I put my post as a mild trigger warning. As what I might say could be triggering for some who are searching for validation for their cPTSD but have not experienced (severe) sexual, ritual or physical abuse and overt forms of domestic violence. I want to start with the disclaimer. That I wholly agree with Pete Walkers observation that the core of all abuse is emotional abuse and abandonment. I also see how this is a core element in whether or not one will develop cPTSD.
So what I really like about the book is the central theme of Abandonment Depression. I love the mindfulness techniques he discusses to address this, and the loving attitude to productivity. Here's his description of abandonment depression:
Everything he has to say about the importance of grieving, dealing with the inner and outer critc and centering emotional healing makes tons of sense to me. His advice also on different forms of therapy for cPTSD is gold. And i love his mindfulness techniques.The etiology of a self-abandoning response to depression. Chronic emotional abandonment is one of the worst things that can happen to a child. It naturally makes her feel and appear deadened and depressed. Functional parents respond to a child's depression with concern and comfort; abandoning parents respond to it with anger, disgust and further abandonment, which in turn create the fear, shame and despair that become characteristic of the abandonment depression. A child who is never comforted when she is depressed has no model for developing a self-comforting response to her own depression. Without a nurturing connection with a caretaker, she may flounder for long periods of time in a depression that can devolve into The Failure to Thrive Syndrome. In my experience failure to thrive is not an all-or-none phenomenon, but rather a continuum that begins with excessive depression and ends in the most severe cases with death. Many PTSD survivors "thrived" very poorly, and perhaps at times lingered near the end of the continuum where they were close to death, if not physically, then psychologically. When a child is consistently abandoned, her developing superego eventually assumes totalitarian control of her psyche and carcinogenically morphs into a toxic Inner Critic. She is then driven to desperately seek connection and acceptance through the numerous processes of perfectionism and endangerment described in my article "Shrinking The Inner Critic in Complex PTSD" (see link for this article: Shrinking the Inner Critic). Her inner critic also typically becomes emotional perfectionistic, as it imitates her parent's contempt of her emotional pain about abandonment. The child learns to judge her dysphoric feelings as the cause of her abandonment. Over time her affects are repressed, but not without contaminating her thinking processes. Unfelt fear, shame and depression are transmuted into thoughts and images so frightening, humiliating and despairing that they instantly trigger escapist 4F acting out. Eventually even the mildest hint of fear or depression, no matter how functional or appropriate, is automatically deemed as danger-ridden and overwhelming as the original abandonment. The capacity to self-nurturingly weather any experience of depression, no matter how mild, remains unrealized. The original experience of parental abandonment devolves into self-abandonment. The ability to stay supportively present to all of one's own inner experience gradually disappears.
However, I noticed some important gaps in what he presents and it bothers me. For instance, that he paints a very incomplete picture for people who suffer from addictions, people who develop complex dissociative coping strategies and also very wrongly, and i would say damagingly, mis-characterizes borderline personality disorder as incurably narcissistic. All of these things are associated with more severe and compounded trauma. that cPTSD is 'specifically' meant to address.
Also the part on trauma 'types' chapter six seems to undo all the other careful work to undo shame and promote self compassion. I just found myself trying to work out which 'type' I was, identifying with many of the negative characteristics in all the types. And well I would take that part with a pinch of salt or feel free to completely ignore it. It is ridden with negative value judgements and dismissive statements and I would say occasionally misinformation.
And while I'm at it, he says that the therapeutic relationship usually ends when someone has developed a 'real' relationship with at least one other person... Huh? This makes zero sense to me. I have needed therapy to work through trauma, that no relationship can handle on its own. Even though I have been in an extremely loving, open and supportive relationship for 15 years! The success of my relationships is that I have learned that what i experienced traumatizes others, and that I need to be careful with sharing and how I tell, and hide my more severe flashbacks because they freak people out, only my partner is witness to the worst not my therapist. Still needing therapy to resolve trauma doesn't mean I do not have loving connected, honest and real relationships... or that because I do I don't need therapy...
In my opinion there are two essential problems;
1.He centers his own experiences. And while these are important, valuable and also very painful experiences, and it feels much better to hear it form another survivor. They are the experiences of a very privileged white man, so it does mean his personal experience of trauma, and compounded trauma, is limited.
Though he gives lip service to the notion of how damaging sexual abuse can be or extreme forms of physical/domestic violence, he does not describe how in detail. As these are outside of his experience, even though he occasionally mentions case histories the emotional and relational impact is his theme, nothing specific.
He does not pay much heed to the compounding of the trauma, that occurs from not having the same opportunities and degree of safety he enjoyed, which cPTSD dx was initially all about.
2.In an effort to universalize his own experience and make cPTSD universally applicable, he also forgets the essentially political nature of the term and who it is for, and what it intended to center.
Judith Herman coined the term cPTSD for a number of reasons:
a. To make VISIBLE the epidemic of sexual abuse and incest against children and to stop the negative pathologization of survivors in medicine, specifically addressing the problems and stigmas with the Borderline Diagnosis.
b.To put domestic violence up there with the impacts of war. To BREAK THE SILENCE about domestic violence and sexual violence. And give survivors a voice and dignity in the public sphere.
c. And to discuss the impact of long term traumatization and compounding of trauma, which often occurs when people are being oppressed. In other words pointing out that the problem is systemic, not personal.
It might feel radical to say that emotional abandonment is the essence of what cPTSD is about. And in many ways that is true, ( thank you Alice Miller). But what is false is to imagine that the extremity of the impact of sexual/domestic violence is discussed and understood at large in our society, and that all it is a side issue that complicates the syndrome of cPTSD a bit. And this is one size fits all.
I don't feel seen a lot. What I experienced, child trafficking, incest and severe misogyny/sexism, is NEVER discussed except with ignorance and sensationalism or with negative stereotypes. Judith Hermans description of cPTSD and the context she framed it in was one of the few times in my life that I felt completely seen and understood - not just as someone who suffers, but someone who is in a world like ours and in terms of my identity. There is still a real problem with finding therapists who can deal with what I lived through. It's a systemic problem, people just don't want to hear or know, and don't know and haven't heard... the cPTSD diagnosis was not just intended as a personal label to understand ourselves more generously but a tool for social change. To reform psychotherapy and psychiatry.
To me, the work by Pete Walker, has wonderful insights. Obviously the author has done a lot of great healing work for himself and others, he has helped me so much too. Vitally, he has broken some important silences about emotional healing, especially for men. However, his personal 'traumatic' experiences are not unspeakable, they wouldn't shut up everyone in the room, or make your, until then, best friend never speak to you again because they have no idea how to relate to you - because you are invisible when you become a victim of "those types" of abuse, worse some people immediately see you as incompetent or inferior because you are a survivor of any form of sexual assault or severe domestic violence as an adult or a child. It just does my head in that someone writes about a label and owns it so deeply but sort of side steps why it exists and who for. And gets a lot wrong about people who have been more severely impacted or less privileged than he in the process.
Angry feeling here.. Spectrum my big toe... this diagnosis was not meant to be for him, or people like him, it was to represent the voiceless and the invisible. The unspeakable in our society. It was not only about our relational attachment to our parents, it was how the severe violence in the domestic sphere needs to be seen heard and understood in terms of it's impact on individuals AND our communities. It was about making 'private'/ swept under the carpet/ denied 'everyday' violence like incest and severe child abuse visible, and the victim blaming in psychiatry and psychotherapy, a public and social issue. If he doesn't center this and explore it, then I feel he has just appropriated the label and watered it down to 'self help'.