344- Pre-trauma, (C)PTSD and maladaptive coping

Today, I'm discussing Pre-trauma, PTSD and maladaptive coping. Indeed, I recently read Ochberg's PTSD therapy book, where, in pages 246-251, his collaborator John P. Wilson 
explains the relation of PTSD to personality disorders, and personality propensities. 


In different segments, authors explains that events and personality prior to trauma are complex matters, and that one of the duties of a therapist is aiding a patient in recovery to rediscover those functional levels which the person had prior to the traumatic event. 

To this end, a therapist needs (p. 247 of the book) 

1. knowledge of pre-trauma personality structure
2. nature & role of the person in the trauma
3. situational appraisal of trauma & initial coping response 
4. post-trauma attempts at assimilation of the experience 

It can be a difficult process for anyone, but I find that in my case, points 1 & 2 are basically impossible to disentangle. 

Indeed, not only I experienced multiple traumas, altering my diagnosis to c-ptsd ( a term that wasn't even invented in 1988), but these all started even before my birth!  I don't know if anyone researched the effects of trauma as early as in the womb, but even without this doubt, there is plenty to discuss for all those I subsequently experienced from birth onward. 

So, you're back from reading the link? Alright, let's look at the list above. 

Knowledge of pre-trauma is impossible to find, as my personality developed during all the traumas that I endured. By definition, therefore, the second needed step is also mission impossible. So, that'd leave me with the third and fourth parts. Let's see how those go about.  

3. Situational appraisal of trauma & initial coping response. 

The situation is a complicated set of traumas, some of which I detailed in that link above, and in other entries as well. The assessment part would find their everlasting effects on my daily life, again, discussed partially here. 
This appraisal would also uncover splitting ; struggles in rebuilding myself, partially due to the difficulties in differentiating my personality from my trauma, and also to identity issues (topics in progress).

This appraisal would uncover my coping mechanisms, mostly maladaptive, based on initial coping response, and extended into adulthood. 

During my traumas, I had to withdraw into anything that gave me a sense of either escapism or relative comfort. I never could find a safety aspect.

Escapist, maladaptive coping, took many forms : 

• Dissociation
• Sensitization - which pertains to that overthinking a set of situations, in the hope to anticipate and thus be able to avoid negative effects in the future, which are based on previous trauma and negative effects- seemingly from lack of knowledge about them in the first place. I associate this aspect with cptsd's hyper-vigilance. 
• Avoidance, in general and in social situations alike, as discussed. 

Safety behaviors and escapism, such as : 

• Listening to music, or watching tv - this was always in secret, as I wasn't allowed ; it started at my grandparent's home, during my short school vacations, and extended over clandestine visits to classmates. 
• Reading books (that weren't school or religious ones), also in secret ; I don't recall how it started, except that I was insatiably curious and had to escape into invented worlds as much as learning about the real world outside of my religious cult's prison. I used to take detours from errands, causing me to go home late with the groceries and I accepted all the beatings and punishments, never telling what I was really doing that had delayed me. In time, I'd also swindled some of the cash that my father had confiscated, back into my pocket, and bought books (and cds) that I'd hid carefully - and which I still own to this day. 
• Playing videogames. Even more in secret. When I wasn't reading, my detours from errands found me in arcades. 
• For a while, I experienced what I'd call, in retrospect, psychotic episodes, with auditory and rare times visual, hallucinations. Back then, I was influenced both by sci-fi and by the new-age, mystical teachings of the cult, so I wasn't even aware that what I was hearing and seing wasn't real, nor abnormal. Thus, I hadn't reported it. 
• I was highly emotional, but had to suppress expression of feelings and emotions, containing them for hours, days and weeks at a time ; I learned to cry in silence, only at night.
• Misplaced/misdirected aggressiveness, alternating between anger and apathy - common symptoms of (c)ptsd, and also maladaptive coping mechanisms, as they don't tend to produce any form of adaptation to the situation. 

4. post-trauma attempts at assimilation of the experience

• Persistent maladaptive coping mechanisms. Instead of practicing my entertainment and cultural activities listed above as secrets, I do them in the open, so that's a partially healed wound ; but, in parallel, became maladaptive, through a form of dependency and obsessive tendencies, which are direct results of both my traumatic prohibitions, and of these maladaptive coping tools. 
• Struggles in rebuilding myself post-trauma, especially in defining who I am (identity), my personality traits, passions and hobbies - though I did manage creating core aspects, I'm still a work in progress. This is compounded by the conditioning and depersonalization I was subjected to. 
• Struggles finding jobs, career paths, motivation, and other such topics which are also destined to be another blog entry
• Becoming dependant on peer-opinion (to an extent) ; on people's presence to avoid more fearful situations. For example, when I was younger, I couldn't stay home alone, especially at night. I'm also dependant on my wife for a number of apartment-tasks (due to phobias) and either on her or on a friend to monitor me during social gatherings or events - although I can now attend some places with less anxiety, thanks to CBT. 
• I'll list the positives in the next entry in this series. For now, I'll send you to the keyword post-traumatic growth. 

More about maladaptive coping and coping in general, read
Wiki 
Vantagepointrecovery
NHS article on development of maladative coping

In the next entry, I'll discuss adaptive coping, which are more positive, healthier ways of coping and dealing with trauma and its sequalea, mental illnesses, and shall focus in particular on (c)ptsd.