The damage done to strangers, lovers and family members by sociopaths includes physical, emotional, psychological, social and financial harm. Over the years I have encountered many people whose lives have been damaged in this way.
The victimization alone is very sad, but people suffer not only from the actual damage but from their psychological and emotional reactions to it. It is one thing to lose a large sum of money or time that you can’t ever get back. The losses happened and are permanently in the past. It is another thing for a person’s present to be occupied by that loss.
The Aftermath is often more extensive than the victimization itself
It is my observation that for many victims this aftermath lasts a long time and includes considerable dysfunction and this dysfunction causes additional damage. Many have used the label “PTSD” for these psychological, emotional and physical reactions to victimization. Although I agree that diagnosis may fit some, I have never been entirely comfortable with it applied to this context. The reason is that PTSD technically applies to only to situations that are “life-threatening.” PTSD is an anxiety disorder as opposed to an “adjustment disorder” and some symptoms that victims have are not based in “anxiety.”
Psychologist and Professor, Dr Michael Linden, of the Research Group Psychosomatic Rehabilitation, Berlin, Germany has proposed a new disorder be added to the DSM. This disorder, termed Post-Traumatic Embitterment Disorder or PTED describes the reactions I have seen in many people victimized by sociopaths.
I thought seriously about this blog for two weeks before posting it because suggesting there is such a thing as PTED is far from politically correct and sincerely, I would not want anyone to get the idea that I blame victims for their aftermath symptoms. On the other hand, I hope that those who have the symptoms Dr. Linden identifies will consider addressing them. I am also not in favor of the medicalization of common psychological reactions and so am not rushing to advocate PTED be declared an official diagnosis.
What is PTED?
Just as PTSD is thought to result from the threat of loss of life, PTED results from a different kind of threat. Dr. Linden states regarding PTED, “The core pathogenic mechanism is not the provocation of anxiety, but a violation of basic beliefs. This threat to deeply held beliefs, acts upon the patient as a powerful psychological shock, which triggers a prolonged feeling of embitterment and injustice.”
For victims of sociopath’s the sociopath’s behavior violates core beliefs about human nature and sense of safety. That theme is discussed over and over on this website.
Diagnostic and associated features
The essential feature of posttraumatic embitterment disorder is the development of clinically significant emotional or behavioral symptoms following a single exceptional, though normal negative life event. The person knows about the event and perceives it as the cause of illness. The event is experienced as unjust, as an insult, and as a humiliation. The person’s response to the event must involve feelings of embitterment, rage, and helplessness. The person reacts with emotional arousal when reminded of the event. The characteristic symptoms resulting from the event are repeated intrusive memories and a persistent negative change in mental well-being. Affect modulation is unimpaired and normal affect can be observed if the person is distracted”¦
Besides prolonged embitterment individuals may display negative mood, irritability, restlessness, and resignation. Individuals may blame themselves for the event, for not having prevented it, or for not being able to cope with it. Patients may show a variety of unspecific somatic complaints, such as loss of appetite, sleep disturbance, pain.
PTED is said to be a disabling condition and is very difficult to treat.
Additional comments
Although I read two of Dr. Linden’s papers (see below) I was disappointed that he failed to define what it means to be bitter. How does bitterness differ from other reactions like anxiety or grief? Bitter is not an emotion it is a taste. Is he suggesting that victims have an actual bitter taste in their mouths? In studying dictionary definitions I can offer that bitterness is unique in that there is an anger/hostility component- synonym resentful, hostile feeling.
Provided he can more precisely define bitterness, I think Dr. Linden may be communicating something useful here. That is the idea that we have to mobilize our resources to move beyond events that threaten us. Events that threatened core beliefs may be very traumatic for people. It is important for victims to examine their core beliefs in recovering from a relationship with a sociopath.
I am interested in your reactions to this proposed diagnosis.
