PTSD: Victims of War and Victims of Household War

Interview
Complex PTSD

Q: Dear Frank, Could you give a brief explanation of complex PTSD? How do we know if we have PTSD or Complex PTSD? Is the medication and/or therapy similar?

A: Dear Joyce, Complex PTSD is a concept first defined by Judith Herman, MD (see http://www.ptsd.va.gov/professional/PTSD-overview/complex-ptsd.asp) to account for the effects of prolonged, severe interpersonal stress. She was thinking about cases in which a person is captured and humiliated or is sexually victimized within the family. But it is true of victims of war and victims of household war: battered spouses. When emotional trauma is continuous and inescapable, the mind and body adapts in several ways, from stoic to tragic. People can "zone out" or, technically, dissociate. They experience an altered state of consciousness. This might, in extreme cases, develop into multiple personalities. People can abandon hope. Without yearning for dignity and freedom, they accept psychological slavery. People can love their abusers. This is called Stockholm Syndrome (see http://www.giftfromwithin.org/html/stockhlm.html).

The therapy for oppression is different than the therapy for simple PTSD. It requires moving to a safe environment. It requires retraining survival instincts, once there is no real danger. The medication may be similar (anti-depressants, tranquilizers, sedatives) but medication is never enough. And therapy is never enough. It takes liberation and love and plenty of patience to emerge from complex PTSD.