A syndrome called post-traumatic stress disorder (PTSD) can affect victims of sociopaths. The trauma of losing love, friends, family, possessions and of enduring psychological/physical abuse is the cause of this disorder. To fight the symptoms of PTSD, it is helpful to understand the symptoms and how they relate to loss and trauma.
As I read through the current literature on PTSD, I quickly discovered that there is a fair amount of controversy regarding this disorder. We can actually learn about the disorder by listening to the arguments. The first question on which there is much disagreement is, “What trauma is severe enough to cause PTSD?” There were several editorials by experts disparaging the fact that everything from giving birth to a healthy baby to a boss yelling at an employee is now said to cause PTSD. Most experts are in favor of reserving this diagnosis for people who have suffered truly unusual life experiences, like kidnapping, rape, war, 911, etc.
The problem is that many people do experience severe stress reactions to difficult life circumstances. It remains to be determined what we should call these reactions.
Those of us healing from our relationship with a sociopath often vacillate between accepting the trauma and minimizing it. Thus, the argument about what kinds of trauma are severe enough to cause PTSD has a direct effect on us. The argument can leave us feeling weak, like we should be able to get over this. After all it wasn’t as bad as 911, Iraq or Katrina—or was it?
The second question is “what symptoms constitute PTSD?” The following table shows the most common symptoms seen in a group of 103 British men and women diagnosed by psychiatrists with PTSD (Current Medical Research Opinion, 2003):
| Symptom | Frequency (n=103) |
| Insomnia | 98 (95%) |
| Anxiety at reminder cues | 96 (93%) |
| Intrusive thoughts, images, sounds, sensations | 94 (91%) |
| Irritability | 93 (91%) |
| Poor concentration | 93 (91%) |
| Diminished interest in significant activities | 88 (85%) |
| Recurrent dreams of trauma | 86 (83%) |
| Avoidance of activities or places associated with the trauma | 85 (83%) |
| Foreshortening of expectations about the future | 80 (78%) |
| Detachment from others | 78 (76%) |
| Avoidance of thinking or conversing about the trauma | 75 (73%) |
| Poor appetite | 69 (67%) |
| Hypervigilance | 55 (53%) |
| Startle reactions | 46 (45%) |
| Acting or feeling as if the event was recurring | 37 (31%) |
| Inability to recall parts of trauma (amnesia) | 19 (18%) |
I put up this table because I thought that a number of you would also endorse these symptoms. Notice that “acting or feeling as if the event was recurring” was really not that common. But similar symptoms, like “Intrusive thoughts, images sounds and sensations,” were very common. Amnesia was also uncommon. Startle reactions were only seen in half of the subjects.
A feeling of a foreshortened future is a particularly debilitating symptom because it impairs a person’s ability to plan for the future and leads to a sense of hopelessness. I will expand on this further, but I strongly believe this feeling of a foreshortened future has to do less with our thoughts about our past, and more with our thoughts about our present.
As I look at this list of symptoms, I am struck by the fact that many, many of those writing into Lovefraud complain of these symptoms, particularly nightmares. There is something special about having had emotional involvement with an aggressor that seems to produce nightmares. Since so many have all of the most common symptoms, I think it has to be that the trauma of life with a sociopath is severe enough to cause this disorder in many people.
Here’s where defining exactly what trauma is gets sticky. Rachael Yehuda, Ph.D., said in a recent article published on MedScape, “One of the things that biology has taught us is that PTSD represents a type of a response to trauma, but not the only type of response. It is a response that seems to be about the failure to consolidate a memory in such a way as to be able to be recalled without distress.” Well, this is precisely the definition that is too broad. I personally have a lot of memories that I experience or re-experience with distress. Yet these memories are not accompanied by the list of symptoms in the table above.
For me what made the experience traumatic was the truly life course-changing nature of the trauma. The answer to the question, “Will I ever be the same?” for me defines trauma significant enough to cause PTSD. The trauma that causes this disorder redefines us in a way that is different from other emotionally significant experiences. This trauma strikes at the core of our identity.
The final controversy surrounds the treatment of PTSD. Interestingly, there is no question that medications (SSRIs, particularly Zoloft) are very helpful. The problem is though that when a person goes to a physician and receives a medication, he/she is by definition “sick.” Assumption of a “sick role” or “victim identity” is one of the many factors that slow recovery from PTSD.
