exposure traumatic events. Comparing to ordinary PTSD, complex trauma disorder produce more profound and enduring changes in our body and neveral system which often lead to shorten of life span. As time passes, those symptoms that are established within traumatized children become more prominent in their adolescence. Even when the individual is eventually being removed from stressful environment, those symptoms still persist as the individual maladaptive the new environment without danger. For instance, they cannot get back to normal lives because because the truma periodically interrupts through unpredictable vivid images and sensations of the trauma, causing psychological harm such as isolation and dissociation.

The periodically confront and instill of helplessness and fear destroy the ordinary individual’s adaptation to community and self. The captivity convince the victim of repeated trauma that resistance is futile. For example, in the movie Room, a movie showcased the experience of a girl being abused and held hostage in a small basement for seven years, the perpetrator demoralized the girl by destroying her autonomy. Depression, anxiety, suicide come as the results of her hopelessness to escape and detachment with the rest of the world. As time passes, she started to think of how to stay alive rather than escape. But later, her son, also the rapist’s son, acted as external coping, helping her regain the determination to live. Her intrusive symptoms after release are more serves than those of female who were raped once. She is more vulnerable to disappointments due to her lost of hope during the long confinement. Plus, it is highly possible for her to past her stress and alternation toward certain things to her son.

Judith Herman demonstrates in his book Trauma and Recovery that the chronically abused child’s emotional states are disrupted through the formation and deformation of personality. According to a lab conducted by Lenore Terr, a well-known psychiatrist, traumatic memory happened to children before they were two and one-half years old were indelibly encoded in their memory through visual and enactive form of memory such as play and drawing. Just as other traumatized adults, traumatized children often altern the harsh reality through dissociation. In incidents such as parental scapegoating, children would self-blame and think that people suffer because of them.

Moreover, abused children are rageful and aggressive when approach problems because those devices are usually how they obliterate their chronic dysphoria, and there's a high possibility of them taking aggressive actions on themselves, leading to self-injury. Furthermore, a child would be unable to develop a sense of autonomy under repeatedly stressful experience and therefore remains more dependent that other children. The chronic bad events deduct the child’s positive view on the world, and thus they assume that the world as a dangerous place and that they made everyone around them suffer. Chronically traumatized people often are less likely to have active engagement with the world since they are generally passive and helpless.

Judith Herman also insists that chronically traumatized people often are less likely to have active engagement with the world since they are generally passive and helpless.

Traumatic events breach individual’s attachments towards individuals and communities. This would lead to the damage of self-care as the traumatized individuals lose their basic sense of self. For instance, Sylvia Plath committed suicide as her life gets more despair by prolonged domestic abuse. As stated in her book Unabridged Journals: “I took myself in leash and washed my battered face, smeared with a purple bruise from Ted and my neck raw and wounded, too.” She is under domestic captivity and subordination, and she chooses to forgive her husband over and over again which result in turning to blame herself. She directed her rage against herself which lead to her self-injury and suicide.

Victims of childhood abuse developed extraordinary capacities such as the practice of doublethink to adapt the unbearable reality. George Orwell in his book 1984 defines as “the power of holding two contradictory beliefs in one’s mind, and accepting both of them.” Individuals alter their abnormal unconsciousness and consciousness through dissociation of personality and formation of hallucinations. There’s a positive correlation between period of captivity and level of disconnection.

Social attitudes of some cultures failed to recognize most repeated child abuse as violation. For example, Asian cultural norm is based on the idea of “respect the elder”, and youth have to follow everything said by the elder. In each of these instances, the youth develop a wrong ideology in which they think that they are responsible for those relationships as the victim. Even when they struggle to fight back, they are more likely to lose in the unfair fight. Children perceive that nothing is wrong with their situation and, as a result, do not seek for external coping methods. Their initiative and judgements are shutted down as a result of duress. They became the victim of Complex Trauma and lose their sense of self. Trauma children have more difficulties with their adaptation to adult life. They can find it difficult to accurately assess danger, and they, as a result, are more likely to repeat the victimization later in their adult life. Plus, the psychologist Josefina Card has found that those traumatized individuals reported having difficulties to get along with their wives or girlfriends, which means that they are more likely to have marriage problems such as divorce. In order to diagnosis, the survival needs external coping from people who recognize the exposures as traumatic event and are not going to blame the survivor.

However, due to the lack of knowledge on the effects of captivity, the society does not take Complex post-traumatic stress disorder seriously and mislabels it as normal PTSD. There is a strong tendency of blaming the victim, so psychologists need to understand the perpetrator’s crimes through the lense of the victims. The current DSM Diagnosis of PTSD give us classifications on diagnosis and treatments toward specific symptoms, but it lack of accurate understanding of the complex trauma disorder, which has greatly impacted the effect of treatments. In general, the symptoms of individuals who are exposed to prolonged trauma are not the same as ordinary disorders. Without its own canon in the DSM, the psychiatrics often try to fit C-PTSD patients into mold of existing general PTSD treatments.

Psychiatrists need to understand the corrosion of personality caused by prolonged stress and terror. When conducting treatments, we need to first acknowledge the individual’s childhood history, adaptive style level, and emotional health level. That is, we can not treat individuals who had prone to autism the same diagnosis as a periously mentally health person, even toward the same event. C-PTSD patients who have multiple underlying characteristics are at risk of being misdiagnosed as personality disorder.

People of prolonged exposure to traumatic events need social context-relationships with family and friends- to hold back the PTSD. Traumatized children must find way to form attachments and intimacy, such as trusts and safety, toward caretakers and out of the familial community and to maintain hope and meaning to goals and future. Psychiatrists also need to construct an explanation for traumatized children that release them from self-blame and self-harm. In order to do this, psychiatrist heed first let the child believe that unbearable event had occurred, which would lead to worse symptoms. We need to let children know that dissocationtion would not externally help them to alter the harsh reality, and they need to learn to remember it occasion and justifies it.

Although the complex traumatic disorder has not yet been accurately defined, it has gained wider recognition by many researchers and psychists. At close future, it would have its own portion in the books for diagnoses.