Post-traumatic embitterment disorder refers to a psychological adjustment disorder. In this disorder, affected individuals have problems coping with failure.
What is post-traumatic embitterment disorder?
Posttraumatic embitterment disorder is also known as post-traumatic embitterment disorder (PTED) and is one of the adjustment disorders. The medical term is relatively new and was coined in 2003 by German psychiatrist and neurologist Michael Linden. The mental disorder occurs when people suffer extraordinary stresses that are not, however, unusual in life. These include, for example, the loss of a job, losses suffered, interpersonal conflicts or problems in the partnership. In this context, the affected individuals experience the associated events as humiliating, mortifying and unjust. As a result, they behave permanently bitter and aggressive towards themselves or other people. Post-traumatic embitterment disorder touches all areas of life and is associated with hopelessness, despair, thought blockages and anger. According to Michael Linden, post-traumatic embitterment disorder manifests after intense social upheaval. The clinical picture was defined for the first time after the reunification of Germany in 1990. However, no major social changes play a role in the outbreak of bitterness, but rather stresses that are considered quite common in life. According to estimates, two to three percent of all German citizens suffer from post-traumatic bitterness disorder.
Causes
Bitterness usually comes from a major personal slight. Those affected feel that they have been misunderstood or treated unfairly by others. At the same time, however, they feel unable to do anything about the injustice they have suffered. However, if the person cannot defend himself effectively, this leads to feelings such as helplessness, resignation and finally bitterness. Not infrequently, intense bitterness triggers extreme feelings such as punishing the perceived tormentor, which are associated with aggressive fantasies and sometimes even result in acts of violence or extended suicides. As a rule, however, bitterness is a feeling that subsides over time. It has not yet been possible to clarify what causes post-traumatic bitterness disorder to occur abruptly. According to Michael Linden, psychologists and psychiatrists also contribute to the disorder. This is due to the fact that they do not recognize the actual problems of their patients and therefore only treat them for aggression or depression. Post-traumatic embitterment disorder shows up in the male sex equally as in women and can affect both young and old people.
Symptoms, complaints and signs
There are some symptoms that are considered typical of post-traumatic bitterness disorder. For example, affected individuals exhibit a fundamentally bad mood and make a bitter impression. In addition, they feel unfairly treated by life, are disappointed by their fellow human beings, blame other people as much as themselves and behave aggressively. They rarely have friends as they increasingly withdraw from social life. Other possible symptoms of PTED are listlessness, inner restlessness, sleep disturbances and physical complaints. In extreme cases, sufferers develop aggressive thoughts that include their own death or extended suicide. Furthermore, the patient avoids certain people or places associated with the traumatic experience.
Diagnosis and course of the disease
In order to diagnose post-traumatic embitterment disorder, several criteria must apply. For example, the patient is quite aware of his psychological distress, which he sees as the reason for it. He regards the triggering experience as insulting, deeply unjust and humiliating. As a result, he feels helpless, angry and bitter. If the patient remembers the triggering event, he reacts emotionally agitated. The imposing memories cause a permanent impairment of his mental health. Prior to the triggering experience, there were no mental illnesses that could explain his behavior.In addition, the symptoms persist for longer than six months and restrict the affected person in his or her everyday life. It is also important to make a differential diagnosis with other mental illnesses such as depression or post-traumatic stress disorder. In addition, most adjustment disorders are temporary. Because post-traumatic embitterment disorder is a relatively new mental disorder, its exact course is still unclear. In addition, there are large individual differences.
Complications
Suicidal and homicidal ideation may occur as severe complications of post-traumatic embitterment disorder. When the sufferer kills others as well as himself, it is also referred to as extended suicide. However, the suicidal thoughts may also be limited to the affected person only. In both cases, rapid treatment is required. Depending on how acute the suicidal tendency is, outpatient or inpatient therapy may be considered. In cases of danger to self or others, placement is also possible to ensure the safety of the affected person and others. Post-traumatic embitterment disorder often leads to a depression-like pattern of thinking. The bitterness that develops as a result of a tragic event can have a negative impact on finding a job. Following the principle of self-fulfilling prophecy, the sufferer may sabotage himself. As a further complication, self-harming behavior is possible, for example in the form of drug, alcohol and tobacco use. A negative basic attitude can also lead to difficulties in many other areas of life. Family and social conflicts often occur as a complication of post-traumatic embitterment disorder. Aggressive behavior may also make an appearance. Without appropriate treatment, complications are more likely than with treatment. The bitterness can promote other mental illnesses, for example, depression, anxiety disorders, and psychosomatic complaints.
