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1. 00:01 many victims of narcissistic abuse claim to suffer PTSD post-traumatic stress disorder owing to the exposure to the abusers's maltreatment torture and worse unfortunately this claim is counterfactual you cannot suffer PTSD you cannot be afflicted with PTSD in a
2. 00:27 in an abusive relationship you can however on rare occasions develop CPTTSD complex trauma in 1992 Judith Herman was the first to propose this diagnosis of complex trauma CPTTSD complex post-traumatic stress disorder and that very same year I applied it to
3. 00:49 the study of narcissistic abuse in the following years I gave numerous interviews and wrote many articles on how CPTtsd could be an outcome of abusive relationships with narcissists and with psychopaths and now of course it is a mainstream view however a few caveats very few
4. 01:14 people react with CPTSD very few it's a trauma it's not candy you know not everyone develops trauma trauma is a highly idiosyncratic highly specific and rare actually reaction so yes when you're in a relationship or so-called relationship with a narcissist and a psychopath you
5. 01:39 chances are that you might develop CPTTSD especially if the exposure is very long and the abuse is very intense your chances to develop PTSD are nil zero and today I want to disambiguate i want to tell you a bit about post-traumatic stress disorder my name
6. 01:59 is Sam Vaknin and I'm the author of malignant self- loveve narcissism revisited the first book ever on narcissistic abuse and the first book that suggested that CPTtsd complex trauma might be a useful adjunct a useful diagnosis in the study of
7. 02:15 narcissistic abuse i'm also a professor of psychology so let's delve right in post-traumatic stress disorder we are talking about survivors of traumatic events or highly traumatic experiences so we're talking about people who have endured natural
8. 02:37 disasters where the victims of crime especially violent crime were caught in a war or a battle zone or a conflict area and people who have witnessed or have been victims in mass shootings this is the kind these are the kinds of events these are the kind of occurrences
9. 02:58 that yield and produce post-traumatic stress disorder so people in Gaza may develop post-traumatic stress disorder vietnam vets veterans who fought in Vietnam have developed post-traumatic stress disorder people who were in Hurricane Katrina developed um um
10. 03:19 PTSD and of course mass shootings from Coline to Norway in all these cases people have been diagnosed with PTSD you cannot develop PTSD in an abuse that is low intensity relatively speaking when compared to war or to violent life-threatening crime or to natural
11. 03:39 disasters the worst abuser narcissist or psychopath is with all due respect um not comparable so when you're exposed to long-term repetitive low inensity abuse even if it is extreme you are very unlikely to develop PTSD probably in some cases you may
12. 04:02 develop CPTSD ptsd post-traumatic stress disorder involves sleep disturbances startle reactions jumpiness and they last for a few months contrary to myths propagated online by self-styled experts the overwhelming vast majority of people who develop PTSD symptoms recover many of
13. 04:27 them spontaneously after a few months actually now startled reactions are common in PTSD and very uncommon in CPTSD sleep disturbances however are common in all post-traumatic conditions cptsd and PTSD alike and other types of post-traumatic conditions there's a
14. 04:49 whole chapter in the diagnostic and statistical manual dedicated to traumatic disorders or disorders induced by trauma ptsd also usually involves paranoid ideiation and extreme hypervigilance bordering on actual paranoia so this is also an element that is usually absent in CPTSD
15. 05:12 the Diagnostic and Statistical Manual lists how else eight criteria the famous the famous bullet list of the DSM eight criteria to diagnose PTSD it requires exposure to actual orthreatened death death life-threatening serious injury or extreme sexual violation
16. 05:36 rape direct experience is one way of ending up with PTSD but witnessing is another even if you have not been the victim of any of these but you have witnessed another person being victimized your empathy will cause you to develop PTSD even when you have just learned
17. 05:59 that this has happened to a loved one this would cause you PTSD even if you um were recurrently exposed all the time time and again repetitively exposed to details of such an event you would you might develop PTSD ptsd doesn't have to be the outcome of
18. 06:20 direct experience it could be the outcome of vicarious experience or um
19. 06:27 experience by proxy indeed there is something called vicarious traumatization which believe it or not afflicts mostly therapists now PTSD involves flashbacks flashbacks are vividness flashbacks is when you lose your ability to tell apart memory from reality the memory
20. 06:49 becomes real if you were a Vietnam veteran you're a soldier in Vietnam you're in a supermarket there's a sudden noise and you're again in Vietnam you're not in the supermarket supermarket vanishes dissipates disappears and you are again in the killing fields of
21. 07:08 Vietnam shooting at an at a helicopter a chopper above your head so flashbacks are about about divorce sudden abrupt divorce from reality it's a dissociative um artifact a dissociative syndrome or a symptom I'm sorry and syndrome actually and you lose it and you are back
22. 07:34 entrapped in the memory the memory acquires the vividness and reality of the actual experience you're going through it again you're replaying and reenacting it but you are not aware that it's a replay or reenactment you think you are there that's why emotional
23. 07:55 flashbacks is there's no such thing emotional flashbacks are memories which are connected to extremely intense overpowering overwhelming emotions but they are not flashbacks so there there's no such thing as emotional flashbacks it's another piece of online nonsense based
24. 08:17 on work by people who should have known better so flashbacks are an element in PTSD there's an avoidance of internal and external stimuli known as triggers now triggers don't have to be external i mentioned a noise in a supermarket a visual a visual thing or
25. 08:41 but a smell by the way all factory but uh triggers can be in internal for example the vividness of a memory which then leads to a flashback so it doesn't have to be external it could be internal and that is why nowadays we do not debrief people after
26. 09:03 life-threatening severe trauma we don't force them to revisit the memories because this could trigger them and they could have um an instance of flashback or even psychosis ptsd involves negative alterations in cognitions and moods associated with the
