Workplace bullying might end up as Complex PTSD

 

Dear Bloggers,

As some of you might know that my wife is suffering from Complex PTSD caused by her managers over a period of three years and then something in her brain just snapped. Since this event she has been in therapy and until today there is no way to cure her fully. This means that there are no opportunities for her to do any kind of job. As there are to many triggers out there and she might be harmful towards other people. Instead of working she is going two mornings in a week to a farm with care for people with mental challenges and she is learning to do some light tasks and learns to ride a horse.

Complex PTSD is a traumatic experience due to workplace bullying or sexual abuse. But as more attention is paid to these kinds of experiences and exactly what they can do to victims, we are beginning to understand more about this condition. And this increased understanding should, in turn, give hope to the hundreds of people who find themselves subjected to workplace bullying every day.

Because the victims of C-PTSD do exhibit some of the same symptoms seen in standard PTSD, it can easily be misdiagnosed. But C-PTSD sufferers also exhibit some other symptoms that are more specific to the condition. These can include difficulties regulating emotions such as prolonged sadness, inability to control your temper or inhibited temper, and even suicidal thoughts. My wife became a victim of workplace bullying by her manager.

Other symptoms of complex PTSD include either forgetting or consistently reliving traumatic events; feeling detached from your own body and thoughts; overwhelming feelings of helplessness, shame, guilt or stigma; a distorted perception of the bully. Workplace bullying is so much more than just making your job more difficult. It is a very real form of abuse that can undermine a person’s entire sense of well-being.

By understanding the realities of C-PTSD, we can begin to break through the wall that surrounds workplace bullying and begin to let victims know that they are not alone and healing is very much possible. It will not work after three years of constant abuse at the certain point you might just snap.

Just an example of what you encounter with a partner with C-PTSD

All of a sudden a loud scream and she is sitting straight up in our bed her heart is pounding, I am fully awake at 2 am. She is totally panic-stricken and consumed with terror in her eyes. And mumbles: “He is throwing me out of a window”.

Our bedroom is quiet. There are no intruders, only our faithful hairy friends Fedde and Heiko are standing on the other side of the bedroom door.

I wonder if her loud screaming has scared any of our children.

After 5 minutes, maybe 10 minutes as I lie in a snoozing mode again, I feel her and she is terrified in our darkened room. I try to decide if I should call a doctor to give her something to calm her down… perhaps I’m having it wrong and is it only just a bad dream. I am both afraid and confused. I know that it is safe in our bedroom, that there is no immediate threat, but her body and emotions are hijacked, and without my consent I find her immersed in past horrifying events.

Thankfully I do know now, from more than 8 years of experience, that a panic attack will eventually pass.

It feels like it’s going to kill her, but it won’t. but her body and emotions are hijacked, and without my consent I find her immersed in past horrifying events. I have to wait it out.

PTSD is typically the result of a specific, horrifying event, Complex PTSD is the consequence of numerous traumatic events, over a longer period of time. CPTSD is frequently caused by childhood abuse and neglect or, in my wife’s case, being trapped for many years in a very abusive workplace.

Complex PTSD and PTSD share symptoms, but there are some symptoms unique to CPTSD. If you are interested in a somewhat detailed list of symptoms for both PTSD and CPTSD, you can scroll to end of this post.

When I look objectively at the symptoms of PTSD and Complex PTSD, I can check off 99% of them (anger isn’t a symptom for her and also low self esteem has never been an issue) but still she tries to live in denial that she has CPTSD… until she is triggered and panicking so badly that she is struggling to speak’

Every morning she is waking up and begins her day with limited emotional energy. Our children are priority so she does everything to work around her limitations with PTSD to be available for them. She carefully plans her day tasks and she is trying to avoid crowds when she has to go to the shop.

One crowded, overwhelming event can sideline her for several days afterwards, so she is choosing her activities carefully, mindful of the probable fallout.

Still, 8 1/2 years after escaping her abusive managers, she still has nightmares and panic attacks. She is having huge gaps in her memories of the past years.

CPTSD is basically an emotional injury ~ an invisible illness. Since it isn’t as tangible as a broken bone I frequently have to remind her that living so much of her life being on “high alert” and in “panic mode” is both emotionally and physically exhausting.

According to my wife: “For me, being triggered causes a level of overwhelm that is very difficult to describe. Research done by PTSD patients has shown that when someone with PTSD is triggered and panics, the right half of the brain “takes over” and the logical, thinking left side of the brain is sometimes almost totally “shuts down.” When this happens to me it becomes almost impossible for me to speak and I can’t think. All I am aware of is the panic and a desperate need to hide. If I were walking with someone else, we would have to stop talking until the truck has passed because there would be no way to hear each other over the noise of the truck. For the minutes that the truck is roaring past, there is only the truck. I am totally consumed by the noise and vibrations of the passing truck. 

