Definition
Complex Post-Traumatic Stress Disorder (C-PTSD) is a diagnostic category proposed by Judith Herman in Trauma and Recovery (1992) and formalized in ICD-11 (6B41) as a sibling diagnosis to PTSD. C-PTSD applies to survivors of prolonged, repeated, interpersonal trauma — captivity, organized abuse, coercive control, child abuse, trafficking, totalitarian institutions — situations from which escape is difficult or impossible and where the perpetrator exercises sustained dominance.
The ICD-11 criteria require all three core PTSD elements (re-experiencing, avoidance, persistent threat sense) plus three Disturbances of Self-Organization (DSO) clusters: (1) affective dysregulation — heightened emotional reactivity, dissociative numbing; (2) negative self-concept — pervasive feelings of worthlessness, shame, guilt linked to the traumatic events; (3) disturbances in relationships — difficulty sustaining closeness, avoidance of relationships, distrust.
Herman's clinical observation, since validated across decades of research, is that the DSO cluster is not separable from the trauma — it is the structural deformation produced by chronic exposure to coercive interpersonal harm. Standard PTSD treatments (prolonged exposure, EMDR) often fail with C-PTSD without prior stabilization and trust-building phases, because the survivor's relational and self-evaluative apparatus is itself the wound.
Context
C-PTSD is the predictable downstream outcome of sustained exposure to the techniques catalogued in the Kompendium. The DSO cluster is, in epistemic terms, a description of what survives an extended epistemic annihilation campaign:
- Negative self-concept corresponds directly to internalized EA-1.3.2 (autoamplification) — the victim's epistemic apparatus, having been progressively corrupted, now generates self-attacking beliefs autonomously.
- Affective dysregulation is the somatic signature of metakognitivní destrukce — when reflective evaluation is disabled, affect can no longer be modulated by accurate self-narrative.
- Disturbances in relationships are the rational behavioral output of betrayal trauma: the survivor's attachment system has been weaponized.
Within the Prismatic Platform:
- The kompendium at /kompendium/06-klinicke-aplikace/ explicitly anchors the epistemic-annihilation framework in the C-PTSD literature, making the taxonomy clinically actionable for trauma-informed practitioners.
- The Decision Engine treatment of testimony from C-PTSD survivors incorporates calibration-aware weighting: such testimony is not less reliable in content, but its presentation (fragmented, affect-laden, non-linear) requires different epistemic processing.
- Kompendium /kompendium/07-teoreticke-reflexe/ treats C-PTSD as evidence that epistemic harm is biologically and developmentally real — not merely a philosophical construct.
See Also
- Betrayal Trauma — Mechanistic precursor to C-PTSD
- Epistemická anihilace — Causal pathway
- Metakognitivní destrukce — Reflective-awareness disabling
- Epistemická alienace — Self-cognitive estrangement
- Kognitivní anihilace — Cognitive-process counterpart
- Kompendium — Full taxonomy
- Klinické aplikace — Trauma-informed clinical use
- Teoretické reflexe — Theoretical foundations
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Created by Tomáš Korcak (korczis) | Open Source under GHL