Acute traumatic Stress, Paranoia & Displacement Due to the Narcissist

purplehaze

Jedi Master
After you have managed to escape the narcissist, you will still be in fear. These fears are multiple and are to do with your personal safety. This is, the narcissist will make efforts to ensure that you do not feel safe and every means will be used including:
# telling you that violence will be used against you with a real risk of execution.
# telling you that you will have no access to your belongings, pets or children
# turning up at the place where you stay unexpectedly
# ringing you and leaving intimidating messages
# passing on bills and financial commitments to you which are not yours
# using a lawyer to write intimidating letters
# spreading lies about you to your family and friends (if you have some left)
# start a court case against you claiming that the narcissist was the victim
# telling you not to speak to people because they are all working for the narcissist
# telling you that nobody ever loved you like (s)he did and that you are a liar
# go through your personal belongings where possible (e.g. break into your email account)
# threatening to phone work and inform them that you are unsuitable for the work
# intimidating you sexually be making inappropriate advances

As you can imagine, this all has one main effect on you. It all stresses you. Taking this into account together with the stress you might be experiencing through a move, new financial commitments and new surroundings, it is more than likely that you will experience acute traumatic stress - you can feel your heart pumping overtime.

Additionally to the stress, you might develop a paranoid tendency. As you have been informed that the narcissist has her/his spies operating against you, you feel you cannot trust anybody. A person sitting outside your house in a car, might just be one of those spies. The shopkeeper down the road seems not to smile at you anymore. Well, he too might have turned against you. This deep sense of distrust becomes reinforced because it does happen that things you said or did leak to the narcissist. Work colleagues and friends, who might have begrudged you for some time, see this as the perfect opportunity to add to your distress. There is only one way of dealing with this: Use the appropriate channels (such as your GP) and make your situation officially known. Rather than loosing your job, take sick leave if you feel that you cannot cope. Accept help from everywhere except from the narcissist.

Finally, you will struggle with a problem of cognitive nature. Any situation which will resemble a situation reminding you of the narcissist can trigger fear. So it can quite easily happen that a person who genuinely talks to you in order to help you, chooses the wrong tone and you see the narcissist in this person. You have to use all your reasoning powers to separate other people from your narcissist (seeing a problem shifted somewhere else is called displacement). It happens very easily that you displace fears, hopes, even positive feelings into other people simply there is something about them which is similar to your narcissist. However, you also will have to learn to understand your inner alarm bells. If someone really resembles the narcissist, you better stop contact fast. Do not ignore your inner feelings and concerns like you did in the past.

Summarizing, this is a very difficult time for you where not just one major issue affects you, but at least three. You have to try to stay calm as much a possible and give yourself plenty of rest. You need to be in as relaxed and quiet environment. In this situation it might be an idea to return to a place where you feel definitely safe (e.g. your parent's home if you are sure you felt safe there). In my case, I simply wanted to be on my own.

Dr. Ludger Hofmann-Engl

http://www.chameleongroup.org.uk/npd/paranoid.html
 
Very good list. What is interesting is to see how some of this manifests in the cyberspace environment in slightly different ways. I think the equivalent is the setting up of websites to defame and subtly threaten (or not so subtly, as the case may be), stalking the person around the net, finding where they may post and signing up as several individuals and starting flame wars; sending private, defamatory emails to individuals you have met in an effort to convince them that you are a criminal or whatever. All of this is intended to be intimidating and to frighten you.
 
Absolutely Laura. We have been through it and at least one of our victims has been through it with her predator.

It can be stressful - especially if the predator involves your children and/or family.
 
And if you have a narcissist or two in the family the stress just keeps on coming. You are the villain if you cut contact with this person or persons. The narcissist is very clever at charming those who he needs and making sure the victim feels his wrath . often without anything direct that links back to him or her. My personal little devil in disguise has been working overtime for some years feeding off me without me realising the true extent of her malice. I should have played her at her own game and not let on that I had worked it all out. But I reacted as a typical victim and it was obvious to her that I had worked all the strands of her manipulation out. Breaking into my email was part of it she knew my passwords. Spreading lies and infiltrating social circles to defame me subtly and surely. Punch drunk is not the word! It left me suicidal The narcissist has no regard for your children or anything only her/his own games. My children found some of their friends were not allowed to play anymore because of the little lies that were being spread. Party invites dried up etc...These may seem small things but how do you explain to a child why so and so cant play anymore or a friend they have had for years crosses the road with their mother as you go by?
With a partner I guess people expect relationships to break down and hard as it is you can move on eventually but when it is your mother or your daughter or your sister who is the narcissist there are infinite ways these people link to you and you have a terrible time trying to extricate yourself. We all make mistakes in life and relationships but the difference with the narcissist is he or she plans down to the last detail how to cause distress and nothing is spontaneous. The narcissist uses the Chinese whisper tactic to create paranoia in the target. School, work etc the victim can find it hard to find a place where they are 'safe'.
I am using the experience as a springboard to new things though. It was painful, unbearable to begin with but now I think it might be the making of a whole new life. One where I call the shots!