References
Linden, Michael, Kai Baumann, Barbara Lieberei, and Max Rotter. 2009. “The Post-Traumatic Embitterment Disorder Self-Rating Scale (PTED Scale).” Clinical Psychology & Psychotherapy 16, no. 2: 139-147.
Linden, Michael, Kai Baumann, Max Rotter, and Barbara Schippan. 2008. “Diagnostic criteria and the standardized diagnostic interview for posttraumatic embitterment disorder (PTED).” International Journal of Psychiatry in Clinical Practice 12, no. 2: 93-96.
Hi Elizabeth Conley,
Sorry to hear about your two simultaneous flat tires on the interstate highway while driving alone with your daughter.
How the heck were you able to replace both? Do you carry
two spares in your trunk?
This writing wound me up. I wrote several responses and didn’t post them as upon reflection they were too bitter 😛
I definitely believe there is such a thing as CPSTD from these psychologically and emotionally unsafe relationships. The anxiety felt by a mugging victim is a one time event, but targets in pathological relationships can suffer that sense of foreboding and terror and stress several times a day for years and years – it has an impact definitely. For many of us the stress blows out into the physical body in the form of chronic migraine, allergies, chronic fatigue syndrome, fibromyalgia, lupus and so on. Whether the stress alone causes these syndromes or just makes a gateway for infection to enter is unsure, but stress definitely contributes to their development.
Ongoing stress can permanently rewire the brain – the amygdala and the autonomic nervous system. It alters the chemical cascades and can even permanently alter our genetics. Anyone interested in this should check out a doco called The Ghost in Your Genes (google video). Researchers measured the stress levels (salivary cortisol) of women who were in New York during 9/11. Those who were in their third trimester of pregnancy when it happened gave birth to infants who showed abnormal levels of cortisol despite the fact they weren’t even born when the event happened and were not old enough to understand and process the significance of what happened.
This knowledge has implications for all of us who have a history of being treated unfairly. My father was an unavailable man so that means more than likely I was born with elevated stress hormones, which elevated even further with each witnessed argument and the strain of the split up of their marriage. That altered response to stress would have hit me each and every time I went through something stressful … so I was already at a disadvantage in terms of being able to process this.
I am quite useless at explaining it but the theory is called Kindling and comes from neurologist and psychiatrist Dr Scaer who wrote a book called The Body Bears the Burden. Basically a history of trauma weakens the defences and makes developing PTSD far more likely. The theory is outlined by a far more articulate writer than me here
http://abortionhurts.blogspot.com/2005/07/one-two-three-strikes-youre-out.html
You might also like to examine her explanation of how humans are programmed against violence and killing. She has looked through Army research to find data for post traumatic stress disorder.
And from psychopathy research we know that bullies can spot vulnerable people from their very walk without them opening their mouths.
I think all these factors come together and none of them are a conscious decision to remain ’embittered’ or to even think that way. Being bitter after all the hurts is natural – it is amazing we have strength to continue moving towards light and healing after such experiences. It would definitely be easier to remain at a low place.
Well for the last couple of days..I was feeling ‘verbittert’ …interesting post Libele..
and after working around the house all day.. I went to the sunbed.. and then the grocery.. and I turned heads.. I felt good again..I felt like me… I needed a bit of that male energy coming my way… bitter not me.. I’m hot..
I haven’t lost it.. I’ve found it! LOL!b
From where I stand, there is NOTHING normal about the event and / or events caused by psychopaths. In my case, my life was physically (verbally) threatened, and I know so many bloggers have noted the same. So, in my particular case, PTSD seems to “fit” better.
I am not in favor of the PTED, though, because it suggests just that: normalcy of the absolutely astonishing experience that resembles PTSD quite a lot. PTSD is diagnosed in rape victims and in victims of incest and in war and trauma survivors. Have we not survived a war? have we not continued to try and explain to peers just how and why our situation is different from “normal break-up” and even “normal abusive relationship”. Ok, there is nothing normal about an abusive relationship, but I think it was Donna who said in one of the articles that the sole significant qualifier that unites all of our perpetrators is pathological lying and manipulation. This has threatened me to the core of who I was, and it turned out to be life threatening not only on a physical but especially on an emotional level.