Many therapists are of the belief that “debriefing” or retelling the story is necessary for recovery. One group of researchers reviewed the studies on debriefing and concluded that there is no scientific evidence that it prevents PTSD. Instead, the evidence points to post-trauma factors like social support and “additional life stress” being most important.
How can we put this all together? Considering last week’s post, those who experience trauma serious enough to have stress hormone overdose as manifested by dissociation, are likely to also develop PTSD. An examination of the symptoms of PTSD reveals that at the core of the disorder is the fact that the person really doesn’t believe in his/her heart that the trauma has ended. PTSD is about ONGOING, not past, trauma. For those of us whose lives were assaulted by a sociopath, there is ongoing stress. The stress is the social isolation, financial ruin, and threatened further losses long after the relationship has ended. Those who recover from this without PTSD work hard to put the trauma behind them in every way.
Putting the trauma behind you does not mean you can’t take medication to help with the process. It does mean facing those bills, former friends, and other personal issues you want to avoid. Remember AVOIDANCE STRENGTHENS FEAR.
Above all, stop the ongoing trauma by ending contact with the sociopath. Do not assume a sick role, instead, work to stay healthy. Fight to be the person you want to be. Don’t allow this single experience to define you. Make living for today the place you love to be. As Louise Gallagher says in her recent post, “This is, in many ways, the greatest challenge of recovery — to accept the past is simply the route I took to get to where I am today, a place I love to be. The past cannot be changed. It cannot be altered. It cannot be made ‘better.’ It can only be accepted so that it, and I, may rest in peace with what was, eager to accept what is true in my life today.”
PTSD? It’s been 15 months since I was assaulted, eight months since the court date, seven months since he and I weren’t in an official relationship (I’d realized he’d been cheating), and two weeks since I last spent the night with him, my favorite lunatic.
I don’t sleep normally anymore.
I still burst into tears at having to listen to raised voices – anyone, anywhere!
I’ve lost interest in my usual activities.
I’ve lost 18 lbs in the last two months – 33 since I left him.
I tried to return to work a couple of weeks ago and kept crying.
I’m a bit jumpy
I’ve cried for most of the 15 months since the assault (until I got here).
I don’t or didn’t remember parts of that night
But the last two weeks here have done wonders for me.
I knew I wasn’t crazy.
I knew it wasn’t something I did or didn’t do…
But, I didn’t know what HAD happened.
I’m off the anti-depressants since I’ve come here.
I’m eating, perhaps a bit too much even.
I don’t know about my career, he may have gotten that, but so what.
I even slept in my bed twice in the last week – for the first time in months.
I feel better knowing, and being able to shine a light on the monster under the bed makes it much easier to understand.
Dear Pb,
Welcome back to sanity! The healing road is rough, uphill, and filled with pot holes, but the journey does get easier as you go along. I strongly suggest that you get some therapy and possibly some medication for the PTSD. I had severe PTSD with almost all of the above mentioned symptoms to the point I was totally non functional, but with medications and therapy I have come a lonnnnng way since then.
The thing I found MOST helpful was “rapid eye movement therapy” from a licensed psychlogist and it is specifically for some of the PTSD symptoms. It isn’t as readily available as BCT or “talk therapy” but I find that it is much more effective and it doesn’t go on forever either. In only a few months I improved markedly with once a week therapy for 50 minutes.
I’m still not “perfect” but my life is functional again. I have a LIFE and I have some joy and peace in my life now that weren’t there before the rapid eye movement therapy. Google it and see what you think. For me it did help (I am a retired registered family nurse practitioner (with considerable mental health experience as well)
I’m glad you are here, this blog is one of the, if not THE BEST places on the internet with more good solid information and great support from the bloggers here.
You know, I’ve always said I don’t mind shoveling s**t – as long as it’s fresh s**t and I have a good shovel.
I guess I should be careful what I wish for, eh?
I am most certainly not gonna stand here endlessly digging the same pile over and over with a teaspoon.
I’m thankful that it was a quick trip to hell and back – as horrible as it was.
And seriously, I don’t know what would have become of me had I not found this site. I can’t stand to not understand. I have, at the very core of my being, a very strong sense of what is right and wrong, of justice. And, it was killing me to not understand what the hell changed so fast. I knew that whatever happened was plain old wrong and not fair.
