Chapter 40: Intertwined Steps - CPTSD, Independence Paradox...
On Tuesday noon, Liang Siyu, who had completed the first round of data collection, was still worried.
When Danny and Cohen invited him to lunch, he shook his head and declined: "An old friend of mine is back, and I promised to see him. We might chat for a while, and I'll be home a little late this afternoon."
Before leaving, he came back and gave a few more instructions: "By the way, Cohen, when you go back to pack your luggage, could you please check on Ada for me? Tell her that I'll go for a walk with her tonight, and that she absolutely mustn't go out by herself, as it's too hot in the afternoon and she could easily get heatstroke."
Cohen has been staying in a guest room at his house recently. After today's experiment, they have a six-day break before starting the second round of data collection next Monday afternoon.
Cohen, who was about to go on vacation, nodded, but couldn't help but complain, "Ned, your occupational hazard is getting worse and worse."
He thought Ada was fully recovered by today, but Ned had to go to great lengths to persuade her to continue staying home and resting, this workaholic.
Liang Siyu had no way to refute it, so he could only smile and leave. Actually, the person he went to see today was not an old friend, but a psychiatrist practicing independently.
This doctor also has a degree in clinical psychology and is a rare integrative expert.
He paid double the fee for this expedited lunchtime meeting.
Next to New York University, in a low-key brownstone building, a slightly worn leather sofa is soft and comfortable, and a glass of water, room temperature, without ice, sits in front of him.
"You know this is a shadow counseling session, right? I'm here for my partner."
The voice on the other end was very gentle, without the slightest surprise: "Of course, this is very common, when the person involved is not prepared."
"Since your partner is not present, I cannot offer any diagnostic advice, as required by professional ethics. However, I can listen to your observations to help you understand what is happening and offer some possible strategies."
Liang Siyu recounted everything he had observed truthfully, from his initial nightmare of a plane crash to the recent incident at the country club.
He even compiled a table that clearly marked the time of each incident, Ada's symptoms, and their core interactions.
"I have a few questions that have been bothering me, and I would like to ask you for advice."
Dr. Finch gently held the piece of paper; it was almost the clearest third-party statement he had ever seen. He nodded and said, "Go on."
Liang Siyu's voice was slightly hoarse: "This time recently, I think I made a big mistake. I thought that pressure and touch were a useful grounding technique."
He recalled the scene: "When she didn't react to the chocolate candy, I quickly grabbed her hand, asked her to look me in the eye, and asked her to shake my hand back. However, she only regained consciousness for a second or two."
“I thought I should use more force, so I gripped her upper arm harder. But looking back, that’s when things got worse, she screamed, and then she suddenly broke down.”
“Mr. Liang, please stop blaming yourself. In that situation, you were acting on instinct as a partner. You did nothing wrong.” Dr. Finch paused, allowing the other person to fully absorb his words.
"The grounding technology is correct, but only if it is safe. From your description, it seems that when she was in a dissociated or frozen state, her brain was temporarily offline, and only the most basic safety detectors were working."
"You try to wake her by gripping her harder, but she perceives it as a threat and confinement. The ensuing breakdown is a forced shutdown after extreme panic."
"This precisely illustrates that her trauma was far more severe than the flight panic you initially observed."
Liang Siyu had thought about it repeatedly, and his speculations were similar, which led to a reasoning that sent chills down his spine.
"At that moment, she screamed and said two words, which were in Chinese: 'No, let go.'"
"By the way, we never speak Chinese normally. She is a third-generation ABC (American-born Chinese). We only took Chinese classes for a few years in elementary and middle school, but we didn't have a language environment and neither we nor our parents can speak Chinese anymore."
"I didn't even realize it at the time; it was only after thinking about it repeatedly these past few days that I realized it."
"Does this mean that something bad happened when she was very young, perhaps, while she was with her grandparents?"
Dr. Finch asked intently, “Mr. Liang, are you sure she doesn’t use Chinese at all?”
"It's confirmed. Apart from asking each other's Chinese names, we've never spoken Chinese."
Liang Siyu added, "We talked about it at the time, and she communicates entirely in English with her parents."
Dr. Finch's expression was grave: "In a dissociative state, the brain bypasses the rational language center and directly connects to the most primitive traumatic memories. Your speculation is very likely."
“I want to seriously remind you not to mention this clue in front of her. Leave it to her doctor and counselor to handle.”
"This is a long and difficult job, a very early psychological trauma that you can't touch, understand? Don't give her any hints, don't try to talk to her about her grandparents and childhood."
Liang Siyu heard his own heavy heartbeat. Although he was already heartbroken when he made this deduction, being confirmed by a specialist doctor made him feel like he had fallen to the bottom.
"I understand, I will do it." He closed his eyes briefly and nodded again.
With a deeper sense of unease, he asked about his greatest fear.
"There's one more thing I need to confess to you. To be honest, I've suspected something worse, like... schizophrenia."
“As I just mentioned, after her first nightmare, I mistakenly thought she had relapsed autoimmune encephalitis. Actually, at that time, she suddenly asked me, ‘Are hallucinations and delusions also symptoms of this disease?’”
"Of course, we've been inseparable for the past six months, and I'm certain that her intelligence and social skills haven't been impaired at all. But, thinking back to that sentence still scares me a little. Do you understand that feeling?"
“I completely understand,” Dr. Finch said, his gaze focused. “Mr. Liang, anyone would be worried.”
