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Addiction:
Adoption:
Auto Accidents:
Chaplains, Police, EMT:
Childhood & Adult Sexual Victimization:
Compassion Fatigue:
Culture, Race and Ethnicity:
Domestic Violence & Sexual Assault:
Grief:
Journalists, Survivors and the Media:
Male Sexual Abuse & Domestic Violence:
Partners & Families:
PTSD Treatment & Recovery:
PTSD & Health:
PTSD & Workplace Issues:
Recovery & Self Help:
Resiliency:
School Disasters:
Spirituality & Trauma:
Survivor Guilt:
Trauma Responses in the Aftermath of Disasters:
Veterans & Their Families:
 
Note From Joyce Boaz, Director, Gift From Within (GFW)
Before you read, please be aware that this story contains graphic details
of S.V.'s traumatic events that might be triggering for some.

S.V.'s Story: My Survival From Complex Post-Traumatic Stress Disorder

 
 
Introduction by S.V.:

In the early stages I was never clear about PTSD symptoms. Reading a technical description in a book never really covered what I was feeling...the despair, the feeling of insanity, the ugliness, the hopelessness...so, in return, I always felt as if I was really messed up, beyond repair, beyond PTSD. I think there is value in letting PTSD sufferers, especially people early into the trauma, understand the real truth and realize that their symptoms are not insanity, that they are normal, and that they can survive.

Being told I was experiencing "hyper vigilance" wasn't as good as being told that I was overreacting to sounds. Being told that I was experiencing "paranoia" wasn't as good as being told that paranoia can involve checking locks on windows and doors constantly and being certain that there was an imminent danger. I did not share these things with my therapists (You, Dr. J., and Dr. R.) in the beginning because I didn't connect them with the technical terms so I was embarrassed and really truly felt like I was insane rather than suffering from PTSD. It's a relief to be told what the symptoms really mean, how they can display themselves, and how to learn how to control the symptoms, as much as possible. It is nice to be able to not be afraid to share the feelings.

Introduction by Dr. Frank Ochberg:

The facts reported here by "S.V." are the facts I reviewed as an expert witness, hired by her attorney to assist with her case. Nothing is embellished, exaggerated or distorted. I share her anger at professionals who broke their Hippocratic vows to "above all, do no harm." Most physicians, psychologists and dental surgeons are well-trained, trustworthy, reliable individuals. But SV endured the malpractice and malignancy of two outrageous practitioners. They harmed her in profound ways. Her path to recovering a sense of security and dignity has been long and difficult. Not every survivor will or should reveal intimate details of trauma and recovery to a wide readership. But SV has chosen to do so. The idea of writing and of sharing this paper is her own. I applaud her courage and candor. I hope it inspires others who are victimized by members of the helping professions to endure and prevail.

 
  At some point in life, everyone will have to deal with some sort of psychological trauma. The death of a loved one, loss of a job, an unexpected injury; there are many incidents that could be considered traumatic to a person. Most minor trauma's can be dealt with successfully and a person can remain functional within their daily lives.

Unfortunately, some people will sustain one or more severe traumatic events during their lives and will be diagnosed with Complex PTSD. After a series of traumatic events, I was diagnosed with Complex PTSD, which has caused me great suffering. Complex PTSD is an emotional nightmare, however; I am determined to master it.

PTSD was established as a medical diagnosis in 1980. (Ochberg) The Diagnostic and Statistical Manuel of Mental Disorders, 4th Edition, most often referred to as the DSM IV, lists the criterion for mental disorders, including PTSD. The DSM IV gives a very technical description, and the criterion for a PTSD diagnosis is listed in section 309.89. For the purposes of this paper, I will avoid the technical jargon and simply explain PTSD, as I have experienced it.

According to The National Center for PTSD Web-site, PTSD can occur when someone is witness to or experiences a life-threatening event. ("What is PTSD?") Stockholm Syndrome can co-exist with PTSD. I have the symptoms of Stockholm Syndrome also, and have probably had these symptoms from childhood on.

