COMPLEX POST TRAUMATIC STRESS DISORDER (CPTSD)
No, this is not just another name or version of post-traumatic stress disorder. In fact, once you read this article, you may not only finally understand why you struggle the way you do, but more importantly, to walk away with hope that life can be much different moving forward.
Does this describe you or someone you know?
- Living with a constant feeling of emptiness or hopelessness
- Difficulty managing emotions — like getting really angry or shutting down easily.
- Difficulty trusting people
- A history of unstable or unhealthy relationships
- Avoiding intimate relationships whether friendship or romantic
- Wonder if you’re/they’re bipolar with shifting intense emotions
- Living with a deep sense of shame or worthlessness
These symptoms highly suggest that you or the person you know may be suffering with CPTSD.
HOW IS CPTSD DIFFERENT THAN PTSD?
Most significantly, PTSD is caused by a single event and can happen at any time in life. CPTSD, on the other hand, is a result of traumas that repeat for months or years. The symptoms of both do involve re-experiencing the trauma, hyper-arousal, getting triggered and avoidance. However, what is unique to CPTSD are the symptoms listed above.
WHAT CAUSES CPTSD?
As mentioned above, CPTSD is a result of complex life experiences that are chronic and usually from childhood — patterns of physical, mental or emotional abuse, or perhaps not so obviously, from neglect, and abandonment. Witnessing ongoing abuse, even if not directed at you, can also create CPTSD symptoms.
The basic underlying reason why people develop CPSTD is because their childhood experiences doled out by parents/caregivers (those that children are supposed to trust will love them, respect them, and have their best interest in mind) taught them that their feelings or thoughts don’t matter. In fact, they were made to feel that they are nothing, a nobody, and unlovable. These heartbreaking words have been echoed by many clients suffering from CPTSD: “I don’t matter.” Just as sad, they were not allowed to express their emotions because it was not “safe.” Imagine as a child having to shove down and repress all the many hurts, anger, sadness and other intense emotions from being ignored or abused, or being told in words or actions that you or how your feel is irrelevant? All the while, thinking this is “normal” and just “how it is.” In other words, this is THE truth!
The child then grows up into adulthood feeling empty, broken, not trusting, not feeling loveable or worthy. As a result, you can see why they would have difficulty trusting anyone or letting anyone get close. Getting close would equal getting hurt. And, since they didn’t learn how to express emotions, they then have difficulty regulating their inner tumultuous world. Hence, the key symptoms of CPTSD.
Can CPTSD lead to other mental health diagnosis?
Absolutely! The obvious ones would be anxiety, and depression. Not so obvious, however, may be symptoms that meet the criteria for ADD/ADHD, Bipolar, or Borderline Personality Disorder. Let me explain how coping strategies can turn into a mental health concern.
A beautiful part of humans is that we are all hard wired to survive and we will consciously, but mostly subconsciously, develop amazing and very effective strategies to help us get through life. Survival means being able to react to situations when our safety is at risk and feelings of fear arise. Commonly known are the three F’s: Fight, flight, or freeze.
Let’s discuss the flight strategy first as this is the one that can look like or lead to another mental health diagnosis.
Flight means to get the heck away to find safety. However, that doesn’t always mean physically. Think, for example, of a child who couldn’t flee or yell, or cry from fear of more punishment. That child could develop ADD (escaping the present moment by day dreaming about other places, things etc.), or disassociate (mania in bipolar). Even mood swings caused by the difficulty of regulating emotions could look like bipolar. And lastly, because of the inability to trust people and regulate emotions, unstable relationships could mimic borderline personality disorder.
Fight brings out the obvious – aggressive behaviors. This strategy is quite simple; for one’s survival and safety (emotional and physical), the other has to “put down” or controlled.
As to the last F, if you ever wonder why people shut down in times of conflict, they are displaying the “freeze” strategy. Holding in intense emotions over time can eventually lead to depression and anxiety; an inner world filled with trauma bound feelings.
ANOTHER “F” STRATEGY – FAWN
There is one other “F” known as Fawn. This is behavior that is also known as co-dependency. If one “fawns” over the other, there is less likely to create conflict (hence avoiding pain and rejection) and additionally, the other huge payoff is being liked/accepted. Fawning enough will in turn cause one to self-sacrifice leading to more sadness, depression, and resentment. Not to mention, of course, the anxiety of wondering if the fawning is enough to be liked.
Today can be the beginning of the end of your suffering. Today, you can begin to release yourself from your life-long symptoms that have prevented you from truly enjoying and embracing life. There is so much joy to be had and to be experienced. Our clients have found it. We have found it. Thank your coping strategies for helping you survive the world to get to where you are today. But now, it’s time to thrive, not just survive. It’s time to know you matter and you are loveable!
It will take commitment on your side to dive into your history to free yourself from the chains of your past. The standard cognitive behavioral therapy or just medication will not cut it. Working with a skilled therapist who can safely guide you to removing your layers of scars, protections, and wounds is your way out AND the only way out. Better yet, working with a therapist who taps into your body’s energy in addition to psychotherapy will move you along most effectively. After all, that accumulated trauma is still residing within your body.
When you are ready to begin your healing and truly live life to its fullest, we are here to guide and support you through every step of the way.
* Note that CPTSD is not officially recognized in the Diagnostic and Statistical manual of Mental Health Disorders (DSM) by the American Psychiatric Association. However, the World Health Organization in 2018 did recognize it as its own mental health concern and included it in the 11th revision of International Statistical Classification of Diseases and Related Mental Health Concerns System (ICD).
Bessel van der Kolk. (2015). The body keeps score: Brain, mind, and body in the healing of trauma. Penguin Publishing Group.
Walker, P. (2013). Complex PTSD: From surviving to thriving: A guide and map for recovering from childhood trauma (1st ed edition). CreateSpace Independent Publishing Platform.
Lisa Aranas, JD, LCPC, is a Life Coach and Licensed Clinical Professional Counselor. She is also a certified divorce and custody mediator, personal trainer, and holistic nutritionist. For the past 20 years,she has devoted herself to doing what she loves best—bringing harmony and happiness to anyone whose life she can touch. Learn more about her here.