Before treatment. The thing that would really mess me up about my functioning was around my attachments and my relationships. I would be most messy around real or imagined abandonment, and that would really affect my ability and functioning. To show up to places like work, prioritize these three ideas about what one really takes you out the most.
So you might have been officially diagnosed. With C-P-T-S-D or over time you've come to realize you have it due to exploring some childhood trauma that you may have gone through. But as time goes on, you might be frustrated and you might be losing motivation, wondering why isn't my C-P-T-S-D getting any better?
It's not like, I'm not trying, you're trying to educate yourself on C-P-T-S-D-A lot, but then what? Like what do you do with that information? Or maybe you are in therapy and talking about it, but you're not really getting anywhere. Or maybe therapy isn't available to you or you've lost faith in it and you're trying to do some different things.
But C-P-T-S-D is super tricky to make improvements on, and we can get bogged down and we can lose focus in that endeavor. And the reason why I think that happens is we take in an overwhelming amount of information. To address multiple complicated C-P-T-S-D issues, and we often don't know what to tackle first.
I liken it to, it's like buying a nearly abandoned house as a fixerupper and easily getting overwhelmed because that is overwhelming. Do you fix the plumbing first? Do you fix the electricity or do you fix the structural problems like a caved in roof? And most importantly, you don't know how to do any of that work on your own.
And putting that abandoned house analogy into context of this video is each of those three things, as I'm likening to something called disturbances and self-organization, which is also known as DSO and DSO, is a set of criteria that separates standard PTSD diagnoses from the complex PTSD diagnosis.
It's about our relationships, it's about our emotions, our affect, and it's also about our sense of self. So let's really focus in this video and see if we can actually find new specific areas of our issues to zero in on, to prioritize them and get some work done from that prioritization on our issues about C-P-T-S-D.
I'm Patrick Tian, MSW. If you don't know me or know about, this channel is all about childhood trauma. And mental health issues. And I want to read you something important, something called about our disturbances of self-organization. This is kind of like a heady and academic quote from our research, but stay with me because it's important.
While disturbances of self-organization is identified as a. Key symptom set, distinguishing C-P-T-S-D from general PTSD diagnostic criteria. Specific DSO assessments, which include attachment themes would be a helpful tool for clinicians to address DSO in clinical populations, and I've simplified that a little bit.
Well, what does that mean? It would be helpful to know what the major C-P-T-S-D areas to focus on and actually how to test ourselves to prioritize them and put everything into perspective. That's where DSO comes in. DSO again, is a symptom of three specific trauma based symptom categories that distinguished complex PTSD from PTSD.
There is affect dysregulation, which is about our emotions. There is negative self-concept, which is our sense of self and disturbances in relationships, which is standard about our relationships, including our relationship to self. So now let's unpack these three things. A lot goes into affect dysregulation.
We can briefly unpack that as triggers. Short ones and lasting triggers. We can also call it being activated where we lose focus. That happens a lot in C-P-T-S-D and childhood trauma. We can also liken it to sensory sensitivity. We can also liken that to be making assumptions and acting upon those assumptions, like being a little bit impulsive or overshooting or even undershooting things.
Based on our emotions or our affect, it also falls under being. Kind of the opposite of that is being disconnected from our emotions where we are numb or when we're dissociated. Affect is a large topic, including many different psych ideas in childhood. C-P-T-S-D, I like to think about affect as how we display and express our emotions.
How that gets really out of whack when we grow up, when we're not safe, when we grow up in childhood trauma, for example, you might not know if you come across as intense, but others notice that about you, which is a disconnection from our inside feelings to how our system displays those feelings on the outside.
So check out two videos I have about affect that gets into these issues. One is called 11 Oddly specific Childhood Trauma Issues, and the other is called Three Unknown Childhood Trauma Symptoms. Now let's move on to the second thing, which is negative self-concept and C-P-T-S-D, which in my mind is about how we experience and know ourselves and having a sense of self.
With childhood trauma-based C-P-T-S-D, a poor sense of self can look like things ranging from having a lot of self-doubt about yourself or your life or your emotions about how you see things, to not knowing who you simply are. Many childhood trauma survivors feel like they are chameleons in different settings, but they don't have a grounded sense of themself and who they are.
