Killing Me Slowly: Complex PTSD

Little children recite the rhyme, “Sticks and stones can break my bones, but words will never hurt me.” This common childhood truism is not true. The psychological literature points to the opposite position. Words do hurt, as do other forms of non-physical mistreatment by others. Though not currently recognized in the DSM-IV TR as a clinical diagnosis, evidence continues to mount for the existence of a syndrome known as Complex PTSD. It is a disorder occurring in “survivors of prolonged, repeated trauma within a framework of captivity and coercive control.”[1] Complex trauma refers to a type of trauma “that occurs repeatedly and cumulatively, usually over a period of time and within specific relationships and contexts.”[2] So, it is different than PTSD where the victim is most often exposed to one significant and overwhelming traumatic experience. This is “trauma over time.” It can occur in the family, in significant relationships, in the workplace or elsewhere. It is sometimes the result of spousal abuse (e.g. domestic violence), workplace bullying, or even abuse in the church. It is most often non-physical abuse. These abusers prefer emotional, verbal and psychological abuse. Wherever it occurs, the results are devastating. Typical symptoms of CPTSD include: emotional dysregulation, dissociation or depersonalization, changes in self-perception, changes in perception of the perpetrator, changes in relationship with others, physical and medical problems, loss of meaning and despair. The prolonged exposure to this destructive relationship alters our sense of the assumptions that undergird “normal” life. For those who have experienced prolonged trauma often, the world is no longer safe, life has lost its meaning, and the self is seen as worthless (thus the high risk of suicide). It is important to note that CPTSD is not the victim’s fault. It is a set of symptoms that occurs as a result of abuse and mistreatment by others. In the counseling world, it is often diagnosed (or misdiagnosed) as borderline personality disorder (BPD) which often has a pejorative connotation that goes with this diagnosis, adding hurt upon hurt, creating secondary wounding.

From a biblical perspective, this connection between non-physical mistreatment and real injury is not new. Proverbs 18:21 says, “The tongue can bring death or life.” Fathers are warned (Eph. 6:4) not to “provoke their children to anger by the way they treat them.” James tells of the devastating power of the tongue (James 3:2-18). We sin against others most often with our tongue and other forms of non-physical maltreatment. The scripture places accountability on the perpetrator of the sins against others and calls them to account for their mistreatment of others. If you suspect that you or someone you love is suffering from Complex PTSD as a result of prolonged traumatic exposure and mistreatment, please prayerfully consider referring them for counseling. Look for a counselor who understands this concept of Complex PTSD, who has had some success in treating clients with this presenting problem. For further reading: Shattered Assumptions: Towards a New Psychology of Trauma by Ronnie Janoff-Bulman; Bully in Sight: How to Predict, Resist, Challenge and Combat Workplace Bullying by Tim Field; Trauma and Recovery by Judith Herman;

bully girls

[1] Turkus, J. A. (Fall 1998). Psychopharmacology of Posttraumatic Stress Disorder. Centering , 3 (4).

[2] Courtois, C. A. (2004). Complex Trauma, Complex Reactions: Assessment and Treatment. Psychotherapy: Theory, Research, Practice, Training , 41 (4), 412.



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