It is the third day of the A to Z challenge and it is time for the letter C! I am loving this challenge because I feel I can spread awareness around mental illnesses that are more than just a short term thing, but actually affect people’s lives often permanently. So today’s post is about C-PTSD (Complex Post Traumatic Stress Disorder). A lot of my blog has been around this disorder so far but I still feel like it deserves a place in this month’s challenge. So here we go!
Complex Post Traumatic Stress Disorder is linked to complex trauma. Unlike Post-traumatic stress disorder, that is based upon a single event, CPTSD is often linked to long-term childhood trauma. Complex trauma does not only mean long-term, it also means that the trauma happened in a situation where there was no way out. The person was trapped in the situation, and there was nowhere to turn for help, no way to escape. The reason why some people who have been through childhood trauma, develop C-PTSD and others don’t, is that there was no safe person to turn to. This kind of situation, especially when going on for a long time, creates something called learned helplessness, You get conditioned that you are indeed helpless, and that kind of feeling follows you even later in life, when even the tiniest problems make you feel overwhelmed and frozen, and you are unsure about what to do. Examples of complex trauma are emotional, physical and sexual childhood abuse, domestic violence, trafficking, being a prisoner at war, sprititual abuse. These kinds of things are more common that one might think, because most of them do not get reported. It is first much later in life that someone suddenly feels the effects of the trauma again (often when actually moving away and starting their own lives), and the first stage of feelings is often denial. Childhood abuse, trafficking, domestic violence, ritual abuse and abuse during wartimes do more often than not, go unreported.
Alright, so, you are in a traumatic situation that lasts for a long time, and you can’t get out. So what do you do? The reaction is very closely linked to Stockholm Syndrome: you adapt to the situation and you soothe, obey to and please the abuser. That is all that they can do, really. To make it through, mentally. They believe in what they have been told, they connect to the abusers in a way so that it makes sense to them. Because the abusive situation is all they know, all they need to get through, all they need to adapt to. It is here where conditioning often comes in, the victim believes what they are being told about themselves and the world, they trust the abusers, they often even walk the path of agreeing with that they deserve the pain they are going through. Because how else would you be able to make sense of what is happening? There is nothing else, there is no way out, there is no one to question those beliefs or to tell you otherwise. And all this is going to hit them hard when they are out of the abusive situation because now they still hold on to those beliefs of themselves, hence, they have a warped view of themselves, the world and the people who abused them.
There are many symptoms of C-PTSD, like: depression, anxiety, dissociation, affect dysregulation, unstable relationships, denial, self-harm, suicidal behaviour, nightmares, flashbacks, inability to trust others, loss of system of meaning/belief, learned helplessness, toxic shame, self-blame, hurt inner child, hypervigilance, lack of confidence, avoidance, constant search for a saviour, fawning behaviour, physical symptoms like pain and much more.
I think it is important to add that C-PTSD is not in the DSM-V, the official diagnostic manual for psychiatry in the USA. But, it is a working diagnosis, and has been for many many years, with trauma centers, psychiatrists and therapists offering specific support for those struggling with complex trauma issues. The experts in the field assume that it is only a matter of time until C-PTSD gets its rightful place in the diagnostic manual.
It defines you
C-PTSD defines you. That is a harsh thing to say, but unfortunately it affects almost every part of one’s life, of one’s thoughts, of one’s behaviour. Peter Walker talks about the four types of trauma response that people who have been through complex trauma have adapted to: fight, flight, freeze and fawn. It is uncommon to be one pure type, most people with C-PTSD are hybrids. Basically, whatever worked best for your survival during the trauma, is a behaviour that you later in life employ to almost all areas of your life, but mostly those that involve human interactions, like friendships, romantic relationships, work. So your choice or lack of friends and partners and your career choices, have very much to do with what you have been through earlier in your life. The fight type often pushes away all responsibilities, is known to be aggressive and dominant. The fawn type is silent, soothing and takes a submissive position. The flight type is often a busy bee that has no time for closer relationships and is instead more career-focused. And the freeze type is avoiding and withdrawing from most human interactions and is known to live in their own minds a lot.
