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GiantAxon t1_j659ywk wrote

Reply to comment by sweet-n-sombre in TIL of Complex PTSD, which arises from prolonged, inescapable trauma (like child abuse/neglect, sex trafficking, or solitary confinement). It's hard to spot & treat, and can last a lifetime. Victims have a diminished sense of self, and issues with trust, boundaries, cognition, motor skills, & more. by Pfeffer_Prinz

Look, I see your point and I understand that not all these experiences are as depicted in movies. I am sorry to hear that you have first hand knowledge of these things.

Patients are as heterogeneous as anything else, and everyone experiences and perceives different things. But this is precisely why our definitions of things matter and why we need to, in your words, let the psychs figure it out.

The psychs (I'm sure at least some of them prefer to be called psychiatrists) have chosen not to include cptsd in the DSM for the time being. I think there might be good reasons for that, some of which we are discussing right now. The line between subjective experience and standardized diagnoses is hard to draw, but important nevertheless. It affects things like research protocols, and translates to how we understand and treat disorders. For example, how we define depression can translate into guidelines about pharmacology and therapy techniques. Before you say it, yes I know the DSM isn't the end all and be all of psychiatry.

For the time being, psychiatry as a field seems to recognize that there is a syndrome that results from prolonged repeated abuse, but some classify it under attachment disorders, some under trauma, and some prefer to stick to personality disorders due to the similarity in symptoms.

I don't know that it's helpful for us to argue about labels online because we aren't about to start flashing credentials and throwing papers at eachother. I take your point for what it's worth, and I hope you consider mine - I feel that we need careful definitions or else we risk blurring diagnostic boundaries to such an extent that everyone feels included when its time to self diagnose, but at the same time few people are helped by therapies because they are researched and delivered under highly heterogeneous research conditions.

When I ask myself if psychiatry has a bigger problem with diagnostic labels or with validated therapies it's a bit of a chicken and egg situation, but I lean towards poor therapies as a result of broad diagnostic categories for heterogeneous conditions.

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sweet-n-sombre t1_j65f4p8 wrote

Yes I agree with you that psychiatry has a broader labelling, and finding relevant treatment for the individual problem.

And people self diagnosing is a problem too, but I don't think the solution is to disregard some possible experiences from the understanding/context of these labels.

Yes the definition need be cleaner, and I think the actual fully defined criteria for C-PTSD must be so.

Note that the above quoted text was not a definition for C-PTSD, but context of possible experiences that might result in it. The actual evaluation would (should?) ofcourse be done by a professional who'd evaluate exhibited symptoms and not just go on history.

People self-diagnosing simply from the context are hurting themselves, true. And should probably seek a professional for more trained evaluation.

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GiantAxon t1_j65g32y wrote

Couldn't have said it better myself. I like that we can have a discussion, disagree on some things, agree on others. This has been very fun and I learned some things too. Cheers!

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