Dr. Frank Ochberg, a pioneer in the studies of PTSD and Stockholm Syndrome, describes Stockholm Syndrome on his non-profit website, www.giftfromwithin.org.

 
  Stockholm Syndrome occurs when there is a sudden, terrifying capture. The hostage is like an infant. He or she can't talk, eat, move or use a toilet without permission. But then, in every one of these cases, little by little, small acts of kindnesses by a captor evoke feelings deeper than relief. It would be akin to what an infant feels when he gets attention, relieving his thirst, hunger, wetness or fear of neglect - a primitive gratitude for the gift of life; an emotion that eventually develops and differentiates, into different varieties of affection and love.

The attachment goes both ways. The captor often develops reciprocal feelings toward the hostage just as the hostage develops feelings for the captor. It is not a conscious, willful behavior to avoid punishment. It is regression and recovery of a powerful, primitive feeling toward the giver of life. The hostage-taker wants to protect the hostage, but both captors and hostages have little trust in negotiators and police; they are viewed as the common enemy. (Par 6-8)

 
  Some people are more prone to developing PTSD than others. Dr. Ochberg states that there are genetic differences in personality and life experience. The physical differences that may be implicated in PTSD are a smaller hippocampus; a brain structure associated with memory, and the brain chemistry that is generally associated with a tendency toward anxiety or dissociation. Some people are; in general, better able to cope than others. But these people who can cope better may still develop PTSD; they just deal with it more effectively. (Ochberg)

My personal life experiences set me up to be vulnerable to PTSD. I cannot remember much about my childhood before the age of twelve. What little I do remember is that of watching my little brothers being brutalized by my step-father. My mother was a negative force also. She was unable to empathize and in in-fact, was an abuser herself; both physically and psychologically.

My siblings and I were not allowed to sit at the same area at dinner-time; my parents ate in the dining room, while we ate in the kitchen. My step-father would kick us from behind and smack us on the head, for no particular reason. Severe beatings included being hit with the belt, over and over. Both my mother and step-father taunted us if we were upset and or crying. It was best to avoid them, as much as possible. Moreover, the worst part, for me, was the fact that I had to witness my brothers being abused; I felt an extreme amount of helplessness and guilt.

I left my home at the age of fourteen, which made me feel as if I was abandoning my brothers. I was put into a couple of foster homes, one in which I was sexually abused. Mostly, I was a runaway and sometimes literally did not have a place to stay. I eventually wound up into legal trouble and was placed into the juvenile justice system. This only meant that I was given a case-worker; everything else stayed the same, as far as being bounced from home to home and mostly being a runaway. It was hard, as a fourteen-year old, to be self-sufficient. I was angry, depressed, felt hopelessness; but more often than not, I was numb to everything. Between parental beatings, foster care abuses, the stressors of being on my own at times, and the witnessing of the brutalities that were exacted upon my brothers; I had, to a certain extent, developed Simple PTSD. This increased the odds for developing Complex PTSD in the future.

According to Dr. Ochberg, Simple PTSD is not so simple; with flashbacks, numbing and debilitating anxiety. (Ochberg)

I would agree that I was numb to any emotion. I had to be, or I would not have been able to survive. Anxiety was a way of life, to the point I did not realize what life without anxiety would even feel like.

I dropped out of school midway through eighth grade. I continued to get into trouble and at age eighteen, I got into very serious trouble. That was when I decided that I did not want to continue down that road. Unfortunately, that entailed me going back to being a completely passive and submissive person, as I had to be as a child.

In my early twenties I got married. It was a short-lived, abusive marriage. I was attracted to violent men. I was more comfortable in that situation because it was all I knew. I stayed isolated for the most part; uncertain of whom I could trust, if anyone at all.

In March of 2001, when I was twenty-six, I got married a second time to a person that was very nice, supportive, and not the abusive type, whatsoever. It appeared as though this could be a positive turning point in my life. Unfortunately, this positive turning point quickly became a path to destruction.

The marriage itself was good, but in August of that year, I began medical treatment that was supposed to last for three months. The procedures were very painful and I was sedated during and after. I did not know it at the time, but this was the starting point of the destruction. The doctor was over-sedating me during every procedure, with an assortment of intravenous narcotics. Initially, the doctor had said I would only be sedated with one type of drug, and my husband and I assumed that was what he was doing.