"Considering the context, I think she wasn't stating facts, but rather expressing a lot of doubt."
He slowed his speech, “You have to understand, ‘flashbacks’ are not ordinary memories; they are an uncontrollable, oppressive experience. Past sensory experiences can invade reality like hallucinations. This feeling of blurred boundaries is terrifying.”
Liang Siyu interrupted the doctor for the first time: "So, she was misled by me at the time, and she suspected that the uncontrollable 'memory flashbacks' were just hallucinations?"
“Exactly,” Dr. Finch nodded. “At least based on the current situation, I think ‘complex trauma’ is a more reasonable explanation. Schizophrenia? Unlikely. After six months of living together, you would have discovered more abnormalities.”
"Of course, this is not a diagnosis; it will always require her own doctor to make the final confirmation."
Liang Siyu had relaxed considerably. He took a sip of water and asked, "Is the complex trauma you mentioned an atypical manifestation of PTSD?"
Dr. Finch smiled and said, “Covered traumatic stress, CPTSD, is not listed separately in DSM-5, but there are quite a few cases in clinical practice. The WHO’s ICD-11 classifies it as a separate type of traumatic stress.”
“Its source is not as clear, typical, or significant as PTSD; however, some small, long-term, and persistent negative situations can also cause trauma, such as parent-child relationships and intimate relationships.”
"In other words, its triggers are more widespread and harder to predict?"
Liang Siyu quickly realized the key point: "This is also what I've been very worried about lately. If she goes out alone, for example, and has an attack while crossing the street, I just can't imagine what it would be like."
Dr. Finch's expression also turned serious: "Yes, that's precisely the tricky part of CPTSD."
"Moreover, her episode was indeed much more severe than the cases I had seen before. Most people experience dissociation, but rarely faint directly."
"The key to solving the problem is not to predict the trigger point, that's too difficult. Because the memory is fragmented during an attack, she may not even be aware of it herself."
"It would be best to help her recognize the early signs of 'dissociation' through professional treatment, such as feeling lighter or hearing sounds from a distance. She can then find a safe place on her own or use grounding techniques to pull herself back to reality."
He also offered another suggestion: "If she's not ready to see a doctor right now, you can try asking her to establish safe boundaries and tell you immediately if she feels something is wrong."
Liang Siyu gave a wry smile: "Perhaps it's easier to persuade her to see a doctor than this."
Seeing Dr. Finch's slightly surprised look, he explained, "She is a very independent and strong-willed girl. If we were to discuss this formally, I think she would probably prefer to identify the danger herself and save herself."
He guessed that she had seen a counselor in California to overcome her fear of flying, but it must have been temporary and short-term.
She had no idea that her fainting spell on Sunday was PTSD, which means she had never had such an episode before.
Liang Siyu sighed: "Actually, what I'm most worried about is that when she can't hold on anymore, she will still try to hold on until, until the worst happens."
Dr. Finch leaned back slightly, his voice becoming even softer.
“Mr. Liang, what you are describing is one of the most common and heartbreaking paradoxes among CPTSD survivors.”
"Within the framework of trauma psychology, we tend to view this strong sense of independence as a learned survival strategy. In long-term negative environments, relying on themselves is almost their most important tool for survival."
Liang Siyu had never thought in this direction before, and he immediately sat up straight.
Dr. Finch paused slightly, "Of course, there is another paradox, the safety paradox. CPTSD often occurs when a person feels safe, or even when everything is fine, rather than in harsh environments."
"At this moment, her deepest intuition finally allowed her to let down her guard a little, and the long-suppressed trauma burst forth. Because she knew that she was allowed to appear vulnerable."
He gazed gently at the tense young man before him: "Her outward rationality is resisting, insisting on facing things independently. But please believe me, she actually needs you."
"Before her rational mind acknowledges it, she already trusts you deep down."
"Thank you," Liang Siyu murmured. "Really, thank you so much. You may not know how important all of this is to me."
“I used to think that I couldn’t do anything and couldn’t help her at all.”
He suddenly lost control of himself, quickly lowered his head, and gently wiped away the moisture from the corner of his eyes.
The lush green shadows of the trees were reflected by the window. Dr. Finch got up and adjusted the blinds. Sunlight streamed through the blinds, casting soft, parallel lines.
When Liang Siyu got home, he wanted to calm down and, following Dr. Finch's advice, find a suitable time, a comfortable afternoon or evening, to talk to her again about what happened at the country club.
Unexpectedly, Xu Aida was waiting for him as soon as he entered the door.
“Ned, you’re back?” She walked over in a pale yellow lounge dress, her steps light, and grabbed his arm. “There’s something I want to talk to you about.”
"I had a remote call with the school clinic doctor today, and he said that the waiting list isn't too long during the summer break, and I can see a cardiologist on Friday. I'm planning to take the train back myself, so it won't interfere with my later experiments. What do you think?"
Liang Siyu froze instantly. How could he have forgotten about this? He had lied and said it might be vasovagal syncope.
Clearly, she had checked Wikipedia that day; the diagnosis method was simple: tilt table test.
The Acela train takes just over two hours to get back to Baltimore, as convenient as a daily commute, so it's perfectly normal for her to want to go back for a checkup.
-----------------------
Author's Note: [Disclaimer] The content of this chapter largely aligns with mainstream research on CPTSD, but does not constitute any medical advice. Please remember, professional help is better than any online resource.
Continue read on readnovelmtl.com