I’ve been told repeatedly that in many ways my situation was (and continues to be) somewhat extreme and unique. I am still struggling and doing little steps forward.”

There’s no way around it: PTSD sucks. There are ways that she has improved a lot in the past 8 years though. I can now write about it here on my blog. As horrible as CPTSD is, I want you to know this: there is still joy in the midst of the struggle.

I still laugh with my children. We have so much fun together. Our girls love to make us laugh… it’s become a bit of a competition between them to see who can show the funniest memes each day.

I have been blessed with two Shetland Sheepdogs, one of them is being a service dog for me. They bring all of us so much joy. Truthfully, I am not sure that She’ll ever will totally “conquer” her CPTSD but she is slowly but surely learning to manage it.

Instead of actively working she is trying to learn new ways to heal and better manage the symptoms of PTSD while she embraces her weakness and struggles. Many people do recover from PTSD and even CPTSD. There are numerous healing resources to explore. Perhaps you are also in the thick of PTSD or CPTSD.

CPTSD is a more severe form of Post-traumatic stress disorder. It is delineated from this better known trauma syndrome by five of its most common and troublesome features: emotional flashbacks, toxic shame, self-abandonment, a vicious inner critic and social anxiety.

• CPTSD emotional flashbacks do not typically have a visual component. Emotional flashbacks are sudden and often prolonged regressions to the overwhelming feelings of past abuse/abandonment.
• Fatigue with symptoms of or similar to Chronic Fatigue Syndrome
• Numbness, both physical (toes, fingertips, and lips) and emotional (inability to feel love and joy)
• Clumsiness
• Hyperawareness and an acute sense of time passing, seasons changing, and distances travelled
• Feelings of worthlessness, rejection, a sense of being unwanted, unlikeable and unlovable
• Social isolation, avoidance of relationships
• night terrors, chronic insomnia
• Variations in consciousness, including forgetting traumatic events (i.e. Psychogenic amnesia), reliving experiences (either in the form of intrusive PTSD symptoms or in ruminative preoccupation), or having episodes of dissociation.
• explosive or extremely inhibited anger (may alternate)
• Changes in self-perception, such as a chronic and pervasive sense of helplessness, paralysis of initiative, shame, guilt, self-blame, a sense of defilement or stigma, and a sense of being completely different from other human beings

 

If I could share one thing with you it would be this: please be gentle and take care of  yourself.

The Old Sailor,

The Old Vase

Dear Bloggers,

Finally, after a time of moving and renovating (not yet completely finished), I find the peace of mind to start writing again and yes, I have neglected your readers for quite a long time. I therefore hope that you can pick up the thread again and I hope you have not missed me that much. I will try to write again on a more regular base. As you probably know, my love has a complex Post Traumatic Stress Disorder due to her work. She has been completely demolished mentally by two managers at the Royal Telecom Company. It is very sad to see that someone is being robbed of their independence and that those people just get away with it. Lawyers do not see much in a lawsuit and these big companies have so much power that it will be a waste of money to fight for about two years and come to a tipping point what we would call a settlement in the Netherlands. And then I am not even talking about the mental scars that will be ripped open again especially for my wife. No, I want to save her this pain. However, I will try to express what it feels like for us as a family.

Over the years, I have started to dig in deeper into the background of psychology and that a person can put a lot of situations into perspective. A requirement is that you dare to expose yourself and you're not afraid of the opinions of others. You must also be open to slow but certain developments and absolutely continue to believe in yourself and your partner. Together you can achieve a lot, if you are only there for each other.

“I first heard of a psychologist and later a colleague at work about having in-depth conversations. That colleague then benefited greatly from the talks. So I decided to go to therapy. At first only for my wife, but it made me increasingly angry. It was the unfairness of some jerk who thought that if someone did not leave, he would have to take care of it personally. What a nauseous game was played and nobody did a thing. I went with her to the conversations every time. When the therapy that my wife got was still not finished after two years, the discussions continued on and on, but there was not much added value for me. My wife was sliding into a deeper and darker inner person and more and more went to work alone with the therapist. After a huge crisis where she left home and hopped in the car in deep state of dissociation. As we did not know how this would end we called the police and they were looking out for her. Lucky enough she came to her senses and drove back home. The therapist was called and the therapist is now coming at home and therefore she did not have to come with me anymore. ”

“Initially I was rather skeptical about psychosocial in the beginning
support. "I really don't need that." In retrospect, it helped us a lot. We both received concrete and practical tips for our way of thinking. They were often very small and simple things. Of those things that I thought: why didn't I come up with this ideas myself? "

As an example, the therapist draws a vase, which during
the therapy would serve as a metaphor.