27. 09:24 event for example feeling guilty for having survived survival guilt feeling that you are to blame you're responsible for what has happened estrangement from your own body and sometimes from your own mind which is a great definition of psychosis anhidonia inability to
28. 09:40 experience pleasure pleasure in anything constriction your life suddenly narrows down and you want to limit everything your movements your social contacts your activities the food you intake everything becomes more and more and more narrow like a tunnel that's
29. 09:58 constriction and of course the aforementioned dissociation you develop memory gaps you tend to forget things repeatedly including very important things obligations assignments tasks um facts and and faces and names so dissociation takes over basically
30. 10:19 metastasizes and consumes um the whole of the personality and of the psychonamics and then there there are alterations in arousal and reactivity people with PTSD become aggressive reckless or self-destructive these behaviors multiply until they become normative the
31. 10:40 norm in other words PTSD has a massive impact on day-to-day functioning in social settings in the workplace in romantic relationships intimate relations in the family in church everywhere it is an all pervasive thing it affects everything whereas complex trauma is more insidious
32. 11:02 more pernicious more slow and glacial complex trauma erodess you and corrods you ptsd explodes you destroys you complex trauma is a form of implosion whereas PTSD is a form of explosion it's and it and the speed the elacrity of PTSD and the intensity and the
33. 11:22 abruptness are not absolutely not clinical features of complex trauma complex trauma crawls spraws complex trauma is kind of a colonizer that captures additional territory all the time in a process that lasts you know many years whereas PTSD just comes
34. 11:43 abruptly takes over destroys everything it's like a hurricane basically culture influences the symptoms of PTSD in some cultures somatic symptoms are more acceptable and mental symptoms are frowned upon or stigmatized whereas in other cultures of course the symptoms
35. 12:04 are mostly psychological there's a high prevalence of coorbidities ptsd often comes with depression and substance use disorder SUD substance abuse this is also common in complex trauma complex trauma we have depression anxiety substance abuse they are common coorbidities or co-
36. 12:24 occurrences with um CPTSD but as I said one of the main differentiating factors in the different differential diagnosis between PTSD and CBDSD are the flashbacks you're being taken over by a memory that seems utterly real to you intrusive memories and this also happens in
37. 12:50 dreams the dreams become so real that when you wake up you can't tell the difference and the dream continues actually in reality this causes a lot of alarm and distress and ultimately someone with PTSD develops avoidance avoidant behaviors a defensive
38. 13:11 withdrawal from distressing memories thoughts feelings as well as external and internal reminders triggers but so much can trigger you a triggering cascade you can be triggered by so many things that ultimately you avoid everything close yourself in a dark room
39. 13:30 and that's it don't even open the television ptsd is discriminating it's higher among the young among women minorities and people with co-orbidities pre-existing conditions in other words people who are already weakened somehow they're weak they have shortcomings vulnerabilities
40. 13:51 frailties they're more likely to develop PTSD people for with poor psychosocial resources for example people in developing countries de display display more PTSD than people in developed countries industrial countries so when you're weak when you're down when you're
41. 14:09 vulnerable you're more likely to develop PTSD and there's something known as threshold PTSD it's not clinically there's a big debate whether it exists or not so it's not yet clinically recognized threshold PTSD actually characterizes anywhere between 50 to 90% of people who have
42. 14:28 been exposed to trauma inducing events natural disasters violent crime rape and so on so it seems that everyone reacts with something a condition that could develop into full-fledged PTSD but doesn't whereas threshold PTSD characterizes 50 to 90% of people
43. 14:52 ptsd is anywhere between 10 to 30% depending on the settings the culture the intensity of the event the the extent of the threat to life or personal injury and so on the rates are much reduced when there is a cohesive community response social a social
44. 15:10 network that affords sakore and understanding and acceptance and empathy and so on people who surround the person with PTSD can miti mitigate and amilarate the PTSD and PTSD is more common in man-made traumatic events than in natural disasters because I think
45. 15:30 there's a perception of evil at work it's like coming face to face with evil so terrorism mass shootings war rape they provoke the onset of PTSD much more commonly than natural disasters and still in COVID 19 in the pandemic for example we saw sharply elevated stress
46. 15:52 and trauma related disorders including in on some occasions rare occasions PTSD i think it's because COVID 19 was perceived as man-made actually not as a natural disaster we have quite a few tools to deal with PTSD uh we have talk therapy prolonged exposure therapy cognitive
47. 16:16 processing therapy EMDR brief eclectic therapy narrative exposure therapy written narrative exposure and even virtual reality and lately AI is entering the game so we have quite a few tools and they are superior to psychopharmarmacology ssris
48. 16:36 um somehow are helpful especially in the initial stages but antisycchotics are not they're counterindicated as a first line treatment debriefing is definitely nowadays a no no you should not do that although we have been doing it for decades okay acute stress disorder is
49. 16:55 one of the precursors of PTSD so there are conditions that lead to PTSD if they are left untackled and untreated and acute stress disorder required what is known as pies proximity immediacy expectancy and simplicity there's a protocol of treatment that requires the
50. 17:15 presence of supporting people supporting people including professionals immediate reactions developing specific expectations regarding the treatment and keeping it simple this usually somehow puts acute stress disorder ASD under control and prevents it from developing
51. 17:34 into full-fledged PTSD you can already see that PTSD has very little to do with complex trauma or CPTSD so next time you're the victim of narcissistic abuse don't go spewing nonsense about how this gave you PTSD it did not