Re the displacement..... I was having problems separating the real from the unreal friends etc and probably lost some true ones along the way but as you say it is wise to remain on guard in life cause there is a real chance that you will run into another narcissist sooner or later.
 
piranah

Kathy Krajco writes about them as "bystanders" - enabling with their silence. The psychopath/ narcissist uses them like chess pieces to "check" you everywhere you go.

Our most recent predator threatened us and tried to hack us. It's been a week and guess what's happened? As usual -- NOTHING. Nothing but stalking and annoyance.

Of course because we follow up on these predators and watch them go right back to predation or do things that confirms they are lying? Then WE get blamed as stalkers. LOL

Big difference between harrassment and holding someone accountable. ;)
 
Bystanders indeed! A couple of years ago, in this thread, http://www.cassiopaea.org/forum/index.php?topic=3521.msg23762#msg23762 I quoted France's premier Victimology Expert, Marie-France Hirigoyen who wrote a book called "Stalking the Soul" where she says:


Marie-France Hirigoyen said:
Perverse abusiveness fascinates, seduces, and terrifies. We sometimes envy abusive individuals because we imagine them to be endowed with a superior strength that will always make them winners. They do, in fact, know how to naturally manipulate, and this appears to give them the upper hand, whether in business or in politics. Fear makes us instinctively gravitate toward them rather than away from them: survival of the fittest.

The most admired individuals are those who enjoy themselves the most and suffer the least. In any case, we don't take their victims, who seem weak and dense, seriously, and under the guise of respecting another's freedom, we become blind to destructive situations.

In fact, this "tolerance" prevents us from interfering in the actions and opinions of others, even when these actions and opinions are out of line or morally reprehensible.

We also weirdly indulge the lies and "spin" of those in power. The end justifies the means.

To what degree is this acceptable? Don't we, out of indifference, risk becoming accomplices in this process by losing our principles and sense of limits? Real tolerance means examining and weighing values.

This type of aggression, however, lays traps in the psychic domain of another person and is allowed to develop because of tolerance within our current socio-cultural context. Our era refuses to establish absolute standards of behavior. We automatically set limits on abusive behaviors when we LABEL them as such; but in our society, labeling is likened to intent to censure. We have abandoned the moral constraints that once constituted a code of civility which allowed us to say "That just isn't done!" We only become indignant when facts are made public, worked over and magnified by the media. [...]

Even psychiatrists hesitate to use the term "abuse"'; when they do, it's to express either their powerlessness to intervene or their fascination with the abuser's methods. [...]

[Psychopathy] arises from dispassionate rationality combined with an incapacity to respect others as human beings. Some [psychopaths] commit crimes for which they are judged, but most use charm and their adaptive powers to clear themselves a path in society, leaving behind a trail of wounded souls and devastated lives. ... We have all been fooled by abusive human beings who passed themselves off as victims. They fulfilled our expectations in order the better to seduce us. ...

We subsequently feel betrayed and humiliated when, in their search for power, they show their true colors. This explains the reluctance of some psychiatrists to expose them. Psychiatrists say to each other, "Watch out, he's a [psychopath]", the implication being "This could be dangerous," and also, "There's nothing that can be done." We then give up on helping the victim.

Designating [psychopathy] is certainly a serious matter... whether the subject is serial killing or perverse abusiveness, the matter remains one of predatory behavior: an act consisting in the appropriation of another person's life.

The word "perverse" shocks and unsettles. It corresponds to a value judgment, and psychoanalysts refuse to pronounce value judgments. Is that sufficient reason to accept what goes on? A more serious omission lies in not labeling abuse, because the victim then remains defenseless...

Victims are often not heard when they seek help. Instead, analysts advise them to assess their conscious or unconscious responsibility for the attack upon them. ... Emotional abusers directly endanger their victims; indirectly, they lead those around them to lose sight of their moral guideposts and to believe that freewheeling behaviors at the expense of others are the norm. [Dr. Marie-France Hirigoyen, Stalking the Soul]
Marie-France has a hard time dealing with the word and concept of psychopathy, however. She describes them, describes what they do, even suggests that they MAY be incurable, but French psychiatry and psychology is so controlled by Freud that she just can't take the obvious step and speak it out loud.
 
PTSD would actually describe how one feels after a prolonged bout with a narcissist. All your reference points within social life may seem out of kilter and the victim feels the stress every time they have to come into contact with people or situations connected to the narcissist. Often in trying to expose the narcissist one has come up against a social brick wall time and again. It may lead to the sense of disconnection of the self. The turning point comes when one realises that it is them and not you. A friends son committed suicide by throwing himself in front of a train and this was due to bullying at school which could not be proved. The fledgling narcissist and his mates who were involved in the torment were never held accountable. The blame was put on the victim and his mental weakness! Many are strong enough to withstand the onslaught from the narcissist and his enablers and we as a society need to watch out for these gentle people who do nothing wrong but show their nature and get attacked for it. I have watched headteachers and others tick all the boxes for preventing abuse and bullying but show no real understanding of how it can go under the radar. How the cleverest narcissists are all around you and acting and manipulating. You will never be able to weed out all narcissists but you can protect yourself with a force field so their attempts to affect you do not get through.
 
