2024 Author: Harry Day | [email protected]. Last modified: 2023-12-17 15:43
Trauma is defined as an event of extreme danger or life threatening that can lead almost everyone to despair. Complex post-traumatic stress disorder (CPTSD) is included in ICD-11 (code 6B41) as an independent diagnosis and occurs as a result of repeated or prolonged traumatic events. In addition to the symptoms of PTSD, CPTSD is characterized by impaired affect regulation, negative self-perception, and impaired relationships. I want to note that we will officially start using the 11 version of ICD from January 1, 2022, unless, of course, the deadlines are again shifted.
Thought patterns characteristic of CPTSD are usually formed by school age, and consist of memories, emotions and bodily sensations, and are to contact with other people … Due to constant criticism and refusal, already in childhood, a negative self-image and negative thinking stereotypes are formed. With continued (emotional, physical, etc.) violence by the parents (one of the parents), the victim is in a passive role, not finding the conditions for the formation of his own personality. Parents cannot be perceived as strong (however, there may be a substitution of "strength = aggression" for an aggressive parent) and protective, which is necessary condition for emotional separation from them in adulthood. These patterns lead to behaviors designed to avoid rejection by others in any case, so that their own weaknesses are not revealed, that is, to be held back, not to attract attention and not to express their own needs.
The main concerns of an adult seeking help can be divided into three areas:
(1) negative self-perceptions
(2) fear of criticism, and
(3) an equally strong fear of rejection.
The client has a negative self-image and considers himself "socially awkward", unattractive, perhaps even "stupid" and vulnerable. In life, he can behave with restraint, because he is not sure what others really like, not sure whether he is doing, whether he is doing the right thing. Others are perceived as critical, humiliating, error-tolerant, and competent.
In cognitive behavioral therapy, therapy goals are set with the client after analysis. For example: reduce fear of social situations, increase tolerance for negative emotions, or increase self-esteem. It is further emphasized that learning new behaviors and confronting previously avoided situations are useful for achieving goals. Cognitive behavioral interventions can also include relaxation procedures, systematic desensitization, in vivo exposure, and role-playing to develop social skills and enhance self-esteem. The gradual development of socially literate behavior is mainly achieved through positive feedback and constructive criticism … These interventions also train the ability to handle praise and criticism, with frequent repetitions and a slow approach being important. The use of video recordings has proven to be effective in shaping behavior and self-esteem, especially if the instruction is to pay attention to the positive things that are visible in the video. Therapeutic relationship can serve as a model for the client to test assumptions about relationships with others (the so-called empathic confrontation or empathic reality checkIn the process of work, it is very important for the psychologist to encourage self-confidence and the development of close relationships. Important factors for the prognosis of success are high intelligence, supportive relationships, for example, in marriage, good self-control, healthy lifestyle, developed empathy, and social well-being of the client.
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