# Complex PTSD



## healthbound (Mar 19, 2006)

*Complex PTSD: A National Center for PTSD Fact Sheet*
By Julia M. Whealin, Ph.D.

*What are the differences between the effects of short-term trauma and the effects of chronic trauma?*
The diagnosis of PTSD accurately describes the symptoms that result when a person experiences a short-lived trauma. For example, car accidents, natural disasters, and rape are considered traumatic events of time-limited duration. However, chronic traumas continue for months or years at a time. Clinicians and researchers have found that the current PTSD diagnosis often does not capture the severe psychological harm that occurs with such prolonged, repeated trauma. For example, ordinary, healthy people who experience chronic trauma can experience changes in their self-concept and the way they adapt to stressful events. Dr. Judith Herman of Harvard University suggests that a new diagnosis, called Complex PTSD, is needed to describe the symptoms of long-term trauma. 

*What are examples of captivity that are associated with chronic trauma?*
Judith Herman notes that during long-term traumas, the victim is generally held in a state of captivity. In these situations the victim is under the control of the perpetrator and unable to flee. 

Examples of captivity include: 


Concentration camps
Prisoner of War camps
Prostitution brothels
Long-term domestic violence
Long-term, severe physical abuse
Child sexual abuse
Organized child exploitation rings
*What are the symptoms of Complex PTSD?*
The first requirement for the diagnosis is that the individual experienced a prolonged period (months to years) of total control by another. The other criteria are symptoms that tend to result from chronic victimization. 

Those symptoms include:


Alterations in emotional regulation, which may include symptoms such as persistent sadness, suicidal thoughts, explosive anger, or inhibited anger
Alterations in consciousness, such as forgetting traumatic events, reliving traumatic events, or having episodes in which one feels detached from one's mental processes or body
Alterations in self-perception, which may include a sense of helplessness, shame, guilt, stigma, and a sense of being completely different than other human beings
Alterations in the perception of the perpetrator, such as attributing total power to the perpetrator or becoming preoccupied with the relationship to the perpetrator, including a preoccupation with revenge
Alterations in relations with others, including isolation, distrust, or a repeated search for a rescuer
Alterations in one's system of meanings, which may include a loss of sustaining faith or a sense of hopelessness and despair
*What other difficulties do those with Complex PTSD tend to experience?*

Survivors may avoid thinking and talking about trauma-related topics because the feelings associated with the trauma are often overwhelming.
Survivors may use alcohol and substance abuse as a way to avoid and numb feelings and thoughts related to the trauma.
Survivors may also engage in self-mutilation and other forms of self-harm.
There is a tendency to blame the victim.
A person who has been abused repeatedly is sometimes mistaken as someone who has a "weak character."
Because of their chronic victimization, in the past, survivors have been misdiagnosed by mental-health providers as having Borderline, Dependent, or Masochistic Personality Disorder. When survivors are faulted for the symptoms they experience as a result of victimization, they are being unjustly blamed. 

Researchers hope that a new diagnosis will prevent clinicians, the public, and those who suffer from trauma from mistakenly blaming survivors for their symptoms.

*Summary* 
The current PTSD diagnosis often does not capture the severe psychological harm that occurs with prolonged, repeated trauma. For example, long-term trauma may impact a healthy person's self-concept and adaptation. The symptoms of such prolonged trauma have been mistaken for character weakness. Research is currently underway to determine if the Complex PTSD diagnosis is the best way to categorize the symptoms of patients who have suffered prolonged trauma.


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## Meg (Mar 25, 2006)

I read an article about the relationship between borderline personality disorder and the concept of complex PTSD for female survivors of childhood sexual abuse just last week. In fact, I wrote a review of it. I thought that they made a very good point - the comorbidity of these disorders in this population was incredibly high. The value in making one diagnosis of complex PTSD on one axis of the DSM rather than two diagnoses on two different axes seems to me to clarify what is most important in terms of treatment, and also makes it clear that features such as self-harm, which is often associated with borderline personality disorder, are arising from anxiety related to PTSD. I am really interested in this article, thanks healthbound! I hope that this diagnosis is added. 

Meg


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## healthbound (Mar 25, 2006)

Hey Meglet - Great comments.

I'd be interested in reading your review or even the articles you read about the relationship between borderline and complex ptsd???

I strongly believe that Complex ptsd should be added to the DSM.


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## Meg (Mar 25, 2006)

Thanks! 

