Advertisement

The Destructive Nature of Complex PTSD

  • Yochai Ataria
Chapter

Abstract

This chapter shows that a destructive mechanism—defined as body-disownership—constitutes the very core of complex posttraumatic stress disorder (PTSD), particularly when accompanied by structural dissociation.

References

  1. American Psychiatric Association. (1980). Diagnostic and statistical manual of mental disorders (3rd ed.). Washington, DC: American Psychiatric Association.Google Scholar
  2. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.Google Scholar
  3. Arieli, A., & Ataria, Y. (in press). Helplessness: The inability to know-that you don’t know-how. Philosophical Psychology.Google Scholar
  4. Ataria, Y. (2015d). Where do we end and where does the world begin? The case of insight meditation. Philosophical Psychology, 28(8), 1128–1146.  https://doi.org/10.1080/09515089.2014.969801.
  5. Ataria, Y. (2017). The structural trauma of western culture: Toward the end of humanity. New York: Palgrave Macmillan.Google Scholar
  6. Ataria, Y., Dor-Ziderman, Y., & Berkovich-Ohana, A. (2015). How does it feel to lack a sense of boundaries? A case study of a long-term mindfulness meditator‏. Consciousness and Cognition, 34, 133–147.  https://doi.org/10.1016/j.concog.2015.09.002.
  7. Birmes, P., Brunet, A., Carreras, D., Ducassé, J. L., Charlet, J. P., Lauque, D., … Schmitt, L. (2003). The predictive power of peritraumatic dissociation and acute stress symptoms for posttraumatic stress symptoms a three-month prospective study. American Journal of Psychiatry, 160, 1337–1339.Google Scholar
  8. Breh, D. C., & Seidler, G. H. (2007). Is peritraumatic dissociation a risk factor for PTSD? Journal of Trauma & Dissociation, 8(1), 53–69.Google Scholar
  9. Bremner, J. D., Southwick, S., Brett, E., Fontana, A., Rosenheck, R., & Charney, D. S. (1992). Dissociation and posttraumatic stress disorder in Vietnam combat veterans. The American Journal of Psychiatry, 149(3), 328–332.Google Scholar
  10. Briere, J., Scott, C., & Weathers, F. (2005). Peritraumatic and persistent dissociation in the presumed etiology of PTSD. American Journal of Psychiatry, 162(12), 2295–2301.Google Scholar
  11. Candel, I., & Merckelbach, H. (2004). Peritraumatic dissociation as a predictor of post-traumatic stress disorder: A critical review. Comprehensive Psychiatry, 45(1), 44–50.Google Scholar
  12. Carlson, E. B., Dalenberg, C., & McDade-Montez, E. (2012). Dissociation in posttraumatic stress disorder part I: Definitions and review of research. Psychological Trauma: Theory, Research, Practice, and Policy, 4(5), 479–489.  https://doi.org/10.1037/a0027748.
  13. Cimino, M. (Director). (1978). The deer hunter [motion picture].Google Scholar
  14. Cloitre, M., Garvert, D. W., Brewin, C. R., Bryant, R. A., & Maercker, A. (2013). Evidence for proposed ICD-11 PTSD and complex PTSD: A latent profile analysis. European Journal of Psychotraumatology, 4(20706), 1–12.  https://doi.org/10.3402/ejpt.v4i0.20706.
  15. Coppola, F. F. (Producer), Conrad, J. (Writer), & Coppola, F. F. (Director). (1979). Apocalypse now [motion picture].Google Scholar
  16. Courtois, C. A. (2004). Complex trauma, complex reactions: Assessment and treatment. Psychotherapy: Theory, Research, Practice, Training, 41(4), 412–425.  https://doi.org/10.1037/0033-3204.41.4.412.
  17. DePrince, A. P., Chu, A., & Visvanathan, P. (2006). Dissociation and posttraumatic stress disorder. PTSD Research Quarterly, 17(1), 1–8.Google Scholar
  18. Dyer, K. F., Dorahy, M. J., Hamilton, G., Corry, M., Shannon, M., MacSherry, A., … McElhill, B. (2009). Anger, aggression, and self‐harm in PTSD and complex PTSD. Journal of Clinical Psychology, 65(10), 1099–1114.  https://doi.org/10.1002/jclp.20619.
  19. Franklin, C. L., Posternak, M. A., & Zimmerman, M. (2002). The impact of subjective and expressed anger on the functioning of psychiatric outpatients with post-traumatic stress disorder. Journal of Interpersonal Violence, 17(12), 1263–1273.  https://doi.org/10.1177/088626002237855.
