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Trauma

Cancer and COVID-19

Understanding the effects of CPTSD in the time of coronavirus.

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I couldn’t believe it!

After living almost six years with a metastasized tumor in my liver that was being managed with daily chemo pills, my latest MRI scan showed that a separate lesion had grown.

The shock gripped my body, rendering my mind numb. The denial was instantaneous.

I thought that the emotional ups and downs and sleepless nights I experienced these last months were due to the isolation from COVID-19. But like most cancer patients, even those in remission — which I wasn’t — I’m always stressed before, during, and after a scan. Now, I was also worried about contacting coronavirus at the hospital.

It only hit me later that the cancer had spread.

My goal here is to illustrate the impact trauma can have on a person’s physical, mental, and emotional body. When survivors feel threatened in a similar way to their first trauma, it can trigger post-traumatic stress disorder (PTSD) for single major events or complex post-traumatic stress disorder (CPTSD) for multiple traumas.

Understanding PTSD vs. CPTSD

The American Psychiatric Association (APA) defines PTSD as “... a psychiatric disorder that can occur in people who have experienced or witnessed a traumatic event such as a natural disaster, a serious accident, a terrorist act, war/combat, rape, or other violent personal assault.”

While survivors of one traumatic event may experience PTSD, those who’ve experienced multiple traumas can develop CPTSD. According to Braden Counseling Center, CPTSD “often stems from ongoing childhood neglect, domestic abuse, human trafficking, and living in a war-torn region for more than one year.”

Obviously, a survivor doesn’t choose to have PTSD or CPTSD. The amygdala, the limbic system of the brain, overrides the analytical part of the brain when there is a threat. This way, the victim can react instantaneously, automatically activating the fight/flight/freeze syndrome in the amygdala. If the threat disappears shortly thereafter, the person returns to normal. If it persists, traumatization occurs.

It’s also important for the survivor, as well as others who’ve not been traumatized before, to understand that post-traumatic stress disorder (PTSD) can get triggered when other crises occur in the future.

Intellectually, I do understand that I am undergoing two traumas simultaneously. I’ll call them “CC”: Cancer and COVID. And because I’d undergone multiple traumas throughout my childhood, I have (CPTSD).

Knowing things intellectually, I’ve learned, doesn’t mean that I get to avoid the emotional roller coaster that happens when a new trauma occurs. However, anticipating that could happen lets me know how to manage it.

What Does PTSD Feel Like?

As a retired psychotherapist having counseled trauma survivors for 35 years, I’ve observed clients being triggered right in my office. PTSD comes on instantly and unexpectedly, a flashback triggered by a suppressed memory from the time of the original trauma. For example, with war veterans, it could be the unexpected visual flashback of a slaughter. It could also be certain things that the brain noticed at that time, i.e., the smell of gunfire, stepping onto a minefield, the noise from a machine gun, etc.

At that moment, the survivor’s physical, mental, and emotional body gets thrown back into the horror of battle. Time becomes disoriented. Because the body reproduces the same chemical, mental, and emotional reactions as it had back then, he/she feels as though it’s happening in the present moment. The survivor cannot tell the difference between past and present. However, if the survivor has had psychotherapy sessions, then he/she is able to discern that it’s not happening at that moment, and that it’s a memory.

What Does CPTSD Feel Like?

I didn’t know I had CPTSD until recently when I read Pete Walker’s excellent book, CPTSD: From Surviving to Thriving. I always wondered why I didn’t have visual flashbacks until Pete mentioned that survivors of multiple traumas have CPTSD, which comes in the form of regressing emotionally back to the time of the trauma.

As I mentioned, CPTSD occurs with multiple traumas, not just one major incident. Some of mine included escaping from China because my father was on the Communist execution list, racial abuse when we settled in NYC, physical, emotional and sexual abuse, and almost dying twice from severe illnesses when I was 10 and 12.

Nowadays, I get triggered by seemingly unrelated incidents, which surprises me. For example, when my 5-year-old granddaughter stuck her tongue out at me, making faces at me because she didn’t like something I did, I freaked out and yelled at her. I started to pack my bags, ready to leave my son’s home that night. I had nowhere to go; I didn’t care. I would have left had my son not stopped me. I knew I wasn’t going to take that from her or anyone anymore!

Later, I realized that this incident brought back the memory of my father yelling and beating me, children at school bullying me, spitting, calling me “chink,” sticking out their tongues. The teachers did nothing, instead labeling me “oversensitive.” With no one defending me, my face burning with shame, I froze.

Now, when I’m triggered, I eventually understand that the trauma is not happening in present time. I can remind myself that I am safe, even when I’m feeling the emotions of my younger child.

Finding Hope

Trauma survivors endure a lot of pain during the recovery process. In order to do so, they must confront the very traumatic act that they would rather forget.

In the mental health field, there is a consensus that PTSD and CPTSD cannot be cured. From my personal and professional observation, however, PTSD and CPTSD can be managed, allowing survivors to lead a fulfilling life. It, however, requires working long term with a skilled, trauma-informed therapist.

For me, and for the many clients I’ve counseled, it’s been well worth the struggle.

For more information on trauma, sign up for my newsletter or email me at info@gayook.com to request a blog topic.

References

1. “Remission, What Does It Mean?”, WebMD Medical Reference Reviewed by Laura J. Martin, MD on November 11, 2018

2. Reviewed by American Psychiatric Association, Felix Torres, M.D., DFAPA, MBA, January 2020

3. “Understanding the Difference Between PTSD and CPTSD, Braden Counseling Center, for trauma treatment, different locations in Illiniois.

4. “How PTSD and Trauma Affect Your Brain Functioning”, Melanie Greenberg, PhD, licensed clinical psychologist and life coach, Psychology Today, September 29, 2018

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