I obsessed forever, re-read my journals, checked dates with his cell bills (a significant number of our bad nights were preceded by phone calls to a couple of women. The man would cry on their shoulders and come home to take it out on me)…It was funny to note that I had called him “psycho” a number of times – but only because he kept calling his ex and I psychos’. I was joking initially.
All the signs were there. I just didn’t recognize them for what they were.
Red Flags – things that just didn’t feel right, right away:
Self-importance/Insecurity – he used his job as validation, wears supplier t-shirts/jackets while not at work so that folks will know what he does for a living. He’d brag about how much money he made, or how much money he’d spent on his ex-wife and daughter. He loaned folks money all over the place, or donate his services to his church (but he never attended). He’d give you the shirt off his back. Lack of confidence? We can deal with that, right?
Disrespectful – Publicly trashing his ex-wife, calling her “psycho” in front of folks at work or play (he was smearing his wife). I thought the poor guy just needed to vent for a while and excused it.
A Tendency to Snap at work/Perfectionist – Both are considered good characteristics in his job.
His house was too clean – need I say more? I was delighted to see a fellow as clean as I – NEVER AGAIN!
No sense of the appropriate or boundaries – socially, sexually, or financially. He was a devilish child in some ways and I admit it was attractive, but not for long.
Rush to involvement – very confusing. I thought he was crazy about me.
He was always busy – If he had to be still, he had to be drinking, having sex, or be asleep. His house was very clean.
Lavish attention, purchases, and gifts – food, clothing for his daughter, activities and trips, a set of kitchen cabinets for my rental suite, a bathroom, or mortgage payments for someone else.
Impulsive/need for instant gratification – “I want what I want and I want it now” mentality, or his daughter or I would say we like something, and he would want to go buy it.
Overindulgence of his daughter – to confuse her as to what love is, secure her loyalty, to control her, and to appear a doting father to everyone else.
Lack of real friends – No one ever visited. Who wants to visit a nasty drunk, especially in his own home where he’s likely to behave even worse than he behaves in public.
He spoke in double negatives – I know it sounds petty, but it bothered me when he said things like, “I don’t got no”, “I seen…”, or “I don’t want to do that no more”. I thought I was being judgmental and chided myself, but really, it indicated a lack of ability and respect for communication.
Inexcusable Behavior:
Showing up drunk on our first date – I accepted his excuse of being nervous because he hadn’t asked a woman out “in over 20 years”
Drinking while driving – I didn’t know how to approach it and I didn’t want to argue, but it made me uncomfortable.
Humiliating me in public or in front of the few visitors we had – I stopped dating him twice over this. He cried, begged, and said he was testing me.
Insane jealousy
“Testing” me with his drinking
Trashing his ex-wife in front of, and to, his daughter – he has no respect for a childs right to be a child and to love both parents. It’s about what he wants or needs, not his daughter.
Involving his daughter in our arguments – repeatedly. He was telling me to get out one night because I dared to mention that I had let him vent about his ex-wife for months…Well, as soon as I said her name he began yelling for me to get out. The phone rang and it was my “best friends” step-daughter asking to speak to S’s daughter.
He yelled into the phone “She can’t come to the phone because she’s crying because [I] won’t leave.”
I couldn’t believe he would involve two children in his rant. His daughter was already in tears. I had tried to not get into it with him, but he wouldn’t stop. And, then he says that to an eight year old girl. I realize now it was the early stages of his smear campaign. She likely repeated that to my best friend after hanging up the phone.
Spying on me – he would go home and turn off the motion sensor lights and spy on me when we were visiting at the neighbours. He would call me constantly while at work.
Reading my journals – he said it was an accident that he opened two folders with my name on them.
The drunken black-outs
Harassing me for months – I was so stressed out from having to watch my words, explain myself or why I did things the way I did – it was awful. I was scared to speak half the time.
Running me out of our home, for months, because it was his house; he’d tell me to go spend the night somewhere else if I said something he didn’t like.
Assaulting me – He tells everyone that I attacked him and that he only admitted guilt in court because he “had to” (assuming he tells folks he admitted guilt at all. I’m sure he doesn’t tell folks he’s on probation).
Things I simply wasn’t aware of:
Isolating Me – He asked me to stop working, move in, and fired his nanny and cleaner. He said I “shouldn’t have to work” and he wanted to “take care” of me. I was financially dependant on him and no longer working. My social circle had consisted of folks from work.
