Ngaba nawe utshintshile emva kokwenzakala okukhulu, ixesha elide? Masithethe ngeCPTSD (i-Complex PTSD)!

Sonke kufuneka sijongane namava anzima nabuhlungu ebomini bethu esingenakukwazi nokuwacinga, akunjalo? Kodwa kukho amava athile angapheli ngosuku olunye okanye ezimbini. Asithuthumbisa ixesha elide, emba ezintliziyweni zethu. Namhlanje, siza kuthetha ngengxaki yengqondo enokubangelwa ziziganeko ezibuhlungu kakhulu ebeziqhubeka ixesha elide. Oku kubizwa ngokuba yi -CPTSD okanye i-Complex Post-Traumatic Stress Disorder . Mhlawumbi ukhe weva ngale nto, okanye uziva ezi mpawu ngokwakho. Makhe sibone ukuba yintoni na.

Yintoni i-CPTSD (i-Complex PTSD)? Ngamafutshane...

Ngamafutshane, i-CPTSD yimeko yengqondo enokuthi ivele ukuba ujongene noxinzelelo olungapheliyo ixesha elide. Oku kunokubangela utshintsho olukhulu kungekuphela nje engqondweni yakho kodwa nakwindlela oziphatha ngayo. Cinga ngako, njengokuba inxeba lithatha ixesha ukuphola, amanxeba aqatha ngokweemvakalelo nawo athatha ixesha ukuphola, kwaye ngamanye amaxesha anokukhokelela kwiimeko ezahlukeneyo ezibangela uxinezeleko engqondweni.

Kukho iindlela ezininzi eziphambili zokuphendula uxinzelelo ezinokubonwa kwi-CPTSD:

• Ukuhlala ukhathazekile okanye usoyika (Ukuxhalaba): Usenokuhlala uvakalelwa kukuba kukho into embi eza kwenzeka.
• Ukubuyela umva okanye amaphupha amabi: Usenokuvakalelwa kukuba esi siganeko sibuhlungu siphinde senzeke ngokwenene, okanye usenokuba namaphupha amabi rhoqo anxulumene naso.
• Ukuphepha iindawo, abantu, nezinto ezinxulumene nesiganeko esibuhlungu: Usenokungathandi ukuba kufutshane okanye ukuya kwiindawo ezikukhumbuza ngesiganeko.
• Ubunzima bokulawula iimvakalelo (Iimpendulo eziphakamayo zeemvakalelo): Usenokuba nomsindo lula, ucaphuke, wenze izinto ngokungxama, kwaye ude ube ndlongondlongo ngezinto ezincinci.
• Ubunzima obuqhubekayo ekuqhubekeni kobudlelwane: Ubunzima bokunxibelelana nabantu, ukubathemba, kunye nokwakha ubudlelwane.

Khawucinge nje, kukho umntu ogama linguNilanthi. Ukususela ebuntwaneni bakhe, bekukho iimfazwe ekhaya, kwaye utata wakhe wayemxhaphaza kakhulu umama wakhe kunye naye. Iminyaka idlule ngolu hlobo. Nangona uNilanthi eselula ngoku, uhlala esoyika, enengxaki yokuthemba abantu, kwaye ecaphuka ngezinto ezincinci. Uhlala ephupha ngezinto ezenzeka kuye esengumntwana. Olu hlobo lwemeko lunokuba ngumzekelo we-CPTSD.

Ziziphi iingozi ezingapheliyo ezinokubangela i-CPPTSD?

• Ukuxhatshazwa ngokwasemzimbeni okanye ngokwesondo komntwana ixesha elide.
• Ubundlobongela basekhaya obuhlala ixesha elide.
• Ukuba lixhoba lorhwebo ngabantu okanye ngokwesondo.
• Ukuhlala kwindawo efana nemfazwe ixesha elide (iMfazwe).
• Ubundlobongela obuqhelekileyo ekuhlaleni.

Le meko ayiqhelekanga nje kuphela kwabo baye bafumana umvandedwa omkhulu ebuntwaneni, kodwa banokuba ne-CPTSD xa sele bekhulile ukuba bafumana umvandedwa onjalo wexesha elide.

Ngaba i-CPTSD iyaqatshelwa ngokwezonyango?

Lo ngumba onzima kancinci. Kwanaphakathi kweengcali zengqondo, kukho izimvo ezahlukeneyo malunga nokuba i-CPTSD yimeko eyahlukileyo okanye yinxalenye ye-PTSD (Post-Traumatic Stress Disorder).

