The Misdiagnosis and Ignorance of Complicated PTSD

Misdiagnosis of CPTSD is widespread. The lack of information and understanding of CPTSD is large. Worst of all, the unwillingness to assist and help, inside our Healthcare Programs, is heartbreaking.


Complicated Submit Traumatic Stress Dysfunction (CPTSD) is continuously misdiagnosed as Emotionally Unstable Persona Dysfunction (EUPD), beforehand often called Borderline Persona Dysfunction (BPD).

CPTSD is form of like a subset of PTSD but it surely appears to be like fairly totally different. Complicated PTSD comes from long-term publicity to trauma and/or neglect; oftentimes it stems from childhood sexual, bodily, and emotional abuse, neglect, or long-term trauma whereby escape could be seemingly not possible or too harmful. We see CPTSD in survivors of long-term childhood abuse, human trafficking, refugees, or those who have skilled long-term home violence or intimate companion violence.

The persistent nature of the trauma and the inescapability of it, for no matter cause, be it age or danger to life, makes CPTSD fairly totally different from PTSD which in distinction is much extra episodic. PTSD is often brought on by trauma seen in fight, a automobile accident, or a pure catastrophe, it’s one occasion versus long-term, typically years, of trauma increase incident by incident with no secure attachments and no escape in sight.

There’s an incredible crossover between PTSD and CPTSD; flashbacks, evening terrors, dissociation, fugue states, emotional dysregulation, and hypervigilance. There are core variations that imply behavioural patterns, cognitive pondering and rationale, relationship points, and disturbances within the sense of self, current in a means that lessens the probability of CPTSD being ‘misdiagnosed’ as PTSD. As an alternative, CPTSD is commonly labeled as EUPD (beforehand BPD) and a myriad of different diagnoses resembling panic dysfunction, melancholy, anxiousness, and so forth.

EUPD (beforehand BPD) has a big overlap with CPTSD and it’s one thing all the area of psychology struggles with. Notably, right here within the UK the place CPTSD is principally unprecedented, positively by major care companies and oftentimes by secondary care companies. It’s merely not a prognosis many clinicians are given a lot details about, solely psychiatrists and trauma-specialised psychologists are ‘within the know’. This leaves the survivor feeling extra alienated, additional dissociated, self-blaming, and reinforces the worry of relationships.

EUPD is a fear-based Persona Dysfunction, it’s led virtually solely by a persistent worry of abandonment. That is one thing that you simply don’t see a lot of in CPTSD survivors, there’s some degree of it in all of us, however with CPTSD it’s extra the worry of the connection itself versus abandonment. Individuals who have CPTSD really feel that relationships and interpersonal areas are unsafe locations to be.

EUPD (BPD) victims often have an unstable sense of id, virtually as in the event that they don’t know who they’re. Whereas individuals with CPTSD have a distorted sense of self, viewing themselves as shameful, accountable, and successfully only a dangerous particular person. They know who they’re, it’s merely a warped view induced by the trauma. The 2 views are very totally different.

EUPD (BPD) is a psychological well being situation with the very best charge of suicide, greater than melancholy, anxiousness, PTSD, or every other sickness. Suicidal ideation or gestures and self-harming behaviours are extra congruent with EUPD. It is a tough one although, as there’s nonetheless a excessive danger in CPTSD shoppers because of the sheer degree of trauma and distorted sense of self. Self-harming behaviours and suicidal intention is harmful and extra of a traditional symptom of EUPD, however we are able to see it in CPTSD if the particular person has been retriggered or goes by means of new trauma.

We all know that one thing EUPD and CPTSD have in widespread is early trauma. It’s typically the case that an individual with EUPD has suffered childhood abuse or trauma nonetheless, not all have. Not each particular person on the market on the planet with EUPD has a historical past of serious, persistent, childhood trauma, EUPD might be hereditary. With Complicated PTSD that is far, way more more likely to be the case; there has to have been a minimum of one interval of their life the place they’ve skilled long-term, persistent, repetitive, and inescapable trauma. Most frequently, although not solely, this trauma is skilled in early childhood after which follows them as a ‘blueprint’ as they undergo life; main CPTSD survivors to unintentionally fall into unsafe relationships, abusive marriages and so forth.


I write a good bit about Complicated PTSD. Partially, it is because I do a good quantity go work for the CPTSD Basis and I’m a survivor myself. That being stated, I’ve skilled firsthand that ignorance of the situation inside our healthcare system each personal and public.

The UK isn’t educated to cope with Complicated trauma the professionals and clinicians are seemingly terrified to cope with it, seemingly as a result of they really feel they lack the coaching. We love calling ourselves ‘Trauma-informed’ and ‘Trauma led’, and but there’s such a niche within the understanding of what ‘trauma’ can truly seem like.

When home abuse charities declare to be ‘Trauma knowledgeable’ and run packages, ladies’s refuges, man complete county hotlines for recommendation, but not one of the workers have even heard of CPTSD … there’s a drawback.

When band 8a Neighborhood Psychological Well being Nurses, resolve to e-book a affected person with CPTSD in for a session with two clinicians every week, merely as a deterrent to cease the affected person from disclosing any trauma (as a result of THEY really feel unqualified to cope with it) … we now have an issue.

When counsellors and psychotherapists have ‘Trauma’ on their bio however haven’t heard of CPTSD not to mention accomplished any coaching/CPD on the topic, nor have they knowingly handled any affected person with CPTSD … we now have an issue.

GPs will not be allowed to prescribe the kind of remedy required nor are they in a position to diagnose Complicated PTSD, this needs to be carried out by a psychiatrist and but, GPs will not be educated to recognise the indicators of CPTSD. They haven’t heard of it, nor have the disaster groups or group psychological well being groups they seek advice from, so it goes untreated or worse, handled as melancholy, anxiousness, panic assaults I.e the issues a GP is allowed to diagnose and deal with. Referrals are made for NHS counselling, however the NHS delivers CBT as an (virtually) obligatory response and CBT merely isn’t the remedy to assist CPTSD.

‘Do no hurt’ is what our Nurses and docs swear to uphold; so it’s comprehensible that when confronted with Complicated trauma and the signs it presents, they shrink away from the affected person in worry of inflicting ‘extra hurt than good’. Counsellors and therapists preemptively fear themselves sick about transference, attachment points, and attainable issues round flashbacks or dissociation. Earlier than the affected person is aware of what is occurring they’ve been referred to, because the skilled can not inform the distinction between the terrifying *cluster B* that’s EUPD/BPD and Complicated PTSD. Heaven is aware of discovering a therapist keen to attempt to deal with EUPD is difficult sufficient.

This worry of ‘doing extra hurt than good’ and successfully passing the buck, (the ‘buck’ being a trauma survivor!), is so extremely ironic. Individuals with CPTSD are afraid of the connection area, they blame themselves for his or her trauma, and so they view themselves as an excessive amount of, too disgusting, too shameful, and quintessentially dangerous as people. The way in which the healthcare area reacts, that ‘passing the buck’, does nothing however retraumatise and consolidate this distorted sense of self. The unhappy reality is that the system is ready up in such a means, because of the lack of coaching and common understanding, that the ‘do no hurt’ actively turns into ‘doing extra hurt than good’.

As knowledgeable, clinician, front-line help employee, and educator … if you wish to declare being ‘trauma-informed’ and ‘trauma led’ then you want to do the analysis and get a superb grasp of CPTSD as a result of it’s all round us, unseen, unheard and untreated. The hyperlinks under are glorious for far more in-depth information.



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