PTSD IS what one HAS after dealing with a narcissist and/or sociopath. Make NO MISTAKE.

Sandra Brown, MA (author of Women Who Love Psychopaths) recently had a wonderful list from BullyOnline on her site regarding the difference between Psychological Injury (which is what PTSD is!) and Mental Illness:

Differences between mental illness and psychiatric injury

The person who is being bullied will eventually say something like "I think I'm being paranoid..."; however they are correctly identifying hypervigilance, a symptom of PTSD, but using the popular but misunderstood word paranoia. The differences between hypervigilance and paranoia make a good starting point for identifying the differences between mental illness and psychiatric injury.


Paranoia

* paranoia tends to endure and to not get better of its own accord

* the paranoiac will not admit to feeling paranoid, as they cannot see their paranoia

* sometimes responds to drug treatment

* the paranoiac often has delusions of grandeur; the delusional aspects of paranoia feature in other forms of paranoia is a form of mental illness; the cause is thought to be internal, eg - a minor variation in the balance of brain chemistry

* mental illness, such as schizophrenia

* the paranoiac is convinced of their self-importance

* paranoia is often seen in conjunction with other symptoms of mental illness, but not in conjunction with symptoms of PTSD

* the paranoiac is convinced of their plausibility

* the paranoiac feels persecuted by a person or persons unknown (eg "they're out to get me")

* sense of persecution

* the sense of persecution felt by the paranoiac is a delusion, for usually no-one is out to get them

* the paranoiac is on constant alert because they know someone is out to get them

* the paranoiac is certain of their belief and their behaviour and expects others to share that certainty

vs.

Hypervigilance

* is a response to an external event (violence, accident, disaster, violation, intrusion, bullying, etc) and therefore an injury

* wears off (gets better), albeit slowly, when the person is out of and away from the situation which was the cause

* the hypervigilant person is acutely aware of their hypervigilance, and will easily articulate their fear, albeit using the incorrect but popularised word "paranoia"

* drugs are not viewed favourably by hypervigilant people, except in extreme circumstances, and then only briefly; often drugs have no effect, or can make things worse, sometimes interfering with the body's own healing process

* the hypervigilant person often has a diminished sense of self-worth, sometimes dramatically so

* the hypervigilant person is often convinced of their worthlessness and will often deny their value to others

* hypervigilance is seen in conjunction with other symptoms of PTSD, but not in conjunction with symptoms of mental illness

* the hypervigilant person is aware of how implausible their experience sounds and often doesn't want to believe it themselves (disbelief and denial)

* the hypervigilant person is hypersensitized but is often aware of the inappropriateness of their heightened sensitivity, and can identify the person responsible for their psychiatric injury

* heightened sense of vulnerability to victimisation

* the hypervigilant person's sense of threat is well-founded, the hypervigilant person often cannot (and refuses to) see that the pathological is doing everything possible to get rid of them