  20. Fuchs, T. (2005). Corporealized and disembodied minds: A phenomenological view of the body in melancholia and schizophrenia. Philosophy, Psychiatry, & Psychology, 12(2), 95–107.Google Scholar
  21. Gershuny, B. S., Cloitre, M., & Otto, M. W. (2003). Peritraumatic dissociation and PTSD severity: Do event-related fears about death and control mediate their relation? Behaviour Research and Therapy, 41(2), 157–166.Google Scholar
  22. Ginzburg, K., Butler, L. D., Saltzman, K., & Koopman, C. (2010). Dissociative reactions in PTSD. In P. F. Dell & J. A. O’Neil (Eds.), Dissociation and the dissociative disorders: DSM-V and beyond (pp. 457–469). New York: Routledge.Google Scholar
  23. Greenspan, G. S., & Samuel, S. E. (1989). Self-cutting after rape. The American Journal of Psychiatry, 146(6), 789–790.  https://doi.org/10.1176/ajp.146.6.789.
  24. Hagenaars, M. A., Van Minnen, A., & Hoogduin, K. A. (2010). The impact of dissociation and depression on the efficacy of prolonged exposure treatment for PTSD‏. Behaviour Research and Therapy, 48(1), 19–27.  https://doi.org/10.1016/j.brat.2009.09.001.
  25. Heidegger, M. (1996). Being and time (J. Stambaugh, Trans.). Albany: New York Press.Google Scholar
  26. Herman, J. L. (1992a). Complex PTSD: A syndrome in survivors of prolonged and repeated trauma‏. Journal of Traumatic Stress, 5(3), 377–391.  https://doi.org/10.1002/jts.2490050305.
  27. Herman, J. L. (1992b). Trauma and recovery. New York: Basic Books.Google Scholar
  28. Lanius, R. A., Vermetten, E., Loewenstein, R. J., Brand, B., Schmahl, C., Bremner, J. D., & Spiegel, D. (2010). Emotion modulation in PTSD: Clinical and neurobiological evidence for a dissociative subtype. American Journal of Psychiatry, 167(6), 640–647.  https://doi.org/10.1176/appi.ajp.2009.09081168.
  29. Leder, D. (1990). The absent body. Chicago: The University of Chicago Press.Google Scholar
  30. Marmar, C. R., Weiss, D., & Metzler, T. (1998). Peritraumatic dissociation and posttraumatic stress disorder. In J. Bremner & C. Marmar (Eds.), Trauma, memory, and dissociation (pp. 229–252). Washington: American Psychiatric Press.Google Scholar
  31. Marmar, C. R., Weiss, D. S., Schlenger, W. E., Fairbank, J. A., Jordan, B. K., Kulka, R. A., & Hough, R. L. (1994). Peritraumatic dissociation and posttraumatic stress in male Vietnam theater veterans. The American Journal of Psychiatry, 151(6), 902–907.Google Scholar
  32. Marshall, G. N., & Schell, T. L. (2002). Reappraising the link between peritraumatic dissociation and PTSD symptom severity: Evidence from a longitudinal study of community violence survivors. Journal of Abnormal Psychology, 111, 626–636.Google Scholar
  33. Murray, J., Ehlers, A., & Mayou, R. (2002). Dissociation and post-traumatic stress disorder: Two prospective studies of road traffic accident survivors. The British Journal of Psychiatry, 180, 363–368.Google Scholar
  34. Myers, C. (1940). Shell shock in France 1914–18. Cambridge: Cambridge University Press.Google Scholar
  35. Nijenhuis, E., Van der Hart, O., & Steele, K. (2010). Trauma-related structural dissociation of the personality. Activitas Nervosa Superior, 52(1), 1–23.Google Scholar
  36. Noë, A. (2004). Action in perception. Cambridge: The MIT Press.Google Scholar
  37. O’Regan, K. J., & Noë, A. (2001a). A sensorimotor account of vision and visual consciousness. Behavioral and Brain Sciences, 24(5), 939–1031.Google Scholar
  38. O’Regan, K. J., & Noë, A. (2001b). What it is like to see: A sensorimotor theory of perceptual experience. Synthese, 129(1), 79–103.Google Scholar
  39. Orth, U., & Wieland, E. (2006). Anger, hostility, and posttraumatic stress disorder in trauma-exposed adults: A meta-analysis. Journal of Consulting and Clinical Psychology, 74(4), 698–706.  https://doi.org/10.1037/0022-006x.74.4.698.
  40. Ratcliffe, M. (2008). Feelings of being. Oxford: Oxford University Press.Google Scholar