In between the weekly appointments, I was sick and in pain, constantly. The doctor prescribed Hydrocodone, which is a powerful, morphine based pain killer, along with two other pain killers, Vicoden, and Demerol. Between those pain killers and the assortment of intravenous narcotics the doctor was administering to me, I became addicted to the pain killers. Despite my abusive childhood, and being on my own at age fourteen, I had never developed a drug problem.

When the treatment ended, it did not take long for the doctor to contact me. I went to his home to get the pain killers. That visit turned into three weeks of pure horror. I was unconscious and sedated for most of those three weeks. I do not remember a lot and the things that I do remember included violent attacks, physically and sexually. There was not a landline phone in the house and it really would not have mattered if there was because I was so sedated.

At one point, I was conscious enough to grab the doctor's cell phone. I went into the bathroom and locked the door. As I was dialing 911, he was kicking the door in. The phone kept ringing and I was begging for them answer. The police did not answer before the door was kicked in and the cell phone was destroyed. I was thrown into the shower and jabbed with a needle again.

There was one other time that I felt I was consciously aware of my surroundings. I believed that I could escape. I was on the sofa and the doctor did not seem to be around. I was looking at the flight of stairs that I would have to get down, to make it out the door. I really thought I was going to make it. I made it down about two of the steps when I was quickly grabbed from behind and literally went airborne. When I slammed onto the floor, I was beaten, as the doctor was mumbling that he would kill me and throw me into a gravel pit. Being drugged, I had completely overestimated the speed and agility that I would have needed while making a run for it; I did not have any speed, agility, or concept of the actual situation at hand. And I still do not know where the doctor came from; I just know he grabbed me very quickly. As he was choking me, I remember feeling as if I was detached from my body. He was threatening me and all I could think about was how my strength was nothing compared to his. I had zero control. I could not move. I was beaten to the point that my hands, arms, and torso, were one big bruise.

To my benefit, on one particular day, the doctor accidentally left his cell phone. The police later found that he had been issued a traffic citation, on that morning, for speeding in excess of 100 miles per hour. The police theorized that he was running late and therefore, he forgot his cell phone. I was in and out of consciousness but at one point was able to call the police. When the police arrived, I was physically removed from the situation. Emotionally, I am still not free of that situation. After being hospitalized to stabilize my body, I went home. I was not fed very much during the three weeks and as a result, I had lost about 25 pounds and I looked like a skeleton. This was when I was officially diagnosed with Complex PTSD. Even though I was removed from the situation, I continued to have severe psychological and physical consequences.

The doctor videotaped a lot of those three weeks. I was not permitted to watch most of the videos, on the advice of mental health experts, but I did have to watch a small portion; to confirm that it was me. Police and mental health officials believed that since I did not remember most of it, it would have caused further psychological injury if I was forced to watch it.

In his book, The Post-Traumatic Stress Disorder Sourcebook, Glenn R. Schiraldi lists numerous symptoms that can accompany PTSD. (13) The physical symptoms, that I endured, and sometimes still do, include nausea, tachycardia, insomnia, panic attacks, paranoia, hyper vigilance, and hyperventilation. (13) Furthermore, I cannot wear any clothes that feel restrictive, such as turtlenecks.

Mentally and emotionally, I experienced extreme fear. For about a month, I stayed up every night, crouched in the corner, looking toward my bedroom window. I was certain that I was going to be attacked again. I did not sleep very much anyway, but I never slept while it was dark out. When I did sleep, I had night terrors. I also could not be around anyone. I felt disassociated and interactions with people did not seem real. I experienced extreme paranoia; I did not trust anyone. Sometimes just a certain scent would bring on a fear response. At times, I felt that the police, my husband, and pretty much everyone were conspiring against me. These feelings were hard to deal with because at times, I knew they were irrational thoughts; more often than not though, the irrational thoughts prevailed. It made me feel insane.