Here's the reference for the article I mentioned: McLean, L. M., & Gallop, R. (2003). Implications of childhood sexual abuse for adult borderline personality disorder and complex posttraumatic stress disorder. _The American Journal of Psychiatry, 160_ , p. 369.

It's only a brief report so the detail of the introduction and discussion were a little lacking, but they had a decent results section, and I found the analyses that they did quite interesting. I'm not sure if I should post it in case of breaking copyright or something. You might be able to read it at a uni library if you have access to one. I got the impression that it was kind of a summary of a thesis, and I would be very interested to read the entire thing. Anyway, there you go!

Meg


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## healthbound (Mar 26, 2006)

Thanks meglet hopefully I'll get a chance to check it out 

You sound like you are a psych student??? 

I'm fascinated by borderline as a diagnosis in general. But, I'm even more fascinated by the potential relationship between borderline and complex ptsd. And even MORE fascinated by the potential _misdiagnosis _ of borderline and the possible damaging effects of treating a person who has perhaps been misdiagnosed with borderline when perhaps a more accurate diagnosis (and then therefore different and more effective treatment) would be a diagnosis of complex ptsd without borderline?


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## Meg (Mar 26, 2006)

It's certainly an important question. If I get a chance I might have a look for other articles by these authors and see if they've written anything more detailed than that little report. I'll get back to you if I find anything. 

Yes, I am a psych student - I am in the first year of my doctorate in clinical psychology. 

Meg


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## David Baxter PhD (Mar 26, 2006)

healthbound said:
			
		

> I'm even more fascinated by the potential relationship between borderline and complex ptsd. And even MORE fascinated by the potential misdiagnosis of borderline and the possible damaging effects of treating a person who has perhaps been misdiagnosed with borderline when perhaps a more accurate diagnosis (and then therefore different and more effective treatment) would be a diagnosis of complex ptsd without borderline?



That is in fact the other thread of current thinking on PTSD and borderline - that rather than being comorbid disorders it is a problem of misdiagnosis of PTSD symptoms as BPD. I'm inclined personally to believe that's more common, although I'm not trying to say that the two cannot coexist.


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## healthbound (Mar 26, 2006)

> That is in fact the other thread of current thinking on PTSD and borderline


Interesting, I didn't realize that.



> that rather than being comorbid disorders it is a problem of misdiagnosis of PTSD symptoms as BPD. I'm inclined personally to believe that's more common, although I'm not trying to say that the two cannot coexist.


That is exactly what I have been thinking more about. I wonder if those who are predisposed to information/training/experience about borderline, but not ptsd (like someone who specializes in psychodynamic psychotherapy which I understand is commonly used to treat borderline?) may be too quick to make an inaccurate diagnosis of borderline rather than ptsd. In the case of an actual misdiagnosis, I'm nervous about the treatment for the client and think this is where the client is potentially in a bit of danger.

For example, transference seems to be an integral part of psychodynamic psychotherapy, but I seriously question the efficacy of stimulating transference as a way of approaching someone with complex ptsd.

Regardless, I guess it's like many things...diagnosing isn't an exact science. But in this case, I it would be nice if it was a "pretty close to exact science"


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## David Baxter PhD (Mar 26, 2006)

Transference is a part of any type of psychotherapy, to a degree.

<edit>I should have added "I think" or "In my opinion" to the above. I'm not sure everyone would agree with the statement as originally posted. </edit>


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## healthbound (Mar 26, 2006)

Is it?  :red: It makes good sense that it would be. But from what I was reading, it seemed like it was more of an integral part of psychodynamic therapy for both the client and the therapist??


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## David Baxter PhD (Mar 26, 2006)

The term and the emphasis on the process certainly comes from psychodynamic therapies, and more specifically from psychoanalysis. I probably should have preface my earlier statement with "I think" or "In my opinion", but I do think that at the very least without a degree of transference therapy will be less effective.

Transference isn't all about negative feelings or even romantic feelings, although that it probably what is most discussed in common literature.

*Definitions of transference on the Web*

Bad colloquial definition:



> the emotional relationship formed between the patient and the analyst; "falling in love" with the analyst, or temporarily substituting the analyst for the object of desire, etc.
> http://www.geneseo.edu/~easton/humanities/Freud.htm



Better definitions:



> (psychoanalysis) the process whereby emotions are passed on or displaced from one person to another; during psychoanalysis the displacement of feelings toward others (usually the parents) is onto the analyst
> http://wordnet.princeton.edu/perl/webwn
> 
> Transference is a phenomenon in psychology characterized by unconscious redirection of feelings from one person to another. For instance, one could mistrust somebody who resembles an abusive parent or an ex-spouse in manners, voice or external appearance.
> ...