  41. Ratcliffe, M. (2015). Experiences of depression. Oxford: Oxford University Press.Google Scholar
  42. Reinders, T., Nijenhuis, S., Paans, J., Korf, J., Willemsen, M., & den Boer, A. (2003). One brain, two selves. Neuroimage, 20(4), 2119–2125.Google Scholar
  43. Resick, P. A., Bovin, M. J., Calloway, A. L., Dick, A. M., Kng, M. W., Mitchell, K. S., … Wolf, E. J. (2012). A critical evaluation of the complex PTSD literature: Implications for DSM-5.‏ Journal of Traumatic Stress, 25(3), 241–251.  https://doi.org/10.1002/jts.21699.
  44. Scaer, R. C. (2007). The body bears the burden: Trauma, dissociation, and disease. New York: Haworth Medical Press.Google Scholar
  45. Scarry, E. (1987). The body in pain: The making and unmaking of the world. New York: Oxford University Press.Google Scholar
  46. Stovall-McClough, K. C., & Cloitre, M. (2006). Unresolved attachment, PTSD, and dissociation in women with childhood abuse histories. Journal of Consulting and Clinical Psychology, 74(2), 219–228.  https://doi.org/10.1037/0022-006x.74.2.219.
  47. Terr, L. C. (1991). Childhood traumas: An outline and overview. Journal of the American Psychiatric Association, 148(1), 10–20.  https://doi.org/10.1176/foc.1.3.322.
  48. Ursano, R. J., Fullerton, C. S., Epstein, R. S., Crowley, B., Vance, K., & Kao, T. C. (1999). Peritraumatic dissociation and posttraumatic stress disorder following motor vehicle accidents. The American Journal of Psychiatry, 156(11), 1808–1810.Google Scholar
  49. Van der Hart, O., Nijenhuis, E., Steele, K., & Brown, D. (2004). Trauma-related dissociation: Conceptual clarity lost and found. Australian and New Zealand Journal of Psychiatry, 38, 906–914.  https://doi.org/10.1111/j.1440-1614.2004.01480.x.
  50. Van der Kolk, B. A. (1994). The body keeps the score: Memory and the evolving psychobiology of posttraumatic stress. Harvard Review of Psychiatry, 1(5), 253–265.  https://doi.org/10.3109/10673229409017088.
  51. Van der Kolk, B. A., & Fisler, R. (1995). Dissociation and the fragmentary nature of traumatic memories: Overview and exploratory study. Journal of Traumatic Stress, 8, 505–525. Retrieved January 11, 2011, from David Baldwins Trauma Pages. http://www.trauma-pages.com/a/vanderk2.php.
  52. Van der Kolk, B. A., Pelcovitz, D., Roth, S., & Mandel, F. S. (1996). Dissociation, somatization, and affect dysregulation: The complexity of adaption to trauma‏. The American Journal of Psychiatry, 53 (Suppl.), 83–93.Google Scholar
  53. Van der Velden, P., & Wittmann, L. (2008). The independent predictive value of peritraumatic dissociation for PTSD symptomatology after type I trauma: A systematic review of prospective studies. Clinical Psychology Review, 28, 1009–1020.Google Scholar
  54. Waelde, L. C., Silvern, L., & Fairbank, J. A. (2005). A taxometric investigation of dissociation in Vietnam veterans. Journal of Traumatic Stress, 18(4), 359–369.  https://doi.org/10.1002/jts.20034.
  55. Weaver, T. L., Chard, K. M., Mechanic, M. B., & Etzel, J. C. (2004‏). Self-injurious behaviors, PTSD arousal, and general health complaints within a treatment-seeking sample of sexually abused women. Journal of Interpersonal Violence, 19(5), 558–575.  https://doi.org/10.1177/0886260504262965.
  56. Weierich, M. R., & Nock, M. K. (2008). Posttraumatic stress symptoms mediate the relation between childhood sexual abuse and nonsuicidal self-injury. Journal of Consulting and Clinical Psychology, 76(1), 39–44‏.  https://doi.org/10.1037/0022-006x.76.1.39.
  57. Wolf, E. J., Miller, M. W., Reardon, A. F., Ryabchenko, K. A., Castillo, D., & Freund, R. (2012). A latent class analysis of dissociation and posttraumatic stress disorder: Evidence for a dissociative subtype. Archives of General Psychiatry, 69(7), 698–705.  https://doi.org/10.1001/archgenpsychiatry.2011.1574.

Copyright information

© The Author(s) 2018

Authors and Affiliations

  • Yochai Ataria
    • 1
  1. 1.Tel-Hai CollegeUpper GalileeIsrael

Personalised recommendations