When should you see a doctor?
If bitterness persists over a long period of time and has an increasingly negative effect on the well-being of the person affected or on those around them, it is advisable to talk to a therapist. People who suffer from a personality disorder after a traumatic event or as a result of protracted mental health problems should have this treated. The earlier the disorder is diagnosed and treated, the better the chances of recovery. Therefore, even the first signs of bitterness should be examined by a therapist or doctor. If there is a long underlying medical history, the responsible physician must be informed if the symptoms become more severe or are associated with further, possibly self-injurious symptoms. In addition to the psychologist, a specialist in neurological disorders may be consulted if it is suspected that the suffering is due to a physical illness. Adolescents who show signs of bitterness should be presented to an adolescent psychologist. Otherwise, the disorder will continue to shape itself and cause further mental and physical illness as it progresses.
Treatment and therapy
Treatment of post-traumatic embitterment disorder is not easy. Thus, patients often resign or resist treatment offers. So-called wisdom therapy is considered a helpful therapeutic approach. This is a variant of cognitive behavioral therapy developed by Michael Linden. As part of the psychotherapeutic procedure, the patient processes the event that triggered his bitterness in order to finally be able to distance himself from it, which gives him a new perspective on life. For this purpose, proven cognitive strategies are used, which include behavioral analysis, analyzing automatic thoughts, activity building, cognitive renaming, and an exposure procedure. At the same time, the patient rebuilds social contacts. For a calm approach to life problems, patients perform role-plays that put them in the shoes of people who have offended others. For some patients, wisdom therapy does lead to success. Others at least regain their ability to function. It is not uncommon, however, for the treatment to take months or even years to show success.
Prevention
To prevent post-traumatic bitterness disorder, it is advisable to counteract negative thoughts and feelings. Relaxation techniques such as meditation, yoga, qi gong, or hypnosis, among others, are suitable for this purpose.
Aftercare
Psychotherapy over a longer time frame is recommended as an effective aftercare treatment for post-traumatic embitterment disorder. Psychotherapy should cause the patient to live a joyful life in the long run without being burdened by various symptoms. Follow-up care is important to develop effective strategies for everyday life. While outpatient follow-up is recommended for milder cases, patients with severe embitterment disorder should consider rehab. In the course of rehab, the patient can work through what he or she has experienced and thus be prepared for re-entry into everyday life. As an aftercare measure, rehab strengthens the patient’s body and mind and helps them regain a sense of responsibility for themselves and their environment. Even after severe experiences, the patient’s own limits should be recognized and his or her self-worth strengthened. Personal resources can be mobilized in the course of aftercare, so that the patient becomes fit for everyday life again. In the further course, relaxation methods such as autogenic training or progressive muscle relaxation can also be used in everyday life to minimize states of restlessness or anxiety. Concentration exercises, yoga or Qi Gong also serve excellently as aftercare measures and can be integrated well into everyday life. Creative approaches, such as art or music, can also have a positive effect on the patient’s soul and increase the quality of life.
Here’s what you can do yourself
In addition to psychotherapeutic treatment, those affected can exchange information with each other, especially in self-help forums on the Internet. In many cities, there are self-help groups for people with trauma experiences. Since the clinical picture of post-traumatic embitterment disorder is still relatively unknown, there are currently only a few self-help groups that are specifically aimed at sufferers of this disorder. It is therefore advisable to attend a group that deals with the related clinical picture of post-traumatic stress disorder. Attending a group is also recommended because it helps sufferers connect with others and have conversations. In general, rebuilding social contacts is particularly important. Those affected should maintain relationships with family members, friends and acquaintances or make new friends. If there are no opportunities for this in the private sphere, it is advisable to seek out sports clubs or cultural associations. It is equally important to pursue regular activities and interests and to deepen them. Those affected should live according to a regular daily routine. Stress should be avoided or significantly reduced. In addition, activities such as yoga, meditation, Reiki, progressive muscle relaxation, autogenic training, Qi Gong, hypnosis or praying can help to deal with negative thoughts in everyday life and also contribute to stress reduction.