That was very much my case. Negative self-concept is also struggling with a lot of. Guilt and shame thinking about those two issues at baseline, which affects our relationships and affects our emotions. An example of not having a strong sense of self is when someone gives you a compliment or you do well at something and it just doesn't land.
When you get that kind of feedback and you might feel some squirrels or some guilt or some shame about receiving that kind of attention. It's also the part of us that thinks that we're awful when that's not true, but there's a core belief in there that believes that to be very true. Check out a recent video of mine on sense of self, and I'll have the link to all those video links in the description of this video.
Moving on to the third category of DSO is disturbances and relationships really focuses on attachment as well as issues like projection. Many symptoms mix and mash into a bit of a soup in our relationships and our insecure attachment styles. And projection really goes hand in hand with childhood trauma based C-P-T-S-D.
In addition, disturbances in relationships are not just romantic. They're all kinds of relationships about trust and connection and authenticity, issues that come up in our friendships, coworkers, romantic relationships, low stakes relationships, even our connections with our own children. So, and related to sense of self.
We also have a disconnection in relationship with ourselves, which is why I personally love inner child work. It addresses that missing piece of connecting our, our adult self to our inner child self and having a relationship going on. So check out some of the videos I did on relationship issues and attachment issues, and I'll put those in the, the link description.
There'll be a category under those videos. So here's a lightning quick recap on these three issues of DSO. And remember the abandoned house analogy from earlier because it applies here. One affect dysregulation is about struggling emotionally, specifically about controlling our emotions. Negative self-concept is about struggling with a poor sense of self.
How could we not struggle with that given how we grew up? And the third category of disturbances in relationships are about intimacy problems. Things like trust. Projection in us getting triggered in relationships. So how do we focus on wondering what to prioritize? Maybe you already know something, you identified with something I already said in this video.
Right now I'm working on a tool to track C-P-T-S-D progress, uh, like getting better with our C-P-T-S-D. And it's based off of a childhood trauma questionnaire I developed when I started this YouTube channel. If some of you might remember it. It was actually one of my first real YouTube videos. There's a link in the description where you can catch the video there.
That questionnaire has now been empirically validated and has now become a clinical assessment. If you remember this video that I'm referencing, the questions that I'll read in a little bit might be familiar to you. That assessment became a research paper that was recently published in the Journal of Affect.
Disorders this year in 2025. Link is in the description. What my research partner Steven Foster, who wrote the paper in me, I came up with the assessment and Steven wrote the paper. What he found when he was empirically validating the questionnaire that became the assessment is that many of our questions.
Fell into these three specific categories that are essentially DSO, and I didn't know that my questionnaire and now the assessment would sync up with DSO specifically, but it kind of makes sense to me that it did because C-P-T-S-D, and this is what I love about this stuff, it is highly patronized. Like you can catch the same things in all kinds of places, but what we currently.
Don't have is a targeted tool that measures DSO, but the assessment can actually measure that. The tool that we're creating right now is to have a place where survivors can take the assessment and then take it again a couple months or three months down the road to measure any changes. Hopefully they're measuring some progress the first time you take the test, along with your assessment score.
This is what I love about it, is you get a specific readout. Of the 3D SO categories, which will help you prioritize which one you might need to focus on first. You can kind of think about like emergency room, kind of triage, and if you don't see progress, you can actually try treatments that we mentioned in the tool that you haven't tried yet instead of shooting in the dark or trying the same thing over and over again or getting overwhelmed.
Or worse thinking that your C-P-T-S-D isn't fixable because that's not true. Keep in mind everyone is different and things that don't work right now might work for you down the road if you're in a different place. Here is how the assessment questions fall in line with DSO, and I'm gonna read these to you.
Here are three questions that fall under affect dysregulation in the assessment. Angry people and people in positions of authority freak me out. I can be greatly affected by another person's mood. Rejection puts me in a very bad place. My emotions or my reactions can get in the way of my functioning and prevent me from who I want to be.