* the hypervigilant person is on alert in case there is danger

* the hypervigilant person cannot bring themselves to believe that the pathological bully cannot and will not see the effect their behaviour is having; they cling naively to the mistaken belief that the pathological will recognise their wrongdoing and apologise


~~~~~~~~~~~
Other differences between mental illness and psychiatric injury include:

Mental illness

* the cause often cannot be identified

* the person may be incoherent or what they say doesn't make sense

* the person may appear to be obsessed

* the person is oblivious to their behaviour and the effect it has on others

* the depression is a clinical or endogenous depression

* there may be a history of depression in the family

* the person has usually exhibited mental health problems before

* may respond inappropriately to the needs and concerns of others

* displays a certitude about themselves, their circumstances and their actions

* may suffer a persecution complex

* suicidal thoughts are the result of despair, dejection and hopelessness

* exhibits despair

* often doesn't look forward to each new day

* is often ready to give in or admit defeat

vs.

Psychiatric injury

* the cause is easily identifiable and verifiable, but denied by those who are accountable

* the person is often articulate but prevented from articulation by being traumatized

* the person is obsessive, especially in relation to identifying the cause of their injury and both dealing with the cause and effecting their recovery

* the person is in a state of acute self-awareness and aware of their state, but often unable to explain it

* the depression is reactive; the chemistry is different to endogenous depression

* there is very often no history of depression in the individual or their family

* often there is no history of mental health problems

* responds empathically to the needs and concerns of others, despite their own injury

* is often highly sceptical about their condition and circumstances and is in a state of disbelief and bewilderment which they will easily and often articulate ("I can't believe this is happening to me" and "Why me?" - click here for the answer)

* may experience an unusually heightened sense of vulnerability to possible victimization (ie hypervigilance)

* suicidal thoughts are often a logical and carefully thought-out solution or conclusion

* is driven by the anger of injustice

* looks forward to each new day as an opportunity to fight for justice

* refuses to be beaten, refuses to give up

Common features of Complex PTSD: People suffering Complex PTSD report consistent symptoms which further help to characterize psychiatric injury and differentiate it from mental illness. These include:

* Fatigue with symptoms of or similar to Chronic Fatigue Syndrome (formerly ME)

* An anger of injustice stimulated to an excessive degree (sometimes but improperly attracting the words "manic" instead of motivated, "obsessive" instead of focused, and "angry" instead of "passionate", especially from those with something to fear)

* An overwhelming desire for acknowledgement, understanding, recognition and validation of their experience

* A simultaneous and paradoxical unwillingness to talk about the abuse (click here to see why) or here (click here to see why)

* A lack of desire for revenge, but a strong motivation for justice

* A tendency to oscillate between conciliation (forgiveness) and anger (revenge) with objectivity being the main casualty

* Extreme fragility, where formerly the person was of a strong, stable character

* Numbness, both physical (toes, fingertips, and lips) and emotional (inability to feel love and joy)

* Clumsiness

* Forgetfulness

* Hyper-awareness and an acute sense of time passing, seasons changing, and distances traveled

* An enhanced environmental awareness, often on a planetary scale

* An appreciation of the need to adopt a healthier diet, possibly reducing or eliminating meat - especially red meat

* Willingness to try complementary medicine and alternative, holistic therapies, etc

* A constant feeling that one has to justify everything one says and does

* A constant need to prove oneself, even when surrounded by good, positive people

* An unusually strong sense of vulnerability, victimization or possible victimization, often wrongly diagnosed as "persecution"

* Occasional violent intrusive visualizations

* Feelings of worthlessness, rejection, a sense of being unwanted, unlikeable and unlovable

* A feeling of being small, insignificant, and invisible

* An overwhelming sense of betrayal, and a consequent inability and unwillingness to trust anyone, even those close to you

* In contrast to the chronic fatigue symptoms, depression etc., occasional false dawns with sudden bursts of energy accompanied by a feeling of "I'm better!", only to be followed by a full resurgence of symptoms a day or two later

* Excessive guilt - when the cause of PTSD is bullying, the guilt expresses itself in forms distinct from "survivor guilt"; it comes out as:

1. an initial reluctance to take action against the pathological and report him/her knowing that he/she could lose his/her job or otherwise have consequences

2. later, this reluctance gives way to a strong urge to take action against the pathological so that others, especially successors in the relationship, don't have to suffer a similar fate

3. reluctance to feel happiness and joy because one's sense of other people's suffering throughout the world is heightened

4. a proneness to identifying with other people's suffering

5. a heightened sense of unworthiness, undeservingness and non-entitlement (some might call this shame)

6. a heightened sense of indebtedness, beholdenness and undue obligation

7. a reluctance to earn or accept money because one's sense of poverty and injustice throughout the world is heightened

8. an unwillingness to take ill-health retirement because the person doesn't want to believe they are sufficiently unwell to merit it

9. an unwillingness to draw sickness, incapacity or unemployment benefit to which the person is entitled

10. a desire to help others, often overwhelming and bordering on obsession, and to be available for others at any time regardless of the cost to oneself

11. an unusually high inclination to feel sorry for other people who are under stress or are pathological,

Fatigue