This requires some explanation, I think:
"In a" normal "situation, this vase is filled with a lot of energy.
But this vase of ours has a very ugly and deep crack, which drains the energy. This makes the leaves fall off. A solution had to be found here.

At one point she felt a little better again; and her energy was somewhat replenished. Bold that she was, she walked around thinking: "I am as good as new and I am feeling actually better" and went back to her old routines as she was used to. But the vase soon became empty again. That hole first had to be fixed. In the meantime I have learned to think differently and I now deal with it differently. We now distribute our energy better and in a different way. ”

“Occasionally, during the conversations with the psychiatrist and the therapist, it was rather deep in the past. The way of thinking becomes
also formed by what you have experienced. Where the hell does all this fear come from? What gives rise to those gloomy thoughts? Why do you sometimes see things that are not there at all? What are you doing? What do you think? One hundred questions and nothing really changed the lack of energy was every session the biggest problem. In the beginning, the conversations were quite heavy and in the beginning we had to stop often enough halfway. And despite the intensity, the conversation was often uplifting. After such a conversation, we always went on happy. Then we had the feeling: it is heavy but maybe it is not so bad. "

"When we were advised to do more with mindfulness, I thought," that is all too vague to me and really not for me ". But I tried and it helped. We have learned to put things and events into perspective more and more and it gave us both peace. Also in my job as a bus driver where I occasionally meet young people who have been marked for life by stupid harassment, like being bullied. I could put the world around me in perspective a little better. ”

The old porcelain vase that was always so dear to me because it was so beautiful and graceful, we still tried to put the pieces together and glue them together, but even if we did the job so precisely when you look closer you will still see the cracks and the energy is slowly but surely running out of the cracks. It will never be the same again. 

 

Now we have learned that the old vase can no longer be saved, it must be replaced by a beautiful new transparent thin glass vase. "The vase comes like in the good old days on the foreground just like before and it is our new vase," Although the new vase is more fragile than the old one and we have to be careful as it cannot contain as much energy as the old vase. Just let me explain that. The new vase is elegant, fragile and transparent, so you can see that it contains energy. Water gives energy to the flowers. The broken vase has been renewed. Now we have to try to save the withered flowers that have been damaged. We only can try?

The Old Sailor,

The day that something snapped in her brain

Dear Bloggers,

If one day you have the feeling that something in your brain just snapped.
I take care of my wife in times for better and for worse that is what I promised her when we married 20 years ago. And now that has become reality.

"She was still in bed because she had to get up later than me. I was up at 4.30 in the morning to go to work as I am a commuterbus driver. She talked about a snap in her head that she had felt on her job yesterday but there was nothing strange to see. It turned out that she could not get out of bed. She had woken up from the alarm clock and could not filter the sound properly. It's like there are ringing a lot of bells and she could not stop it. 

 

She also noticed that her right side did not work too well.
Obviously she wanted to get up. But it failed and so she was laying next to the bed. She knew that this was trouble and all the things she learned at the Red Cross as a rescuer and she began to check out all the signs of a cerebral infarction. Once in front of the mirror, she smiled at herself. I do not have a slanting mouth so that is all that matters. Eventhough she did not manage to talk properly and she seemed to be a bit confused. Just go to work dear, I'm taking good care of myself today. The day passed and when I came back home she was laying on the couch and looked at me with teary eyes.

Only then did she warn me by crying very hard and said she would like to shout and scream like a wild animal. There is such a pain in the back of my head and on this side of my face I feel nothing. When I sat down next to her, she was a little panicky and tried to talk to me what was not going to well. Fortunately, she was consiousness and we found together that it looked very similar to the picture of a stroke. Then the mill was turning. And so we crossed all of a sudden through the doctor's office towards the hospital, no serious brain injury was detected. But what was exactly the cause of this was not really clear but it according to the doctor it seemed to be a part of serious stress.

After half a night at the hospital, we returned home and she told me that she was very afraid of getting a stroke. Still somehow it kept worrying us and we were forwarded by our own doctor to see the neurologist for further and deeper research. Due to the serious anxiety and panic disorder, it was all very complicated to get an MRI scan. But together we can concur the whole world.