Of these, the highlighted one best describes it, I think. It's like projecting conflicts and insecurities or fears onto a safe canvas where they can be resolved.


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## healthbound (Mar 26, 2006)

At first I just thought transference was "projecting" or in extreme cases a combination of projecting and having a flashback.? Sort of tainting or perceiving similarities about a current situation that is reminiscent of a past disturbing one.

Then after I read a bit more about it, I got confused because, as you mentioned, much of the information related transference seemed to be about sexual or romantic feelings along with abandonment or anger feelings.


How is transference different (or is it different) than simply being able to identify similar situations based on passed experience and therefore being able to make different choices that might minimize the chances of "re-creating" something similar.? I'm not talking about perceived similarities, I'm talking about actual similarities.? For example when one is trying to "break a pattern" of abusive relationships? -? A woman who has been in an abusive relationship, but sought therapy and was able to break free and do some healing.? Later when she is ready to date again, she actually subconsciously chooses a partner similar to her ex.? However, this time, since she'd been through an abusive relationship, she knows certain "tell tail" signs of abusive (or potentially abusive) behaviour.

At what point do we know when we are engaged in transference vs a time when we have actually learned from our past experiences and are simply more conscious about the choices we are making?

Identifying what is "real" and what is "perceived" is one of my greatest challenges.? I think that is one reason why I like to solicit feedback as well as consider many "angles" when making important decisions.? I find it helpful to better understand or consider a few variables and then take those other considerations and match them against my own perceptions/instincts.? Many times my own perceptions/instincts were correct.? But there have also been times when I was wrong too.

It's challenging though.? Because there have times in my past while I was "in" a particular situation, I couldn't consciously see any "clues" about what was happening.? But then in hindsight I was able to see those subtle clues as well as remember that if I ad actually listened to myself/instincts, I could have made alternative choices.? Therefore, is my challenge really more to do with gaining confidence in my own perceptions and instincts rather than assuming that I'm projecting?

I'm sure it's different in every situation.? Maybe that's why (after I decide that I should probably pay attention to what my instincts are saying) that I like going through the process of doing a bit of a reality check with other perceptions.? This way, I can better determine if I am, in fact, perceiving things accurately or distortedly.

I lack confidence in my perceptions because in the past (and still sometimes in the present), there were paradoxes between what was done and what was communicated to me about what was being done.? So, I knew something wasn't "right", but I was told that it was fine and normal, but rather I was "not right" or skewed or whatever.

Actually - one other quick thing...there is always the scenario that a current situation doesn't actually have to do with the past --- and that a person is simply frustrated with what is going on _in that moment _


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## David Baxter PhD (Mar 26, 2006)

First, you need to remember that Freud saw pretty much everything as "sexual" so it really isn't surprising that the colloquial understanding is a little confused.

The best way I can explain how I conceptualize it is this. Look at the highlighted quote above:



> the patient talks to the analyst, s/he transfers his conflicts onto analyst. This creates a controlled situation, a form of repetition of the conflict, in which the analyst can intervene. What is repaired in analysis is not quite what is wrong in real life, but the patient is able to construct a new narrative for herself, in which she can interpret and make sense of the disturbances from which she suffers.



As I said earlier, think of the therapist as a canvas or a projection screen onto which the client can project fears, anxieties, insecurities, doubts, conflicts, etc., without fear of having them deflected back in a defensive way - the therapist doesn't need protecting and therefore doesn't need to deflect them. Or alternatively think of it as a safe enclosure into which all the conflicts and fears and distress can be dumped - you don't need to worry about the fence. Once all these issues are pushed away from you a bit, with the help of the therapist you can look at them from the outside, dissect and reconstruct them, work then out in alternate ways, look at them with different eyes - they are outside you at a safe distance and the therapist is there to keep them at a safe distance. Once they are reworked and understood in a new way, and the relationship between the preent you and these conflicts and fears of yesterday are reconstructed in a way in which you are no longer helpless or powerless, where they are no longer beyond your control - then you can take them back into you as part of you and your past and move on into the future toward your goals.

