March 18, 2024
Today, we're embarking on a profound journey of understanding as we explore the intricate landscapes of Complex Post-Traumatic Stress Disorder (cPTSD) and Adverse Childhood Experiences (ACEs).
WARNING: the following is real, raw, and relational to some. Let's kick things off with a glimpse into my own journey of ACEs and cPTSD. As a tiny little brown female child being raised in a lower socio-economic area, my journey with cPTSD is deeply intertwined with a childhood marked by emotional neglect and exposure to mature themes far beyond my years. Growing up in the 70s, I sought comfort and companionship in the world of American television (think telenovelas, soap operas, and those three main channels on a tiny square box), music icons like Led Zeppelin, Pink Floyd, and the Doors while roaming the streets of Queens, NY. However, amidst the cultural immersion, I also encountered numerous challenges that no elementary school child should face. From witnessing my father's suicide attempt to his disappearance to encountering unsettling situations of sexual harassment, watching bookies come to my home in search of money owed, to the bully that put a knife to my throat just because he thought I was a F'kin Hindu… my childhood was marred by experiences that left lasting scars. Smoking cigarettes and other things at just nine years old became a coping mechanism, highlighting the early onset of unhealthy coping strategies to navigate this painful landscape of my upbringing. With an ACE score of 6, my journey with cPTSD was a daunting one, marked by emotional turbulence and inner turmoil.
So what is an ACE score and cPTSD? Adverse Childhood Experiences and Complex Post-Traumatic Stress Disorder are related yet distinct concepts in the context of psychological health and trauma. Understanding their differences and the linkage between them is crucial in the fields of mental health and therapeutic practice.
ACEs refer to traumatic events that occur during childhood (0-17 years). These events can include physical, emotional, or sexual abuse; physical or emotional neglect; and household dysfunction such as witnessing domestic violence, growing up with family members who have substance use disorders, mental health issues, experiencing parental separation or divorce, and having an incarcerated family member.
The ACE study, a landmark research project, highlighted the strong and graded relationship between the breadth of exposure to ACEs and a variety of negative outcomes in adulthood, including poor physical health (e.g., heart disease, diabetes), mental health issues (e.g., depression, anxiety), and behavioral problems (e.g., substance abuse, violence). The higher the ACE score (a tally of different types of abuse, neglect, and other hallmarks of a rough childhood), the greater the risk for these outcomes.
cPTSD is a condition that results from prolonged or repeated exposure to traumatic events, often over months or years, and typically involves an aspect of captivity, loss of control, or entrapment. This can include long-term abuse, torture, slavery, and exposure to war zones or concentration camps.
Post-Traumatic Stress Disorder (PTSD) often stems from exposure to a single or brief traumatic event. In contrast, Complex Post-Traumatic Stress Disorder (cPTSD) results from prolonged or repeated trauma, leading to more profound emotional disruption. Individuals with cPTSD may experience a pervasive sense of threat, profound feelings of shame or guilt, and chronic difficulties in managing emotions. Additionally, cPTSD typically involves complex alterations in self-perception and significant challenges in forming and maintaining relationships. These symptoms extend beyond the usual scope of PTSD, indicating the layered and enduring impact of complex trauma.
The correlation between ACEs and cPTSD is rooted in the severity and recurrence of early trauma. High ACE scores typically reflect exposure to chronic trauma that may culminate in cPTSD, with the disruptive childhood environment acting as a fertile ground for this complex psychological condition to develop. While ACEs serve as a measure of traumatic incidents during one's formative years, cPTSD encapsulates the intricate array of psychological impacts that stem from enduring and multifaceted trauma.
In summary, ACEs are specific traumatic events that occur in childhood and have a cumulative effect on an individual's lifelong health and well-being. In contrast, cPTSD is a diagnosis that describes the complex psychological responses to prolonged and repeated trauma, which can certainly include the traumas identified as ACEs. Understanding the link between ACEs and cPTSD is critical for effective diagnosis, treatment, and support for those affected by these experiences, especially in the BIPOC community.
As a trauma-informed, non-pathologizing therapist with firsthand insights into the healthcare field, the significance of properly understanding ACEs and cPTSD cannot be overstated when striving for accurate diagnoses and root cause treatment. If cPTSD were recognized in the Diagnostic and Statistical Manual of Mental Disorders (DSM), it could revolutionize mental health care by reducing the prevalence of misdiagnoses and encouraging a more holistic approach to treatment. It would acknowledge the profound and varied impacts of prolonged trauma on an individual's mental health rather than fragmenting their experience into separate, potentially unrelated diagnoses. This recognition could lead to a reduction in the multitude of diagnoses that may actually be manifestations of the complex trauma response.
Advocating for healing and resilience becomes especially poignant against this backdrop of understanding. Amid the challenges, there remains a beacon of hope. By embracing trauma-informed care, we advocate for a system that is attuned to the lived experiences of individuals, acknowledges the prevalence of trauma, and commits to addressing systemic inequalities. This shift can cultivate resilience and promote community healing as we endeavor to transform the narrative surrounding cPTSD. This is about managing symptoms and nurturing an environment where individuals can move from surviving to thriving.
Resources such as Bessel van der Kolk's "The Body Keeps the Score" dive into the profound effects of trauma on the body and mind and offer insights into recovery. This book revolutionized my therapy practice. Similarly, Pete Walker's "cPTSD: From Surviving to Thriving" provides a roadmap for individuals to navigate the complex journey of healing from complex trauma. Gabor Maté's "The Myth of Normal" challenges the very notions of "normality" in health and psychology, arguing for a compassionate and holistic approach to mental health. These works, along with others that explore ACEs and cPTSD through a trauma-informed lens, are indispensable for therapists committed to fostering true healing and resilience in those they serve. --- There is also a podcast episode from the Best of You, Episode 15 – The Pain of Million Cuts, which I highly recommend listening to if you score high on the ACE assessment.
