17.} The Soul of the Heart Matters

Development of PTSD is unpredictable and can occur at any age.

The severity and timing of symptoms differs from person to person.

Cases are categorized by the following classifications:

Acute: symptoms present less than three months.

Chronic: symptoms present three months or longer.

Delayed Onset: no symptoms present for at least six months.

PTSD typically develops immediately after the trauma, however

symptoms may not emerge in some individuals until years afterwards.

Also, trauma may induce either mild symptoms or chronically debilitate.

Recovery from trauma is possible naturally over time, but manifestations

lasting a year or more do not resolve unless treatment is actively pursued.

PTSD sufferers experience an array of symptoms after traumatic episodes.

These persist in avoidance behaviors, requiring treatment for recovery.

Variables surrounding traumatic events influence how PTSD develops.

Elements that could vary the degree and likelihood of PTSD:

uncontrollable, unexpected, or inescapable events;

human-caused, rather than natural, events;

assault, often with a sense of betrayal;

degree of threat, suffering, or fear;

past and present vulnerabilities;

insufficient emotional support;

concurrent causes of stress;

a false sense of responsibility;

genetically or by other potential

combinations of childhood trauma, but most

especially, childhood emotional and physical abuse;

long-term injury and torture of repeated violent acts.

During long-term traumas, a victim is often

held in a state of captivity.

In such

situations,

the victim is

under the control

of the perpetrator

and unable to flee.

Requisite one for a

diagnosis of C-PTSD

is extended periods

(months to years) in

someone else's

total control;

second is long-term,

severe maltreatment

such as abuse beginning

in childhood and continuing

throughout that person's life.

Post-Traumatic Stress Disorder

(PTSD) has been found to be an

undiagnosed and underdiagnosed

illness in the primary care setting.

Patients with histories of child abuse

in addition to physical or sexual trauma

are known to have developed depression,

substance abuse, hypertension, obesity,

diabetes, and somatic disorders.

Gaps in continuity of care

will bring an early death

to those lacking the proper

motivation to live healthier lives.

Primary care treatment is often based

on symptoms of depression and anxiety.

Lack of time prevents primary care providers

from properly assessing and counseling, or providing

referrals for proper health care that will actually help their

patient to recover some semblance of normalcy in their troubled

lives with the aid of therapists, psychiatrists or group therapy meetings

where peers can share struggles with flashbacks or content of distressful dreams,

emotional numbing, avoidance, hyper-arousal, anger, frustration, anxiety, depression,

disassociation. PTSD presents with numerous hard-to-treat symptoms like chronic pain,

avoidance, risky sex behavior, substance abuse, suicidal ideation, plus eating disorders.

Social, family and work issues become added to the recovery as progress allows.

Adults with C-PTSD sometimes experienced prolonged interpersonal

traumatization as children as well as prolonged trauma as adults.

This early injury interrupts the development of a robust sense

of self and of others. Because physical and emotional pain

or neglect was often inflicted by attachment figures such

as caregivers or older siblings, these individuals may

develop a sense they are fundamentally flawed

and that others cannot

be relied

upon.

This can

become a

pervasive way

of relating to others

in adult life described

as insecure attachment.

The diagnosis of dissociative

disorder and PTSD do not include

insecure attachment as a symptom.

Individuals with Complex PTSD also

demonstrate lasting personality

disturbances with a

significant risk of

revictimization.

Six clusters of

symptoms have been

suggested for diagnosing C-PTSD.

1: alterations in regulation of affect in expressing emotions;

2: alterations in attention diminish executive the functionions;

3: alterations in one's self-perception reveals differences to others,

4: alterations in relating to others including isolation and withdrawal,

5: the psychological distress and anxiety of somatization,

6: fundamental alterations in systems of meaning.

Experiences in these areas may include:

Difficulties regulating emotions, including symptoms

such as persistent dysphoria, chronic suicidal preoccupation,

self injury, explosive or extremely inhibited anger (may alternate),

or compulsive or extremely inhibited sexuality (may alternate).

Variations in consciousness, which can include the forgetting

of traumatic events (psychogenic amnesia), reliving experiences

(either of intrusive PTSD symptoms or in ruminative preoccupation),

or having episodes of dissociation.

Changes in self-perception, such as a

chronic and pervasive sense of helplessness,

paralysis of initiative, shame, guilt, self-blame,

a sense of defilement or stigma, and a sense of being

completely different from other human beings

Varied changes in the perception of the

perpetrator, such as attributing total

power to the perpetrator (caution:

victim's assessment of power

realities may be more

realistic than the

clinician's),

becoming

preoccupied with

the relationship to the

perpetrator, including a

preoccupation with revenge,

idealization or paradoxical gratitude,

a sense of a special relationship with

the perpetrator or acceptance

of the perpetrator's belief

system or rationalizations.

Alterations in relations with

others, including isolation and

withdrawal, persistent distrust,

a repeated search for a rescuer,

disruption in intimate relationships

and repeated failures of self-protection.

Loss or change in, one's system of meanings,

which may include a loss of sustaining faith

or a sense of hopelessness and despair,

as emotional dysregulation brings forth...