One of the most difficult things I had to deal with was the self-blame. The "how could I have been so stupid", "how did I not realize he was giving me ten times the amount of drugs during the treatment", "why did I go to his house?" Things were further complicated by the fact that I had apparently gone outside of the home, with the doctor, a couple of times, during the three weeks. One would have to be either an anesthesiologist or have undergone a surgery themselves, with the use of this particular sedation, to fully understand how this is possible. It is possible though, and I have no memory of it. The following is an excerpt, on IV sedation, from the website http://www.dentalfearcentral.org/iv_sedation.html :

 
  A lot of dental offices use terms such as "sleep dentistry" or "twilight sleep" when talking about IV sedation. This is confusing, because it suggests that IV sedation involves being put to sleep. In reality, you remain conscious during IV sedation. You will also be able to understand and respond to requests from your dentist. However, you may not remember much about what went on because of two factors: firstly, in most people, IV sedation induces a state of deep relaxation and a feeling of not being bothered by what's going on. Secondly, the drugs used for IV sedation can produce either partial or full memory loss (amnesia) for the period of time when the drug first kicks in and until it wears off. As a result, time will appear to pass very quickly and you will not recall much, or perhaps nothing at all, of what happened. So, it may indeed appear as if you were "asleep" during the procedure.  
  The doctor had contacted my husband, who was out of the country at the time, and told him that I was with him now and that I did not plan on coming back. My husband and I went through a very hard time after this incident ended. I could not fathom why he had failed to contact the police. What the doctor was claiming would have been so out of character for me. My husband did not fully understand everything until the lead detective, an anesthesiologist, and a psychiatrist explained everything to him. I was still angry at him for a long time. But I can say that he felt an incredible amount of guilt once he understood the full picture. Neither of us had any contact with our families at that point in our lives either, so there was no one to intervene.

According to the Web page sponsored by the United States Government:

 
  The National Center for Post-Traumatic Stress Disorder states that PTSD can cause stable neurobiological and physiological alterations in the central and autonomic nervous system. There can be altered brainwave activity, decreased volume of the hippocampus, and abnormal activation of the amygdala .The amygdala is used by our brains to coordinate a fear response. ("What is PTSD"?)  
  For months after the attack, I would become terrified and could feel the adrenaline response overcome me. My body reacted as if there was a life or death situation still at hand, when in fact, it was just a continued fear of the situation that I had been in. I was hyper-vigilant.

I left my home for therapy only. I could not go to any public places, such as stores, gas stations, and I did not even go outside into my yard. I felt like I could possibly be attacked and if I went to public places; I believed that every person around was talking about me, looking at me with disgust, and felt as if they all knew about the abuse. This of course was not the case but I truly believed it at the time.

At one point, when my husband was out of town, I had been up for several days, had not eaten anything in several days, and ended up trying to commit suicide. I was delirious and extremely paranoid. I holed up in a hotel room, with a gun. An eight hour standoff with the police followed. I discharged the gun twice; both times just because I was so out of it and also because I really didn't know how to handle a gun. The second time the gun went off, the bullet put a hole in the right side of the hooded sweatshirt that I was wearing at the time. At that point, I became very frightened, put the gun down, and surrendered. I was immediately taken to a psychiatric ward. This was the first of two psychiatric hospitalizations. It was also the first of two suicide attempts.

I no longer worry about a suicide attempt happening again because I have learned that suicide is not something that can be carried through with easily. I also realize the negative impact that it would have on those around me. After the first suicide attempt, one or both of my brothers would stay with me when my husband was out of town. This ended up being a good thing as it brought my brothers and me closer together.

When I went for therapy, I got out of the car, directly in front of the door to psychologist's office building, took the elevator up, and went directly to the private waiting area and locked the door. I was usually experiencing mild hyperventilation by that point. For the next two years, this was the routine. I was also prescribed anti-depressants, mood stabilizers, anti-anxiety medication, and sleeping pills. Three months into therapy, I left my home and husband and got an apartment, on the advice of my psychologist. At this point, I became completely isolated, except for my interactions with my psychologist.

