[Music]
cptsd
pervades all areas of a sufferer's life
there are key
cognitive behavioral physiological and
emotional signs of the disorder that
patients and supporters alike
can look out for dr romini walks through
those symptoms
in this session can someone develop
cptsd
while the abuse is still occurring so
while the abuse is
still occurring absolutely you're going
to see very likely
the um many of the patterns you'd see in
ongoing see ptsd
that they'll be emotional numbing that
there'll be
a fear and a confusion about
close relationships there'll be shifts
in their self-perception
viewing themselves as bad negative
damaged and helpless there also are
shifts in their perception
of the perpetrator they sometimes view
the perpetrator as all-powerful and
all-knowing
there are times i'll have fantasies
about revenge against the perpetrator
all of that can be happening in real
time what we
however what you got to keep in mind is
if the perpetration
stops those patterns don't stop you know
what i'm saying that the two
so yes they absolutely can develop at
the same time and i must say i've
worked with clients who will share with
me that while it was happening
their sense of valuation just kept
deteriorating a very common theme i'd
hear
particularly in women and girls who were
sexually abused as
as girls for years and years and years
it really
impacted their sense of body image they
had a very distorted sense of themselves
of their bodies as their bodies start
sexualized more and more they'd cover it
up they would develop eating disorders
or distorted body image so
you'd see again all these plates sort of
shifting developmentally
because these are children being
affected when it comes to spotting the
signs
we break them up into a few categories
the cognitive physiological emotional
behavioral
let's start with uh cognitive what are
some of those words
so when we talk about any kind of a
cognitive symptom or cognitive sign
it's an alteration in how a person is
thinking
and perceiving and even believing okay
so it's a
and t when we look at a cognitive
symptom it's a
it's a problem or a disorder and
thinking it's a distortion
more often than not so the kinds of
cognitive distortions we can see
in ptsd are often about the self viewing
themselves
as bad as damage sometimes even blaming
themselves that's
that's not an uncommon theme that
somehow they were complicit
in their own abuse maybe i shouldn't
have said that maybe well i didn't try
to run away
is one they'll blame themselves for you
know
for something happening to them again
them against their will
they'll view themselves as helpless and
powerless
and they'll take that perception of
powerlessness and helplessness
into other areas of their lives and
almost feel crushed
when they can't for example in school or
in a job
because that sense of helplessness that
sense of powerlessness
tends to dog them in other areas so
these are incorrect perceptions
so when we see those and they're so
distorted and they're so consistent
that's not an uncommon pattern at all in
cptsd
what about things like flashbacks and
suicidal ideation
those absolutely those would definitely
fall under the cognitive symptoms
not just of cptsd but also of ptsd
so it's this re-experiencing when a
person experiences a trauma
one of the hardest things that happens
for them is the re-experiencing
and if you talk to someone who's
experienced trauma what's so
heartbreaking
is things in their environment can set
it off it could be anything
a time of day a sound and they
re-experience it
the re-experience though is them not
actually experiencing that but to them
it is
well they're thinking about it they're
saying okay they're thinking about it
they're in it they can't break out of it
they will um in fact people who are with
them might even feel that in the moment
they become mildly dissociated
like they're in that space and they're
far away
many many many clients over the years
where we're doing the traumatic work
and i start to lose them i can see
they're slipping and i'm like come back
in
i need you here because what i want to
do
any of us who work in trauma is we don't
want their thinking
about the trauma to become so
dissociated because then they're back in
it
i want them in the room you know i'll
it's in fact that will almost
almost make noise like you're here
you're like we're talking about i'm
still getting this yeah you know
right here we're talking about it it's
not happening right now and so it's
really keeping them
in the room it's okay i'm here you're
safe
no one can come in like but you're
keeping them in the room
but that re-experiencing it's a mental
re-experiencing but
some people will literally describe like
they feel like their body is in it again
they feel like they're being held back
and i'll even see that in their posture
like they're back like
they're being held you know what was
done to them was being done to them and
so it's it's devastating it's absolutely
devastating
and this isn't a conscious choice this
is
a a subconscious way to cope right it's
it's i mean
trauma chops up the brain a bit right
you know it
really the brain is amazing and how it
tries to protect itself but there's more
and more interesting work on how
the brain isn't the only place that
holds memory our bodies hold memory too
and a lot of this you know interesting
work that's coming out on trauma is
really understanding
how our bodies hold this too people feel
this physically
all over their body and so we can't
underestimate that
it's very easy i mean listen i'm all
about the penthouse suite here
but it's all happening around the body
one pattern we do observe
in cptsd is disruptions and attention
and concentration
that there will be times that it almost
will feel
at times almost dissociative that they
just won't be present
and a person with cptsd just won't be
present and there will also be times
when
they themselves will acknowledge like
could you say that again i just wasn't
i didn't get that right and so we do
know
that trauma in all its forms disrupts
attentional processes
and the research the neuropsychological
research
on attentional performance and
concentration and people who have
endured trauma
there's clearly disruptions there for
sure and that can make
life a lot more difficult it makes
school very difficult
it makes work difficult because you're
not tracking as well it can even make
conversation difficult
like i said even in therapy i'll have
clients say could you repeat that
and i can see what that is it's sort of
that frank attentional
impairment they have now remember
attention concentration
memory these are all linked yes central
nervous system processes
so it would make sense but it can be
frustrating
because sometimes people think that
they're almost being arrogant why don't
you listen to me
you know and again it's it's this almost
as though there is
this always this distracting pull that
people with
cptsd will acknowledge experiencing so i
think that's an important part of the
pattern to
note because it can be misunderstood by
some people some people might even see
it as something like add or adhd
it can look like that as well but it is
very frustrating for people
who are experiencing cptsd on top of the
many others
disruptive uncomfortable symptoms that
they're experiencing so how common is
amnesia for someone who has cptsd
well in in stress disorders as a whole
and certainly in post-traumatic stress
disorder
it's not unusual to see dissociative
symptoms and dissociation
is when a person almost breaks away it's
as though they break away from
their own reality or break away from
themselves they're not almost
they're not present in the situation
anymore they've gone someplace
else dissociation is known to be a
mechanism that people who've experienced
trauma
manifest and so in its most extreme
manifestation
we see dissociative identity disorder a
person actually
you know breaks off into separate and
distinct
personalities that dissociate from sort
of the host
personality in the case of the kind of
dissociation we see
in in post-traumatic stress the person
may dissociate when
they're reminded of the trauma when
they're talking about the trauma
that's a pretty classical traumatic
presentation
you can see some dissociative
symptomatology obviously
in complex ptsd this person has endured
trauma and it's a
so they may dissociate in that moment
and how and
that becomes almost a regulation issue
so is amnesia just a form of
dissociation
amnesia is a is a blockage of
memory typically we'll see around trauma
so the person
cannot recall events right around the
trauma
you see what i'm saying so amnesia is
almost a it's it's a memory function
that gets disrupted
at the time of trauma again something we
do see there's actually something called
dissociative amnesia that happens during
the time of a trauma
person just simply cannot recall it
which is actually quite horrible
because sometimes people who have been
through a trauma and can't accurately
recall it
people doubt that they even experienced
the trauma because they can't remember
it but they can't remember it because
that's how what happens to the brain
during trauma
quite frankly so um that's that's a
that's a misnomer and a misunderstanding
many many people hold
so you can see that form of dissociative
amnesia
in people with ptsd here's the trick
with complex ptsd
they've had repeated exposures to the
trauma
some they'll remember some they won't
and some of that not remembering
may be a byproduct of a dissociative
amnestic episode
you