Cheating – He wasn’t a looker, and he worshipped me…I had no idea what he was up to until he started acting strange. Even then, that was the night of the assault, and it still took me months to figure it out.
Projection – Abusive, cheating, lying, psycho, not normal, a freak, troubled…my life’s gonna “suck”, I must really like to be “alone”, I don’t know what “reality” is – all things he accused me of but were in fact his issues.
Rush to involvement – I had no idea this was a sign of an abuser; to get you involved before you can figure out what it is you’re dealing with.
The Smear Campaign/Pity Ploy – This is what he’d done to his ex-wife, and had begun with me, at work and in our social circle. He had alienated my best friend by the time he assaulted me.
Carolyn: I understand. I use many techniques, but I am also dealing with intrusive thoughts, startle, etc., etc.
I have researched one type of therapy that may help, and if you can I encourage you to explore it. Neurotherapy or “brain-training” is used to help with ADD/ADHD, chronic depression, and PTSD. You may find a practitioner in your area, but please research it. If I had the money, that’s what I’d be doing!
Carolyn: Ox-D mentions eye-movement therapy. There’s also a variation of this that uses gentle “buzzer” stimulation to the hands in alternating signals. The idea is that the cross-stimulation helps with getting the stored and highly charged memories out so the emotional charge can be removed. It has been shown to be effective with rape victims and war veterans.
I believe that the neurotherapy offers even more potential to “smooth out those old ruts of repetitive thinking” and lay down some new, healthier thought patterns.
Hello PB:
Good for you that you can recognize all those patterns. And you KNOW that they are dysfunctional, and YOU are not the problem!
For this holiday season, give yourself the gift of forgiveness and freedom. Celebrate your strength and intelligence in your choice to break away from the craziness and abuse.
I would recommend that be cautious about Neurotherapy and research it as Rune suggested because the evidence is not there to prove it is effective over the long term:
Neurotherapy—also called neurofeedback and EEG neurofeedback—is a form of behavior modification that uses electroencephalographic (EEG) biofeedback technology to increase voluntary control over the amplitude and pattern of various brain wave frequencies. Proponents claim that modifying brain wave patterns is effective against anxiety reactions, mood disorders, substance abuse, attention deficit disorders and various other mental and emotional problems. Research shows that brain wave activity can be altered through various forms of biofeedback. However, a comprehensive review has concluded that none of these claims is supported by well-designed studies.
Lohr JM and others. Neurotherapy does not qualify as an empirically supported behavioral treatment for psychological disorders. The Behavior Therapist, 24, 97-104, 2001.
Kline JP and others. A cacophony in the brainwaves: A critical appraisal of neurotherapy for ADHD. Scientific Review of Mental Health Practice, Vol 1, No.1, Spring/Summer 2002.
As always, “buyer beware.” But I understand that part of the challenge of empirically proving the effectiveness of neurotherapy is that ANYTHING that helps us to gain control over our thoughts is effective — and in the studies, people in the control groups were also learning techniques to address their thought patterns, so they were also gaining help.
I have some more recent studies, but thank you for the references. I know that there has been controversy in this area, but I also know of people who have experienced permanent change with the help of neurotherapy.
I have had PTSD since a child (as a result of “mild” molestation by my favoriate maternal uncle).
I spent 5 years in therapy and went the whole route of recommendations for someone who was molested. During the course of my therapy, one “route of treatment” I found most helpful, COUPLED with talk therapy, was holotropic breathwork. I did several sessions over 2 years and it enabled me to work through all the issues of abuse without any medication AND a wonderful counselor.
Today, I still periodically have bouts when my PTSD comes back — I was taught “skills” to deal with it: deep breathing, rest, good food, no alcohol, exercise. Only twice, since I have gotten older (I’m now 52) have I had to take medication. I took Xanax for two short periods of time, when the symptoms were more than I good deal with and keep working at my job. I’m a senior litigation paralegal.
Greentrees:
You might look at comments under “Entanglements with Sociopaths.” Ox-D describes the benefits she found with EMDR.
Your breathwork sounds like a clinical variation on “pranayoga” — Indian breathing techniques that are used for health and shifting of consciousness.
I think we should catalogue these techniques that have helped!