Like painting, or music, you transfer your feelings, your fears, your conflicts onto a new canvas where they are given new shapes and where you can observe and reconstruct and understand them in new ways.

Now, I honestly have no idea to what extent this reflects common thinking about the process. It's just how I tend to think of it. But it helps me to conceptualize and understand the process in psychotherapy.


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## foghlaim (Mar 27, 2006)

i hope ye don't mind me thinking out loud on this thread.  I was thiinking about the deflection bit, by the therapist.. i.e if the therapist involved can't actually handle the issues the client brings up and "deflects" them back to the client.  could this be ( a reason) why for some.. the connection that's needed to help the client work thru "whatever" issues.. doesn't happen.?? 



> the therapist doesn't need protecting and therefore doesn't need to deflect them.


as a client i have wondered about this.. i usually dismiss it, because of the "Supervisory" (the therapists therapist) aspect that's present with my Dr. (even said i hope you have one if not then we both in trouble).
i'm wondering again out loud... do most clients or all clients try and protect the therapist.. by not saying what they really need \ want to say??   

 sorry for all this.. if it don't belong here on this thread... no problem.. please move to appropraite thread.


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## David Baxter PhD (Mar 27, 2006)

> do most clients or all clients try and protect the therapist.. by not saying what they really need \ want to say??



I don't think so. After all, that's one of the best parts about therapy is NOT having to worry about upsetting the person you're talking to.

If the client is not saying something, it's more likely to "protect" the client, i.e., it's something to distressing or upsetting to the client to talk about (yet).


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## foghlaim (Mar 27, 2006)

ok thanks david.


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## healthbound (Mar 29, 2006)

Although, I have to say that I have done this in the past.

For me, a therapist still represents a person of power and depending on their approach and my perceived dependency on a particular person in a power-position, there have been times when I have forfeited my opinions, perceptions, emotions and behaviors to preserve or "protect" that person even when they are doing something inappropriate. And furthermore, I might wait until I am 98% sure of that something "isn't right" (which usually means repeated incidences of inappropriateness and me protecting them) before I even feel like I have a "right" to talk to someone about it. Even then I notice that I tend to discard my own experience sometimes.

When I've been in situations like this, I have spoke out or asserted myself in the beginning, but maybe I wasn't effective enough, maybe I was too vulnerable, maybe I was scared or maybe it didn't even cross my mind that I would be in a situation where I would be engaged in such a dynamic.

But after having said all that - I've only had that experience with one therapist (and I've seen my share of therapists), one chiropractor, one doctor, both parents (and every other family member), and 2 employers.


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## healthbound (Mar 29, 2006)

Thought I'd add this quote by Dr Baxter in another thread...



> The problem is that people suffering from PTSD are vulnerable to doubting their own perceptions and memories - and sometimes the people close to them take advantage of this for their own reasons.
> 
> Part of the therapy for PTSD is to help the individual learn to trust his/her instincts again. What may be easy and clear for the rest of us is anything but easy or clear for them.



This is exactly what I was trying to describe. In my experience with my current therapist, her approach was more to convince me to see what she was presenting to me rather than sort of following my lead and then helping me "discover" those things "on my own". I felt she didn't really hear me or even value or try to cultivate my instincts or opinions. In fact, my instincts and opinions were invalid and disregarded. That was a huge trigger for me because it reminds me of times when I was "supposed" to be able to rely on the person in the position of power, but I knew or felt that they were doing something "wrong". And then when I spoke up about it, I was told I was wrong, lying, making it up, over reacting, ridiculous, crazy, perceiving things that weren't there etc etc etc.

I strongly agree with Dr Baxter that part of therapy for PTSD is to help a person learn and get better at identifying and trusting his/her instincts. I've had some excellent therapists in the past. Two that immediately come to mind. The one I saw after my sister's death truly believed in me. She really did listen to me and taught me to believe in myself and my perceptions. She really helped me identify my strength, resiliency and spark for life again. Makes me teary eyed every time I think of it. Just the fact that she believed in me and "saw" my value was extremely healing in itself.

But, therapists are humans too  and so there's gonna be some that are better than others. And, there are some whose approach is more effective for PTSD clients than others too.


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## Cat Dancer (Mar 29, 2006)

> For me, a therapist still represents a person of power and depending on their approach and my perceived dependency on a particular person in a power-position, there have been times when I have forfeited my opinions, perceptions, emotions and behaviors to preserve or "protect" that person even when they are doing something inappropriate.