The fatigue is understandable when you realize that in pathology, the target's fight or flight mechanism eventually becomes activated. The fight or flight mechanism is designed to be operational only briefly and intermittently; in the heightened state of alert, the body consumes abnormally high levels of energy. If this state becomes semi-permanent, the body's physical, mental and emotional batteries are drained dry. Whilst the weekend theoretically is a time for the batteries to recharge, this doesn't happen, because:

* the person is by now obsessed with the situation (or rather, resolving the situation), cannot switch off, may be unable to sleep, and probably has nightmares, flashbacks and replays;

* sleep is non-restorative and unrefreshing - one goes to sleep tired and wakes up tired

* this type of experience plays havoc with the immune system; when the fight or flight system is eventually switched off, the immune system is impaired such that the person is open to viruses which they would under normal circumstances fight off; the person then spends each weekend with a cold, cough, flu, glandular fever, laryngitis, ear infection etc so the body's batteries never have an opportunity to recharge.


When activated, the body's fight or flight response results in the digestive, immune and reproductive systems being placed on standby. It's no coincidence that people experiencing constant abuse, harassment report malfunctions related to these systems (loss of appetite, constant infections, flatulence, irritable bowel syndrome, loss of libido, impotence, etc). The body becomes awash with cortisol which in high prolonged doses is toxic to brain cells. Cortisol kills off neuroreceptors in the hippocampus, an area of the brain linked with learning and memory. The hippocampus is also the control centre for the fight or flight response, thus the ability to control the fight or flight mechanism itself becomes impaired. Most survivors of bullying experience symptoms of Chronic Fatigue Syndrome

http://howtospotadangerousman.blogspot.com/2008/07/ptsd-as-trauma-disorder-not-psychiatric.html
A couple of us that run EOPC have PTSD. We see a STREAM of victims, many who write us offlist -- who know they have PTSD but are afraid to get help because their family & friends will treat them like they are crazy; or are in denial because of the stigma of PTSD.

The 'symptoms' listed for Paranoia and Mental Illness sound very much like the pathological! Not the victim(s).

If you read the list of symptoms of PSYCHOLOGICAL INJURY -- that's precisely what pathologicals leave people with.

It doesn't just "feel" that way -- it IS that way.
 
Acute traumatic Stress, Paranoia & Displacement Due to the Narcissist

Apologies but I'm kind of lost here. Hope I can articulate this since I'm very confused.

The list above Post #8 by purple haze.

What has me confused is some of the traits of a person with "Psychiatric injury." Some of the traits seem to be well, to put it bluntly, traits that I'd imagine a psychiatrist would view as psychotic. Paranoia, fear, fatigue, hypersensitivity etc.. Could it be possible that persons in such states are more susceptible to ponerogenic manipulation? Hope that makes sense. I'll try rewording it.

Is a person who has "PSYCHOLOGICAL INJURY" though not broken, put into a "-state-" of being more influenced by psychopathy?

* is often highly sceptical about their condition and circumstances and is in a state of disbelief and bewilderment which they will easily and often articulate ("I can't believe this is happening to me" and "Why me?")

I think this is implying creating dissociative states and deflecting - where the person thinks and asks the question "I can't believe this is happening to me" and "Why me?" Even though if they were given the direct clinical explanation, they would stear clear of those facts (What the therapists observes/Concludes).

If the above is the case and the PTSD that is left with the victim - It seems like psychopaths/psychopathy will always have fresh fertile grounds since the disease makes its own, by to some degree or another, incubationing - within the minds of its own victims. Of course I'm not to versed but simply speculative ponderance on my part, thus the need to ask. Hope it makes sense to anyone who can either expand on this or help clarify my intelligence or ignorance. Thanks for some very interesting information. Gives new meaning to the term walking wounded and (in grasping and making personal hypothetical's) how pathology is spread. It's taking some time to get through Women Who Love Psychopaths. The simplicity of the writers style really helps me to understand more easily, either that or I'm starting to grasp psychological terms more deeply. :)
 
Re: Acute traumatic Stress, Paranoia & Displacement Due to the Narcissist

Steve M. said:
Is a person who has "PSYCHOLOGICAL INJURY" though not broken, put into a "-state-" of being more influenced by psychopathy?

YES!!!!

* is often highly sceptical about their condition and circumstances and is in a state of disbelief and bewilderment which they will easily and often articulate ("I can't believe this is happening to me" and "Why me?")

I think this is implying creating dissociative states and deflecting - where the person thinks and asks the question "I can't believe this is happening to me" and "Why me?" Even though if they were given the direct clinical explanation, they would stear clear of those facts (What the therapists observes/Concludes).

We covered this on our site for Online Predators (also works for Offline Predators) http://cyberpaths.blogspot.com/2006/12/lures-of-online-predator.html

If the above is the case and the PTSD that is left with the victim - It seems like psychopaths/psychopathy will always have fresh fertile grounds since the disease makes its own, by to some degree or another, incubationing - within the minds of its own victims. Of course I'm not to versed but simply speculative ponderance on my part, thus the need to ask. Hope it makes sense to anyone who can either expand on this or help clarify my intelligence or ignorance. Thanks for some very interesting information. Gives new meaning to the term walking wounded and (in grasping and making personal hypothetical's) how pathology is spread. It's taking some time to get through Women Who Love Psychopaths. The simplicity of the writers style really helps me to understand more easily, either that or I'm starting to grasp psychological terms more deeply. :)

-noise