When I read some posts, I almost wish I can report that I was beaten up, screamed at, ignored… This we can feel and experience as evil… Nope, I lived in a perfect lie.
Dear Pollyannanomore –
Thank you so much for this last post about CPTSD that you wrote. It validates so much of what I was trying to convey
about it in a much more descriptive and succint way. Thanks for the link!
As regards abortion, I hope for the day when there is never any need or desire to terminate a life, based upon the premise that we care enough about human beings to educate and nurture them so that they will never find it necessary
to contemplate that as a choice.
Until that time arrives, I pray that people are more aware of
the dynamics underlying what to some is only a divisive issue.
Reading about young mothers disposing of newborns or infants like trash is very distressing.
Addressing the underlying causes for this that you mention in this post are precisely what is needed to bring about awareness and change. Great post!
A perfect lie can be so much more damaging, because it is hidden within your being. And when anyone tries to point it out to you, based on what outsiders might see, it is masked and there are no physical injuries to point to.
That is frustrating for those who see it and can’t get thru to the one being abused.
Thank you for your validation. you are so right, Inquirente
THank you, Dr. Leedom for a thought-provoking article.
I think that the a problem exists with the formal definition of PSTD, if it requires a “life threatening” situation as a trigger. I’m not sure who would be the arbiter of that definition, since a lot of things would fit that category from a psychological level, if not necessarily a legal one. For example, anything that a child feels is a threat of abandonment would be perceived as life-threatening, just as the loss of a job to a person who is living at the edge of homelessness might also be perceived that way.
My own perspective on trauma has been that it is a breach of boundaries that is felt so profoundly that it 1) causes the person who experience it to lose their previous identity or orientation in relationship with the world, and/or 2) to lose control of their emotional reactions.
That leaves a lot of latitude, and it includes very “minor” things as well as life-threatening ones. Personally, if I’m in a situation where circumstances a person’s behavior drives me to tears, rage or fear that overrides my reasoning ability, I feel like my boundaries have been insulted and I immediately start protecting myself from that person or circumstance. (It’s the reason I basically avolid movies by Stephen Speilberg, after E.T. made me feel so emotionally jerked around.) To group this kind of experience with traumas may sound trivial, but I think it keeps me aware of the mechanism of trauma and more alert to more significant threats.
As far as bitterness goes, my take on it is that bitterness is old unresolved anger. Which means that the trauma processing stopped at a relatively early stage.
Again to go back to my own case, I was bitter all my life, although completely in denial about it. Because my trauma processing stopped at denial. Things that happened to me “didn’t matter.” My recovery strategy was to ignore them and keep forging on. As a result, I had most of the symptoms that Dr. Lindman describes, but I think this is because unprocessed trauma has two main effects. One is to keep us preoccupied with the details of the denied threat, and the other is to keep a level of background anxiety running pretty constantly unless we’re in the “relieved” aspect of the addiction cycle.
When faced with research efforts such as this, I sometimes feel like a bit of a broken record when I keep referring to the stages of trauma processing as a model for understanding these symptoms. And I understand the scientific research model for identifying a symptom or cluster of symptoms and then trying to correlate it with something. But I still get a little frustrated.
The Kubler-Ross grief model, adapted to experiences that threaten identity or fundamental beliefs about the nature of the world, makes sense of the experiences of trauma processing — from the first blow to the ultimate resolution. Bitterness, obsessive thinking, regressive fugue states, chronic distrust or defensiveness, and all the other states that are so commonly represented here on Love Fraud, are symptoms of progressive trauma processing.
That said, I do think that bitterness can be a sign of an extremely difficult therapeutic situation. That is, people who have a level of distrust or despair that discourages them from seeking help to resolve traumas that are causing major life dysfunction.