Cinga ngoku: I-World Health Organisation (WHO) ibize i-CPTSD njengesimo esahlukileyo kwincwadi yayo yamva nje, ethi `International Classification of Diseases (ICD-11),` ngo-2019. Nangona kunjalo, i-American Psychiatric Association (APA) ayiyamkeli i-CPTSD njengesimo esahlukileyo kwi -`Diagnostic and Statistical Manual of Mental Disorders (DSM-5) . Nangona kunjalo, i-DSM-5 iquka imeko ebizwa ngokuba yi-`dissociative PTSD` njengeqela le-PTSD, kwaye iimpawu zayo zifana kakhulu ne-CPTSD.

Ezinye iingcali zikholelwa ukuba i-CPTSD, i-PTSD, kunye ne-BPD (Borderline Personality Disorder) zonke zisenokuba ziimeko zempilo yengqondo ezinxulumene nokwenzakala okufanayo. Oko kukuthi, zisenokuba zinxulumene ngokumalunga nobunzima beempawu zazo.

Ngoko ke yintoni umahluko phakathi kwe-CPTSD kunye ne-PTSD?

Lo ngumbuzo obuzwa ngabantu abaninzi. Umahluko ophambili bubude bexesha lomothuko kunye neempawu.

Sasicinga ukuba i-PTSD ibangelwa kukwenzakala okwethutyana, njengengozi okanye intlekele yendalo. Kodwa uphando lufumanise ukuba abantu abajongene nokwenzakala okwethutyana, okuphindaphindiweyo, bavelisa ezinye iimpawu ukongeza kwi-PTSD. Kungezi mpawu zongezelelweyo apho i-CPTSD ifunyaniswa khona.

Kuzo zombini i-CPTSD kunye ne-PTSD,

• Ukuphinda ubone esi siganeko (ukubuyela umva kwezinto),
• Ukuphaphama rhoqo nangokungeyomfuneko (ukuhlala ulumkile ngokungeyomfuneko ngezinto ezikungqongileyo),
• Iimpendulo zoxinzelelo lwengqondo kunye nokuziphatha zinokubonakala, njengokuphepha izinto ezikukhumbuza ngesiganeko esibuhlungu.

Nangona kunjalo, abantu abane-CPTSD bahlangabezana nezinye iingxaki :

• Iingxaki ezingapheliyo nezixhaphakileyo zokulawula iimvakalelo: Ukucaphuka lula ngezinto ezincinci, ukuziva ulusizi, nokungakwazi ukulawula iimvakalelo.
• Imiba malunga nobuwena kunye nokuziva ngathi ungubani: Iingcinga ezimbi malunga nokuba ungubani kunye nokuba ixabiso lakho liyintoni. Iimvakalelo zokuba neentloni, ukuziva unetyala, kunye nokusilela ziqhelekile.
• Iingxaki zokugcina ubudlelwane: Kunzima kakhulu ukwakha nokugcina ubudlelwane obuqinileyo nobunentsingiselo nabanye.

Yintoni umahluko phakathi kwe-CPTSD kunye ne-BPD (Borderline Personality Disorder)?

I-CPSD kunye ne-BPD zineempawu ezininzi ezifanayo, ezifana nokuziphatha ngokungxama, ukuziva ungento yanto, kunye nobunzima bokugcina ubudlelwane obuzinzileyo. Oku kuye kwakhokelela ezinye iingcali ukuba zibuze ukuba ngaba ezi zimbini ziimeko ezahlukeneyo ngokwenene.

Ngokweekhrayitheriya zangoku, umahluko omkhulu kukuba i-CPTSD ifuna ukuba kubekho ukwenzakala okungapheliyo. Nangona i-BPD ingadingi ukuba kubekho ukwenzakala , i-BPD idla ngokunxulunyaniswa kakhulu namava abuhlungu, njengokuxhatshazwa kwabantwana okanye ukungahoywa.

Omnye umahluko kukuba i-BPD idla ngokubonakala kubantu abadala, kodwa i-CPTSD inokwenzeka nakweyiphi na iminyaka.

Ixhaphake kangakanani i-CPTSD?

Ngenxa yokuba i-CPTSD yimeko esandul’ ukuchongwa, uphando alwanelanga malunga nokuba ixhaphake kangakanani. Nangona kunjalo, iingcali ziqikelela ukuba le meko inokuchaphazela phakathi kwe-1% kunye ne-8% yabemi behlabathi. Oku kuthetha ukuba kusenokubakho abantu eSri Lanka abanengxaki yesi sifo.

Zithini iimpawu ze-CPTSD?