I've done this too, I think. I've been hospitalized twice, once for anorexia and once for depression, both times i was in the hospital for two months. After the first time, I was 17 and at my orthodontist's office and while I was there one of the ladies asked me if I would talk to her counselor friend who worked in the same building. So I did and over the next couple of years I saw him off and on. Then I went away to college and in my second year I kind of had a breakdown and ended up in the hospital again, different hospital, but I saw that counselor because he had an office in the same town. And once he got really mad at me over my self-injury. I don't remember if it was because I did it or didn't do it, or didn't ask for help or because I did ask for help, but he raised his voice and turned red. I was afraid and it was like waves of hotness went all over me,it was fear or something like that. I felt sick. I really couldn't figure out what I'd done wrong and I'm still not sure, but after that I made sure to say what I thought he wanted to hear. I didn't want him to be mad at me. And he used to make me hug him before I could leave which was uncomfortable. I don't necessarily think that was wrong or anything, but it did make me feel uncomfortable.


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## healthbound (Mar 30, 2006)

Hey Janet 

One thing I tend to struggle with from time to time is remembering I'm an adult. I know it sounds "strange" - like, duhhh, who would forget that they're an adult? Well, in my case, I will sometimes have a sort of flashback where I seem to "slip" back into the mindset and emotional experiences of a child. I "forget" that I have rights, power, control over what happens to me and ultimately the ability to direct my life the way I want it to go. This includes saying, "no" to things that don't feel right to me - regardless of whether they actually are or not and disagreeing with someone -- even if they are a doctor, therapist, teacher or employer. I think this is exactly what Dr Baxter was referring to.

Like me, it sounds like you are quick to discount yourself and your instincts, perceptions, feelings and experiences even when you are correct (or even if you're not "correct" - you still feel the way you feel and for that reason alone, you are correct ). Learning to identify my instincts, own thoughts, own feelings own perceptions and even my own experiences is challenging sometimes. And then accepting them as important or of value is awkward. And then taking things one step further and acting or reacting according to my instincts etc. seems almost preposterous.

The good news is that even though this process is confusing and challenging, I have found that every time I don't take a back seat to another person's agenda, I feel a bit better about myself --- AND everything seems to fall right into place. The fears I had about being assertive (or whatever) made sense when I was a child...but, don't make sense now, as I am an adult.

It's a bit tricky because I find that in those scenarios where I am triggered, everything in my being seems to scream "NO!" or "DANGER!" and then, of course, I revert back to the coping mechanisms I adopted when I _was _ powerless and I actually _didn't _ have any control. And that's where I tend to get stuck. I'm learning to better identify when I'm stuck so that I can try to work through things that way.

So far, I think I'm doing ok. I'll realize that I've been really disconnected or that I'm feeling very uncomfortable about something - but I'm not sure what. Then I'll ask myself what's been going on lately etc. I can usually begin to work through things.


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## healthbound (Mar 30, 2006)

I know I'm rambling...but I'm going to try and tell a quick story about an experience I had today that relates to what I'm trying to say. 

I had a dentist appointment today. I haven't met anyone that loves to go to the dentist, but still, I noticed that I seemed to be so preoccupied with the fact that I had to be at the dentist at 2pm today that I almost felt immobilized for the hours leading upto it.

I pushed myself a bit and just continued to get done what I had to get done.

Then, finally it was time for me to go. All of the sudden, I did not want to go. But again, I pushed myself and got in the car. For some reason, as I was driving there, I began to remember the night my sister died. It was strange because I was particularly remembering some details about driving from my place to hers. The memories were vivid, but I seemed to be experiencing them a bit differently than I had in the past. All of the sudden I realized I was remembering that night. It struck me as odd that those memories would pop into my mind like that as I was not driving the same route and I couldn't see the building she was living with at the time etc.

It was a few blocks later that I realized the connection. This was my first visit to see this dentist. Well, it was my first in about 12 years. My son's father still goes to him, and I had recently arranged for my son to go back to seeing him and so I decided to also go back to him. I started going to him when I was pregnant. I introduced him to my son's father, my son and to my sister. I heard of him through a friend of mine who was his assistant. That friend and my sister became really good friends and spent a lot of time together. Also, I the receptionist looks really familiar to me - and I know I know her from my teen years, but I can't seem to place where. I know that the dentist would have heard about my sister's death because my our mutual friend (his assistant) was impacted by her death too. I was pretty sure the receptionist (although I'm not certain) knew about her death and definitely knew me at a very tumultuous time in my past.