I have an observation that doesn’t qualify as a theory, but seems to keep popping up in my mind. That is the divide in post-traumatic types between the kind that have fast access to anger vs. the type that have fast access to fear. In a way this is the shark vs. carp divide or the dependent vs. independent personality disorders or the addictive vs. codependent differential. I think that bitterness is an isolating symptom, and to the extent that a person experiences it, they will retract from dependencies and intimacy.
At the far extreme, that may mean sociopathy. But bitterness can also be found in codependents like me, who expect little and give much, but also maintain a private scorecard of all the ways I’ve been wronged by the person I’m involved with.
For me, getting out of denial about my foundational traumas gave me a chance to resolve them and the patterns of bitterness pretty much dissolved along the way. But of course, first I had to elevate bitterness to an acceptable response, instead of something I didn’t admit to, and then get righteously angry. That is, go through the angry phase that is so pivotal to our healing.
As others have mentioned, the definition of bitterness in this research is not clear. The symptoms listed look more like PSTD in my expanded definition of trauma. The reference to a “normal” trauma is particularly odd. If it shakes our world, it might be normal to someone else, but we still have to process it to get back to center and move on. We might be able to process a little insult in a moment, but if it rattles us, we still have to go through resolving it so we’re not carrying it in the future.
Thanks Keeninsight 🙂 I don’t think I am articulate at all but did some research into PTSD over the last few years and found the links incredible. I wonder how many of us actually stayed longer because of these triggering symptoms and what that told us about who we were at that time ie not strong enough and can’t cope alone.
PInow – you said “Have we not survived a war?” AMEN – that sums it up perfectly. We have indeed survived a war waged for many years with adversaries who pretended to be our friends and lovers – how can you possibly win in that kind of war, when the enemies are not even clearly identified but instead function as Trojan horses – gifts with death inside them?
You also note the difficulty we have in telling our stories to others – they don’t understand why we couldn’t just leave and why it bothers us so much compared with other breakups. It’s the betrayal I think. Betrayal makes the difference.
Inquirente – I like your pointing out that our wounds are invisible – this makes it incredibly difficult to explain to others. I actually at one point begged him to just hit me so “I have a reason to leave you.” I equated danger with physical violence and didn’t understand about worse dangers than that. The danger he inflicted damaged my soul and my core – bruises heal with time but I don’t really know how to heal these hurts except by talking it out and writing out my story to understand it and by learning as much as I can.
Kathleen – I understand what you are saying. I am finding the same – that all the hurts I thought I had mourned and come to terms with are bubbling up from the past and demanding attention and salvation. It is both a gift and a curse. I didn’t want to have to deal with them, but also recognise that because I hadn’t dealt with them I married a dangerous man. I don’t have a choice now. It is agonising to realise all the ways I have been abandoned over the years but also extremely freeing – I was so worried about him abandoning me and he did it every day in hundreds of little ways. I was avoiding the original abandonment and I can’t avoid it anymore. Thirty years of avoidance is enough – time to look at what lies beneath and admit how much it hurts still.
Thankyou everyone for your acceptance, listening, validation, understanding and encouragement. This is such a hard journey to take after everything else.
Pollyannanomore,
You wrote: “This is such a hard journey to take after everything else.” I just want to say that it’s hard, but fascinating and rewarding and joyous.
I’ve never felt in my life the way I felt when I got serious about healing myself. I still can’t describe it, except it was something like those old adventure stories about a safari into deepest Africa. Tough and harrowing, but wildly exciting and rewarding, and every step of the way I became more convinced that I was capable of more than I’d ever imagined. And like those great adventurers, I know that I’d come home completely changed, relaxed about things that made other people flap, insightful about things that used to fog my mind, and just somehow broader in all my perspectives. And that’s actually the way it turned out.
So what I’m trying to say to you is, even though you may not be i the mood for this right now, you will be once you get started, I promise.
And if you haven’t got a good therapist already, go looking for one who deals with PSTD or childhood abuse issues. They know this path.
Namaste. The healing spirit in me salutes the healing spirit in you.
Kathy