Ngokwehlelo lwe-'ICD-11' lwe-World Health Organisation, i-CPTSD iquka uninzi lweempawu eziphambili ze-PTSD. Oko kukuthi:

• Ukubuyela umva: Ukuziva ngathi isiganeko esibuhlungu siphinda senzeke ngokwenene.
• Ukuphepha nokungabandakanyeki ebantwini, kwiziganeko, nakwizinto ezibangela ukwenzeka kwengozi.
• Ukuphaphama kakhulu yimeko ehlala ihleli yokuphaphama kakhulu ngenxa yokoyika ingozi.
• Iingcinga neemvakalelo ezimbi rhoqo.

Ukongeza koku, kukho nezinye iimpawu ezininzi ezingaqhelekanga kwi-CPTSD:

• Ukusabela ngokugqithisileyo kwizinto ezibangela iimvakalelo ezimbi, umsindo, kunye nokuziphatha okunobundlobongela (Affective Dysregulation): Ngamafutshane, ukucaphuka ngokukhawuleza, ukucaphuka, kunye nobunzima bokulawula iimvakalelo nakwizinto ezincinci.
• Ukuba nembono engalunganga ngawe: Ukuhlala uhlupheka ziintloni, unetyala, iimvakalelo zokusilela, kunye nokungabi naxabiso.
• Ubunzima obukhulu ekwakheni nasekugcineni ubudlelwane obunentsingiselo: Kunzima kakhulu ukuthemba abantu nokwakha ubudlelwane obusondeleyo.

"Ndiyakhumbula, ndandinomhlobo owayebandezeleka kakhulu esengumntwana. Wayengenakuze abathembe abanye abantu. Nokuba umntu wayencuma aze athethe naye, wayecinga ukuba ubeka umgibe. Wayenabahlobo abambalwa kakhulu." – Olu hlobo lwemeko lunokubonwa kwi-CPTSD.

Yintoni ebangela i-CPTSD? Kwenzeka ntoni engqondweni yethu?

Ngokutsho kwe-ICD-11, i-CPTSD ibangelwa kukuvezwa kwisiganeko esibuhlungu okanye uthotho lweziganeko ezinobungozi kakhulu. Ezi ziganeko zihlala zinde, ziphindaphindwa, kwaye zibandakanya iimeko apho kungenakwenzeka ukubaleka okanye nokuba yingozi.

Eminye imizekelo yile:

• Ubundlobongela basekhaya obuhlala ixesha elide.
• Ukuxhatshazwa ngokwesondo okanye ngokwasemzimbeni ngexesha lobuntwana.
• Ukuthuthumbisa.
• Ukujongana nokubulawa kwabantu abaninzi.
• Ukuba likhoboka.

Olu hlobo loxinzelelo olukhulu noluhlala ixesha elide lunokubangela utshintsho kwikhemistri kunye nolwakhiwo lwengqondo yakho . Uphando lubonise ukuba ukwenzakala kunokubangela utshintsho oluhlala luhleli kwiindawo eziphambili zengqondo yethu. Ezi ndawo zezi:

• `Amygdala`: Le yinxalenye ephambili yengqondo yethu elawula uloyiko nezinye iimvakalelo. Ifana nendawo encinci elawula iimvakalelo zethu, ingakumbi ezo ziqonda iimvakalelo ezifana noloyiko. Le nxalenye inokuba negalelo elikhulu ngenxa yokwenzakala, yiyo loo nto sihlala sisoyika kwaye silumkile.
• IHippocampus: Le yinxalenye ephambili yengqondo yethu egcina iinkumbulo zethu kwaye isinceda sifunde izinto ezintsha. Ukulimala kunokunciphisa ukusebenza kwale nxalenye, yiyo loo nto ngamanye amaxesha siba neengxaki zokukhumbula iziganeko nokufunda izinto ezintsha.
• I-Prefrontal cortex: Kulapho senza khona izinto ezininzi ezibalulekileyo, ezinje ngokucwangcisa, ukwenza izigqibo, ukuveza ubuntu bethu, kunye nokulawula indlela yokuziphatha kwezentlalo. Ukonzakala kunokutshintsha nokusebenza kwale ndawo, yiyo loo nto kunzima ukulawula iimvakalelo nokwenza izigqibo ngokungxama.

Ezinye izifundo ze-neuroimaging zibonise ukuba olu tshintsho lubonakala ngakumbi kwiingqondo zabantu abane-CPTSD kunabo bane-PTSD.

Ungaziqonda njani ngokuchanekileyo ukuba une-CPTSD?