The next concept under negative self-concept, here are some sample questions from the assessment. When someone is caring or nurturing, I often question it and feel uncomfortable. I often don't trust my own feelings and the feelings of others. I often hide my real feelings and emotions. And lastly, the sample question from the assessment.
Under disturbances in relationships, or essentially our intimacy is when I was growing up, one or both of my parents or caregivers were deeply dissatisfied and negative with their significant other. In other words, growing up, my parents or caregivers were rageful, volatile. Dominating, depressed, unavailable, or neurotic.
And lastly, growing up there was manipulation and or injustice in my environment. So you can get a sense of how the assessment questions got categorized in relation to the DSO concepts. Again, that wasn't planned. When the tool is ready, when someone fills out the assessment, they will be given specific resources about their top issue.
For example, if you scored the highest in disturbances of relationships or intimacy, you'll get some ideas that maybe you haven't tried yet, such as maybe joining a group or trying a different type of therapy. If therapy is available to you or simply an inner child resource. That can help you develop more trust and not project so much onto others, like say, projecting an abusive parent onto a partner or boss, or whatever.
You can also see what resources are recommended in the other two categories of DSO as well. C-P-T-S-D is such an intense thing to deal with that. Maybe we might recommend a group therapy option for you, and maybe you're not ready for something like that. There will also be less demanding resources, such as checking out my online community where there isn't such a spotlight on you, as in either individual therapy or a group.
Maybe after doing some work and say like an online. Community like that, you might be ready down the road to do individual therapy and maybe down the road, maybe you'll do a group. That's what I mean about the right resource at the right time. And if you wanna be alerted when this tool is ready and up and running, you can consider join the mailing list.
Just click this bubble up here, takes you to my website, and you can sign up as a subscriber and you'll get updates about the tool or when the tool is ready. And again, that tool is gonna be insightful for you and resource heavy to give people ideas about what. They have tried and maybe what they haven't tried yet.
Also, you'd be able to measure if things are actually getting better for yourself, which is pretty much the main goal of the tool. Here are some helpful ideas about what to do with this info on DSO related to C-P-T-S-D, which again is the criteria that separates complex PTSD. From PTSD, here are some of my recommendations and final thoughts here.
For now, until that tool is ready, think about these three categories and maybe go back in the video and watch the examples I gave earlier, along with the example questions. Maybe write down things that really jumped out at you and maybe do some reflecting on why they seem to affect you or they're important.
The next thing is related to that first question. Out of those three categories, and I know it can be really hard to suss this out, which one really affects your functioning the most? Is it a trigger with a friend or with a partner about what they think about you? Is it a work expectation that brings up a lot of guilt and shame?
Is it an issue about not knowing who you fully are? That is confusing because? The others around you don't seem to maybe struggle with that so much, and I certainly felt like at that in my life and I had to really hide that. I didn't have a sense of self. What will really help in figuring out which of these three ideas to be prioritized will be about which one really affects your functioning.
Here's what I mean, before treatment, the thing that would really mess me up about my functioning was around. My attachments and my relationships, I would be most messy around real or imagined abandonment, and that would really affect my ability and functioning to show up to places like work. That's what I mean about that.
Prioritize these three ideas about what. One really takes you out the most. Like with most of these childhood trauma issues, a lot of them overlap. Like a fight with your partner, which is a disturbance in relationships, might dysregulate you, and it often does. It often makes you feel like you don't maybe know what you're doing in the relationship.
Due to a sense of self problem, try to not get overwhelmed or get into the analysis so much about that. Try to think about what happens first for you. For example, like that relationship fight that I just mentioned, maybe that was actually caused by not feeling comfortable when things are going well in the relationship, which is actually a sense of.
Self issue first, and a relationship one second. So that's what I mean about that stuff. So I hope that this was helpful to you and stay tuned for more information about the update on the tool and when it'll be made ready and to the public. Leave a comment, ask questions. I would love to hear from you on these issues or what your experience was.
And as always, may you be filled with loving kindness. May you be well. May you be peaceful entities and may you be joyous and I will see you next time.