Sociopaths, Narcissists & Pathologicals LOVE "broken" people -- it's like pre-tenderized meat for them. Vulnerable persons, traumatized (divorced, broken up), child of pathologicals, disabled (physical disability can result in emotional/ mental trauma) and so on.... this is their playground. Think about all the "lonely" people on online dating -- 95% of the people on online dating are some sort of predator (married, sex addict, romance addict, sociopath, etc) it's a perfect hunting ground for them. Same goes in Real Life.
 
Re: Acute traumatic Stress, Paranoia & Displacement Due to the Narcissist

Thanks purple haze that was an interesting read. Indeed these vultures feed off of the tender meat as you say. Make no mistake they are professionals who have honed their abusive skills to the point where most people will not be aware of their power. Calm and curious is the way to find them out. If you think you are paranoid or losing your mind retreat from the person or persons who you believe to be the problem. Do not try to convince others of your problem. Back off completely. Allow the bully/narcissist no inroad into your life at all. Focus on something positive and you should see yourself recover and the hyper vigilance will fade. Trying to take these people on needs very strong personality and clever handling Also support from others is useful. But you may find they are targeted by the narcissist in order to isolate you. Try to find support from those who are unknown to the narcissist or who have been through a similar thing and so are aware.
 
Re: Acute traumatic Stress, Paranoia & Displacement Due to the Narcissist

Just found this interesting work which further links complex ptsd to emotional trauma. It also connects the amygdala hijack quite nicely.:

November/December 2010 Issue

The Legacy of Addictions: A Form of Complex PTSD?
By Claudia J. Dewane, DEd, LCSW
Social Work Today
Vol. 10 No. 6 P. 16

“The alcoholic family is one of chaos, inconsistency, unclear roles, and illogical thinking. Arguments are pervasive, and violence or even incest may play a role. Children in alcoholic families suffer trauma as acute as soldiers in combat; they also carry the trauma like an albatross throughout their lives.”

— Pamela Weintraub

Does this albatross make adult children of addiction prone to a type of posttraumatic stress disorder?

Much of my clinical work has involved clients with posttraumatic stress disorder (PTSD), from Vietnam War veterans to victims of military sexual trauma and those with adult trauma. Many women who were sexually assaulted while serving in the military had experienced childhood trauma, and research continues to explore that connection. Is it an overrepresentation of already-traumatized women who join the military as a means to escape toxic childhoods or family situations? Or because they experienced childhood trauma, are they more susceptible to another trauma as adults? Do they in essence become “trauma . magnets”?

The question is similar for those living with the legacy of addiction. This article explores that possibility and presents a treatment protocol building on the work of Pete Walker, MA, MFT, a marriage and family therapist who has worked extensively with adults traumatized in childhood. His work focuses on the complex PTSD secondary to childhood abuse. I found his framework applicable to those who also endured the confusing childhood environment of addiction.

PTSD, as we know it in the DSM-IV, is a reaction to a prescribed event, usually a one-time specific and defined trauma such as war, rape, or a natural disaster. Recurrent, intrusive images or recollections of the event, sometimes dissociative episodes, are symptomatic of PTSD.

For example, I had worked with, by all appearances, a very functional former Marine who was a veteran of the Vietnam War. He ostensibly “had it all”—a college education, a lucrative business, a beautiful wife, and two young boys he adored. While he was on a business trip, I received a call from security officials at an airport. (The client had my card in his pocket.) My client had been waiting to board a plane. As he slung his suitcase bag over his shoulder to board, he experienced a true flashback: He was back in the jungle slinging his rucksack over his shoulder. He began acting as if he were on patrol, which led to security being called. He came out of the flashback as I talked to him on the phone, but we both decided he should not board the plane that day.

That example is a true flashback, an intrusive and dissociative recollection. The National Center for PTSD distinguishes between this type of PTSD and complex PTSD. Complex PTSD is not listed in the DSM-IV, and many researchers assert it should be considered for inclusion in the DSM-V, corroborated by the argument that neuroscience should now be incorporated into the DSM.

Many clinicians and researchers believe cumulative, prolonged, or repeated trauma, such as being a prisoner of war or a Holocaust survivor, deserves its own category (Roth, Newman, Pelcovitz, van der Kolk, & Mandel, 1997). This history of subjection to totalitarian control can also be exemplified by living in extremely dysfunctional families. The symptoms of complex PTSD include alterations in emotional regulation and consciousness, changes in self-perception, alterations in perception of the perpetrator, alterations in relations with others, and changes in a person’s system of meanings, including a tendency to blame oneself for the abuse (Herman, 1997). Comparing these symptoms of complex PTSD to those features of adult children of addiction reveals striking similarities (see Table 1).

The tendency has historically been to view victims of dysfunctional childhoods as irreparably damaged, with a characterological disorder suggesting that the severe psychological consequence that occurs with prolonged exposure to trauma is some form of character weakness. Reconsideration is being given to diagnoses such as borderline, antisocial, and schizoid personality disorders and dissociative identity disorders as potentially having complex PTSD.

The symptomatology of complex PTSD includes a conception of emotional flashbacks—emotional and intrusive recollections of overwhelming feeling states of childhood: fear, shame, alienation, rage, grief, and/or depression. Walker (2009) calls these sudden and often prolonged emotional regressions to the frightening and abandoned feelings of childhood “amygdala hijackings.” The amygdala performs a primary role in the formation and storage of memories associated with emotional events, suggesting that prolonged fear may result in permanent changes in the brain, with lingering synapse hyperreactivity.

