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PART III : THEORY
Developing a complex PTSD
A description ( or diagnostic category ) of the reactions of those who have been exposed to enduring trauma during childhood has long been needed . It would cover ‘ chronic situations of trauma ’, such as on-going violence , prolonged neglect , and abuse including multiple rape . Such situations may result in what is termed ‘ complex PTSD ’.
Symptoms occur in three main areas :
• Deficient regulation of affective and somatic states . Individuals oscillate between states of intense emotion , are depressed , hypersensitive , experience delayed motor development , suffer sleeping and eating disorders , are not conscious of their own feelings .
• Deficient awareness , concentration or regulation of behaviour . Individuals often focus in a narrow or restricted manner on threats , are impulsive , are prone to self harm .
• Lowered social and emotional functioning . Individuals often do not trust themselves or others , and constantly expect or prepare for rejection .
Trauma , risk and resilience
Resilience is not rare and indicates healthy adjustment . It is therefore important to understand the factors that help healing and enable people to cope .
It is also helpful to distinguish recovery ( during which survivors heal over time after being destabilised and showing symptoms of distress ) from resilience ( the ability to remain stable and keep going during and after catastrophes ).
Research has shown that resilience is not just a personal characteristic . An individual ’ s ability to cope is complemented by external factors that protect her against risk . To take an obvious example , survivors will be more resilient if they have support from their communities .
Some elements of resilience seem to be universal , while culture influences others . ( See the chapter on culture and understandings of trauma in Part III , pages 134-136 ).
Whether an individual has light or extreme symptoms is likely to be influenced by protective or risk factors .
1 . Her genetic inheritance . We are born with various degrees of robustness or vulnerability . 2 . Her experiences before exposure to trauma . 3 . The character of the trauma event . 4 . Her situation immediately after the trauma event ( for example , how quickly she received help ). 5 . Her situation in the long term ( for example , the quality of rehabilitation support she received ).