Examining the ‘D’ in CPTSD | Terry Baranski


From CPTSD Foundation: “One of the banes of our culture’s psychiatric ideology is its tendency to pathologize mental health difficulties as ‘disorders’ and ‘diseases,’ both of which imply that there’s something wrong with a person that needs to be fixed. This often leads someone diagnosed with a disorder to self-shame, self-blame, and try to fight against their symptoms. In this article, I’ll investigate the notion of disorders and argue that they are actually processes that, as trauma expert Gabor Maté eloquently states, are ‘normal responses to abnormal circumstances.’

. . . So what exactly are these dynamic processes? To shed some light, we must trace them back to their causes. With CPTSD (along with virtually any other mental health condition), the symptoms that manifest are, in my view, actually a collection of coping strategies that kicked in during childhood due to trauma. These adaptations are highly intelligent when they first come online — they prevent our traumatic experiences from becoming even worse, and in many cases actually save our lives. Once the trauma is over, however, they often become maladaptive and outlive their usefulness.

. . . The notion of a disorder tends to create an attitude that symptoms are something to be gotten rid of — to battle against using any means necessary. Far from being compassionate, this approach essentially puts the internal system at war with itself. The process perspective, on the other hand, opens the door to treatment modalities such as Internal Family Systems (IFS), which work with our coping strategies rather than against them, using self-compassion and understanding. IFS respects that coping strategies came about for good reasons, and therefore doesn’t attempt to change behaviors directly. Instead, a bottom-up approach is used to heal and release a person’s trauma, at which point behavioral change comes about as a natural outcome.”

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  1. One thing I’ve been thinking about lately is that this idea that people who grew up in traumatic, abusive or generally unsafe environments, who need to learn coping behaviors to survive these environments, get told as adults that these behaviors no longer serve them.

    Except that for patients in the mental health system or patients in the health care system in general, these behaviors are often still needed. There’s a similar dynamic as to being a child when one is a patient. They have little power, and possibly almost no power, such as if they’re in a psych ward. They are being blamed and labeled with things like borderline personality, oftentimes, coercively or forcibly drugged or otherwise forcibly treated, like with ECT. They might be being held against their will.

    This is a situation that requires certain survival behaviors, including not letting oneself be more vulnerable than is necessary, not being open or trusting etc.

    Some people may never reach that place of relative safety where they really are able to drop all of those so-called ineffective behaviors. The world is not a safe place, for many, whether in the mental health system or other carceral or alienating environment.

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    • You are absolutely right! These behaviors serve a definite purpose, and unless it’s a truly safe environment, they will be needed again and again! It has to be up to the person him/herself to decide which of those historical coping measures remain relevant. In a typical psychiatric environment, defensive measures are generally quite essential!

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    • You’re spot on KateL, clients in the healthcare system, and especially in the “mental health” system, are expected to blindly obey like good little children.

      And the saddest part is the psychiatry has a label for adults who think for themselves: “non-compliant”, making “patients” damned if they do and damned if they don’t.

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    • This particular idea resonates with my personal experience within the mental health system during my tenure as a trainee. I distinctly recall being informed, in a somewhat authoritative and unconventional manner, that all my external achievements – be it socioeconomic status, relationships, physical well-being, or even my acknowledgement of the profound extent of my childhood trauma – were deemed inadequate for healing due to my lack of engagement in therapy. It appeared that abstaining from medication and therapy, and instead relying solely on my belief in realism and fostering secure and supportive relationships, was perceived as a form of denial towards the trauma I had endured, unless I did many years of therapy (BTW therapy is not also part of my culture and many people recover from childhood trauma without meds or therapy). Over time, I have come to realize that (based on my own experiences) the majority of what we label as mental illnesses are indicative of individuals’ attempts to recover from their distressing childhood experiences. Unfortunately, at every juncture, the mental health system steers them away from this path, as it tends to prioritize medicating individuals and convincing them of their inherent fragility and powerlessness. Having witnessed this dynamic from an insider’s perspective for numerous years, I continue to be astonished by the evident abuse of authority within the system.
      I have absolutely nothing against meds or therapy in fact I endorse where I can when appropriate but people like me who are looking the system from outside, it is very much obvious how even simple let us say projection defense is hijacked as personality disorder when in many times it is also the mechanism for experiencing love. But you will never hear the other side.

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