As someone deeply immersed in the journey of healing, I've come to recognize the profound wisdom that arises from overcoming trauma. Embracing a holistic view of mental health has been pivotal in my own growth. Through years of dedicated effort, I've amassed a toolkit of diverse resources enriched by both formal education and personal experience. Navigating my way through a substantial ACE score of 6 and grappling with complex PTSD remains an ongoing process—one that I actively engage in alongside my therapist. Alongside traditional methods, I've embraced practices like biohacking and draw strength from my faith in Christ. If you're seeking support and guidance, I urge you to seek out a therapist who shares my commitment to a trauma-informed approach.
When seeking a therapist, it's crucial to find a clinician who can provide a supportive and comprehensive therapeutic experience. Here's a list of qualities and competencies to consider:
1. Specialization in Trauma: Look for a therapist with specialized training and experience in treating trauma, particularly cPTSD.
2. Knowledge of ACEs: The therapist should understand the impact of Adverse Childhood Experiences on long-term mental health.
3. Trauma-Informed Care: Ensure they practice trauma-informed care, which involves recognizing the presence of trauma symptoms and acknowledging the role trauma may play in an individual’s life.
4. Therapeutic Approaches: Find out if they are proficient in therapeutic modalities proven effective for trauma, such as EMDR (Eye Movement Desensitization and Reprocessing), Somatic Experiencing, or Dialectical Behavior Therapy (DBT).
5. Empathy and Patience: The therapist should demonstrate empathy and patience, as healing from cPTSD can be a slow and challenging process.
6. Non-Judgmental Stance: They must maintain a non-judgmental stance to create a safe environment where you can share your experiences openly.
7. Cultural Competence: Cultural sensitivity is key, especially if your trauma is interlinked with cultural factors or marginalization.
8. Collaborative Approach: Look for a therapist who values collaboration and works with you to create personalized treatment goals.
9. Boundaries and Professionalism: Effective therapists should establish and maintain clear boundaries, ensuring a professional relationship that fosters trust.
10. Self-Care Advocacy: They should encourage and assist you in developing a self-care routine that supports your healing process.
11. Resourcefulness: A good therapist can provide or direct you to additional resources, such as support groups or reading material, to aid recovery.
12. Continuous Learning: Opt for someone committed to continuous education and staying updated on the latest research and techniques in treating trauma.
13. Flexibility in Treatment: The therapist should be flexible and willing to adjust treatment plans as your needs change throughout the therapy process.
14. Support System Integration: They should understand the importance of a support system and may include family therapy or conjoint sessions when appropriate.
15. Confidentiality: It's essential that the therapist upholds strict confidentiality, creating a trusting space for healing.
16. Availability: Consider their availability for regular sessions and the possibility of support between sessions if needed.
Finding the right therapist may take time, but it's a crucial step towards healing and recovery from cPTSD and the impacts of high ACE scores. An initial consultation is often recommended to gauge the therapist's fit for your unique needs. Remember that healing IS possible. If you are in Florida, I have a couple of openings at the moment, so contact me to set up your free 15-minute consultation to see if I am the right fit for you.
I wanted to share a poem from my Wrath to Riches, Justice to Gems book called
Broken World
The broken world around me
The brokenness inside my soul
Memories that are destructive
Oh God it's taking a toll
Atrocious disgusting behavior
From the beginning of time
Humans hurting humans
Overwhelmed by painful crime
No eutopia built on greed
will ever succeed
You say if I believe
I will be free indeed
Please Lord free me from captivity
Between favor and judgment
The day of vengeance of our God
Wrath and fury, death and destruction
Where is your justice Lord?
In my weakness You are strong
Glory of God will be shown
The year of the the Lord's favor is now
Don't waste this day, repent
The year of jubilee is here
Believe in the One who's sent
Divine King
Everlasting
The Spirit anointed
The Messiah sent
All of Your fullness rest
On the Savior of the world
He brings good news to the poor
He binds up the brokenhearted
He proclaims liberty to the captives
Takes in those who are discarded
Oil of gladness
Garment of praise
A perfect future is possible
As we claim Your name
I claim Your holy name
Jesus
Jesus
Jesus
Take away the pain
The broken world around me
The brokenness inside my soul
Memories that are destructive
Oh God it's taking a toll
Atrocious disgusting behavior
From the beginning of time
Humans hurting humans
Overwhelmed by painful crime
Working out my salvation
Keeping my eyes on the cross
Guide me in Your purpose, Lord
Use me to help the lost
In my weakness You are strong
Glory of God will be shown
In conclusion, regardless of the storms you've weathered, whether it's the torrents of abuse or the icy winds of neglect, there's a path toward healing. And on that path walks the ultimate healer, the one who knows the depths of sacrifice for the sake of all—Jesus. Trust in His love, and let it guide you through the darkest valleys toward the light of restoration and renewal.
A prayer for us!
Oh, Great Physician, we cry out to you, for You are the One that we can trust completely and fully to help us through this path of everlasting. Help us feel your presence in these stormy times when we feel we have no hope when we feel the anger rise. Guide us to those who can help us through. Help us to choose You every day as we take up our cross and carry the thorns. Heal us if it is Your will, and use our scars to help others. In Jesus name, Amen!
In Service, Faith, Hope, and Love,
Diana
PS Please listen to my new podcast, The Holistic Counselor, to learn more about mental wellness.
And now for the disclaimer to make sure you understand that YOU are responsible for YOU:
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