Once at home, the misery got started and was for real. I had a full-time job in addition to it I had to take care of my wife and two children, My working hours were quickly reduced from 40 to 36 hours. She could not take care of herself for the hours she was at home. Most of the day she slept and I had to leave her home alone for several hours, I could not live with this. What I also arranged before I went to work, I fixed her medication, prepared a sandwich for her and made sure she did not had to miss anything. Nothing really worked out and she slipped slowly into the abyss.

As a blessing in diguise I had to be unemployed and sit home for a half-year in connection with my temporary contract and enjoy a benefitpay. I have visited many hospitals in this year and psychological helpers our car brought us everywhere. A deadly tiring route for the both of us.

It's amazing she has not even once been taken to a mental hospital and for everyone it is a big surprise because in this total period of 24 months with the help of a psychiatrist and to deal with a complex Post Traumatic Stress Disorder and a pretty intensive treatment for this, she has been advised to spend a day and to search for a daycare to find some balance. Now her days are filled with a morning spend at a care farm and 1x physio gym. She has always been a busy and active person. Her job was call centre agent and she was a specialist in solving complaints. Now she has now been disapproved for work for 80 to 100%. 

 

I did not cancel my job to help her but I work a 32-hour contract with a few good appointments with the planner and together with our eldest daughter we are doing fine. We put ourselves in such a way as caregivers do because the only alternative was a hospitalization / nursing home. We do not have a personal carebudget because this is not indicated, and unfortunately my salary is not big enough for hiring a nurse 8 hours a day for private guidance and for domestic assistance.

She can do quite a lot and even though she has already being picking up a lot of things, it's no longer as it was before, and she can not do as much anymore as in the good old days. Her long-term memory is as good as before, but some moment she no longer knows where she has left her glasses. The sense of time she has lost with some regularity. 

 

She can get into a panic attack at any time if something happens in her area that she has not provided. Her senses such as hearing, brightness, light, smell and taste are severely affected and seriously reinforce more than necassary during the bad periods. I therefore try to protect her all day from too many incentives of this kind. Unfortunately, I can not always be as successful in this regard. Nevertheless, she is accepting her situation slowly

Besides being a partner and her sweetheart, I became mainly her driver, nurse, butler, caregiver, supervisor, spokesman, administrative / agenda administrator etc. etc. Her hobbies are now a little puzzling and working a bit on the tablet.

Together we were always active in the neighborhood and we were happy to help with friends, acquaintances and family. All practical / physical hard work is going to be pretty good. But what we miss the most is walking hand in hand (although this happens sometimes more and more often.), We cannot say spontaneously anymore: "Let's go on a trip for a weekend," an old-fashioned steamy night (even a little bit of cuddling is not always possible No longer we can be unprejudiced intimate). What I miss the most is being the equivalent in a conversation (if that's possible because these kind of things are often too tiring to hold the concentration). I never know how she will respond as it is differently due to the PTSS or because she can dissociate sometimes completely. I often see that when I tell her things, it does not come to her completely. Also, she often can not remember all of it and I havr to tell it again.

And then ther is the worry about the finances. Previously, we both had jobs with related to it a fairly good income. Now we only have her benefitspayment and my 32-hour salary. In addition, we have two school-aged children therefor you will pay enough, which remains after deduction of transport costs, school fees and daycare expenses. We live in a private home which is not really suitable for someone who suffers from conversion disorders, which makes climbing stairs difficult sometimes. We are looking for a nice bungalow so we can sleep on groundlevel, but how do I sell our current property. Fortunately, as what has happened to many other homeowners, the mortgage is not heavily underwater. But a bungalow often costs quite a bit more. I get that residual debt for what we have to take on as extra mortgage we will never be able to pay this all back because I'm not in a position to work more because I want to take care of her and I need to take care of her.

And then the decoration of our house is cheerful but not too crazy because that is not possible anymore. Anyone who comes will agree with us. As this situation now it is not ideal. No, we know that it isn't ideal, yes we realize that. But how would you be doing this...? Nobody has an answer to these questions. I do not want to buy new furniture in the wild, as it shows afterwards that it might take several years to sell the house and move and maybe it might turm out different.

Let me make one thing clear PTSD will hit the whole family.
And one more thing ........... My wife fortunately has no admission indication for a nursing / nursing home. Because then she should live there seperate from us. We do not want that, our children are entitled to have a loving mother and I would like to offer my life for my love. She's only 47 years old and I'm 49. But our life never gets back to how it was. Yep, and all of this has been done to her at her workplace by a couple of sick types who will call themselves Team Leader. And as I feel now, my life will never be really fun anymore and I've had my best days in live already. A PTSD gets the both of you and will hold you hostage. These kind of things are too sad for words.

