What we’ve said about Complex PTSD

“the injury is not to some fear response and understanding of the world issue that circumscribed to the trauma it's a wholesale inhibition or change of this person's personality due to developmental issues”

“it is totally implausible for someone who has a multi-trauma terrible developmental life from early childhood onwards to have a normal functioning personality. It's completely clinically implausible”

“PTSD plus what's the major category of the three categories is disturbances of self-organization. And that includes three things that they name. So difficulties in regulating emotions”

“it's fright, exposure, avoidance, and re-experiencing. And then CPTSD is bad fear. So that adds betrayal, affect regulation, and developmental impact”

“PTSD as defined by the DSM-5 is different than PTSD that is defined by the ICD-11. Baseline PTSD in the DSM-5 essentially more or less covers what is actually called complex PTSD in the ICD-11”

“Complex post-traumatic stress disorder, a history of subjection to totalitarian control. I mean, that's a very loaded way of writing its criteria already, if you ask me”

“I think now of CPTSD as a big bucket that contains a bunch of small buckets. And one of those small buckets is BPD”

“Because there's a lot of patients who don't have typical BPD symptoms. And I do see a lot of the CPTSD stuff. So I do think it's actually... I don't know. I think it's a useful term”

“I think it's a major error, uh, to, uh, to conceive of, of the entirety of what we call borderline personality disorder as simply being complex post-traumatic stress”

“i don't think that complex trauma should exist as a concept i think that it um while is clinically useful and can be used to accurately describe many types that it's flawed in this origin”

“the problem at the outset was not the diagnostic categorization the problem was the lack of general practice in building therapeutic alliance and having collaborative care where both the patient and the physician are equal parties”

“Survivors of childhood abuse often accumulate many different diagnoses before the underlying problem of a complex post-traumatic syndrome is recognized”

“Like you can have severe personality dysfunction, but not fit neatly into BPD or NPD. So a lot of providers get caught up on that”

“my approach is simply is there ptsd or not if there's ptsd that's ptsd to me and we're going to subsume most of those problems under ptsd”

“if you have, this is from my clinical experience now, sufficient experience with people who are not war veterans with PTSD, then you're going to see that in the really clear cases, almost without exception you are going to see criterion d”

“externalizing behaviors are more part of BPD. So things like impulsivity, attempts to avoid abandonment, temper outbursts, theoretically those are more BPD type traits”

“To me, the only difference is maybe CPTSD should focus more on trauma-focused therapy, so EMDR and trauma-focused therapies. And BPD should focus a lot more on the interpersonal dysfunctioning and the emotional regulation”

“trauma disorders respond better to trauma therapy. And that personality problems or developmental interpersonal problems respond better to changes and exercises in how you conduct your relationships and with who”

“for trauma disorders, what you might call complex trauma and cluster B personality, We should be prescribing mindfulness, but it must be a modified mindfulness, and you may need to do things that are basically more grounding techniques”

“BPD isn't the person's fault, and they deserve understanding. And CPTSD people can be manipulative, and they're responsible for what they do”

“What I'm not going to do is I'm not going to say that someone has complex PTSD or when they simply have a bunch of little t traumas in their history”

“some patients use it as a defense to not look at their personality dysfunction. And I feel like the McLean screen and the conversation about traits allows me to open up that conversation earlier”

“the patient and the providers making pretend that treatment is major depressive disorder in the back of their mind know that there's a personality disorder, but don't communicate it. And it's really setting up for bad treatment outcomes”

“What I say to trainees is, I don't care what you call it. Give the right treatment. And that's my approach. And so whatever a patient prefers to call something, we're going to go ahead and call it that”

“worry less about what you call something in terms of a single label worry more about your overall understanding of yourself and how your clinician understands you and whether you guys agree on that and whether you agree on the treatment plan”

“I ask, what's your understanding of what this means? Because... It's very interesting that it's very possible you and the patient will be in agreement with a diagnosis, but then you hear what they think that actually means”

“for complex PTSD, the book I very commonly recommend is Complex PTSD from Surviving to Thriving by Pete Walker. It's written by a person who has complex PTSD”