Akukho vavanyo luthile lokuxilonga i-CPTSD. Endaweni yoko, ugqirha okanye umcebisi wezempilo yengqondo uza kukubuza oku kulandelayo:

• Iimpawu zakho.
• Imbali yakho yezonyango.
• Imbali yakho yempilo yengqondo.
• Indlela owachaphazeleka ngayo kukudandatheka.

Oogqirha basebenzisa imigaqo ekwi-'ICD-11' ye-World Health Organisation ukufumanisa i-CPTSD. Nangona kunjalo, ngenxa yokuba i-CPTSD yimeko esandul' ukuchongwa, abanye oogqirha basenokungazi ngayo. Ngenxa yoko, kunokuba nzima kancinci ukufumana uxilongo olusemthethweni. Ugqirha unokukuxelela nokuba une-PTSD endaweni ye-CPTSD. Ke ngoko, ukuba unale mpawu, kubaluleke kakhulu ukubona umcebisi wezempilo yengqondo onamava kweli candelo.

Ziziphi iindlela zonyango ze-CPTSD?

Iindaba ezimnandi zezokuba kukho unyango lwe-CPTSD! Unyango oluphambili yi-psychotherapy, okanye "i-talk therapy" njengoko sonke sisazi. Ngokukodwa, isebenzisa uhlobo lonyango lokuziphatha kwengqondo olubizwa ngokuba yi -trauma-focused CBT .

Olu nyango lunikezelwa yingcali yezempilo yengqondo eqeqeshiweyo nenelayisenisi, efana nengcali yezengqondo okanye ingcali yezengqondo. Olu nyango lubonelela ngenkxaso, imfundo, kunye nesikhokelo kuwe nakubantu obathandayo ukukunceda usebenze ngcono kwaye uphucule impilo-ntle yakho.

Kwi-CBT egxile kwiTrauma, ezi zinto zenzeka:

• Ufunda ngendlela umzimba wakho osabela ngayo xa uxinezelekile okanye uxinezelekile.
• Funda indlela yokulawula iimpawu.
• Inceda ekuchongeni iipatheni zengcinga ezinengxaki kwaye izitshintshe (ukuzitshintsha).
• Unyango lokubona abantu abanengxaki yokuphazamiseka kwengqondo: Abantu abane-PTSD kunye ne-CPTSD badla ngokuphepha izinto okanye iimeko ezinxulumene noxinzelelo lwabo. Ngenxa yoko, abafumani thuba lokufunda ukuba banokulawula uloyiko lwabo nokuba sele bechaphazelekile kwezo zinto zibangela uloyiko. Kunyango lokubona abantu abanengxaki yokuphazamiseka kwengqondo, ingcali yokunyanga ikubonisa kancinci kancinci kwiimeko ezikwenza woyike. Bakuqeqesha ukuba uhlale kwezo meko kwaye ujongane nazo.

Olunye unyango olujolise kwingozi yi- Eye Movement Desensitization and Reprocessing (EMDR) . Kolu nyango, ucinga ngesiganeko (iziganeko) esibuhlungu ngelixa ugxila kwizandi ezithile okanye iintshukumo ezivezwa yingcali yezonyango. Injongo kukunciphisa uxinzelelo oluvayo malunga nezo ziganeko ngokuhamba kwexesha.

Unyango Lokucubungula Ingqondo (CPT) lolunye uhlobo lonyango olugxile kwingozi. Olu nyango lugxile ekusombululeni iingcinga neemvakalelo ezibuhlungu nezihlala ziyingxaki eziphakama engqondweni yakho emva kwesiganeko esibuhlungu.

Amayeza e-CPTSD

Okwangoku, akukho mayeza athile avunyiweyo yi-US Food and Drug Administration (FDA) ukunyanga i-PTSD okanye i-CPTSD. Nangona kunjalo, oogqirha banokunika amayeza anjengala ukunceda ukulawula ezinye zeempawu ze-CPTSD:

• Ii-Antidepressants: Ezifana ne-`Selective Serotonin Reuptake Inhibitors (SSRIs)` okanye i-`Serotonin kunye ne-Norepinephrine Reuptake Inhibitors (SNRIs).`
• Amayeza okulwa nokuxhalaba.
• Amayeza okulala.

La mayeza athomalalisa iimpawu kuphela, awanyangi isifo ngokupheleleyo. Ngoko ke, unyango oluphambili lolonyango lwengqondo.

Ithini ingqikelelo ye-CPTSD?

Ngenxa yokuba i-CPTSD yimeko esandul’ ukuchongwa, abaphandi bezonyango abakafumani thuba lokwenza uphando olude ngayo.