This brings us to an important part of overcoming PTSD and reducing the Stockholm Syndrome symptoms. Finding a good, competent, trustworthy psychologist and psychiatrist is vital to recovery. This cannot be emphasized enough. Dr .Ochberg and Dr. R. call this tragic and incomprehensible, but the fact is; I was referred to a psychologist that caused me more psychological damage. I went from a sadistic doctor that drugged and beat me, to a psychologist that was narcissistic and a sociopath. The psychologist had an agenda and the agenda did not include my well-being.

I did not receive the proper trauma therapy in regard to the brutal attacks and beatings I had endured. I was "treated" by this psychologist, two to three times per week, for two years. I began seeing him shortly after the standoff. I was in a complete breakdown mode, literally. I became dependent on him and he was the only thing consistent in my life. When I had to go to the police station to watch a small portion of what the first doctor had taped, to confirm that it was me, the psychologist accompanied me and observed the tape; the tape included me being severely abused while unconscious.

After two years of manipulation and dependency, the psychologist crossed the line completely and began a sexual relationship with me. Within three weeks I made my second attempt at suicide by taking an anti nausea pill and about 100 pills that included Xanax, an anti-anxiety pill, and Adderall, an Attention Deficit Disorder pill. I blacked out and the next thing that I remembered was waking up in the hospital cardiac unit. I was there for about a week.

The psychologist continued seeing me, even after the suicide attempt. I was severely depressed. The relationship was abusive. The psychologist had a fiancé. He told me that he should have never taken me on as a patient after going to the police station with me and watching the portion of the video, because he liked it. He gave me a book, The Story of O, and pointed out that he liked that kind of thing; the book is disturbing in that it contains material that involves women being tortured, controlled, and debased. I felt emotionally numb at this point.

I began seeing a new psychologist, a female, Dr. R. For the first six months, I did not mention anything about my previous psychologist. I felt that I had to protect him and also felt that I still needed him in my life to survive. When I could no longer handle the situation with my previous psychologist and began to feel suicidal again, I told Dr. R. what was happening. With my consent, she took control of situation by calling the previous psychologist and telling him to not contact me again. Dr. R. also filed a complaint with the State. Without this intervention, I believe that another suicide attempt would have been imminent. At this point, Dr. Ochberg, an expert in PTSD, agreed to treat me also. He diagnosed me with Complex PTSD.

In my recent interview with him, he states that treatment for Complex PTSD requires learning to live in a normal world, after living in hell. Dr. Ochberg gets very active in helping clients find jobs, friends, volunteer activities, school opportunities, lawyers, doctors, and other therapists. He says that if a person has learned to survive without having parents or professionals that you could trust and respect, it can be a long, tough road, finding truly trustworthy peers and professionals. Complex PTSD includes loss of self-confidence, difficulty knowing who to trust and how to trust, and often, swings of mood including rage and depression. (Ochberg)

I now have a team of professionals. I see Dr. R. about twice a week. We work on daily issues as well as past issues. Dr. R. uses a combination of cognitive behavioral therapy (understanding how one thinks about the trauma and the behaviors it affects and then working toward a new understanding and practicing new behaviors) and psychodynamic therapy which looks at how early experiences affected the way a person experiences and remembers trauma. (Dr. R.)

In an email interview, Dr. R. stated the following:

 
  Without treatment for PTSD and/or Complex PTSD, a person will remain angry and/or fearful for a long time. It takes many positive experiences to help recover from the trauma and most people with PTSD or Complex PTSD do not have those experiences because they are too busy avoiding negative events. Therefore, they tend to be isolated. With treatment, a person with PTSD has a bright future, and the self understanding they gain from therapy can be a real asset. It can be very difficult when people in the environment think that a person with PTSD or Complex PTSD should be recovering faster than the person appears to be. Healing is individual and there is no right or wrong timetable. Dr. R.s has been a great therapist for me.  
  I have a treating psychiatrist that prescribes and monitors my medication, Dr. J. I discuss my progress with her also. She and my psychologist have good communication. Dr. J. is a positive force in my life. I also believe that the medications assist in stabilizing my mood.