I definitely feel safe with him...I know him, remember him and trust him. But, knowing that he and the receptionist know me in other contexts was scary to me.

Once I realized what I was thinking, I felt sad. And that was it. I just felt really sad. Her death was and still is a sad thing.

Actually - I just realized that this story doesn't really relate to what I was saying - lol. Oh well, I'm glad I shared it anyway. I guess one way it relates is that I'm doing some different things compared to the last year - and the last decade, really. The fact that I switched dentists, felt scared but chose to go anyway knowing what I know makes me think I'm making progress. Like, I'm beginning to allow myself to accept more of the present moment instead of recalling and reliving some of my older coping mechanisms. If I were, I probably would have made the appointment and then cancelled it or not shown up because I slept through it - only later to wake up feeling guilty and wondering how I could have done that.


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## Cat Dancer (Mar 30, 2006)

That's true about forgetting I'm an adult sometimes. Kind of embarrassing.? :red: And when I do assert myself I always feel SO guilty. I don't want to hurt anyone's feelings or anything like that. 

I think your dentist experience was a good example of this (working through a situation):



> I'll realize that I've been really disconnected or that I'm feeling very uncomfortable about something - but I'm not sure what.? Then I'll ask myself what's been going on lately etc.? I can usually begin to work through things.



So it DOES fit. 



> Like, I'm beginning to allow myself to accept more of the present moment instead of recalling and reliving some of my older coping mechanisms.



This is good. I'm really going to think about this and try to work on this myself. I have been going too much back to the past and not living enough today. I'm really trying to take better care of myself, exercising and trying to eat better. This is one little thing I can do to be more in control of my life and feel better about me. I need a lot of strength that I just haven't had. I guess we all need strength and ultimately it is up to us to try to find it. 

I always like reading your posts. They're very thoughtful and insightful.


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## foghlaim (Mar 30, 2006)

great posts healthbound....and Janet....... 

there's parts of me in them too.. 

*s*

nsa


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## healthbound (Mar 30, 2006)

Hi guys,

I love that many of us can identify with some of each other's experiences. It reminds me that I'm not an alien.

Orrrrr... if I _am _ an alien, at least I know other aliens now


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## David Baxter PhD (Mar 30, 2006)

Doesn't that little rodent look like he's belting out "I did it myyyyyyyy.... wayyyyyyyyy!"?


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## healthbound (Mar 30, 2006)

hahaha...hilarious. I love that little rodent.


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## foghlaim (Mar 30, 2006)

healthbound... but ye have the hairtwirling thing... so i'm the alien fromm the other planet.. the one to yer left... lol.



david: you're wicked.. heh heh..


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## cindylo (Oct 12, 2006)

Hi

I have just quickly read the above post. I have an interest in trauma. I am wondering if people that are involved in abusive relationships ie a narcissist where there is not necessarily physical abuse could also be diagnosed with complicated PTSD?

Cindy


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## ThatLady (Oct 12, 2006)

In my opinion, trauma is trauma. It doesn't really matter whether the abuse is physical or emotional. It's still abuse, and it's still traumatizing. Therefore, my answer to your question would be: "Yes, such individuals could be diagnosed with complicated PTSD if the necessary criteria were met."


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## cindylo (Oct 13, 2006)

Thanks for your reply.

I believe that being involved with such a manipulative and abusive individual would be enough to send a person insane.

Thanks again

Cindy


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## tasha (Dec 5, 2010)

healthbound said:


> Hey Janet
> 
> One thing I tend to struggle with from time to time is remembering I'm an adult. I know it sounds "strange" - like, duhhh, who would forget that they're an adult? Well, in my case, I will sometimes have a sort of flashback where I seem to "slip" back into the mindset and emotional experiences of a child. I "forget" that I have rights, power, control over what happens to me and ultimately the ability to direct my life the way I want it to go. This includes saying, "no" to things that don't feel right to me - regardless of whether they actually are or not and disagreeing with someone -- even if they are a doctor, therapist, teacher or employer.


 
This is exactly how I feel most of the time.  I allowed it to ruin my marriage because I very often perceived myself as a child incapable of exercising my rights & opinions.  It was a good marriage, but I became fearful & resentful of being "treated like a child" when it was actually me reverting to my childhood reactions to perceived "authority".  Sadly, my marriage ended before I knew I had C-PTSD.


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