And it is not only that, the learned helplessness that you got conditioned with, keeps you stuck in life. You do not know how to take control, how to make decisions, how to speak up for yourself. All you know is to please and to freeze.
Denial and Toxic Shame
As if all that I have mentioned isn’ t bad enough, two of the main symptoms of C-PTSD are denial and toxic shame. Denial, you say? How can one deny that they have been through trauma? A lot of times someone does not even know that what they have been through is not considered “normal”. and even if they did, they blame themselves for what has happened. Remember the Stockholm Syndrome? The trauma victim is emotionally attached to the abuser, the might even adore them, so how could they even want to admit that something really bad happened? If you acknowledge and admit that you have been through trauma, then you would have to change your whole view of yourself and your life. You would have to re-narrate your own story. So a lot of times people minimize what has happened in the past, because they just don’t want to deal with the effects that it has on them now and would have on their life if it came out. The thing is, everything we bottle up will eventually push to come out. The trauma needs to be processed, sooner or later, and that involves a grieving process.
Another part of this is toxic shame and self-blame. There has been some discussions on if C-PTSD actually should be classed as a shame disorder and not an anxiety disorder. Unhealthy levels of shame are called toxic shame. The term toxic here means that it poisons and corrupts every part of one’s being and has a corrosive effect on the individual’s psychological outlook, emotional states and ability to maintain a positive self-image. It affects every part of one’s behaviour and well-being. Someone who has been through complex trauma in the past, the toxic shame they have experienced during the traumatic situation continues even when they are safe. It is an automatic reaction in interpersonal relationships and when looking at the past. Toxic shame easily leads to self-blame and guilt.
For survivors of complex trauma, the source and trigger for the toxic shame they experience, comes from the original trauma. A lot of times it is about childhood trauma, where the child has been put in a devastating position. As children we are dependent upon caregivers to provide us with a sense of safety and connection to the world. When those caregivers are abusive, we are faced with a dilemma: your biological drive to seek closeness from the very source of the terror you feel a need to escape from. So that conflict is often solved by blaming oneself: children will develop a fantasy that they are bad kids relying upon good parents to avoid confronting the terrifying reality that they are good kids relying upon bad parents.
Emotional flashbacks are very specific to complex trauma and C-PTSD. While other types of flashbacks are terrible, this is one is terrible and confusing. It takes victims of complex abuse a long time to even recognize this feeling as a flashback because you feel the emotions but you do not understand what they are related to.
Imagine that all the negative emotions you have ever felt, hit you at once. All the despair, all the fear, all the anger, all the sadness, all the hopelessness, all the helplessness, the feeling of no way out, all the self-hatred, all the absolute terror. All these feelings are all at once attacking you. You feel as if you are in the traumatic situation, emotionally, without being in survival mode. All these feelings you had to push down to survive, to soothe the abuser, they suddenly are there. All those feelings you never allowed to come out because you did not know what they would do to you. Your soul is being shredded into pieces. Your brain is screaming. And all you want is for it to stop, because you can’t handle it.
Emotional flashbacks are confusing because they are often not obviously connected to a traumatic situation, and first seem like an overly emotional reaction to something small, or to nothing at all. A lot of times this is where C-PTSD becomes clear to the victims, when emotional flashbacks are being explained to them. They are not being oversensitive, they are actually experiencing flashbacks!
All this was probably a lot to take in. If you are worried that you or someone you are close to, suffers from C-PTSD, please contact a professional to get an assessment. There is a lot of help out there and there also a lot of things you can do yourself, you can check out some of those things here.
If you want to read more on Complex Post-Traumatic Stress Disorder, you can check out my other posts here, they all have a lot of references and further reading options.