The tendency to overreact may be rooted in permanent fear conditioning, both emotionally and physiologically, with a number of resultant sympathetic nervous system responses (e.g., rapid heartbeat, respiration, cortisol production, immobility). The psychic imprinting of PTSD results in changed brain chemistry; the amygdala triggers the nervous system and panic, and prolonged panic may result in permanent panic.

For example, a highly educated, 45-year-old professional woman described an incident in which her father, whose parenting was characterized by emotional unavailability, railed at her for some of her parenting techniques. She became immobilized and described being reduced to an emotional pile of rubble, feeling that she was again a 10-year-old girl and totally incapable of responding appropriately. Is this perhaps an example of an amygdala hijacking?

Walker says, “I believe one of the key processes of recovering from complex PTSD is deconstructing the toxic superego/critic and reconstructing and replacing it with a healthy ego/executive function that is user friendly to the individual. As this is achieved, one’s narrative about one’s life becomes more complete, accurate, congruent, and capable of generating healthy self-compassion and self-protection.”

That interpretation is reminiscent of ego reconstructive goals of psychodynamic approaches, providing the secure object relation, but it also goes further. The approach combines the best of the theoretical frameworks of psychodynamic and postmodern. Some may see these theoretical approaches as being contradictory, with one soundly rooted in the past and the other fluidly rooted in the future. I prefer to view them as using the past and the present to create the future.

Conceptualizations of Trauma
In his reconceptualization of trauma, Walker suggests that complex PTSD is an attachment disorder and that clients who go untreated rely on a number of self-injurious defenses. His trauma typology includes the four Fs: the tendency to use the fight, flight, freeze, or fawn responses. These reactions are defense mechanisms designed to escape danger and ways to get some sense of attachment. In object-relations explanations, this process is called “trauma bonding” (Cooper, & Lesser, 2002), which comes from an earlier psychoanalytic term of “identification with the aggressor.”

Some children react to abuse or neglect by overidentifying with their inadequate caretaker, sometimes even merging their identity with this person and adopting perfectionism as the only way to survive in an unpredictable and unsafe world—the trauma bond. The child learns to act in a certain way to avoid or prevent the trauma of abuse or abandonment. Paradoxically, the child develops a strong affective bond to the abusive person. The child needs the relationship, so separation from that person can intensify the bond, increase idealization of the relationship, contribute to the victim’s sense of psychological powerlessness, and result in an inability to form another primary relationship. What may appear as a strong connection in a child-parent relationship may actually be a strong trauma bond and not a healthy, secure attachment.

This arrested development morphs into damaged self-esteem. In adulthood we see the unrealistic and self-blaming “if only” behaviors: “If only I were perfect,” “If only I didn’t do stuff to make him mad.”

Emotional Neglect
When we think of trauma, we think in terms of physical abuse and fear, but emotional neglect is suggested as the primary cause of complex PTSD. Emotional neglect occurs when a supportive caretaker is unavailable to provide comfort or protection. Adults who were neglected as children never felt special, loved, wanted, or important. We’ve all seen kids get off the school bus and run into someone’s waiting arms. What if they had no one who was happy to see them get off the school bus or, worse, were expecting to be met at the bus and learned not to rely on such expectations? These children grew up thinking they were a burden and as adults think of the world as a terrifying place with no refuge. No one answered their cries for help, literally or figuratively, giving way to emotional flashbacks in which defensive reactions are used throughout life. “How can you stand to listen to people’s problems all day? You must be so sick of hearing the same ones from me” may be a disguised repetition of this world view.

Emotional flashbacks usually do not have a visual or memory component to them like a recurrent intrusive recollection of PTSD. Therefore, the individual rarely realizes that he or she is reexperiencing a traumatic time from childhood. It may be seen as a descendent of dissociation, what Walker calls “a gross overfiring of right-brain emotional processing with a decrease in cognitive processing in the left brain.”

The four Fs are conceptualized in Table 3, describing appropriate and inappropriate examples of defensive reactions.

Fight, rooted in a protective narcissistic survival response, happens when people demand perfection of themselves and others and get stuck in “injustice collecting.” Flight defenses, such as obsessive-compulsive behaviors, can manifest in a variety of physical and emotional escapes. I’ve seen PTSD clients counting the ceiling tiles in my office or obsessively focusing on bodily sensations while simultaneously recounting trauma-laden material. It can also be seen in a tendency to personalize and catastrophize: “My husband looked at me funny; I know he is having an affair.”

Freeze reactions, usually a type of dissociative defense, don’t need to be as dramatic as a dissociative identity disorder; it can be manifest in a chronic inability to make a decision. Fawn, a defense rooted in the loss of ego differentiation, is evident in codependent behaviors or being inappropriately passive.

Some clinicians who specialize in traumatology define complex PTSD as an attachment disorder. Thus the therapeutic relationship in working with adult children of addiction is so important because it represents the only safe relationship in which to try different ways of relating and attachment. In the context of the therapeutic relationship, the client can begin to replace unhealthy responses and construct a new life narrative, one in which traumatic events don’t define them.

Treatment with those traumatized by a legacy of addiction and experiencing emotional flashbacks would include the following, as laid out by Walker in the article “13 Steps for Managing Flashbacks:”

• Providing psychoeducation about emotional flashbacks, realizing that knowing gives some relief, but insight is not always followed by change.