Dr. Ochberg works with me using his own treatment; The Counting Method. (Ochberg) The Counting Method involves Dr. Ochberg counting, out loud, to 100, at an even and steady pace. During the counting, I remain silent and think about the traumatic event. After the counting is completed, Dr. Ochberg asks what I thought about and around what numbers that I thought about a particular memory. We then reframe the memory in such a way so that it is not so intrusive to my thoughts.

Dr. Ochberg also assists me in getting past my social anxiety. We set up lists of things that I can benefit from. Taking this class was one of those things. The original plan was to take a traditional course, however, when I went to register, I panicked and signed up for on-line courses instead. My doctors agreed that it was still a step forward though. I also have a volunteer opportunity that involves working with abused children; it is waiting for me, when I am ready to take that step.

I have learned how to be aware of any symptoms that I might start having. I address them immediately with my doctors, before they become a big problem and cause a major setback.

I am back living with my husband. Although we do not have a typical marriage, we are very close friends; we get along now better than ever before. My husband is a source of unconditional support.

I am also very close to my brothers now. Currently, one of my brothers, " T", is staying with us while he attends the Fire Academy. "M", my younger brother will be going to Eastern this fall. I enjoy having them close because we offer each other emotional support.

I work very hard on getting better. I have come so far in the past two years. Having a good team of experts has helped tremendously. I still have social anxiety; however, I am able to go into public places and can be around people, for short periods of time, without panicking.

I have bad days still but for the first time ever, I feel excited about life. I am going to have a fulfilling and meaningful future, I am certain of that. I plan on finishing my education and working with abused children. And for the first time in my life, I also believe that I deserve to have a positive future. It is as if I have a life force inside of me that did not exist before. I no longer feel responsible for the abuse that I have endured; I am over the self-blame, for the most part.

Three of the most important things that I have learned are patience, persistence, and forgiveness. I cannot allow myself to become despondent when I have a setback. I cannot beat myself up because I become embarrassed and frustrated when I have irrational thoughts and paranoia. I have to remind myself that I do not have to hate myself or feel insane because I have temporary, irrational thoughts. Rather than feeling hatred for myself and my thoughts; I need to keep moving forward with therapy and not dwell on a setback. I have learned that I have to forgive myself, as many times as it might take.

I will end this paper with a poem that Dr. Ochberg gives to his patients. It is very meaningful to me.

Survivor Psalm
I have been victimized.
I was in a fight that was
not a fair fight.
I did not ask for the fight.
I lost.
There is no shame in losing
such fights.
I have reached the stage of
survivor and am no longer a
slave of victim status.
I look back with sadness
rather than hate.
I look forward with hope
rather than despair.
I may never forget, but I need
not constantly remember.
I was a victim.
I am a survivor.
© Frank Ochberg, MD & Gift From Within

Works Cited

Dental Fear Website. March 2004. "Intravenous Sedation". Online posting. 16 March 2006.www.dentalfearcentral.org/sedation.html

Gift From Within. 1995. Gift From Within Website. 2 March 2006.www.giftfromwithin.org

Ochberg, Frank M. Online interview. 18 March 2006.

Ochberg, Frank M. "Stockholm Syndrome: The Ties That Bind Captive to Captor." Copyright Los Angeles Times 2005. Par.6-8. Online posting. 13 March 2006http:www.giftfromwithin.org/html/stockhlm.html

Ochberg, Frank M. "Survivor Psalm."www.giftfromwithin.org/html/Poetry-for-Trauma-and-PTSD-Survivors.html

Robbins, Elizabeth. Online interview. 26 March 2006.

Schiraldi, Glenn R. The Post-Traumatic Stress Disorder Sourcebook. New York: McGraw-Hill, 2000.

United States. Government Printing Office. Diagnostic and Statistical Manual of Mental Disorders IV. Section 309.89. Washington: DSMV, 2004.

United States. Government Printing Office. The National Center for PTSD, Veteran's Affairs. "What is PTSD?" Online posting. 13 March 2006 Washington: 1989.http://www.ptsd.va.gov

 

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