The Old Sailor,

They call it a conversion disorder

Dear Bloggers,

The recent discussion between me and the caretakers of my spouse are a difficult case and is leading to speculation and misinformation about the nature of psychogenic illness. I therefore thought it would be useful to discuss the concept of a conversion disorder in general.
 
According to one of the doctors who tried to explain me about dealing with the disbelief of most of the patients they react many times like this: “So you’re telling me it’s all in my head?”

The concept of what are now called conversion symptoms is a tricky one for various reasons. There is an unfortunate stigma attached to the notion that our brains can cause physical symptoms. Making the diagnosis is complex. Outcomes are variable and are hampered by the difficulty in communicating the diagnosis to patients. Conversion disorder symptoms often mask underlying physiological disease. And the risks of both false positives and false negatives are high.

This complexity leads some to argue, in essence, that a conversion disorder symptoms do not exist at all. The diagnosis is tricky as the patient might feel it like a way to blame the patient for the failings of the physician.
What are conversion disorder symptoms?

Various terms have been used over the years to refer to symptoms that are generated by psychological stress or other factors. Hysteria is an unfortunate term which was invented to refer to the uterus, as if such symptom were uniquely female. For obvious reasons the term “hysteria” is no longer used. 

Psychosomatic is still a proper term, meaning physical symptoms with a mental cause, but the term does have a bit of a stigma attached. The term conversion disorder is most widely used today, or psychogenic simply meaning having a mental cause.

As my wife has been diagnosed with complex PTSD with anxiety related problems and has a psychogenic overlay. In this case there is an underlying physiological disease or disorder which then results in stress and anxiety which further generates the conversion disorder symptoms on top of the physiological symptoms. 
 

Psychogenic signs and symptoms are real the patient really experiences them. A conversion disorder is a real disorder, it is just that the problem is with the brain’s software, not hardware.

Sometimes my wife is overtaken by her anxiety disorder, which may be reactive or may be primary and due to a biochemical disorder in the brain. Anxiety puts a lot of stress on the body and can absolutely manifest with physical, and sometimes very dramatic, symptoms. Stress itself can also manifest with physical symptoms. My wife is living like she is constantly being scared with very hectic moves

So we all have psychogenic symptoms at some point in our lives, and we take them for granted. The fact that more dramatic symptoms can also result from purely psychogenic causes should not be that surprising.
How do we known when symptoms are psychogenic?

At times patients will have psychogenic weakness, either partial or complete paralysis of a limb. This happens to my wife when the tension gets to high at that moment she loses power in her right hand and she is dragging one leg around. The first times I was very worried and thought she was having a stroke as she didn't feel her face on one side as well.True neurological weakness has certain features which cannot be simulated (voluntarily or involuntarily) and there are techniques they use in the neurological exam to look for these features. And strange enough there was nothing found.

Further still, without a detailed knowledge of neuroanatomy, patients with psychogenic symptoms will tend to display distributions of symptoms that do not follow anatomical pathways. Or they will display patterns of movements that do not correspond to any part of the motor system.

To summarize, there are cases in which patients exhibit neurological symptoms which seem to defy neuroanatomy, reveal features of effort, do not correspond to known systems in the nervous system, and lack any hard or objective finding that should be present. Even in these cases, they're likely to do a full workup looking for an underlying problem (as stated above, psychogenic symptoms may simply be overlaying a physiological lesion or disease). In psychogenic cases thorough neuroanatomical scans are normal, as are physiological tests for nervous system function.

It is not a negative judgment about the patient, it is simply an attempt to make an accurate diagnosis.

Sometimes patients are simply uncomfortable with this situation (perhaps because it was not communicated to them well). They may seek a diagnosis until they find someone willing to make one, and then they will blame their previous doctors for “missing” the real diagnosis. Sometimes the actual diagnosis is missed, and patients were right to seek other opinions. But at other times the new diagnosis is the fake, but it is more acceptable to the patient than the stigma of stress or anxiety induced symptoms.

It should also be pointed out that sometimes there is an underlying disorder causing psychogenic symptoms – serious anxiety or depression. These are just as much “real” disorders as anything else.

Patients who have disturbing symptoms due to psychological stress or anxiety will often seek multiple opinions.
In some cases the patient has what can only be called mental illness, and needs to be redirected toward psychiatric treatment.

Conclusion

In a perfect world the unfortunate stigma attached to the psychogenic and conversion disorder diagnosis would disappear. It is very counterproductive. We need broader understanding that the brain is also an organ and can manifest symptoms in a variety of ways. Psychogenic causes are just another item on the differential diagnosis.

The Old Sailor,