Kwabaninzi, i-CPTSD inokuba yimeko yobomi bonke. Kodwa ungakhathazeki! Eyona nto ilungileyo kukuba iimpawu zakho zinokulawulwa kakuhle ngonyango lwengqondo kwaye, ukuba kuyimfuneko, amayeza. Oku kuthetha ukuba olu nyango lunokukunceda uphile ubomi obuqhelekileyo.

Ukuba une-CPTSD, uzinyamekela njani?

Ukongeza ekufuneni unyango, kukho izinto ezininzi onokuzenza ukuze uphile kakuhle engqondweni yakho:

• Zilolonge kancinci ukuze unciphise uxinzelelo kwaye uphucule indlela oziva ngayo. Nokuba uhamba kancinci okanye into efana neyoga ilungile.
• Zibekele usukelo olunokwenzeka onokulufikelela. Musa ukulindela izinto ezinkulu ngaxeshanye. Yonwaba ngokuphumelela okuncinci.
• Chitha ixesha nabantu obathembayo. Baxelele ngamava akho kunye nokuba yintoni enokubangela iimpawu zakho.
• Chonga amaxesha kunye neendawo ezikwenza uzive ukhululekile kwaye unoxolo, bandakanyeka kuzo rhoqo, kwaye uye kwezo ndawo.
• Joyina iqela lenkxaso kwabo baye badlula kwiziganeko ezibuhlungu. Kuyakunika amandla okuthetha nabantu abaye badlula kwiziganeko ezifanayo nezakho.
• Yiba nobubele kuwe, yiba nomonde. Khumbula, iimpawu azipheli ngobusuku obunye. Ziza kancinci kancinci.

Eyona nto ibalulekileyo kukuqonda ukuba awuwedwa. Musa ukoyika ukucela uncedo.

Ufanele uye nini kugqirha?

Ngelixa unyangwa i-CPTSD, kubaluleke kakhulu ukubona ugqirha wakho kunye/okanye ingcali yezempilo yengqondo rhoqo. Ukuba iimpawu zakho ziya zisiba mandundu, yazisa ugqirha wakho ngoko nangoko.

Ufanele uye nini kwiYunithi yoNyango oluNgxamisekileyo (i-ETU) ?

Ukuba uziva ngathi ufuna ukuzenzakalisa okanye ucinga ngokuzibulala, yiya kwigumbi likaxakeka elikufutshane ngoko nangoko, okanye utsalele umnxeba kwinombolo yoxakeka efanelekileyo eSri Lanka (umz. 1926 National Mental Health Helpline).

Ukucela uncedo emva kwesiganeko esibuhlungu kunokuba nzima kakhulu. Kodwa khumbula, ukufumana unyango lwe-CPTSD kubalulekile. Ekuhambeni kwexesha, unyango lunokukunceda uphile. Thetha nogqirha wakho malunga neendlela zonyango. Balapha ukukunceda nokukuxhasa.

Okokugqibela, izinto ekufuneka uzikhumbule (Umyalezo Wokuya Ekhaya)

Ngoko ke, sithethe kakhulu nge-CPTSD namhlanje. Njengoko ufunda oku, usenokuba ubonile ukuba le meko yengqondo inzima kwaye inzima kangakanani.

• I-CPSD yingxaki yengqondo ebangelwa kukwenzakala okungapheliyo nokunzima.
• Ukongeza kwi-PTSD, oku kubangela iingxaki ngokulawula iimvakalelo, ukuzithemba, kunye nokugcina ubudlelwane.
• Le meko inokuba nzima ukuyiqonda, kodwa ingcali enamava ingayenza.
• Eyona nto ingcono kukuba le meko ingalawulwa kakuhle ngonyango lwengqondo (ingakumbi i-Trauma-focused CBT, i-EMDR, i-CPT) kwaye, ukuba kuyimfuneko, amayeza.
• Ukuba unale mpawu, musa ukubandezeleka wedwa kwaye ngokuqinisekileyo funa ingcebiso kagqirha. Ukucela uncedo akubonisi ubuthathaka, yenye yezona zinto zinamandla onokuba nazo kuwe.

Khumbula, nangona ungenakukulawula okwenzekileyo kwixesha elidlulileyo, ungathatha inyathelo namhlanje lokuphucula ikamva lakho. Ndikunqwenelela amandla okwenza njalo!

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I- CPSD, isifo soxinzelelo esiyinkimbinkimbi emva kwesiganeko esibuhlungu, impilo yengqondo, ukwenzakala, uxinzelelo, unyango lwengqondo, i-PTSD