Complex PTSD – Shame and Guilt – A Way Out

The issues of shame and doubt that traumatised and people suffering from Complex PTSD or PTSD suffer from or struggle with it is a fair assessment of their conduct to find there is a huge imbalance between unrealistic guilt and denial. In coming to terms with issues of guilt, survivors need the help of others who are willing to recognise that a traumatic event has occurred, to suspend their preconceived judgements, and simply to bear witness to her/his tale and most importantly to tell them they are believed. The day I worked up the courage to ask my therapist did she believe my story and she told me unequivocally that she did, was a pivotal moment in my life and a huge leap forward in therapy.  When others can listen without ascribing blame, the survivor can accept her own failure to live up to what she sees as “ideal” standards at the moment of extremity. Ultimately, she can come to a realistic judgement of her conduct with a fair attribution of responsibility.

Issues of shame and guilt similar to war veterans surface in the treatment of rape and child sexual abuse survivors, who often castigate themselves utterly, either for placing themselves at risk or for resisting ineffectively. These are precisely the arguments that rapists invoke to blame the victim or justify the rape. It is all part of the evil grooming technique. The survivor cannot come to a fair assessment of her own conduct until she clearly understands that no action on her/his part absolves the realist of responsibility for his/her crime.

As survivor’s of sexual abuse our shame and guilt is often exacerbated by the harsh judgment or lack of understanding or others. Yes; even if it happened to you as a child. I know that sounds incredible but it’s true. There are some who continue to believe that there is always something YOU COULD HAVE DONE !!!! and you might have only been six years old. However, it is not fully assuaged by simple pronouncements absolving her from responsibility, because of simple pronouncements, even favourable ones, represent a refusal to engage with the survivor in the lacerating moral complexities of the extreme situation. From those who bear witness, the survivor seeks not absolution but fairness, compassion, and the willingness to share the guilty knowledge of what happens to people in extremity.

Finally, the survivor desperately needs help from others to mourn her losses. All of the classic writings ultimately recognise the necessity of mourning and the reconstruction of the resolution of traumatic life events. Failure to complete a process of grieving perpetuates the traumatic reaction. Litton observes “unresolved or incomplete mourning results in stasis and entrapment in the traumatic process”.  Therefore to move forward it is necessary to grieve what has been taken from you. It is only that the healing from PTSD and Complex PTSD will take place. Grief itself is a long process defined by Elizabeth Kubler Ross where she talks about the five stages of grief. In our bereavement, we spend different lengths of time working through each step and express each stage with different levels of intensity. The five stages of loss do not necessarily occur in any specific order. We often move between stages before achieving a more peaceful acceptance of death. Many of us are not afforded the luxury of time required to achieve this final stage of grief. Make no mistake be it the trauma of war, witnessing a horrific murder, child sexual abuse; they are all events that rob us of something essential. Be it innocence, our sense of safety and place in the world or our own knowledge of what we once were. We have to mourn that loss and rebuild it and need our loved ones and therapists help to do so. If we do not, as no common ritual recognises the mourning that follows traumatic life events,  in its absence of such support, the potential for pathological grief and severe, persistent depression is extremely high bringing with it high levels of anxiety and risks of suicidality.

Sharing the traumatic experience with others is a precondition for the restitution of a meaningful world. It is the way forward for hope and life of a future spent with loved ones.

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