• Helping clients identify flashbacks, the unique defenses used, and how they are hampering healthy relationships.

• “Tears of relief and tears of grief”—grieving the lost childhood and nurturing.

• Deconstructing the “inner critic,” a hypervigilant superego makes a person develop perfectionism; the person is always on trial or always on guard.

• Giving specific tools to handle emotional flashbacks.

Walker says our role may lie in rescuing the wounded child. Emotional flashbacks can be seen as messages from the wounded child, as if the child is seeking validation of past abuse and neglect: “See how bad it was? See how scared I was most of the time? I try not to be that scared, so I _____ (fight, flee, freeze, or fawn).” The needs for nurturing are still being sought. Clients can be taught that these emotional flashbacks are messages from a child still searching for attachment and seeking safety.

If a therapist consistently responds in a compassionate manner to a client’s manifestation of suffering, the client can begin to internalize self-empathy and strive toward self-soothing. The client may not take total ownership of reactions to childhood abuse and neglect. As flashbacks decrease, the defenses, in the form of narcissism, obsessive-compulsive disorder, codependence, and the like, also start to crumble.

It seems reasonable to hypothesize that clients who present with the legacy of addiction may indeed have a form of complex PTSD, an attachment disorder. Using this framework may open the way to a liberating approach for both clients and therapists.

— Claudia J. Dewane, DEd, LCSW, a clinical social worker for 30 years with a specialty in trauma work, is an associate professor of social work at Temple University.



References
Cooper, M., & Lesser, J. (2002). Clinical social work practice: An integrated approach. Boston: Allyn and Bacon.

Herman, J. (1997). Trauma and recovery: The aftermath of violence — from domestic abuse to political terror. New York: Basic Books.

Roth, S., Newman, E., Pelcovitz, D., van der Kolk, B., & Mandel, F. S. (1997). Complex PTSD in victims exposed to sexual and physical abuse: Results from the DSM-IV Field Trial for Posttraumatic Stress Disorder. Journal of Traumatic Stress, 10(4), 539-555.

Walker, P. (2009). Emotional flashback management in the treatment of complex PTSD. Retrieved from http://www.psychotherapy.net/article/Emotional_Flashback_Management

Here's the link if anyone wants to see the tables mentioned:
http://www.socialworktoday.com/archive/111610p16.shtml
 
Re: Acute traumatic Stress, Paranoia & Displacement Due to the Narcissist


May I say, this thread is a wonderful find for me. What is shared here very helpfully articulates the grey areas that come with trauma, the ones that are difficult to grasp or define. With the inability to define these grey areas perhaps comes the inability to resolve the initial trauma, and then via the ripple affect, before you know it the trauma has pretty much infected the rest of the compartments of life. I've been in this situation and been rendered speechless and stunned as I've watched my life go down like a game of dominos. This happens because of the grey areas: the undefined, unseen, ungraspable waves that come from the traumatic event, like what has been addressed here.

An example would be: Traumatic event > hypervigilance > loss of speech > loss of social skills/behavioural issues > bullied > isolation > paranoia > mental illness .... etc

My point is that, it's often the "stuff" that comes with the trauma that "puts the icing on the cake", so to speak. But this "stuff" is really, really difficult to define and pin-point - especially for the sufferer. Difficult to probably empathise with also, as it's not really displayed in material form and easy to see from an outsiders view. So then, it is most difficult to heal and so it's a slippery slope for the sufferer too.


quote from swanseagal
PTSD would actually describe how one feels after a prolonged bout with a narcissist. All your reference points within social life may seem out of kilter and the victim feels the stress every time they have to come into contact with people or situations connected to the narcissist. Often in trying to expose the narcissist one has come up against a social brick wall time and again. It may lead to the sense of disconnection of the self. The turning point comes when one realises that it is them and not you. A friends son committed suicide by throwing himself in front of a train and this was due to bullying at school which could not be proved. The fledgling narcissist and his mates who were involved in the torment were never held accountable. The blame was put on the victim and his mental weakness! Many are strong enough to withstand the onslaught from the narcissist and his enablers and we as a society need to watch out for these gentle people who do nothing wrong but show their nature and get attacked for it. I have watched headteachers and others tick all the boxes for preventing abuse and bullying but show no real understanding of how it can go under the radar. How the cleverest narcissists are all around you and acting and manipulating. You will never be able to weed out all narcissists but you can protect yourself with a force field so their attempts to affect you do not get through.


So well articulated, thank you swanseagal.
 
Re: Acute traumatic Stress, Paranoia & Displacement Due to the Narcissist

purplehaze said:
An overwhelming sense of betrayal, and a consequent inability and unwillingness to trust anyone, even those close to you

[url=https://www.amazon.com/dp/1558745262]The Betrayal Bond: Breaking Free of Exploitive Relationships[/url] said:
Exploitive relationships can create trauma bonds—chains that link a victim to someone who is dangerous to them. Divorce, employee relations, litigation of any type, incest and child abuse, family and marital systems, domestic violence, hostage negotiations, kidnapping, professional exploitation and religious abuse are all areas of trauma bonding. All these relationships share one thing: they are situations of incredible intensity or importance where there is an exploitation of trust or power.

In The Betrayal Bond Patrick Carnes presents an in-depth study of these relationships, why they form, who is most susceptible, and how they become so powerful. He shows how to recognize when traumatic bonding has occurred and gives a checklist for examining relationships. He then provides steps to safely extricate from these relationships.
 
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